Objective To investigate the clinical significance of the level of serum soluble human leukocyte antigens Ⅰ(sHLA-Ⅰ) in patients with acute leukemia,lymphoma or multiple myeloma.Methods Concentrations of serum sHLA-Ⅰ in 112 patients with acute leukemia,lymphoma multiple myeloma were determined by enzyme linked immunosorbent assay.Results Concentrations of serum sHLA-Ⅰ in acute leukemia,lymphoma multiple myeloma patients were significantly increased compared with normal control(all P0.01).The levels of sHLA-Ⅰ of Lymphoma and multiple myeloma patients were significantly higher than those of acute leukemia subjects(all P0.05),but no difference was detected between lymphoma and multiple myeloma(P0.05).The sHLA-Ⅰ levels in untreated and relapsed patients were significantly higher than those in the complete remission subjects(all P0.01),while there was no difference between the untreated and relapsed patients significantly(P0.05).The serum level of sHLA-Ⅰ was closely correlated with the peripheral leukocytes and contents of serum LDH as well as β2 macroglobulin.Conclusions Serum sHLA-Ⅰ can be as a prognosis and relapse index for malignant hemopathy.
To evaluate efficacy and safety of second-generation tyrosine kinase inhibitors (TKI) dasatinib, nilotinib and imatinib in treatment of newly diagnosed patients with chronic-phase chronic myeloid leukemia (CML).The clinical data and follow-up results of 163 patients with chronic-phase chronic myeloid lenkemia(CP-CML) who were treated in our hospital during the nearly 3 years were analysed retrospectively, among 163 patients 47 received dasatinib, 43 received nilotinib and 73 received imatinib. The efficacy, disease progression and safety were evaluated.After treatment for 3 months, the rate of complete hematologic response(CHR) in three treatment groups were 77%, 79% and 67%, respectivily, CHR at 12 months in three treatment groups were 92%, 91% and 90%, respectively. By 3 months, the rates of complete cytogenetic response(CCyR) with dasatinib and nilotinib were higher than that with imatinib (55%, 53% vs 33%)(P<0.05 for both comparisons), CCyR at 12 months in three treatment groups were 86%, 88% vs 69% (P<0.05 for both comparisons). The rates of major molecular response(MMR) for dasatinib (11%) and nilotinib (9%) by 3 months were significantly higher than that for imatinib (1%) (P<0.05 for both comparisons), MMR at 12 months in three treatment groups were 49%, 50% and 28%, respectively (P<0.05 for both comparison). Progression to the accelerated or blast phase of CML occurred in 2 (4%) patients received dasatinib, 2 (5%) received nilotinib and 6 (8%) received imatinib. The safety profiles of these 3 second-generation TKI treatments were similar.Both dasatinib and nilotinib induced strikingly higher and faster rates of complete cytogenetic response and major molecular response, with a statistically significant difference from imatinib.
Objective To investigate the curative effect of the Idarubicin(IDA) in combination with Am-Cand VP16 (IAE) regimen for treatment on refractory acute myelecytic leukemia. Methods Idarubiein 7 mg/m2 iv gtt for 3 days, Ara-C 100 mg/m2 and VP16 100 mg/d iv gtt for 5 days continuously were used as one course.Results Among 17 refractory leukemia patients complete remission was achieved in 9 patients and partial remission in 4 patients, but no remission in 3 patients and one patient died of cerebral hemorrhage after one-two courses of the treatment. Conclusion The IAE regimen for treatment of refractory acute myelocytic leukemia is an effective therapy. The major toxic side effects encountered were marrow suppression,neutropenia and thrombocytopenia. The toxic side effects in heart, liver and kidney were not found.
Key words:
Leukemia, myloid, acute; Drug therapy, combination
The current study aimed to explore the levels of leptin (LEP) and LEP receptor (LEP-R) on the progression of aplastic anemia (AA) with bone marrow fat conversion. An AA model was developed by infusing C57BL/6 lymph node cells into BALB/c mice. At 0, 3, 6, 9, 12, 15 and 18 days after modeling, routine blood counts, bone marrow biopsy slides, lymphocyte subsets (CD4+ and CD8+ T cells) and cytokine levels [including interleukin (IL)-2, IL-4, IL-5 and interferon-γ] were assessed. LEP and LEP-R levels in peripheral blood serum, mesenchymal stem cells (MSCs) and bone marrow were also analyzed by enzyme-linked immunosorbent assay, polymerase chain reaction and immunohistochemistry. The relevance of LEP, LEP-R and other factors was analyzed by Pearson's correlation analysis. Peripheral pancytopenia (reduced count of white blood cells, red blood cells, hemoglobin and platelets), abnormal immune factor levels and histological changes in bone marrow sections were detected in the AA model mice, suggesting that these mice mimicked the pathological changes commonly observed in AA. In addition, following the establishment of AA, the LEP level was gradually increased and the LEP-R level was reduced in the mice over time (P<0.05). The expression of adipogenic genes, including CCAAT/enhancer-binding protein (C/EBP)α, C/EBPβ and peroxisome proliferator-activated receptor γ, was markedly increased, while the expression of the osteogenic gene runt-related transcription factor 2 was reduced compared with the levels in the control group (P<0.05). Taken together, damage to LEP-R may lead to dysregulation of LEP and the enhancement of MSCs to differentiate into adipocytes, resulting in excessive fat in bone marrow of AA patients.
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