Mitochondrial quality control includes mechanisms such as mitochondria-derived vesicles, fusion / fission and autophagy. These processes rely on the collaboration of a variety of key proteins in the inner and outer membranes of mitochondria to jointly regulate the morphological structure and functional integrity of mitochondria, repair mitochondrial damage, and maintain the homeostasis of their internal environment. The imbalance of mitochondrial quality control is associated with leukemia. Therefore, by exploring the mechanisms related to mitochondrial quality control of various leukemia cells and their interactions with immune cells and immune microenvironment, this article sought possible targets in the treatment of leukemia, providing new ideas for the immunotherapy of leukemia.
【摘要】 目的 分析交叉抗原表达的急性白血病的临床特征及缓解率。 方法 对2009年10月-2010年11月血液内科的210例交叉表达髓系和淋巴细胞系相关抗原的初治急性白血病患者的标本,采用流式细胞术检测白血病细胞的免疫表型,根据免疫标记和FAB(French、American、Britain)分型进行分组,分析其异质性的生物学特征和影响缓解率的相关因素。 结果 210例急性白血病的FAB分型以AML-M1/M2(82例)和ALL(78例)为主;免疫分型以B淋巴细胞系和髓系混合表达多见(116例),其中CD34表达率高达91.4%(192例), CD7表达率为50.5%(106例),且与CD34相关(P=0.04);出现CD34、CD7、CD19三者共表达的患者缓解率较低(9.09%)。 结论 交叉抗原表达的急性白血病的诊断有赖于免疫分型的判断,其分化抗原的表达类型是影响其缓解率的重要因素。【Abstract】 Objective To observe the clinical characters of acute leukemia with cross-lineage antigen expression and analyze the remission rate. Methods Between October 2009 and November 2010, 210 patients were diagnosed and classified by morphology. Cytochemistry and immunology were used to analyze the immunophenotype. According to the immunostaining relative factors and FAB (French, American, and Britain) phenotype standard, the samples were divided into several groups. The conical characters and relative factors of remission rate were analyzed. Results In 210 patients with cross-lineage antigen expression, AL, AML-M1/M2 (82 cases) and ALL (78 cases) were common in FAB phenotype,and cross-lineage of B lineage and myelolineage were common in immunotype (116 cases). CD34 got the highest expression frequency of all (192 cases),and had the most important effect on patients′ prognosis. CD7 was also positive commonly (106 cases) and related with CD34 (P=0.04). So it′s significant for the outcome. The patients who got co-expression of CD34, CD7 and CD19 had worse prognoses. Conclusions Acute leukemia with cross-lineage antigen expression is a special type and is confirmed by immunotype. Furthermore, expression types of differentiation antigen are critical for the prognosis.
【摘要】 目的 了解住院白血病患者的社会支持状况。 方法 采用相关“社会支持评定量表”,调查分析2010年8-11月80例住院白血病患者的社会支持状况。 结果 白血病患者获得的社会支持为(42.34±7.04)分,支持度较高,与常模(34.56±3.74)分比较差异有统计学意义(Plt;0.01),无配偶及医疗自费患者所获得的社会支持相对较低。 结论 医护人员在临床中应注意拓宽住院白血病患者的社会支持渠道,帮助患者保持较高的社会支持水平,从而促进康复,提高生活质量。【Abstract】 Objective To explore the social support condition of the inpatients with leukemia. Methods According to “Social Support Assessment Inventory”, the social support conditions of 80 patients with leukemia who were hospitalized between August and November, 2010 were analyzed. Results The total score of social support was 42.34±7.04 in inpatients with leukemia, and 34.56±3.74 in normal controls; the difference was significant (Plt;0.01). The patients who remained single or had no medical insurance obtained less social support. Conclusions Nurses should help patients with leukemia keep in a moderate high level of social support to promote the recovery of patients and improve their quality of life.
Objective To assess the clinical effectiveness and safety of inductive treatment with arsenic trioxide (As203) for acute promyelocytic leukemia (APL). Methods Randomized controlled trials (RCTs) were identified from MEDLINE (1966 -July, 2005 ), EMBASE (1984 -July, 2005 ), The Cochrane Library ( Issue 3, 2005) and CBM- disc (1978 -July, 2005). The references of eligible studies were handsearched. RCTs of As203 treating for APL were included. Data were evaluated and extracted by two reviewers independently with designed extraction form. RevMan 4. 2.7 software was used for data analysis. Results Six RCTs involving 323 patients were included. Two studies reported that there was no statistical difference between As2O3 group and all-transretinoic acid (ATRA) group in mortality for patients with APL or APL patients with complications of desseminated intiavascular coagulation or cerebra hemorrhage. The pooled result of 4 studies showed that there was no statistical difference with RR 0.98, 95 % CI 0.86 to 1.12 in complete remission (CR) rates between the two groups. The result of one study showed that the CR rate of patients with intravenous injection of As203 in 2 divided dosages with longer injection duration was higher with RR 1.31, 95% CI 0.86 to 1.12 compared with those with a single intravenous injection. Adverse effects in As2O3 group were less than ATRA group. Conclusions Inductive treatment with As2O3 for acute promyelocytic leukeuia has similar mortality and CR with less adverse effects compared with ATRA. More trials of high quality are required.
