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Shenqi Fuzheng Injection Combined with Chemotherapy for acute leukemia:A Meta-Analysis

Chinese Journal of Integrative Medicine 2022年第1期28卷 81-87页

作者： MENG Fu-xue YANG Xin LI Mei-ling Department of Hematology and Rheumatology the Third Affiliated Hospital of Guizhou Medical UniversityDuyunGuizhou Province(558000)China

Objective:To evaluate to the efficacy and safety of Shenqi Fuzheng Injection(SFI)combined with chemotherapy in the treatment of acute leukemia(AL)by meta-analysis.Methods:Pub Med,Cochrane library,Embase,Sino Med,China National Knowledge Infrastructure(CNKI),VIP Journal Integration Platform,Wanfang Database were searched from establishment to November 1,2018.The randomized controlled trials(RCTs)of SFI combined with chemotherapy in the treatment of AL were included.The Cochrane risk assessment form(Rev Man 5.1)was used to evaluate the quality of included studies.Results:A total of 14 RCTs and 1,088 patients was included.The quality evaluation was mostly low risk or unclear.Meta-analysis showed that compared with chemotherapy alone,SFI combined with chemotherapy can improve the total clinical effective rate in patients with AL(RR=1.15,95%CI:1.056–1.177;P=0.0001),and relieve adverse reactions caused by chemotherapy drugs,including infection(RR=0.561,95%CI:0.397–0.792;P=0.001),nausea and vomiting(RR=0.662,95%CI:0.524–0.835;P=0.001),bleeding(RR=0.548,95%CI:0.39–0.768;P=0.0001),cardiotoxicity(RR=0.230,95%CI:0.080–0.660;P=0.006)and hyperhidrosis(RR=0.348,95%CI:0.208–0.581;P=0.0001).The incidence rates of adverse reactions in SFI combined with chemotherapy group were significantly lower than that of the chemotherapy alone group(P<0.01).Conclusions:Shenqi Fuzheng Injection combined with chemotherapy has good efficacy and safety for AL,and it can alleviate the adverse reactions caused by chemotherapy.However,subject to the limitations of the methodological quality of the literature,the conclusions of this study need to be further verified by large-scale and multi-center RCTs.

关键词： Shenqi Fuzheng Injection chemotherapy meta-analysis acute leukemia Chinese medicine

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Hematopoiesis reconstitution and anti-tumor effectiveness of Pai-Neng-Da capsule in acute leukemia patients with haploidentical hematopoietic stem cell transplantation

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World Journal of Clinical Cases 2022年第14期10卷 4425-4435页

作者： Jiao-Jiao Yuan Ying Lu Jun-Jie Cao Ren-Zhi Pei Rui-Lan Gao Department of Hematology The Affiliated People’s Hospital of Ningbo UniversityNingbo 315000Zhejiang ProvinceChina Institute of Hematology Research The First Affiliated Hospital of Zhejiang Chinese Medical UniversityHang Zhou 310006Zhejiang ProvinceChina

BACKGROUND With the rapid development of haploidentical hematopoietic stem cell transplantation(haplo-HSCT),primary poor graft function(PGF)has become a lifethreatening complication.Effective therapies for PGF are inconclusive.New Chinese patent medicine Pai-Neng-Da(PND)Capsule exerts dual effect in promoting hematopoiesis recovery and regulating immunity.Still,the application of PND capsule in hematopoietic stem cell transplantation,especially in the haplo-HSCT setting,has not yet been reported.AIM To evaluate the role of PND capsule in acute leukemia patients with haplo-HSCT.METHODS We retrospectively collected data of acute leukemia patients who underwent haplo-HSCT at the Affiliated People’s Hospital of Ningbo University between April 1,2015 and June 30,2020.Twenty-nine consecutive patients received oral PND capsule from the sixth day to the first month after haplo-HSCT were included in the PND group.In addition,31 patients who did not receive PND capsule during haplo-HSCT were included in the non-PND group.Subsequently,we compared the therapeutic efficacy according to the western medical evaluation indexes and Chinese medical symptom scores,and the survival between the PND group and the non-PND group,using the chi-square test,Fisher’s exact test,and the Kaplan-Meier method.RESULTS The duration of platelet engraftment was shorter in the PND group than in the non-PND group(P=0.039).The PND group received a lower frequency of red blood cells and platelet transfusions than the non-PND group(P=0.033 and P=0.035,respectively).In addition,PND capsule marginally reduced the rate of PGF(P=0.027)and relapse(P=0.043).After 33(range,4-106)months of follow-up,the 3-year relapse-free survival(P=0.046)and progression-free survival(P=0.049)were improved in the PND group than in the non-PND group.Also,the therapeutic efficacy of the PND group according to Chinese medical symptom scores was significantly better than that of the non-PND group(P=0.022).Moreover,the adverse events caused by PND capsule were mild.Nevertheless,the

