Arsenicals ; therapeutic use ; Humans ; Leukemia, Promyelocytic, Acute ; drug therapy ; Medicine, Chinese Traditional ; Oxides ; therapeutic use

The big trouble for invasive fungal infection(IFI)is how to define the diagnosis.Delayed therapy is the main reason of the death in the IFI patients,which underlines the importance of empiric therapy.Both cost-effectiveness ratio and patients' particular status should be considered when choosing an antifungal drug.Amphotericin B,Itraconazole,voriconazole,caspofungin and micafungin are all recommended.But there are still plenty of questions unanswered about empiric therapy,for example,how to establish th therapy based on scientific evidence.

Hematopoietic stem cell transplantation (HSCT) is an effective and sometimes the only curative therapy for patients with certain hematological diseases.HSCT has been practiced in China for approximately fifty years,and great improvements have been made within the past decade,especially in fields such as haploidentical HSCT system,strategies to overcome relapse and GVHD.This review will describe the current situation and provide a prospective of these novel characteristics of HSCT system in China.

China ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; diagnosis ; therapy ; Practice Guidelines as Topic

Objective To investigate the effieacy and safety of intravenous itraconazole for the treatment of invasive fungal infection(IFI)in patients with hematological disease or undergoing allogeneic hematopoietic stem cell transplantation(HSCT).MethodsSix hundred and sixty-six patients with above mentioned conditions and diagnosed as IFI from January.2007 to July,2007 were enrolled.Intravenous itraconazole was administered at a dose of200 nag every 12 hours for 2 days and followed by 200 mg every 24 hours.Patients were then switched to oral itraconazole according to the clinical situation Responses were determined on the basis of clinical and microbiological criteria.Results The probability of defervescence Was 69.8%and the total response rates among related to itraconazole were the proven.probable and possible IFI patients were 73.7%.68.1%and 68.2%(P=0.380).Adverse effects were found in 58 patients (8.7%).which were mainly mild to medium reversible dysfunction of liver and gastrointestinal tract, Conclusion Itraconazole is an effective and safe antifungal agent for patients with hematological disease or undergoing HSCT and is suitable for empirical antifungal therapy.

Objective To detect serum concentrations of Dickkopf-1(DKK-1) and soluble receptor activator of nuclear factor-κB ligand (sRANKL) in patients with multiple myeloma (MM) and to investigate its clinical significance. Methods Serum DKK-1, sRANKL, osteoporotegerin(OPG) and tartrate-resistant acid phosphatase 5b (TRACP-5b) levels were quantified in 30 newly diagnosed MM patients and 20 healthy control subjects by using sandwich ELISA. Results The serum DKK-1, sRANKL,OPG and TRACP-5b levels were significantly higher than those in the healthy controls (42.96 μg/L vs 5.33 μg/L, 1.83 pmol/Lvs 0. 79 pmol/L, 1799. 30 pmol/L vs 822.40 pmol/L, 5.81 U/L vs 0. 28 U/L, respectively; all P＜0. 05). Serum levels of DKK-1 were positively correlated with sRANKL and TRACP-5b, respectively.Serum concentrations of DKK-1 and sRANKL were significantly elevated in stage Ⅲvs stages Ⅰ and Ⅱaccording to International Staging System (ISS) (46. 33 μg/L vs 37.91 μg/L, 2.26 pmol/L vs 1.19pmol/L, respectively, all P ＜0.05). Serum concentrations of DKK-1 , sRANKL and TRACP-5b were significantly higher in patients with more than 3 lytic bone lesions than those with only 1-3 lytic bone lesions (46. 30 μg/L vs 31.98 μg/L, 2. 18 pmol/L vs 0. 69 pmol/L, 6.02 U/L vs 5. 13 U/L, all P ＜ 0.05).Conclusions MM patients have increased serum DKK-1, sRANKL, OPG and TRACP-5b levels as compared with the healthy controls. Serum concentrations of DKK-1 and sRANKL have close relationship with MM stage and lytic bone disease.

