Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi最新文献

{"title":"[Single-cell analysis of immune-lineage features in T-cell large granular lymphocytic leukemia].","authors":"K Huang, L L Zhang, C Qiu, R N Li, Y C Shen, W W Li, H Pan, Z Gao, L W Fang, Y J Chu, W P Yuan, J Shi","doi":"10.3760/cma.j.cn121090-20241125-00479","DOIUrl":"10.3760/cma.j.cn121090-20241125-00479","url":null,"abstract":"<p><p><b>Objective:</b> To investigate alterations in the immune lineage of T-cell large granular lymphocytic leukemia (T-LGLL) at the single-cell transcriptome level and to elucidate its pathogenic mechanisms. <b>Methods:</b> Peripheral blood samples were collected from 5 T-LGLL patients before and after treatment (from June 2019 to December 2020) and 3 healthy controls at the Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC. Single-cell transcriptome sequencing libraries were prepared and sequenced using 10× Genomics technology. Differentially expressed genes in immune cells were compared between patients and healthy donors, followed by pathway enrichment analyses. <b>Results:</b> Profiling 67,237 immune cells revealed that, in T-LGLL: 1) Effector CD8+ T cells exhibited increased numbers, enhanced cytotoxicity, and greater proliferative capacity. Following effective immunosuppressive therapy, both the proliferative capacity and effector functions of these cells significantly decreased (<i>P</i><0.05). 2) The proportion of regulatory T (Treg) cells was reduced, accompanied by increased apoptosis. After effective immunosuppressive therapy leading to remission, Treg cell proportions increased, and apoptotic pathways were downregulated (<i>P</i><0.05). 3) Antigen-presenting cells (APCs) showed enhanced functionality. Monocytes and dendritic cells were enriched in antigen synthesis and presentation pathways, while B cells displayed increased antigen-binding capacity and were enriched in pathways related to T-cell activation (<i>P</i><0.05). 4) Natural killer (NK) cells exhibited attenuated cytotoxic function but demonstrated an enhanced regulatory capacity over T cells (<i>P</i><0.05) . <b>Conclusions:</b> T-LGLL patients present a characteristic immunological profile marked by an imbalance in immune homeostasis. This profile includes abnormal activation and expansion of effector CD8(+) T cells, and a reduction in Treg cell numbers accompanied by functional impairment. Furthermore, APCs and NK cells were found to positively regulate T-lymphocyte activation, differentiation, and proliferation.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 5","pages":"453-459"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Allogeneic hematopoietic stem cell transplantation from an HLA-matched first cousin donor for acute myeloid leukemia: a case report].","authors":"Q L Xu, H W Ma, Y Liu, M C Liu, L J Wang, X H Ran","doi":"10.3760/cma.j.cn121090-20240921-00361","DOIUrl":"10.3760/cma.j.cn121090-20240921-00361","url":null,"abstract":"","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 5","pages":"480"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Sequential CD19-targeted chimeric antigen receptor T cell therapy and azacitidine with venetoclax for relapsed mixed phenotype acute leukemia after allogeneic hematopoietic stem cell transplantation: a case report].","authors":"X J Guo, Y Yang, G X Wang, Y Cao, X X Hu, C H Jiang","doi":"10.3760/cma.j.cn121090-20241203-00528","DOIUrl":"10.3760/cma.j.cn121090-20241203-00528","url":null,"abstract":"","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 5","pages":"479"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Advances in the application strategies of CRISPR/Cas9 technology in chimeric antigen receptor T cell therapy for hematological malignancies].","authors":"Y W Wang, Y M Tang","doi":"10.3760/cma.j.cn121090-20240911-00343","DOIUrl":"10.3760/cma.j.cn121090-20240911-00343","url":null,"abstract":"<p><p>Chimeric antigen receptor (CAR) T-cell therapy has achieved breakthroughs in treating relapsed/refractory B-cell malignancies. However, it still faces challenges, including complex manufacturing processes, limited indications, T-cell exhaustion, and insufficient durability of therapeutic efficacy. CRISPR/Cas9, a highly efficient and relatively simple gene-editing technology, offers new avenues for overcoming these limitations. This review briefly outlines the working mechanism of CRISPR/Cas9 and focuses on its recent applications and clinical practices in developing universal CAR T-cells, enhancing T-cell function, and extending CAR T-cell therapy to T-cell and myeloid leukemias. Furthermore, this review highlights optimization strategies developed over the past two years to enhance the editing precision, delivery efficiency, and safety of the CRISPR/Cas9 system, aiming to provide insights for the optimal design and clinical application of CAR T-cell therapy.