目的:了解左旋门冬酰胺酶(L-ASP)对儿童急性淋巴细胞白血病凝血功能变化的影响。方法:观察86例患儿在诱导缓解后治疗期间,L-ASP使用前后活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)、抗凝血酶Ⅲ(AT-Ⅲ)、D-二聚体变化情况。结果:与用药前比,用药结束后一天的PT、APTT、TT均显著延长(P<0.01);FIB、AT-Ⅲ显著降低(P<0.01),D-二聚体显著升高(P<0.01);用药结束后1周时PT、APTT、TT、D-二聚体较用药前差异无显著性,FIB、AT-Ⅲ虽有回升,但仍低于正常(P<0.01)。结论:L-ASP可引起ALL患儿凝血功能异常,尤其对FIB、AT-Ⅲ影响明显,应引起临床高度重视。L-Asp主要影响蛋白质的合成而引起蛋白质成份的凝血因子减少,从而引起凝血功能障碍,且对纤维蛋白原的合成影响更为显著。
目的 探讨吉西他滨+米托蒽醌+足叶乙甙(GME)方案诱导化学疗法(化疗)治疗复发难治性急性白血病的疗效。 方法 2010年5月-2011年4月对20例复发难治性急性白血病应用GME方案化疗,以了解其有效性、毒副反应。 结果 随访7个月20例复发难治性白血病经过GME方案诱导化疗1个疗程后总反应率为50%,其中5例完全缓解,4例部分缓解,1例形态学完全缓解而血细胞计数未完全缓解,均无早期死亡患者。 结论 GME方案可作为复发难治性急性髓系白血病的一种安全、有效的诱导化疗方案,值得临床尝试。
【摘要】 目的 观察慢性粒细胞性白血病(chronic myelogenous leukemia, CML)急变(blast crisis,BC)患者罕见染色体异常的临床及实验室特点。 方法 2010年2月1例患者因咳嗽和高热来我院就诊,采用常规方法检查患者骨髓细胞,应用R显带技术和荧光原位杂交技术分析骨髓细胞核型。 结果 患者具有CML-BC的典型临床及实验室特点,同时核型出现不典型t(1;9;22)合并亚二倍体罕见核型异常,临床表现病情进展快,对伊马替尼疗效差,生存期短。 结论 慢性粒细胞性白血病患者在急变期出现伴不典型Ph染色体的亚二倍体复杂核型为高危核型,此类患者可能存在对伊马替尼的耐药,如能取得血液学缓解应尽早接受异基因骨髓造血干细胞移植,争取获得长期疗效。【Abstract】 Objective To report a case of chronic myelogenous leukemia (CML) blastic transformation into acute myelogenous leukemia with rare atypical hypodiploid t(1;9;22) complex chromosome abnormalities, and to analyze its clinical and laboratory characteristics. Methods A 47-year-old man was referred to our hospital due to cough and high fever in February 2010. We collected and analyzed the patient’s clinical materials, and performed chromosomal karyotype analysis with R-banding and fluorescence in situ hybridization (FISH). Results The patient demonstrated typical clinical and laboratory characteristics of blastic crisis of chronic myelogenous leukemia (CML-BC) and displayed rare atypical hypodiploid t(1;9;22) complex chromosome abnormalities. Meanwhile, the disease was rapidly progressive, with poor response to imatinib and had short overall survival. Conclusions CML-BC patients with hypodiploidy complex chromosome abnormalities are in high risk. They may show drug-resistance to imatinib. Thus, for this type of patients, once the hematological remission is achieved, allogeneic stem cell transplant should be performed as soon as possible to get better opportunity for long-term survival.
Objective To investigate the risk factors of childhood leukaemia. Methods Questionnaire about risk factors of childhood leukaemia was devised and used. We surveyed and analyzed the relevant risk factors of 143 cases of leukaemia children in Children’s Hospital of Chongqing Medical University from May 2008 to February 2009, comparing with 108 hospitalized cases without leukaemia during the same period. The significant factors were identified by single factor analysis. Then multi-factors conditional logistic regression analysis was conducted. Results In the single factor analysis, 12 of 26 indexes were statistically significant (Plt;0.05), while in the multi-factors logistic regression analysis, there were 8 of 12 indexes with significance (Plt;0.05), which of those are frequent infection history, house decoration, family history of cancer, maternal childbearing age, and history of contact with paint, leather shoes, radiation and pesticides. Conclusion The 8 indexes as listed above are closely related to the pathogeny of leukaemia and may be the distinguished risk factors of childhood leukaemia.