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Zhang XS, Liu BC, Du X, Zhang YL, Xu N, Liu XL, Li WM, Lin H, Liang R, Chen CY, Huang J, Yang YF, Zhu HL, Pan L, Wang XD, Li GH, Liu ZG, Zhang YQ, Liu ZF, Hu JD, Liu CS, Li F, Yang W, Meng L, Han YQ, Lin LE, Zhao ZY, Tu CQ, Zheng CF, Bai YL, Zhou ZP, Chen SN, Qiu HY, Yang LJ, Sun XL, Sun H, Zhou L, Liu ZL, Wang DY, Guo JX, Pang LP, Zeng QS, Suo XH, Zhang WH, Zheng YJ, Jiang Q. [To compare the efficacy and incidence of severe hematological adverse events of flumatinib and imatinib in patients newly diagnosed with chronic phase chronic myeloid leukemia]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:728-736. [PMID: 38049316 PMCID: PMC10630575 DOI: 10.3760/cma.j.issn.0253-2727.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Indexed: 12/06/2023]
Abstract
Objective: To analyze and compare therapy responses, outcomes, and incidence of severe hematologic adverse events of flumatinib and imatinib in patients newly diagnosed with chronic phase chronic myeloid leukemia (CML) . Methods: Data of patients with chronic phase CML diagnosed between January 2006 and November 2022 from 76 centers, aged ≥18 years, and received initial flumatinib or imatinib therapy within 6 months after diagnosis in China were retrospectively interrogated. Propensity score matching (PSM) analysis was performed to reduce the bias of the initial TKI selection, and the therapy responses and outcomes of patients receiving initial flumatinib or imatinib therapy were compared. Results: A total of 4 833 adult patients with CML receiving initial imatinib (n=4 380) or flumatinib (n=453) therapy were included in the study. In the imatinib cohort, the median follow-up time was 54 [interquartile range (IQR), 31-85] months, and the 7-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.2%, 88.4%, 78.3%, and 63.0%, respectively. The 7-year FFS, PFS, and OS rates were 71.8%, 93.0%, and 96.9%, respectively. With the median follow-up of 18 (IQR, 13-25) months in the flumatinib cohort, the 2-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.4%, 86.5%, 58.4%, and 46.6%, respectively. The 2-year FFS, PFS, and OS rates were 80.1%, 95.0%, and 99.5%, respectively. The PSM analysis indicated that patients receiving initial flumatinib therapy had significantly higher cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) and higher probabilities of FFS than those receiving the initial imatinib therapy (all P<0.001), whereas the PFS (P=0.230) and OS (P=0.268) were comparable between the two cohorts. The incidence of severe hematologic adverse events (grade≥Ⅲ) was comparable in the two cohorts. Conclusion: Patients receiving initial flumatinib therapy had higher cumulative incidences of therapy responses and higher probability of FFS than those receiving initial imatinib therapy, whereas the incidence of severe hematologic adverse events was comparable between the two cohorts.
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Affiliation(s)
- X S Zhang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China
| | - B C Liu
- National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - X Du
- The Second People's Hospital of Shenzhen, Shenzhen 518035, China
| | - Y L Zhang
- Henan Cancer Hospital, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - N Xu
- Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - X L Liu
- Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - W M Li
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - H Lin
- First Hospital of Jilin University, Changchun 130021, China
| | - R Liang
- Xijing Hospital, Airforce Military Medical University, Xi'an 710032, China
| | - C Y Chen
- Qilu Hospital of Shandong University, Jinan 250012, China
| | - J Huang
- The Fourth Affiliated Hospital of Zhejiang University, Hangzhou 322000, China
| | - Y F Yang
- Institute of Hematology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - H L Zhu
- Institute of Hematology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - L Pan
- Institute of Hematology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - X D Wang
- Sichuan Academy of Medical Sciences Sichuan Provincial People's Hospital, Chengdu 610072, China
| | - G H Li
- Xi'an International Medical Center Hospital, Xi'an 710038, China
| | - Z G Liu
- Shengjing Hospital of China Medical University, Shenyang 110020, China
| | - Y Q Zhang
- The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Z F Liu
- The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - J D Hu
- Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - C S Liu
- First Hospital of Jilin University, Changchun 130021, China
| | - F Li
- The First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - W Yang
- Shengjing Hospital of China Medical University, Shenyang 110020, China
| | - L Meng
- Tongji Hospital of Tongji Medical College, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China
| | - Y Q Han
- The Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China
| | - L E Lin
- Hainan General Hospital, Haikou 570311, China
| | - Z Y Zhao
- Hainan General Hospital, Haikou 570311, China
| | - C Q Tu
- Shenzhen Baoan Hospital, Shenzhen University Second Affiliated Hospital, Shenzhen 518101, China
| | - C F Zheng
- Shenzhen Baoan Hospital, Shenzhen University Second Affiliated Hospital, Shenzhen 518101, China
| | - Y L Bai
- Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou 450003, China
| | - Z P Zhou
- The Second Hospital Affiliated to Kunming Medical University, Kunming 650106, China
| | - S N Chen
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Institute of Blood and Marrow Transplantation of Soochow University, Suzhou 215006, China
| | - H Y Qiu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Institute of Blood and Marrow Transplantation of Soochow University, Suzhou 215006, China
| | - L J Yang
- Xi'an International Medical Center Hospital, Xi'an 710117, China
| | - X L Sun
- The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - H Sun
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - L Zhou
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Z L Liu
- Huazhong University of Science and Technology Union Shenzhen Hospital, Nanshan Hospital, Shenzhen 518000, China
| | - D Y Wang
- Huazhong University of Science and Technology Union Shenzhen Hospital, Nanshan Hospital, Shenzhen 518000, China
| | - J X Guo
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, China
