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

{"title":"[The state of the art: diagnosis and therapeutic interventions of clonal hematopoiesis of indeterminate potential and clonal cytopenias of undetermined significance].","authors":"Z J Xiao","doi":"10.3760/cma.j.cn121090-20241228-00600","DOIUrl":"10.3760/cma.j.cn121090-20241228-00600","url":null,"abstract":"<p><p>Clonal hematopoiesis of indeterminate potential (CHIP) and clonal cytopenias of undetermined significance (CCUS) are included in both fifth edition of the World Health Organization classification (WHO 2022) and International Consensus Classification (ICC). Recently three models were developed for prediction of myeloid neoplasms risk and clinical trials are initiated to investigate potential treatments for CHIP and CCUS. Challenges in diagnosis and therapeutic intervention of CHIP and CCUS were discussed.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 1","pages":"5-8"},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587457","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 complement inhibition therapy for paroxysmal nocturnal hemoglobinuria].","authors":"Y M Shi, F K Zhang","doi":"10.3760/cma.j.cn121090-20240903-00332","DOIUrl":"10.3760/cma.j.cn121090-20240903-00332","url":null,"abstract":"<p><p>Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired clonal hematologic disorder. Historically, most PNH patients mainly received supportive treatment, which led to poor quality of life and high mortality rates. The advent of downstream complement C5 inhibitors has dramatically changed the natural course of PNH. These inhibitors alleviate clinical symptoms, significantly reduce severe complications, and improve survival rates. Despite their ability to control intravascular hemolysis and enhance hemoglobin levels, approximately half of the treated patients still require blood transfusions due to extravascular hemolysis (EVH) mediated by upstream complement component C3. Upstream complement inhibitors not only control IVH but also reduce the deposition of C3 fragments, thereby solving the problem of EVH and further improving the clinical outcomes of PNH patients. However, due to the cascade of complement activation and the increased accumulation of PNH red blood cells after treatment with upstream complement inhibitors, there may be an increased risk of more severe breakthrough hemolysis events. Additionally, the potential risk of infections associated with complement inhibitors is another issue that needs to be addressed.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 1","pages":"90-96"},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587504","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":"[Legionella infection complicating acute lymphoblastic leukemia: a case report].","authors":"L Q Han, B Zhang, J Zhang, J S Li, Y J Liu, Y X Su, Y J Song","doi":"10.3760/cma.j.cn121090-20240823-00316","DOIUrl":"10.3760/cma.j.cn121090-20240823-00316","url":null,"abstract":"","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 1","pages":"88-89"},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587441","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":"[Strengthen the construction of hematological intensive care unit to comprehensively improve the prognosis of patients with hematological critical illnesses].","authors":"Y Hu, Y H Wu","doi":"10.3760/cma.j.cn121090-20241225-00592","DOIUrl":"10.3760/cma.j.cn121090-20241225-00592","url":null,"abstract":"<p><p>The survival time of patients with hematological malignancies has improved significantly in recent years; however, the incidence of severe complications has also increased and may escalate rapidly alongside the progression of the primary disease. The establishment of a hematology intensive care unit (HCU) is of great clinical significance for early identification, centralized monitoring and management of hematological critically ill patients, leveraging the advantages of specialties, accurately controlling the condition, and improving the level of diagnosis and treatment in hematology. It is recommended that blood centers with adequate resources actively establish HCUs to enhance the prognosis of patients with hematological critical illnesses.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587443","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":"[A clinical investigation of constructing a diagnostic model for sepsis-induced coagulopathy utilizing data-independent acquisition proteomics].","authors":"Q Chen, J C Song, X L Wan, J J Zeng, X M Song, L C Zhong, L P He","doi":"10.3760/cma.j.cn121090-20241219-00579","DOIUrl":"10.3760/cma.j.cn121090-20241219-00579","url":null,"abstract":"<p><p><b>Objective:</b> This study used data-independent acquisition (DIA) proteomics to analyze plasma protein expression in sepsis-induced coagulopathy (SIC), identify key biomarkers, and develop a diagnostic model. <b>Methods:</b> This prospective study included 46 adult sepsis patients from the intensive care unit. Patients were categorized into a general sepsis group (<i>n</i>=26) and an SIC group (<i>n</i>=20) based on established SIC criteria. Plasma samples underwent proteomic and bioinformatics analyses to identify differentially expressed protein (DEP) using LASSO regression and Random Forest. A diagnostic model was constructed and assessed via receiver operating characteristic (ROC) curve analysis. <b>Results:</b> The baseline data revealed that SIC patients exhibited longer prothrombin times, lower platelet counts, and higher D-dimer, fibrin degradation products, blood lactate, SOFA scores, and APACHE Ⅱ scores compared with general sepsis patients (<i>P</i><0.05). DIA proteomics identified 2 637 proteins, with 240 DEP meeting the criteria (fold change >1.5, <i>P</i><0.05), including 81 upregulated and 159 downregulated DEP. Subcellular localization analysis revealed that DEPs were predominantly extracellular and nuclear. Gene ontology (GO) annotation showed that DEP were mainly involved in cellular physiology, biological regulation, and stress response processes in biological processes. Domain annotation revealed a predominance of immunoglobulin V regions in DEP, which are crucial for antigen recognition and binding. KEGG enrichment analysis showed significant enrichment of DEP in pathways related to natural killer cell-mediated cytotoxicity, glycosylphosphatidylinositol anchor biosynthesis, tumor necrosis factor signaling, and NF-κB signaling. LASSO regression identified angiogenin and C-type lectin domain family 10 member A as key DEP. The SIC diagnostic nomogram showed an area under the curve of 0.896, with 0.731 specificity and 0.900 sensitivity. <b>Conclusion:</b> The nomogram incorporating angiogenin and C-type lectin domain family 10 member A provides an accurate tool for SIC diagnosis.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 1","pages":"45-52"},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587502","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":"[Safety and efficacy of mitoxantrone liposome combined chemotherapy in the treatment of mixed phenotype acute leukemia].","authors":"H W Jiang, C Lu, J He, Q Z Wei, M F Su, Y H Wu, J B Hu","doi":"10.3760/cma.j.cn121090-20241210-00554","DOIUrl":"10.3760/cma.j.cn121090-20241210-00554","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the safety and efficacy of mitoxantrone liposome (MIT-LIP) combined chemotherapy in treating mixed phenotype acute leukemia (MPAL) . <b>Methods:</b> December 2021 to November 2024, MPAL patients who underwent the MAED (MIT-LIP + cytarabine + etoposide + dexamethasone) regimen were retrospectively analyzed. Data on clinical characteristics, adverse reactions, therapeutic outcomes, and long-term prognoses were collected. <b>Results:</b> A total of 7 MPAL patients who received MAED regimen were admitted. Among them, two patients were initially diagnosed with T-ALL or B-ALL, respectively, and transformed into AML after treatment. Three patients were initially diagnosed as MPAL (B/myeloid), one as MPAL (T/myeloid), and one with MPAL (myeloid/plasmacytoid dendritic cell). Among the 7 patients, there were 3 males and 4 females, 1 chromosome abnormalities and 6 gene abnormalities, including 1 case with BCR∷ABL fusion gene. The median age was 38 years (range: 16-58 years). There was no clear related drug allergy and organ toxicity during MAED regimen, and the main adverse effect was hematological toxicity. After induced chemotherapy, all patients achieved complete remission (CR), 2 maintained MRD-negative CR and 1 maintained MRD-positive CR. The other 4 patients underwent allogeneic hematopoietic stem cell transplantation, 2 maintained MRD-negative CR, and 2 relapsed. The current median follow-up time was 12 months, the overall survival (OS) rate was 100%, the relapse-free survival (RFS) rate was 60%, and the median OS time and median RFS time were not reached. <b>Conclusion:</b> The MAED regimen demonstrates high safety and a favorable CR rate in MPAL treatment.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 1","pages":"64-69"},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587442","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 prevention and treatment of immunotherapeutic and molecular targeted agents-related infections in patients with hematological malignancies (2025)].","authors":"","doi":"10.3760/cma.j.cn121090-20241114-00451","DOIUrl":"10.3760/cma.j.cn121090-20241114-00451","url":null,"abstract":"<p><p>As novel therapeutic agents continue to emerge, immunotherapy and molecular-targeted drugs demonstrate expanding application prospects in hematological malignancy treatment. This expert consensus revision incorporates the latest evidence-based medicine from domestic and international sources, updating recommendations for infection diagnosis, prevention, and treatment. The document integrates recommendations for recently launched or imminent antibodies and small molecule targeted compounds, including COVID-19 considerations. This format of recommendations is modified according to the levels of evidence of The Oxford Centre for Evidence-Based Medicine (CEBM).