维奈克拉联合去甲基化药物治疗髓系肉瘤5例临床疗效及安全性分析

目的:探讨维奈克拉联合去甲基化药物治疗髓系肉瘤的有效性及安全性。方法:纳入5例髓系肉瘤患者,其中初诊患者2例,复发难治患者2例,造血干细胞移植后1例。3例给予维奈克拉联合地西他滨,2例给予维奈克拉联合阿扎胞苷,分析临床疗效及安全性。结果:5例患者治疗后病灶超声影像学消失,4例伴有骨髓侵犯均获得完全缓解,不良反应主要为骨髓抑制。截至随访终止日期,4例患者存活,1例患者后因本病复发死亡。结论:维奈克拉联合去甲基化药物治疗髓系肉瘤可取得较好的临床疗效,且无明显不良反应。     

塞利尼索联合去甲基化药物治疗维奈克拉暴露难治/复发急性髓系白血病疗效分析

维奈克拉联合去甲基化药物(HMA)方案在难治/复发急性髓系白血病(R/R AML)患者中的缓解率可达50%, 然而仍有约1/3的患者对该方案原发耐药。维奈克拉联合HMA一线治疗失败的患者经挽救治疗后预后仍较差, 中位生存期仅2.9个月[1]。维奈克拉耐药的机制复杂, 另外R/R AML患者往往存在骨髓抑制、伴发感染等合并症, 后续低强度治疗方案选择较为困难。塞利尼索(Selinxor)是第一个口服选择性核输出蛋白(XPO1)抑制剂[2]。既往研究表明, XPO1在AML中高表达, 参与肿瘤的发生发展。塞利尼索竞争性抑制XPO1核输出功能, 激活肿瘤抑制蛋白如p53、p21的功能;并降低细胞质中致癌蛋白的水平, 如C-kit、BCL2和MCL1, 发挥抗白血病活性[3]。本回顾性研究中我们分析了12例接受塞利尼索联合HMA地西他滨(DAC)、阿扎胞苷(AZA)治疗的R/R AML患者的临床资料, 初步观察探讨其疗效和安全性。     

维奈克拉联合多药化疗治疗复发难治早期前体T淋巴细胞白血病15例疗效及安全性分析

目的探讨维奈克拉(Venetoclax, Ven)联合多药化疗治疗复发难治早期前体T淋巴细胞白血病(R/R ETP-ALL)患者的疗效及安全性。方法回顾性分析2018年12月至2022年2月在苏州大学附属第一医院住院治疗的15例R/R ETP-ALL患者的临床资料。再诱导治疗以Ven为基础联合多药化疗, 其中8例联合去甲基化药物, 4例同时联合去甲基化药物和HAAG方案, 2例同时联合去甲基化药物和CAG预激方案, 1例联合克拉屈滨。Ven用法为100 mg第1天, 200 mg第2天, 400 mg第3～28天, 口服;联合唑类抗真菌药物时减量至100 mg/d。结果 15例R/R ETP-ALL患者中, 男10例, 女5例, 中位年龄35(12～42)岁。难治4例, 复发11例。用药第21天疗效:完全缓解(CR)率为60.0%(9/15), CR伴血液学不完全恢复(CRi)率为6.7%(1/15), 总有效率(ORR)为66.7%。所有患者12个月总生存(OS)率为60.0%, 中位OS时间为17.7个月;全部CR患者12个月无病生存(DFS)率为60.0%, 中位DFS时间未达到...     

抗CD22序贯抗CD19嵌合抗原受体T细胞治疗复发/难治性儿童急性B淋巴细胞白血病2例

例1,女,9岁,诊断为急性B淋巴细胞白血病（B-ALL）,KRAS基因T58I突变。先后接受CCLG-ALL2015、hyper-CVAD（A）方案化疗,均短期复发。FC方案预处理后,行嵌合抗原受体T细胞（CAR-T）治疗。回输鼠源化抗CD19 CAR-T细胞5×10 6/kg（转染率50.66%）。+2 d...     

不同成脂条件下人骨髓间充质干细胞的早期成脂特性

BACKGROUND:There are various methods to induce adipogenic differentiation of bone marrow mesenchymal stem cells, and the main component for adipogenic induction is indomethacin or rosiglitazone. However, there is a lack of comparative study on the induction efficiency and mechanism among these methods. OBJECTIVE:To compare the adipogenic responses of human bone marrow mesenchymal stem cells to different induction methods, and to analyze the mechanism underlying different induction efficiency. METHODS:After isolation and purification, the adipogenic abilities of human bone marrow mesenchymal stem cells in three different culture systems were compared by oil red O staining and lipogenic gene assay. At 0, 1, 3 and 7 days of adipogenensis, mRNA expressions of PPARγ, C/EBPα, Adiponectin and Leptin were detected. At 7 days of adipogenensis, protein expressions of PPARγ and C/EBPβ were detected by western blot assay, and effects of DIMI versus DIMR on phosphorylation of PPARγ at Ser273 were compared. RESULTS AND CONCLUSION:Findings from oil red O staining and real-time PCR showed that DIMR significantly induced adipogenic differentiation of bone marrow mesenchymal stem cells compared with DIM and DIMI at 7 days of induction. Western blot showed that the protein expressions of PPARγ and C/EBPβ in the DIMI group were significantly higher than those in the DIMR and DIM at 7days of induction. In addition, the ratio of PPARγ phosphorylation at Ser273 was lower in the DIMR group than the DIMI group. To conclude, DIMR has the most potential to induce early adipogenesis of human bone marrow mesenchymal stem cells by weakening the phosphorylation of PPARγ-Ser273.