三氧化二砷治疗复发性急性早幼粒细胞白血病临床观察

目的 探讨三氧化二砷治疗复发性早幼粒细胞白血病的疗效.方法 对9例复发的急性早幼粒细胞白血病患者应用三氧化二砷治疗,观察其完全缓解率.结果 9例中完全缓解6例,占66.7%,有效率77.8%.结论 三氧化二砷治疗复发性早幼粒细胞白血病,其完全缓解率高,且与维甲酸与化疗药物之间无交叉耐药,副作用小,值得临床推广应用.     

三氧化二砷治疗复发性急性早幼粒细胞白血病临床观察

目的 探讨三氧化二砷治疗复发性早幼粒细胞白血病的疗效.方法 对9例复发的急性早幼粒细胞白血病患者应用三氧化二砷治疗,观察其完全缓解率.结果 9例中完全缓解6例,占66.7%,有效率77.8%.结论 三氧化二砷治疗复发性早幼粒细胞白血病,其完全缓解率高,且与维甲酸与化疗药物之间无交叉耐药,副作用小,值得临床推广应用.     

急性早幼粒细胞性白血病分子生物学研究进展

对急性早幼粒细胞性白血病维甲酸受体家族及ＰＭＬ／ＲＡＲα，ＰＬＺＦ／ＲＡＲα，ＮＰＭ／ＲＡＲα融合基因结构及功能的研究，在阐明独特的维甲酸反应机理，探讨ＡＰＬ发生机制，提高诊断水平，判断预后，监测疗效等方面具有深远意义。     

48例急性早幼粒细胞白血病的细胞遗传学研究

目的　探讨不同病期急性早幼粒细胞白血病 (APL)的细胞遗传学特点及意义。方法　随机选取 4 8例APL患者 ,采集新鲜骨髓 ,采用 2 4h预加秋水仙素的短期培养法制备染色体 ,应用G显带技术进行核型分析并照相。结果　本研究4 8例患者 (未缓解期 16例 ,复发期 3例 ,完全缓解期 2 9例 )中 ,具有染色体异常的有 2 8例 ,其中未缓解期 16例 (16 /16 ) ,复发期 3例 (3/3) ,完全缓解期 9例 (9/2 9)。异常类型以染色体易位和片段缺失比例较高 ,其中具有典型t(15 ;17)易位者 7例 ,为未缓解期或复发期患者 ;易位涉及 8q2 2者 5例。其中 ,同时具有t(15 ;17) ,t(8;2 1)易位 1例 ;同时具有t(5 ;8) ,t(15 ;17)易位 1例 ;t(5 ;8)易位 1例 ;t(8;17)易位 1例 ;以t(8;2 1)为基础的复杂易位 1例。具有 17q2 1-者 6例。结论　对白血病进行细胞遗传学研究不但具有十分重要的诊断和预后价值 ,而且能发现与疾病发生有关的新基因及涉及白血病转化和增殖的分子损伤位点。     

D-二聚体测定与急性早幼粒细胞白血病

目的探讨D -二聚体含量与急性早幼粒细胞白血病(APL)经全反式维甲酸(ATRA)治疗前后弥漫性血管内凝血(DIC)发生率的关系及意义。方法应用ELISA法检测21例APL患者(包括7例合并DIC患者)发病时及应用ATRA治疗后D -二聚体水平的变化 ,并与正常对照组比较。结果21例APL患者治疗前血浆D -二聚体水平(2.38±0.98)mg/L较正常对照组(0.25±0.09)mg/L明显升高(P<0.01) ,其中7/21例并发DIC者(2.52±0.12)mg/L明显高于14/21例不并发DIC者 ,(2.18±0.96)mg/L。结论APL患者D -二聚体检测值随维甲酸治疗逐渐降低 ,并可预测ATRA治疗过程中DIC变化及预后     