ObjectiveTo compare the sensitivity among three diagnostic criteria for multiple myeloma.MethodsA total of 220 patients with multiple myeloma were studied retrospectively to compare thesensitivity, aswellastheirclinicalmanifestations, cellmorphologyinbonemarrowand immunophenotype.Results (1) The sensitivity of domestic diagnostic criterion in 1975 was 79.1％ (174/220) and there were some drawbacks in type identify.The sensitivity of WHO diagnostic criterion in 2001 was 97.3％ (214/220) and the sensitivity of domestic diagnostic criteria in 2011 was 100％. (2) Immunoglobulin level in 12.7％ (28/220) patients was ＜ 30 g/L,plasma cells count in bone marrow in 13.6％ (30/220) was ＜ 10％ ; 2.7％ (6/220) patients had not met the standard in immunity globulin and bone marrow plasma cells count.(3) The immunophenotype was CD38 positive ( 100％ ),restricted light chain (kappa/lambda) and CD19 100％,CD138 (98.2％,216/220) negative.ConclusionsAmong the three diagnostic criteria,the highest was 2011 domestic diagnostic criteria.Comprehensive analysis include clinical manifestations,cell morphology,immunophenotype will contribute to the diagnosis for multiple myeloma.

With the quick development revelant techniques, proteomics is a very active subject in modern biological fields. The key techniques of proteomics are two dimensional electrophoresis, mass spectrometry and bioinformatics. From the new point of view, proteomics may play a vital role in the early detection of neoplasm by looking for tumor specific protein and elucidating the relationship between the change of expression and different phases of tumorigenesis. The article briefly review the relevant technique, strategy and application for the early diagnosis of in digestive system tumors.

Hematopoietic stem cell transplantation (HSCT) is the only effective curative therapy for patients with certain hematological diseases. Haploidentical HSCT has been practiced worldwide for approximately twenty years. Significant improvements on this therapy were made in China within the past decade, with the novel non-in-vitro, T-cell-depleted haploidentical HSCT system. This review de-scribes the current situation and provides a prospective overview of these novel HSCT systems in China.

Allo-HSCT is a potentially curative therapy for many hematological malignancies,the basis of which is graft-versus-leukemia(GVL) effect.However,acute graft-versus-host disease(GVHD) is responsible for 15% to 40% of mortality and is the major cause of morbidity after transplantation.Therefore,separation of GVHD and GVL partially or completely could improve the transplant outcomes.This study focuses on the effects of G-CSF on T cells in peripheral blood stem cell grafts and bone marrow grafts and its mechanisms after in vivo G-CSF application.The separation of GVHD and GVL effect and the mechanisms of which after in vivo G-CSF and interleukin-11(IL-11) treatment of healthy donors were investigated.The main contributions of this research are listed as follows:(1) Immune tolerance of T cells was induced simultaneously in peripheral blood stem cell grafts and bone marrow grafts after in vivo G-CSF application;(2) T cell hyporesponsiveness and polarization of T cells from Th1 to Th2 were maintained after mixture of G-CSF-mobilized peripheral blood grafts(G-PB) and G-CSF-primed bone marrow grafts(G-BM) according to different proportions in vitro;(3) Treating donor with G-CSF and IL-11 decreased GVHD and retained GVL effect;(4) The incidence of acute GVHD was decreased after Allo-HSCT using G-PB and G-BM as allografts;(5) In combination with other techniques,the HLA barriers were overcomed using G-PB and G-BM as allografts;(6) The incidences of acute GVHD were significantly decreased and the GVL effects were retained or enhanced in relapsed patients after treatment by G-CSF-mobilized peripheral blood graft infusion compared with those received steady-state peripheral blood lymphocyte infusion,indicating that GVHD and GVL could be partially separated in clinical settings.Based on our results,we would conclude that the issues on the deficiency of donors are resolved,and novel strategies offered for the prophylaxis and treatment of patients with hematological malignancies who relapse after Allo-HSCT.Further studies on the mechanism of the separation of GVL and GVHD are warranted.