To retrospectively analyze the safety and efficacy of low dose subcutaneous decitabine combined with arsenic trioxide in patients with intermediate or high-risk myelodysplastic syndrome (MDS). Three of the total 11 MDS patients achieved complete remission (CR) and 6 achieved hematological improvement (HI), 1 stable disease (SD), and 1 progressive disease (PD). One patient was treated with allogeneic hematopoietic stem cell transplantation (allo-HSCT). The median follow-up time was 413(90-1 275) d. Nine patients were still alive. Low dose subcutaneous decitabine combined with arsenic trioxide can be an alternative regimen for intermediate or high-risk MDS patients.

Objective: To analyze the efficacy and safety of lenalidomide combined with interferon (IFN) and interleukin-2 (IL-2) for treatment of refractory/relapsed or minimal residual disease (MRD)-positive acute myelogenous leukemia (AML). Methods: Twelve patients with AML who were hospitalized in the Affiliated Cancer Hospital of Zhengzhou University from August 2013 to May 2019 were selected. These patients were previously treated with thalidomide combined with IFN and IL-2, and then treated with combined with IFN and IL-2. According to the Frence-American-British (FAB) classification system, there was 1 case of M₀, 1 case of M₁, 4 cases of M_2a, 3 cases of M_2b, 1 case of M_4EO, and 2 cases of M_5b. There were 2 cases with FLT3-ITD mutation-positive, 1 case with c-kit mutation-positive. There were 2 cases in the low-risk group, 7 cases in the intermediate-risk group, and 3 cases in the high-risk group. Three cases were refractory AML, 7 cases were relapsed AML (including 3 cases of recurrence once, 4 cases of recurrence twice; 5 cases of recent recurrence, 2 cases of long-term recurrence), 2 cases were MRD-positive. The efficacy and adverse reactions of 12 cases were evaluated. Results: Twelve patients had received more than one cycle therapy of lenalidomide combined with IFN and IL-2, of which 4 patients achieved morphological complete remission (CR), 2 patients had CR with incomplete recovery of blood cells (CRi), 4 patients had no remission, 1 case had a decrease in MRD, and 1 case had an increase in MRD, and the total effective (CR+ CRi+ partial remission+ MRD decreased) was in 7 cases. There were no adverse reactions such as rash, constipine, bradycardia and peripheral neuritis; six patients had grade Ⅲ or higher experienced myelosuppression. No patients died of complications during the treatment, and the duration of remission of all patients was 2-20 months. Conclusion Lenalidomide combined with IFN and IL-2 for treatment of refractory/relapsed or MRD-positive AML is effective, and it can reduce the MRD value in MRD-positive patients, it could be a new treatment method for AML.

Objective: To compare the effects of video assisted thoracoscopic surgery(VATS) of intercostal surgery and by subxiphoid surgical treatment for early thymoma, to investigate the feasibility and clinical application value of VATS subxiphoid surgical treatment for thymoma. Methods: From January 2014 to January 2017, 30 thymoma patients who met the diagnostic criteria of the Masaoka stageⅠ~Ⅱ in the People's Hospital of Jingshan County were selected, and were divided into two groups according to the different surgical methods.The observation group (12 patients) received VATS underwent subxiphoid surgery, 18 patients in the control group were treated with VATS intercostal surgery.The operation time, blood loss, drainage time, length of stay, degree of pain, antibacterial time, incidence rate of complication and patients' satisfaction were compared between the two groups. Results: The preoperative general data between the two groups had no statistically significant differences(all P>0.05). The operation time, intraoperative bleeding volume, postoperative drainage time, antibacterial time, postoperative hospitalization time in the observation group were (102.2±26.6)min, (105.9±29.4)mL, (3.8±1.4)d, (6.8±0.3)d, (8.5±1.6)d, respectively, which in the control group were (124.6±35.1)min, (255.6±82.8)mL, (5.2±1.2)d, (9.3±0.8)d, (14.4±1.8)d, respectively, there were statistically significant differences between the two groups(t=1.516, 2.517, 2.857, 4.462, 3.327, all P<0.05). The incidence rate of complications (8.33% vs.16.67%), satisfaction(82% vs.59%) between the two groups had statistically significant differences(χ²=4.013, 4.427, all P<0.05). During the follow-up period, there was no recurrence or metastasis in the two groups. Conclusion Compared with VATS intercostal surgery, VATS subxiphoid approach for surgical treatment of thymoma can reduce surgical trauma and reduce the incidence of complications, reduce the pain of patients, shorten the hospitalization time, its curative effect is more significant.

Objective: To detect the expression of CRLF2 in adult Ph negative acute B lymphocytic leukemia (B-ALL) in newly diagnosed cases, and to investigate the relationship between CRLF2 and the general clinical characteristics, efficacy and prognosis. Methods: 103 cases of newly diagnosed adult B-ALL patients were investigated from Apr 2016 to Dec 2017 in the Department of Hematology, Henan Cancer Hospital. Bone marrow samples was used to detect the expression of CRLF2 in leukemic cells. The expression of CRLF2 ≥20% was defined as CRLF2-high group and <20% was defined as CRLF2-low group. The clinical characteristics and prognosis of the two groups were compared. Results: The Median overall survival (OS) and disease free survial (DFS) in CRLF2-high group were 9.0 months and 4.25 months, respectively. CRLF2-low group were 15.5 months and 10.25 months, respectively. There was a statistically significant difference in median OS and DFS between the two groups (P=0.007, P=0.000) . The 18-month OS and DFS in CRLF2-high group were 38.6% and 25.1%, respectively. CRLF2-low group were 57.8% and 42.3%, respectively. Multivariate analysis showed high expression of CRLF2 was an independent risk factor for OS (HR=2.991, 95% CI 1.429-6.261, P=0.004) and DFS (HR=2.374, 95%CI 1.146-4.960, P=0.041) in patients. Conclusion Patients with high expression of CRLF2 had poor prognosis.

