复方黄黛片诱导治疗急性早幼粒细胞白血病193例疗效分析

目的 总结复方黄黛片诱导治疗193例急性早幼粒细胞白血病(APL)患者的疗效与不良反应.方法 复方黄黛片1.25 g,每日3次,饭后服;3 d后逐渐增量至7.5 g/d.结果 193例患者均获完全缓解(CR),其中78.8%的患者在用药44.3(31～60)d后获CR;疗程中未出现严重的感染、出血,不诱发与加重DIC.治疗中的主要不良反应是胃肠道症状.110例患者治疗前后的丙氨酸转氨酶、尿素、肌酐、心电图的QTc间期等指标变化不大.结论 复方黄黛片治疗APL具有CR率高,不抑制骨髓,不诱发与加重DIC,使用安全,患者耐受性好等特点.     

间期荧光原位杂交和常规染色体分析诊断急性早幼粒细胞白血病的比较

本研究主要探讨急性早幼粒细胞白血病(APL)细胞遗传学特征并比较间期荧光原位杂交技术(I-FISH)和常规染色体核型分析技术(CC)。应用常规染色体核型分析及I-FISH技术对157例APL患者细胞遗传学特征进行研究,采用短期培养法制备骨髓细胞染色体,应用染色体R显带技术对136例拟诊APL患者进行常规细胞遗传学检测,其中对45例同时进行了CC和I-FISH检测,对其余21例仅进行I-FISH分析。结果表明:136例进行CC分析的APL患者中,120例(88.2%)存在t(15;17)(q22;q21)易位,其中107例(78.7%)为单纯t(15;17)(q22;q21)易位,13例(9.6%)为伴t(15;17)(q22;q21)异位的复杂核型异常;在16例无t(15;17)(q22;q21)易位的APL患者中1例(0.7%)为t(5;17)(q24;q21)易位,3例(2.2%)正常核型,12例(8.8%)未见分裂相。在所有66例进行FISH检测的APL患者中,64例存在PM I/RARα融合基因,其阳性率为97.0%,灵敏度显著高于常规染色体核型分析(p=0.041);而5例其他类型AML患者和5例正常标本均未检出PM I/RARα融合基因。结论:常规染色体核型分析和间期荧光杂交技术联合分析APL患者细胞遗传学特征是诊断该病和监测微小残留病的有力工具。     

MICM分型在急性早幼粒细胞白血病诊断中的应用

目的 探讨MICM分型在急性早幼粒细胞白血病（APL,M3）诊断中的价值.方法 形态学采用Wright染色,细胞化学过氧化物酶（POX）、糖原染色（PAS）、非特异性酯酶加氟化钠抑制试验（NSE＋NaF）、特异性酯酶（CE）染色按常规方法;应用免疫酶标记技术和流式细胞术进行免疫学分型;用24 h短期培养法G带方法进行染色核型分析;用RT-PCR检测PML/RARa融合基因.结果 61例APL中粗颗粒型17例、细颗粒型12例、混合颗粒型30例、变异型2例,POX、NSE、NSE＋NaF、PAS、CE阳性率分别为99.7%、82.4%、71%、97%、99.6%;33例免疫学分型：CD13 90.8%、CD14 91.8%、CD33 96.6%、CD68 86%、MPO 96.6%、HLA-DR 28.7%、CD19 15%、CD10 12%、CD3不表达;31例染色体分析中21例具有t（15;17）,其中1例还具有额外累及17号染色体异常,6例正常核型,4例培养无分裂象;24例APL中17例PML/RARa融合基因转录本阳性,4例阴性,3例失败.结论 MICM分型使APL的诊断更准确,便于临床更好地选择治疗方案和判断预后.     

基于对比学习的急性早幼粒细胞白血病智能检测算法模型在全血细胞分析中的建立与验证

摘要:目的利用 学习统计软件建立基于对比大模型的急性早幼粒细胞白血病( M3)智能检测算法模型(简称M3模型),并验 证其有效性。方法通过实验室信息 系统(LS)和医院信息系统(HIS)检索并统计北京协和医院8256例行全血细胞分析的 门诊及住院患者数据,建立M3筛查模型。采用2023年7一10月本院行全血细胞分析的门诊及住院患者数据对M3模型进行 验证。结果M3 模型对全血细胞分析中M3的筛查具有一定应用价值,在筛查中性粒细胞毒性变化方面有一定作用,成功筛 出2例中性粒细胞蓝绿色包涵体。结论M3 模型对M3诊断的特异性有待提高。后续研究将增加M3阳性病例以优化模型, 在保证高敏感性的同时提高特异性,为全血细胞分析智能审核提供帮助。     

Andrographolide inhibits growth of acute promyelocytic leukaemia cells by inducing retinoic acid receptor‐independent cell differentiation and apoptosis

