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Sarcopenia and gut microbiota alterations in patients with hematological diseases before and after hematopoietic stem cell transplantation

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中国癌症研究:英文版 2023年第4期35卷 386-398页

作者： Boshi Wang Wei Hu Xue Zhang Yanchao Cao Lin Shao Xiaodong Xu Peng Liu Department of Clinical Nutrition Peking University People’s HospitalBeijing 100044China Peking University People’s Hospital Peking University Institute of HematologyNational Clinical Research Center for Hematologic DiseaseBeijing 100044China

Objective: The aim of this study was to investigate the prevalence of sarcopenia(SP) and its relationship with gut microbiota alterations in patients with hematological diseases before and after hematopoietic stem cell transplantation(HSCT).Methods: A total of 108 patients with various hematological disorders were selected from Peking University People’s Hospital. SP was screened and diagnosed based on the 2019 Asian Sarcopenia Diagnosis Strategy. Physical measurements and fecal samples were collected, and 16S rRNA gene sequencing was conducted. Alpha and beta diversity analyses were performed to evaluate gut microbiota composition and diversity.Results: After HSCT, significant decreases in calf circumference and body mass index(BMI) were observed,accompanied by a decline in physical function. Gut microbiota analyses revealed significant differences in the relative abundance of Enterococcus, Bacteroides, Blautia and Dorea species before and after HSCT(P<0.05). Before HSCT, sarcopenic patients had lower Dorea levels and higher Phascolarctobacterium levels than non-sarcopenia patients(P<0.01). After HSCT, no significant differences in species abundance were observed. Alpha diversity analysis showed significant differences in species diversity among the groups, with the highest diversity in the postHSCT 90-day group and the lowest in the post-HSCT 30-day group. Beta diversity analysis revealed significant differences in species composition between pre-and post-HSCT time points but not between SP groups. Linear discriminant analysis effect size(LEfSe) identified Alistipes, Rikenellaceae, Alistipes putredinis, Prevotellaceae defectiva and Blautia coccoides as biomarkers for the pre-HSCT sarcopenia group. Functional predictions showed significant differences in anaerobic, biofilm-forming and oxidative stress-tolerant functions among the groups(P<0.05).Conclusions: This study demonstrated a significant decline in physical function after HSCT and identified potential gut microbiota biomarkers and functional alterations a

关键词： Sarcopenia hematological diseases hematopoietic stem cell transplantation gut microbiota 16S rRNA gene sequencing

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Comprehensive evaluation of nutritional status before and after hematopoietic stem cell transplantation in 170 patients with hematological diseases

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Chinese Journal of Cancer Research 2016年第6期28卷 626-633页

作者： Peng Liu Boshi Wang Xia Yan Jingjing Cai Yu Wang Department of Clinical Nutrition Peking University People's Hospital Beijing 100044 China Department of Hematology Peking University People's Hospital Beijing 100044 China

Objective： To investigate the nutritional status of patients before and after hematopoietic stem cell transplantation（HSCT）, and explore optimal methods for assessing nutritional status in patients with hematological diseases.Methods： This cohort study enrolled 170 patients who were diagnosed with hematological diseases and underwent allogeneic HSCT in the Department of Hematology, Peking University People＇s Hospital between May2011 and April 2013. We used fixed-point continuous sampling and four nutritional screening tools, Nutritional Risk Screening 2002（NRS-2002）, Mini Nutritional Assessment（MNA）, Subjective Global Assessment（SGA） and Malnutrition Universal Screening Tools（MUST）, in combination with body measurements, to extensively screen and evaluate nutritional risks and status in patients receiving HSCT before entering and after leaving laminar air flow rooms.Results： After HSCT, patients had significant reduction in weight, hip circumference, waist-hip ratio, calf circumference, mid-upper arm circumference, and suprailiac skinfold thickness compared with pre-HSCT measurements. Before HSCT, NRS-2002 identified that 21.2% of patients were at nutritional risks, compared with100% after HSCT. MUST indicated that before HSCT, 11.77% of patients were at high nutritional risk,compared with 59.63% after HSCT. MNA assessed that 0.06% of patients were malnourished before HSCT,compared with 19.27% after HSCT. SGA identified that before HSCT, 1.76% of patients had mild to severe malnutrition, which increased to 83.3% after HSCT. There is a significant increase in the nutritional risk and malnutrition in patients who received HSCT.Conclusions： Before HSCT, some patients already had nutritional risk or nutritional deficiencies, and prompt and close nutritional screening or assessment should be performed. The nutritional status of patients after HSCT was generally deteriorated compared with that before transplantation. Body measurements should be taken more frequently during the subsequent treatment window in the laminar

