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白血病·淋巴瘤

白血病·淋巴瘤

CSTPCD

Journal of Leukemia & Lymphoma
中华医学会、山西省肿瘤研究所、山西省肿瘤医院主办。本刊是以白血病、淋巴瘤、多发性骨髓瘤为主的血液系统恶性肿瘤专业的学术期刊。办刊宗旨：反映血液系统恶性肿瘤领域的科研成果及学术动态，临床与基础并举，但侧重于临床；普及与提高兼顾，但侧重于提高。为从事白血病、淋巴瘤、多发性骨髓瘤等血液系统恶性肿瘤基础研究与临床诊治的工作者提供交流经验、沟通信息的园地。读者对象为中高级医务工作者。主要栏目有述评、专论、专家讲坛、论著、短篇论著、调查报告、综述、会议速递、讲座、短篇及个案报告等。为中国科技论文统计源期刊（中国科技核心期刊）、中国生物医学核心期刊、中国肿瘤学类核心期刊。被美国《化学文摘》（CA）等国际著名检索期刊及国内各大检索数据库收录。
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  • 发文量：4976
  • 被引量：676
  • H指数：1
  • 开始收录时间：1992,1(1)
  • CNKI综合因子：0.256
  • 维普期刊影响因子： 0.511
  • 万方期刊影响因子：0.65
  • 创刊时间：1992
  • 国内刊号/CN：11-5356/R
    国际刊号/ISSN：1009-9921
  • 发行周期：月刊
    邮发代号：22-107
  • 主管单位：中华人民共和国卫生部
    主办单位：中华医学会；山西省肿瘤研究所；山西省肿瘤医院
白血病·淋巴瘤-联系信息
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  • 电话：0351-4650389 4650386 4651416
  • 邮箱：bxblbl@cmaph.org
  • 地址：太原市职工新街3号
  • 邮编：030013
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白血病·淋巴瘤 >2021年第11期

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  • 摘要：患者 女，22岁，未婚，2006年4月出现腰骶部疼痛，白细胞增高，在我院根据骨髓、染色体、融合基因诊断为慢性粒细胞白血病急淋变，TA＋VP方案化疗后骨髓部分缓解，给予伊马替尼300mg／d口服，1个月后骨髓完全缓解。此后给予MOAP方案、VPMM＋伊马替尼方案化疗。2006年11月27日骨髓提示复发，原始淋巴细胞占0．405。由于患者无兄弟姐妹，骨髓库无相合供者，且父母年龄偏大，与其叔叔HLA4／6相合，经家属及本人同意行半相合移植。
  • 摘要：目的 分析再程放疗后复发的颅内原发性非霍奇金淋巴瘤(NHL)的治疗方法及效果.方法 颅内原发性NHL患者1例术后行全脑放疗DT50 Gy,复发后行适形放疗DT50 Gy及利妥昔单抗+CHOP方案联合化疗.21 d为1个周期.结果 随访13个月,患者仍处于完全缓解中.结论 颅内原发性NHL首选放疗,再程放疗后复发采用利妥昔单抗联合CHOP方案化疗安全、有效.
  • 摘要：目的 研究MLL-AF9融合基因反义寡核苷酸(ASODN)对人类急性单核细胞白血病细胞THP-1增生和凋亡的影响.方法 选择THP-1细胞特有的MLL-AF9融合基因为靶基因,设计并合成靶向MLL-AF9的ASODN及正义核苷酸(SODN),应用脂质体转染方法,将其转入细胞,RT-PCR法比较转染前后MLL-AF9 mRNA表达水平的变化,Western blotting法鉴定MLL-AF9蛋白表达量,改良MTT法检测细胞增生抑制率,并通过Hoechst33258染色观察ASODN作用于THP-1后细胞出现凋亡形态特征,流式细胞仪检测细胞凋亡水平.结果 与空白对照组、脂质体对照组和SODN组相比,ASODN组细胞中MLL-AF9表达明显降低(P＜0.01),相对应MLL-AF9蛋白水平亦明显下降,同时细胞生长受到抑制,被诱导凋亡产生凋亡小体.ASODN转染THP-1细胞0、24和48 h后,ASODN组凋亡率分别为(10.4±3.0)%、(22.8±2.5)%和(24.7±3.1)%,与对照组相比凋亡率显著增加(P＜0.01)且呈时间依赖性.结论 利用ASODN靶向沉默MLL-AF9融合基因的表达能有效抑制THP-1细胞增生并促进其凋亡.%Objective To study the effects of antisense oligonucleofide(ASODN)fusion gene MLL-AF9 on cell proliferation and apoptosis of human acute monocytic leukemia cell line THP-1 expressing MLL-AF9.Methods ASODN and sense oligonucleotide(SODN)targeting MLL-AF9 were designed,constructed and transfected into THP-1 by lipofectmine.The level of MLL-AF9 mRNA expression was examined by reverse transcription polymerage chain reaction(RT-PCR)and the expression of MLL-AF9 protein was detected by Western blotting. Cell proliferation rate was analyzed by modified-MTT assay.Hoechst33258 staining Wag used to detect the apoptotic bodies in the cells.The change of apoptosis rate was detected by flow cytometry.Results The level of MLL-AF9 mRNA and protein expression after transfection was significantly decreased in ASODN-treated group in comparison with that in the control group,liposome group and SODN group(P＜0.01).Proliferation of the ASODN-treated cells was inhibited and apoptosis was evidently increased by(10.4±3.0)%,(22.8±2.5)%and(24.7±3.1)% for 0,24 and 48 h,respectively in a time-dependent manner (P＜0.01).Staining of the ASODN-treated cells with Hoechst 33258 showed the morphology characteristic of apoptosis.Conclusion Special ASODN targeting MLL-AF9 effectively inhibited MLL-AF9 expression in THP-1 cell,reduced cell proliferation and induced apoptosis.