| | - L P Pang
- Peking University Shenzhen Hospital, Shenzhen 516473, China
| | - Q S Zeng
- The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - X H Suo
- Handan Central Hospital, Handan 057150, China
| | - W H Zhang
- First Hospital of Shangxi Medical University, Taiyuan 300012, China
| | - Y J Zheng
- First Hospital of Shangxi Medical University, Taiyuan 300012, China
| | - Q Jiang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China
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Zhang MY, Bao M, Shi DY, Shi HX, Liu XL, Xu N, Duan MH, Zhuang JL, Du X, Qin L, Hui WH, Liang R, Wang MF, Chen Y, Li DY, Yang W, Tang GS, Zhang WH, Kuang X, Su W, Han YQ, Chen LM, Xu JH, Liu ZG, Huang J, Zhao CT, Tong HY, Hu JD, Chen CY, Chen XQ, Xiao ZJ, Jiang Q. [Clinical and genetic characteristics of young patients with myeloproliferative neoplasms]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:193-201. [PMID: 37356980 PMCID: PMC10119718 DOI: 10.3760/cma.j.issn.0253-2727.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Objectives: To investigate the clinical and genetic features of young Chinese patients with myeloproliferative neoplasms (MPN). Methods: In this cross-sectional study, anonymous questionnaires were distributed to patients with MPN patients nationwide. The respondents were divided into 3 groups based on their age at diagnosis: young (≤40 years) , middle-aged (41-60 years) , and elderly (>60 years) . We compared the clinical and genetic characteristics of three groups of MPN patients. Results: 1727 assessable questionnaires were collected. There were 453 (26.2%) young respondents with MPNs, including 274 with essential thrombocythemia (ET) , 80 with polycythemia vera (PV) , and 99 with myelofibrosis. Among the young group, 178 (39.3%) were male, and the median age was 31 (18-40) years. In comparison to middle-aged and elderly respondents, young respondents with MPN were more likely to present with a higher proportion of unmarried status (all P<0.001) , a higher education level (all P<0.001) , less comorbidity (ies) , fewer medications (all P<0.001) , and low-risk stratification (all P<0.001) . Younger respondents experienced headache (ET, P<0.001; PV, P=0.007; MF, P=0.001) at diagnosis, had splenomegaly at diagnosis (PV, P<0.001) , and survey (ET, P=0.052; PV, P=0.063) . Younger respondents had fewer thrombotic events at diagnosis (ET, P<0.001; PV, P=0.011) and during the survey (ET, P<0.001; PV, P=0.003) . JAK2 mutations were found in fewer young people (ET, P<0.001; PV, P<0.001; MF, P=0.013) ; however, CALR mutations were found in more young people (ET, P<0.001; MF, P=0.015) . Furthermore, mutations in non-driver genes (ET, P=0.042; PV, P=0.043; MF, P=0.004) and high-molecular risk mutations (ET, P=0.024; PV, P=0.023; MF, P=0.001) were found in fewer young respondents. Conclusion: Compared with middle-aged and elderly patients, young patients with MPN had unique clinical and genetic characteristics.
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Affiliation(s)
- M Y Zhang
- Peking University People's Hospital, Beijing 100044, China
| | - M Bao
- Peking University People's Hospital, Beijing 100044, China
| | - D Y Shi
- Peking University People's Hospital, Beijing 100044, China
| | - H X Shi
- Peking University People's Hospital, Beijing 100044, China
| | - X L Liu
- Nanfang Hospital, Southern Medical University, Guangzhou 510080, China
| | - N Xu
- Nanfang Hospital, Southern Medical University, Guangzhou 510080, China
| | - M H Duan
- Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100730, China
| | - J L Zhuang
- Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100730, China
| | - X Du
- Department of Hematology, Shenzhen Second People's Hospital (First Affiliated Hospital of Shenzhen University), Shenzhen 518035, China
| | - L Qin
- The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, Zhenzhou 471003, China
| | - W H Hui
- Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - R Liang
- Xi Jing Hospital, The Fourth Military Medical University, Xi'an 710032, China
| | - M F Wang
- Second Hospital of Shanxi Medical University, Taiyuan 030001, China
| | - Y Chen
- Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - D Y Li
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
| | - W Yang
- Shengjing Hospital Affiliated to China Medical University, Shenyang 110020, China
| | - G S Tang
- Nanfang Hospital, Southern Medical University, Guangzhou 510080, China
| | - W H Zhang
- First Hospital of Shanxi Medical University, Taiyuan 300012, China
| | - X Kuang
- Kaifeng Central Hospital, Kaifeng 475000, China
| | - W Su
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China
| | - Y Q Han
- The Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China
| | - L M Chen
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - J H Xu
- Department of Hematology, the First Hospital of Qiqihar, Qiqihar 161005, China
| | - Z G Liu
- Shengjing Hospital Affiliated to China Medical University, Shenyang 110020, China
| | - J Huang
- The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 322000, China
| | - C T Zhao
- The Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - H Y Tong
- The First Affiliated Hospital of College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - J D Hu
- Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - C Y Chen
- Shandong University Qilu Hospital, Jinan 250012, China
| | - X Q Chen
- Northwest University School of Medicine, Xi'an 710069, China
| | - Z J Xiao
- Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, National Clinical Research Center for Blood Diseases, The State Key Laboratory of Experimental Hematology, Tianjin 300020, China
| | - Q Jiang
- Peking University People's Hospital, Beijing 100044, China
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Zheng YZ, Zheng H, Chen ZS, Hua XL, Le SH, Li J, Hu JD. [Mutational spectrum and its prognostic significance in childhood acute lymphoblastic leukemia based on next-generation sequencing technology]. Zhonghua Xue Ye Xue Za Zhi 2022; 43:19-25. [PMID: 35231988 PMCID: PMC8980667 DOI: 10.3760/cma.j.issn.0253-2727.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Indexed: 11/05/2022]
Abstract
