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Chong-Wen Dai,
Guang-Sen Zhang,
Jian-Kai Shen,
Wen-Li Zheng,
Min-Fei Pei,
Yun-Xiao Xu,
Yi-Xiong Cao, Yan Yi,
Jun-Jie Yang,
Hong-Ling Peng,
Hai-Ying Zhong,
Rui-Juan Li
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ABSTRACT: In the present study, 90 patients with newly diagnosed acute promyelocytic leukemia (APL) were studied for all-trans retinoic acid (ATRA) and arsenic trioxide (As(2)O(3)) combination treatment in remission induction and postremission therapy. In addition, 20 APL patients who had achieved complete remission (CR) with an ATRA-based regimen received ATRA/As(2)O(3) combination for consolidation and maintenance were also enrolled. The results showed that ATRA/As(2)O(3) combination therapy yielded a high CR rate of 93.3% and a significantly shorter time to enter CR (median: 31 days; range: 18-59 days) compared to the ATRA-based regimen (n = 72; median: 39 days; range: 25-62 days). With the ATRA/As(2)O(3) combination for CR maintaining, regardless of the way by which CR was attained, the relapse-free survival was significantly better than with an ATRA plus cytotoxic chemotherapy regimen (92.9 +/- 3.2% vs. 72.4 +/- 7.6%, for the 3-year Kaplan-Meier estimate of relapse-free survival). The drug toxicity profile showed that with the use of As(2)O(3), the incidence of hepatotoxicity was obviously high during remission induction but decreased significantly during postremission treatment. We conclude that APL patients may benefit from the early use of the combination of ATRA and As(2)O(3), in either remission induction or consolidation/maintenance.
Acta Haematologica 03/2009; 121(1):1-8. · 1.35 Impact Factor
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Thrombosis and Haemostasis 12/2006; 96(5):692-4. · 5.04 Impact Factor
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ABSTRACT: MYH9-related disease is a rare autosomal dominant disorder characterized by the triad of giant platelet, thrombocytopenia and inclusion bodies in neutrophil. In recent years, much progress has been made in the investigation of its clinical feature and pathogenesis.
Clinical manifestations were analyzed in two Chinese MYH9-related disease families. Polymerase chain reaction (PCR), DNA sequencing and CpoI restrictive endonuclease map analysis were used to identify spot mutation in nonmuscle myosin heavy chain 9 (MYH9) gene. Indirect immunofluence combined propidium iodine (PI) nuclei count-staining technology was applied to probe nonmuscle myosin heavy chain IIA (NMMHC-A) in MYH9-related disease neutrophils and platelets. Western blot was undergone to examine the expression of NMMHC-A in MYH9-related disease patients.
All of the patients manifested with the typical triad, mild to moderate bleeding tendency were their common clinical feature, some patients were accompanied by renal lesion. G5521A mutation in MYH9 gene was identified in both families. Spindle-like inclusions with yellow fluorescence in MYH9-related disease neutrophils were clearly revealed by indirect immunofluence combined PI nuclei count-staining technology, which matched very well with the inclusions, detected by Wright-Giemsa's stain. An upregulation of NMMHC-A in MYH9-related disease neutrophils was observed by Western blotting analysis.
Mutation of MYH9 gene exists in cases of Chinese MYH9-related disease. In the two families, the point mutation was located in exon 38(G5521A), and the transference rule of the MYH9 gene mutation is corresponding with clinical phenotype distribution. Indirect immunofluorescence combining with PI nuclei staining technology is sensitive and more specific than Wright-Giemsa's staining in detecting MYH9-related disease inclusions, with which we might easily distinguish MYH9-related disease inclusions from infection-associated inclusions. The expression of the NMMHC-A in MYH9-related disease neutrophils was upregulated than normal control.
Clinica Chimica Acta 12/2006; 373(1-2):49-54. · 2.54 Impact Factor
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ABSTRACT: We determined the diagnosis of hereditary hemorrhagic telangiectasis (HHT) in a suspected HHT family, identified ALK1 gene mutation and established a gene diagnosis method of HHT. The level of related plasma proteins (transforming growth factor beta and thrombomodulin) were also analyzed.
Bleeding history and family history were collected; Dilatant nasal mucosal capillaries in proband were observed under nasal cavity endoscope; exons 3, 7, 8 of ALK1 gene in proband and her family members were amplified with polymerase chain reaction (PCR), and the PCR products were analyzed. Using enzyme-linked immunosorbent assay (ELISA), plasma TGF-beta1 and TGF-beta2 concentrations were measured. Plasma thrombomodulin (TM) level was detected by Western blotting.
Of all family members, four had epstaxis, two had evident telangiectases on skin or mucosa. Gene screening results showed that C to T substitution at position 1231 in exon 8 of ALK1 gene (CGG-->TGG) existed in proband, her affected brother and their father. The mutation did not exist in proband's sister-in-law and nephew. Plasma TGF-beta1 concentrations in the affected HHT was 20,538, 17,194, 13,131 pg/ml, while that of normal control and unaffected family members was 15,950, 20,297, 12,836 pg/ml, respectively. Plasma TGF-beta2 in HHT patients was 14,502, 9550, 10,592 and that of normal controls 8579, 20,297, 7680 pg/ml respectively. Level of plasma TM was in HHT subjects significantly lower than in normal subjects.
