Mitochondrial quality control includes mechanisms such as mitochondria-derived vesicles, fusion / fission and autophagy. These processes rely on the collaboration of a variety of key proteins in the inner and outer membranes of mitochondria to jointly regulate the morphological structure and functional integrity of mitochondria, repair mitochondrial damage, and maintain the homeostasis of their internal environment. The imbalance of mitochondrial quality control is associated with leukemia. Therefore, by exploring the mechanisms related to mitochondrial quality control of various leukemia cells and their interactions with immune cells and immune microenvironment, this article sought possible targets in the treatment of leukemia, providing new ideas for the immunotherapy of leukemia.
ObjectiveTo explore the risk factors of nosocomial infection in children with acute lymphoblastic leukemia during induction remission chemotherapy.MethodsThe children with acute lymphoblastic leukemia who were admitted to the Department of Pediatrics, Huai’an First Hospital Affiliated to Nanjing Medical University between December 2012 and December 2018 were divided into the infection group (including the severe infection subgroup and the non-severe infection subgroup) and the non-infection group according to whether nosocomial infection occurred during induction and remission chemotherapy. The clinical data of patients were collected. Univariate analysis and multivariate logistic regression were used to analyze the risk factors of nosocomial infection during induction remission chemotherapy in children with acute lymphoblastic leukemia.ResultsA total of 96 patients were included. There were 67 cases in the infection group (26 in the severe infection subgroup and 41 in the non-severe infection subgroup) and 29 cases in the non-infection group. Univariate analysis showed that the granulocyte deficiency time and the prevalence of skin and mucosal damage in the infection group were significantly higher than those in the non-infection group, and the infection group had significantly lower laminar bed use and serum albumin level than the non-infection group did (P< 0.05). Multivariate logistic regression analysis showed that prolonged agranulocytosis [odds ratio (OR)=23.075, 95% confidence interval (CI) (3.682, 144.617), P=0.001], skin and mucosal lesions [OR=12.376, 95%CI (1.211, 126.507), P=0.034], hypoalbuminemia [OR=5.249, 95%CI (1.246, 22.113), P=0.024] were independent risk factors for nosocomial infection during induction and remission of childhood acute lymphoblastic leukemia, while laminar bed [OR=0.268, 95%CI (0.084, 0.854), P=0.026] was the protective factor.ConclusionsLong-term agranulocytosis, skin and mucosal lesions, and hypoalbuminemia are independent risk factors for nosocomial infection in children with acute lymphoblastic leukemia during induction remission chemotherapy. Laminar flow bed is its protective factor.
【摘要】 目的 探讨仪器法和镜检法计数白血病幼稚粒细胞百分比的相关性和一致性。 方法 2009年6-9月对71例慢性粒细胞性白血病（慢粒）、亚急性粒细胞性白血病（M2）、急性早幼粒细胞性白血病（M3）及急性粒单核细胞性白血病（M4）白血病患者进行仪器法和镜检法计数周围静脉血幼稚粒细胞的百分比的检测，并进行比较分析。 结果 两种方法计数的慢粒、M2、M3及M4型共71例白血病患者的幼稚粒细胞的百分比比较，有统计学意义（t=6.404，Plt;0.01）；但具有相关性（r=0.771，Plt;0.001）。且四种类型白血病中的每一种类型的白血病的两种方法的幼粒值也都具有相关性和不一致性（Plt;0.05）。 结论 SYSMEX XE-2100全自动血细胞分析仪对慢粒、M2、M3及M4的周围静脉血幼稚粒细胞识别能力欠佳，仍需采用镜检法进行检测。【Abstract】 Objective To investigate the correlation and consistency of the percentage of immature granulocytes of peripheral venous blood in patients with leucocythemia between the instrument method and microscope test method. Methods From June to September 2009, instrument method and microscope test method were used to measure the percentage of immature granulocytes of peripheral venous blood in patients with leucocythemia [chronic granulocytic leukemia (CGL), subacute granulocytic leukemia (M2), acute promyelocyte leukemia (M3), and acute myelomonocytic leukemia (M4)]. Results The difference in the percentage of immature granulocytes of the 71 samples between the 2 methods was significant (t=6.404,Plt;0.01), but still with correlation (r=0.771,Plt;0.001). Besides, there were also correlation and consistency of the percentage of immature granulocytes of the four types of leukemia between the two methods (Plt;0.05). Conclusion The identification ability of SYSMEX XE-2100 type automatic blood cell analyzer for measuring the percentage of immature granulocytes of peripheral venous blood in patients with CGL, M2, M3 and M4 is still weak. Currently, microscope test method still needs to be applied in the measurement.
