leukemia

摘要： Hematolymphoid malignancies are common neoplasms in childhood.The involvement of the gastrointestinal(GI)tract,liver,biliary system,pancreas,and peritoneum are closely interlinked and commonly encountered.In leukemias,lymphomas,and Langerhans cell histiocytosis(LCH),the manifestations result from infiltration,compression,overwhelmed immune system,and chemotherapyinduced drug toxicities.In acute leukemias,major manifestations are infiltrative hepatitis,drug induced gastritis,neutropenic typhlitis and chemotherapy related pancreatitis.Chronic leukemias are rare.Additional presentation in lymphomas is cholestasis due to infiltration or biliary obstruction by lymph nodal masses.Presence of ascites needs a thorough workup for the underlying pathophysiology that may modify the therapy and affect the outcome.Uncommon hematolymphoid malignancies are primary hepatic,hepatosplenic,and GI lymphomas which have strict definitions.In advanced diseases with extensive spread,it may be impossible to distinguish these diseases from the primary site of origin.LCH produces biliary strictures that mimic as sclerosing cholangitis.Liver infiltration is associated with poor liver recovery even after chemotherapy.The heterogeneity of gut and liver manifestations in hematolymphoid malignancies has a clinical impact on their management.Though chemotherapy is the mainstay of therapy in all hematolymphoid malignancies,debulking surgery and radiotherapy have an adjuvant role in specific clinical scenarios.Rare situations presenting as liver failure or end-stage liver disease require liver transplantation.At their initial presentation to a primary care physician,given the ambiguity in clinical manifestations and the prognostic difference with time-bound management,it is vital to recognize them early for optimal outcomes.Pooled data from robust registries across the world is required for better understanding of these complications.

摘要： BACKGROUND Leukemia is a broad term for blood cell cancer.Leukemia is divided into acute or chronic,depending on cell differentiation.Leukemia patients are prone to adverse reactions during chemotherapy,such as anxiety,depression,and even suicide,affecting prognosis.As a nursing model developed by three well-known cognitive psychologists,empathetic nursing with mindfulness cognitive therapy(ENMCT)can effectively reduce anxiety and depression and improve the quality of life in patients with chronic disease.AIM To explore the effect of ENMCT on cancer-induced fatigue,hope level,and negative emotions in patients with long-term leukemia chemotherapy.METHODS A total of 103 patients with long-term leukemia chemotherapy diagnosed and treated in our hospital from July 2017 to October 2019 were enrolled and randomly assigned to observation and control groups using the random number table approach.Fifty-one patients in the control group received routine nursing,while 52 patients in the observation group received empathic nursing with mindfulness cognitive therapy.After three months of nursing care,cancerinduced fatigue was measured with the Piper Fatigue Scale(PFS),hope level with the Herth Hope Index(HHI),and negative emotion with the Hamilton Anxiety Scale(HAMA)/Hamilton Depression Scale(HAMD).Self-management(Chinese Strategies Used by People to Promote Health)was also recorded.RESULTS The observation group’s total scores in behavior,cognition,emotion,feeling,and PFS were lower than the control group after the intervention(P<0.05).Keeping close contact with others,the attitude of taking positive actions,the attitude toward reality and future,and the total HHI score were higher in the observation group than the control group(P<0.05).The observation group’s HAMA and HAMD scores were lower than the control group(P<0.05).The observation group’s positive attitude,self-decision,and self-relief scores were greater than the control group(P<0.05).CONCLUSION Empathetic nursing with cognitive mindfulness therapy is beneficial in improving cancer-related fatigue,negative emotions,expectation level,and self-management ability in patients with longterm leukemia chemotherapy.

