1.Analysis of prognostic factors of extranodal NK/T-cell lymphoma treated with pegaspargase/L-asparaginase: a multicenter retrospective study.
Zi Yuan SHEN ; Xi Cheng CHEN ; Hui Rong SHAN ; Tao JIA ; Wei Ying GU ; Fei WANG ; Qing Ling TENG ; Ling WANG ; Chun Ling WANG ; Yu Ye SHI ; Hao ZHANG ; Yu Qing MIAO ; Tai Gang ZHU ; Chun Yan JI ; Jing Jing YE ; Ming Zhi ZHANG ; Xu Dong ZHANG ; Liang WANG ; Kai Lin XU ; Wei SANG
Chinese Journal of Hematology 2023;44(8):642-648
Objective: To explore the prognostic factors of extracellular NK/T cell lymphoma (ENKTL) treated with pegaspargase/L-asparaginase. Methods: The clinical data of 656 ENKTL patients diagnosed at 11 medical centers in the Huaihai Lymphoma Working Group from March 2014 to April 2021 were retrospectively analyzed. The patients were randomly divided into two groups: a training set (460 cases) and a validation set (196 cases) at 7∶3, and the prognostic factors of the patients were analyzed. A prognostic scoring system was established, and the predictive performance of different models was compared. Results: Patients' median age was 46 (34, 57) years, with 456 males (69.5% ) and 561 nasal involvement (85.5% ). 203 patients (30.9% ) received a chemotherapy regimen based on L-asparaginase combined with anthracyclines, and the 5-year overall survival rate of patients treated with P-GEMOX regimen (pegaspargase+gemcitabine+oxaliplatin) was better than those treated with SMILE regimen (methotrexate+dexamethasone+cyclophosphamide+L-asparaginase+etoposide) (85.9% vs 63.8% ; P=0.004). The results of multivariate analysis showed that gender, CA stage, the Eastern Cooperative Oncology Group performance status (ECOG PS) score, HGB, and EB virus DNA were independent influencing factors for the prognosis of ENKTL patients (P<0.05). In this study, the predictive performance of the prognostic factors is superior to the international prognostic index, Korean prognostic index, and prognostic index of natural killer lymphoma. Conclusion: Gender, CA stage, ECOG PS score, HGB, and EB virus DNA are prognostic factors for ENKTL patients treated with pegaspargase/L-asparaginase.
Male
;
Humans
;
Middle Aged
;
Asparaginase/therapeutic use*
;
Prognosis
;
Retrospective Studies
;
Lymphoma, Extranodal NK-T-Cell/drug therapy*
;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use*
;
Etoposide
;
Cyclophosphamide
;
Methotrexate/therapeutic use*
;
DNA/therapeutic use*
;
Treatment Outcome
2.Observation of liver indexes in patients with relapsed/refractory multiple myeloma treated with CAR-T-cells based on BCMA.
Qian SUN ; Yue Kun QI ; Kun Ming QI ; Zhi Ling YAN ; Hai CHENG ; Wei CHEN ; Feng ZHU ; Wei SANG ; De Peng LI ; Jiang CAO ; Ming SHI ; Zhen Yu LI ; Kai Lin XU
Chinese Journal of Hematology 2023;44(10):832-837
Objective: To observe the characteristics of the evolution of liver indexes in patients with relapsed/refractory multiple myeloma (RRMM) treated with CAR-T-cells based on BCMA. Methods: Retrospective analysis was performed of patients with RRMM who received an infusion of anti-BCMA CAR-T-cells and anti-BCMA combined with anti-CD19 CAR-T-cells at our center between June 1, 2019, and February 28, 2023. Clinical data were collected to observe the characteristics of changes in liver indexes such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), and direct bilirubin (DBIL) in patients, and its relationship with cytokine-release syndrome (CRS) . Results: Ninety-two patients were included in the analysis, including 41 patients (44.6%) in the group receiving a single infusion of anti-BCMA CAR-T-cells, and 51 patients (55.4%) in the group receiving an infusion of anti-BCMA combined with anti-CD19 CAR-T-cells. After infusing CAR-T-cells, 31 patients (33.7%) experienced changes in liver indexes at or above grade 2, which included 20 patients (21.7%) with changes in one index, five patients (5.4%) with changes in two indexes, and six patients (6.5%) with changes in three or more indexes. The median time of peak values of ALT and AST were d17 and d14, respectively, and the median duration of exceeding grade 2 was 5.0 and 3.5 days, respectively. The median time of peak values of TBIL and DBIL was on d19 and d21, respectively, and the median duration of exceeding grade 2 was 4.0 days, respectively. The median time of onset of CRS was d8, and the peak time of fever was d9. The ALT, AST, and TBIL of patients with CRS were higher than those of patients without CRS (P=0.011, 0.002, and 0.015, respectively). CRS is an independent factor that affects ALT and TBIL levels (OR=19.668, 95% CI 18.959-20.173, P=0.001). The evolution of liver indexes can be reversed through anti-CRS and liver-protection treatments, and no patient died of liver injury. Conclusions: In BCMA-based CAR-T-cell therapy for RRMM, CRS is an important factor causing the evolution of liver indexes. The evolution of liver indexes after CAR-T-cell infusion is transient and reversible after treatment.