Objective: This study analyzed the correlation between genetic mutation and prognostic significance in childhood acute lymphoblastic leukemia (ALL) . Methods: Targeted exome by next-generation sequencing (NGS) technology was used to carry out molecular profiling of untreated 141 children with ALL in Fujian Medical University Union Hospital from November 2016 to December 2019. Correlation of genetic features and clinical features and outcomes was analyzed. Results: Among the 141 pediatric patients with ALL, 160 somatic mutations were detected in 83 patients (58.9% ) , including 37 grade Ⅰ mutations and 123 grade Ⅱ mutations. Single nucleotide variation was the most common type of mutation. KRAS was the most common mutant gene (12.5% ) , followed by NOTCH1 (11.9% ) , and NRAS (10.6% ) . RAS pathway (KRAS, FLT3, PTPN11) , PAX5 and TP53 mutations were only detected, and NRAS mutations was mainly found in B-ALL while FBXW7 and PTEN mutations were only found, and NOTCH1 mutation was mainly detected in T-ALL. The average number of mutations detected in each child with T-ALL was significantly higher than in children with B-ALL (4.16±1.33 vs 2.04±0.92, P=0.004) . The children were divided into mutation and non-mutation groups according to the presence or absence of genetic variation. There were no statistically significant differences in sex, age, newly diagnosed white blood cell count, minimal or measurable residual disease monitoring results, expected 3-year event-free survival (EFS) and overall survival (OS) between the two groups (P>0.05) . On the other hand, the proportion of T-ALL and fusion gene negative children in the mutant group was significantly higher than the non-mutation group (P=0.021 and 0.000, respectively) . Among the patients without fusion gene, the EFS of children with grade I mutation was significantly lower than children without grade I mutation (85.5% vs 100.0% , P=0.039) . Among children with B-ALL, the EFS of those with TP53 mutation was significantly lower than those without TP53 mutation (37.5% vs 91.2% , P<0.001) . Conclusion: Genetic variation is more common in childhood ALL and has a certain correlation with clinical phenotype and prognosis. Therefore, targeted exome by NGS can be used as an important supplement to the traditional morphology, immunology, cytogenetics, and molecular biology classification.
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Affiliation(s)
- Y Z Zheng
- Department of Pediatric Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - H Zheng
- Department of Pediatric Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - Z S Chen
- Department of Pediatric Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - X L Hua
- Department of Pediatric Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - S H Le
- Department of Pediatric Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - J Li
- Department of Pediatric Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - J D Hu
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory, Fujian Medical University Union Hospital, Fuzhou 350001, China
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Zheng YZ, Wen JJ, Wang LY, Zheng H, Hua XL, Li J, Hu JD. [SET-NUP214-positive pediatric acute myeloid leukemia: a report of two cases]. Zhonghua Xue Ye Xue Za Zhi 2021; 42:769. [PMID: 34753234 PMCID: PMC8607043 DOI: 10.3760/cma.j.issn.0253-2727.2021.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Y Z Zheng
- Department of Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fuzhou 350001, China
| | - J J Wen
- Department of Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fuzhou 350001, China
| | - L Y Wang
- Department of Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fuzhou 350001, China
| | - H Zheng
- Department of Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fuzhou 350001, China
| | - X L Hua
- Department of Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fuzhou 350001, China
| | - J Li
- Department of Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fuzhou 350001, China
| | - J D Hu
- Department of Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fuzhou 350001, China
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Chen SZ, Xu JJ, Xiao TT, Weng YX, Chen DB, Zhang Y, Ren JH, Luo XF, Zheng ZH, Zheng XY, Chen ZZ, Hu JD, Yang T. [Clinical characteristics and prognostic risk factors analysis of carbapenem-resistant organism in the department of hematology]. Zhonghua Xue Ye Xue Za Zhi 2021; 42:563-569. [PMID: 34455743 PMCID: PMC8408494 DOI: 10.3760/cma.j.issn.0253-2727.2021.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Indexed: 11/04/2022]
Abstract
Objective: To study the distribution and drug resistance of Carbapenem-Resistant Organism (CRO) and to analysis the risk factors of CRO 30-day mortality. Methods: A total of 181 patients with CRO infection diagnosed in Department of Hematology, Fujian Medical University Union Hospital from January 2018 to June 2020 were retrospectively investigated. The clinical and laboratory data of the patients were collected, the prognosis of patients diagnosed with CRO infection in day 30 was followed up, and the risk factors of prognosis were analyzed. The clinical significance of Carbapenem-Resistant Enterobacteriaceae (CRE) active screening was further evaluated in the CRE subgroup. Results: Among the total of 181 CRO isolates, 47.2% were CRE, 37.0% were Pseudomonas aeruginosa, and 32.6% were Klebsiella pneumoniae, which were highly resistant to carbapenem and had high MIC value, 76.8% (139/181) of CRO were MIC of imipenem resistance≥16 μg/ml. The main sources of isolates were blood and sputum. The 30-day all-cause mortality rates of patients with CRO or CRE infection were (41.4±3.7) % and (44.7±5.4) %, respectively. The COX multivariate regression analysis showed that the level of procalcitonin >0.2 ng/ml and the MIC value of imipenem resistance ≥ 16 μg/ml were independent risk factors for 30-day mortality of CRO infected patients. The CRE subgroup analysis showed that MIC value of imipenem resistance ≥16 μg/ml were independent risk factors for 30-day mortality of CRE infected patients. The 30-day cumulative survival rate of patients with CRE active screening was higher than the patients without CRE active screening [ (68.0±9.3) % vs (50.0±6.5) %, P=0.21]. Conclusion: The high MIC value of imipenem resistance isolates seriously affects the prognosis of patients with CRO infection in the hematology department, and the mortality rate was high. CRE active screening is expected for early prevention, early diagnosis, and early treatment for high-risk patients.