摘要： BACKGROUND Pulmonary lymphomatoid granulomatosis(PLG)is a lymphoproliferative disease associated with Epstein-Barr viral infection occurring mainly in adults and rarely in children.It is characterized by multiple pulmonary nodules.Its diagnosis depends on lung biopsy findings.Most patients are immunodeficient,and it commonly presents in children undergoing chemotherapy for leukemia.We report the case of a child with PLG caused by a mutation in the macrophageexpressed gene 1(MPEG1),suggesting possible PLG occurrence in children undergoing treatment for pulmonary nodular lesions.CASE SUMMARY This study reports a case of PLG without apparent immunodeficiency,suggesting the possibility of this disease occurrence during the treatment of pulmonary nodular lesions in children.Initially,the cause was assumed to be an atypical pathogen.Following conventional anti-infective treatment,chest computed tomography findings revealed that there were still multiple nodules in the lungs.Additionally,the patient was found to be infected with the Epstein-Barr virus.Histopathological examination of the resected lung revealed lymphoproliferative lesions with necrosis.Small lymphocytes,plasma cells,and histiocytes were observed in the background,although Reed-Sternberg cells were absent.Immunohistochemical staining[CD20(+),CD30(+),and CD3(+)]and EBV-encoded small RNA1/2 in situ hybridization of small lymphocytes revealed approximately 200 cells/high-power field.Whole exon sequencing of the patient revealed a mutation in the MPEG1.The patient was eventually diagnosed with PLG and transferred to the Department of Pediatric Oncology for bone marrow transplantation.CONCLUSION As PLG is rare and fatal,it should be suspected in clinical settings when treatment of initial diagnosis is ineffective.

摘要： Differentiation syndrome is a complication commonly encountered in acute promyelocytic leukemia patients when treated with Al-Trans retinoic acid.This Differentiation syndrome has veryclose similarities clinically and radiologically to SARS-CoV2 pneumonitis which makes diagnosis of differentiation syndrome challenging specially during this COVID-19 pandemic.We hereby report a case of a 68-year-old male with acute promyelocytic leukemia who on initiation of Al-Trans retinoic acid developed acute respiratory distress with radiological findings of multiple ground glass opacities in bilateral lungs suggestive of SARS-CoV2 pneumonitis.Considering the radiological similarities to differentiation syndrome and on high clinical suspicion,this patient was immediately started on steroids with which he recovered rapidly.During this pandemic of SARS-CoV2,distinguishing differentiation syndrome from SARS-CoV2 pneumonitis clinically and radiologically is extremely challenging.

摘要： Leukemia is blood cancer, including bone marrow and lymphatictissues, typically involving white blood cells. Leukemia produces an abnormalamount of white blood cells compared to normal blood. Deoxyribonucleicacid (DNA) microarrays provide reliable medical diagnostic services to helpmore patients find the proposed treatment for infections. DNA microarraysare also known as biochips that consist of microscopic DNA spots attachedto a solid glass surface. Currently, it is difficult to classify cancers usingmicroarray data. Nearly many data mining techniques have failed becauseof the small sample size, which has become more critical for organizations.However, they are not highly effective in improving results and are frequently employed by doctors for cancer diagnosis. This study proposes a novelmethod using machine learning algorithms based on microarrays of leukemiaGSE9476 cells. The main aim was to predict the initial leukemia disease.Machine learning algorithms such as decision tree (DT), naive bayes (NB),random forest (RF), gradient boosting machine (GBM), linear regression(LinR), support vector machine (SVM), and novel approach based on thecombination of Logistic Regression (LR), DT and SVM named as ensembleLDSVM model. The k-fold cross-validation and grid search optimizationmethods were used with the LDSVM model to classify leukemia in patientsand comparatively analyze their impacts. The proposed approach evaluatedbetter accuracy, precision, recall, and f1 scores than the other algorithms.Furthermore, the results were relatively assessed, which showed LDSVMperformance. This study aims to successfully predict leukemia in patientsand enhance prediction accuracy in minimum time. Moreover, a Syntheticminority oversampling technique (SMOTE) and Principal compenent analysis(PCA) approaches were implemented. This makes the records generalized andevaluates the outcomes well. PCA reduces the feature count without losing anyinformation and deals with class imbalanced datasets, as well as faster modelexecution along with less computation cost. In this study, a novel processwas used to reduce the column results to develop a faster and more rapidexperiment execution.

摘要： Objective:To observe the effect of CAGE regimen in the treatment of adult refractory acute non-lymphocytic leukemia.Methods:In this experiment,86 adult patients with refractory acute non-lymphocytic leukemia who were treated between January 2018 and January 2022 were selected as experimental subjects and were divided into two groups,the observation group and the control group,according to different treatment methods,with 43 patients in each group.The observation group was treated with the CAGE regimen,whereas the control group was treated with conventional therapy.The disease remission rate and incidence of adverse reactions were observed.Results:The comparison of disease remission rates between the two groups showed that there was no significant difference in the results of the first course of treatment and the second course of treatment between the two groups(P>0.05),but the incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion:The CAGE regimen has a significant therapeutic effect in the treatment of adult refractory acute non-lymphocytic leukemia.It improves the treatment advantage of patients during the treatment process,thus alleviating the condition of patients and improving their quality of life.

