Impact of FLT3 Receptor (CD135) Detection by Flow Cytometry on Clinical Outcome of Adult Acute Myeloid Leukemia Patients

Background

The significance of FMS-like tyrosine kinase 3 (FLT3)-ITD mutation in acute myeloid leukemia (AML) prognosis has been well established. The aims of this study were to investigate the prognostic impact of the FLT3 protein (CD135) expression and its association with FLT3-ITD mutation, and to identify its role in minimal residual disease.

胃癌细胞中miR-135a表达对紫杉醇敏感性的影响

目的研究胃癌细胞中miR-135a表达与紫杉醇敏感性的关系,并探索可能的作用机制。方法运用Taqman microRNA芯片筛选接受紫杉醇化疗有效及无效胃癌患者血清中差异表达microRNAs,选择与紫杉醇敏感性关系较大的microRNA-135a(miR-135a)为研究对象,在体外培养的胃癌细胞中转染miR-135a mimic与miR-Ctrl,用细胞增殖曲线、流式细胞仪、Western blot等方法探索miR-135a表达对紫杉醇敏感性的影响及可能的作用机制。结果miR-135a在紫杉醇化疗无效患者血清中的表达水平明显高于化疗有效患者(P0.05),可能与紫杉醇耐药有关。miR-135a通过抑制紫杉醇诱导的细胞周期G2期阻滞及细胞凋亡(P0.05)而降低胃癌细胞对紫杉醇的敏感性。结论 miR-135a有望成为临床胃癌紫杉醇化疗疗效的预测标志物。     

Hereditary fructose intolerance: a difficult diagnosis in the adult.

A 21 year old woman presented with viral meningitis and was treated parenterally with fructose-containing solutions. A dramatic clinical picture developed consisting of an acute lcterus, complicated by severe gastrointestinal hemorrhagic episodes, hypoglycemia and a pronounced proximal tubular acidosis. A syndrome of disseminated intravascular coagulation was documented. The presence of a Fanconi syndrome characterized by an important bicarbonaturia, glycosuria, aminoaciduria and a markedly decreased phosphate reabsorption led to the correct diagnosis of a previously unknown hereditary fructose intolerance. All symptoms of the Fanconi syndrome disappeared within 48 hours after the intravenous administration of fructose was stopped. The hepatic dysfunction, however, lasted for three months.After recovery, a decreased liver fructose-1-phosphate-aldolase was found. An intravenous fructose tolerance test was subsequently performed: within 60 minutes after initiation of the fructose infusion, plasma bicarbonate ion (HCO₃^?) decreased from 25 to 14 meq/liter and the urinary HCO₃^? excretion increased from 10 to 111 μeq/min. Plasma phosphate decreased from 4.4 to 2.6 mg/100 ml, concomitantly with an increase in renal phosphate clearance from 9 to 20 ml/min. Both plasma uric acid and urinary uric acid excretion increased from 3.2 to 6.7 mg/100 ml and from 0.3 to 1.98 mg/min, respectively. Plasma parathyroid hormone (PTH) levels remained unchanged whereas the urinary cyclic AMP excretion decreased during fructose administration. Biochemical evidence of hepatic dysfunction was present. All parameters normalized within three hours after withdrawal of the fructose.Although exceptional, this case illustrates that “routine” administration of fructose-containing solutions can provoke a dramatic clinical situation in patients with unknown hereditary fructose intolerance. The occurrence of a proximal tubular acidosis may alert for the existence of this disorder.     

Metastatic melanoma to the lung: long-term results of surgical excision

The only long-term survivor of multiple bilateral pulmonary metastases from malignant melanoma after staged thoracotomies has been described, and a series of 18 patients who underwent pulmonary resection for metastatic malignant melanoma at one clinic have been reviewed. Median survival was 16.5 months and the 5 year survival rate was 11.1 percent. Forty-four percent of the patients had multiple metastases and 11.1 percent had bilateral metastases. There was no correlation between length of survival and disease-free interval, number of metastases, or the presence of unilateral versus bilateral tumor nodules. Twenty-seven percent of the patients had more metastases found intraoperatively than suspected preoperatively. Unfavorable results occurred when the extent of the disease required pneumonectomy. The current literature has also been reviewed and arguments have been made to support the surgical approach to carefully selected patients with metastatic melanoma to the lung.     

Chronic intravascular coagulation associated with chronic myelocytic leukemia. Use of heparin in connection with a surgical procedure.

A women with Philadelphia chromosome-positive chronic myelocytic leukemia lived nearly 12 years from the time of diagnosis. During most of this period she received no therapy, and marked cyclic oscillations in the white blood cell count were documented. The last two years of her illness were marked by a hemorrhagic disorder associated with hypofibrinogenemia, thrombocytopenia, increased plasma fibrinopeptide A concentration and markedly elevated serum levels of fibrin degradation products. The coagulation disorder was rapidly reversible on several occasions with heparin therapy. After treatment with heparin and platelet transfusions, the patient underwent successful resection of a large ovarian cyst with excellent hemostasis during the procedure. Postoperatively, the administration of heparin and platelets was discontinued and a large wound hematoma developed. After resumption of therapy with heparin and platelets, the remainder of her postoperative course was uneventful. The literature on the subject is reviewed and tentative guidelines are offered concerning the management of patients with intravascular coagulation who require diagnostic or therapeutic surgical procedures.     

An investigational tetravalent meningococcal serogroups A, C, W-135 and Y-tetanus toxoid conjugate vaccine co-administered with Infanrix™ hexa is immunogenic, with an acceptable safety profile in 12-23-month-old children

Tetravalent meningococcal serogroups ACWY conjugate vaccines will provide an advantage to those at most risk of invasive meningococcal disease; namely young children. Co-administration of ACWY-TT with DTaP-HBV-IPV/Hib was assessed in a randomized trial in 793 children aged 12-23 months. Pre-specified criteria for non-inferiority of immunogenicity following co-administration versus separate ACWY-TT and DTaP-HBV-IPV/Hib administration were reached. One month post-vaccination, ≥97.3% of ACWY-TT vaccinees had rSBA titres ≥1:8 (all serogroups). Seroprotection/seropositivity rates against DTaP-HBV-IPV/Hib antigens were ≥98.2%. The safety profile of co-administration was similar to that of DTaP-HBV-IPV/Hib alone. ACWY-TT and DTaP-HBV-IPV/Hib co-administration during the second year would facilitate introduction of ACWY-TT into routine toddler vaccination schedules.