中国实验血液学杂志最新文献

{"title":"[Application of Fine-Needle Aspiration in the Diagnosis of Classic Hodgkin Lymphoma and Its Clinical Pathological Analysis].","authors":"Lan Chen, Zhou-Ying Liu, Zheng-Xian Chen, Jin-Song Zhang","doi":"10.19746/j.cnki.issn.1009-2137.2025.04.017","DOIUrl":"10.19746/j.cnki.issn.1009-2137.2025.04.017","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the cytologic characteristics fine-needle aspiration using histology as the gold standard and to evaluate its diagnostic application in classic Hodgkin lymphoma.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 17 patients who underwent both coarse-needle aspiration and fine-needle aspiration and were histologically confirmed with classic Hodgkin lymphoma(CHL) at our hospital from December 2012 to December 2023. Clinical information of these patients was collected, and the smear morphology, immunocytochemistry and corresponding biopsies were reviewed.</p><p><strong>Results: </strong>Among the 17 cases of CHL, there were 5 cases of mixed cellularity, 10 cases of nodular sclerosis and 2 cases were unsubtyped. Fifteen cases were correctly diagnosed by fine-needle aspiration, with an accuracy rate of 88.2%. The other two cases were misdiagnosed as non-Hodgkin lymphoma. Morphologically single dispersed mononuclear Hodgkin cells and multinucleated Reed-Sternberg cells were observed in a heterogenous background of lymphocytes in cytology smears, and these cells were positive for CD30 immunocytochemistry.</p><p><strong>Conclusion: </strong>Fine needle aspiration is less invasive and quicker, and the cell morphology is better preserved as compared to histological biopsy. It is easier to recognize pathognomonic Hodgkin or Reed-Sternberg cells and it is helpful for the rapid diagnosis and clinical management of CHL.</p>","PeriodicalId":35777,"journal":{"name":"中国实验血液学杂志","volume":"33 4","pages":"1047-1050"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041613","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}

{"title":"[Detection and Transfusion Strategy of Mimicking Antibodies].","authors":"Hui Zhang, Jie-Wei Zheng, Sha Jin, Wei Shen, Shan-Shan Li, Xiao-Wen Cheng, Dong Xiang","doi":"10.19746/j.cnki.issn.1009-2137.2025.04.036","DOIUrl":"10.19746/j.cnki.issn.1009-2137.2025.04.036","url":null,"abstract":"<p><strong>Objective: </strong>To explore serological detection and blood transfusion strategies of mimicking antibodies, so as to provide appropriate transfusion strategies.</p><p><strong>Methods: </strong>Detailed serological tests, including ABO blood group, Rh typing, antibody specificity, etc,were performed on two patients with autoimmune hemolytic anemia(AIHA). Meanwhile, the references about blood transfusion from mimicking antibody patients published from 1977 to 2024 in China and abroad were retrospectively summarized and analyzed.</p><p><strong>Results: </strong>The patient 1 blood type was AB,CCDee and the antibody is mimicking anti-e, transfusion the e-negative red blood cells (RBCs) was effective. After two transfusions of e-RBCs, hemoglobin levels significantly increased from 48 g/L to 91 g/L, with complete resolution of hemolytic symptoms. The patient 2 blood type was O,CcDee, and the antibody was mimicking anti-c, the patient was diagnosed with AIHA and treated with hormone. No blood products were transfused during hospitalization, and his hemolysis was relieved.</p><p><strong>Conclusion: </strong>Strictly grasping the indication of blood transfusion, blood transfusion should not be performed in the unnecessary conditions, and the corresponding antigen-negative RBC should be screened for transfusion in the necessay conditions.</p>","PeriodicalId":35777,"journal":{"name":"中国实验血液学杂志","volume":"33 4","pages":"1168-1172"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041633","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}

