The identification of BCR-ABL fusion gene and the advent of tyrosine kinase inhibitors (TKI) targeting this mutation have promoted the landmark progress of diagnosis and treatment in chronic myeloid leukemia (CML), and have dramatically changed the treatment management and disease prognosis for CML patients. Most of the western countries hold a view that CML is cut and dried, but the situation is not the same in developing countries. Currently, more attention is paid to the discontinuation of TKI. In addition, deep challenges remain in the low- and middle-income countries. This paper reviews the treatment progress of CML and challenges in low-and middle-income countries reported at the 61st American Society of Hematology Annual Meeting.

Objective:In order to clarify the clinical characteristics and prognostic factors of AITL, we performed a retrospective analysis on the AITL patients at our hospital.Methods:The clinical data of 84 AITL patients diagnosed by lymph node pathology and immunohistochemistry in the Fujian Medical University Union Hospital between July 2009 and September 2018 were collected, and the prognostic factors affecting overall survivol (OS) and progression-free surrival (PFS) were retrospectively analyzed by Log-rank test and Cox progortional hazard regression model.Results:The median age of the 84 patients was 62 y (range, 39-86 y) with 52.4% of the patients aged >60 y. The male-to-female ratio was 2.5∶1. 80 patients (95.2%) presented with advanced-stage disease, and B symptoms were observed in 53 cases (63.1%) . Fifty-nine patients (70.2%) had intermediate high and high risk as per the international prognostic index (IPI) and 42 (50.0%) had intermediate high risk as per the prognostic index for peripheral T-cell lymphoma (PIT) . The treatment response could be evaluated in 61 of the 67 patients who underwent chemotherapy. The complete remission (CR/CRu) rate was 26.2% (16/61) , and the partial response rate was 41.0% (25/61) . The 5-year OS rate and PFS rate in 61 patients was 46.0% and 38.3%, respectively. The univariate analysis showed that age, IPI score, PIT score, hemoglobin level, presence of serous effusions, and chemotherapy influenced the OS. Age >60 y, hemoglobin level <110 g/L, and presence of serous effusions were poor prognostic factors for PFS. Multivariate analysis showed that age >60 y and serous effusion were independent poor prognostic factors of OS.Conclusions:AITL is a Non-Hodgkin lymphoma with high invasion, rapid progress, and poor prognosis. The age, IPI score, PIT score, hemoglobin levels, and serous effusion can be used as reference factors for predicting the prognosis in AITL patients.