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 5","pages":"481-488"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Chinese expert consensus on the diagnosis and treatment of adult Langerhans cell histiocytosis (2025)].","authors":"","doi":"10.3760/cma.j.cn121090-20250222-00086","DOIUrl":"10.3760/cma.j.cn121090-20250222-00086","url":null,"abstract":"<p><p>Langerhans cell histiocytosis (LCH) is a clonal hematologic neoplasm primarily characterized by the activation of the mitogen-activated protein kinase (MAPK) signaling pathway; it can involve any organ or system and presents with diverse clinical manifestations. Based on current evidence-based medicine and combined with domestic clinical experience, this consensus elaborates on the pathogenesis, clinical manifestations, diagnosis, treatment, and efficacy evaluation of adult LCH, aiming to provide professional guidance for its diagnosis and treatment in China.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 5","pages":"397-401"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Efficacy of selinexor combined with subcutaneous decitabine in myeloid malignancies refractory to or relapsed after venetoclax therapy].","authors":"R H Mi, L Wang, N Hu, C Li, L Chen, Y X Ma, X D Wei","doi":"10.3760/cma.j.cn121090-20240920-00358","DOIUrl":"10.3760/cma.j.cn121090-20240920-00358","url":null,"abstract":"<p><p>Venetoclax (Ven) is now widely used for both acute myeloid leukaemia (AML) and high-risk myelodysplastic syndrome (MDS), yet there is no consensus on salvage regimens after Ven failure. This study retrospectively evaluated the efficacy and safety of selinexor combined with subcutaneous decitabine (DAC) in 10 patients with AML or MDS with excess blasts (MDS-EB1/2) who had experienced prior Ven treatment failure. A literature review was also performed. Among the 7 patients with AML, 1 achieved complete remission (CR), 2 achieved CR with incomplete hematologic recovery (CRi), 1 achieved partial remission (PR), 2 had no remission, and 1 experienced disease progression (PD). Among the 3 patients with MDS, 2 achieved marrow CR and 1 had stable disease (SD). The median duration of response among the 6 responding patients was 2 months (range, 0.5-6 months). All 10 patients experienced varying degrees of myelosuppression. Five patients had mild gastrointestinal reactions, all of which were manageable. The overall tolerability was good, and no treatment-related deaths occurred. These findings suggest that selinexor combined with subcutaneous decitabine offers a novel and well-tolerated therapeutic option for patients with myeloid malignancies who have previously failed venetoclax-based therapy.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 5","pages":"473-477"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Chinese expert consensus on the diagnosis and treatment of POEMS syndrome (2025)].","authors":"","doi":"10.3760/cma.j.cn121090-20241219-00578","DOIUrl":"10.3760/cma.j.cn121090-20241219-00578","url":null,"abstract":"<p><p>POEMS syndrome is a rare plasma cell disorder characterized by diverse clinical manifestations, making patients susceptible to missed diagnosis and misdiagnosis, which can delay treatment and adversely affect prognosis. There is no gold standard for diagnosing POEMS syndrome; the diagnosis primarily relies on a comprehensive assessment of clinical and laboratory findings. The application of autologous hematopoietic stem cell transplantation and novel agents has led to significant improvements in both the treatment and prognosis of POEMS syndrome. This consensus addresses the diagnostic challenges associated with POEMS syndrome and provides treatment recommendations for both transplant-eligible and transplant-ineligible patients.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 5","pages":"389-396"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The cure for acute promyelocytic leukemia and China's contributions].","authors":"L Chen, S J Chen","doi":"10.3760/cma.j.cn121090-20250307-00119","DOIUrl":"10.3760/cma.j.cn121090-20250307-00119","url":null,"abstract":"<p><p>Acute promyelocytic leukemia (APL) was historically regarded as the most aggressive subtype of acute leukemia due to its high early mortality rate. The transformation in APL treatment represents a milestone in targeted cancer therapy. The discovery and clinical application of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) have dramatically improved the prognosis of APL, increasing the 5-year overall survival rate from less than 35% to over 90%. Chinese hematology/oncology community have made significant contributions to this transformation: Professor Wang