Objective To explore the clinical features of sev er e aplastic anemia (SAA) patients with chronic hepatitis B virus (HBV) infection.Methods 737 SAA cases newly diagnosed in the institute of Hemat ology and Blood Disease Hospital,CAMS in recent 13 years (1991 ~ 2003) were anal yzed.The ratio of SAA patients with chronic hepatitis B (21 cases,group Ⅰ) in them was investigated.A case-control study was undertaken to investigate the di fferences of clinical and laboratory features、therapeutic effectiveness and pro gnosis between SAA patients with chronic HBV infection \[the cases with chronic hepatitis B and those with antibodies to hepatitis virus B (23 cases,group Ⅱ )\] and SAA control group (42 cases,group Ⅲ ).Results ①The ratio of SAA patients with chronic hepatitis B in all SAA was 2.8%.②There was no significant difference of clinical features am ong them before treatment.③The recovery of PB counts、bone marrow hematopoiesis of group Ⅰ was slower than that of group Ⅱ and group Ⅲ after treatment.Th e percentage of CD8 + cells of group Ⅰor Ⅲwas significantly higher than that of group Ⅱ (P

Objective To evaluate the specificity,sensitivity and clinical significances of direct antiglobulin test of bone marrow monouclear cells (BMMNC-Coombs test) and Flow Cytometry (FACS).Methods Autoantibodies on bone marrow mononuclear cells of 270 patients with immune and 471cases with primary or secondary anaemia and 19 normal controls were measured by BMMNC-Coombs test,and a part of IRP patients with negative BMMNC-Coombs test were retested by FACS.Results In 270 immune hemocytopenia patients,there were 163 (60.37%) with positive BMMNC -Coombs test.The positive rate of patients with immunorelated pancytopenia (IRP) was upmost and accounted for 67.2%.AIHA 63.6%,ITP 57.1%,Evans syndrome 43.2%.Both 471 patients with primary or secondary anaemia and 19 normal persons were all negative.In BMMNC-Coombs positive cases,there were mainly three types including IgG,IgG+C_3,IgG+IgM+IgA+C_3,they accounted for 30.4%,26.4%,20.8%.61 1RP with negative BMMNC-Coombs test were teased again for their BMMNC autoantibodies by FACS.83.6% of them were found to be positive with autoantibodies on BMMNC.The positive rate of autoantibodies on hematopoietic stem cells of IRP patients was 94.1%.it was higher than positive rate on any other types of bone marrow hematopoietic cells.Conclusion the sensitivity and specificity of BMMNC-Coombs test for diagnosis of autoimmune hemocytopenia was high,but the sensi- tivity of FACS assay was higher than that of BMMNC-Coombs test for detecting autoantibodies.Also had IRP,AIHA, ITP and Evans syndrome patients autoantibodies on bone marrow hematopoietic cells,The difference between IRP and other immune hemocytopenias was that IRP patients did have autoantibodies only on BMMNC.

Objective To investigate the prevalence of liver damage in B-cell lymphoma patients with positive HBV surface antigen(HBsAg)after rituximab and chemotherapy.Methods Records of 19 B-cell lymphoma patients with positive HBV surface antigen(HBsAg)after rituximab and chemotherapy from June,2001 to Aug,2007 in Beijing Cancer Hospital were reviewed to analyze the prevalence of liver damage.At the same time,the relationship between the level of HBV-DNA and the damage of liver was analysed.Results According to WHO criteria of liver toxicity,of the 19 patients,12(63.2%)suffered liver damage,4(21.1%)patients in grade Ⅰ,6(31.2%)patients in grade Ⅱ and 2(10.5%)patients in grade Ⅲ.None of the patients in this study experienced grade Ⅳ liver toxicity.Of the 6 patients with HBV-DNA＞104 copy/ml before therapy,5(83.3%)suffered liver damage.Of the 5 patients with HBV-DNA＜104 copy/ml before therapy,3(60%)suffered liver damage.Conclusion The prevalence of liver damage is higher in B-cell lymphoma patients with positive HBsAg after rituximab and chemotherapy.These patients should be closely monitored for liver function when they received rituximab therapy and should reveive anti-HBV therapy.