三氧化二锑诱导急性早幼粒细胞白血病细胞凋亡的研究

目的 研究锑剂三氧化二锑（Sb2O3)对早幼粒细胞白血病细胞株NB4凋亡的诱导作用，以寻求早幼粒细胞白血病治疗的新方法。方法 采用细胞生长曲线，形态学及硝基四氮唑蓝（NBT）还原试验，判定NB4细胞的生长，分化及功能。采用细胞周期分析和DNA电泳研究细胞凋亡。结果 Sb2O3能诱导早幼粒白血病细胞凋亡，且具有时间，剂量依赖性。结论 Sb2O3能有效地诱导早幼粒白血病细胞凋亡，提示锑剂诱导细胞半亡的疗法，有望成为临床治疗早幼粒细胞白血病的新方法。     

急性早幼粒细胞白血病68例回顾性临床分析

目的探讨初治中低危急性早幼粒细胞白血病(APL)患者诱导缓解治疗及完全缓解(CR)后的治疗方案。方法回顾性分析68例初治APL患者3种不同诱导治疗方法CR率、达CR所需时间及副作用,并分析CR后不同巩固治疗方案对预后的影响。结果全返式维甲酸(ATRA)联合蒽环类药物化疗、单用亚砷酸(AS2O3)及ATRA+AS2O3+化疗3种方法治疗初诊APL完全缓解率分别为90%、89%、89%,无显著差异,P>0.05;ATRA+AS2O3+化疗组达CR所需时间最短,ATRA+化疗组副作用最少,P<0.05;CR后选用ATRA、AS2O3、化疗序贯治疗能明显延长患者无病生存期。结论 ATRA+化疗方案可做为初治APL患者诱导缓解的首选方案;ATRA、AS2O3、化疗序贯治疗均可做为CR后的有效治疗方案,中低危患者可不必联用Ara-c化疗。     

HLA-DR阴性的急性髓系非早幼粒细胞白血病

正正常髓系细胞分化成熟的过程中,人类白细胞抗原(简称HLA-DR)可表达在造血祖细胞,粒细胞、单核细胞及巨核细胞的前体细胞上,但在早幼粒细胞阶段往往缺乏,与之相一致的是绝大多数的早幼粒细胞白血病细胞上也缺乏HLA-DR     

全反式维甲酸联合亚砷酸治疗急性早幼粒细胞白血病的临床疗效

目的探讨全反式维甲酸联合亚砷酸治疗急性早幼粒细胞白血病的临床疗效。方法选取我院在2005年03月~2013年02月收治的56例急性早幼粒细胞白血病患者随机分为观察组和对照组,观察组患者给予全反式维甲酸联合亚砷酸治疗,对照组患者给予亚砷酸治疗。结果两组患者在完全缓解率上无明显的差异性（P>0.05）,但是在达到完全缓解的时间上存在显著差异性（P<0.05）;两组患者在不良反应发生率上无明显差异性（P>0.05）。结论全反式维甲酸联合亚砷酸治疗急性早幼粒细胞白血病效果显著。     

三氧化二砷诱导卵巢癌HO8910细胞凋亡

目的探讨三氧化二砷对卵巢癌细胞株HO8910的抑制增殖效应及凋亡诱导作用。方法用三氧化二砷处理HO8910细胞,采用MTT法检测药物对细胞的抑制作用,倒置显微镜和电镜观察细胞形态学改变,琼脂糖凝胶电泳观察DNA降解,以及应用流式细胞仪观察细胞凋亡过程中细胞周期的变化。结果在三氧化二砷作用下,HO8910细胞呈凋亡改变,DNA琼脂糖凝胶电泳呈典型的凋亡特征。细胞凋亡的同时,细胞周期发生特定的改变,亚G1峰出现,S+G2~M期细胞所占比例组明显增高。结论三氧化二砷能诱导卵巢癌细胞凋亡,抑制卵巢癌细胞增殖。     

高白细胞急性白血病去白细胞术的微循环观察

目的观察高白细胞性急性白血病(HyperleukocyticAcuteLeukemia,HLAL)去白细胞术前后的微循环学变化,指导HLAL的治疗。方法40例HLAL患者行去白细胞术,观测术前后的微循环学参数,应用t检验分析统计学差异。结果全部患者术后临床症状均完全缓解。4例DIC者1例痊愈,3例显效。甲襞微循环除管襻形态无明显改善外,血流形态、襻周状态及总积分值均有改善(P<0.01),而全部血流变学参数均显著降低(P<0.05)。结论去白细胞术既能迅速减轻肿瘤负荷,又能纠正患者微循环的异常,是HLAL的安全有效治疗方法。     

