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ABSTRACT: To assess the incidence rates and risk factors for clonal evolutions in aplastic anemia (AA) patients, we studied 802 hospitalization cases from January 1991 through December 2007 by using the cumulative incidence curves and the Cox proportional hazards mode. We found that the case of 19 patients had evolved to myelodysplastic syndrome or acute myeloid leukemia (MDS/AML), while 21 patients (two of them with concurrent MDS) developed paroxysmal nocturnal hemoglobinuria (PNH). The cumulative incidence of clonal evolutions was assessed as 3.7%, whereas the incidences of MDS/AML and PNH were 1.7% and 2.1%, respectively, at 5 years. By multivariate analysis, age, severity of the disease, and the number of days of rhuG-CSF therapy were the risk factors for AA evolution to MDS/AML. The relative risk (RR) for very severe AA was approximately seven times higher than that for severe AA (SAA) and non-SAA (NSAA) (P = 0.001), but the latter two did not differ significantly (P = 0.743). PNH clone was monitored sequentially in 237 patients; positive clones were detected in 41% of the patients, but more than half of them were transient or instable. White blood cell count at initial diagnosis was identified as the only significant risk factor for AA evolution to PNH (P = 0.007). Our results suggest that the transformation to PNH for subpopulations of AA patients may be natural evolution as the clinical manifestation and pathogenesis between AA and PNH were closely related. Furthermore, normalizing hematopoiesis of AA may represent a viable approach to prevent clone evolutions, especially to MDS/AML.
Annals of Hematology 01/2011; 90(5):529-37. · 2.62 Impact Factor
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Jie Bai,
Yangping Xue,
Lei Ye,
Jianfeng Yao,
Chunlin Zhou,
Zonghong Shao, Linsheng Qian,
Renchi Yang,
Haiyan Li,
Hongyun Zhang,
Yizhou Zheng
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ABSTRACT: To find out risk factors of incidences of long-term complications of thrombosis, myelofibrosis with myeloid metaplasia (MMM) and evolution into malignance in Chinese PV patients, we evaluated 320 PV patients referred to our center from April 1984 to June 2005 by Kaplan-Meier estimation and Cox proportional hazards models. A total of 250 events of thrombosis were observed in 138 (43.13%) patients. Advanced age, prior thrombosis and hemoglobin out of control were statistically significant risk factors of incidences of thrombotic events. A total of 43 patients progressed into MMM at a median time of 84 (7-240) months, higher white blood cell (WBC) count, splenomegaly, receiving alkylating agent and hydroxycarbamide were associated with the progression into MMM. During the follow-up time, 11 and 2 patients died of fatal complications of thrombosis and acute myeloid leukaemia (AML), respectively. These results suggest that advanced age, prior thrombosis and hemoglobin out of control contributed to relatively high incidence of thromboembolism; higher WBC count, splenomegaly, receiving alkylating agent and hydroxycarbamide were risk factors of evolution to MMM. The main poor factors that influenced the survival of Chinese PV patients were incidences of thromboembolism and evolution into AML.
International journal of hematology 12/2008; 88(5):530-5. · 1.17 Impact Factor
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Jie Bai,
Zonghong Shao,
Liping Jing,
Hong Liu,
Jun Shi,
Mingfeng Zhao,
Rong Fu,
Guangsheng He,
Juan Sun,
Hairong Jia, Linsheng Qian,
Tianying Yang,
Chongli Yang
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ABSTRACT: To understand the clinical feature and natural course of polycythemia vera (PV).
The clinical symptoms, signs, laboratory examination and prognosis of 185 patients with PV were analysed.
There are 122 males and 63 females. The mean age was (52.7 +/- 14.1) years. The mean hemoglobin level was (208.3 +/- 21.2) g/L. Pancytosis was displayed in 74 (40%) cases, excess of red blood cells in 33 (17.8%), excess of red blood cells and granulocytes in 67 (36.2%) and excess of red blood cell and platelets in 11 (5.9%). Splenomegaly was found in 123 (66.5%) patients and hepatomegaly in 30 (16.2%). Quantitative assess of serum Epo was done in 25 patients. The level was low in 16 (64.2%) and normal in 9 (36.0%). Hematopoietic progenitor culture yields was elevated in 11 patients, endogenous erythroid colonies (EEC) formation was found in 10 cases (90.9%). Eighty two patients (44.3%) had 101 attacks of vascular thrombotic incidents, 7 patients developed myelofibrosis (MF). Secondary cancer occurred in 1 patient. Two patients died of thrombosis.
PV is an elderly adult myeloproliferative disease with a high frequency of thrombosis. EEC can be found out in PV patients. The serum Epo level is not increased in PV patients. The main sequelae of PV is MF.
Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi 12/2002; 23(11):578-80.
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ABSTRACT: To study the relationship between soluble resistance-related calcium-binding protein (sorcin) gene and multidrug resistance gene (mdr1), and their significance in clinical drug resistance and prognosis of acute myeloid leukemia (AML).
Amplification of sorcin gene and mdr1 gene in K562/A02 cell detected by Northern blot, were monitored by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) in 65 AML patients and 27 normal controls, with their relationship and clinical outcame analyzed.
The amplification of sorcin gene and mdr1 gene in AML patients were significantly higher than that in the normal control, which were related to clinical drug resistance and prognosis. The amplification of sorcin gene was related to the amplification of mdr1 gene in the two groups. The clinical drug resistance incidence rate and complete remission rate were 92.9% and 7.1% in sorcin(+)/mdr1(+) group. They were 8.6% and 91.4% in the sorcin(-)/mdr1(-) group (P < 0.001).
The co-amplification of sorcin and mdr1 gene can be taken as a good indicator of clinical drug resistance and prognosis of AML.
Zhonghua zhong liu za zhi [Chinese journal of oncology] 07/2002; 24(4):370-4.
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ABSTRACT: To investigate the complications and conversions in myeloproliferative disorders (MPD).
Three hundred and fifty six patients with MPD were reviewed, including 78 with etiologic thrombocythemia (ET), 93 with primary myelofibrosis (MF), 185 with polythythemia vera (PV). The clinical observation, follow-up, analysis with SPSS statistic software were performed.
Out of the 356 cases, 101 (28.5%) developed thromboembolic events, 81 (22.8%) hemorrhage, 60 (16.9%) hypertension, 20 (5.6%) coronary heart disease, 3 (0.8%) hemolysis and 1 (0.3%) gastrointestinal ulcer, 2 (0.6%) calculus and 1 (0.3%) bone marrow necrosis. Twenty four patients (6.7%) developed MF (9 in ET, 15 in PV), 2 (0.6%) erythrocytosis (1 in ET, 1 in MF), 3 (0.8%) thrombocythemia (all in PV), 5 (1.4%) acute leukemia (2 in ET, 3 in MF) and 1 (0.3%) multiple myeloma (in ET). Eleven cases (3.1%) died, 5 (1.4%) from acute leukemia, 2 (0.6%) fatal hemorrhages, 1 (0.3%) each myocardial infarction and infectious shock, 2 (0.6%) unknown causes.
Embolism and bleeding were the main complications in MPD. Conversions among ET, MF and PV hematological malignancies could occur.
Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi 07/2002; 23(6):314-7.
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ABSTRACT: To study the relationship between the expression of soluble drug resistance-related calcium-binding protein (sorcin) gene and the clinical multidrug resistance in acute leukemia (AL).
A semi-quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) was used to investigate the transcription levels of the human sorcin gene in 95 AL patients and 27 controls.
Sorcin gene expression was significantly higher in AL patients than in normal contrls (P < 0.001), and higher in relapsed/refractory acute myeloid leukemia (AML) patients than in those newly diagnosed or in complete remission. Sorcin gene overexpression was significantly lower in non-resistant patients than in resistant ones (P < 0.001). CR rates of these two groups were 20.0% and 80.0%, respectively. Sorcin gene expression was higher in AML-M(5) patients than M(2), M(3), M(4) patients.
Sorcin gene overexpression is significantly associated with clinical multidrug resistance and prognosis, it is one of the indicators for predicting prognosis of AL patients.
Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi 06/2002; 23(6):293-6.
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ABSTRACT: Giant tumor cells and their varieties in the bone marrow were found in 7 patients with abnomal hematopoiesis phenomena. These cells were artificially devided into 5 kinds according to the difference of their morphology. Most of these cells were corresponding to lymphoid-monocytoid-macrophagocytoid cells with Wright's staining, cytochemical stainings, immunocytochemical stainings, flow cytometry examination, electron microscopy and pathologic study. The bone marrows were hypercellular and marked dysplastic hematopoiesis phenomena. Two of the 7 cases were diagnosed as malignant lymphoma with bone marrow biopsy. All cases characteristically showed no lymph node enlargement or hepatosplenomegaly or any local tumor mass. As to the prognosis of these cases, two patients died with survival time of 8 and 17 months, respectively, one was on critical condition at course of 10 months, and the other 4 cases were in comparatively stable condition with courses of 2.5 to 24 months. These patients seem to be a group of rare malignant lymphoid-monocytoid-macrophagocytoid proliferative diseases.
Zhongguo shi yan xue ye xue za zhi / Zhongguo bing li sheng li xue hui = Journal of experimental hematology / Chinese Association of Pathophysiology 07/2000; 8(2):136-141.
