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Pembrolizumab-induced Guillain-Barrésyndrome in triple-negative breast cancer:A case report

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World Journal of Clinical Oncology 2025年第2期16卷 144-151页

作者： Phani Bhavana Cherukuri Muhammad Tayyeb Sai Rakshith Gaddameedi Doantrang Du Trishala Meghal Department of Internal Medicine Monmouth Medical CenterLong BranchNJ 07740United States Department of hematology Oncology Monmouth Medical CenterLong BranchNJ 07740United States

BACKGROUND The programmed cell death protein 1 inhibitor pembrolizumab has become a key treatment for various cancers,including triple-negative breast ***,it is associated with immune-related adverse events,including rare but serious neurological complications such as Guillain-Barrésyndrome(GBS).GBS is a potentially life-threatening autoimmune disorder characterized by muscle weakness and *** present a unique case of pembrolizumab-induced GBS to highlight the importance of recognizing this complication and managing it promptly in patients receiving immune checkpoint *** SUMMARY A 69-year-old woman with a medical history of hypertension,anxiety,depression,and stage IIIB triple-negative breast cancer treated with pembrolizumab,carboplatin,and paclitaxel,presented to the emergency department with a 1-month history of tingling,lower extremity weakness,and shooting *** progressed to global weakness,ascending paralysis,and double *** examination revealed significant lower extremity weakness and sensory *** resonance imaging of the lumbar spine and cerebrospinal fluid analysis confirmed *** treatment with intravenous immunoglobulin led to relapse,requiring additional intravenous immunoglobulin and high-dose *** patient’s condition improved,pembrolizumab therapy was permanently discontinued,and she was discharged to a rehabilitation *** Pembrolizumab can induce GBS,necessitating early recognition,prompt diagnosis,and multidisciplinary management to prevent serious complications.

关键词： Pembrolizumab Guillain-Barrésyndrome Triple-negative breast cancer Immune-related adverse events Intravenous immunoglobulin therapy High-dose steroids Case report

Human leukocyte antigen and donor-specific antibodies in liver transplantation

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World Journal of Gastroenterology 2025年第2期31卷 157-160页

作者： Qimudesiren Sha-Na Chen Li-Ren Qian School of Clinical Medicine Inner Mongolia Minzu UniversityTongliao 028000Inner Mongolia Autonomous RegionChina Department of hematology International Mongolian Hospital of Inner MongoliaHohhot 010065Inner Mongolia Autonomous RegionChina Senior Department of hematology The Fifth Medical Center of PLA General HospitalBeijing 100071China The Second School of Clinical Medicine Southern Medical UniversityGuangzhou 510515Guangdong ProvinceChina

In this article,we comment on an article published in a recent issue of the World Journal of *** specifically focus on the roles of human leukocyte antigen(HLA)and donor-specific antibodies(DSAs)in pediatric liver transpl-antation(LT),as well as the relationship between immune rejection after LT and ***,LT remains the standard of care for pediatric patients with end-stage liver disease or severe acute liver ***,acute and chronic re-jection continues to be a significant cause of graft dysfunction and *** mismatch significantly reduces graft survival and increases the risk of acute *** them,D→R one-way mismatch at three loci was significantly related to graft-versus-host disease incidence after *** adverse impact of HLA-DSAs on LT recipients is already ***,the evaluation of HLA and DSA is crucial in pediatric LT.

关键词： Liver transplantation Human leukocyte antigen Donor-specific antibodies De novo donor-specific antibody Antibody-mediated rejection

GSDME as an executioner of chemotherapy-induced cell death

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Science China(Life Sciences) 2017年第11期60卷 1291-1294页

作者： Xiaoliang Yu Sudan He Cyrus Tang hematology center and Collaborative Innovation center of hematology Jiangsu Institute of Hematology Soochow University

Cell death is a crucial process required for development, tissue homeostasis, and pathological cell loss in multicellu- lar organisms. Cell death mainly occurs in two alternative modes： apoptosis or necrosis. Apoptosis is a form of pro- grammed cell death with typical morphological features, including cell shrinkage, chromatin condensation, and DNA fragmentation （Degterev and Yuan, 2008）. The dying cell is eventually fragmented into membrane-bound apoptotic bodies that are engulfed by surrounding phagocytes.