ObjectiveTo observe and analyze the clinical features and prognosis of proliferative diabetic retinopathy (PDR) with chronic myeloid leukemia.MethodsA retrospective case series study. From May 2011 to December 2020, 5 patients (10 eyes) were included in this study in Eye-ENT Hospital of Fudan University. Basic information about the patient's age, gender, diabetes history and CML history were collected. The endocrine and hematological indexes of all patients were evaluated. All the patients were undertaken visual acuity, intraocular pressure, slit lamp and fundus examination and other examinations to observe the eye conditions. Ophthalmic treatments included panretinal laser photocoagulation, intravitreal injection of anti-vascular endothelial growth factor, vitrectomy. During the follow up period from 5 months to 6 years, prognosis was observed at each office visit. During the follow up period, patients' vision, intraocular pressure, anterior segment and retinal status were observed.ResultsThere were 4 males and a female in 5 patients. The ages were from 27 to 49 years, with the mean age of 39 years. All patients were bilateral. All patients suffered type 2 diabetes for 3 months to 13 years. Four of them were diagnosed as chronic myeloid leukemia before visiting to ophthalmologists, while the other visited to ophthalmology first due to poor vision. The initial visual acuity ranged from light perception to 0.4 and 6 eyes were less than 0.1. In addition to the typical manifestations of diabetic retinopathy, such as venous tortuous dilation, exudation, microaneurysm and neovascularization, patients also presented with Roth spot as leukemic fundus manifestations. All eyes developed to PDR stage. Abnormal thickening of the neovascular membranes may occur in the lower part of the retina, with secondary traction retinal detachment. All the eyes were treated with pan retinal photocoagulation and 9 eyes underwent pars plana vitrectomy. After treatment, retina of 8 eyes kept flat. The best corrected visual acuity ranged from no light perception to 1.0, and only 4 eyes reached more than 0.2. Unfortunately, one eye lost vision because of secondary neovascular glaucoma.ConclusionsPDR patients with CMLof fundus not only have venous tortuous dilation, exudation, microaneurysm and neovascularization, also present with Roth spot as leukemic fundus manifestations. Diabetic retinopathy combined with CML could progress rapidly, and its aggravating complications such as hyperplastic membrane, vitreous hemorrhage and traction retinal detachment may result in poor visual prognosis. Early screening and treatment can help improve the prognosis of patients.
Mouse animal models are the most commonly used experimental tools in scientific research, which have been widely favored by researchers. The animal model of mouse leukemia appeared in the 1930s. During the past 90 years, researchers have developed various types of mouse leukemia models to simulate the development and treatment of human leukemia in order to promote effectively the elucidation of the molecular mechanism of leukemia' development and progression, as well as the development of targeted drugs for the treatment of leukemia. Considering that to myeloid leukemia, especially acute myeloid leukemia, there currently is no good clinical treatment, it is urgent to clarify its new molecular mechanism and develop new therapeutic targets. This review focuses on the various types of mouse models about myeloid leukemia used commonly in recent years, including mouse strains, myeloid leukemia cell types, and modeling methods, which are expected to provide a reference for relevant researchers to select animal models during myeloid leukemia research.
Combined with leukemia is a risk factor for aggravating diabetic retinopathy. A combination of diabetic retinopathy and leukemia can be expected to have a rapid progression and patients often visit the department of ophthalmology first. In addition to the typical manifestations of diabetic retinopathy such as retinal venous tortuous dilation, microaneurysm, retinal hemorrhage and exudation, patients may also be associated with leukemic retinopathy. Areas of extensive capillary non-perfusion and neovascularization may appear in the early stage of mild microangiopathy. Moreover, severe complications such as vitreous hemorrhage, neovascular membranes and traction retinal detachment appear earlier, which may be a prognostic indicator for poor vision. The causes of leukemia aggravating diabetic retinopathy include retinal ischemia due to hyperviscosity, anemia and thrombocytopenia, direct infiltration of tumor cells, chemotherapy and radiotherapy, high level of vascular endothelial growth factor. In clinic, rapidly progressing diabetic retinopathy should alert the ophthalmologist to the underlying hematological disorder. Patients with both diabetes and leukemia need to be screened much earlier and followed up at shorter intervals. Early detection and aggressive management may help preserve visual acuity in such cases.
