Ph^＋成人急性淋巴细胞白血病治疗进展

费城染色体阳性（Ph^＋）急性淋巴细胞白血病（ALL）为难治性血液系统疾病之一,占成人急性淋巴细胞白血病（aALL）比例较高,成人Ph＋ALL对传统化学治疗方案效果不好,近年来,伊马替尼作为一线药物联合化学治疗和造血干细胞移植（HSCT）得到应用,提高了该病完全缓解率及预后。但由于ABL基因的突变,伊马替尼耐药等问题成为治疗中的又一挑战。几种新的酪氨酸激酶抑制剂（TKI）成为人们关注的热点,有望成为较伊马替尼更有潜力的抗肿瘤活性药物。     

穿心莲内酯对急性淋巴细胞白血病细胞的生长抑制及凋亡诱导作用

目的:研究穿心莲内酯(andrographolide,AND)对急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)细胞生长和凋亡的影响。方法:人ALL细胞株CEM-C1经AND处理12 h、24 h和48 h,应用CCK-8法检测AND对细胞活力的影响;应用Wright-Giemsa染色法观察AND处理24 h对CEM-C1细胞形态及数量的影响;应用流式细胞术+annexin V-FITC/碘化丙啶(propidium iodide,PI)双染色法分析AND作用24 h对CEM-C1细胞凋亡的作用;采用流式细胞术+PI染色法分析AND作用24 h对CEM-C1细胞周期分布的作用;用Western blot法检测AND对CEM-C1细胞凋亡相关蛋白水平的影响;应用JC-1线粒体膜电位(mitochondrial membrane potential,MMP)检测试剂盒检测AND作用24 h对CEM-C1细胞MMP的影响。最后将CEM-C1细胞接种于BALB/c-nu雌性裸鼠右胁腹侧建立裸鼠ALL移植瘤模型,通过检测肿瘤体积及重量观察AND的体内抗ALL...     

急性淋巴细胞白血病浸润牙龈1例

患者男性 ,30岁 ,在无任何诱因下出现左上颌牙龈包块2个月。检查 :贫血貌 ,颌下可触及肿大淋巴结 ,5 6 78颊侧面有一 5ｃｍ× 4ｃｍ× 2 5ｃｍ大小的肿块 ,表面呈菜花状 ,有糜烂。实验室检查 :Ｈｂ 6 6ｇ/Ｌ ,ＷＢＣ 2 4× 10 9/Ｌ ,Ｐｌｔ 190×10 9/Ｌ ,Ｌ 0 37,Ｎ 0 6 0 ,骨髓象增生明显活跃 ,淋巴系统显著增生 ,其中原幼淋占 0 6 5。临床初步诊断 :左上颌牙龈白血病浸润。遂活检左上颌牙龈包块以进一步证实。病理检查　灰白组织一块 2ｃｍ× 1 5ｃｍ× 1ｃｍ ,切面灰白 ,质细嫩 ,呈鱼肉状。镜检 :牙龈黏膜下方为弥漫浸润的肿瘤性原…     

五海汤治疗急性淋巴细胞白血病40例探讨

五海汤治疗急性淋巴细胞白血病４０例探讨高德法，王玉湘西安中医血液病医院关键词急性淋巴细胞白血病，五海汤，治疗１９８９～１９９４年，作者等采用五海汤治疗急性淋巴细胞白血病（ＡＬＬ，包括Ｌ１、Ｌ２、Ｌ３）４０例，其中住院２１例，门诊１９例，疗效均较满意。...     

91例急性非淋巴细胞白血病的细胞遗传学研究

为探讨急性非淋巴细胞白血病患者细胞遗传学改变,对９１ 例急性非淋巴细胞白血病（ＡＮＬＬ） 的骨髓染色体进行了检查,对染色体畸变,特别是特异性染色体畸变以及染色体畸变发生率作了研究,结果有６７．０％ 的患者有染色体异常改变,其中结构异常占４３．９ ％ ,数目异常占２３ ．１％ 。Ｍ２、Ｍ３、Ｍ５、Ｍ４ 畸变比率最高,共占染色体畸变总数的９０ ．２ ％ ,Ｍ１、Ｍ７ 次之,Ｍ６ 较少有染色体畸变,此畸变与ＡＮＬＬ的细胞类型常带有一种特异的对应关系。同时对不同时期的染色体核型作了动态观察,表明染色体核型动态检查对于观察ＡＮＬＬ的病情及指导治疗和判断预后都有一定的价值。并对ＡＮＬＬ 的细胞遗传学与ＦＡＢ分型、免疫分型间的关系作了探讨,表明形态学、免疫学、细胞遗传学对ＡＮＬＬ分型是不可分割的一个整体。     

