Objective To compare the efficacy and safety of arsenic trioxide(As2O3) with all-trans retinoic acid(ATRA) for the treatment of acute promyelocytic leukemia(APL).Methods We searched the database of Chinese journal full text data base,CDMD,CPFD,CBFD,Chinese Citation Database(1994-2010).We included randomized controlled trials and controlled clinical trials which compared As2O3 with ATRA for the treatment of APL.We adopt complete remission rate,and adverse reactions as result indicators.Data were entered and analyzed with the Cochrane review manager software(Revman 4.2).Results Three eligible randomized controlled trials(RCTs) and 6 controlled clinical trials were included(n=614).They all are focusing on the comparison of As2O3 monotherapy with ATRA monotherapy in treating APL patients.Meta analysis showed that effect index for complete remission was 1.81(0.87,3.77).It indicated no statistically significant difference.Effect index for incidence of liver dysfunction was 1.01(0.25,4.06),which showed no statistically significant difference between As2O3 group and ATRA group.Conclusion As2O3 is not superior to ATRA in treating APL patients regarding complete remission.The incidence of liver dysfunction during treatment is not much different between As2O3 group and ATRA group.Due to limitation of included trials,this conclusion need to be validated by further studies.
Objective To provide criteria for clinical use of antibiotic drugs by observing the clinical distribution and drugresistance of Pseudomonas aeruginosa(PAE) in hospital.Methods 176 strains of Pseudomonas aeruginosa were observed in hospital from March 2012 to March 2013,and drug susceptibility of Pseudomonas aeruginosa were identified by use of BioMerieux automatic microorganism identification instrument.The data was analyzed using SPSS 17.0 software.Results 56.3 % of the 176 strains of Pseudomonas aeruginosa in clinical were mainly distributing in sputum specimen,and mainly occurring in surgery,department of internal medicine and ICU.The rates of drug resistance for imipenem,Cefoperazone/sulbactam,piperacillin/tazobactam,meropenem,Amikacin were 17.0%、20.4 %、22.2 %、22.7% and 28.4 % respectively.The ampicillin,cefazolin,cefuroxime,cefoxitin,cefuroxime axetil cotrimoxazole had high rates of drug resistance with 100%、97.7%、97.6%、93.8 %、 92.0 % and 96.5 % respectively.The ceftazidime,cefotaxime,cefepime,ciprofloxacin,gentamicin,levofloxacin were from 31.2 % to 68.8 %.Conclusion The Pseudomonas aeruginosa mainly came from the sputum specimens of surgical and ICU patients and the rates of drug resistance were a serious problem.We should strengthen the screening of drug resistance in order to guide proper use of drugs in clinical to control hospital infection.
Objective To assess the effectiveness and safety of thalidomide for treating multiple myeloma.Methods Randomized controlled trials(RCTs) of thalidomide for multiple myeloma were collected from CHKD Data Library(1994-2010),Wanfang Medical Journals(1994-2010).The methodological qualities of the included studies were evaluated,and data analyses were performed using the Cochrane Collaboration's software RevMan 4.3.Results A total of 7 RCTs involving 193 patients were included.As for total effective rate and the effectiveness of reducing M-protein and reducing myeloma cells amounts,improving anaemia complete remission rate,significant differences were found between with or without thalidomide for the treatment of multiple myeloma(OR=3.54,95%CI=1.83-6.81;OR=3.19,95%CI=1.75-5.82;OR=3.07,95%CI=1.67-5.67;OR=2.96,95%CI=1.58-5.54).Conclusion According to the domestic evidence,treatment for multiple myeloma with thalidomide can improve the total effectiveness.However,more high–quality,large-sample,randomized,double-blind,controlled trials are required.
Objective To study the clinical characteristics,therapeutic outcome and prognostic of BCR-ABL-positive adult acute lymphoblastic leukemia.Methods The clinical data of 29 newly diagnosed adults with BCR-ABL(+)ALL were retrospectively analyzed.The follow-up period were 3～80 months.Results There were 29(16.1%) of 178 ALL patients diagnosed as BCR-ABL(+)ALL.Among the 29 cases,28 patients(96.6%) were classified as B immunophenotype and 3.4% as T immunophenotype.The complete remission(CR) rate after 1 or 2 cycles of induction chemotherapy was 48.3%.Part remission rate was 3.4%,2 cases(18.3%) obtained CR when treated by combination imatinib and traditional chemotherapy after failure of traditional chemotherapy alone.The median survival time of 29 cases was 14.5 months.For patients treated with imatinib combining traditional chemotherapy and those with traditional chemotherapy alone,CR rate was 80% and 50%(P0.01),the median survival time was 18.6 months and 11.1 months(P0.05).For 2 patients receiving allo-HSCT after CR,1 case overall survival was 19 months,another obtained long-term disease-free survival.Conclusion The BCR-ABL(+) adult ALL had bad outcome of traditional chemotherapy.The combination of imatinib and traditional chemotherapy can improve CR rate and median survival time.was beneficial to improve the CR rate and survival duration.Part of patients treated by allo-HSCT after complete remission can obtain long-term disease-free survival.