关键词： Pai-Neng-Da capsule Hematopoiesis reconstitution Anti-tumor acute leukemia Haploidentical hematopoietic stem cell transplantation Effectiveness

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Autologous hematopoietic stem cell transplantation conditioning regimens and chimeric antigen receptor T cell therapy in various diseases

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World Journal of Transplantation 2024年第1期14卷 32-41页

作者： Shahzaib Maqbool Maryam Farhan Baloch Muhammad Abdul Khaliq Khan Azeem Khalid Kiran Naimat Department of Medicine Holy Family HospitalRawalpindi 46000Pakistan Department of Community Medicine Allama Iqbal Medical CollegeLahore 45000Pakistan Department of Community Dentistry Baqai Medical UniversityKarachi 43000Pakistan Department of Medicine Allama lqbal Medical CollegeLahore 45000Pakistan Department of MedicineLiaquat University of Medical and Health Sciences Karachi 43000Pakistan

Conditioning regimens employed in autologous stem cell transplantation have been proven useful in various hematological disorders and underlying malignancies;however,despite being efficacious in various instances,negative consequences have also been recorded.Multiple conditioning regimens were extracted from various literature searches from databases like PubMed,Google scholar,EMBASE,and Cochrane.Conditioning regimens for each disease were compared by using various end points such as overall survival(OS),progression free survival(PFS),and leukemia free survival(LFS).Variables were presented on graphs and analyzed to conclude a more efficacious conditioning regimen.In multiple myeloma,the most effective regimen was high dose melphalan(MEL)given at a dose of 200/mg/m2.The comparative results of acute myeloid leukemia were presented and the regimens that proved to be at an admirable position were busulfan(BU)+MEL regarding OS and BU+VP16 regarding LFS.In case of acute lymphoblastic leukemia(ALL),BU,fludarabine,and etoposide(BuFluVP)conferred good disease control not only with a paramount improvement in survival rate but also low risk of recurrence.However,for ALL,chimeric antigen receptor(CAR)T cell therapy was preferred in the context of better OS and LFS.With respect to Hodgkin’s lymphoma,mitoxantrone(MITO)/MEL overtook carmustine,VP16,cytarabine,and MEL in view of PFS and vice versa regarding OS.Non-Hodgkin’s lymphoma patients were administered MITO(60 mg/m2)and MEL(180 mg/m2)which showed promising results.Lastly,amyloidosis was considered,and the regimen that proved to be competent was MEL 200(200 mg/m2).This review article demonstrates a comparison between various conditioning regimens employed in different diseases.

关键词： Conditioning regimens Multiple myeloma Lymphoma Hodgkin Non-Hodgkin acute leukemia

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Risk factors for CMV infection within 100 days posttransplantation in patients with acute leukemia

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Blood Science 2022年第3期4卷 164-169页

作者： Juan Chen Aiming Pang Yuanqi Zhao Li Liu Runzhi Ma Jialin Wei Xin Chen Yi He Donglin Yang Rongli Zhang Weihua Zhai Qiaoling Ma Erlie Jiang Mingzhe Han Jiaxi Zhou Sizhou Feng State Key Laboratory of Experimental Hematology National Clinical Research Center for Blood DiseasesHaihe Laboratory of Cell EcosystemInstitute of Hematology and Blood Diseases HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeTianjin 300020China