  • 摘要：目的 探讨骨髓坏死(BMN)的形态学和临床特征.方法 对23例BMN的组织、细胞和超微结构形态学进行观察,分析临床过程及转归.结果 BMN的原发病21例为恶性疾病,1例严重感染合并DIC,1例为血管炎.骨髓活组织检查显示坏死区呈大片无结构的嗜酸性的物质,可伴有网硬蛋白和胶原纤维增生;骨髓涂片中细胞结构模糊不清,核同缩,坏死的细胞周边散在形状不一的嗜酸性物质;外周血可见幼粒、幼红细胞.结论 BMN的发生多与恶性肿瘤和血液恶性疾病有关,持续剧烈骨痛和发热是临床主要症状,可疑的病例应该早期进行骨髓检查.
  • 摘要：目的 探讨慢性粒细胞白血病(CML)DNA聚合酶β蛋白表达及其与CML急变机制的关系.方法 用Western blotting方法检测62例CML患者及K562细胞DNA聚合酶β蛋白表达,并与23例健康人作对照;对26例异基因外周血干细胞移植(allo-PBSCT)及12例使用伊马替尼治疗的CML患者用RT-PCR、Western blotting分别动态检测bcr-abl mRNA和DNA聚合酶β蛋白表达;伊马替尼体外作用于CML患者MNC及K562细胞后,用Western blotting方法检测DNA聚合酶B表达及ber-abl融合蛋白磷酸化.结果 与健康人比较,CML患者及K562细胞DNA聚合酶β蛋白的表达明显升高(P＜0.05).allo-PBSCT及伊马替尼治疗后患者DNA聚合酶β蛋白的表达随着bcr-abl mRNA表达的降低而下降.伊马替尼体外作用后,DNA聚合酶β蛋白表达随着bcr-abl融合蛋白酪氨酸磷酸化水平的降低而下降.结论 bcr-abl融合基因增加DNA聚合酶β蛋白表达;DNA聚合酶β蛋白增加可能是CML急变机制之一.
  • 摘要：目的 检测急性淋巴细胞白血病(ALL)患儿的CD4+CD25+调节性T细胞(Treg),探讨其在儿童ALL发生、治疗过程中的意义.方法 以40例ALL儿童不同治疗阶段的55份外周血为标本,细胞膜表面抗原采用双色或三色单克隆抗体直接标记法,检测细胞核抗原FoxP3时先标记膜表面抗原,固定破膜后再标记胞核抗原,应用多参数流式细胞仪进行检测.结果 ALL患儿的CD4+CD25+ Treg同时表达CD62L和胞核抗原FoxP3.ALL标危组治疗不同阶段儿童的CD4+CD25高表达T细胞数值分别为:首次诱导缓解组(1.04±0.33)%,维持治疗组(1.60±0.44)%,持续完全缓解组(1.29±0.30)%;ALL中/高危维持治疗组则为(2.24±0.75)%.结论 ALL患儿的CD4+CD25+Treg数值高于健康儿童,并且与疾病的危险度和治疗的效应有一定的关系;CD4+CD25+Treg水平升高可能是白血病复发的原因之一.%Objective To evaluate the proportion and clinical significance of CD4+CD25+ regulatory T cells in childhood acute lymphocyte leukemia(AEL)during different therapeutic stages.Methods 55 peripheral blood samples from 40 children patients with ALL were detected by muhiparameter flow cytometry with fluoresce-hbeled monoclonal antibody.Results Treg cells phenotypically express not only CD62L but also FoxP3 protein.In patients with ALL standard-risk the proportion of CD4+CD25Hi was(1.04±0.33)% in the first course of induction treatment, (1.60±0.44)% in maintenance treatment groups, and(1.29±0.30)% in complete remission groups respectively,while in patients with ALL the intermediate and high risk during maintenance therapy was(2.24±0.75)%.Conclusion Compared with healthy children,the proportion of Treg ceHs in ALL is significantly higher,and may be related to the effect of chemical treatment and severity of ALL.The elevated proportion of Treg may contribute to disease relapse.
  • 摘要：Objective To analyze the relationship between immature granulocytes in peripheral blood and leukemic relapse after allogeneic peripheral blood stem cell transplantation.Methods The bone marrow wag followed up and immaature granulocytes in peripheral blood smear were evaluated on 14 days,30 days,90 days,180 days,1 year after allo-PBSCT for 97 cases with leukemia.The relationship between frequency of immature granulocytes and leukemic relapse was analysed.Results 15 of 97 patients relapsed on and after 30 days.The relapse rate was 24.6% in 14 of 57 patients with immature granulocytes occurred peripheral blood.and the relapse rate was 2.5% in patients without immature granulocytes of peripheral blood (P＜0.05).The incidences of GVHD in relapse group and no relapse group were not statistically different(P＞0.05).Conclusion There Was a relationship between persistent immature granuiocytes of peripheral blood and leukemic relapse,and the treatment became difficult after relapse and the prognosis was poor.%目的 了解异基因外周血干细胞移植(allo-PBSCT)后白血病复发与外周血幼稚粒细胞的关系.方法 97例白血病患者经allo-PBSCT治疗,于14、30、60、90、120、180 d及1年以后骨髓随访时同时观察外周血幼稚粒细胞出现情况,分析与白血病复发的关系.结果 97例中,15例发生白血病复发.在30 d及其以后外周出现幼稚粒细胞的57例中,复发14例,复发率24.6%,而30d及其以后外周血未出现幼稚粒细胞者的40例中仅有1例复发,复发率2.5%(P＜0.05).复发与不复发者移植物抗宿主病(GVHD)差异无统计学意义(P＞0.05).结论 白血病复发与移植后外周血幼稚粒细胞有关,复发后治疗难度大,预后差.