Zhenyi's group pioneered ATRA-induced differentiation therapy, while Professor Zhang Tingdong's group verified the clinical efficacy of ATO. The research team of Shanghai Institute of Hematology (SIH) cloned the PML::RARA fusion gene resulting from the chromosomal translocation (15;17) and the first variant PLZF::RARA fusion gene. Based on the characterization of the leukogenesis at molecular and cellular levels and the mechanisms of action of effective drugs, the SIH team established a synergistic targeted therapy protocol for newly diagnosed APL patients, achieving a disease-free survival rate of 95.7% in a nationwide multi-center clinical trial. Subsequently, several teams explored the use of oral arsenic (Realgar-Indigo naturalis formula or oral ATO solution) combined with ATRA to treat APL, which is of high cost-effectiveness and can be promoted in resource-restricted regions. This review systematically summarizes the key therapeutic breakthroughs in APL, elucidates the underlying scientific mechanisms and clinical significance, and identifies remaining challenges for optimizing disease management.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 5","pages":"377-384"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Bioinformatic analysis of venetoclax sensitivity and resistance mechanisms in acute myeloid leukemia].","authors":"Y Yang, C H Xu, N Wang, J T Fan, D D Yang, M M Niu, L Shen, H Wang","doi":"10.3760/cma.j.cn121090-20250114-00028","DOIUrl":"10.3760/cma.j.cn121090-20250114-00028","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the anti-leukemic effects and resistance mechanisms of venetoclax in acute myeloid leukemia (AML). Genomic, transcriptomic, and clinical data from AML patients who underwent venetoclax drug sensitivity testing were downloaded from the Beat AML database. Correlation analysis was performed between these data and venetoclax sensitivity outcomes. Differentially expressed genes (DEGs) associated with venetoclax sensitivity were identified from transcriptomic data and subsequently validated using GEO database transcriptomic results and in vitro experiments (including Western blot). Functional enrichment analyses (KEGG and GSEA), transcription factor enrichment analysis (KnockTF), and data from public databases were employed to further investigate key genes and pathways influencing drug sensitivity. <b>Results:</b> After filtering the Beat AML cohort, data from 52 patient samples with available in vitro venetoclax sensitivity results were included for analysis. Patients with FLT3 mutations exhibited greater sensitivity to venetoclax compared to those with FLT3 wild-type. Correlation analysis between clinical information and drug sensitivity data indicated that higher peripheral blood tumor burden was associated with increased sensitivity to venetoclax. Transcriptomic analysis and in vitro experiments confirmed that venetoclax inhibits the FLT3-related signaling pathway, including downregulation of FLT3 expression and reduced phosphorylation of its downstream targets AKT and STAT5. KEGG pathway and KnockTF transcription factor enrichment analyses indicated that venetoclax resistance was associated with increased transcriptional activity of FOXM1 and STAT3. Moreover, high expression of FOXM1 and STAT3 correlated with shorter overall survival in patients. <b>Conclusion:</b> Venetoclax can inhibit the activation of FLT3-related signaling pathways. The activation of STAT3 and FOXM1 transcription factors is a potential key mechanism contributing to venetoclax resistance in AML.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 5","pages":"460-467"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Chinese expert consensus on the diagnosis and treatment strategies for refractory/resistant cytomegalovirus infection in immunocompromised populations (2025)].","authors":"","doi":"10.3760/cma.j.cn121090-20250112-00024","DOIUrl":"10.3760/cma.j.cn121090-20250112-00024","url":null,"abstract":"<p><p>The number of immunocompromised individuals in China is rapidly increasing, and the incidence of cytomegalovirus (CMV) infection in this population is significantly higher than in the general population, severely affecting their quality of life and prognosis. Currently, a standardized diagnostic and treatment system for refractory/resistant CMV infections in immunocompromised populations is lacking. Based on domestic and international data on the epidemiology, evidence-based medicine, and clinical research regarding refractory/resistant CMV infections, this consensus formulates recommendations for the diagnosis, treatment, and management of these infections.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 5","pages":"402-409"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}