Objective To assess the clinical effectiveness and safety of inductive treatment with arsenic trioxide （As203） for acute promyelocytic leukemia （APL）. Methods Randomized controlled trials （RCTs） were identified from MEDLINE （1966 -July, 2005 ）, EMBASE （1984 -July, 2005 ）, The Cochrane Library （ Issue 3, 2005） and CBM- disc （1978 -July, 2005）. The references of eligible studies were handsearched. RCTs of As203 treating for APL were included. Data were evaluated and extracted by two reviewers independently with designed extraction form. RevMan 4. 2.7 software was used for data analysis. Results Six RCTs involving 323 patients were included. Two studies reported that there was no statistical difference between As2O3 group and all-transretinoic acid （ATRA） group in mortality for patients with APL or APL patients with complications of desseminated intiavascular coagulation or cerebra hemorrhage. The pooled result of 4 studies showed that there was no statistical difference with RR 0.98, 95 % CI 0.86 to 1.12 in complete remission （CR） rates between the two groups. The result of one study showed that the CR rate of patients with intravenous injection of As203 in 2 divided dosages with longer injection duration was higher with RR 1.31, 95% CI 0.86 to 1.12 compared with those with a single intravenous injection. Adverse effects in As2O3 group were less than ATRA group. Conclusions Inductive treatment with As2O3 for acute promyelocytic leukeuia has similar mortality and CR with less adverse effects compared with ATRA. More trials of high quality are required.
Objective To systematically review the health economic evaluation studies of medicines for the treatment of acute myeloid leukemia (AML). MethodsThe PubMed, EMbase, Cochrane Library, CBM, CNKI, and WanFang Data, as well as the CRD database specifically for health economics were electronically searched from inception to June 2022, and related journals in the field of health economics and the websites of HTA institutions in various countries were manually searched. The quality of the studies was assessed using the CHEERS checklist. The basic characteristics of health economics evaluation publications were summarized, the quality of model structures and methodologies was assessed and economic evaluation results were compared among different treatments. Results A total of 17 studies were included, and cost-effectiveness analyses were conducted from the perspectives of the health system, patients, the whole society, and medical insurance payers. The economic evaluation models were relatively unified, but there were differences in methods and results reporting, and the quality needed to be improved. The research objects were mainly the comparison of hypomethylating agents, targeted medicine and traditional chemotherapy regimens, as well as the comparison of different chemotherapy combinations and different drug dosages. Conclusion Real-world studies are mainly focused on traditional chemotherapy regimens, and model-based health economic evaluations, such as Markov models, are more frequently applied to newly developed targeted drugs and demethylation drugs. Among all treatments, the chemotherapy regimens including cytarabine, midostaurin, and decitabine are found to be more cost-effective.
【摘要】 目的 探讨小儿白血病合并回盲肠综合征的临床特点、诊断及治疗。方法 对2005年2月—2009年10月间4例小儿白血病合并回盲肠综合征的临床症状、体征及辅助检查进行回顾性分析。结果 在小儿白血病的治疗过程中,可出现回盲肠综合征。临床表现为腹痛、腹胀及腹泻等;查体可见腹肌紧张,右下腹压痛,或有反跳痛等;血常规中白细胞减少,尤其中性粒白细胞显著下降;给予抗感染,静脉营养,丙种球蛋白增强机体抵抗力,输浓缩红细胞及血小板支持治疗,可以收到较好的治疗效果。若保守治疗症状得不到缓解,或病情加重,可行手术治疗。结论 回盲肠综合征是小儿白血病治疗过程的合并症,其临床表现复杂,体征缺乏特异性,根据不同的病情采用相应的治疗方法可收到良好的临床效果。