  • 摘要：目的 探讨急性早幼粒细胞白血病(APL)合并弥散性血管内凝血(DIC)的治疗效果.方法 对全反式维甲酸(ATRA)+三氧化二砷(As2O3)或两者交替、单用ATRA、造血干细胞移植(HSCT)3种治疗方案的疗效进行比较.结果 采用ATRA+As2O3或者两者交替组获得CR中位时间分别为34 d、35.5 d,单用ATRA获得CR中位时间为62 d,差异有统计学意义(P＜0.05).ATRA+As2O3组或两者交替组,3年无病生存率分别为78%和80%,与单用ATRA组比较.差异有统计学意义(P＜0.05),DIC纠正时间为16～18 d,三种治疗方案差异无统计学意义.15例行HSCT者,仅2例复发,其余13例中位无病生存时间(DFS)为13.5年,该13例PCR检测PML-RARα融合基因阴性.结论 应用ATRA+As2O3或两者交替加成分血、抗纤溶纠正DIC及其化疗治疗APL获得CR时间明显缩短,而且3年无病生存率相对较高.缓解后6个月进行HSCT者,DFS可进一步延长.%Objective To analyse the outcome of different regimens for the treatment to patients with aeute promyelocytic leukemia(APL)accompanied by disseminated intravagcular coagulation(DIC).Methods The outcome of different chemotherapy regimens was compared. Results The median time achieving complete remission by all-trans retinoic acid(ATRA)combined with arsenic trioxide(As2O3)or alternative of ATRA and As2O3 were 34 days and 35.5 days,respectively.The median time of CR for the patients treated with ATRA only was 62 days.There is a statistical difference where three-year disease-free survival rates of the patients given by ATRA and As2O3 or alternative of them were 78 percent and 80 percent,respectively.Compared with the patients administered with ATRA only.there is significant difference(P＜0.05).The time of improving DIC was about 16 days to 18 days.There was no significant difference among this three chemotherapy regimens.Among 15 patients with autologous henmtopeietic stem cell transplantation,the disease-free survival time of 13 cases.who have no PML-RARα gene deteced by PCR was 13.5 years except 2 cases with relapse.Conclusion The time achieving complete remission of APL was reduced dramaticaly by administering all-trans retinoic acid(ATRA)combined with arsenic trioxide(As2O3)or alternative treatment of them and principles of blood transfusion and anti-fibmolysis to improve DIC,this regimen showed a relatively higher three-year disease-free survival (DFS) rate.These cases who received hematopeietic stem cell transplantation after six mortths of remission,DFS time wag further prolonged.
  • 摘要：Objective To investigate therapeutic effect,safety and post transplant immunological reconstitution for patients of lymphoma after autologous bone marrow transplantation and occurrence of Rheumatoid Arthritis.Methods The clinical situation,laboratory index and immunological reconstitution was observed for patients of lymphoma after inductive treatment,BCEA of pretreatment,autologous bone marrow transfusion,G-CSF and radiotherapy to lymph node.Results Recovery of hemopoiesis was observed after 28 days.Disappearance of joint swelling and negative ESR,CRP,IgMRF were observed after 2 months.The patients started to work after 3 months. No recurrence of lymphoma and Rheumatoid Arthritis has been observed until today.Conclusion The autologous bone marrow transplantation was safe and effective for the treatment to patient of lymphoma with rheumatoid arthritis,which was a new method for the treatment to lymphoma and other autoallergic diseases.%目的 探讨淋巴瘤并发类风湿关节炎(RA)患者进行自体骨髓移植治疗的疗效、安全性及移植后免疫重建过程.方法 对1例临床诊断非霍奇金淋巴瘤(NHL)ⅢB、RA患者,诱导治疗反应良好后,行预处理方案BCEA,回输自体骨髓,给予粒细胞集落刺激因子(G-CSF)等综合治疗,术后补行选择性淋巴结放疗,观察移植前后患者的临床表现、实验审指标的变化及免疫重建的过程.结果 移植后28 d造血功能恢复,2个月后关节肿全部消失,红细胞沉降率正常.CRP、IgMRF均转为阴性.患者出院后3个月恢复正常工作,随访13年NHL及RA无复发.结论 淋巴瘤并发RA患者进行自体骨髓移植治疗安全性好,中短期疗效显著,为淋巴瘤并发其他自身免疫病的治疗提供了新的可选择的治疗方法.
  • 摘要：Objective To analyze the initial response rate of radiotherapy and chemotherapy,and the influence of different treatment modalities on pmgnnsis of primary non-Hodgkin lymphoma(NHL)of the nascl cavity.Methods From January 1993 to December 2002,70 patients were confirmed by histopathology as NHL,including 52 T cell origin,2 B cell and 16 NK cell.The main radiotherapy portal was set in front of the nose with a spade like protrusion,supplement with a portal next to the ear on one side or both sides.Combined portal in facial cervical area was first used when there was invasion of the oropharynx.The median dose to the nasal cavity wag 54.0 Gy with a range of 336 to 66 Gy,given before or during after radiotherapy or alone,consisted of 2-6 cycles chemotherapy of COP,CHOP or COBDP.Prognostic factors were analyzed with Cox model. Results The local control rates was 12.5%, 66.7% and 74.0% in chemotherapy alone,radiotherapy alone,and chemotherapy plus radiotherapy.The 5-year survival rate Wag 12.5%,50.0% and 62.0%,respectively(P＜0.05).Multifaetor analysis showed that tumor extension and treatment methods were the most important prognostic factors besides Ann-Arbor stage,but gender,pathology,age and symptoms had little effect on prognosis.Conclusion Chemotherapy plus radiotherapy group achieved a better survival rate than radiotherapy alone.For some NHL patients with good financial condition,APBSCT is a good choice.%目的 评价原发鼻腔非霍奇金淋巴瘤(NHL)放疗和化疗的近期疗效,并对影响预后的因素进行分析.方法 1993年1月至2002年12月收治的原发鼻腔NHL 70例伞部经病理证实,其中T细胞来源52例,B细胞来源2例,NK/T细胞来源16例.放疗主野为鼻前凸字形野,辅单或双侧耳前野,累及口咽者先用面颈联合野,放疗采用60Co或直线加速器常规放射,2 Gy/次.鼻腔靶区中位剂量54 Gv(36～66 Gy).辅助化疗在放疗前、中、后进行或单纯化疗,方案为COP、CHOP、COBDP.用COX模型对影响预后的多因素进行分析.结果 单化组、单放组、放加化组局部控制率分别为12.5%、66.7%、74.0%,5年总生存率分别为12.5%、50.0%、62.0%(P＜0.05).首程治疗后的CR率是独立的预后因素,除AnnArbor分期外,局部侵犯范围、发热、治疗方法也是影响预后的主要因素,而病理类型、性别、年龄及全身症状等因素对预后影响不大.结论 放化疗联合治疗原发鼻腔NHL的生存率优于单纯放疗和单纯化疗.对于原发鼻腔NHL的治疗有条件者可试用自体干细胞移植.