关键词： GSDME executioner chemotherapy-induced cell death

Management of gastrointestinal bleed in the intensive care setting,an updated literature review

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World Journal of Critical Care Medicine 2025年第1期14卷 20-41页

作者： Vignesh K Nagesh Sai Priyanka Pulipaka Ruchi Bhuju Emelyn Martinez Shruthi Badam Gomathy Aarthy Nageswaran Hadrian Hoang-Vu Tran Daniel Elias Charlene Mansour Jaber Musalli Sanket Bhattarai Lokeash Subramani Shobana Tannishtha Sethi Ritvik Sethi Namrata Nikum Chinmay Trivedi Amer Jarri Colin Westman Nazir Ahmed Shawn Philip Simcha Weissman Jonathan Weinberger Ayrton I Bangolo Department of Internal Medicine Palisades Medical CenterNorth BergenNJ 07047United States Department of Internal Medicine University of Arkansas for Medical SciencesLittle RockAR 72205United States Department of Internal Medicine Hackensack Palisades Medical CenterNorth BergenNJ 07047United States Department of Gastroenterology Hackensack University Medical CenterHackensackNJ 07061United States Department of Pulmonology and Critical Care HCA Florida Bayonet Point HospitalHudsonFL 34667United States Department of hematology&Oncology John Theurer Cancer Center at Hackensack University Medical CenterHackensackNJ 07601United States

Gastrointestinal(GI)bleeding is a critical and potentially life-threatening condition frequently observed in the intensive care unit(ICU).This literature review consolidates current insights on the epidemiology,etiology,management,and outcomes of GI bleeding in critically ill *** bleeding remains a significant concern,especially among patients with underlying risk factors such as coagulopathy,mechanical ventilation,and renal *** GI bleeding in the ICU requires a multidisciplinary approach,including resuscitation,endoscopic intervention,pharmacologic therapy,and sometimes surgical *** with enhanced management strategies,GI bleeding in the ICU is associated with considerable morbidity and mortality,particularly when complicated by multi-organ *** review reiterates the need for adequate resuscitation and interventions in managing GI bleeding in critically ill patients,aiming to enhance survival rates and improve the quality of care within the ICU setting.

关键词： Gastrointestinal bleed Varices Variceal bleeding Diverticular bleed Angiodysplasia Ulcer Hemorrhoids Endoscopy Enteroscopy Embolization

Fever and Infection Prevalence in hematology-Oncology Hospitalized Patients: A Single-center Retrospective Study

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Journal of Cancer Therapy 2018年第3期9卷 231-241页

作者： Inês Almeida Costa Sérgio Chacim José Mariz Internal Medicine Department Centro Hospitalar de Sao Joao Porto Portugal Departmentof hematology-Oncology Clinic Instituto Português de Oncologia (IPO) Porto Portugal

Fever is prevalent in hospitalized patients. In hematology-oncology patients, it is related with infection, a disease manifestation or a consequence of immunological dysfunction. This single-center retrospective study aims to determine fever prevalence, describe its causes and evaluate the impact of infection on mortality. We reviewed clinical records of 222 patients admitted to the hospital in three random months of 2015. Around 35% of all hospitalizations were complicated by fever, 42.5% of unknown origin. 90.4% were under treatment. Around 81% did antibiotics, most commonly piperacillin/tazobactam, for around 11 days. 41% changed antibiotics due to fever persistence or microbiological results. The diagnostic yield of microbiological tests was 25%;in 66.7%, a Gram-negative microorganism was isolated. We didn’t find an association between infection and mortality. We conclude that fever is common in our hematology-oncology clinic and that the team is trained to assume infection;empirical treatment is in accordance with international recommendations.