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Affiliation(s)
- S Z Chen
- Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fuzhou 350001, China
| | - J J Xu
- Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fuzhou 350001, China
| | - T T Xiao
- Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fuzhou 350001, China
| | - Y X Weng
- Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fuzhou 350001, China
| | - D B Chen
- Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fuzhou 350001, China
| | - Y Zhang
- Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fuzhou 350001, China
| | - J H Ren
- Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fuzhou 350001, China
| | - X F Luo
- Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fuzhou 350001, China
| | - Z H Zheng
- Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fuzhou 350001, China
| | - X Y Zheng
- Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fuzhou 350001, China
| | - Z Z Chen
- Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fuzhou 350001, China
| | - J D Hu
- Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fuzhou 350001, China
| | - T Yang
- Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fuzhou 350001, China
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Hu Y, Jin J, Zhang Y, Hu JD, Li JM, Wei XD, Gao SJ, Zha JH, Jiang Q, Wu J, Mendes W, Wei AH, Wang JX. [Venetoclax with low-dose cytarabine for patients with untreated acute myeloid leukemia ineligible for intensive chemotherapy: results from the Chinese cohort of a phase three randomized placebo-controlled trial]. Zhonghua Xue Ye Xue Za Zhi 2021; 42:288-294. [PMID: 33979972 PMCID: PMC8120118 DOI: 10.3760/cma.j.issn.0253-2727.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the safety and efficacy of venetoclax with low-dose cytarabine (LDAC) in Chinese patients with acute myeloid leukemia (AML) who are unable to tolerate intensive induction chemotherapy. Methods: Adults ≥ 18 years with newly diagnosed AML who were ineligible for intensive chemotherapy were enrolled in this international, randomized, double-blind, placebo-controlled trial. Globally, patients (n=211) were randomized 2∶1 to either venetoclax with LDAC or placebo with LDAC in 28-d cycles, with LDAC on days 1-10. The primary endpoint was OS; the secondary endpoints included response rates, event-free survival, and adverse events. Results: A total of 15 Chinese patients were enrolled (venetoclax arm, n=9; placebo arm, n=6) . The median age was 72 years (range, 61-86) . For the primary analysis, the venetoclax arm provided a 38% reduction in death risk compared with the placebo[hazard ratio (HR) , 0.62 (95%CI 0.12-3.07) ]. An unplanned analysis with an additional 6 months of follow-up demonstrated a median OS of 9.0 months for venetoclax compared with 4.1 months for placebo. The complete remission (CR) rates with CR with incomplete blood count recovery (CRi) were 3/9 (33%) and 0/6 (0%) , respectively. The most common non-hematologic adverse effects (venetoclax vs placebo) were hypokalemia[5/9 (56%) vs 4/6 (67%) ], vomiting[4/9 (44%) vs 3/6 (50%) ], constipation[2/9 (22%) vs 4/6 (67%) ], and hypoalbuminemia[1/9 (11%) vs 4/6 (67%) ]. Conclusion: Venetoclax with LDAC demonstrated meaningful efficacy and a manageable safety profile in Chinese patients consistent with the observations from the global VIALE-C population, making it an important treatment option for patients with newly diagnosed AML who are otherwise ineligible for intensive chemotherapy.