  • 摘要：目的 探讨急性髓系白血病(AML)完全缓解(CR)后的治疗方案,以提高缓解率,缓解后的长期生存率和临床治愈率.方法 将AML(M2、M3)随机分为两组,甲组缓解后治疗均采用以米托蒽醌为主的强烈化疗方案(MDA、MEA、MD-Ara-C);乙组用传统的标准化疗方案(HA、DA)治疗3年,M3间歇期用全反式维甲酸(ATRA)治疗.观察CR率及5年长期生存率.结果 甲组M2CR率,M2、M3缓解后5年长期生存率与乙组比较差异有统计学意义(P＜0.05),但M3甲乙两组CR率差异无统计学意义(P＞0.01).结论 AML早期采用强烈短期化疗方案优于传统的长期标准化方案和维持治疗.
  • 摘要：@@ 4 淋巴细胞的分化演变及对应的淋巴瘤rn4.1 B淋巴细胞的分化演变及对应的淋巴瘤6-8 rn4.1.1 B细胞的分化演变过程(图2,表2)rn最原始的B细胞叫前(躯)B细胞,由干细胞转化而来,位于骨髓中,因此,骨髓是B细胞的中枢,原始幼稚B细胞在骨髓中分化成熟.最早成熟的B细胞是"童贞"B细胞,即B细胞,该细胞虽然成熟了,但没有受到任何抗原刺激.B1细胞成熟后迁徙到外周的淋巴组织中定居,为参与免疫反应做准备.外周淋巴组织包括:淋巴结、扁桃体、脾脏以及皮肤和黏膜组织中散在淋巴组织.
  • 摘要：目的 探讨恶性血液病合并肺结核的临床特征及其治疗方法.方法 对2001年至2006年5年中收治的恶性血液病合并肺结核患者19例进行回顾性分析.结果 急性髓系白血病4例,急性淋巴细胞白血病3例,再生障碍性贫血4例,骨髓增生异常综合征3例,恶性组织细胞病1例,慢性粒细胞白血病1例,慢性淋巴细胞白血病2例,淋巴瘤1例.恶性血液病合并肺结核临床多表现为不典型肺结核,经抗结核治疗有效,并不影响恶性血液病治疗的转归.结论 恶性血液病合并肺结核并不少见,在恶性血液病治疗完全缓解后出现的不明原因发热,仍应高度警惕合并肺结核的可能.
  • 摘要：目的 研究骨髓异常增生综合征(MDS)染色体核型变化与预后的关系.方法 对47例MDS的患者进行染色体核型检查.结果 47例MDS患者中染色体核型异常19例,染色体核型异常率40.4%,治疗好转5例,14例转变成急性白血病,占核型异常73.7%.结论 染色体核型异常的患者转白血病的概率高,预后不良.
  • 摘要：Objective To find the possible relationship between defects in the FA/BRCA pathway of genomic maintenance and potential pathogenesis of acute myeloid leukaemia.Methods Twenty-five AML cell lines derived from diverse subtypes of AML were screened to investigate for possible defects in FA,BRCA patllway.Results The absence of FANCN protein in two cell lines,THP-1 and M-07e were observed,which was correlated with the results of MMC-induced G2 arrest,growth inhibition and chromosomal breakage test in both cell lines.But no gene aberrance in these two cell lines by MLPA test and DNA sequencing were found.Conclusion There is a possible relationship between defects in the FA/BRCA Dathway and potentialpathogenesis of acute myeloid leukaemia.A disturbance of the"FA pathway"may represent an early event in the development of this type of leukaemia.%目的 寻找维持基因稳定性的范可尼贫血(FA)/BRCA途径发生缺陷与急性髓系白血病(AML)潜在发病机制的关系.方法 筛选了25株来源于不同亚型的AML细胞株寻找可能存在的FA/BRCA途径缺陷.结果 发现在两株AML细胞株:THP-1和M-07e中,存在FANCN表达缺失,这种FANCN蛋白表达缺失与丝裂霉素C诱导的G2期细胞阻滞、细胞生长抑制试验和染色体断裂试验结果相一致.而MLPA及DNA测序法未发现这两株细胞株中存在FANCN编码基因异常.结论 FA/BRCA途径发生缺陷与AML发病机制可能存在相关性,FA患者中FA分子途径紊乱是发展为白血病的早期事件.
  • 摘要：目的 观察重组人白细胞介素-11(rhIL-11)对急性白血病(AL)化疗后血小板(Plt)减少的疗效.方法 对42例AL(治疗组)化疗后Pit＜20×109/L的患者皮下注射rhIL-111.5 mg/d,用至Plt≥40×109/L停药;对其中17例初诊急性髓系白血病(AML)完成2个疗程化疗后统计疗效,并以35例未加用rhIL-11的AL患者和其中15例初诊AML(对照组)完成2个疗程化疗患者作对照.结果 治疗组Plt升到≥40×109/L所需时间平均为(9.8±2.7)d,短于对照组(14.6±4.8)d(P＜0.05);治疗组在第2个疗程化疗后Ph＜15×109/L的患者有3例(17.6%),明显少于对照组10例(66.7%)(P＜0.05);第2个疗程化疗前Plt水平和化疗后Plt最低平均水平,治疗组为(173.7±81.2)×109/L和(23,5±18.3)X 109/L高于对照组(99.6±74.5)×109/L和(10.2±9.8)×109/L(P＜0.05);治疗组和对照组的完全缓解(CR)率分别是70.6%和73.3%,有效(CR+PR)率分别是82.4%和86.7%,二组比较差异无统计学意义(P＞0.05).结论 rhIL-11可安全有效地促进AL化疗后Plt恢复,而且疗效持久.%Objective To investigate the treatment of recombinant human interleukin-11(rhIL-11)to chemotherapy-induced thrombocytopenia in acute leukemia(AL).Methods 42 AL patients whose platelet count dropped below 20×109/L after chemotherapy received rhIL-11 by 1.5 mg daily until the platelet count was increased above 40×109/L.The efficiency of chemotherapy to 17 newly diagnosed acute myelocytic leukemia(AML)patients was evaluated after receiving two periods of chemotherapy.35 AL patients and 15 newly diagnosed AML patients were used as controls.Results The mean time of platelet count increasing from 20×109/L to above 40×109/L Was shorter in treating group (9.8±2.7)d than in control group(14.6±4.8)d .The number of patients whose platelet＜15×109/L was less in treating group than in control group after second chemotherapy,and the minimum mean count of platelet Was higher in treating group(23.5±18.3)×109/L than that in control group(10.2±9.8)×109/L .CR and CR+PR rate were not different between treating group and control group. Conclusion rhlL-11 can safely and effectively promote chemotherapy-induced platelet recovery in patients of acute leukemia with persistent affection.