Outcomes after Second Hematopoietic Cell Transplantation in Children and Young Adults with Relapsed Acute Leukemia

Children with acute leukemia who relapse after hematopoietic cell transplantation (HCT) have few therapeutic options. We studied 251 children and young adults with acute myelogenous or lymphoblastic leukemia who underwent a second HCT for relapse after their first HCT. The median age at second HCT was 11 years, and the median interval between first and second HCT was 17 months. Most of the patients (n?=?187; 75%) were in remission, received a myeloablative conditioning regimen (n?=?157; 63%), and underwent unrelated donor HCT (n?=?230; 92%). The 2-year probability of leukemia-free survival (LFS) was 33% after transplantation in patients in remission, compared with 19% after transplantation in patients not in remission (P?=?.02). The corresponding 8-year probabilities were 24% and 10% (P?=?.003). A higher rate of relapse contributed to the difference in LFS. The 2-year probability of relapse after transplantation was 42% in patients in remission and 56% in those in relapse (P?=?.05). The corresponding 8-year probabilities were 49% and 64% (P?=?.04). These data extend the findings of others showing that patients with a low disease burden are more likely to benefit from a second transplantation. Late relapse led to a 10% decrement in LFS beyond the second year after second HCT. This differs from first HCT, in which most relapses occur within 2 years after HCT.     

Silencing SATB1 Inhibits the Malignant Phenotype and Increases Sensitivity of Human Osteosarcoma U2OS Cells to Arsenic Trioxide

In a previous study, we found that the global genome organizer Special AT-rich binding protein 1 (SATB1) is highly expressed in mesenchymal-derived human osteosarcoma U2OS cells and that the knock-down of SATB1 results in the inhibition of cell proliferation. The present study was aimed at investigating the effect of silencing SATB1 on cell migration, invasion, apoptosis and resistance to the chemotherapeutic drug arsenic trioxide. Cell migration and invasion were detected by wound-healing assays and trans-well invasion assays, respectively. Cell apoptosis was analyzed by an in situ Cell Death Detection POD Kit, based on terminal deoxynucleotydyl transferase mediated dUTP nick-end labeling (TUNEL) staining and mRNAs were analyzed by real time qRT-PCR. We found that cell migration and invasion were inhibited and that the proportion of apoptotic cells and sensitivities to the chemotherapeutic drug arsenic trioxide were enhanced by knockdown of SATB1 in U2OS cells. Furthermore, mRNA of ABCC1 and ABCG2 were decreased strikingly after SATB1 silencing. It was concluded that the elevated expression of SATB1 in U2OS cells contributes to maintenance of the malignant phenotype and resistance to chemotherapeutic drugs ATO, suggesting that silencing SATB1 in the cells might improve the effects of arsenic trioxides in the treatment of osteosarcoma in which SATB1 is over-expressed and that ABCC1 and ABCG2 were involved in SATB1 mediated resistance of U2OS cells to ATO.     

清营汤方剂与施他宁联合治疗对重症胰腺炎患者细胞因子水平的影响

为探讨早期应用清营汤治疗重症胰腺炎患者细胞因子水平的影响。采用酶联免疫法测定其外周血清中IL 2、IL 2R及sIL 2R水平。结果显示 ,重症胰腺炎早期联用清营汤方剂组治疗 1周后 ,机体细胞因子IL 2、IL 2Rα水平迅速上升 ,sIL 2Rα下降明显 ;而常规施他宁对照组IL 2及IL 2Rα水平呈下降趋势 ,sIL 2Rα变化不明显 ,两组结果相比差异显著。早期应用清营汤治疗重症胰腺炎患者 ,有利于尽快恢复机体免疫调节功能 ,为临床今后开展对重症胰腺炎早期清营汤治疗提供了实验证据     