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Affiliation(s)
- Y Hu
- Union Hospital Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - J Jin
- The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Y Zhang
- Nanfang Hospital of Southern Medical University, Guangzhou 510515, China
| | - J D Hu
- Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - J M Li
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - X D Wei
- The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
| | - S J Gao
- The First Hospital of Jilin University, Changchun 130021,China
| | - J H Zha
- AbbVie, Inc., Mettawa, Illinois, USA
| | - Q Jiang
- AbbVie, Inc., Mettawa, Illinois, USA
| | - J Wu
- AbbVie, Inc., Mettawa, Illinois, USA
| | - W Mendes
- AbbVie, Inc., Mettawa, Illinois, USA
| | - A H Wei
- The Alfred Hospital and Monash University, Melbourne, Victoria, Australia
| | - J X Wang
- Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China
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Zheng XY, Liang AB, Yang XZ, Fu JF, Hou M, Sun AN, Lu H, Jin J, Hu JD. [Pharmacokinetic study of domestic caspofungin compared with original caspofungin for empirical therapy in patients with persistent fever and agranulocytosis]. Zhonghua Xue Ye Xue Za Zhi 2021; 41:1031-1034. [PMID: 33445852 PMCID: PMC7840557 DOI: 10.3760/cma.j.issn.0253-2727.2020.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- X Y Zheng
- Department of Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fuzhou 350001, China
| | - A B Liang
- Department of Hematology, Tongji Hospital, Tongji University, Shanghai 200065, China
| | - X Z Yang
- Department of Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fuzhou 350001, China
| | - J F Fu
- Department of Hematology, Tongji Hospital, Tongji University, Shanghai 200065, China
| | - M Hou
- Department of Hematology, Qilu Hospital, Shandong University, Jinan 250012, China
| | - A N Sun
- Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - H Lu
- Department of Hematology, Jiangsu Province Hospital, Nanjing 210029, China
| | - J Jin
- Department of Hematology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - J D Hu
- Department of Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fuzhou 350001, China
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Zheng YZ, Pan LL, Li J, Chen ZS, Hua XL, Le SH, Zheng H, Chen C, Hu JD. [Clinical features and prognosis of ETV6-RUNX1-positive childhood B-precursor acute lymphocyte leukemia]. Zhonghua Xue Ye Xue Za Zhi 2021; 42:45-51. [PMID: 33677868 PMCID: PMC7957247 DOI: 10.3760/cma.j.issn.0253-2727.2021.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
目的 探讨ETV6-RUNX1融合基因阳性儿童急性前体B淋巴细胞白血病(B-ALL)的临床特征及预后。 方法 回顾性分析2011年4月至2020年5月福建医科大学附属协和医院小儿血液科收治的927例初诊B-ALL患儿的临床资料。根据ETV6-RUNX1检测结果,分为ETV6-RUNX1+组及ETV6-RUNX1−组,对比两组的临床特征及预后;182例ETV6-RUNX1+患儿规范治疗,其中144例接受中国儿童白血病协作组(CCLG)-ALL 2008方案治疗(CCLG-ALL 2008方案组),38例接受中国儿童癌症协作组(CCCG)-ALL 2015方案治疗(CCCG-ALL 2015方案组),对比两种方案的疗效、严重不良反应(SAE)发生率及治疗相关死亡(TRM)率。 结果 927例B-ALL患儿中,189例(20.4%)ETV6-RUNX1阳性。ETV6-RUNX1+组初诊时有危险因素(年龄≥10岁或<1岁,WBC≥50×109/L)的患者比例均显著低于ETV6-RUNX1−组(P值分别为0.000和0.001),而泼尼松诱导试验反应良好、诱导化疗第15天或第19天微小残留病(MRD)<1%,以及诱导化疗第33天或第46天MRD<0.01%的患者比例显著高于ETV6-RUNX1−组(P值分别为0.001、0.028和0.004)。ETV6-RUNX1+组的5年无事件生存(EFS)及总生存(OS)率均显著高于ETV6-RUNX1−组(EFS:89.8%对83.2%,P=0.003;OS:90.2%对86.3%,P=0.030)。CCLG-ALL 2008组感染相关SAE发生率显著高于CCCG-ALL 2015组(27.1%对5.3%,P=0.004),TRM发生率也高于CCCG-ALL 2015组,但差异无统计学意义(4.9%对0,P=0.348)。 结论 ETV6-RUNX1+儿童B-ALL初诊危险因素较少,早期治疗反应较好,复发率低,总体预后良好;适当减低化疗强度,可降低感染相关SAE及TRM发生率,并进一步提高该亚型ALL患儿的OS率。
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Affiliation(s)
- Y Z Zheng
- Department of Pediatric Hematology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - L L Pan
- Department of Pediatric Hematology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - J Li
- Department of Pediatric Hematology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - Z S Chen
- Department of Pediatric Hematology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - X L Hua
- Department of Pediatric Hematology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - S H Le
- Department of Pediatric Hematology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - H Zheng
- Department of Pediatric Hematology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - C Chen
- Department of Pediatric Hematology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - J D Hu
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory, Fujian Medical University Union Hospital, Fuzhou 350001, China
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Li TT, Luo LT, Chen Y, Yang T, Hu JD. [Clinical characteristics and prognosis in 84 patients with angioimmunoblastic T-cell lymphoma: a single-center analysis]. Zhonghua Xue Ye Xue Za Zhi 2021; 41:915-920. [PMID: 33333694 PMCID: PMC7767809 DOI: 10.3760/cma.j.issn.0253-2727.2020.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
