3.A retrospective comparative study of haplotype hematopoietic stem cell transplantation and human leukocyte antigen-matched sibling donor hematopoietic stem cell transplantation in the treatment of acute B-lymphocyte leukemia.
Zhi Dong WANG ; Yu Qian SUN ; Chen Hua YAN ; Feng Rong WANG ; Xiao Dong MO ; Meng LYU ; Xiao Su ZHAO ; Wei HAN ; Huan CHEN ; Yu Hong CHEN ; Yu WANG ; Lan Ping XU ; Ya Zhe WANG ; Yan Rong LIU ; Yi Fei CHENG ; Xiao Hui ZHANG ; Kai Yan LIU ; Xiao Jun HUANG ; Ying Jun CHANG
Chinese Journal of Hematology 2022;43(3):221-228
<b>Objective:b> To investigate whether haplotype hematopoietic stem cell transplantation (haplo-HSCT) is effective in the treatment of pre transplant minimal residual disease (Pre-MRD) positive acute B lymphoblastic leukemia (B-ALL) compared with HLA- matched sibling donor transplantation (MSDT) . <b>Methods:b> A total of 998 patients with B-ALL in complete remission pre-HSCT who either received haplo-HSCT (n=788) or underwent MSDT (n=210) were retrospectively analyzed. The pre-transplantation leukemia burden was evaluated according to Pre-MRD determinedusing multiparameter flow cytometry (MFC) . <b>Results:b> Of these patients, 997 (99.9% ) achieved sustained, full donor chimerism. The 100-day cumulative incidences of neutrophil engraftment, platelet engraftment, and grades Ⅱ-Ⅳ acute graft-versus-host disease (GVHD) were 99.9% (997/998) , 95.3% (951/998) , and 26.6% (95% CI 23.8% -29.4% ) , respectively. The 3-year cumulative incidence of total chronic GVHD was 49.1% (95% CI 45.7% -52.4% ) . The 3-year cumulative incidence of relapse (CIR) and non-relapse mortality (NRM) of the 998 cases were 17.3% (95% CI 15.0% -19.7% ) and 13.8% (95% CI 11.6% -16.0% ) , respectively. The 3-year probabilities of leukemia-free survival (LFS) and overall survival (OS) were 69.1% (95% CI 66.1% -72.1% ) and 73.0% (95% CI 70.2% -75.8% ) , respectively. In the total patient group, cases with positive Pre-MRD (n=282) experienced significantly higher CIR than that of subjects with negative Pre-MRD [n=716, 31.6% (95% CI 25.8% -37.5% ) vs 14.3% (95% CI 11.4% -17.2% ) , P<0.001]. For patients in the positive Pre-MRD subgroup, cases treated with haplo-HSCT (n=219) had a lower 3-year CIR than that of cases who underwent MSDT [n=63, 27.2% (95% CI 21.0% -33.4% ) vs 47.0% (95% CI 33.8% -60.2% ) , P=0.002]. The total 998 cases were classified as five subgroups, including cases with negative Pre-MRD group (n=716) , cases with Pre-MRD<0.01% group (n=46) , cases with Pre-MRD 0.01% -<0.1% group (n=117) , cases with Pre-MRD 0.1% -<1% group (n=87) , and cases with Pre-MRD≥1% group (n=32) . For subjects in the Pre-MRD<0.01% group, haplo-HSCT (n=40) had a lower CIR than that of MSDT [n=6, 10.0% (95% CI 0.4% -19.6% ) vs 32.3% (95% CI 0% -69.9% ) , P=0.017]. For patients in the Pre-MRD 0.01% -<0.1% group, haplo-HSCT (n=81) also had a lower 3-year CIR than that of MSDT [n=36, 20.4% (95% CI 10.4% -30.4% ) vs 47.0% (95% CI 29.2% -64.8% ) , P=0.004]. In the other three subgroups, the 3-year CIR was comparable between patients who underwent haplo-HSCT and those received MSDT. A subgroup analysis of patients with Pre-MRD<0.1% (n=163) was performed, the results showed that cases received haplo-HSCT (n=121) experienced lower 3-year CIR [16.0% (95% CI 9.4% -22.7% ) vs 40.5% (95% CI 25.2% -55.8% ) , P<0.001], better 3-year LFS [78.2% (95% CI 70.6% -85.8% ) vs 47.6% (95% CI 32.2% -63.0% ) , P<0.001] and OS [80.5% (95% CI 73.1% -87.9% ) vs 54.6% (95% CI 39.2% -70.0% ) , P<0.001] than those of MSDT (n=42) , but comparable in 3-year NRM [5.8% (95% CI 1.6% -10.0% ) vs 11.9% (95% CI 2.0% -21.8% ) , P=0.188]. Multivariate analysis showed that haplo-HSCT was associated with lower CIR (HR=0.248, 95% CI 0.131-0.472, P<0.001) , and superior LFS (HR=0.275, 95% CI 0.157-0.483, P<0.001) and OS (HR=0.286, 95% CI 0.159-0.513, P<0.001) . <b>Conclusion:b> Haplo HSCT has a survival advantage over MSDT in the treatment of B-ALL patients with pre MRD<0.1% .