关键词： Nutritional risk screen nutritional assessment hematopoietic stem cell transplantation hematological diseases

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Diagnostic performance of Neutrophil CD64 index,procalcitonin,and C-reactive protein for early sepsis in hematological patients

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World Journal of Clinical Cases 2022年第7期10卷 2127-2137页

作者： Yu-Xi Shang Zhi Zheng Min Wang Hui-Xia Guo Yi-Juan Chen Yue Wu Xing Li Qian Li Jian-Ying Cui Xiao-Xiao Ren Li-Ru Wang Department of Hematology Fuxing HospitalEighth Clinical Medical CollegeCapital Medical UniversityBeijing 100038China Department of General Surgery Xuanwu HospitalCapital Medical UniversityBeijing 100053China

BACKGROUND Patients with hematological diseases are immunosuppressed due to various factors,including the disease itself and treatments,such as chemotherapy and immunotherapy,and are susceptible to infection.Infections in these patients often progress rapidly to sepsis,which is life-threatening.AIM To evaluate the diagnostic efficacy of the neutrophil CD64(nCD64)index,compared to procalcitonin(PCT)and high-sensitivity C-reactive protein(hs-CRP),for the identification of early sepsis in patients with hematological diseases.METHODS This was a prospective analysis of patients with hematological diseases treated at the Fuxing Hospital affiliated with Capital Medical University,between March 2014 and December 2018.The nCD64 index was quantified by flow cytometry and the Leuko64 assay software.The factors which may affect the nCD64 index levels were compared between patients with different infection statuses(local infection,sepsis,and no infection),and the control group and the nCD64 index levels were compared among the groups.The diagnostic efficacy of the nCD64 index,PCT,and hs-CRP for early sepsis was evaluated among patients with hematological diseases.RESULTS A total of 207 patients with hematological diseases(non-infected group,n=50;locally infected group,n=67;sepsis group,n=90)and 26 healthy volunteers were analyzed.According to the absolute neutrophil count(ANC),patients with hematological diseases without infection were divided into the normal ANC,ANC reduced,and ANC deficiency groups.There was no statistically significant difference in the nCD64 index between these three groups(P=0.586).However,there was a difference in the nCD64 index among the non-infected(0.74±0.26),locally infected(1.47±1.10),and sepsis(2.62±1.60)groups(P<0.001).The area under the diagnosis curve of the nCD64 index,evaluated as the difference between the sepsis and locally infected group,0.777,which was higher than for PCT(0.735)and hs-CRP(0.670).The positive and negative likelihood ratios were also better for the nCD64 index than either

关键词： CD64 index hematological diseases Sepsis Procalcitonin C-reactive protein

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Cytogenetic and Molecular Characterization of hematological Neoplasm in an Ecuadorian Population

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Open Journal of Blood diseases 2013年第4期3卷 108-115页

作者： Cesar Paz-y-Mino Maria Eugenia Sanchez Santiago Araujo Ligia Ocampo Victor Hugo Espin Paola ELeone Instituto de Investigaciones Biomedicas Universidad de las AmericasQuitoEcuador Laboratorio de Genetica Sociedad de Lucha contra el Cancer(SOLCA)QuitoEcuador Laboratorio de Genetica Hospital Carlos Andrade MarinQuitoEcuador.