Objective:To investigate the safety and efficacy of a modified baseline BEACOPP regimen(bleomycin+etoposide+adriamycin+cyclophosphamide+vincristine+ procarbazine hydrochloride+ prednisone) in the treatment of advanced Hodgkin 's lymphoma (HL). Methods:From March 2006 to September 2008, 22 previously untreated patients with stages Ⅱ(bulky), Ⅲ and Ⅳ HL were treated with a modified baseline BEACOPP regimen. Each patient was scheduled to receive 6 to 8 cycles of BEACOPP with consolidation radiotherapy to bulky (≥5 cm) or residual disease.Results:There were 11 males and 11 females with a median age of 28 years (15 to 61 years old). Twelve patients (54.5%) had nodular sclerosis HL, and 10(45.5%) had mixed cellularity HL. There were 4 patients in stageⅡ, 7 in stage Ⅲ and 11 in stage Ⅳ. Sixteen patients (72.7%) achieved a complete remission (CR) and 5 patients (22.7%) had partial remission (PR). The total effective rate (CR+PR) was 95.5%. Among all kinds of clinical factors International Prognostic Score (IPS) had significant effect on CR rate (P=0.011). The 1-, 2- and 3-year total survival rates were the same (95.5%); the 1-, 2- and 3-year progression-free survival (PFS) rates were 72.7%, 53.1% and 53.1%, respectively;the 1-, 2- and 3-year disease-free survival rates were 85.9%, 76.4% and 76.4%,respectively. Univariate analysis showed that the gender, IPS and whether achieving CR had significant effects on PFS (P<0.05). The main toxic effects were bone marrow depression and liver injury. Three patients (13.6%) had grade Ⅲ drug-induced lung injury. No treatment-related death was observed.Conclusion:The modified baseline BEACOPP regimen was effective and safe for treatment of newly diagnosed patients with advanced HL.

Objective:To summarize the clinical characteristics of Burkitt lymphoma(BL)and Burkitt-like lymphoma(BLL)and the effect of treatment on 13 cases,and to explore the treatment-related complications and optimal treatment.Methods:Clinical data of 13 BL and BLL patients treated between August 1996 and October 2008 in our hospital were retrospectively analyzed.All of these patients received chemotherapy as the first-line treatment.The efficacy and adverse reactions were evaluated.Results:Of the 13 patients,there were 12 males and 1 female,with a median age of 15 years(ranging from 11 to 62).There were 3 stage Ⅰ cases,2 stage Ⅱ cases,2 stage Ⅲ cases,and 6 stage Ⅳ cases.The advanced stage(stage Ⅲ and Ⅳ)patients accounted for 61.5%(8 cases).CNS was involved in 4 cases and bone marrow was involved in 2 cases at diagnosis.The commonly involved sites included superficial lymph nodes(61.5%),abdominal organs(53.8%),and celiac and retro-pentoneal lymph nodes(38.5%).B symptoms were observed in 7 patients(53.8%).Serum lactate dehydrogenase level was elevated in 8 of 10 cases,while serum udc acid level was elevated in 1 of 10 cases.Eleven patients were diagnosed as BL and 2 patients were diagnosed as BLL.Of the 13 patients,11(84.6%) achieved complete remission(CR)or CR/unconfirmed(CRu),and 1 patient(7.7%) got partial remission(PR).Dudng the follow-up of 8 months(ranging from 5 to 35),6 patients were still alive.The 1-year overall survival,progression-free survival and disease-free survival were 56.98%,32.31% and 39.77%,respectively.Nine patients(69.2%)developed grade Ⅲ or Ⅳ myelosuppression.Conclusion:Intensive short-course chemotherapy is the optimal first-line treatment for BL and BLL.