  • 摘要：目的 提高对以风湿病症状为突出表现的血液系统肿瘤的认识,以减少该类疾病的漏诊.方法 总结15例以风湿病症状为突出表现,拟诊风湿性疾病,但最终确诊为血液系统肿瘤患者的临床资料,分析其临床表现.结果 15例患者中,有多种风湿病表现,发热占66.7%(10/15),皮疹占40%(6/15),关节炎占20%(3/15),拟诊风湿病中以血管炎居多6例(40%) ,成年人斯蒂尔(Still)病3例,淀粉样变、皮肌炎、风湿性多肌痛、脂膜炎各1例,未分类2例.所患血液系统肿瘤中以淋巴瘤居多9例(60%) ,白血病3例,多发性骨髓瘤3例.结论 血液系统肿瘤可出现风湿病表现,对于风湿病难以解释的临床表现、常规治疗效果差者,要警惕血液系统肿瘤的可能.%Objective To strengthen the awareness that hematological tumors present with certain rheumatic symptoms for early diagnosis and treatment to a hidden neoplasm.Methods 15 patients admitted to rheumatic ward with suspected rheumatic disease were finally diagnosed as hematological tumors.Their rheumatic manifestations and occult malignancies were collected.Results A variety of rheumatic manifestations were presented.Among 15 patients,10(66.7%)had fever,6(40%)skin lesion,3(20%)arthritis,6(40%)vasculitis,3 adult onset of Still's disease,2 unelassified,and one of the each following disease:amyloidosis,dermatomyositis,polymyalgia rheumatica,and panniculitis.9 of lymphoma,3 leukemia,3 multiple myeloma were finny diagnosed. Conclusion Rheumatic disorders associated with hematological tumors include a variety of conditions.An extensive investigation for occult malignancies with some rheumatic symptoms is recommended when accompanied by specific findings of suggestive malignancy.
  • 摘要：目的 探讨CAG方案治疗老年人急性髓系白血病(AML)疗效及不良反应.方法 共选择老年AML患者45例,治疗组23例应用cAG方案,对照组22例应用DA、HA或MA方案.结果 治疗组1个疗程完全缓解率(CR)率39.1%,有效率57.7%;对照组CR率31.8%,有效率54.5%.两组间差异无统计学意义(P＞0.05).两组间骨髓恢复时间、所需浓缩红细胞及单采血小板数,差异有统计学意义(P＜0.05).结论 CAG治疗老年人AML疗效肯定,较普通化疗方案骨髓抑制时间短,输血量减少.
  • 摘要：Objective To investigate the expression of SHP-1 and JAK1 mRNA in acute leukemia patients and their impact on disease development,and outcome of the primary chemotherapy.Methods Semi-quantitative reverse transcription polymerase chain reaction was used to measure the expression of SHP-1 and Janus kinase 1(JAK1)mRNA in 93 patients with acute leukemia(AL)and 20 healthy adults as normal 、controls(NC).Results The expression of SHP-1 mRNA in de novo AL patients was significantly lower than that in NC group(P=0.000),which was elevated when complete remission(CR)was achieved(P=0.032)and decreased after the disease relapsed (P=0.015).The expression of JAK1 mRNA in NC group was a lower than that in de novo AL group, but with no statistical significance(P=o.051).While there was statistical significance between NC group and relapsed AL group(P=0.047).The complete remission(CR)rate of the primary chemotherapy in SHP-1 positive group Was 88.9%,but 60.38%in negative group,and there was a statistical significance between them(P=0.018).There Was a negative correlation between the expression level of SHP-1 and JAKI mRNA (P=0.048).Conclusion The expression of SHP-1 mRNA Was significantly decreased or absent in the specimens of acute leukemia patients,and the positive expression of SHP-1 mRNA may be proposed as a factor of preferable therapeutic efficacy in de novo AL and a marker for the progress of the disease.The abundance of JAK1 mRNA was possibly elevated in patients with acute leukemia.%目的 探讨SHP-1和JAKI mRNA在急性白血病(AL)患者的表达及其与AL复发及初次诱导缓解化疗疗效的关系.方法 采用半定量反转录一聚合酶链反应(RT-PCR)的方法检测93例AL患者骨髓单个核细胞中SHP-1和JAK1 mRNA的表达,20例健康志愿者为健康对照.结果 初治AL患者SHP-1 mRNA表达水平较健康对照组明显降低(P=0.000),治疗完全缓解(CR)后表达增高(P=0.032),复发时SHP-1 mRNA水平降低(P=0.015);初治AL患者JAKI mRNA表达水平较NC组略增高,但差异无统计学意义(P=0.051),复发AL患者JAK1 mRNA表达水平较NC组增高,有统计学意义(P=0.047);初治AL患者SHP-1 mRNA阳性组的诱导化疗CR率为88.89%,阴性患者组CR率为60.38%,差异有统计学意义(P=0.018);SHP-1与JAK1 mRNA表达呈负相关(P=0.048).结论 AL患者中SHP-1 mRNA表达降低或缺如,SHP-1mRNA阳性表达是初治AL患者预后良好的因素,并可作为判断疾病进展的预测指标.AL细胞中JAK1 mRNA丰度可能增高.