Objective:To investigate the risk factors for cytomegalovirus(CMV)infection within 100 days and the relationship between early CMV infection and 1-year relapse for patients with acute leukemia following allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods:Three hundred fifty-nine patients with acute leukemia who received allo-HSCT at our center between January 2015 and January 2020 were retrospectively reviewed.Results:Of 359 patients,48.19%(173)patients experienced CMV infection within 100 days posttransplantation.In univariate and multivariate logistic analysis,haploidentical-related donor(HRD)(Pacute leukemia.CMV infection within 100 days did not influence the incidence of relapse in 1 year for patients with acute leukemia.

关键词： acute leukemia Allogeneic hematopoietic stem cell transplantation Cytomegalovirus Risk factors Relapse

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Intravenous-oral itraconazole versus oral posaconazole in preventing invasive fungal diseases for acute leukemia patients

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Blood Science 2023年第2期5卷 106-110页

作者： Li Liua Xiaolei Peia Runzhi Maa Yi Hea Rongli Zhanga Jialin Weia Qiaoling Maa Weihua Zhaia Aiming Pang Erlie Jiang Mingzhe Han Donglin Yang Sizhou Feng Hematopoietic Stem Cell Transplantation Center National Clinical Research Center for Blood DiseasesState Key Laboratory of Experimental HematologyHaihe Laboratory of Cell EcosystemInstitute of Hematology&Blood Diseases HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeTianjin 300020China

Invasive fungal diseases(IFDs)are major and lethal infectious complications for patients with neutropenia after chemotherapy.Prophylaxis with intravenous and oral suspended itraconazole(200 mg Q12h intravenously×2 days followed by 5 mg/kg·d orally in twice)or oral suspension of posaconazole(200 mg Q8h)was administered for preventing IFDs.The only 2 episodes of proven IFDs were not included after propensity-score matching(PSM),while the incidence of possible IFDs was 8.2%(9/110)in itraconazole group and 1.8%(2/110)in posaconazole group,respectively(P=.030).In clinical failure analysis,the failure rate of posaconazole group was lower as compared to the itraconazole group(2.7%vs 10.9%,P=.016).Both intravenous-oral itraconazole and posaconazole suspension are effective in preventing IFDs,while posaconazole suspension seems more tolerable.

关键词： acute leukemia Antifungal prophylaxis Invasive fungal disease Itraconazole Posaconazole

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Clinical Characteristics of Bloodstream Infections in Pediatric acute leukemia： A Single-center Experience with 231 Patients

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Chinese Medical Journal 2017年第17期130卷 2076-2081页

作者： Jia-Feng Yao Nan Li Jin Jiang Hematology Oncology Center Beijing Key Laboratory of Pediatric Hematology OncologyNational Key Discipline of PediatricsMinistry of EducationBeijing Children's HospitalCapital Medical UniversityBeijing 100045China

Background：acute leukemia is the most common pediatric hematological malignancy.Bloodstream infections （BSIs） are severe complications in these patients during chemotherapy.This study aimed to explore the clinical presentation and etiology of BSI,as well as the common sites of infection,and to provide a basis for the rational regarding antibiotic use.Methods：We performed a retrospective chart review of all pediatric patients who had acute leukemia accompanied by a BSI in our hospital from December 2011 to September 2015.All patients were selected based on clinical presentation and had to have at least one positive blood culture for inclusion.The basic clinical characteristics,blood culture results,and antimicrobial susceptibilities were analyzed.Results：All 231 patients had a fever;of them,12 patients continued to have a fever.Twenty-five patients had nonremitting （NR） leukemia,and 206 patients achieved complete remission （CR）.Differences in the duration of fever between the NR and CR groups were significant （9.6 ＆#177; 7.9 vs.5.1 ＆#177; 3.8 days,P =0.016）.One hundred and eighty patients had agranulocytosis.Differences in fever duration between the agranulocytosis and nonagranulocytosis groups were significant （6.2 ＆#177; 5.1 vs.4.1 ＆#177; 2.6 days,P =0.001）.The other sites of infection in these 231 patients were the lung,mouth,digestive tract,and rectum.Blood culture comprised 2635 samples.There were 619 samples,which were positive.Of the 619 positive blood culture samples,59.9% had Gram-negative bacteria,39.3% had Gram-positive bacteria,and 0.8% had fungus.The primary pathogens were Pseudomonas aeruginosa,Enterobactercloacae,Escherichia coli,and Klebsiella pneumoniae.Of these 231 patients,217 patients were cured.The effective treatment ratio was 94%.Conclusions：Gram-negative bacteria were the main pathogenic bacteria in patients with acute leukemia in our center.NR primary illness,agranulocytosis,and drug-resistant pathogenic bacteria were all risk factors for poor prognosis.