Chinese HHT individuals have mutant ALK1 gene, a C1231T variation on exon 8 of ALK1 is responsible for HHT clinical phenotypes in this family. ALK1 gene analysis, together with special clinical phenotypes and family history, provides a reliable method in diagnosing HHT. In affected HHT subjects, plasma TGFbeta levels were not obviously different from those of normal subject; while plasma TM concentration was significantly lower than that in normal subjects. The significance and mechanism remain to be elucidated.
Chinese medical journal 06/2004; 117(6):808-12. · 0.86 Impact Factor
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ABSTRACT: To analysis and define the clinical phenotype and related mutation of hereditary hemorrhagic telangiectasia. (HHT).
The proband of a Chinese HHT family, female, aged 48, and 2 of her family members: her father, aged 74, and her brother, aged 44 underwent nasal cavity endoscopy and automatic photochonography to observe the capillaries in nasal mucosa. Samples of peripheral blood were collected. The exons 3, 7, and 8 of the activin receptor-like kinase 1 (ALK1) gene of the proband and her family members and 2 healthy people as contrds were amplified by polymerase chain reaction, and the PCR products were sequenced. The levels of plasma thrombomodulin (TM) of the proband and her family members were detected by Western blotting combined with density screening.
Except the mother and sister-in-law, other 4 of the family members had epistaxis or bleeding in other sites. The proband and her father had obvious telangiectasis of nasal mucosa or finger skin respectively. ALK1 gene analysis confirmed that a C1231T mutation (CGG-->TGG) in the exon 8 existed in the proband, her brother, and her father, no mutation was found in her sister in law, her nephew, and the healthy persons. Six bands were shown in the expression of plasma thrombomodulin. Density screening was conducted for the 2 bands with differential expression: those with the molecular masses of 56,000 and 28,000. The result of density screening showed that the average value of screening at the 56,000 band was 218.3 in the normal controls, significantly higher than that of the HTT patients (145.1); and the average value of screening at the 28,000 band was 222.0 in the normal controls, significantly higher than that in the HTT patients (145.1).
ALK1 gene mutation, a C1231T variation on exon 8, exists in Chinese type 2 HHT individuals. The levels of plasma thrombomodulin levels at the 56,000 and 28,000 fragments of the HTT patients are lower than of normal subjects whose significance and mechanism remain to be elucidated.
Zhonghua yi xue za zhi 02/2004; 84(3):182-5.
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ABSTRACT: To observe the localization of inclusion and expression of nonmuscle myosin heavy chain-A (NMMHC-A) in cytoplasm of neutrophils of May-Hegglin anomaly (MHA) patients, and elucidate and identify the property of the inclusions in constitutional elements.
Peripheral blood was drawn from the MHA proband, the proband's father, and a healthy control. White blood cells and platelets were isolated and smeared. Indirect immunofluorescence technique combined with propidium iodide (PI) nuclei staining technology was used to detect the inclusion and nonmuscle myosin in cytoplasm of neutrophils and platelet. Neutrophils were isolated. Protein in the neutrophils was extracted and underwent Western blot assay to examine the expression of NMMHC-A.
Spindle-like inclusions with yellow fluorescence were clearly displayed in the neutrophils of the MHA patient and her father, that matched very well in shape, size and localization with the inclusions, revealed by Wright-Giemsa's stain. In normal control, except a diffusive distribution of fluorescent spot in neutrophils cytoplasm, not any inclusion was detected. As for NMMHC-A expression, Western blot assay showed that NMMHC-A was upregulated in the neutrophils of the MHA patient (60.9) and her father (58.9).
A new method to display MHA inclusions and identify the major component of inclusions in the neutrophils, which was originated from a mutant of nonmuscle myosin, of MHA was set up. Immunofluorescence analysis is more sensitive than Wright-Giemsa's staining in detecting inclusions of MHA.
Zhonghua yi xue za zhi 09/2003; 83(15):1313-6.
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ABSTRACT: To describe the clinical phenotype and identify the nonmuscle myosin heavy chain 9 (MYH9) gene mutation in the first May-Hegglin anomaly family in China.
The exons 25, 31 approximately 32 38 and 40 in the MYH9 gene of the proband and her affected father were amplified with polymerase chain reaction, and the PCR products were sequenced. After the specific point mutation in exon 38 was identified in these two cases, the corresponding region of the MYH9 gene was amplified and nuclear acid sequence analysis was conducted among 30 healthy persons, one patient with idiopathic thrombocytopenic purpura and one patient with thrombotic thrombocytopenic purpura. The CpoI restriction endonuclease map from the PCR products of exon 38 of MYH9 gene was analysed among the proband, her father and other family members, 30 normal controls, 1 ITP patient, and one TTP patient.
The proband and her affected father manifested a typical triad of thrombocytopenia, giant platelets, and inclusion bodies in leukocytes. The patient showed mild hemorrhagic tendency since infancy, while the platelet aggregation function was normal. A 5521G --> A mutation (GAG --> AAG) in the exon 38 of the MYH9 gene existed in the proband and her affected father, resulting in a characteristic change in CpoI restriction endonuclease map.
The cases of May-Heggelin anomaly in China show typical triad of thrombocytopenia, giant platelets, and inclusion bodies in leukocytes too. Mutation of MYH9 gene exists in cases of May-Hegglin anomaly in China. The point mutation is located in exon 38 (G5521A) in this family.
Zhonghua yi xue za zhi 07/2002; 82(13):918-20.