目的 对就诊于我院的初治血管免疫母细胞性T细胞淋巴瘤(AITL)患者进行回顾性研究,探讨AITL患者的临床特征及影响预后的因素。 方法 收集2009年7月至2018年9月就诊于福建医科大学附属协和医院,经淋巴结病理及免疫组织化学检查确诊为AITL患者的临床资料,采用Log-rank检验及Cox比例风险回归模型分析影响患者总生存(OS)期和无进展生存(PFS)期的预后因素。 结果 纳入患者84例,中位发病年龄62(39~86)岁,年龄>60岁者44例(52.4%),男60例(71.4%),男女比例2.5∶1,Ann Arbor分期Ⅲ~Ⅳ期者80例(95.2%),伴B症状者53例(63.1%)。国际预后指数(IPI)评分0~2分者25例(29.8%),3~5分者59例(70.2%)。外周T细胞淋巴瘤预后指数(PIT)评分0~1分者42例(50.0%),2~4分者42例(50.0%)。可评估疗效的61例患者中有16例(26.2%)获得完全缓解/不确定的完全缓解,25例(41.0%)获得部分缓解,总体反应率为67.2%,5年OS率和PFS率分别为46.0%和38.3%。单因素分析显示,年龄、IPI评分、PIT评分、HGB水平、是否有浆膜腔积液、是否化疗对AITL的OS有预后意义,而年龄>60岁、HGB<110 g/L及存在浆膜腔积液是影响PFS的不良因素。多因素分析显示,年龄>60岁、有浆膜腔积液是OS的独立不良预后因素。 结论 AITL是一种侵袭性高、进展快、预后差的非霍奇金淋巴瘤,初诊时多为Ⅲ~Ⅳ期。治疗前的年龄、IPI评分、PIT评分、HGB水平及是否有浆膜腔积液可作为评价预后的参考指标。
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Affiliation(s)
- T T Li
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - L T Luo
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - Y Chen
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - T Yang
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - J D Hu
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou 350001, China
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Cui CY, Shu YX, Cui XG, Hu JD. Microstructure evolution and wear behavior of AISI 304 stainless steel after Nd:YAG pulsed laser surface melting. Appl Opt 2020; 59:10862-10869. [PMID: 33361907 DOI: 10.1364/ao.406214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/03/2020] [Indexed: 06/12/2023]
Abstract
The microstructure and wear behavior of AISI 304 stainless steel after Nd:YAG pulsed laser surface melting (LSM) were investigated. The microstructural features of the LSM layer were characterized by field emission scanning electron microscope and high-resolution transmission electron microscope. Experimental results showed that the microstructure was obviously refined to the nano- and sub-micrometer scales on the AISI 304 stainless steel surface after LSM treatment. Fine grains with grain size of less than 200 nm were obtained when the applied laser energy densities were in the range of 1.90×107 to 3.52×107J/m2 during LSM. The results indicated that the calculated surface temperature, cooling rate, and measured grain size are closely related to the adopted laser energy densities. The lower the laser energy density is, the lower the surface temperature, and the faster the cooling rate, the finer the grain size. In addition, the microhardness and wear resistance of the stainless steel was significantly improved. Finally, the wear mechanism after LSM process was revealed.
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Zheng YZ, Li J, Le SH, Zheng H, Hua XL, Chen ZS, Zheng L, Chen C, Hu JD. [Bacterial distribution and drug resistance of pathogens of blood stream infection in children with hematological malignancies after chemotherapy]. Zhonghua Xue Ye Xue Za Zhi 2019; 40:235-237. [PMID: 30929393 PMCID: PMC7342547 DOI: 10.3760/cma.j.issn.0253-2727.2019.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Y Z Zheng
- Department of Pediatric Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory, Fujian Medical University Union Hospital, Fuzhou 350001, China
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Sun AN, Tian XP, Cao XS, Ouyang J, Gu J, Xu KL, Yu K, Zeng QS, Sun ZM, Chen GA, Gao SJ, Zhou J, Wang JH, Yang LH, Luo JM, Zhang M, Guo XH, Wang XM, Zhang X, Shi KQ, Sun H, Ding XM, Hu JD, Zheng RJ, Zhao HG, Hou M, Wang X, Chen FP, Zhu Y, Liu H, Huang DP, Liao AJ, Ma LM, Su LP, Liu L, Zhou ZP, Huang XB, Sun XM, Wu DP. [Efficacy and safety of IA regimen containing different doses of idarubicin in de-novo acute myeloid leukemia for adult patients]. Zhonghua Xue Ye Xue Za Zhi 2019; 38:1017-1023. [PMID: 29365393 PMCID: PMC7342198 DOI: 10.3760/cma.j.issn.0253-2727.2017.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
目的 探讨含不同剂量去甲氧柔红霉素(IDA 8、10、12 mg/m2)的IA方案诱导治疗成人初发急性髓系白血病(AML)(非急性早幼粒细胞白血病)的临床疗效和安全性。 方法 采用多中心、单盲、非随机、临床对照研究,纳入2011年5月至2015年3月苏州大学附属第一医院及其他36家单位收治的1 215例成人初发AML患者,根据诱导化疗方案中IDA的剂量对患者进行分组,分析不同剂量IDA联合阿糖胞苷(100 mg/m2)组成的IA方案在成人初发AML诱导治疗中的完全缓解(CR)率、血液学及非血液学不良事件。 结果 可纳入缓解率分析的AML患者共1 207例,IDA 8 mg/m2、10 mg/m2和12 mg/m2组的CR率分别为73.6%(215/292)、84.1%(662/787)和86.7%(111/128),差异有统计学意义(P<0.001);以IDA 8 mg/m2组为参照组,在调整了年龄、骨髓原始细胞比例、FAB分型、危险度分层后,IDA 10 mg/m2和IDA 12 mg/m2为影响患者CR的有利因素[OR=0.49(95% CI 0.34~0.70),P<0.001;OR=0.36(95%CI 0.18~0.71),P=0.003]。在中、低危组中三组CR率分别为76.5%(163/213)、86.9%(506/582)和86.1%(68/79),差异有统计学意义(P=0.007);在调整了年龄、骨髓原始细胞比例、FAB分型因素后,IDA 10 mg/m2为影响患者CR的有利因素[OR=0.47(95% CI 0.31~0.71),P<0.001]。在高危组中,三组CR率分别为50.0%(18/36)、60.6%(43/71)和81.8%(18/22),差异无统计学意义(P=0.089),但在调整了年龄、骨髓原始细胞比例、FAB分型因素后,IDA 12 mg/m2为影响患者CR的有利因素[OR=0.22(95% CI 0.06~0.80),P=0.022]。8 mg/m2、10 mg/m2和12 mg/m2组中性粒细胞≤0.5×109/L的中位持续时间分别为14(11~18)、15(11~20)和18(14~22)d,差异有统计学意义(P=0.012);三组PLT≤20×109/L的中位持续时间分别为14(7~17)、15(11~20)和17(15~21)d,差异有统计学意义(P=0.001);三组肺部感染发生率分别为9.8%、13.5%和25.2%,差异有统计学意义(P<0.001)。 结论 在中国成人(18~60岁)初发AML中,建议中、低危组患者采用含IDA 10 mg/m2的IA方案进行诱导治疗;而高危组AML建议选择含IDA 12 mg/m2的IA方案进行诱导治疗。
