【摘要】 目的 探讨高三尖杉酯碱（HHT）联合三氧化二砷（As2O3）、羟基脲治疗高白细胞慢性粒细胞白血病（CML）的疗效和毒副作用。 方法 对2004年11月-2009年12月行高三尖杉酯碱联合As2O3、羟基脲治疗高白细胞CML患者21例的疗效和不良反应进行分析。 结果 经高三尖杉酯碱联合As2O3、羟基脲治疗后3～6个疗程，21例CML患者中完全缓解15例，占71%；部分缓解2例，占10%；总有效率81%；未缓解4例，占19%。不良反应仅表现乏力、纳差、恶心、脱发。 结论 HHT联合As2O3、羟基脲是治疗高白细胞CML一种有效率高，临床容易开展，安全性好的方法。【Abstract】 Objective To investigate the effects and side effects of homoharringtonine combined with arsenic trioxide or hydroxycarbamide on hyperleukocytic chronic myelocytic leukemia (CML). Methods The therapeutic effects and adverse effects of homoharringtonine combined with arsenic trioxide or hydroxycarbamide administered in 21 cases with CML from November 2004 to December 2009. Results In 21 patients with CML, the CR rate was 71% (15/21) and PR rate was 10% (2/21). The total respondence rate was 81% and the side effects were slight. The side effect only shows short of strength, appetite decrease, naupathia, hair loss and no heart side effect. Conclusion Homoharringtonine combined with arsenic trioxide or hydroxycabamide has a high effect rate on CML with good safety.
目的 探讨婴儿急性白血病（IAL）的临床与实验室检查特征。 方法 对1999年12月－2011年6月收治的15例婴儿急性白血病的临床资料进行总结与分析。 结果 其中急性淋巴细胞白血病（ALL）6例，急性髓系白血病（AML）8例，分类不明1例，其中以M4（4例）、M5（3例）为主。临床表现多样，髓外浸润明显。1例细胞形态学与免疫分型有差异，1例合并染色体异常。放弃治疗者11例，死亡2例，正规治疗的2例于诱导缓解后获完全缓解。 结论 IAL预后差，需完善相关检查并不断总结临床资料以提高IAL治愈率。
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.
目的：了解左旋门冬酰胺酶（L-ASP）对儿童急性淋巴细胞白血病凝血功能变化的影响。方法：观察86例患儿在诱导缓解后治疗期间，L-ASP使用前后活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)、抗凝血酶Ⅲ(AT-Ⅲ)、D-二聚体变化情况。结果：与用药前比,用药结束后一天的PT、APTT、TT均显著延长(P＜0.01);FIB、AT-Ⅲ显著降低(P＜0.01),D-二聚体显著升高(P＜0.01);用药结束后1周时PT、APTT、TT、D-二聚体较用药前差异无显著性,FIB、AT-Ⅲ虽有回升,但仍低于正常(P＜0.01)。结论：L-ASP可引起ALL患儿凝血功能异常，尤其对FIB、AT-Ⅲ影响明显，应引起临床高度重视。Ｌ-Ａｓｐ主要影响蛋白质的合成而引起蛋白质成份的凝血因子减少,从而引起凝血功能障碍,且对纤维蛋白原的合成影响更为显著。
【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.
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.
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.