OBJECTIVE: To investigate the clinical characteristics and prognosis of patients with acute myeloid leukemia(AML) combined with paroxysmal nocturnal hemoglobinuria(PNH). METHODS: The clinical data of 13 AML combined with PNH patients treated in our hospital from January 2017 to May 2019 were collected and retrospective analyzed. The complete remission(CR) rate for induction chemotherapy was analyzed. The level of PNH RESULTS: Among the 13 patients, 11 (84.6%) cases were CR after first induction chemotherapy. The median overall survival(OS) time was 17 months(0-30 months), the median progression-free survival(PFS) time was 16 months(2-26 months). There were no significant difference in the number of PNH CONCLUSION The patients of AML combined with PNH have higher CR rate after the first induction chemotherapy. The level of WBC and LDH at first diagnosed are the factors that affecting the OS of the patients. The OS of patients with WBC lower than 10×10
Hemoglobinuria, Paroxysmal ; Humans ; Induction Chemotherapy ; Leukemia, Myeloid, Acute/drug therapy* ; Prognosis ; Remission Induction ; Retrospective Studies

OBJECTIVETo compare the efficacy and toxicity of 10 mg/m² or 8 mg/m² idarubicin (Ida) combined with cytarabine (IA"3+7"regimen) as induction chemotherapy for adult patients with newly diagnosed acute myeloid leukemia (AML).

METHODSFrom June 2004 to October 2013, 335 adult AML (non acute promyelocytic leukemia) patients receiving the IA regimen as induction chemotherapy were enrolled, including 198 cases with 10 mg/m² Ida and 137 cases with 8 mg/m² Ida for 3 days. We compared the hematologic response, hematologic side effects and prognosis between the two regimens.

RESULTSExcept for 4 early deaths, the complete remission (CR) rate after the first cycle of induction chemotherapy was 72.5%, 10.0% partial remission (PR) and 82.5% overall remission (OR) rate. The CR and OR rates were higher in the 10 mg/m² Ida group than the 8 mg/m² Ida group (CR: 78.9% vs 63.5%, P=0.003; OR: 88.2% vs 75.4%, P=0.007). Multivariate analysis showed that female, HGB≥100 g/L, FLT3-ITD mutation negative and 10 mg/m² Ida were favorable factors for CR. All patients presented cytopenias of grade Ⅳ. There was no differences on the recovery time of ANC≥0.5×10⁹/L and PLT≥20×10⁹/L after induction chemotherapy. Within a median follow-up of 14 (1-118) months, 98 (29.3%) patients relapsed, 92 (27.5%) died. The disease-free survival (DFS) and overall survival (OS) at 3 years were 53.2% and 58.9%, respectively. DFS and OS at 3-year were 34.2% and 37.4% in the chemotherapy cohort, 74.5% and 81.2% in the transplant cohort. 10 mg/m² Ida was an independent favorite factor for DFS (P=0.040) and OS (P=0.007).

CONCLUSIONAs compared to 8 mg/m², 10 mg/m² Ida significantly improved the CR, with the same extent of hematological side effects, and was an independent favorite factor for DFS and OS.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; Cytarabine ; Disease-Free Survival ; Female ; Humans ; Idarubicin ; Induction Chemotherapy ; Leukemia, Myeloid, Acute ; Prognosis ; Remission Induction

BACKGROUND: Standard remission induction chemotherapy consisting of anthracycline plus cytarabine (3+7) is administered for adult acute myeloid leukemia (AML). However, the effects of intensified regimen on complete remission (CR), relapse and overall survival (OS) remain unknown. METHODS: We analyzed 1195 patients treated with idarubicin plus cytarabine/BHAC (3+7) from 2002 to 2013. Among them, 731 received early intensification with 3-day cytarabine/BHAC (3+10, N=363) or 2-day idarubicin plus cytarabine/BHAC 3 days (5+10, N=368). The 3+10 and 5+10 strategies were applied to patients with bone marrow blast counts of 5–20% and >20% on day 7 of 3+7, respectively. RESULTS: Early intensification correlated with a younger age (median: 40 vs. 45 yr) and higher t(8;21) frequency (20.4% vs. 7.1%), compared to 3+7. After early intensification, the early death rates were higher among the elderly (3+10 [15.7%], 5+10 [21.7%] vs. 3+7 [6.3%], P=0.038), while the post-induction CR rate was higher in young patients (3+10 [79.8%], 5+10 [75.1%] vs. 3+7 [65.1%], P<0.001). Early relapse rate was also decreased (3+10 [11.8%], 5+10 [11.7%] vs. 3+7 [22.0%], P<0.001). In multivariate analysis, early intensification correlated with an inferior 5-year OS among elderly patients (19.2% vs. 22.8%; hazard ratio [HR]=1.84, 95% confidence interval [CI]; 1.11–3.06, P=0.018) and lower overall relapse rate among young patients (33.0% vs. 41.4%, P=0.023; HR=0.71, 95% CI; 0.55–0.93, P=0.012). CONCLUSION: Early intensification correlated with higher CR and lower relapse rates, but not OS in young AML patients. In elderly patients, early intensification correlated with a higher early death rate and poorer OS.
Adult* ; Aged ; Bone Marrow ; Cytarabine ; Drug Therapy* ; Humans ; Idarubicin ; Induction Chemotherapy* ; Leukemia, Myeloid, Acute* ; Mortality ; Multivariate Analysis ; Recurrence ; Remission Induction