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Affiliation(s)
- A N Sun
- Jiangsu Institute of Hematology, the First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, Soochow University, Suzhou Institute of Blood and Marrow Transplantation, Suzhou 215006, China
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - D P Wu
- Jiangsu Institute of Hematology, the First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, Soochow University, Suzhou Institute of Blood and Marrow Transplantation, Suzhou 215006, China
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Yan CH, Xu T, Zheng XY, Sun J, Duan XL, Gu JL, Zhao CL, Zhu J, Wu YH, Wu DP, Hu JD, Huang H, Jiang M, Li J, Hou M, Wang C, Shao ZH, Liu T, Hu Y, Huang XJ. [Epidemiology of febrile neutropenia in patients with hematological disease-a prospective multicentre survey in China]. Zhonghua Xue Ye Xue Za Zhi 2017; 37:177-82. [PMID: 27033752 PMCID: PMC7342950 DOI: 10.3760/cma.j.issn.0253-2727.2016.03.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
目的 了解中国血液病患者中性粒细胞缺乏(粒缺)伴发热的发生率、临床和微生物学特征及危险因素。 方法 前瞻性研究2014年10月20日至2015年3月20日来自全国11家血液病中心发生粒缺伴发热的连续血液病患者发热情况及危险性因素。 结果 1 139例患者共发生784例次粒缺伴发热,粒缺持续21 d时发热的累积发生率为81.9%。多因素分析显示中心静脉置管(P<0.001,HR= 3.407,95% CI 2.276~4.496)、胃肠道黏膜炎(P<0.001,HR=10.548, 95% CI 3.245~28.576)、既往90 d内暴露于广谱抗生素(P<0.001,HR=3.582,95% CI 2.387~5.770)和粒缺持续时间>7 d(P<0.001,HR= 4.194,95% CI 2.572~5.618)是粒缺伴发热的危险因素。无任何危险因素、具备1项、2项、3~4项危险因素患者发热的累计发生率依次增加(35.4%、69.2%、86.1%及95.6%,P<0.001)。784例次粒缺伴发热中,不明原因发热253例次(32.3%),临床证实的感染429例次(54.7%),微生物学证实的感染102例次(13.0%)。最常见的感染部位依次为肺(388例次,49.5%)、上呼吸道(159例次,16.0%)、肛周组织(77例次,9.8%)、血流(60例次,7.7%)。最常见的病原菌为革兰阴性菌(44.54%),其次为革兰阳性菌(37.99%)和真菌(17.47%)。发热与未发热患者相比,两组之间总体病死率差异无统计学意义(9.2%对4.8%,P=0.099)。多因素分析显示年龄>40岁(P=0.047,HR=5.000,95% CI 0.853~28.013)、血流动力学不稳(P=0.001,HR=13.185, 95% CI 2.983~54.915)、既往耐药菌的定植或感染(P=0.005,HR=28.734,95% CI 2.921~313.744)、血流感染(P=0.038,HR=9.715, 95% CI 1.110~81.969)和肺部感染(P=0.031,HR=25.905, 95% CI 1.381~507.006)是与总体死亡相关的危险因素。 结论 发热是血液病患者粒缺期常见的合并症,不同部位的感染有不同的致病菌谱。粒缺持续时间>7 d、中心静脉置管、胃肠道黏膜炎和既往90 d内暴露于广谱抗生素是粒缺伴发热发生的危险因素。
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Affiliation(s)
- C H Yan
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China
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Wu ZJ, Zheng XY, Yang XZ, Liu TB, Yang T, Zheng ZH, Gao F, Chen CX, Li JG, Zhang CQ, Lin WQ, Zheng HY, Lin SX, Hu JD. [Clinical characteristics and prognosis in 12 patients with adult T cell leukemia/lymphoma confirmed by HTLV-1 provirus gene detection]. Zhonghua Xue Ye Xue Za Zhi 2016; 37:1027-1032. [PMID: 28088963 PMCID: PMC7348501 DOI: 10.3760/cma.j.issn.0253-2727.2016.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Indexed: 11/24/2022]
Abstract
Objective: To analyze the clinical characteristics and prognosis of adult T cell leukemia/lymphoma (ATLL). Methods: Peripheral blood samples from patients who were suspected as ATLL from March, 2013 to July, 2015, were collected for HTLV-1 provirus genes detection in genomic DNA extraction by PCR. Cases showing positive results were confirmed as ATLL. Clinical and laboratory characteristics, therapeutic outcomes and survival evaluation were collected. Results: 12 out of 23 suspected patients were confirmedly diagnosed as ATLL through HTLV-1 provirus genes detection by PCR. Eight patients were male and four patients were female. Median age was 51 (range 28-66) years old. All of those patients came from coastal cities of Fujian province where a HTLV-1 epidemic area locates. In the subtype classification of these 12 ATLL, 11 patients were classified as acute type and one case as lymphoma type ATLL. As one of the clinical characteristics of ATLL, ' flower cells ', with typical or atypical morphology had been observed in a high rate (81.8%). Clinical symptom such as hepatomegaly, splenomegaly and lymphadenectasis were detected in most of patients, and hypercalcemia and elevated LDH were also noted commonly. The ATLL cells immunophenotype were typical, and the major subtype was CD4+ CD8- type. Confection of hepatitis B virus was detected in a high rate (54.5%). Ten patients received chemotherapy, and 2 cases in complete remission after chemotherapy received allogeneic hematopoietic stem cell transplantation. At the end of the follow-up, 7 cases died, 4 cases survived, 1 case was lost, and the median survival was 2.8 (0.9-10.8) months. We found a case had HTLV-1 provirus negative after transplantation. Conclusion: In the coastal area of Fujian Province, ATLL is not rare. Characteristics of those ATLL are typical. But prognosis is still unsatisfactory.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - J D Hu
- Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou 350001, China
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Huang Y, Zheng J, Hu JD, Wu YA, Zheng XY, Liu TB, Chen FL. Discovery of somatic mutations in the progression of chronic myeloid leukemia by whole-exome sequencing. Genet Mol Res 2014; 13:945-53. [PMID: 24634115 DOI: 10.4238/2014.february.19.5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We performed whole-exome sequencing in samples representing accelerated phase (AP) and blastic crisis (BC) in a subject with chronic myeloid leukemia (CML). A total of 12.74 Gb clean data were generated, achieving a mean depth coverage of 64.45 and 69.53 for AP and BC samples, respectively, of the target region. A total of 148 somatic variants were detected, including 76 insertions and deletions (indels), 64 single-nucleotide variations (SNV), and 8 structural variations (SV). On the basis of annotation and functional prediction analysis, we identified 3 SNVs and 6 SVs that showed a potential association with CML progression. Among the genes that harbor the identified variants, GATA2 has previously been reported to play important roles in the progression from AP to BC in CML. Identification of these genes will allow us to gain a better understanding of the pathological mechanism of CML and represents a critical advance toward new molecular diagnostic tests for the development of potential therapies for CML.
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Affiliation(s)
- Y Huang
- Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China
| | - J Zheng
- Fujian Institute of Hematology, Union Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - J D Hu
- Fujian Institute of Hematology, Union Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - Y A Wu
- Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China
| | - X Y Zheng
- Fujian Institute of Hematology, Union Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - T B Liu
- Fujian Institute of Hematology, Union Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - F L Chen
- Department of Nephrology, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
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16
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Wang XJ, Chen J, Zhang ZH, Piao XY, Hu JD, Tao S. Distribution and sources of polycyclic aromatic hydrocarbons in soil profiles of Tianjin area, People's Republic of China. Bull Environ Contam Toxicol 2004; 73:739-748. [PMID: 15389341 DOI: 10.1007/s00128-004-0488-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Affiliation(s)
- X J Wang
- College of Environmental Sciences, MOE Laboratory of Earth Surface Process, Peking University, Beijing 100871, China
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17
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Shi QZ, Lu LH, Hu JD, Chen YY, Yang YL. [The study of inhibitory and apoptosis of K562 cells by antisense oligodeoxynucleotides]. Zhongguo Ying Yong Sheng Li Xue Za Zhi 2001; 17:213-216. [PMID: 21189610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIM To study the effect of bcr-abl fusion gene antisense phosphorothioate oligodeoxynucleotide (Aspo) on bcr-abl mRNA and apoptosis of K562 cells. METHODS Cells were exposed to Aspo. P210 was measured by Flow Cytometry. Cellular bcr-abl mRNA was detected by RT-PCR mediquantitative analysis. Cell apoptosis was measured by Flow Cytometry and observed by electron microscope (EM). RESULTS The P210 was down regulated or completely suppressed after 24h treatment with more than 5 micromol/L Aspo. The decrease of bcr-abl mRNA was about 45%. After incubation 48 h with 10 micromol/L Aspo. Also, 20% - 30% K562 cells were induced to apoptosis at 120 h when the cell number was 1 x 10(4)/ml at the beginning. While the cell number was 1 x 10(5)/ml, the apoptosis rate was 30% after 48 h culture and the typical morphology of apoptosis cell was observed under EM. CONCLUSION bcr-abl Aspo could inhibit the expression of bcr-abl mRNA and P210. Also,it could induce apoptosis of K562 cells.
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Affiliation(s)
- Q Z Shi
- Fujian Institute of Hematology, Union Hospital Affiliated to Fujian Medical University, Fuzhou 350001, China
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18
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Mei YW, Hu JD. Moyamoya disease associated with herpes zoster ophthalmicus: a case report with angiographic findings. Acta Acad Med Wuhan 1983; 3:58-59. [PMID: 6602958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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