关键词： Fever Infection hematology-Oncology Onco-hematology Neutropenia

Combined prednisone and levothyroxine improve treatment of severe thrombocytopenia in hepatitis B with compensatory cirrhosis accompanied by subclinical and overt hypothyroidism

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Science China(Life Sciences) 2018年第8期61卷 924-933页

作者： Jing Xue Ru Feng Haixia Fu Qian Jiang Hao Jiang Jing Lu Hui Liu Jingwen Wang Ting Niu Xin Wang YANDi Xie Hao Wang Lanping Xu Kaiyan Liu Xiaojun Huang Xiaohui Zhang Peking University People's Hospital Peking University Institute of Hematology Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation Collaborative Innovation Center of Hematology Peking University Departments of hematology Beijing HospitalNational Center of Gerontology Department of hematology Beijing Tongren Hospital Department of hematology Sichuan University West China Medical Center Department of hematology Shandong Provincial Hospital Peking University People's Hospital Institute of Hepatic Diseases

The aim of the present study was to investigate the relationship between hypothyroidism and thrombocytopenia in hepatitis Brelated compensatory liver cirrhosis and to determine whether treatment with levothyroxine and prednisone is superior in a multicenter, open-label, observational study in China. In total, 125 consecutive hepatitis B-related compensated liver cirrhosis patients with severe thrombocytopenia accompanied by hypothyroidism were included. The patients were divided into four groups according to treatment strategy: a control group(n=29), a prednisone group(n=25), a levothyroxine group(n=32) and a prednisone plus levothyroxine group(n=39). Severe thrombocytopenia was more prevalent in hepatitis B-associated compensatory liver cirrhosis patients with hypothyroidism than in euthyroid patients(29.6% vs. 14.7%, P<0.05). Combination treatment with prednisone and levothyroxine decreased the risk of bleeding and improved platelet recovery compared to control treatment and treatment with either prednisone or levothyroxine alone. The platelet count before therapy, serum thyroid stimulating hormone and combination treatment with prednisone and levothyroxine were associated with bleeding events. Therefore, the present study suggests that hypothyroidism is associated with severe thrombocytopenia in hepatitis B-associated compensatory liver cirrhosis. Treatment with prednisone plus levothyroxine may present a novel approach in these patients.

关键词： hepatitis B cirrhosis thrombocytopenia hypothyroidism treatment

Hypoxia inducible factor in hepatocellular carcinoma:A therapeutic target

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World Journal of Gastroenterology 2015年第42期21卷 12171-12178页

作者： Daniel Lin Jennifer Wu Fellow hematology and Medical Oncology Program NYU School of Medicine Perlmutter Cancer Center NYU Langone Medical Center Division of Hematology and Oncology NYU School of Medicine Subdivision of GI Oncology Perlmutter Cancer Center NYU Langone Medical Center Division of Hematology and Oncology

Hepatocellular carcinoma(HCC) is one of the most commonly diagnosed and deadly cancers worldwide; its incidence has been rising in the United States due to the increase in hepatitis C associated cirrhosis and the growing epidemic of obesity. There have been no effective therapeutic options in the advanced disease setting beyond sorafenib, a multi-targeted tyrosine kinase inhibitor that showed significant survival benefit. Because of this, there is an urgent need to search for novel pathways in sorafenib experienced patients. This review will focus on the role of hypoxia and hypoxiainducible factor alpha(HIF-1α) in cancer development, specifically in HCC. We will discuss the biology of HIF-1α, the pathways with which it interacts, and the function of HIF-1α in HCC. Furthermore, we will review studies highlighting the relevance of HIF-1α in the clinical setting, as well as the pre-clinical data supporting its further investigation. Finally, we will conclude with a discussion of the potential role of a HIF-1α m RNA antagonist for the treatment of HCC, and hypothesize the ways in which such an inhibitor may be best utilized in the management of advanced HCC. Hypoxia plays a significant role in the development of HCC. HIF-1α is a key transcription factor involved in the hypoxic response of cancer cells. It activates transcription of genes responsible for angiogenesis, glucose metabolism, proliferation, invasion and metastasis in HCC. Its involvement in multiple, essential tumor pathways makes it an attractive potential therapeutic target in HCC.