关键词： acute leukemia Agranulocytosis Bloodstream Infection Etiology Pediatric

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No association between cytochrome P450 2D6 gene polymorphism and risk of acute leukemia： evidence based on a meta-analysis

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Chinese Medical Journal 2013年第19期126卷 3750-3753页

作者： RUAN Xiao-lan LI Sheng ZENG Xian-tao XIA Ling-hui HU Yu Institute of Hematology Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei 430022 China Targeted Biotherapy Key Laboratory of Ministry of Education Wuhan Hubei 430022 China Department of Urology Zhongnan Hospital Wuhan University Wuhan Hubei 430071 China Department Stomatology Taihe Hospital Hubei University of Medicine Shiyan Hubei 442000 China

Background Many studies indicated the human cytochrome P450 2D6 （CYP2D6） gene polymorphism was associated with acute leukemia （AL） susceptibility,however,the results were inconsistent.So we performed this meta-analysis to evaluate the relationship between CYP2D6＊3 or CYP2D6＊4 polymorphism and AL susceptibility.Methods We searched PubMed database up to February 20,2013,and finally yielded 9 case-control studies including 1343 cases and 1843 controls which tested the association between CYP2D6＊3 or ＊4 polymorphism and AL.After data extraction,we conducted a meta-analysis using the Comprehensive Meta Analysis software.Results Overall,no significant association between CYP2D6＊3 or ＊4 polymorphism and AL risk was found in this metaanalysis （＋ vs.-：OR=1.13,95% CI=0.79-1.63; ＋/＋ vs.-/-：OR=1.73,95% C/=0.99-3.02;-/＋ vs.-/-：OR=1.03,95% C/=0.68-1.56; （-/＋ and ＋/＋） vs.-/-：OR=1.08,95% C/=0.72-1.63; ＋/＋ vs.（-/＋ and-/-）：OR=1.76,95% C/=0.98-3.17）.Similar results were also been found in stratified subgroup analysis.There was no publication bias.Conclusion CYP2D6＊3 or ＊4 polymorphism might not be associated with AL susceptibility.However,the results need to be further confirmed by well-designed and high quality randomized controlled trials with larger sample sizes.

关键词： cytochrome P450 2D6 CYP2D6 acute leukemia polymorphism

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Meta-analysis of Cytochrome P4501A1 MspI Gene Polymorphism and Childhood acute leukemia

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Biomedical and Environmental Sciences 2011年第6期24卷 683-687页

作者： ZHANG Yao Dong TAN Li Na ZHANG Xiao Ling WEI Hai Yan XIONG Hao HU Qun Department of Endocrinology Zhengzhou Children＇s Hospital Zhengzhou 450053 Henan China Department of Cardiothoracic Surgery Zhengzhou Children＇s Hospital Zhengzhou 450053 Henan China Department of Pediatrics Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430030 Hubei China Department of Hematology Wuhan Children＇s Hospital Wuhan 430016 Hubei China

