Objective:To increase the understanding of neuroleptic malignant syndrome, rhabdomyolysis and acute renal injury in advanced-aged patients with Parkinson's disease after abdominal surgery.Methods:We report a case of malignant syndrome, rhabdomyolysis and acute renal injury in an 85-year-old patient with Parkinson's disease after abdominal surgery in our department.The diagnosis and successful treatment experience were summarized, and a literature review was conducted.Results:The body temperature was as high as 40.5℃ in this patient, accompanied by stiffness, sustained involuntary shaking, increased muscle tone, serum creatine kinase at 104 615 U/L, tachycardia, low blood pressure, accelerated breathing rate, disturbance of consciousness, excessive sweating and other clinical manifestations, which met the diagnostic criteria for neuroleptic malignant syndrome.The patient had complications including concurrent rhabdomyolysis, acute renal injury and shock.The emergency was resolved after an early diagnosis and proactive treatment.Conclusions:If patients with Parkinson's disease have a high fever with rigidity or sudden aggravation within a short period of time after medication, the possibility of neuroleptic malignant syndrome should be considered and the causes should be screened.

Objective:To analyze the prevalence of anemia and its influencing factors in the elderly population dwelling in urban communities in Beijing.Methods:A random cluster sampling method was adopted to select the elderly people of communities in Beijing, and cross-sectional research was conducted through questionnaire surveys, field tests and blood sample collection.The criteria for diagnosing anemia were from WHO standards, and the health evaluation indicators in the questionnaire survey included demographic data and eating habits, socio-economic information, information on enjoying health services, health and physical fitness and other information.Blood samples were drawn for routine blood tests and biochemical tests.Results:A total of 1 947 elderly people aged 65 years and above were investigated, including 789 males(40.5%)and 1 158 females(59.5%). Among the 1 947 survey subjects, 288 elderly people had anemia, with the prevalence of anemia of 14.79%(288/1 947). The prevalence of anemia was 16.35%(129/789)in males and 13.73%(159/1 158)in females.There was no statistically significant difference in the prevalence of anemia between male and female( χ2=2.760, P=0.097). Logistic regression analysis was used to analyze the factors affecting anemia.The results showed that the higher age( OR=1.055, P=0.000), the higher frequency of meat-eating( OR=1.353, P=0.046), the lower frequency of fruit-eating( OR=0.759, P=0.048), the worse health status of cohabitants( OR=0.757, P=0.037), the lower BMI( OR=0.905, P=0.001)and the lower exercise frequency( OR=0.769, P=0.012)were correlated to the higher anemia risk in the elderly population dwelling in urban communities in Beijing. Conclusions:The prevalence of anemia is relatively high in the elderly in Beijing communities.According to our findings, older people should reduce the frequency of eating meat, while ensuring nutritional intake, increase the intake of fruits and take appropriate exercises to reduce the prevalence of anemia.

Objective:To investigate the correlation of miRNA-181b (miR-181b) and prognostic factors of myelodysplastic syndrome (MDS), to predict target gene and main biological functions of miR-181b, and to evaluate the risk prediction ability of miR-181b in MDS.Methods:The samples of 131 bone marrow in MDS patients who followed the criteria of World Health Organization (WHO) classification (2016) from the Blood Diseases Hospital, Chinese Academy of Medical Sciences between January 2019 and September 2019 were collected, and the clinical data including routine blood test results, related gene test results of blood diseases were retrospectively analyzed. The expression levels of miR-181b in all bone marrow samples were detected by using quantitative real-time polymerase chain reaction (qRT-PCR). According to the international prognostic scoring system (IPSS), WHO classification-based prognostic scoring system (WPSS) and revised IPSS (IPSS-R), the patients were divided into different groups by the risk grade, and the expression differences of miR-181b in different risk groups were compared, and the correlation between the expressions of miR-181b and partial prognostic factors, including white blood cell (WBC), hemoglobin (Hb), platelet (Plt), absolute neutrophil count(ANC), myeloblast and gene mutations was analyzed. Bioinformatics online tool TargetScan was used to make target gene prediction and the potential function of miR-181b.Results:The expression levels of miR-181b was increased with the increasing risk of IPSS, WPSS and IPSS-R, and there were statistically significant differences in miR-181b expression levels of different risk groups in different scoring systems (all P < 0.01). There was a positive correlation between the expression level of miR-181b and the scores of the three prognostic scoring systems (r was 0.437, 0.368, 0.327; all P = 0.001); miR-181b expression was positively correlated with the proportion of bone marrow myeloblasts ( r = 0.450, P < 0.01) and was negatively correlated with Plt ( r = -0.199, P = 0.024). And miR-18b was not associated with WBC, Hb, ANC, and related gene mutations of blood diseases (all P > 0.05). A total of 1 363 potential target genes of miR-181b were predicted by using bioinformatics, and biological processes of these target genes were mainly enriched in transcription regulation, RNA metabolism regulation. Among them, 22 target genes were related to the hematological malignancies, including RUNX1, ASXL2, NRAS, ATM and KRAS, which have been previously confirmed to be related to MDS. The relative expression level [the median ( P25, P75)] of miR-181b in patients who had those hematological malignancies related to miR-181b target gene mutation (32 cases) was 1.33(0.63, 1.60), which was higher than that in patients without mutation (99 cases) [0.85 (0.49, 1.38)], and the difference was statistically significant ( Z = 2.285, P = 0.022). Conclusions:miR-181b has a correlation with the risk grade of prognostic scoring systems in MDS, and it may be involved in the molecular biology pathogenesis of MDS.

