Impact of luteinizing hormone suppression on hematopoietic recovery after intensive chemotherapy in patients with leukemia

Allogeneic stem cell transplantation in the treatment of acute myeloid leukemia: An overview of obstacles and opportunities

As an important treatment for acute myeloid leukemia, allogeneic hematopoietic stem cell transplantation (allo-HSCT) plays an important role in reducing relapse and improving long-term survival. With rapid advancements in basic research in molecular biology and immunology and with deepening understanding of the biological characteristics of hematopoietic stem cells, allo-HSCT has been widely applied in clinical practice. During allo-HSCT, preconditioning, the donor, and the source of stem cells can be tailored to the patient’s conditions, greatly broadening the indications for HSCT, with clear survival benefits. However, the risks associated with allo-HSCT remain high, i.e. hematopoietic reconstitution failure, delayed immune reconstitution, graft-versus-host disease, and post-transplant relapse, which are bottlenecks for further improvements in allo-HSCT efficacy and have become hot topics in the field of HSCT. Other bottlenecks recognized in the current treatment of individuals diagnosed with acute myeloid leukemia and subjected to allo-HSCT include the selection of the most appropriate conditioning regimen and post-transplantation management. In this paper, we reviewed the progress of relevant research regarding these aspects.

Therapeutic Advances in Immunotherapies for Hematological Malignancies

Following the success of immunotherapies such as chimeric antigen receptor transgenic T-cell (CAR-T) therapy, bispecific T-cell engager therapy, and immune checkpoint inhibitors in the treatment of hematologic malignancies, further studies are underway to improve the efficacy of these immunotherapies and to reduce the complications associated with their use in combination with other immune checkpoint inhibitors and conventional chemotherapy. Studies of novel therapeutic strategies such as bispecific (tandem or dual) CAR-T, bispecific killer cell engager, trispecific killer cell engager, and dual affinity retargeting therapies are also underway. Because of these studies and the discovery of novel immunotherapeutic target molecules, the use of immunotherapy for diseases initially thought to be less promising to treat with this treatment method, such as acute myeloid leukemia and T-cell hematologic tumors, has become a reality. Thus, in this coming era of new transplantation- and chemotherapy-free treatment strategies, it is imperative for both scientists and clinicians to understand the molecular immunity of hematologic malignancies. In this review, we focus on the remarkable development of immunotherapies that could change the prognosis of hematologic diseases. We also review the molecular mechanisms, development processes, clinical efficacies, and problems of new agents.

Clinical efficacy and safety of comprehensive nursing intervention in acute leukemia patients with myelosuppression after chemotherapy

OBJECTIVE

To investigate the clinical efficacy and safety of comprehensive nursing intervention in acute leukemia patients with myelosuppression after chemotherapy.

METHODS

Eighty acute leukemia patients with myelosuppression after chemotherapy admitted to our hospital from April 2018 to December 2021 were selected and divided, according to the nursing mode, as the conventional group (n=40) with routine nursing mode and the comprehensive group (n=40) with the comprehensive nursing mode. Patients' anxiety (Self-Rating Anxiety Scale, SAS) scores, depression (Self-Rating Depression Scale, SDS) scores, occurrence of complications, nursing satisfaction, nursing experience, complaint rate, and Visual Analogue Scale (VAS) score were compared between the two groups so as to analyze the efficacy and safety of comprehensive nursing intervention. The improvement of quality of life in the two groups was observed and analyzed using the short form of quality of life measurement (WHOQOL-BREF). Logistic regression analysis was performed to analyze the risk factors for nosocomial infection in patients with comprehensive nursing intervention.

RESULTS

No statistically significant differences in SAS and SDS scores between the two groups were found prior nursing (P>0.05), while after nursing, scores in the two groups both decreased, with those in the comprehensive group significantly lower than in the conventional group (P<0.05). The incidence of complications after nursing in the comprehensive group was significantly lower than that in the conventional group, and the difference was statistically significant (P<0.05). Nursing satisfaction of patients in the comprehensive group were significantly higher than that in the conventional group (P<0.05). After nursing, the nursing experience of the comprehensive group was significantly better than that of the conventional group (P<0.05); the complaint rate of the comprehensive group was significantly lower than that of the conventional group (P<0.05); before nursing, there was no significant difference in the VAS scores between the two groups of patients (P>0.05); after nursing, the VAS score of the comprehensive group was significantly lower than that of the conventional group (P<0.05). Before nursing, there was no significant difference in WHOQOL-BREF scores between the two groups (P>0.05); after nursing, the comprehensive group was higher than the conventional group. Among the 40 patients in the comprehensive nursing group, 15 patients developed infection. The number of neutrophils, age above 40, white blood cell count, hemoglobin content, high-intensity chemotherapy and glucocorticoid therapy were independent risk factors for nosocomial infection in patients with comprehensive nursing intervention (P<0.05).

CONCLUSION

Comprehensive nursing intervention for patients with myelosuppression after chemotherapy for acute leukemia can effectively improve the patient's nursing experience, reduce the patient's complaint rate, alleviate the patient's physical pain, relieve the patient's anxiety, depression and other negative emotions, and reduce the patient's complications, suggesting that comprehensive nursing intervention exerts better clinical efficacy and has high safety, which merits promotion clinically.