Objective To analyze the clinical effect of two different drainage methods after video-assisted thoracoscopic(VATS) lobectomy,and to explore the safety,reliability and practicability of clinical application of thoracic drainage tube in Department of Thoracic Surgery.Methods 1 120 cases who underwent VATS lobectomy were selected.According to different drainage methods,they were divided into two groups.560 cases in the observation group received 16-18 silicone elastic drainage,560 patients in the control group received 28-30 traditional silicone chest tube drainage.After drainage,drainage time,residual pleural fluid volume,pain score,catheter site infection rate,the incidence of pneumothorax after extubation,postoperative incidence rate of pulmonary atelectasis were compared between the two groups.Results The postoperative pleural flow of the observation group was (816 ±176) mL,which was less than (1 580 ± 204) mL of the control group,the difference was statistically significant (P =0.006).The drainage days [(5.01 ± 0.57) d],the pleural fluid volume [(2.1 ± 0.6) cm],the catheter site infection rate (0.017％),extubation pneumothorax rate (0.017％),incidence rate of postoperative atelectasis (0.16％) in the observation group were lower than those in the control group [(8.45 ± 1.24) d,(4.3 ± 0.9) cm,0.031％,0.053 ％,0.031％],the differences were statistically significant (all P ＜ 0.05).The NRS pain score between the two groups had statistically significant difference (x2 =16.24,P ＜ 0.001).Conclusion Curative effect of thin tubedrainage after VATS lung resection is safe and reliable,and can reduce the patients' postoperative pain discomfort caused by drainage tube and related complications,it is worthy of clinical popularization and application.

To retrospectively analyze the safety and efficacy of low dose subcutaneous decitabine regimen in patients with acute myeloid leukemia (AML) and intermediate-or higer-risk myelodysplastic syndrome (MDS).Of 6 AML cases,2 achieved complete remission (CR),2 with partial remission(PR),1 with stable disease(SD),1 with progressive disease(PD).As to the 8 MDS patients,one achieved CR and 6 with hematologic improvement (HI),1 case SD.Low dose subcutaneous decitabine regimen could be an alternative choice of older AML or MDS patients.

Objective To observe the clinical response and safety of second-generation tyrosine kinase inhibitor dasatinib in the treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph + ALL). Methods The clinical data of 10 adult Ph + ALL patients treated with dasatinib were analyzed with review of literatures. Results All the 10 Ph+ ALL patients treated with dasatinib achieved remission in 7 weeks, including 9 cases of complete remission [7 cases achieved complete molecular remission (CRm) in 13 weeks]. The median overall survival time (OS) was 13.8 months (5-33), and the median disease-free survival (DFS) time was 10.8 months (4-25). There were 3 cases of pleural effusion, 4 cases of Ⅳ degree of bone marrow suppression and 6 cases of extremely low blood platelet, which could be that was improved via by symptomatic treatment and, with no case of the death occurred during the treatment of dasatinib, the safety was high. Conclusion Dasatinib can deepen molecular biological reaction and prolonged the survival time of patients in the treatment of adult Ph+ ALL, with high remission rate and safety, and which can be considered as first-line treatment.

Humans ; Leukemia, Myeloid ; complications ; Lymphoma ; complications

Bufanolides ; therapeutic use ; Hematologic Neoplasms ; drug therapy ; Humans ; Recurrence

OBJECTIVETo explore the clinical features and survival of patients with CD56 expression in de- novo acute myeloid leukemia（AML）with t（8;21). .

METHODSClinical data of 82 de novo AML with t（8;21）who were newly diagnosed from Jan 2008 to Apr 2014 were analyzed retrospectively, 50 expressed CD56 and 32 not. Clinical characteristics and prognoses were compared between patients expressing and nonexpressing CD56.

RESULTSThere were no statistically significant differences in terms of age, gender, white blood cell count（WBC）, percentage of bone marrow blasts, extramedullary infiltration rate, the early mortality or the presence of additional cytogenetic abnormalities between CD56 + and CD56- groups（P＞0.05). The expressions of lymphatic antigens CD19 between CD56 + and CD56- groups showed significant difference （30.0% vs 53.1% , P=0.036). The complete remission and 3-year overall survival（OS）showed no significant differences between CD56+ and CD56-groups, while 3- year disease- free survival（DFS）showed significant differences（25.8% vs 46.9%, P=0.014). Multivariable analysis for DFS identified CD56 positivity as an independent predictor. DFS of who received allogeneic hematopoietic stem cell transplantation（HSCT）was better than those treated with intermediate- dose cytarabine/high dose cytarabine（IDAC）as postremission therapy.

CONCLUSIONThe expression of CD56 in de-novo AML with t（8;21) appeared to be associated with poorer prognosis.

Bone Marrow ; CD56 Antigen ; Chromosome Aberrations ; Chromosomes, Human, Pair 21 ; Chromosomes, Human, Pair 8 ; Cytarabine ; Disease-Free Survival ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia, Myeloid, Acute ; Prognosis ; Remission Induction ; Retrospective Studies ; Survival Analysis