80例儿童急性淋巴细胞白血病的染色体分析

目的与方法本文对80例儿童急性淋巴细胞白血病（急淋）进行了细胞遗传学研究。结果发现正常核型为50%,染色体数量异常占40%,结构异常的染色体包括t（9;22）（q34;q11）,（8;14）（q24,q32）,6q占10%等。结论探讨认为细胞形态学,免疫表型和细胞遗传学的联合分析（MIC）有助于儿童急淋的诊断和分型,尤其细胞遗传学对于儿童急性淋巴细胞白血病的诊断和预后判断具有重要意义。     

大剂量甲氨蝶呤治疗急性淋巴细胞白血病的护理

急性白血病是骨髓中原始与早期幼稚血细胞急剧增生的恶性疾病[1],死亡率较高,治疗以化疗为主,达到完全缓解后也要定期巩固,维持化疗,防止复发,而对髓外白血病的防治是急性淋巴细胞门血病(ALL)获长期无病生存的重要环节.     

长链非编码RNA HOTAIR对急性淋巴细胞白血病细胞增殖与凋亡的影响

目的:研究长链非编码RNA HOTAIR调控糖皮质激素受体的表达对急性淋巴细胞白血病细胞增殖及凋亡的作用。方法:采用RT-qPCR法检测人正常骨髓基质细胞系HS-5及急性淋巴细胞白血病细胞系MOLT-4、CCRF-CEM和CEM-C1中HOTAIR和糖皮质激素受体的表达。用si RNA沉默CEM-C1细胞中HOTAIR的表达,CCK-8法检测si-HOTAIR对CEM-C1细胞活力的影响; Brd U法检测si-HOTAIR对CEM-C1细胞增殖的影响以及对地塞米松抑制CEM-C1细胞增殖的增效作用; Hoechst 33342染色法和caspase 3/7活性检测法研究si-HOTAIR对CEM-C1细胞凋亡的影响;并采用Western blot法检测糖皮质激素受体的蛋白表达水平。结果:人急性淋巴细胞白血病细胞系MOLT-4、CCRF-CEM和CEM-C1中HOTAIR的表达显著高于人正常骨髓基质HS-5细胞(P 0. 01)。在CEM-C1细胞中干扰HOTAIR表达后,细胞活力降低,细胞增殖被抑制并发生凋亡,地塞米松抑制CEM-C1增殖的作用被增强,糖皮质激素受体表达上调(P 0. 01)。结论:长链非编码RNA HOTAIR增强急性淋巴细胞白血病的活力,促进其增殖并抑制其凋亡,该作用可能与其抑制糖皮质激素受体的表达有关。     

儿童急性淋巴细胞和非淋巴细胞白血病诊断治疗

高怡瑾教授很荣幸邀请到Smith教授访问复旦大学附属儿科医院,并借此机会在上海医学会儿科学分会血液学组的学术活动中做儿童急性髓系白血病学术报告,Smith教授是美国辛辛那提儿童医院儿科学系教授,血液肿瘤科临床主任,并在美国儿童肿瘤协作组织（COG）担任儿童急性非淋巴细胞白血病（AML）临床试验组主席。     

Preliminary results of the treatment of acute leukemia with mitoxantrone]

