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Prognostic factors and staging systems of multiple myeloma:a single centre study in China

Chinese Medical Journal 2007年第19期120卷 1655-1658页

作者： TAO Zhong-fei FU Wei-jun YUAN Zhen-gang WANG Dong-xing CHEN Yu-bao HOU Jian department of haematology Shanghai Changzheng Hospital Second Military Medical University Shanghai 200003 China

Background Previous studies found a range of prognostic factors but no consensus about the proper staging system for multiple myeloma has been achieved. This study explored the prognostic factors to find a staging system for multiple myeloma most suitable for Chinese patients. Methods Between February 1990 to August 2004, 206 patients （138 men and 68 women, mean aged （59±11） years） who were initially diagnosed as multiple myeloma in Changzheng Hospital （Shanghai, China） and had followup records were enrolled in this study. Potential prognostic factors were evaluated by univariate and multivariate analyses. Four staging systems were applied to compare their suitability for the patients. Results The median survival time of the patients was 33 months. The 1-, 3- and 5-year survival rates were 80.18%, 48.08% and 33.7% respectively. Factors identified as adversely affecting survival were older age, severe bone lesions, low haemoglobin, low platelet, low serum calcium, low serum albumin, high proportion of plasma cells in marrow, high serum creatinine, high serum β2 microglobulin and high C-reactive protein. Among these, only C-reactive protein, β2 microglobulin, albumin and age were the independent prognostic factors. There were statistically significant survival differences among the three groups in Durie Salmon staging system and Bataille staging system, but not in British Medical Research Council staging system or International Staging System. Conclusions High β2 microglobulin, high C-reactive protein, low albumin and old age are independent prognostic factors of multiple myeloma. Bataille staging system appears to be optimal for Chinese multiple myeloma patients.

关键词： multiple myeloma prognosis survival analysis clinical staging system

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Comparison of serum reproductive hormones, antioxidants, PGE2 and PGF2-α between primary and secondary infertile women in Calabar

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Asian pacific Journal of Reproduction 2017年第4期6卷 181-185页

作者： Idongesit K Isong Chinyere AO Usoro Zibril A Okhormhe Dorathy C Okpokam Christopher EJ Udiong department of Medical Laboratory Science(Chemical Pathology Unit) University of CalabarCalabarNigeria department of Medical Laboratory Science(haematology/Blood Transfusion Unit) University of CalabarCalabarNigeria

Objective:To compare the prolactin, progesterone, luteinizing hormone, follicle stimulating hormone, estradiol, antisperm antibodies, tumor necrosis factorα, total antioxidant capacity, prostaglandin E2 and F2α between primary and secondary infertile women in ***:One hundred and two volunteers infertile women (test group), aged 20-45 years attending the infertility clinic in the University of Calabar Teaching Hospital (UCTH) were recruited. Fourteen of the women had primary infertility while 88 of them had secondary infertility. Sixty apparently healthy, age matched women served as the control group. Five millilitres of blood was collected, allowed to clot and serum was obtained from the subjects and Enzyme Linked Immunosorbent Assay method was used for prolactin, progesterone, estradiol, follicle stimulating hormone (FSH) and luteinizing hormone (LH), prostaglandin E2and F2α, human TNF-α,Chlamydia trachomatis IgG, antisperm antibodies assay, while serum total antioxidant capacity was assessed ***:The result shows on comparison that primary infertile women has a significantly higher level of progesterone than those with secondary infertility (P>0.05). There was a significant difference in the levels of prolactin and total antioxidant capacity in the primary and secondary infertility when compare to the control group atP>0.05. Their mean ages were (31.10±5.37) years and (33.10±4.91) years respectively. There was a positive correlation between TAC and FSH, TNF and anti-sperm anti-bodies in the test group ofr=0.207 andr=0.632;P>0.05 ***: These findings suggest no alterations in levels of prostaglandin F2α, TNF and anti-oxidant between primary and secondary infertile females.