  • 摘要：目的 探讨亚砷酸(As2O3)联合阿米福汀(AMI)诱导人髓系白血病细胞HL-60凋亡的可能机制.方法 不同浓度As2O3,单用和联合AMI对HL-60细胞进行不同时间干预,用MTT比色法检测细胞的生长抑制作用,用半定量RT-PCR法检测抑凋亡基因Survivin mRNA的表达水平.结果 As2O3组和联合组均可显著抑制HL-60细胞的增生,呈浓度依赖性,联合组对其抑制作用明显大于As2O3组.联合组降低Survivin的表达作用比As2O3组更明显.结论 As2O3通过下调抑凋亡基因Survivin的表达诱导HL-60凋亡;AMI可增强As2O3对Survivin的下调作用,增强HL-60细胞对As2O3的敏感性,发挥促凋亡效应.%Objective To explore the mechanisms of apoptosis induced by arsenic trioxide and amifostine in human acute promyelocytic leukemia cell lines HL-60 in vitro.Methods HL-60 cells were treated with different concentrations of arsenic trioxide alone and combined with amifostine.The inhibitory ratio of the ceils were measured by MTT assay.and the expression of Survivin Was detected by semiquantitate RT-PCR.Results Proliferation of HL-60 cells exposed to arsenic trioxide dwpped down with increasing dose of the dmg and this effect Was significantly hisher when arsenic trioxide Was used in combination with amifostine.Furthermore.there was a more significant decrease in Survivin expression in HL-60 cells treated with arsenic trioxide in combination with amifostine as compared to the cells treated only with arsenic trioxide.Conclusion Arsenic trioxide induced HL-60 cells to undergo apoptosis by downregulating the expression of Survivin. Amifostine enhanced the sensitivity of HL-60 cells to arsenic trioxide by downregulating the expression of Survivin,thus promoting apoptosis effect.
  • 摘要：Objective To investigate the relationship between serum-VEGF(sVEGF)and clinical features in children and adolescent patients with non-Hodgkin lymphoma(NHL) and acute lymphoblagtic leukemia(ALL).Methods The sVEGF in 101 of pretreated NHL and ALL patients were detected by enzymelinked inununosorbent assay(ELISA).The sVEGF prior and post-treatment were compared in 61 patients who achieved complete remission(CR).Results The median sVEGF was 567.70 ng/L in 81 prior-treated NHL patients.It was significantly higher than that in normal controls(P＜0.001).The median sVEGF wag 253.90 ng/L in 49 patients with CR,which was significantly different compared to pretherapeutic level(P＜0.001),whereag no statistical difference was observed compared to the normal controls. No relationships were found between sVEGF and clinical indexes such as clinical stage,"B"symptoms,gender,performance status(PS)score,bulk and serum lactate dehydrogenage (LDH)et al in untreated NHL patients.The median sVEGF was 198.60 ng/L in 20 untreated ALL patients.which wag no statistically different in comparison with that of normal controls.And the median sVEGF wag 181.73 ng/L in 12 of the CR ALL patients.which wag not statistically different in comparison with that in prior-treatment group or normal controls.Conclusion This study showed that the sVEGF in untreated children and adoleseent patients with NHL were higher than that of normal controls.The high sVEGF dmpped after achieving CR.There was no relationship between the level of sVEGF and clinical characteristics in the NHL patients.The sVEGF level in untreated ALL patients wag not difierent compared to that of the normal controls.and there was no change for sVEGF after chemotherapy in ALL patients.%目的 探讨儿童青少年非霍奇金淋巴瘤(NHL)和急性淋巴细胞性白血病(ALL)患者血清血管内皮生长因子(sVEGF)水平与临床的关系.方法 使用ELISA法检测101例3个月～20岁NHL和ALL患者初诊时sVEGF水平,并对其中获得完全缓解(CR)的61例患者进行治疗前后sVEGF水平的比较.结果 81例初诊NHL患者sVEGF浓度为567.70 ng/L,明显高于正常对照值(P＜0.001),其中49例CR患者sVEGF浓度为253.90 ng/L,与治疗前比较差异有统计学意义(P＜0.001).与正常值相比差异无统计学意义.初诊NHL患者sVEGF与临床分期、B症状、性别、PS评分、巨大肿块和血清LDH等临床指标无明显相关.20例ALL患者初诊时sVEGF浓度198.60 ng/L,与正常值相比差异无统计学意义.其中12例CR患者sVEGF浓度为181.73 ng/L,与治疗前水平及正常值相比,差异均无统计学意义.结论 初诊儿童青少年NHL患者sVEGF水平升高,CR后下降,NHL患者sVEGF水平与临床指标无相关性.初诊ALL患者的sVEGF水平无明显升高,治疗前后无明显变化.
  • 摘要：Objective To explore the sensitivity and specificity of conventional eytogeneties(CC),nested-reverse transcriptase polymerase chain reaction(nested-RT-PCR) and dual-color and dual-fusion fluorescence in situ hybridization(D-FISH) technique in monitoring the tumor load of chronic myeloid leukemia (CML) during treatment.Methods CC,nested-RT-PCR and interphase D-FISH were simultaneously carried out to detect the tumor load of 5 CML patients during treatment with interferon-Mpha(IFN-α).Results 24 specimens from 5 CML patients before and after IFN-α therapy were investigated and the results showed that 23 specimens were Ph+ with different positive ratios by CC.All specimens were bcl-abl mRNA (+) by RTPCR.The Ph-ber-abl+ specimen from case 2 after 75 months of post-treatment showed 4.5%bcr-abl+ cells by FISH.2 specimens from case 1 at 22 mortths,26 mortths of post-treatment.2 specimens from cage 5 after 12 months,16 menths of post-treatment and 2 specimens from case 4 after 6 menths,10 menths post-treatment with same Ph+ ratio respectively were investigated by FISH and showed 47.5% and 39.5%,74.0%and 60.5%,99.0% and 99.5% bcr-abl+ cells,respectively.Conclusion CC can be used as a basic tool to monitor the change of tumor load in CML during treatment. When CC can't evaluate precisely dynamic changes of tumor load and when tumor load in patient with treatment were too low to detect Ph bv CC while bcr-abl mRNA was still positive by RT-PCR,FISH Call be used to detect precisely tumor load and monitor dynamic change of the disease.More sensitive RT-PCR was used to monitor tumor load when it was negative to bcr-abl by FISH during treatment.%目的 探讨常规细胞遗传学(CC)、巢式反转录-聚合酶链反应(RT-PCR)及双色双融合荧光原佗杂交(D-FISH)三种技术监测慢性髓细胞白血病(CML)患者干扰素(INF)治疗过程中肿瘤负荷的灵敏度和特异性.方法 联合应用CC、巢式RT-PCR和D-FISH三种技术对5例INF治疗中CML患者的肿瘤负荷水平进行检测.结果 对5例CML患者INF治疗前后的24份骨髓标本检测显示,23份标本检出不同比率的Ph染色体,所有标本RT-PCR结果均为阳性.病例2治疗后75个月Ph-bcr-abl+标本经D-FISH检测,仍有4.5%的bcr-abl+细胞;病例1治疗后22、26个月的2份标本,病例5治疗后12、16个月的2份标本及病例4治疗后6、10个月的2份标本经CC检测Ph染色体阳性率相同,进一步行D-FISH检测,分别检出47.5%和39.5%、74.0%和60.5%、99.0%和99.5%的bcr-abl+细胞.结论 CC可作为监测CML患者治疗过程中肿瘤负荷水平的基本手段.在CC检测结果无法准确判断体内肿瘤负荷动态变化时以及治疗患者体内肿瘤负荷降低到CC不能检出而RT-PCR仍为阳性时,需借助FISH来准确检测体内肿瘤负荷,监测其动态变化.FISH检测bcr-abl转阴的患者需靠灵敏度更高的RT-PCR监测.
