【摘要】 目的 分析交叉抗原表达的急性白血病的临床特征及缓解率。 方法 对2009年10月-2010年11月血液内科的210例交叉表达髓系和淋巴细胞系相关抗原的初治急性白血病患者的标本，采用流式细胞术检测白血病细胞的免疫表型，根据免疫标记和FAB（French、American、Britain）分型进行分组，分析其异质性的生物学特征和影响缓解率的相关因素。 结果 210例急性白血病的FAB分型以AML-M1/M2（82例）和ALL（78例）为主；免疫分型以B淋巴细胞系和髓系混合表达多见（116例），其中CD34表达率高达91.4%（192例）， CD7表达率为50.5%（106例），且与CD34相关（P=0.04）；出现CD34、CD7、CD19三者共表达的患者缓解率较低（9.09%）。 结论 交叉抗原表达的急性白血病的诊断有赖于免疫分型的判断，其分化抗原的表达类型是影响其缓解率的重要因素。【Abstract】 Objective To observe the clinical characters of acute leukemia with cross-lineage antigen expression and analyze the remission rate. Methods Between October 2009 and November 2010, 210 patients were diagnosed and classified by morphology. Cytochemistry and immunology were used to analyze the immunophenotype. According to the immunostaining relative factors and FAB (French, American, and Britain) phenotype standard, the samples were divided into several groups. The conical characters and relative factors of remission rate were analyzed. Results In 210 patients with cross-lineage antigen expression, AL, AML-M1/M2 (82 cases) and ALL (78 cases) were common in FAB phenotype,and cross-lineage of B lineage and myelolineage were common in immunotype (116 cases). CD34 got the highest expression frequency of all (192 cases),and had the most important effect on patients′ prognosis. CD7 was also positive commonly (106 cases) and related with CD34 (P=0.04). So it′s significant for the outcome. The patients who got co-expression of CD34, CD7 and CD19 had worse prognoses. Conclusions Acute leukemia with cross-lineage antigen expression is a special type and is confirmed by immunotype. Furthermore, expression types of differentiation antigen are critical for the prognosis.
【摘要】 目的 了解住院白血病患者的社会支持状况。 方法 采用相关“社会支持评定量表”，调查分析2010年8-11月80例住院白血病患者的社会支持状况。 结果 白血病患者获得的社会支持为（42.34±7.04）分，支持度较高，与常模（34.56±3.74）分比较差异有统计学意义（Plt;0.01），无配偶及医疗自费患者所获得的社会支持相对较低。 结论 医护人员在临床中应注意拓宽住院白血病患者的社会支持渠道，帮助患者保持较高的社会支持水平，从而促进康复，提高生活质量。【Abstract】 Objective To explore the social support condition of the inpatients with leukemia. Methods According to “Social Support Assessment Inventory”, the social support conditions of 80 patients with leukemia who were hospitalized between August and November, 2010 were analyzed. Results The total score of social support was 42.34±7.04 in inpatients with leukemia, and 34.56±3.74 in normal controls; the difference was significant (Plt;0.01). The patients who remained single or had no medical insurance obtained less social support. Conclusions Nurses should help patients with leukemia keep in a moderate high level of social support to promote the recovery of patients and improve their quality of life.
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。
ObjectiveTo study the effects of leukemia inhibitory factor (LIF) and basic fibroblast growth factor (bFGF) on the proliferation and differentiation of human bone marrow mesenchymal stem cells (hBMSCs). MethodshBMSCs at passage 4 were divided into 4 groups according to different culture conditions:cells were treated with complete medium (α-MEM containing 10%FBS, group A), with complete medium containing 10 ng/mL LIF (group B), with complete medium containing 10 ng/mL bFGF (group C), and with complete medium containing 10 ng/mL LIF and 10 ng/mL bFGF (group D). The growth curves of hBMSCs at passage 4 in different groups were assayed by cell counting kit 8; cellular morphologic changes were observed under inverted phase contrast microscope; the surface markers of hBMSCs at passage 8 including CD44, CD90, CD19, and CD34 were detected by flow cytometry. ResultsThe cell growth curves of each group were similar to the S-shape; the cell proliferation rates in 4 groups were in sequence of group D > group C > group B > group A. Obvious senescence and differentiation were observed very early in group A, cells in group B maintained good cellular morphology at the early stage, with slow proliferation and late senescence; a few cells in group C differentiated into nerve-like cells, with quick proliferation; and the cells in group D grew quickly and maintained cellular morphology of hBMSCs. The expressions of CD44 and CD90 in groups A and C at passage 8 cells were lower than those of groups B and D; the expressions of CD19 and CD34 were negative in 4 groups, exhibiting no obvious difference between groups. ConclusionLIF combined with bFGF can not only maintain multiple differentiation potential of hBMSCs, but also promote proliferation of hBMSCs.
目的 增加对慢性淋巴细胞白血病合并非霍奇金淋巴瘤临床病例的认识。 方法 通过报道2011年11月和2012年7月入住的2例确诊为慢性淋巴细胞白血病合并非霍奇金淋巴瘤患者的诊治过程，复习文献，讨论其发病机制、治疗及预后。 结果 该2例患者均予以化疗，其中1例浅表淋巴结明显缩小，骨髓涂片基本恢复正常，病情控制较好；另1例合并症多、病情恶化快、肿瘤化疗效果欠佳，最后因呼吸衰竭死亡。 结论 慢性淋巴细胞白血病合并非霍奇金淋巴瘤，治疗上应综合考虑患者年龄、ECOG评分、临床分期、预后指数等因素，原则上以治疗恶性程度更高的非霍奇金淋巴瘤为主，可根据慢性淋巴细胞白血病分期进行观察、随访或积极治疗。
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。
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.
Objective To search evidence in the treatment of Philadelphia chromosome （Ph）-positive acute lymphocytic leukemia （ALL） for guiding chnical practice. Methods We searched MEDLINE （February, 1970～July, 2005 ） and SUMSEAILCH （till July, 2005 ）to identify systematic reviews（SIL）, randomized controlled trials（RCTs） and controlled clinical trials （CCTs） in the treatment of Ph-positive ALL. Results One RCT and 8 CCTs were identified. The results showed that Ph-positive ALL had a very poor prognosis . Chemotherapy and bone marrow transplantation （BMT） were the two main ways to treat the disease. Outcome of conventional chemotherapy treatment for adults with the disease was poor. Outcome of treatment with hyper-CVAD and imatinib mesylate was better and BMT was the only way which could potentially cure the disease. Conclusions Treatment of Ph-positive ALL with hyper-CVAD and imatinib mesylate may induce higher remission rate and disease free survival rate. BMT is the best way to cure the disease.