Cancer is one of the major causes of mortality in Ecuador and annually, hematological malignancies are within the top ten most common cancers. In this multicentric study, we analyzed a series of patients diagnosed with different hematological disorders between the years 1984 and 2012. Chromosome abnormalities were detected in 1886 (45.9%) patients. FISH and RT-PCR techniques were used in order to determine the presence of genetic rearrangements and complement conventional cytogenetics results. Using FISH and RT-PCR, positive cases were increased by 1.8% and 6.9% respec- tively. We analyzed fusion genes resulting from t(8;21), t(15;17), inv(16), t(9;22), 11q23 rearrangements, t(4;11) and t(1;19). The frequency of transcripts of some of these fusion genes was of particular interest as our results differ from studies on other populations. Specifically, the fusion gene BCR-ABL was present in the form of the b2/a2 transcript in 95% of CML patients and in the form of b3/a2 transcript in the remaining 5%. The PML-RARA fusion gene also showed a distinct pattern of transcript expression. This fusion gene exhibited the bcr2 (36%) and bcr3 (64%) transcripts, how- ever the bcr1 transcript was absent from our sample population. All cases carrying the CBFB-MYH11 fusion gene ex- hibited the F transcript. This was also of interest due to the rarity of this particular transcript worldwide. Finally all cases carrying the MLL-AF4 fusion gene displayed the e7-e8 transcript. The frequency of the subtypes of some fusion genes differ from those reported in other populations, possibly due to the particular genetic make-up of the Ecuadorian population, mostly mestizo, as well as environmental factors.

关键词： hematological diseases Chromosomal Aberration BCR-ABL PML-RARA CBFB-MYH11 MLL-AF4 Geographical Heterogeneity

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Hematologic Emergencies

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Open Journal of Internal Medicine 2016年第3期6卷 83-92页

作者： Gianfilippo Nifosì Hemato-Oncologic Clinic Department of Internal Medicine University Hospital Center Brugmann Bruxelles Belgium

hematological emergencies are defined as acute life-threatening conditions in hematological diseases due to benign blood disorders or hematological malignancies or as a result of its treatment. This article deals of the most common emergencies encountered by hematologists. Emerging clinical situations, predictable or not, are common in the treatment of hematological diseases. However, the rapid development of new targeted drugs in cancer medicine has led to an increase in chronically ill cancer and hematology patients, who are being treated aggressively despite significant comorbidities and higher age. This development will lead to an increase in the number of hematologic emergencies, and these patients will be seen by various specialists. The knowledge of most hematological emergencies is crucial in daily practice. In this review, we discuss the epidemiology, pathophysiology and clinical with an emphasis on the early diagnosis and treatment of these conditions that can significantly affect the patient’s clinical outcome.

关键词： Urgency hematological diseases Clinical Practice

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Thirty-five Infantile Purpura Nephritis Patients Treated with Integrated Traditional Chinese and Western Medicine

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Chinese Journal of Integrative Medicine 2001年第1期7卷 57-58页

作者：郑天文洪建东李联侨 Quanzhou Municipal Children Hospital

　　Thirty-five patients of infantile purpura nephritis (IPN) were treated with integrated traditional Chinese and western medicine (TCM-WM) from January 1994 to December 1998, with good efficacy obtained, and following is the report.METHODSClinical Data　　All the 65 cases were inpatients, and conformed to the “Standards of the Diagnosis and Therapeutical Effect of hematological diseases” (edited by ZHANG Zhi-nan. Tianjin: Tianjin Science and Technology Press, 1999∶235-239). They were randomly divided into two groups: Treated group: 35 cases, 23 males, 12 females; aged 4-13 years, 7 years on average; disease course 4-18 days, the mean 10 days; mild type 19 cases (asymptomatic hematuria, proteinuria), nephritis syndrome type 13 cases (hematuria, proteinuria, edema, hypertension), and nephrotic syndrome type 3 cases (typical manifestation of nephrosis complicated with renal insufficiency). Control group: 30 cases, 20 males, 10 females; aged 3-14 years, 6 years on average; disease course 3-16 days, the mean 9 days; mild type 16 cases, nephritis syndrome type 10 cases, nephrotic syndrome type 4 cases. The clinical manifestation, sex, age, hospitalisation time of these 2 groups showed insignificant difference.Method of Treatment　　The control group: Adopting intravenous dripping of dexamethasone 0.3-0.5 mg*kg-1*d-1, consecutively for 5-7 days, which was then shifted to prednisone 1-1.5 mg*kg-1*d-1, altogether 2-3 weeks, with Vit C, persantin, chlorphenamine, calcium, etc., orally taken.　　The treated (TCM-WM) group, on the basis of the above-mentioned WM treatment, had also TCM syndrome differentiation performed, and were classified into 3 types:

关键词： syndrome type syndrome differentiation Science and Technology hematological diseases renal insufficiency western medicine

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