{"title":"[Study on the Mechanism of Piperlongumine Inducing Ferroptosis in K562/ADR Cells through the <i>miR-214-3p/GPX4</i> Pathway].","authors":"Ting Zhang, Cui-Cui Wang, Cong Zhu, Xin-Yu Zhou, Xiu-Hong Jia","doi":"10.19746/j.cnki.issn.1009-2137.2025.04.011","DOIUrl":"10.19746/j.cnki.issn.1009-2137.2025.04.011","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the effect of piperlongumine(PL) on the proliferation and ferroptosis of human adriamycin-resistant chronic myeloid leukemia K562/ADR cells, and to explore its possible molecular mechanism.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;CCK-8 assay was used to detect the effect of PL on the survival rate of K562/ADR cells and to screen the appropriate drug concentration. After K562/ADR cells were treated with low, medium and high concentrations of PL(2, 4, and 6 μmol/L), EdU proliferation assay and plate colony formation assay were used to detect cell proliferation and colony formation ability. CCK-8 assay was used to detect the effects of different inhibitors (Fer-1, Z-VAD, Nec-1) combined with PL on cell proliferation. The intracellular Fe&lt;sup&gt;2+&lt;/sup&gt;, ROS, malondialdehyde(MDA) and glutathine(GSH) contents were respectively detected by iron ion colorimetry, DCFH-DA fluorescent probe, MDA and GSH kits. RT-qPCR and Western blot were respectively used to detect the expression level of &lt;i&gt;GPX4&lt;/i&gt; mRNA and protein in cells. Bioinformatics websites predicted miRNA that could target and regulate &lt;i&gt;GPX4&lt;/i&gt; . RT-qPCR was used to detect the effects of different concentrations of PL on the expression levels of the predicted miRNA. Dual luciferase gene reporter assay was used to verify the targeting relationship between &lt;i&gt;miR-214-3p&lt;/i&gt; and &lt;i&gt;GPX4&lt;/i&gt; . After treating cells with PL or PL+&lt;i&gt;miR-214-3p&lt;/i&gt; inhibitor, the Fe&lt;sup&gt;2+&lt;/sup&gt;, ROS, MDA, GSH centents and GPX4 protein expression levels in cells were detected.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;PL inhibited K562/ADR cell proliferation in a concentration-dependent manner（&lt;i&gt;r&lt;/i&gt; =0.979）. Compared with the blank control group, the survival rate, EdU positive cells rate in low, medium and high concentration PL groups were significantly decreased (&lt;i&gt;P&lt;/i&gt; &lt; 0.01). Compared with the PL group alone, the survival rate of cells in the Z-VAD+PL group was increased slightly (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). The cell survival rate was significantly increased in medium or high concentration PL+Fer-1 group (&lt;i&gt;P&lt;/i&gt; &lt; 0.01). Compared with blank control group, ROS expression level in low concentration PL group was slightly increased (&lt;i&gt;P&lt;/i&gt; &lt; 0.05), and GSH content was slightly decreased (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). In medium and high concentration PL groups, the contents of Fe&lt;sup&gt;2+&lt;/sup&gt;, ROS and MDA were significantly increased (&lt;i&gt;P&lt;/i&gt; &lt; 0.01), while the contents of GSH, expression of &lt;i&gt;GPX4&lt;/i&gt; mRNA and protein were significantly decreased(&lt;i&gt;P&lt;/i&gt; &lt; 0.01). Bioinformatics prediction and double luciferase reporter gene experiment confirmed the targeting relationship between &lt;i&gt;GPX4&lt;/i&gt; and &lt;i&gt;miR-214-3p&lt;/i&gt;. Compared with the blank control group, the expression level of &lt;i&gt;miR-214-3p&lt;/i&gt; in cells of medium and high concentration PL groups was significantly increased (&lt;i&gt;P&lt;/i&gt; &lt; 0.01). Compared with PL group alone, the intracellular Fe&lt;sup&gt;2+&lt;/sup&gt;, ROS and MDA contents in PL+&lt;i&gt;miR-214-3p&lt;/i&gt; ","PeriodicalId":35777,"journal":{"name":"中国实验血液学杂志","volume":"33 4","pages":"1007-1015"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041653","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}