Objective To explore the feasibility of expansion for NK cells and the therapeutic efficacy improvement of rituximab by combinational Chemo-immunotherapy of rituximab and inter]eukin-2. To establish a clinical chemo-immunotherapy therapy regime of rituximab and interleukin-2(IL-2) for patients with diffuse large B-cell lymphoma (DLBCL). Methods The clinical data of 24 initially treated inpatients with DLBCL from Aug 2008 to Mar 2009 were analyzed by prospective non-randomized study. Patients in the treatment group (12 cases) were treated by IL-2 plus R-CHOP regime and those in the control group (12 cases)only by R-CHOP. The absolute quantity of NK cells before and after IL-2 and/or R-CHOP treatment in both groups were detected with FCM and compared, and the therapy efficacy and adverse reactions were evaluated.Results The complete remission (CR) rate was 60%(6/10) and the overall response (OR)rate was 80%(8/10)in the treatment group. The CR rate was 50%(5/10) and the OR rate was 70 %(7/10) in the control group.The proliferation of the NK cells in the treatment group was significantly effective compared with that in the control group (P=0.015). The descending range of NK cells between pre-and post-treatment in the treatment group was significantly lower than that in the control group(P =0.005). The quantity of NK cells after treatment by IL-2 was significantly increased than that before treatment by IL-2 in the treatment group (P=0.03). Among 10 patients in the treatment group, 3 cases have got diarrhea and 3 fever. Conclusion Treatment by IL-2 plus R-CHOP can increase the NK cell quantity in patients with DLBCL and may reduce lethal effect for NK cells by chemotherapy. The patients can tolerant the adverse reactions of IL-2 combined with R-CHOP therapy.

Objective:To study the clinical features, therapeutic effects, survival time, and prognosis of patents with mantle cell lymphoma (MCL). Methods:Clinical data of 98 MCL patients admitted from January 2005 to December 2013 were retrospectively an-alyzed. Results:The median age was 61 years old, and the male-to-female ratio was 2.9∶1. Among these cases, 85 (86.8%) were in Ann Arbor stageⅢ-Ⅳ, 46 (46.9%) had bone marrow involvement, 25 (25.5%) had digestive tract involvement, and 53 chose R-CHOP as first-line treatment. The expected 3-year overall survival (OS) of these patients was only 61.4%. A total of 14 cases were treated with R-CHOP followed by ASCT. The expected 5-year OS was 92.3%, and the OS of the ASCT group was significantly higher than that of the R-CHOP group (75.5 months vs. 43.6 months, P=0.039). Elevated ESR,>60 years old, increased LDH level, B symptoms, and Ki-67≥25% were poor prognostic factors. Conclusion: Most patients with MCL were elder adults with bone marrow involvement. R-CHOP followed by ASCT had better clinical efficacy than conventional chemotherapy in the treatment of MCL.

Objective: To evaluate the efficacy and safety of PEG-rhG-CSF therapy in the primary and secondary prevention of chemo-therapy-induced neutropenia . Methods: This single-center, one-arm, and open-label clinical study involved 217 patients with non-my-eloid malignant tumors. These patients included 18 gynecologic oncology (3 endometrial and 15 ovarian cancer), 50 breast cancer, 30 bone tumor, and 119 lymphoma patients who underwent a total of 774 cycles of chemotherapy, comprising 146 primary and 71 sec-ondary prevention patients. The patients ≥45 kg and those <45 kg received a single subcutaneous injection of 6 mg and 3 mg PEG-rhG-CSF, respectively, 24-48 h after the chemotherapy was completed. All patients received only one dose of PEG-rhG-CSF admin-istration per chemotherapy cycle. Results: The overall incidence of febrile neutropenia (FN) was found to be 5.7%, with rates of 4.9% and 7.2% in the primary and secondary prevention groups, respectively. Univariate and multivariate Logistic regression analyses re-vealed that the longer PEG-rhG-CSF was sustained in the treatment cycle, the lower the incidence of FN was. The incidence of FN was significantly lower in the second cycle of the treatment than in the first in both the primary and secondary prevention groups (cycle 1 vs. cycle 2: 11.6% vs. 4.4%, respectively, P=0.039, in the primary group; 16.9% vs. 5.6%, respectively, P=0.034, in the secondary group). The overall incidence of gradeⅣneutropenia was 10.3% (80/774), with rates of 6.7% (34/510) and 17.4% (46/264) in the primary and secondary prevention groups, respectively (P<0.001). The incidence of gradeⅣneutropenia was significantly lower in the second cy-cle of the treatment than in the first (cycle 1 vs. cycle 2: 17.1% vs. 5.3%, respectively, P=0.004, in the primary group; 46.5% vs. 11.3%, respectively, P<0.001, in the secondary group). The treatment-induced toxicity mainly involved bone pain, with 3.7% (8/217) and 1.8% (4/217) incidence rates for grade 1-2 and 3-4 bone pain, respectively. Conclusions: PEG-rhG-CSF administration can effectively reduce the incidence of FN (5.7%) when prophylactically applied to patients with non-myeloid malignant tumors. Primary prevention can sig- nificantly reduce the risk of grade IV neutropenia in all chemotherapy cycles relative to the secondary prevention.