  • 摘要：随着第一个单克隆抗体--利妥昔单抗被美国FDA批准用于治疗CD20+的B细胞淋巴瘤以来,分子靶向治疗已有十余年历史.与传统的放化疗相比,靶向治疗由于选择性高,不良反应较少,改善患者的预后和生存质量明显,而成为一种非常有前景的治疗方法.近十余年来,新的靶向治疗药物不断出现,治疗领域不断扩展,对靶向治疗的认识也在不断地加深.%Ten years had passed for the molecular targeted therapy since approval by the U.S.Food and Drug Administration of the first monoclonal antibody-Rituximab,for the treatment of the B-cell non-Hodgkin's lymphomas with positive CD20- The targeting therapy,which may be a promising approach in the future,has significantly improved the patients'qualities of lives and prognosis because it has higher selectivity and less adverse effects than current chemotherapy and radiotherapy.In the past decade,with the fast development of novel targeting drugs and extension of therapeutic fields,the limitations associated with the targeted treatments were received attentions.
  • 摘要：患者 男，59岁，因“反复气促半年余，加重伴上腹痛3h”于2006年7月入院。患者于入院前半年余内反复活动后气促，上二楼即需休息，伴心悸、胸闷，当时无双下肢水肿、腹胀，当地就医查心电图示“心房纤颤”，服用“康可、地高辛、安体舒通、立普妥、波立维、拜阿司匹林”，病情一度稳定。同年2月，开始出现双下肢水肿、腹胀，右上腹为主，在该院行64排CT示冠状动脉无异常，
  • 摘要：目的 观察吡柔比星(THP)联合化疗方案对急性白血病(AL)的疗效.方法 治疗组AL患者32例,其中急性非淋巴细胞白血病(ANLL)患者20例,采用THP联合阿糖胞苷(Ara-C)(TA方案).急性淋巴细胞白血病(ALL)患者12例,采用THP联合长春新碱(VCR)、泼尼松(Pred)(VTP方案).对照组36例,其中ANLL患者24例,ALL患者12例,用柔红霉素(DNR)替代THP.结果 治疗组有效率87.5%,对照组有效率87.3%(P＞0.05).治疗组完全缓解率62.5%,对照组完全缓解率47.2%,两组差异有统计学意义(P＜0.05).治疗组骨髓抑制较对照组明显,感染发生率高(P＜0.05).结论 吡柔比星联合化疗方案可作为治疗急性白血病一线治疗方案,其完全缓解率高,但骨髓抑制明显.
  • 摘要：目的 研究混合谱系白血病(MLL)基因重排在急性白血病(AL)中的发生率、产生融合基因的常见类型及其临床意义.方法 采用多重巢式RT-PCR法对109例AL患者进行免疫表型检测,分析MLL基因重排阳性患者的临床特征.结果 109例AL中7例发生MLL基因重排,发生率为6.4%,其中AML4例(1例为M2,1例为M4,2例为M5),ALL3例,均为B-ALL.多重巢式RT-PCR检测到的融合类型为MLL-AF4、MLL-AF6、MLL-AF9、MLL-AF10、MLL-ENL.MLL基因重排阳性患者外周血WBC高于MLL基因重排阴性患者,差异有统计学意义(P=0.019).结论 多重巢式RT-PCR是检测MLL基因重排快速有效的方法.伴MLL基因重排的AL患者WBC较高,预后差.%Objective To study the frequency of mixed-lineage leukemia(MEL)gene rearrangement and frequent types of fusion genes and the clinical characteristics in acute leukemia(AL)with MLL gene rearrangement.Methods MLL gene rearrangement was detected by multiplex nested RT-PCR in 109 cases of AL.Immunophenotypes were screened by flow cytometry and the chnical features of MLL gene rearranged were analyzed.Results MLL gene rearrangement were identified in 6.4%(7/109)of the patients,4 cases of AML,1 case of M2,1 case of M4,2 cases of M5,3 cases of.B-ALL.MLL-AF4,MLL-AF6,MLL-AF9,MLL-AF10.MLL-ENL were deleted by multiplex nested RT-PCR.Patients with MLL gene rearrangement presented higher initial white blood cell count(WBC)(P=0.019).Conclusion Multiplex nested RT-PCR is a fast and effective method to detect gene rearrangement of MLL in AL Patients with MLL gene rearrangement presented higher WBC and poor prognosis.