{"title":"[Silent α-Thalassemia Complicated with the Alcohol-Induced Secondary Ring Sideroblastic Anemia].","authors":"Yan Jiang, Ya Chen, Lan Yang, Wei-Bin Li","doi":"10.19746/j.cnki.issn.1009-2137.2025.04.024","DOIUrl":"10.19746/j.cnki.issn.1009-2137.2025.04.024","url":null,"abstract":"<p><strong>Objective: </strong>To explore the characteristics of laboratory examination of secondary sideroblastic anemia (SA).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the general information of a case of alcohol-induced secondary SA, and relevant domestic and foreign literature was reviewed to summarize the clinical characteristics of this disease.</p><p><strong>Results: </strong>The patient was diagnosed with microcytic hypochromic anemia, with abnormal red blood cells detected, such as elliptocytes, target cells, and teardrop cells, etc. Iron overload and more than 15% of ring sideroblasts were detected by Perls' Prussian blue staining of bone marrow smear, while periodic acid-schiff (PAS) staining, <i>EGR1</i> and <i>SF3B1</i> gene tests were all negative, and rare genotype of Hong Kong α-thalassemia (possibly <i>HKαα/αα</i> or <i>HKαα/-α</i>^3.7) was observed.</p><p><strong>Conclusion: </strong>Patient medical history and medication history, peripheral blood and bone marrow cytological morphology, genetic testing, cytogenetics, etc. are helpful for the diagnosis of secondary SA.</p>","PeriodicalId":35777,"journal":{"name":"中国实验血液学杂志","volume":"33 4","pages":"1094-1097"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041702","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}

{"title":"[The Role and Possible Mechanism of T Cell Costimulatory Molecule CD28 Activation in Pathogenesis of Multiple Myeloma].","authors":"Yang-Min Zhang, Li-Ying Zhang, Hua-Yu Ling, Jin-Xiang Fu","doi":"10.19746/j.cnki.issn.1009-2137.2025.04.022","DOIUrl":"10.19746/j.cnki.issn.1009-2137.2025.04.022","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effect of signals mediated by activated CD28 in promoting survival of multiple myeloma (MM) cells and metabolic fitness and its possible mechanism.</p><p><strong>Methods: </strong>The expression of CD28 on 4 MM cell lines (XG2, XG1, RPMI 8226 and U266) was determined by flow cytometry. Two cell lines with the highest or lowest CD28 expression were selected. The proliferation, cell cycle, migration and apoptosis of MM cells <i>in vitro</i> were determined in medium containing high glucose concentration or CD28 agonist monoclonal antibody with different bioassays. shRNA interference assay was used to knock down the expression of <i>CD28</i> on U266 cells. Then, the effect of activated CD28 on glucose uptake rate and drug resistance in MM cells were analyzed using fluorescent glucose analogues (2-NBDG). The expression of <i>Glut1/4, HkII</i> and <i>Fasn</i> was determined with real time quantitative PCR.</p><p><strong>Results: </strong>Flow cytometry analysis showed that all the four tested MM cell lines expressed CD28 and U266 cells had the highest positive rate. The results of <i>in vitro</i> experiment showed that CD28 activation could significantly up-regulate the expression of <i>Glut4</i> and <i>HkII</i>, promote MM cell metabolic remodeling, enhance 2-NBDG/glucose uptake, increase energy metabolism, thereby elevating cell proliferation and migration abilities, leading to an increase in the number of cells in S- and G₂-phases. Meanwhile, activated CD28 subsequently up-regulated resistance of MM cells to bortezomib or dexamethasone.</p><p><strong>Conclusion: </strong>MM cells express high levels of CD28 abnormally, and activation of CD28 can promote up-regulation of glucose uptake in MM cells, thereby promoting cell proliferation and enhancing drug resistance.</p>","PeriodicalId":35777,"journal":{"name":"中国实验血液学杂志","volume":"33 4","pages":"1079-1085"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041625","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}