Humans
;
Antigens, CD19
;
B-Cell Maturation Antigen/therapeutic use*
;
Bilirubin
;
Immunotherapy, Adoptive
;
Liver
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Multiple Myeloma/drug therapy*
;
Retrospective Studies
;
T-Lymphocytes
3.Allogeneic hematopoietic stem cell transplantation combined with CD7 CAR-T for the treatment of T lymphoblastic lymphoma: a case report and literature review.
Xiang Min WANG ; Yi ZHOU ; Jiao Li ZHANG ; Hong Yuan ZHOU ; Qing ZHANG ; Qian SUN ; Hu Jun LI ; Lin Yan XU ; Shu Na YAO ; Zhi Hua YAO ; Dong Mei YAN ; Kai Lin XU ; Wei SANG
Chinese Journal of Hematology 2023;44(10):864-865
4.Expression and Significance of PD-1, TIM-3 and VISTA on T Cell of Acute Myeloid Leukemia Patients.
Meng-Jun GE ; Kai-Lin XU ; Ting XU ; Ya-Nan TANG ; ZHen-Yu LI ; Zhi-Ling YAN ; Hai-Ying SUN ; Hai CHENG ; Feng ZHU ; Wei SANG ; Yi-Hong HUANG ; Ting-Ting QIU ; De-Peng LI
Journal of Experimental Hematology 2020;28(3):748-752
OBJECTIVE:
To study the expression of multiple negative costimulatory molecules on peripheral blood T cells in patients with acute myeloid leukemia (AML) and its affection on prognosis.
METHODS:
The peripheral blood samples from patients with newly diagnosed AML, complete remission (CR), and no-remission (NR) were collected, the expression levels PD-1、VISTA and TIM-3 in CD4 and CD8 T cells were detected by flow cytometry , and the clinical data of patients were analyzed.
RESULTS:
The expression levels of PD-1、VISTA and TIM-3 of CD4 and CD8 T cells in the newly diagnosed AML patients were significantly higher than those in control group (P<0.05). The expression levels of PD-1、TIM-3 and VISTA of CD4 and CD8 T cells in the CR group were significantly lower than those in newly diagnosed and the NR group (P<0.05). The TIM-3 expression level positively correlated with VISTA expression level of CD4 and CD8 T cells in newly diagnosed AML patients (r=0.85 and 0.73). The VISTA and PD-1 expression level of CD4 T cells in newly diagnosed AML, NR after first induction chemotherapy and high risk patients significantly increased (P<0.05), the TIM-3 expression level of CD8 T cells in high risk group significantly increased (P<0.05), and the VISTA expression level of CD8 T cells in CBFβ-MYH11 mutation-positive group significantly decreased (P<0.05).
CONCLUSION
The expression of PD-1、TIM-3 and VISTA in AML peripheral blood T cells may be involved in the immune escape of AML and can be the targets of treatment for acute myeloid leukemia patients.
B7 Antigens
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CD8-Positive T-Lymphocytes
;
Flow Cytometry
;
Hepatitis A Virus Cellular Receptor 2
;
Humans
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Leukemia, Myeloid, Acute
;
Programmed Cell Death 1 Receptor
5.Effect of Asparaginase on Diffuse Large B-Cell Lymphoma Cell Apoptosis and Its Related Mechanism.
Xiang GAO ; Jun JIAO ; Meng-Di LIU ; Yuan-Yuan QIN ; Lin-Yan XU ; Wei SANG ; Kai-Lin XU
Journal of Experimental Hematology 2019;27(5):1482-1489
OBJECTIVE:
To investigate the effects and its potential mechanism of asparaginase on proliferation, cell cycle and apoptosis of diffuse large B-cell lymphoma (DLBCL) cell lines.
METHODS:
CCK-8 assay was used to detect the effect of asparaginase on proliferation of DLBCL cell lines. Flow cytometry was used to analyze cell cycle and apoptosis. Western blot was used to analyze apoptosis and its potential mechanism.