Objective To investigate the relationship between cytochrome P4501A1 （CYPIA1） Msp I gene polymorphism and childhood acute leukemia （AL）. Methods Relevant literature was extensively searched and screened by Pubmed and Wanfang Database, Chinese Science Journal Database and Chinese Journal Net. Various data consolidation, combined OR values and their 95% CI were tested by RevMan 4.2; Funnel plots were used for the bias analysis. Results Six related literatures were found to meet the requirements. According to heterogeneity results, there was no significant difference in homozygous types（P〉0.05）, while there was significant difference in two others types （P all〈0.05）. For wild CYPIAIMspl homozygous for the reference group, Combined OR of heterozygous mutation, homozygous, heterozygous ＋ homozygous mutation in AL and control groups were 1.18, 0.96, and 1.10 respectively. Subgroup analysis： Z values of CYP1A1Mspl homozygous, heterozygous ＋ homozygous in the acute lymphoblastic leukemia （ALL） and the control group were 0.10 and 0.76 respectively, Z values in non-acute lymphoblastic leukemia and control group were 0.74 and 0.75. Conclusion There is no correlation between CYP1A1Mspl gene polymorphism and the susceptibility of childhood AL.

关键词： acute leukemia Cytochrome P4501A1 Genetic polymorphism Meta-analysis

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Second unmanipulated allogeneic transplantation could be used as a salvage option for patients with relapsed acute leukemia post-chemotherapy plus modified donor lymphocyte infusion

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Frontiers of Medicine 2021年第5期15卷 728-739页

作者： Tingting Han Yuqian Sun Yang Liu Chenhua Yan Yu Wang Lanping Xu Kaiyan Liu Xiaojun Huang Xiaohui Zhang Peking University People’s Hospital Peking University Institute of HematologyBeijing 100044China National Clinical Research Center for Hematologic Disease Beijing 100044China Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation Beijing 100044China Collaborative Innovation Center of Hematology Peking UniversityBeijing 100044China Peking-Tsinghua Center for Life Sciences Beijing 100044China

Relapse is the main problem after allogeneic hematopoietic stem cell transplantation(allo-HSCT).The outcome of a second allo-HSCT(HSCT2)for relapse post-HSCT has shown promising results in some previous studies.However,little is known about the efficacy of HSCT2 in patients with relapsed/refractory acute leukemia(AL)post-chemotherapy plus modified donor lymphocyte infusion(post-Chemo+m-DLI)after the first allo-HSCT(HSCT1).Therefore,we retrospectively analyzed the efficacy of HSCT2 in 28 patients with relapsed/refractory AL post-Chemo+m-DLI in our center.With a median follow-up of 918(457–1732)days,26 patients(92.9%)achieved complete remission,and 2 patients exhibited persistent disease.The probabilities of overall survival(OS)and disease-free survival(DFS)1 year after HSCT2 were 25.0%and 21.4%,respectively.The cumulative incidences of nonrelapse mortality on day 100 and at 1 year post-HSCT2 were 7.1%±4.9%and 25.0%±8.4%.The cumulative incidences of relapse were 50.0%±9.8%and 53.5%±9.9%at 1 and 2 years post-HSCT2,respectively.Risk stratification prior to HSCT1 and percentage of blasts before HSCT2 were independent risk factors for OS post-HSCT2,and relapse within 6 months post-HSCT1 was an independent risk factor for DFS and relapse post-HSCT2.Our findings suggest that HSCT2 could be a salvage option for patients with relapsed AL post-Chemo+m-DLI.

关键词： second hematopoietic stem cell transplantation acute leukemia relapse chemotherapy modified donor lymphocyte infusion

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Relapse of acute lymphoblastic leukemia in the pancreas after allogeneic bone marrow transplantation

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Chinese Medical Journal 2010年第22期123卷 3364-3366页

作者： ZHAO Xiao-mu ZHANG Zhong-tao LI Jian-she HAN Wei Department of General Surgery Beijing Friendship Hospital Capital Medical University Beijing 100050 China

The occurrence of metastatic lesions in the pancreas of patients with cancer, including hematological cancers,is uncommon （1.6%-37.5%） and of these, the majority of patients will have widespread disease.1-7 Isolated potentially resectable pancreatic metastases are rarely seen. Resection of metastatic tumors of the pancreas has been reported, but its role in improving survival rates or quality of life is not clear.7,8 However,

关键词： pancreas acute leukemia relapse allogeneic bone marrow transplantation

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