摘要： BACKGROUND With the advancement of medical technology and improvement in living standards,the incidence of multiple primary cancers has gradually increased.In particular,tumors of the digestive system account for a large proportion of multiple primary cancers.The diagnosis and treatment of chronic myeloid leukemia,particularly with synchronous gastric cancer,at the first consultation is relatively rare.CASE SUMMARY Herein,we present the case of a middle-aged man who was referred to the Department of Hematology owing to an elevated white blood cell count.After the examination,he was diagnosed with chronic myeloid leukemia and was administered imatinib.Three months after the initial diagnosis,he visited our hospital again for abdominal pain,and further examination revealed gastric malignancy.After discussion with a multidisciplinary team,S-1(Tegafur,Gimeracil,and Oteracil Potassium Capsules) combined with oxaliplatin—SOX regimen—was initiated.Later,the patient’s condition rapidly progressed.He developed colonic obstruction and underwent an ostomy;however,he died less than 6 months after the initial diagnosis.CONCLUSION Multiple primary cancers are influenced by environmental and genetic factors;a standardized multidisciplinary discussion plays a key role in treatment.

摘要： Leukemoid reaction like leukemia indicates noticeable increased count of WBCs(White Blood Cells)but the cause of it is due to severe inflammation or infections in other body regions.In automatic diagnosis in classifying leukemia and leukemoid reactions,ALL IDB2(Acute Lymphoblastic Leukemia-Image Data Base)dataset has been used which comprises 110 training images of blast cells and healthy cells.This paper aimed at an automatic process to distinguish leukemia and leukemoid reactions from blood smear images using Machine Learning.Initially,automatic detection and counting of WBC is done to identify leukocytosis and then an automatic detection of WBC blasts is performed to support classification of leukemia and leukemoid reactions.Leukocytosis is commonly observed both in leukemia and leukemoid hence physicians may have chance of wrong diagnosis of malignant leukemia for the patients with leukemoid reactions.BCCD(blood cell count detection)Dataset has been used which has 364 blood smear images of which 349 are of single WBC type.The Image segmentation algorithm of Hue Saturation Value color based on watershed has been applied.VGG16(Visual Geometric Group)CNN(Convolution Neural Network)architecture based deep learning technique is being incorporated for classification and counting WBC type from segmented images.The VGG16 architecture based CNN used for classification and segmented images obtained from first part were tested to identify WBC blasts.

摘要： Technology-based interventions are thought to be one of the innovative alternatives for improving the psychosocial health of adolescent survivors.This article outlines an example of technology-based psychosocial intervention for adolescent survivors of leukemia.This technology-based psychosocial support intervention consists of five separate modules related to personal development,coping skills,and a healthy lifestyle.intervention can be applied to adolescents(aged 12-18 years)who have completed leukemia treatment at least 2 years ago and are disease free.Psychosocial interventions are crucial to improving adolescent survivors’psychosocial well-being in long-term follow-up.It is thought that psychosocial interventions can be effective on survivors’self-efficacy,coping skills,and quality of life,and survivors will be satisfied with the program.Regarding the model of childhood cancer survivorship care,this intervention can be integrated into the follow-up program and guide pediatric oncology nurses in preparing support programs for adolescent survivors.

摘要： In the hematopoietic system, a small number of stem cells produce a progeny ofseveral distinct lineages. During ontogeny, they arise in the aorta-gonadmesonephrosregion of the embryo and the placenta, afterwards colonise the liverand finally the bone marrow. After this fetal phase of rapid expansion, thenumber of hematopoietic stem cells continues to grow, in order to sustain theincreasing blood volume of the developing newborn, and eventually reaches asteady-state. The kinetics of this growth are mirrored by the rates of telomereshortening in leukocytes. During adulthood, hematopoietic stem cells undergo avery small number of cell divisions. Nonetheless, they are subjected to aging,eventually reducing their potential to produce differentiated progeny. The causalrelationships between telomere shortening, DNA damage, epigenetic changes,and aging have still to be elucidated.