{"title":"[Application of Targeted mRNA Sequencing in Fusion Genes Diagnosis of Hematologic Diseases].","authors":"Man Wang, Ling Zhang, Yan Chen, Jun-Dan Xie, Hong Yao, Li Yao, Jian-Nong Cen, Zi-Xing Chen, Su-Ning Chen, Hong-Jie Shen","doi":"10.19746/j.cnki.issn.1009-2137.2025.04.042","DOIUrl":"10.19746/j.cnki.issn.1009-2137.2025.04.042","url":null,"abstract":"<p><strong>Objective: </strong>To explore the application of targeted mRNA sequencing in fusion gene diagnosis of hematologic diseases.</p><p><strong>Methods: </strong>Bone marrow or peripheral blood samples of 105 patients with abnormally elevated eosinophil proportions and 291 acute leukemia patients from January 2015 to June 2023 in the First Affiliated Hospital of Soochow University were analyzed and gene structural variants were detected by targeted mRNA sequencing.</p><p><strong>Results: </strong>Among 105 patients with abnormally elevated eosinophil proportions, 6 cases were detected with gene structural variants, among which fusion gene testing results in 5 cases could serve as diagnostic indicators for myeloid neoplasms with eosinophilia. In addition, a <i>IL3</i>∷<i>ETV6</i> fusion gene was detected in one patient with chronic eosinophilic leukemia, not otherwise specified. Among 119 patients with acute myeloid leukemia (AML), 38 cases were detected structural variants by targeted mRNA sequencing, accounting for 31.9%, which was significantly higher than 20.2% (24/119) detected by multiple quantitative PCR (<i>P</i> < 0.05). We also found one patient with AML had both <i>NUP98</i>∷<i>PRRX2</i> and <i>KCTD5</i>∷<i>JAK2</i> fusion genes. A total of 104 patients were detected structural variants by targeted mRNA sequencing in 172 cases with acute B-lymphoblastic leukemia who were tested negative by multiple quantitative PCR, with a detection rate of 60.5% (102/172).</p><p><strong>Conclusion: </strong>Targeted mRNA sequencing can effectively detect fusion gene and has potential clinical application value in diagnosis and classificatation in hematologic diseases.</p>","PeriodicalId":35777,"journal":{"name":"中国实验血液学杂志","volume":"33 4","pages":"1209-1216"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041527","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}

{"title":"[Predictive Value of MIC Typing for <i>IDH1/2</i> Mutations in Patients with Acute Myeloid Leukemia].","authors":"Hui-Juan Chen, Yang-Ling Shen, Yan-Ting Guo, Yi-Fang Zhou, Ying-Jie Miao, Wei-Min Dong, Wei-Ying Gu","doi":"10.19746/j.cnki.issn.1009-2137.2025.04.002","DOIUrl":"10.19746/j.cnki.issn.1009-2137.2025.04.002","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the predictive value of morphology, immunology, and cytogenetics for isocitrate dehydrogenase 1 and 2 (IDH1/2) gene mutation in newly diagnosed acute myeloid leukemia (AML) patients.</p><p><strong>Methods: </strong>The clinical data of 186 newly diagnosed AML patients (except M3 subtype) in the First People's Hospital of Changzhou were retrospectively analyzed, and the variables associated with <i>IDH1/2</i> mutation in patients were screened using LASSO regression to construct a multivariate logistic regression analysis model. The Bootstrap method was used for internal validation of the model and nomograms were used to visualize the model, and receiver operating characteristic (ROC) curve was used to evaluate the predictive performance of the model.</p><p><strong>Results: </strong>A total of 60 AML patients had <i>IDH1/2</i> mutation at initial diagnosis. LASSO regression screened 9 predictive variables associated with <i>IDH1/2</i> mutation, including CD7, CD56, CD11b, CD15, CD64, HLA-DR, platelet count≥50×10⁹/L, isolated +8 and normal karyotype. The nomogram and ROC curve were plotted based on the above 9 variables. The area under the ROC curve (AUC) of the training set and the validation set were 0.871 and 0.806, respectively. Internal validation showed that the nomogram had good predictive ability.</p><p><strong>Conclusion: </strong>The prediction model based on MIC typing constructed in this study has a good predictive ability for the presence of <i>IDH1/2</i> mutations in newly diagnosed AML patients and has important clinical application value when the gene mutation detection results are unavailable.</p>","PeriodicalId":35777,"journal":{"name":"中国实验血液学杂志","volume":"33 4","pages":"939-944"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041554","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}