关键词： Progesterone Estradiol Luteinizing hormone Follicle stimulating hormone Infertile women

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Significance of plasma von Willebrand factor level and von Willebrand factor-cleaving protease activity in patients with chronic renal diseases

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Chinese Medical Journal 2008年第2期121卷 133-136页

作者： LU Guo-yuan SHEN Lei WANG Zhao-yue GUO Xiao-fang BAI Xia SU Jian RUAN Chang-geng department of Nephrology Jiangsu Institute of haematology First Affiliated Hospital of Soochow University Suzhou Jiangsu 215006 China department of Thrombosis and Haemostasis Jiangsu Institute of haematology First Affiliated Hospital of Soochow University Suzhou Jiangsu 215006 China

Background von Willebrand factor （vWF） mediates the initial capture of platelets to vascular subendothelium and is essential for platelet aggregation under high fluid shear stress as in arterial stenosis. On release from endothelial cells, vWF is rapidly cleaved by ADAMTS13/vWF-cleaving protease （vWF-CP）. We investigated the clinical significance of changes in plasma vWF and vWF-CP activities in chronic renal disease.Methods Plasma vWF and vWF-CP activities were measured using enzyme-linked immunosorbent assay （ELISA） and residual collagen binding assay respectively in patients with lupus nephritis （n=31）, primary nephritic syndrome （n=25）, diabetic nephropathy （n=45）, chronic glomerulonephritis （n=38） and 40 normal controls. The relation of their levels with pathological and renal status was analyzed.Results In all diseased patients the levels of vWF were significantly higher and vWF-CP activity significantly lower than the controls （both P〈0.01）. vWF in the four subgroups did not correlate with the stage of disease but correlated negatively with vWF-CP activity, vWF-CP activity was not changed two weeks after renal transplantation. Renal biopsy demonstrated that the vWF level in stage IV was higher than in stages II and III while vWF-CP activity was lower in patients with lupus nephritis. After eight-week treatment, the vWF level significantly decreased and the vWF-CP activity significantly increased in systemic lupus erythema, disease activity index 〈9, but not with index 〉9. Even though the vWF-CP activity was significantly lower in membranous nephropathy than in minimal change disease, mesangial proliferative glomerulonephritis or IgA glomerulonephritis, the vWF level was not significantly different. Conclusions The alterations of plasma vWF and vWF-CP activities were associated with different renal pathologies. Injury to endothelial cells and autoantibodies against vWF-CP activity may result in higher vWF level and lower vWF-CP activity in chronic renal

关键词： chronic renal disease von Willebrand factor von Willebrand factor-cleaving protease residual-collagen binding assay

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An addition of medium-dose ATG to conditioning regimens favours the long-term survival of patients with allogeneic hematopoietic stem cell transplantation

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Stem Cell Discovery 2013年第1期3卷 22-31页

作者： Bingyi Wu Chaoyan Song Zhigang Lu Kunyuan Guo Yingzhi He Sanfan Tu Shaojuan Pan Can Sun Junyong Fang department of haematology Zhujiang Hospital Southern Medical University Guangzhou China

Long-term survival of 116 leukemia/MDS patients received allo-SCT conditioned by a regimen with ATG-F or without ATG-F was analysed, together with the impact of ATG-F on the long-term survival, GVHD and disease relapse. Seventy patients received an ATG-F containing conditioning regimen FBCA, and 46 patients received a non-ATG-F FBC regimen. The FBCA regimen was associated with a 5-year survival of 65.4% in the complete HLA-matched group and 39.3% in the HLA-mismatched group. The difference between the two groups was significant (P = 0.012). For the FBC conditioning regimen, the 5-year overall survival of HLA-matched patients and the HLA-mismatched patients was 34.2% and 24.2% respectively (P = 0.216). The incidence of cGVHD was 32.9% and 83.6% in the FBCA and FBC condition regimen group respectively. Only 2.9% of the cases showed extensive cGVHD in the FBCA group while it was 69.4% in the FBC group (P = 0.00). Multivariate analysis indicated that relapse was related to the disease status and HLA typing, but unrelated to the conditioning regimens whether or not ATG-F was used (HR 0.54, P = 0.109). We conclude that the addition of ATG-F to conditioning regimen favours the longterm survival of allo-SCT.