Objectives The growth inhibiting potential of andrographolide was evaluated in three acute promyelocytic leukaemia cell line models (HL‐60, NB4 and all‐trans retinoic acid (ATRA)‐resistant NB4‐R2). Methods In elucidating the mechanisms of growth inhibition, a special emphasis was placed on assessing the induction of differentiation and apoptosis by andrographolide in the primary acute promyelocytic leukaemia NB4 cells. Key findings The compound was 2‐ and 3‐fold more active in inhibiting the growth of HL‐60 and NB4‐R2 cells compared with NB4 cells, respectively. At IC50 (concentration at which growth of 50% of the cells (compared with medium only treated control cells) is inhibited; 4.5 μM) the compound exhibited strong cell‐differentiating activity in NB4 cells, similar to ATRA (IC50 1.5 μM). In the presence of a pure retinoic acid receptor antagonist AGN193109, the growth inhibition of NB4 cells by ATRA was reversed, whereas the activity of andrographolide was not affected. This clearly suggested that andrographolide's cell differentiating activity to induce growth inhibition of NB4 cells most likely occurred via a retinoic acid receptor‐independent pathway. At higher concentration (2 × IC50), andrographolide was an efficient inducer of apoptosis in NB4 cells. Conclusions Taken together, these results suggest andrographolide and its derivatives, apparently with a novel cell differentiating mechanism and with ability to induce apoptosis, might be beneficial in the treatment of primary and ATRA‐resistant acute promyelocytic leukaemia.     

三氧化二砷和阿糖胞苷交替治疗急性早幼粒细胞性白血病的护理

目的 :总结三氧化二砷和阿糖胞苷交替治疗急性早幼粒细胞性白血病 (M3 )的护理经验。方法 :对 2 1例M3 患者进行三氧化二砷和阿糖胞苷交替治疗并采取有效的护理措施。结果 :2 1例M3 患者治疗总有效率95 2 4 % ,3年生存率 71 4 3% ,5年生存率 5 7 14 % ,生存质量明显提高。结论 :熟悉三氧化二砷和阿糖胞苷的药理作用、药物动力学特点及M3 病理生理特点 ,积极采取有针对性的护理措施有利于提高患者生存率和生存质量。     

复方黄黛片诱导治疗急性早幼粒细胞白血病193例疗效分析

目的 总结复方黄黛片诱导治疗193例急性早幼粒细胞白血病(APL)患者的疗效与不良反应.方法 复方黄黛片1.25 g,每日3次,饭后服;3 d后逐渐增量至7.5 g/d.结果 193例患者均获完全缓解(CR),其中78.8%的患者在用药44.3(31～60)d后获CR;疗程中未出现严重的感染、出血,不诱发与加重DIC.治疗中的主要不良反应是胃肠道症状.110例患者治疗前后的丙氨酸转氨酶、尿素、肌酐、心电图的QTc间期等指标变化不大.结论 复方黄黛片治疗APL具有CR率高,不抑制骨髓,不诱发与加重DIC,使用安全,患者耐受性好等特点.     

Variant cell lines from the human promyelocyte line HL60

The continuous human promyeloid cell line HL60 may be induced to differentiate into neutrophils by the presence of 1.25% dimethylsulphoxide (DMSO) and related compounds [4]. When treated with 12-O-tetradecanoylphorbol-13-acetate (TPA), the cells exhibit many features characteristic of monocytes/macrophages [13]. In both cases, the induced HL60 cells lose their proliferative ability. The availability of this inducible cell line has led to an increasing number of studies aimed at dissecting the process of myeloid differentiation. However, the correct interpretation of such studies may only be reached through the use of appropriate cellular controls; specifically, variant HL60 cell lines which do not differentiate in response to the inducing agents. Here we report the isolation and characterization of two variant cell lines of HL60 which do not differentiate in the presence of 1.25% dimethylsulphoxide but still respond to TPA. Comparison of these HL60 variants with the parental line should facilitate the elucidation of molecular events which regulate myeloid differentiation.     

复方黄黛片诱导治疗急性早幼粒细胞白血病193例疗效分析

目的 总结复方黄黛片诱导治疗193例急性早幼粒细胞白血病(APL)患者的疗效与不良反应.方法 复方黄黛片1.25 g,每日3次,饭后服;3 d后逐渐增量至7.5 g/d.结果 193例患者均获完全缓解(CR),其中78.8%的患者在用药44.3(31～60)d后获CR;疗程中未出现严重的感染、出血,不诱发与加重DIC.治疗中的主要不良反应是胃肠道症状.110例患者治疗前后的丙氨酸转氨酶、尿素、肌酐、心电图的QTc间期等指标变化不大.结论 复方黄黛片治疗APL具有CR率高,不抑制骨髓,不诱发与加重DIC,使用安全,患者耐受性好等特点.     

Effect of retinoids and 1,25(OH)2 vitamin D3 bound to their plasma transport proteins on growth and differentiation of HL-60 cells

We have compared the effect of physiological and pharmacological concentrations of retinoids and 1,25(OH)₂ vitamin D₃ bound to their plasma transport proteins upon the proliferation and differentiation of HL-60 cells. Concentrations of chylomicron remnant retinyl ester similar to that obtained in plasma after a vitamin A-rich meal reduced the proliferation in more than 50% of HL-60 cells. Pharmacological concentrations of chylomicron remnant retinyl ester completely blocked the proliferation of the cells, and induced differentiation in 60% of the cells after 5 days. Physiological and pharmacological concentrations of retinoic acid bound to albumin had comparable effects. In contrast to earlier published data, which have been obtained with retinoids dissolved in ethanol, our results suggest that physiological and pharmacological concentrations of retinol (i.e. retinyl esters in chylomicron remnants) are as active as retinoic acid in reduction of proliferation and induction of differentiation of HL-60 cells. Physiological concentrations of 1,25(OH)₂ vitamin D₃ bound to vitamin D-binding protein (DBP) and retinol bound to retinol-binding protein had only a small effect on differentiation and proliferation of HL-60 cells.