AIM: To explore the cytotoxicity of combination of some chemotherapy reagents towards K562/AS2, an arsenic trioxide (As_2O_3)-resistant leukemic cell line. METHODS: MTT assay was used to detect the cytotoxicity, and the combined drug effect of two drugs was analyzed with Chou-Talalay Combination Index (CI). Flow Cytometry was used to detect the P-glycoprotein on the cell surface and the introcellular concentration of daunorubicin (DNR). RESULTS: The relative resistant folds of K562/AS2 cell line to As_2O_3, DNR, VP16, harringtonine (H), NVT and Ara-c were 7.4, 2.9, 3.8 and 1.1, respectively. The fluorescence of the P-glycoprotein on the surface or of the DNR inside the cells detected was not significantly different between the K562 and the K562/A02 cell line (P 0.05). The combination indexes of As_2O_3 combined with DNR, VP16, H or NVT to K562, K562/AS2 and K562/A02 cell lines were all above 1. The combination indexes of Verapamil combined with DNR to both K562 and K562/AS2 cell lines were above 1, and to the K562/A02 were below 1. CONCLUSION: K562/AS2 cell line is resistant to As_2O_3, DNR, VP16 and NVT. The mechanism of the drug resistance is not associated with the expression of P-gp. Verapamil combined with DNR can reverse the resistance of P-gp expressing leukemia cell, K562/A02, to DNR, but can not reverse the resistance of K562/AS2 cell line. The cytotoxicity of As_2O_3 combined with DNR, VP16, H and NVT shows antagonism to K562, K562/AS2 and K562/A02 cell lines.
Objective:To investigate the relationship between Wnt/β-catenin and multiple myeloma bone disease(MBD).Method:Bone marrow mononuclear cells from MM and controls were isolated,cultured,expanded and then induced to osteogenic differentiation.Realtime Quantitative PCR was employed to detect the osteogenic markers,including Wnt/β-catenin,OPN,OC,ALP,Cbfαl.Alizarin red staining was conducted for detecting mineral deposition.The mRNA expressions of Wnt/β-catenin and osteogenic potential in the two groups were analyzed.Result:Positive alizarin red staining and the red calcium nodules appeared on the MSC post-osteogenic induction in vitro.The mRNA expressions of OPN,OC,ALP,and Cbfαl were significantly lower than those of control groups(P0.05).The mRNA expression of β-catenin on the MSC post-osteogenic induction in vitro in the experimental groups was significantly lower than those of control groups(P0.05).Conclusion:MSCs can be successfully induced to osteoblasts.The osteogenic potential of MSCs in MM patients is lower than controls.Wnt/β-catenin may present a novel target for the future therapy of MBD.
AIM: To establish a arsenic trioxide (As 2O 3 )-resistant leukemic cell line to explore the mechanism of resistance to As 2O 3, and the relationship between the resistant cell line and the multidrug resistance was also investigated. METHODS: The arsenic trioxide (As 2O 3 )-resistant leukemic cell line was established by exposing the cells to the increasing concentration of As 2O 3. MTT assay was used to detect the cytotoxicity. Cell cycle was detected by PI assay. Flow Cytometry was used to detect the P-glycoprotein on the surface of the cells, the intracellular concentration of DNR, and the immuetype of the cells. RESULTS: The cell doublings time and the cell cycle of the arsenic trioxide (As 2O 3 )-resistant leukemic cell line, K562/AS2, is similar to that of K562. The relative resistant fold of K562/AS2 to As 2O 3, DNR, VP16 and Ara-C was 7.4, 2.9, 3.8 and 1.1, respectively. The relative resistant fold of multidrug resistant cell line, K562/ A02, to As 2O 3, DNR, VP16 and Ara-C was 0.8?94?2.5 and 0.9, respectively. The fluorescence of the P-glycoprotein on the surface or of the DNR inside the cells detected was not significantly different between the K562 and the K562/AS2 cell lines. CONCLUSIONS: A cell line, K562/AS2, resistant to clinical achieving level (2 μmol/L) of As 2O 3 has been established. The relative resistant fold of K562/ AS2 to As 2O 3 is about 7.4 fold to the parent K562 line sensitive to As 2O 3. Partial resistance of K562/AS2 to DNR and VP16 is observed , the mechanism of which is unrelated to the P-gp, the expression product of multidrug resistance gene 1 (mdr1).
Objective To explore the cytotoxicity of 2-chlorodeoxyadenosine (2-CDA) to sensitive or multidrug-resistant (MDR) K562 leukemia cell line.Methods MTT assay was used to detect the cytotoxicity,the combined effect of two drugs was analyzed with Chou-Talalay combination index (CI).Flow cytometry was used to detect the P-glycoprotein (P-gp)on the surface of the cells and the intracellular daunorubicin (DNR).Results The IC 50 of 2-CDA to K562 and K562/A02 was (23.9±2.4)nmol/L and (137.6±12.7) nmol/L,respectively (P0.05).The combination index (CI) of 2-CDA combined with DNR to K562 cell line was 1.0,and to the K562/A02 was 5.1.The fluorescence of P-glycoprotein on the surface or of the DNR inside cells detected was not significantly different before and after the K562/A02 cell line exposing to 2-CDA.Conclusion The toxicity of 2-CDA to K562 cell line is remarkable.The multidrug-resistant leukemic cells do not well respond to 2-CDA.The effect of 2-CDA combined with DNR shows synergism on K562 and antagonism on K562/A02 cell line.2-CDA does not influence the synthesis or the function of P-gp.
Objective To evaluate the efficacy of leukapheresis in the treatment of hyperleukocytic acute leukemia.Methods Twenty six patients,who were performed leukapheresis with COBE Spectra before chemotherapy were analyzed respectively.Results Among 26 cases,25 cases achieved remission in clinical features,and dramatic reduction of WBC counts with an overall response rate of 96.1%.Conclusion Leukapheresis could prevent tumor lysis syndrome through reduction of leukemia cells burdens.It is an effective method for hyperleukocytic acute leukemia.
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