关键词： Hematopoietic Stem Cell Transplantation Long-Term Survival Anti-Human Lymphocyte Globulin

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COVID-19 (SARS-CoV-2 infection) in lymphoma patients: A review

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World Journal of Virology 2021年第6期10卷 312-325页

作者： Valentina Bonuomo Isacco Ferrarini Michele Dell'Eva Eugenio Sbisà Mauro Krampera Carlo Visco Section of haematology Department of MedicineUniversity of VeronaVerona 37134Italy

Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection now has a global resonance and represents a major threat for several patient *** from initial case series suggested that cancer patients in general might have an unfavorable outcome following coronavirus disease 2019(COVID-19),due to their underlying conditions and cytotoxic *** recently,data regarding the incidence and clinical evolution of COVID-19 in lymphomas have been reported with the aim to identify those more frequently associated with severe complications and *** with lymphoma appear particularly vulnerable to SARS-CoV-2 infection,only partly because of the detrimental effects of the anti-neoplastic regimens(chemotherapy,pathway inhibitors,monoclonal antibodies)on the immune ***,we systematically reviewed the current literature on COVID-19 in adult patients with lymphoma,with particular emphasis on disease course and prognostic *** also highlighted the potential differences in COVID-19 clinical picture according to lymphoma subtype,delivered treatment for the hematological disease and its relationship on how these patients have been managed thus far.

关键词： Lymphoma SARS-CoV-2 infection Hematological malignancies COVID-19 Rituximab Bendamustine

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Association of Fibrin Monomer Polymerization Function, Cerebrovascular Risk Factors and Ischemic Cerebrovascular Disease in Old People

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2003年第2期23卷 131-133页

作者：洪梅魏文宁李红戈杨锐杨焰 Insititute of haematology Xiehe Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430022 department of Neurology Xiehe Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430022

In order to investigate the association of fibrin monomer polymerization function (FMPF) with traditional cerebrovascular risk factors and ischemic cerebrovascular disease in old people. 1∶1 paired case-control comparative study was performed for FMPF and traditional cerebrovascular risk factors on 110 cases of old ischemic cerebrovascular disease and 110 controls matched on age, sex and living condition. The results showed that cerebrovascular risk factors were more prevalent in case group than in control group. In the case group, FMPF was significantly higher than in control group. There was a significant positive correlation between hypertension and fibrin monomer polymerization velocity (FMPV), hypertension and fibrinogen (Fbg), alcohol consumption and Fbg, but no significant correlation between diabetic mellitus, smoking and FMPF was found. Among the parameters of blood lipids, there were significant positive correlations between total cholesterol (TC) and parameters of FMPF to varying degrees, triglycerides (TG) and FMPV, TG and Fbg. Our results also showed there were significant linear trends between TC and FMPV (P<0. 001), TC and Fbg (P=0. 0087), TG and FMPV/Amax (maximum absorbance)(P=0. 0143) respectively. Multiple logistic regression analysis revealed that FMPF in case group remained significantly higher than control group after adjustment of all risk factors that were significant in univariate analysis. It was concluded that there is a possible pathophysiological link between FMPF and cerebrovascular risk factors. An elevated FMPF is associated with ischemic cerebrovascular disease and an independent risk factor of this disease. In old people, detection of FMPF might be a useful screening to identify individuals at increased cerebrothrombotic risk.