</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 1","pages":"18-30"},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587507","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":"[Clinical characteristics and prognostic analysis of newly diagnosed acute myeloid leukemia with critical illness].","authors":"P Q Liang, M Gao, Y Xie, B Q Li, Q Li, Z Y Liu, D Wang, H Y Qiu, S N Chen, D P Wu, J H Fu","doi":"10.3760/cma.j.cn121090-20241211-00561","DOIUrl":"10.3760/cma.j.cn121090-20241211-00561","url":null,"abstract":"<p><p><b>Objective:</b> This study retrospectively analyzed the clinical characteristics of patients newly diagnosed with acute myeloid leukemia (AML) who were admitted to the hematology intensive care unit (HCU) with critical illness. It also examined factors associated with critical illness and early mortality in these patients. <b>Methods:</b> Clinical data were collected from 91 newly diagnosed AML patients admitted to the HCU of the Department of Hematology, First Affiliated Hospital of Soochow University, from October 2020 to 2024. Reasons for HCU admission, major therapeutic interventions, and risk factors for critical illness and early mortality were analyzed. <b>Results:</b> The median time from diagnosis to HCU admission was 3 days (<i>IQR</i>: 3-9 days), and the median HCU stay was 10 days (<i>IQR</i>: 3-23 days). Of the 91 patients, 71 were admitted to the HCU before induction chemotherapy, while 20 were transferred to the HCU after its initiation. The leading causes of HCU admission were pulmonary infection (78.0% ), respiratory failure (44.0% ), hepatic insufficiency (28.6% ), renal insufficiency (27.5% ), disseminated intravascular coagulation (DIC; 25.3% ), and sepsis (23.1% ). Median Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) and SOFA scores at HCU admission were 14 (<i>IQR</i>: 11-18) and the median Sepsis Related Organ Failure Assessment (SOFA) score was 7 (<i>IQR</i>: 4, 10). Major HCU interventions included vasoactive drugs, noninvasive and invasive mechanical ventilation, continuous renal replacement therapy, therapeutic leukocyte clearance, and cardiopulmonary resuscitation. Among patients receiving induction chemotherapy, the composite complete remission rate was 65.4%, and the overall remission rate was 88.5%. Thirty-five (38.5% ) patients died within 28 days of HCU admission. Independent risk factors for 28-day mortality were DIC (<i>OR</i>=9.350, 95% <i>CI</i> 1.999-43.745, <i>P</i>=0.005), sepsis (<i>OR</i>=6.817, 95% <i>CI</i> 1.571-29.582, <i>P</i>=0.010), and cardiac insufficiency (<i>OR</i>=12.281, 95% <i>CI</i> 2.385-63.254, <i>P</i>=0.003) . <b>Conclusion:</b> The main reason for HCU admission in newly diagnosed critically ill AML patients was pulmonary infection. Nearly 40% of patients experisenced early death, and DIC, sepsis, and heart failure were factors influencing early mortatlity.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 1","pages":"39-44"},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587508","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":"[Analysis of risk factors for early death in hyperleukocytic acute leukemia].","authors":"M H Su, Z S Yan, Q L Li, J Y Zhang, Y K Yin, B Hu, Y Z Liu, D P Li, Y C Mi","doi":"10.3760/cma.j.cn121090-20240917-00351","DOIUrl":"10.3760/cma.j.cn121090-20240917-00351","url":null,"abstract":"<p><p><b>Objective:</b> This study analyzed the clinical characteristics and early mortality risk factors in patients with hyperleukocytic acute leukemia (HAL) to provide a basis for predicting early prognosis. <b>Methods:</b> Data were retrospectively collected from 211 patients with primary HAL who visited the Emergency Center of the Hematology Hospital, Chinese Academy of Medical Sciences, between July 1, 2019 and November 30, 2021. The value of each indicator in early risk stratification and prognosis was analyzed. <b>Results:</b> The early-death group exhibited higher WBC, peripheral blood immature cell proportions, prothrombin times (PT), fibrinogen degradation products (FDP), and D-dimer levels than the non-early death group (<i>P</i><0.05). Mortality in hyperleukocytic AML (20.5% ) was significantly higher than that in hyperleukocytic ALL (9.3% ) (<i>P</i><0.05). There were significant differences in age, creatinine, PT, fibrinogen (FIB) levels, WBC, lactic dehydrogenase (LDH), uric acid, blood potassium, blood calcium, and blood phosphorus levels between the two groups of patients (<i>P</i><0.05). A WBC threshold of 255.96×10⁹/L predicted early mortality with 65.6% sensitivity and 69.0% specificity, with higher WBC levels associated with a 5.164-fold increased mortality risk (<i>P</i><0.05). The age, WBC, LDH, urea, PT, FDP and D-dimer of patients at the time of consultation are risk factors affecting the survival of HAL (<i>P</i><0.05) . <b>Conclusion:</b> HAL is a life-threatening condition with a high early mortality. Age, WBC, LDH, urea, PT, FDP and D-dimer are risk factors for early death in HAL.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 1","pages":"53-57"},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587505","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":"[Recovery of enterogenic sepsis-induced disseminated intravascular coagulation after radical surgery for colon cancer: a case report].","authors":"Y N Liu, Y J Liang, J Zhang, X C Ma","doi":"10.3760/cma.j.cn121090-20250104-00006","DOIUrl":"https://doi.org/10.3760/cma.j.cn121090-20250104-00006","url":null,"abstract":"","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"45 S1","pages":"122-124"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}