Mitoxantrone is a new anthracenodione derivative with a high antineoplastic activity in proliferative diseases of the haemopoietic system. In the Institute of Haematology in Warsaw and in the Department of Haematology, Silesian Medical Academy in Katowice this agent was used in combination with cytarabine in 49 cases of acute leukaemia (35 with acute myeloid leukaemia and 14 with acute lymphoblastic leukaemia). The preparations used were Mitoxantrone (POLFA Works in Jelenia Góra) and Novantrone (Lederle). These agents were given intravenously in doses of 10-20 mg/m2 for 3 days in combination with cytarabine in three doses: 100 mg/m2 on days 1 through 7, and 1 g/m2 or 3 g/m2 every 12 hours on days 1 through 4 of the treatment. Complete remission was obtained in 17 cases (35%), including 13 with acute myeloid leukaemia (37%) and 4 with acute lymphoblastic leukaemia (29). The most frequent side effects were: long-lasting pancytopenia (in 100% of cases), hair loss (39%) and gastrointestinal toxicity (33%). No significant differences were noted in the effectiveness and toxicity between these two preparations. In the light of the presented results it may be accepted that the combination of mitoxantrone with cytarabine is an important advance in the treatment of acute leukaemias.     

Aclarubicin in the treatment of elderly patients with acute nonlymphocytic leukemia

Thirteen previously untreated patients aged 70 and above with acute nonlymphocytic leukemia were treated with aclarubicin (ACR) alone. Among 10 cases (3, acute myelocytic leukemia; 4, acute myelomonocytic leukemia; 2, acute monocytic leukemia; and one, acute erythroleukemia) in which an evaluation was possible, 5 cases (3, acute myelomonocytic leukemia; and 2, acute monocytic leukemia) obtained complete remission (CR). The CR rate was 83% in 6 patients with acute myelomonocytic leukemia or acute monocytic leukemia. The median CR duration and survival was 7.5 and 10 + months, respectively. Although side effects of the drug on digestive system such as nausea, vomiting and anorexia were observed in all patients, they were controllable by conventional treatments. The results suggest that ACR is effective for the clinical management of elderly patients with acute nonlymphocytic leukemia, especially those with acute myelomonocytic leukemia or acute monocytic leukemia.     

The multidrug resistance and apoptosis evaluation in acute myeloid leukemia cells after the in vitro doxorubicin treatment

The apoptosis failure in cytostatic treatment of haemoblastosis is one of the means of chemoresistance. We were interested in the relationship of the after-doxorubicin-treatment-AML cells apoptosis and the immunophenotype, selected clinical and laboratory parameters, and also the P-gp, MRP, LRP, Bcl-2, Bax proteins expression. All analysis were evaluated with the flow cytometry method. To detect apoptotic cells in the sample, we used three methods: annexin test, TUNEL (TdT-mediated dUTP nick end labeling) test, and caspase 8 detection. After the cell cultivation the statisticaly important increase of apoptotic cells in the culture was apparent. The relation between the AML blast in vitro reaction and some clinical parameters such as the age of patient, white blood cell count, and blast percentage was also observed.     

Secondary chronic myelomonocytic leukemia with monosomy 7 after successful treatment of acute promyelocytic leukemia

Current APL chemotherapy protocols usually include high-dose anthracyclines, mitoxantrone, and epipodophillotoxins, which are topoisomerase II inhibitors of high leukemogenic potential. In the last years, several case reports of myelodysplastic syndrome (MDS) or AML (different from APL), occurring during the course of APL have been made. We report herein a first case of CMML with monosomy 7 occurring after treatment of APL.     

Proinflammatory cytokines induce lymphocyte apoptosis in acute African swine fever infection

Twenty-one pigs inoculated with a highly virulent isolate (E70) of African swine fever (ASF) virus were killed 1-7 days later; a further three animals served as uninfected controls. An early increase in TNF-alpha, IL-1alpha, IL-1beta and IL-6 expression was detected in lymphoid organs from infected animals, together with an increase in the serum concentrations of TNF-alpha and IL-1beta. These changes were accompanied by increased apoptosis of lymphocytes, and the presence of infected and uninfected macrophages showing changes indicative of secretory and phagocytic activation. The present study demonstrated an increase in the number of macrophages expressing TNF-alpha, IL-1 and IL-6 in proximity to lymphocytes undergoing apoptosis, supporting previous suggestions that in acute ASF proinflammatory cytokines induce lymphocyte apoptosis.