BACKGROUND: The overall prognosis of acute leukemia has dramatically improved in the past 20 years, primarily due to the use of intensive multiagent chemotherapy in combination with CNS prophylaxis. However, increased aggressiveness of treatment protocols was entailed a great risk of various toxic effects. Endocrine function was also affected. The aim of this study is to compare the effect of chemotherapy on thyroid function in children with acute leukemia. METHOD: Parameters of thyroid function during chemotherapy were measured in 11 children with acute leukemia. Level of the serum 73,74 and TSH were determined before therapy, 7th day and 30th day of chemotherapy. Determination of serum 73, 74 and TSH were performed by conventional radioimmunoassay technique. Statistical analysis was done using SAS software. RESULT: 1) Level of level 73 was normal in 7 cases before therapy and decreased in 9 cases on 7th day of remission induction therapy. On 30th day, 73 level was increased to normal value. 2) Level of 74 was normal before therapy and decreased on 7th day of therapy. On 30th day of therapy 74 level showed various change. Three of them showed sustained low level of 74 on 7th and 30th day. 3) Level of TSH were normal before therapy and decreased on 7th day of therapy, followed achievement of normal level after completion of induction therapy. CONCLUSION: We conclude that during induction chemotherapy in childhood acute leukemia, thyroid function was impaired which was reversible.
Child ; Clinical Protocols ; Drug Therapy* ; Humans ; Induction Chemotherapy ; Leukemia* ; Prognosis ; Radioimmunoassay ; Reference Values ; Remission Induction ; Thyroid Gland*

OBJECTIVE: To explore the prognostic factors of elderly AML patients, as well as the application and prognostic value of comprehensive geriatric assessment（CGA） in elderly AML patients in China, so as to determine a suitable comprehensive assessment method that can predict survival and guide treatment of patients in Chinese people. METHODS: Retrospective analysis was performed on the medical records of 84 AML patients aged over 60 years old, and diagnosed in our department from October 2007 to December 2017, and the clinical, pathological and comprehensive evaluation of related prognostic factors was analyzed. RESULTS: The median age of all patients was 70 (60-91) years old, ratio of male to female was 1.9∶1 (55∶29) , the median OS time was 9 (1-125) months, 1 year OS rate was 35.3%, and 5 year OS rate was 12.6%. The age grouping, remission of induction chemotherapy, whether refractory/relapse, WBC count grouping at initial diagnosis, levels of lactate dehydrogenase and creatinine were risk factors for OS. Remission of induction chemotherapy, whether refractory/relapse, WBC count grouping and co-infections at initial diagnosis, levels of lactate dehydrogenase, and ECOG score were the risk factors for DFS. In the assessment of comorbidities, the two score classifications of charlson comorbidity index(CCI) were the risk factor of OS, however,whose effects for DFS were not statistically different. The effects of 3 score classifications of hemaotopoietic cell transplantation comorbidity index (HCT-CI), 4 score classifications of comulative illness kating scale for geriatrics (CIRS-G) and 3 score classifications of CIRS-G on OS and DFS were not statistically different. The impact of the ACA index on OS and DFS was statistically significant in elderly patients. All indexes related with patients self factors and disease-related factors were no independent prognostic factors for OS and DFS, so the judgment of prognosis needs to be comprehensively evaluated. CONCLUSION The prognosis and treatment selection of elderly AML patients should be combined with traditional clinical and pathological prognostic factors as well as comprehensive assessment of the elderly patients.
Aged ; Aged, 80 and over ; China ; Female ; Humans ; Induction Chemotherapy ; Leukemia, Myeloid, Acute ; Male ; Middle Aged ; Prognosis ; Remission Induction ; Retrospective Studies