关键词： old people fibrin monomer polymerization function cerebrovascular disease risk factor

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Compassionate Use of Midostaurin in Myeloid and Lymphoid Neoplasia with FGFR1 Abnormality

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Case Reports in Clinical Medicine 2014年第10期3卷 560-565页

作者： Photis Beris Monika Nagy Daniel Robert Kaveh Samii Tom McKee Jovita Schuler Division of haematology University Hospital of Geneva Geneva Switzerland department of haematology Unilabs Coppet Coppet Switzerland department of Pathology CMU Geneva Switzerland Novartis Pharma Switzerland Rotkreuz Switzerland

Background: Patients with stem cell myeloproliferative disorders have a particularly poor prognosis and limited treatment options, i.e. mainly aggressive chemotherapy or allogeneic stem cell transplantation. In 2004, Chen et al. reported a patient presenting a t(8;13) (p11;q12) cytogenic anomaly who responded positively to treatment with PKC412 (midostaurin), an oral multi-targeted tyrosine kinase inhibitor. Here, we report a second case treated with the above-mentioned drug. Patient: A 71-year-old woman was diagnosed as having chronic myelogenous leukaemia with eosinophilia secondary to t(8;13) with FGFR1 involvement. Due to her age, an allogeneic stem cell transplantation was not possible. Treatment: A treatment combining aggressive chemotherapy and midostaurin was explored. The patient received one cycle of hyper-CVAD chemotherapy followed by maintenance therapy with midostaurin. A relapse occurred after six months, and she was treated with four more cycles of hyper-CVAD chemotherapy. The patient entered a complete clinical, haematological and cytogenetic remission. A maintenance therapy with midostaurin continued for four months until she developed a chemoresistant relapse followed by acute leukaemia. Conclusion: This is the second case of a t(8;13) myeloid and lymphoid neoplasm with FGFR1 abnormalities treated successfully with midostaurin. Midostaurin is administered orally, allows for outpatient care and in this case showed only occasional and minimal side effects. The combination of hyper-CVAD and midostaurin extended survival by 21 months without allogeneic transplantation. This case further supports the possibility of using midostaurin for the treatment of other diseases with FGFR1 dysregulations;however, specific clinical trials are needed to confirm this hypothesis.

关键词： PKC412 Myeloid and Lymphoid Neoplasms with Eosinophilia and FGFR1 Abnormality Translocation with an 8p11 Breakpoint FGFR1 Rearrangement

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Human parvo-virus B19 infection among children with sickle cell anaemia in Jos,North Central Nigeria

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海南医学院学报 2010年第10期16卷 1263-1265,1268页

作者： Girei AI Alao OO Joseph DE Damulak DO Banwat EB Nwadioha SI Jombo GTA department of haematology Federal Medical CentreGombe department of haematology College of Health SciencesBenue State UniversityMakurdi department of haematology Jos University Teaching HospitalJos department of Microbiology Jos University Teaching HospitalJos department of Microbiology College of Health SciencesBenue State UniversityMakurdi

Objective:Human Parvovirus B19 is known to cause significant morbidity and mortality and among diverse patient population *** patients with sickle all disease,who have high red cell turn over due to chronic haemolysis,infection with parvovirus B19 can cause severe life threatening transient aplastic *** study was conducted to determine the Seroprevalence of parvovirus B19 infection and to provide basic epidemiological data on parvovirus B19 infection among children with sickle cell anaemia in Jos,north central ***: In a hospital based cross sectional survey,200 children aged 1-18 years confirmed to have sickle cell anaemia attending the paediatric sickle cell clinic of Jos university teaching hospital were studied.A questionnaire was designed to obtain basic socio-demographic information,& other relevant aspect of patients′ *** samples were taken for anti parvo-virus B19 ***: The over all prevalence rates of parvo-virus B19 immunoglobulin(IgG) and immunoglobulin(IgM) antibodies were 39.5% and 3.5% respectively,Conclusion: This study confirms that parvo-virus B19 infection is prevalent among children with sickle cell anaemia in Jos,North Central *** is a need for further studies to fully evaluate the clinical impact of the infection on our sickle cell anaemia patients.