关键词： Hypoxia Hypoxia-inducible factor alpha Hepatocellu

Genistein-induced Anticancer Effects on Acute Leukemia Cells Involve the Regulation of Wnt Signaling Pathway Through H4K20mel Rather Than DNA Demethylation

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Current Medical Science 2021年第5期41卷 869-879页

作者： Hua-rong ZHOU Jian-zhen SHEN Hai-ying FU Feng ZHANG Fujian Institute of hematology Fujian Provincial Key Laboratory of HematologyFujian Medical University Union Hospital Fujian Medical Center of HematologyFuzhou 350001China

Objective:To investigate the effects and mechanisms of genistein on the gene expression in the Wnt pathway in acute leukemia(AL)***:The expression of Wnt pathway genes and cell cycle-related genes were analyzed in two AL cell *** sequencing was performed to determine the methylation ***,the enrichment of H4K20mel and H3K9ac was determined using *** cytometry was used to analyze the cell ***:The IC_(50) of genistein in the two AL cell lines was lower than that for the bone marrow mesenchymal stem cell *** upregulated H4K20mel,KMT5A and Wnt suppressor genes,including Wnt5a,and downregulated the downstream target genes of Wnt,such as c-myc and β-*** methylation degree and H3K9ac enrichment in the Wnt5a promoter region remained ***,the enrichment of H4K20mel in the Wnt5a promoter and coding regions *** addition,genistein upregulated Phospho-cdc2,Mytl,Cyclin A,Cyclin E2,p21 and Phospho-histone H3,but downregulated *** cycle arrest was induced in the G2/M ***:Genistein inhibits the activation of the Wnt pathway by promoting the expression of Wnt5a through the activation of KMT5A and enrichment of H4K20mel in the Wnt5a gene promoter and coding regions,rather than *** also blocks the cell cycle in the G2/M ***,genistein is a potential anti-leukemia drug.

关键词： genistein acute leukemia,H4K20mel Wnt pathway G2/M cell cycle arrest

Fludarabine and intravenous busulfan conditioning with post-transplantation cyclophosphamide for allogeneic peripheral stem cell transplantation for adult patients with lymphoid malignancies:a prospective single-arm phase Ⅱ study

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Frontiers of Medicine 2021年第1期15卷 108-115页

作者： Ling Wang Lining Wang Xing Fan Wei Tang Jiong Hu Department of hematology Blood&Marrow Transplantation CenterCollaborative Innovation Center of HematologyRuijin Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200025China

Post-transplantation cyclophosphamide(PT-Cy)alone or in combination with other immunosuppressive drugs has emerged as a promising strategy in the setting of allogeneic hematopoietic stem cell *** survival rate was reported in lymphoid malignancies following PT-Cy strategy compared with myeloid disease in non-myeloablative bone marrow transplant ***,we aimed to evaluate the safety and efficacy of PT-Cy combined with cyclosporine as graft-versus-host disease(GVHD)prophylaxis after myeloablative conditioning and T cell-replete peripheral stem cell transplantation in lymphoid *** single-arm phase Ⅱ clinical trial(NCT01435447)involving 31 adult patients was conducted from January 2013 to June *** donor-type neutrophil engraftment rate was 100%,and the overall incidence of grade Ⅱ to Ⅳ and grade Ⅲ to Ⅳ acute GVHD was 39%and 24%,*** cumulative incidence rates of chronic GVHD(35%),including moderate to severe forms(10%),were reduced compared with those of the historical group(P=0.03 and P=0.04,respectively).With a median follow-up of 18 months,the estimated 2-year overall and event-free survival was 64.8%(95%confidence interval:47.8%–86.7%)and 58.4%(95%CI:41.9%–81.7%),*** 2-year cumulative incidence rate of relapse was 19.5%(95%CI:9.0%–35.8%),whereas the non-relapse mortality rate was 21.8%(95%CI:11.3%–38.1%).These results demonstrated the feasibility of PT-Cy as GVHD prophylaxis in this clinical *** strategy could significantly reduce the incidence of chronic GVHD and its moderate to severe forms but not of acute GVHD and results in similar survival outcomes compared with the historical group.A prospective study with additional patients is warranted to confirm the role of PT-Cy in lymphoid malignancy.

关键词： post-transplantation cyclophosphamide allogeneic hematopoietic stem cell transplantation lymphoid malignancies