RESULTS:
Asparaginase obviously inhibited the proliferation of multiple DLBCL cell lines and caused G/G cell arrest. Furtherly, asparaginase inhibited the expression of HIF-1α which related to poor prognosis of patients with DLBCL, up-regulated the expression of DR4 and caspase 8, reduce the expression of c-FLIP. Meanwhile, asparaginase induced the expression of pro-apoptotic protein BAX and inhibited the expression of anti-apoptotic protein MCL-1.
CONCLUSION
Asparaginase can inhibit the proliferation of DLBCL cell lines, cause the arrest of cells in G/G and induce apoptosis via the endogenous and exogenous apoptotic pathways.
Apoptosis
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Asparaginase
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Cell Line, Tumor
;
Cell Proliferation
;
Humans
;
Lymphoma, Large B-Cell, Diffuse
6.Significance of Peripheral Blood Lymphatic to Monocyte Ratio in the Progress of PGI-DLBCL.
Ke-Meng SUN ; Wei SANG ; Lin-Yan XU ; Dong-Mei YAN ; Xu-Guang SONG ; Cai SUN ; Xiao-Kun SUN ; Kai-Lin XU
Journal of Experimental Hematology 2019;27(4):1118-1122
OBJECTIVE:
To explore the significance of lymphocyte to monocyte ratio (LMR) in the disease progress of primary gastrointestinal diffuse large B-cell lymphoma (PGI-DLBCL).
METHODS:
The clinical data of 43 patients diagnosed as PGI-DLBCL in our hospital from January 2011 to December 2015 were collected, and the disease progress was followed up.
RESULTS:
According to the ROC curve, the threshold value of LMR for 2 years PFS (%) of PGI-DLBCL patients was 2.6. Unvariate analysis showed that LMR (P<0.05), large enclosed mass lesion (P<0.01) and IPI (P<0.05) were prognostic factors affecting PFS, the COX regression model multivariate analysis showed that LMR<2.6 [ (risk ratio (RR)=3.083, 95%CI 1.828-8.313, P<0.01], and large enclosed mass lesions (RR=2.718, 95%CI 1.339-6.424, P<0.05) were the independent adverse prognostic factor for two years PFS.
CONCLUSION
Both LMR<2.6 and large enclosed mass lesions relate with the progress of PGI-DLBCL.
Humans
;
Leukocyte Count
;
Lymphocytes
;
Lymphoma, Large B-Cell, Diffuse
;
Monocytes
;
Prognosis
;
Retrospective Studies
7.Multivariate Analysis of Factors Influencing Recovery from Hemorrhagic Cystitis after Allo-HSCT.
Bing ZHANG ; Chen-Yuan HU ; Di YU ; Huan-Xin ZHANG ; Dong-Mei YAN ; Wei SANG ; Zhen-Yu LI ; Zhi-Ling YAN ; Kai-Lin XU
Journal of Experimental Hematology 2019;27(3):976-982
OBJECTIVE:
To analyze the incidence of hemorrhagic cystitis (HC) after allogeneic hematopoietic stem cell transplantation and the factors affecting HC, so as to provide clinical evidence for further treatment of HC.
METHODS:
The HC of 113 patients after allogeneic hematopoietic stem cell transplantation in Affiliated Hospital of Xuzhou Medical University between the years 2014-2016 was analyzed respectively. All cases of HC were divided into HC group and non-HC(control) group. The follow-up time: from preeonditionig day to 180 d after transplantation. The 10 clinical parameters were selected for univariate analysis with COX regression analysis: sex, age (<25 years and 25 years), primary disease, conditioning regimen with anti-thymoglobulin(ATG), sex-mismatch in recipients, haploidential HSCT, cytomegalovirus (CMV) viremia, EB viremia, graft-versus-host disease (GVHD), and primary disease relapse, the factors significant at the 0.1 level in univariate analysis should be further evaluated by multivariate analysis using a COX regression analysis. The difference was significant at P<0.05 in multivariate analysis.
RESULTS:
The HC occured in 31 of 113 patients (27.4%), with 5 cases of grade I (5.5%), 19 of grade II (16.8%), 5 of grade III (4.4%), and 2 of grade IV (1.8%). The median time of HC onset was 37 days (26-70 d) after transplantation. The median duration of HC was 14 days (5-55d). Univariate analysis showed that conditioning with anti-thymoglobulin (ATG) (RR=6.170, 95%CI: 1.875-20.306, P<0.01), CMV viremia (RR=7.633, 95%CI:2.318-25.133) (P<0.01), haploidentical HSCT (RR=0.307, 95%CI:0.137-0.686, P<0.01), GVHD (RR=1.891, 95%CI:0.918-3.898, P>0.05) were the risk factors for recovery from HC. The multivatiate analysis of above-mentioned risk factors with statistical significance showed that only CMV viremia (RR=4.770, 95%CI: 1.394-16.326, P<0.05) was the indentified risk factor affecting the recovery from HC.