BACKGROUND: To evaluate the effects and toxicity of combination chemotherapy using idarubicin (IDA) plus BH-AC as an induction regimen, we studied two groups of patients with adult acute myeloid leukemia (AML) who received IDA plus either Sunrabin(r) or Enoron(r). METHODS: Twenty-four and twenty-five patients in each group eligible for the induction study were enrolled. The remission induction therapy consisted of IDA 12mg/m2 intravenously for three consecutive days in combination with two kinds of BH-AC, that is Sunrabin(r) or Enoron(r), 300mg/m2 intravenously for seven days. Additional augmentation treatment with BH- AC was given for 3 days based on the results of bone marrow examination performed on the seventh day following initial treatment, i.e. depending on the ratio of the remaining leukemic cells. RESULTS: Complete remission was achieved in 75% vs 74% of each group of patients. The treatment-related mortality during induction chemotherapy was 1 patient in each group. There was no statistical difference in the level of toxicities between two groups. The most frequent side effect after these combination chemotherapy was manageable mucositis. Enoron(r) group showed rather rapid recovery of peripheral blood counts than those of Sunrabin(r) group. CONCLUSION: This study indicate Enoron(r) is comparable to Sunrabin(r) which can be used as an effective induction chemotherapeutic agent in adult patient with AML.
Adult* ; Bone Marrow Examination ; Drug Therapy, Combination ; Humans ; Idarubicin* ; Induction Chemotherapy* ; Leukemia, Myeloid, Acute* ; Mortality ; Mucositis ; Remission Induction

Spontaneous remission(SR) of acute leukemia is an extremely rare event. The precise incidence of SR in acute myeloid leukemia(AML) could not be assessed accurately because the majority of patients usually received induction chemotherapy within a few days after diagnosis. The mechanisms of SR are still not completely understood; therefore, the study of them is expected to contribute to the treatment of acute leukemia. We report a case of AML with SR, observed in a 23-year-old male who experienced severe infection and transfusions, with a brief review of the literature.
Diagnosis ; Humans ; Incidence ; Induction Chemotherapy ; Leukemia ; Leukemia, Myeloid, Acute* ; Male ; Remission, Spontaneous* ; Young Adult

Non-small cell lung cancer (NSCLC) is the leading cause of cancer related deaths. Most patients were presented with advanced disease at the time of diagnosis. In advanced NSCLC, it is almost impossible to anticipate complete remission by using only cytotoxic chemotherapy or molecularly targeted agents. In our case, two patients were diagnosed as advanced NSCLC and received chemotherapy. They achieved complete response (CR). After finishing treatment, disease recurred. They were retreated with the same regimens and achieved second CR. Until now, they have received each regimen, continuously, and the CR state has been maintained.
Carcinoma, Non-Small-Cell Lung ; Humans ; Maintenance Chemotherapy ; Remission Induction ; Retreatment

No abstract available.
Child* ; Cytarabine* ; Cytosine* ; Doxorubicin* ; Humans ; Leukemia, Myeloid, Acute* ; Maintenance Chemotherapy* ; Remission Induction* ; Thioguanine*

OBJECTIVETo evaluate the efficacy and safety of R ± BEACOP protocol on newly diagnosed patients with moderate and high risk diffuse large B-cell lymphoma (DLBCL).

METHODSThe clinical data of 19 newly diagnosed patients with moderate and high risk DLBCL received at least 2 cycles of R ± BEACOP protocol during 2011 to 2014 were collected, their therapeutic efficacy and side effects were evaluated by retrospective analysis.

RESULTSThe overall response rate of 19 assessable patients was 94.7%, including 5 patients (26.3%) in complete remission (CR) and 13 patients (68.4%) in partial remission (PR). The major toxicity was hematologic toxicity and the incidence of grade III-IV hematologic toxicity was 73.7%. Other toxicities were mild and no treatment-related death occurred.

CONCLUSIONR ± BEACOP protocol is a effective and safe protocol for the patients with DLBCL which is worth further multicenter prospectively studying in china.

Antineoplastic Combined Chemotherapy Protocols ; China ; Humans ; Lymphoma, Large B-Cell, Diffuse ; Remission Induction ; Retrospective Studies