  • 摘要：目的 探讨肝素对长春新碱诱导的K562细胞凋亡及增生的影响.方法 肝素预处理K562细胞1 h,再经长春新碱(0.05 mg/L)处理24 h,应用Hoechst 33342染色、DNA电泳、FMC等方法检测细胞凋亡.Trypan blue染色及MTT法检测细胞毒性及增生反应.结果 Hoechst 33342荧光染色见长春新碱凋亡诱导组细胞凋亡率达40.10%,肝素25、50、100、200 U/ml组凋亡率依次为32.47%、29.70%、25.50%、19.53%(均P＜0.05).随肝素浓度增加DNA电泳凋亡梯带亮度逐渐减弱至消失.FACS检测凋亡诱导组凋亡率为21.61%,肝素25～200 U/ml组凋亡率依次为13.64%、11.75%、8.59%、6.03%(均P＜0.05).肝素各组处理K562细胞24 h后细胞存活率、活细胞总数及细胞增生水平与正常对照组比较差异均有统计学意义(P＞0.05).结论 肝素浓度在200 U/ml内对K562细胞无毒性作用及增生影响,在25～200 U/ml以浓度依赖性方式抑制由长春新碱诱导的KS62细胞凋亡.%Objective To investigate the effect of heparin on the apoptosis and proliferation of human myeloid leukemia cell line K562 induced by vincristine.Methods K562 cells were pretreated by heparin for 1h,then cultured with 0.05 mg/L vincristine in 37℃ 5% CO2 for 24 h.Apoptosis of KS62 cells was evaluated by Hoechst 33342 staining,flow cytometer and DNA agarose gel electrophoresis after culture for 24 hours.The effect of heparin on KS62 cell proliferation and toxicitv was determined by Trypan blue staining and MTT assay.Results In the apeptosis induced group,the apeptosis rate was 40.10% dected by Hoechst 33342 fluorescence staining.The hepafin in different concentrations was found to be able to inhibit the apoptosis of K562 cells triggered by vincristine and the apoptosis rate was 32.47%,29.7%,25.5%,19.53% in the heparin groups of 25,50,100,200 U/ml,respectively.The apeptosis rate was significantly lower in the apeptosis induced group than in the heparin groups of 25,50,100,200 U/ml(P＜0.05).The typical DNA ladder could be found in the apoptosis-induced group,and the DNA ladder gradually disappeared along with the increase of heparin(5～200 U/ml).The sub-G1 peak of K562 cells could be found in the induced group by FACS and the apoptosis rate was 21.61%.In the heparin groups of 25,50,100,200 U/ml,the sub-G1 Peak of K562 cells gradually dropped and the apoptosis rate was 13.64%,11.75%,8.59%,6.03%(P＜0.05),respectively.After K562 cells were incubated with different hepafin concentrations(5～200 U/ml)for 24 hours,there was no difference compared with the normal control group in both the total live cell numbers and the cell proliferation rate measured by trypan blue staining and MTT assay(P＞0.05).Conclusion The results suggested that heparin had no influence on KS62 cell toxicity and proliferation,but may inhibit the apoptosis of KS62 cells induced by vincristine.
  • 摘要：目的 探讨白消安注射液用于急、慢性髓细胞白血病外周血干细胞移植预处理的疗效和安全性.方法 6例急、慢性髓细胞白血病患者采用白消安联合环磷酰胺为主的预处理方案,1例慢性髓细胞白血病患者采用白消安联合氟达拉滨的预处理方案.3例接受自体外周血造血干细胞移植,4例接受异基因外周血造血干细胞移植.移植物抗宿主病的预防3例采用环孢素A+甲氨蝶呤,1例采用环孢素A+甲氨蝶呤+吗替麦考酚酯片+抗胸腺细胞球蛋白.结果 全部病例均植活,无一例发生肝静脉阻塞病,无严重不良反应及移植物抗宿主病发生,1例移植4个月后复发,最长无瘤生存期达20个月.结论 白消安联合环磷酰胺或氟达拉滨的预处理方案安全有效.
  • 摘要：目的 明确急性双系列白血病(aBLL)的诊断,判断患者预后.方法 回顾性分析aBLL病例的临床和实验室资料,明确其白血病细胞特征以及治疗疗效和生存情况.结果 共计筛选了352例患者,符合aBLL诊断的11例,其中男4例,女7例,中位年龄38岁,发病时白细胞中位计数56.3×109/L.髓/B淋巴细胞混合(My-B)aBLL患者数多于髓/T淋巴细胞混合(My-T)aBLL患者(分别为8例和3例).7例患者进行了细胞遗传学分析,仅1例有复杂核型改变,其余均为标准核型.诱导治疗缓解率为45.5%(5/11),反应率(CR+PR)为54.5%(6/11),1个疗程缓解2例,缓解持续时间3～14个月,中位时间11个月.生存时间1～23个月,中位生存时间10个月.诱导治疗期死亡l例.结论 aBLL是一种少见的急性白血病亚型,诊断需要结合细胞形态学和细胞免疫表型的检测结果.该采用急性白血病常用化疗方案,疗效差,预后不良.%Objective To determine the diagnosis and the prognosis of acute bilineal leukemia(aBLL).Methods The cases who had been morphologicaUy diagnosed as acute leukemia were retrospectively screened.The characteristics of aBLL blasts and the patients'responses to chemotherapy and the survival rate were identified based on the analysis of both their clinical and laboratory data.Results From total of 352 cases screened,11 cases of aBLL were identified.The incidence of aBLL was 3.1%.Among them 4 were male and 7 female.The median age was 38 years old.The median counts of white blood cell at the onset of the disease was 56.3×109/L.There were more My/B aBLL subtype cases than My/T aBLL (8 cases vs.3 cases). Cytogenefie analysis data were available for 7 cages. All were standard karyotypes except 1 who had complex karyotypie change.The complete remission(CR)rate of chemotherapy was 45.5%(5/11)and the response rate(CR+PR)Wag 54.5%(6/11).Only 2 patients achieved CR after the first course of induction chemotherapy.The median of remission duration was 11 months,ranged from 3 to 14 months.The median of survival time was 10 month. ranged from 1 to 23 months. 1 patient died during the induction course.Conclusion aBLL is a rare subtype of acute leukemia.The diagnosis of the disease could be based on the combinational analysis of morphology and immunophenotype study.The patients'responses to the conventional chemotherapy regimens were not satisfied.Therefore,the prognosis of the disease was poor.

    白血病·淋巴瘤的期刊信息

    • 曾用名：白血病;山西白血病;白血病.淋巴瘤
    • 创刊时间：1992
    • 地区：CN
    • 语言：中文
    • 热门主题：中华医学会;山西省肿瘤研究所;山西省肿瘤医院
    • 学科分类：

      Biochemistry, Genetics and Molecular Biology:Cancer Research;Medicine:Hematology;Oncology;

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