Objective:To investigate the efficacy and safety of obinutuzumab combined with short-course dexamethasone in patients with relapsed immune thrombocytopenia (ITP) who had previously been treated with rituximab.Methods:A retrospective case series study was conducted. A total of 8 patients with relapsed ITP after treatment with rituximab who received obinutuzumab combined with short-course dexamethasone between January 2023 and January 2024 in the First Affiliated Hospital of Harbin Medical University were collected. The clinical characteristics, changes in platelet counts, changes in peripheral blood B-lymphocyte counts, treatment outcome and treatment-related adverse events were analyzed.Results:There were 1 male and 7 females in 8 patients with relapsed ITP after treatment with rituximab. The median age [ M ( Q1, Q3)] of the 8 enrolled patients was 52.5 (40.5, 56.0) years. The median relapsed times was 2.0 (2.0, 2.5) times and the median course of disease was 16.0 (13.0, 18.5) months. The platelet count increased from 8.73 (5.79, 11.65)×10 9/L pre-treatment to 180.00 (83.40, 255.00)×10 9/L post-treatment, and the difference was statistically significant ( Z = -2.37, P = 0.018); conversely, peripheral blood B-lymphocyte count decreased from 322.59 (148.29, 403.07) × 10 9/L pre-treatment to 1.23 (0.57, 1.76) ×10 9/L post-treatment, and the difference was statistically significant ( Z = -2.52, P = 0.012). After obinutuzumab and short-course dexamethasone treatment, 6 patients achieved complete remission, 1 case showed response, and 1 case had no response. No severe adverse events were observed during treatment and follow-up in all patients. Conclusions:Obinutuzumab combined with short-course dexamethasone appears to be effective in treating relapsed ITP patients after treatment with rituximab, and its safety is good.

Objective The correlation between blood system damage and splenomegaly in brucellosis patients and their effects on liver function were analyzed.Methods Data were retrospectively collected in patients with blood system damage diagnosed of brucellosis from 2005 to 2016 at the Department of Infectious Disease of Harbin Medical University First Affiliated Hospital.At the same time,test results of the selected patients liver function,ferritin,D-dimer and abdominal ultrasonography were collected.According to splenomegaly or not,patients were divided into splenomegaly and no-splenomegaly,and any difference in hematopoietic damage caused by splenomegaly or not was analyzed.Results Of the 210 patients (101 cases of splenomegaly,109 cases without splenomegaly),170 were male (80.95％),40 were women (19.05％),and age was (39.65 ± 10.79) years.The patients with abnormal blood system were 103 cases (49.05％);in splenomegaly group there were 58 cases of blood system damage;in no-splenomegaly group there were 45 cases of blood system damage,and there was a statistically significant difference between the two groups (x2 =5.465,P ＜ 0.05);151 cases of brucellosis had elevated aminotransferase (71.90％),but transaminase elevated or not in different intervals of age groups was not statistically different between liver function and age (x2 =10.192,P ＞ 0.05).Ferritin increased in 26 cases (12.38％).D-dimer increased in 22 cases (10.48％).There were 93 patients with splenomegaly and transaminase elevation,and 58 patients with non-splenomegaly and transaminase elevation.There were significant differences between the two groups (x2 =39.204,P ＜ 0.05).Conclusion Brucellosis can cause blood system damage,probably caused by splenomegaly;and patients with brucellosis are often accompanied by elevated transaminases.

OBJECTIVETo investigate the cardiac effect of QT interval prolongation in the treatment of acute promyelocytic leukemia (APL) with arsenic trioxide (As(2)O(3)), and the relationship between QT and serum arsenic concentration.

METHODSBlood serum arsenic concentrations of thirty APL patients were determined at 2 hours, 4 hours, 8 hours, and 24 hours after As(2)O(3) injection using atomic fluorophotometry. Cardiac functions were measured simultaneously using a 12-lead body-surface electrocardiogram (ECG). Q-T intervals were manually measured, and then corrected using Bazett's formula (QTc). QT dispersion (QTd) was also calculated. In order to assess the effects of arsenic on the symptoms of anemia, twenty-four anemia patients were divided into two groups on the basis hemoglobin concentration: Group 1 (Hb > or = 90 g/L), and Group 2 (60 g/L < or = Hb < 90 g/L). QTc and QTd of these patients were also manually measured.

RESULTSAll QT intervals of APL patients treated with As(2)O(3) injection were prolonged [32.2 ms (27, 41 ms); P < 0.05], but the changes of QTd were not prominent [3 ms (-8, 7 ms), P > 0.05]. There was a delay of 2 hours in maximum QTc following peaks in serum arsenic concentration. Changes in QTc and QTd of the two anemic groups were not prominent.

CONCLUSIONSAs(2)O(3) can prolong QTc intervals in APL patients, but the effects are delayed compared to peak serum arsenic concentrations. As(2)O(3) has no prolongation effect on QTd. Mild and moderate anemia do not effect QTc and QTd.

Arsenicals ; pharmacology ; therapeutic use ; Electrocardiography ; drug effects ; Humans ; Leukemia, Promyelocytic, Acute ; drug therapy ; Oxides ; pharmacology ; therapeutic use