急性白血病患者的行为特征、述情障碍及应对方式

目的:探讨急性白血病患者的行为特征、述情障碍以及应对方式特点。方法:采用病例对照和Logistic回归多因素分析的方法,使用经修订的行为特征问卷、多伦多述情障碍量表、简易应对方式问卷,对59例急性白血病患者施测,并与45例非恶性肿瘤血液病患者和63名健康人对照。结果:急性白血病患者的愤怒内泄因子分(14.2±2.8)和述情障碍总分(68.8±8.7)低于非恶性肿瘤患者(15.2±2.1,73.3±8.5,P<0.05),乐观和社会支持分高于健康人(21.9±3.6/20.6±3.0,17.7±2.1/16.4±2.4,P<0.05),积极应对方式和消极应对方式平均分与非恶性肿瘤组及健康人差异无显著性,但幻想条目分高于健康人(1.3±1.0/0.9±1.0,P<0.05),其他有差异的条目分均低于非恶性肿瘤组或健康人。Logistic多元回归分析发现年龄(OR=0.93)、愤怒内泄(OR=0.77)和情绪控制(OR=1.05)三因子对急性白血病和非恶性肿瘤组的鉴别有统计学意义;乐观(OR=1.15)、社会支持(OR=1.25)、积极应对(OR=0.90)对急性白血病和健康组的鉴别有统计学意义。结论:急性白血病患者可能没有明显的C型行为特征和述情障碍。急性白血病患者的“幻想”和乐观可能是一种有心理适应意义的应对,在临床中应重视提高患者的积极心理应对。     

Allotransplants for Patients 65 Years or Older with High-Risk Acute Myeloid Leukemia

The outcome of persons > 65 years with acute myeloid leukemia (AML) is poor. A transplant from an HLA-identical sibling or an HLA-matched unrelated donor can cure some of these patients but is associated with a substantial transplant-related mortality and a high relapse risk. We analyzed 185 subjects > 65 years with high-risk AML receiving conventional (n?=?42) or reduced-intensity (n?=?143) pretransplant conditioning and a transplant from an HLA-identical sibling (n?=?66) or a 10/10 loci HLA-matched unrelated donor (n?=?119). Two-year survival was 37%. Subjects with serious adverse events during before chemotherapy for their leukemia had a poor outcome after stem cell transplantation. Patients who had active leukemia or measurable residual disease (MRD) before transplantation had a worse outcome. Delayed hematologic recovery after induction or consolidation chemotherapy, high-risk AML genetics, donor–recipient HLA-DRβ3/4/5-DP mismatches, and history of cardiovascular disease were also correlated with survival in multivariate analyses. The 57 MRD-negative patients with few other adverse prognostic factors had an excellent outcome (2-year overall survival, 76%), whereas the 58 patients with detectable leukemia and more than 1 other additional factor fared poorly (2-year overall survival, 8%). These data indicate it is possible to identify persons > 65 years with high-risk AML likely to benefit from an allotransplant. Validation of this prediction is needed.     

Thioredoxin-1 inhibitor PX-12 induces human acute myeloid leukemia cell apoptosis and enhances the sensitivity of cells to arsenic trioxide

Thioredoxin-1 (Trx-1), an important redox regulatory factor, plays a significant role in drug-induced apoptosis. Here we investigated the effects of the Trx-1 inhibitor 1-methylpropyl 2-imidazolyl disulfide (PX-12) on human acute myeloid leukemia cells (AML) and the sensitivity of cells to arsenic trioxide (As2O3, ATO). Treatment of cells with a different concentration of PX-12 for 48 h resulted in growth inhibition, the induction of apoptosis and increased the levels of activated caspase-3 expression in AML cell lines HL-60, NB4, U937 and primary AML cells in a dose-dependent manner. In addition, PX-12 enhanced the sensitivity of U937 cells to ATO. These results suggest the effects of Trx-1 inhibitor PX-12 to induce apoptosis in AML cells and therapeutic potential in AML by enhancing the sensitivity of cells to ATO.