关键词：传染病贫血病儿童红细胞

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Iron-Restricted Erythropoiesis in Anaemic Patients with Giant Cell Arteritis and Polymyalgia Rheumatica

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Open Journal of Blood Diseases 2013年第1期3卷 49-52页

作者： Torbjorn Karlsson department of haematology Uppsala University HospitalUppsalaSweden.

The aim of this observational study was to biochemically characterize the anaemia in GCA (giant cell arteritis) and PMR (polymyalgia rheumatica) patients. Values for mean corpuscular volume, mean corpuscular hemoglobin and soluble transferrin receptor were normal, whereas serum iron and total iron binding capacity (TIBC) were subnormal, and mean ferritin was above the upper reference limit. Iron-restricted erythropoiesis (IRE), defined as a bone marrow smear staining positive for iron in combination with transferrin saturation less than 20%, was present in all patients. All patients exhibited clinical and biochemical signs of active inflammation with elevated C-reactive protein and an increased erythrocyte sedimentation rate.

关键词： Anaemia Iron-Restriction Erythropoiesis Giant Cell Arteritis Polymyalgia Rheumatica

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Prognostic analysis of refractory anaemia in adult myelodysplastic syndromes

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Chinese Medical Journal 2008年第18期121卷 1787-1791页

作者： WANG Xiao-qin CHEN Zi-xing CHEN Shu-chang LIN Guo-wei JI Mei-rong LIANG Jian-ying LIU Dun-dan LI De-gao MA Yan department of haematology Huashan Hospital of Fudan University Shanghai 200040 China Jiangsu Institute of haematology First Affiliated Hospital of Soochow University Suzhou Jiangsu 215006 China department of Clinical Oncology Peking Union Medical CollegeHospital Beijing 100730 China

Background Patients with myelodysplastic syndrome （MDS） display a very diverse pattern. In this study, we investigated prognostic factors and survival rate in adult patients with MDS refractory anaemia （MDS-RA） diagnosed according to French-American-British classification and evaluated the International Prognostic Scoring System （tPSS） for Chinese patients. Methods A multi-center study on diagnosis of MDS-RA was conducted to characterize the clinical features of Chinese MDS patients. The morphological criteria for the diagnosis of MDS-RA were first standardized. Clinical data of 307 MDS-RA patients collected from Shanghai, Suzhou and Beijing from 1995 to 2006 were analyzed using Kaplan-Meier curve, log rank and Cox regression model. Results The median age of 307 MDS-RA cases was 52 years. The frequency of 2 or 3 lineage cytopenias was 85.6%. Abnormal karyotype occurred in 35.7% of 235 patients. There were 165 cases （70.2%） in the good IPSS cytogenetic subgroup, 44 cases （18.7%） intermediate and 26 cases （11.1%） poor. IPSS showed 20 （8.5%） categorized as low risk, 195 cases （83.0%） as intermediate-Ⅰ risk and 20 cases （8.5%） as intermediate-Ⅱ risk. The 1-, 2-, 3-, 4- and 5-year survival rates were 90.8%, 85.7%, 82.9%, 74.9% and 71.2% respectively. Fifteen cases （4.9%） transformed to acute myeloid leukaemia （median time 15.9 months, range 3-102 months）. Lower white blood cell count （〈1.5×10^9/L）, platelet count （〈30×10^9/L） and cytogenetic abnormalities were independent prognostic factors by multivariate analysis, but age （〉65 years）, IPSS cytogenetic subgroup and IPSS risk subgroup were not independent prognostic factors associated with survival time. Conclusions Chinese patients were younger, and had lower incidence of cytogenetic abnormalities, more severe cytopenias but a more favourable prognosis than Western patients. The major prognostic factors were lower white blood cell count, lower platelet count and fewer abnormal karyotypes. The international prognostic sc

关键词： myelodysplastic syndrome survival prognosis

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