B-Lymphocytes
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Graft vs Host Disease
;
HLA Antigens/genetics*
;
Haplotypes
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Hematopoietic Stem Cell Transplantation/adverse effects*
;
Humans
;
Leukemia, B-Cell/complications*
;
Leukemia, Lymphocytic, Chronic, B-Cell/complications*
;
Neoplasm, Residual
;
Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy*
;
Recurrence
;
Retrospective Studies
;
Siblings
4.Immune Thrombocytopenia in Patients with Chronic Lymphocytic Leukemia: Pathological Mechanism and Treatment Progress---Review.
Meng-Zhen HUANG ; Shi-Xuan WANG ; Fei LI
Journal of Experimental Hematology 2021;29(5):1671-1675
Chronic lymphocytic leukemia (CLL) patients usually show immune dysfunction, which often leads to autoimmune hemocytopenia. Immune thrombocytopenia (ITP) is one of the common complications. The pathogenesis of CLL-related ITP is complex and has not been fully elucidated. At present, the researches mainly focus on humoral immunity, cellular immunity and innate immune disorders. Recent studies suggest that genomic abnormalities and microRNAs are also involved in CLL-related ITP. Traditional ITP standard therapy has a poor effect on CLL-related ITP. Chemotherapy or monoclonal antibody therapy against the primary pathogenesis of CLL can effectively treat thrombocytopenia, and the emergence of new targeted drugs also provides new treatment options for the disease. In this paper, the progresses of CLL-related ITP pathogenesis, prognosis and treatment in recent years are reviewed.
Antibodies, Monoclonal
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Humans
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Leukemia, Lymphocytic, Chronic, B-Cell/complications*
;
MicroRNAs
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Purpura, Thrombocytopenic, Idiopathic
;
Thrombocytopenia
5.Anti-CD22 CAR-T combined with anti-CD19 CAR-T cells in the treatment of relapsed or refractory acute B lymphocytic leukemia with severe cytokine release syndrome: two cases report and literature review.
Li Li GAO ; Liang HUANG ; Na WANG ; Gao Xiang WANG ; Xiao Xi ZHOU ; Tong Juan LI ; Zhen Ya HONG ; Li MENG ; Jian Feng ZHOU
Chinese Journal of Hematology 2019;40(9):780-782
7.Multiple lymphomatous polyposis of intestine: report of a case.
Cai-qin WANG ; Zhong-xin SHI ; Jing JIANG ; Ji-hong ZHANG ; Ying ZHANG ; Qian WANG
Chinese Journal of Pathology 2011;40(5):341-342
Antigens, CD20
;
metabolism
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CD5 Antigens
;
metabolism
;
Colonic Neoplasms
;
complications
;
metabolism
;
pathology
;
surgery
;
Cyclin D1
;
metabolism
;
Diagnosis, Differential
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Female
;
Humans
;
Ileal Diseases
;
complications
;
pathology
;
surgery
;
Ileocecal Valve
;
Intestinal Neoplasms
;
complications
;
metabolism
;
pathology
;
surgery
;
Intestinal Polyps
;
complications
;
metabolism
;
pathology
;
surgery
;
Intussusception
;
complications
;
pathology
;
surgery
;
Leukemia, Lymphocytic, Chronic, B-Cell
;
metabolism
;
pathology
;
Lymphoma, Mantle-Cell
;
complications
;
metabolism
;
pathology
;
surgery
;
Middle Aged
8.Clinical and histological features of the patients with hepatitis B recurrence after allo-genetic hemopoietic stem cell transplantation.