{"title":"[A Screening Study of GP.Mur Antigen in Blood Donors in Jiangsu Region].","authors":"Lei Shao, Tai-Xiang Liu, Ling Ma, Fang Zhao, Ruo-Yang Zhang, Hong Lin","doi":"10.19746/j.cnki.issn.1009-2137.2025.04.033","DOIUrl":"10.19746/j.cnki.issn.1009-2137.2025.04.033","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the distribution of GP.Mur antigen in blood donors in Jiangsu Province.</p><p><strong>Methods: </strong>Genomic DNA was extracted from 1 114 blood donors in Jiangsu region. PCR-SSP was performed to amplify GP.Mur, and gene analysis was conducted by direct sequencing of the PCR products. The frequency of GP.Mur in the blood donor population of Jiangsu region was calculated.</p><p><strong>Results: </strong>Out of 1 114 randomly selected blood samples, 11 positive bands were detected during amplification. Direct sequencing analysis revealed that among the 11 positive samples, 4 were homozygous for <i>GYP .Mur</i> genotype, 3 were heterozygous for <i>GYP .Mur</i> genotype, and the remaining 4 samples were identified as <i>GYP .HF</i> genotype.</p><p><strong>Conclusion: </strong>This study analyzed the distribution of the GP.Mur antigen and preliminary obtained the frequency data in the blood donor population in Jiangsu region. Further in-depth research on this blood group is of great importance in guiding clinical blood transfusion practices and ensuring transfusion safety.</p>","PeriodicalId":35777,"journal":{"name":"中国实验血液学杂志","volume":"33 4","pages":"1150-1154"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041615","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}

{"title":"[The Relationship between Ig Class Switch Recombination and MMR Protein, Microsatellite Phenotype in Extranodal Marginal Zone Lymphoma of Mucosa-associated Lymphoid Tissue].","authors":"Hong-Xia Wang, Jun Chen, Jing Li, Guo-Feng Lu, Xiu-Hua Han, Rong Yang, Ya-Jun Jiang","doi":"10.19746/j.cnki.issn.1009-2137.2025.04.015","DOIUrl":"10.19746/j.cnki.issn.1009-2137.2025.04.015","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the relationship between Ig class switch recombination (CSR) and mismatch repair (MMR) protein, microsatellite phenotype in extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Forty cases of MALT lymphoma archived in the Department of Pathology, Jiading District Central Hospital, Shanghai University of Medicine & Health Sciences were selected as the observation group, and twenty cases of benign lymphoid tissue hyperplasia were as the control group. The expressions of IgG, IgM, IgD, and IgA in both groups were detected by immunohistochemical double staining, and MMR proteins including MLH1, MSH2, MSH6, and PMS2 in both groups were detected by immunohistochemistry. Multiplex fluorescence PCR capillary electrophoresis was used to detect microsatellite phenotype in tumor and adjacent tissues of the experimental group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In the observation group, the proportions of single Ig heavy chain expression (modeⅠ), negative expression (modeⅡ), and multiple expression (mode Ⅲ) were 65% (26/40), 27.5% (11/40), and 7.5% (3/40), respectively, while in the control group were 0 (0/20), 5% (1/20), and 95% (19/20). The proportion of Ig heavy chain expression mode Ⅰ+Ⅱ in the observation group was 92.5%, which was significantly higher than 5% in the control group (&lt;i&gt;P&lt;/i&gt; &lt; 0.01). In the observation group, partial deletion of MMR protein was observed in 3 cases (7.5%), including 2 cases of MSH6 deletion and 1 case of both MSH6 and PMS2 deletion. In the control group, there was 1 case (5%) with PMS2 deletion. There was no significant difference in the deletion rate of MMR protein between the two groups ( &lt;i&gt;P&lt;/i&gt; &gt;0.05). A total of 5 cases of microsatellite instability (MSI) were detected in the observation group, including 1 case of low-frequency MSI (MSI-L), 4 cases of high-frequency MSI (MSI-H), and 2 cases of MSI-H with MSH6 deletion. When the loss expression of MSI-H or MMR protein was counted as a positive result, the MSI-H rate detected by PCR capillary electrophoresis was 10% (4/40), which was slightly higher than the MMR protein deletion rate detected by immunohistochemistry (7.5%, 3/40), but there was no statistically significant difference between the two groups (&lt;i&gt;P&lt;/i&gt; &gt;0.05). The MMR protein deletion rates among the Ig heavy chain protein expression mode Ⅰ, mode Ⅱ, and mode Ⅲ groups were 0 (0/26), 18.2% (2/11), and 33.3% (1/3), respectively. There was a statistically significant difference in the constituent ratios among the three groups (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). The MMR protein deletion rates among the MSS, MSI-L, and MSI-H groups were 2.9% (1/35), 0 (0/1), and 50% (2/4), respectively. There was a statistically significant difference in the constituent ratios among the three groups (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). MMR protein deficiency was positively correlated with Ig heavy chain expression pattern and MSI ( &lt;i&gt;r&lt;/i&gt; =0.41, &lt;i&gt;P&lt;/i","PeriodicalId":35777,"journal":{"name":"中国实验血液学杂志","volume":"33 4","pages":"1036-1041"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041643","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}

{"title":"[Construction and Evaluation of Risk Prediction Model of Delayed Excretion in Adult Acute Lymphoblastic Leukemia Patients Treated with High-Dose Methotrexate].","authors":"Qian-Song Cheng, Mei-Qi Ding","doi":"10.19746/j.cnki.issn.1009-2137.2025.04.005","DOIUrl":"10.19746/j.cnki.issn.1009-2137.2025.04.005","url":null,"abstract":"<p><strong>Objective: </strong>To explore the risk factors for delayed excretion in adult acute lymphoblastic leukemia (ALL) patients treated with high-dose methotrexate (HD-MTX), and construct a risk prediction model to improve the safety of clinical medication.</p><p><strong>Methods: </strong>From March 2010 to March 2023, 39 adult ALL patients who received 74 courses of HD-MTX chemotherapy in our hospital were analyzed retrospectively. The blood concentration of MTX was monitored by high-performance liquid chromatography (HPLC) at 0, 20 and 44 h after the end of MTX infusion. According to the MTX concentration of 44 h, the patients were divided into excretion delay group (≥0.3 μmol/L) and non-excretion delay group ( < 0.3 μmol/L), and the incidences of side effects were compared between the two groups. Clinical data and the results of laboratory test were collected. The risk factors associated with delayed MTX excretion were screened, and the independent risk factors for delayed excretion were identified by logistic regression analysis. A nomogram prediction model was established by R software based on the risk factors, and the predictive value of the model was also evaluated.</p><p><strong>Results: </strong>A total of 27 courses of delayed excretion occurred in 74 courses of chemotherapy. As compared with the non-excretion delay group, the incidences of mucosal injury and nephrotoxicity increased significantly in the excretion delay group (both <i>P</i> <0.05). The dosage of MTX, blood uric acid level, and MTX peak concentration (i.e., blood drug concentration at 0 h after the end of MTX infusion) were independent factors influencing delayed MTX excretion. Based on these three independent factors, a nomogram prediction model was established for delayed MTX excretion. Calibration curve, concordance index (C-index), area under curve (AUC), and decision curve analysis showed that the model performed well. The model had showed good consistency and discrimination.</p><p><strong>Conclusion: </strong>The incidence of delayed MTX excretion during HD-MTX chemotherapy in adult ALL patients is relatively high. The nomogram model based on the screened independent risk factors can be used to evaluate the risk of delayed excretion, timely identify individuals with high-risk of delayed excretion and adjust rescue measures combined with detection of MTX concentration to reduce the occurrence of side effects and ensure the safety of chemotherapy.</p>","PeriodicalId":35777,"journal":{"name":"中国实验血液学杂志","volume":"33 4","pages":"961-965"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041701","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}