CONCLUSION
Monitoring CMV viremia and antivirotic treatment are effective measurs to prevent the occurrence of HC and promote the recovery from HC.
Cystitis
;
Graft vs Host Disease
;
Hematopoietic Stem Cell Transplantation
;
Humans
;
Multivariate Analysis
;
Retrospective Studies
;
Risk Factors
9.Effect of IKK2 Inhibitor LY2409881 on Diffuse Large B-Cell Lymphoma Cell Apoptosis and Its Mechanism.
Pu YANG ; Xiang GAO ; Jun JIAO ; Lin-Yan XU ; Wei SANG ; Xiao-Kun SUN ; Kai-Lin XU
Journal of Experimental Hematology 2018;26(4):1086-1092
OBJECTIVETo investigate the effects and its potential mechanism of IKK2 inhibitor LY2409881 on proliferation, cell cycle and apoptosis of diffuse large B-cell lymphoma (DLBCL) cell lines.
METHODSCCK8 assay was used to detect the effect of LY2409881 on proliferation of DLBCL cell lines; Flow cytometry was used to analyze cell cycle; Western blot was used to analyze apoptosis and its potential mechanism.
RESULTSLY2409881 inhibited the proliferation of multiple DLBCL cell lines obviously, and caused G cell arrest. Furtherly, LY2409881 inhibited the expression of c-FLIP, induced the activation of DR4 and caspase 8. Meanwhile, LY2409881 induced the expression of pro-apoptotic protein BAX and inhibited the expression of anti-apoptotic protein MCL-1 and BCL-2.
CONCLUSIONLY2409881 inhibits the proliferation of DLBCL cell lines, causes G cell arrest and induces apoptosis via the endogenous and exogenous apoptotic pathways.
Apoptosis ; Cell Line, Tumor ; Cell Proliferation ; Humans ; I-kappa B Kinase ; Lymphoma, Large B-Cell, Diffuse ; Pyrimidines ; Thiophenes
10.Comparison of endothelial differentiation capacity of adipose-derived stem cells and bone marrow mesenchymal stem cells from rats.
Li-Jun FAN ; Qian-Rong XIAO ; Kai-Sang LIN ; Si-Yu WANG ; Zhang-Fang LI ; Chen-Zhong LI ; Tong ZHANG ; Ya-Juan HAN ; Jie SHEN
Journal of Southern Medical University 2016;36(9):1247-1254
OBJECTIVETo compared the differentiation capacity of rat adipose-derived stem cells (ASCs) and bone marrow mesenchymal stem cells (BMSCs) into endothelial cells.
METHODSRat BMSCs and ASCs were isolated, cultured and identified for cell surface markers using flow cytometry. The cell growth curves were drawn by CCK-8 assay, and the cells in active growth were induced for endothelial differentiation following standard protocols. On day 21 of induction, the cells were examined for mRNA expressions of endothelial cell specific markers CD31, KDR, and vWF using qPCR. Immunostaining was performed to observe the expression of CD31 on the cells. The induced cells were also tested for Dil-labeled acetylated low-density lipoprotein (ac-LDL) uptake ability. The tube-forming ability of the induced cells was verified on Matrigel.
RESULTSWe successfully isolated rat ASCs and BMSCs. Morphologically, ASCs were similar with BMSCs, both having long spindle-shaped and fibroblast-like morphology. Flow cytometry showed that both BMSCs and ASCs had high expressions of mesenchymal markers CD29 and CD90 and a low expression of hematopoietic cell surface markers CD45. CCK-8 assay showed that ASCs proliferated more quickly than BMSCs. The cells with induced endothelial differentiation exhibited increased levels of CD31, KDR, and vWF mRNA expressions and immunofluorescent staining identified CD31 antigen expression on the cell membrane. Fluorescence microscopy revealed red fluorescence in the induced cells suggesting uptake of Dil-Ac-LDL by the cells. The induced cells were capable of forming tube on Matrigel, confirming their identity of endothelial cells.
CONCLUSIONBoth rat BMSCs and ASCs can be induced to differentiate into endothelial cells, but ASCs differentiate more quickly into endothelial cells and possess a stronger proliferation ability, suggesting its greater potential than BMSCs in future applications.

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