Jie SHAO ; Xiao-Jun HUANG ; Hao WANG ; Jian-Qiang DONG ; Lai WEI
Chinese Journal of Hepatology 2004;12(7):434-435
Adolescent
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Adult
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Female
;
Hematopoietic Stem Cell Transplantation
;
adverse effects
;
Hepatitis B
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complications
;
surgery
;
virology
;
Hepatitis B Antibodies
;
blood
;
Hepatitis B Surface Antigens
;
blood
;
Hepatitis B virus
;
growth & development
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Humans
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Leukemia
;
complications
;
surgery
;
Male
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Middle Aged
;
Secondary Prevention
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Transplantation, Homologous
;
Virus Activation
9.A Case of Fatal Strongyloidiasis in a Patient with Chronic Lymphocytic Leukemia and Molecular Characterization of the Isolate.
Eshrat Beigom KIA ; Hamid Reza RAHIMI ; Hossein MIRHENDI ; Mohammad Reza NILFOROUSHAN ; Ardeshir TALEBI ; Farzaneh ZAHABIUN ; Hamid KAZEMZADEH ; Ahmad Reza MEAMAR
The Korean Journal of Parasitology 2008;46(4):261-263
Strongyloides stercoralis is a human intestinal parasite which may lead to complicated strongyloidiasis in immunocompromised. Here, a case of complicated strongyloidiasis in a patient with chronic lymphocytic leukemia is reported. Presence of numerous S. stercoralis larvae in feces and sputum confirmed the diagnosis of hyperinfection syndrome in this patient. Following recovery of filariform larvae from agar plate culture of the stool, the isolate was characterized for the ITS1 region of ribosomal DNA gene by nested-PCR and sequencing. Albendazole therapy did not have cure effects; and just at the beginning of taking ivermectin, the patient died. The most important clue to prevent such fatal consequences is early diagnosis and proper treatment.
Aged
;
Albendazole/therapeutic use
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Animals
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Anthelmintics/therapeutic use
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Fatal Outcome
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Humans
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Ivermectin/therapeutic use
;
Larva
;
Leukemia, Lymphocytic, Chronic, B-Cell/*complications/parasitology
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Male
;
Strongyloides stercoralis/*classification
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Strongyloidiasis/*complications/drug therapy
10.Autoimmune hemolytic anemia associated with B-cell chronic lymphoproliferative disorders.
Yun ZHUANG ; Lei FAN ; Yun-Feng SHEN ; Wei XU ; Jian-Yong LI
Journal of Experimental Hematology 2013;21(3):633-636
This study was purpose to investigate the clinical characteristics of B-cell chronic lymphoproliferative disorders (B-CLPD) complicated by autoimmune hemolytic anemia (AIHA) so as to improve the understanding of this disease. The clinical characteristics, laboratory data, therapy and outcome of 14 patients suffering from B-CLPD complicated by AIHA were retrospectively analyzed in Wuxi People Hospital and the First Affiliated Hospital of Nanjing Medical University from 2000 to 2012. The results showed that 9 cases of the 14 patients were patients with chronic lymphocytic leukemia (CLL), 5 cases were patients with lymphoma, at time of hemolysis the median level of hemoglobin was 61 (33 - 84)g/L, the median ratio of reticulocytes was 12.0 (3.1 - 35.0)%, the positive rate of Coombs test was 100%. 1 case received corticosteroid alone, 5 cases were treated with chemotherapy combined with corticosteroid, 8 cases were treated with immunochemotherapy rituximab combined with corticosteroid. Overall response rate was 100%, in which CR was 78.6% (11/14), PR was 21.4% (3/14). The follow-up for these patients were performed to now, 35.7% (5/14) patients relapsed with hemolysis again, but they showed therapeutic response to treatment with above-mentioned therapy. From patients treated with rituximab alone, only 1 patient relapsed. Among 14 patients, 6 cases died, 1 case was lost, the other cases are still alive. It is concluded that the AIHA is the commonest complication of B-CLPD, it can be observed at different stages of B-CLPD, the treatment with corticosteroids can give well therapeutic effect for these patients, but the long time CR is lower, the rituximab has been confirmed to be effective for B-CLPD complicated by AIHA.
Adrenal Cortex Hormones
;
therapeutic use
;
Adult
;
Aged
;
Anemia, Hemolytic, Autoimmune
;
complications
;
diagnosis
;
therapy
;
Antibodies, Monoclonal, Murine-Derived
;
therapeutic use
;
Female
;
Humans
;
Leukemia, Lymphocytic, Chronic, B-Cell
;
complications
;
diagnosis
;
therapy
;
Male
;
Middle Aged
;
Retrospective Studies
;
Rituximab
;
Young Adult