5.Development of acute myeloid leukemia in a myelodysplastic syndrome patient after allogeneic hematopoietic stem cell transplantation for 12 years: a case report and literature review.
Zhen LI ; Yanli ZHANG ; Jian ZHOU ; Baijun FANG ; Quande LIN ; Yongping SONG
Chinese Journal of Hematology 2014;35(1):63-65
6.A case of acute myelocytic leukemia suffered throat pain as initial symptom.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2014;28(24):1996-1997
We report a case of a 47-year-old man who firstly complained of throat pain for half a month accompanied with fever. Specialized examination showed tonsils' hypertrophy and the laryngoscope found his right vocal cord was swelling and hyperemia. The routine blood test counted white blood cell as 31 x 10(9)/L, lymphocyte as 30. 84 x 10(9)/L while prolymphocyte could be seen with microscope. After that B-ultrasound scan gave spleen hypertrophy and multi-lymphatic-node enlargement. Peripheral blood flowcytometry and bone marrow biopsy finally diagnosed the man as actue myelocytic leukemia.
Humans
;
Leukemia, Myeloid, Acute
;
complications
;
diagnosis
;
Male
;
Middle Aged
;
Pain
;
etiology
;
Pharynx
7.Diagnostic Value of G and GM Tests in Acute Leukemia Patients with Invasive Fungal Disease.
Ke-Yu QIAN ; Quan-Xing LYU ; Li-Jun DAI ; Hui-Rong CHANG ; De-Pei WU ; Ai-Ning SUN
Journal of Experimental Hematology 2019;27(5):1678-1681
OBJECTIVE:
To analyze the diagnostic value of (1, 3) -β-D-glucan and galactomannan (GM) tests in the patients with acute leukemia complicated by invasive fungal disease, and explore the application of serological detection (G/GM) and lung CT for early diagnosis of invasive fungal disease (IFD).
METHODS:
A total of 493 patients with acute leukemia complicated by high risk invasive fungal infection, also receival G and GM tests, in Department of hematology of our hospital from June 2016 to December 2016 were selected and were divided into IFD-confirmed group (62 cases) including confirmed and clinical diagnesed IFD, and IFD-unconfirmed group (431 cases) including suspected IFD and non-IFD according to the diagnostic criteria of IFD. The results of G and GM tests in patients of 2 groups were analyzed, then the diagnostic efficacy of G and GM done and combination evaluated. In addition, 26 patients whose lung CT negative at hospitalization, moreover, presentation of changes in lung by CT during hospitalization and serological G and GM test positive were selected, and the difference of time between serological that postive and presentation of changes in lung by CT were compared for the estimation of early diagnotic value.
RESULTS:
The positive rate of (1, 3) -β-D-glucan in IFD-confirmed group and IFD-unconfirmed group was 56.5% and 10.4%, respectively. Meanwhile, that of galactomannan test was 41.9% and 9.0%, respectively. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of (1, 3) -β-D-glucan was 56%, 90%, 44% and 92%, and that of galactomannan was 42%、91%、40% and 93%, respectively. Moreover, the combination of (1, 3) -β-D-glucan and galactomannan could raise the sensitivity to 69% and specificity to 98%. The positive results of serological detection (G/GM) come earlier about five days than CT changes.
CONCLUSION
Both (1, 3) -β-D-glucan and galactomannan test have high sensitivity and specificity, and the combination of them can improve the diagnostic efficacy, and make the clinical antifungal therapy more precisely. In the early clinical diagnosis of IFD, the positive results of serological detection coming earlier than lung CT.
Humans
;
Invasive Fungal Infections
;
diagnosis
;
etiology
;
Leukemia, Myeloid, Acute
;
complications
;
Mannans
8.Secondary acute myeloid leukemia complicated after treatment of non-Hodgkin's lymphoma.
Yi-Qian LIU ; Hong-Xia QIU ; Jian-Yong LI ; Wei XU ; Ji XU ; Xin LÜ ; Han-Xin WU
Journal of Experimental Hematology 2009;17(3):756-759
The aim of this study was to investigate the mechanism, susceptibility, (18)F-FDG positron emission computerized tomography ((18)F-FDG PET/CT) features and the treatment of therapy-related acute myeloid leukemia. One patient with NHL was affected with t-MDS after treatment and then progressed to t-AML. The clinical data including bone marrow cell morphology, flow cytometry, karyotype and PET/CT features were analyzed. The results showed that the primary treatment for NHL refers to varieties of cytotoxic drug such as cyclophosphamide-hydroxydaunomycin-oncovin-prednisone (CHOP) chemotherapy. The interval time from the chemotherapy of NHL to the occurrence of t-MDS was 105 months and t-MDS progressed to AML-M(2) in 2 months. Karyotype analysis results of t-MDS and t-AML were normal. (18)F-FDG PET indicated that the FDG uptake in the bone raised diffusely. The patient showed complete response after second-line therapy (CAG regiments). In conclusion, the occurrence of t-AML/MDS may be associated with the application of the cytotoxic chemotherapeutics. (18)F-FDG PET may be an indicator predicting the transformation of t-MDS to t-AML.
Humans
;
Leukemia, Myeloid, Acute
;
etiology
;
Lymphoma, Non-Hodgkin
;
complications
;
therapy
;
Male
;
Middle Aged
;
Neoplasms, Second Primary
;
etiology
;
Positron-Emission Tomography
10.More than two courses of pre-transplant consolidation therapy benefits patients with acute myeloid leukemia in the first complete remission who underwent human leukocyte antigen-matched sibling allografts: a multicenter study.
Jing LIU ; Depei WU ; Qifa LIU ; Yingjun CHANG ; Yang XU ; Fen HUANG ; Xiaojun HUANG ; Yu WANG
Chinese Medical Journal 2023;136(15):1855-1863
BACKGROUND:
Although the need for consolidation chemotherapy after successful induction therapy is well established in patients with acute myeloid leukemia (AML) in first complete remission (CR1), the value of consolidation chemotherapy before allogeneic hematopoietic stem cell transplantation remains controversial.
METHODS:
We retrospectively compared the effect of the number of pre-transplant consolidation chemotherapies on outcomes of human leukocyte antigen-matched sibling stem cell transplantation (MSDT) for patients with AML in CR1 in multicenters across China. In our study, we analyzed data of 373 AML patients in CR1 from three centers across China.
RESULTS:
With a median follow-up of 969 days, patients with ≥ 3 courses of consolidation chemotherapy had higher probabilities of leukemia-free survival (LFS) (85.6% vs . 67.0%, P < 0.001) and overall survival (89.2% vs . 78.5%, P = 0.007), and better cumulative incidences of relapse (10.5% vs . 19.6%, P = 0.020) and non-relapse mortality (4.2% vs . 14.9%, P = 0.001) than those with ≤ 2 courses of consolidation chemotherapy. Pre-transplantation minimal residual disease-negative patients with AML in CR1 who received MSDT with ≥ 3 courses of consolidation chemotherapy had a higher probability of LFS (85.9% vs . 67.7%, P = 0.003) and a lower cumulative incidence of relapse (9.6% vs . 23.3%, P = 0.013) than those with ≤ 2 courses.
CONCLUSION
Our results indicate that patients with AML in CR1 who received MSDT might benefit from pre-transplant consolidation chemotherapy.
Humans
;
Retrospective Studies
;
Consolidation Chemotherapy/methods*
;
Siblings
;
Hematopoietic Stem Cell Transplantation/methods*
;
Leukemia, Myeloid, Acute/etiology*
;
HLA Antigens
;
Allografts