Objective: To evaluate the prognostic value of ¹⁸F-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) in patients with diffuse large B cell lymphoma (DLBCL) undergoing autologous hematopoietic stem cell transplantation (auto-HSCT). Methods: Forty-eight patients with DLBCL treated at Peking University Cancer Hospital between November 2010 and December 2014 were assessed. All patients underwent PET/CT scanning prior to or after auto-HSCT. Correlation analysis was done based upon patients characteristics, PET/CT scan results and survival. Results: ①Among 48 patients, 27 was male, 21 female, median age was 43 (17-59) years old. ② Patients with negative pre-auto-HSCT PET/CT assessment demonstrated significantly better 3-year progression free survival (PFS) (87.1% vs 53.3%, χ²=7.02, P=0.019) and overall survival (OS) (90.3% vs 60.0%, χ²=6.51,P=0.022) than patients with positive pre-auto-HSCT PET/CT assessment. Three-year PFS (94.1% vs 30.0%, χ²=22.75, P=0.001) and OS (97.1% vs 40.0%, χ²=21.09, P=0.002) were also significantly different between patients with negative and positive post-auto-HSCT PET/CT assessment. ③ Multivariate analysis indicated a significant association of PFS (HR=13.176, P=0.005) and OS (HR=20.221, P=0.007) with post-auto-HSCT PET/CT assessment. Number of prior treatment regimens was associated with PFS (HR=10.039, P=0.040). ④ Harrell’s C index revealed that the value of combined use of number of prior treatment regimens and post-auto-HSCT PET/CT assessment was superior to either one used alone in PFS (Harrell’s C values were 0.976, 0.869 and 0.927 in combined use, number of prior treatment regimens and post-auto-HSCT PET/CT assessment, respectively), and the combined use of ECOG performance status and post-auto-HSCT PET/CT assessment significantly increased the Harrell’s C index in OS (Harrell’s C values were 0.973, 0.711 and 0.919 in combined use, ECOG performance status and post-auto-HSCT PET/CT assessment, respectively). Conclusions Post-auto-HSCT PET/CT assessment is the main predictor of outcomes in DLBCL patients receiving auto-HSCT. Combined use of post-auto-HSCT PET/CT assessment and number of prior treatment regimens and ECOG performance status is a better prognostic tool in patients with DLBCL undergoing transplantation.

Objective: To evaluate the clinical characteristics and survival outcomes of patients with de novo grade 3 or transformed follicular lymphoma (FL). Methods: Fifty-two patients treated at Peking University Cancer Hospital between January 2009 and September 2017 were assessed, including 28 patients with FL 3A grade, 13 patients with FL 3B grade, 11 patients with transformed FL. Baseline characteristics, survival and prognostic factors were analyzed. Results: ① Twenty-six male and 26 female patients were enrolled, including 28 patients with FL 3A grade, 13 patients with FL 3B grade, 11 patients with transformed FL. ②The 3-year progression-free survival (PFS) and overall survival (OS) for the entire cohort were 56.0% and 80.6%, respectively. Patients with international prognostic index (IPI) score 0-1 demonstrated significantly better 3-year PFS (80.3% vs 20.1%; t=18.902, P<0.001) and OS (95.7% vs 57.0%; t=10.406, P<0.001) than patients with IPI score 2-3. Three-year PFS (94.1% vs 37.2% vs 25.2%; P=0.002) and OS (100.0% vs 76.0% vs 59.8%; P=0.020) were also significantly different among patients with FLIPI 1 score 0-1, 2, ≥3. FLIPI 2 score was also identified as a prognostic factor for 3-year PFS (68.4%, 0, 0; P=0.001) and OS(87.5%, 76.2%, 0; P=0.003). ③Multivariate analysis indicated a significant association of PFS (HR=3.536, P=0.015) and OS (HR=15.713, P=0.015) with IPI. FLIPI 2 was associated with OS (score 0-1, HR=0.078, P=0.007; score 2, HR=0.080, P=0.022). Conclusion De novo grade 3 or transformed FL might be a group of curable disease with current treatment strategies. IPI is still a prognostic tool in this scenario.