BackgroundSecond allogeneic hematopoietic stem cell transplant (HCT) remains as an option for disease relapse after initial HCT.MethodsWe analyzed retrospectively the outcomes of 65 consecutive patients who underwent a second HCT for disease relapse at the University of Chicago. Univariate and multivariate analysis were conducted, and a scoring system was generated to select the patients who would benefit second HCT.ResultsAll except four patients received T cell depleted (TCD) first HCT. The majority of patients had AML (n=47) and high risk MDS (n=5). The median age at second HCT was 45years (11-73). 13 patients (20%) achieved CR before second HCT. 98% (n=64) and 72% (n=47) patients achieved neutrophil and platelet engraftment at a median interval of 10 and 18days, respectively, following the second HCT. With a median follow up of 23 (5.5-140) months for survivors after second HCT, the estimated 2years PFS was 17.5% and the 2years OS was 22.6%. The day 100 cumulative incidence of non-relapse mortality rate was 23.6%, and the cumulative incidence of aGVHD and cGVHD were 16.9% and 7.7% respectively at 1year after second HCT. In univariate analysis, patients with remission duration after first HCT of >12months and those in CR before second HCT had significantly better PFS and OS. A scoring system using disease status before second HCT (CR=0 vs. non-CR=1), and remission duration after first HCT (<6=2, 6-12=1 and>12months=0) was generated as an approach to classify patients into different risk categories in the purpose to provide guidance to the transplant physician to inform the outcomes to potential patients undergoing 2nd HCT. A score of <2 (n=26) identified a group with PFS and OS of 31.6% and 36.2% at 2years after second HCT.ConclusionIn conclusion, second HCT is a viable option for disease relapse after TCD HCT for patients entering second HCT in remission and/or remission duration >12months after first HCT with acceptable rates of GVHD and donor engraftment.

Objective Primary pulmonary lymphoma is a rare disease,so it is important to analyze 5 cases with primary pulmonary lymphoma confirmed by pathology in Beijing Hospital through 20 years,sum up the clinical,radiological,di-agnostic,therapeutic,and prognostic manifestations,and improve the diagnosis and treatment of this disease. Method To analyze retrospectively clinical data of 5 cases with primary pulmonary lymphoma confirmed by pathology,and to follow up prognosis. Result 5 cases all were females,with a median age of 34 ~70 years. 3 cases were found from health check,and 2 cases went to hospital because of cough and expectoration of blood in the sputum. Onset time of 5 cases was from 8 weeks to 5 years. 5 cases had no special physical signs. Elevation of Inflammation indexes was found only in 1 case. Tumor related indexes were usually normal. CT features of the 5 cases mainly presented nodules(2/5), masses(2/5),consolidation(1/5). 1 patients had decrease in diffusion dysfunction. The veracious methods included CT-guided percutaneous lung puncture(2/5),thoracoscope(2/5)and thoracotomy(1/5). Histological diagnosis showed that 1 case was Hodgkin lymphoma,4 mucosa-associated lymphoid tissue lymphoma. The main treatment was chemo-therapy and surgery. Followed up for 1. 0-8. 8 years,5 cases all were survival. 4 cases were stable,1 case was found of suspected recurrence in 4. 5 years. Conclusion Primary pulmonary lymphoma is a rare disease,which clinical manifes-tation is atypical. Misdiagnosis and missed diagnosis are common. Diagnosis should be made by experienced pathology specialist. There is no guidelines for treatment. Localized lesions can be considered surgery or radiotherapy,diffuse pre-ferred chemotherapy. The tumor has a good prognosis and high relapse rate.

Objective To sum up the clinical,radiological,diagnostic,therapeutic,and prognostic manifestations of primary pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma,and improve the diagnosis and treatment of the disease.Methods The clinical data of four patients with primary pulmonary MALT lymphoma confirmed by pathology were analyzed retrospectively,and they were followed up to analyze prognosis.Results The four cases were all senile females.Primary pulmonary MALT lymphoma was the most common pathologic type of primary pulmonary non-Hodgkin lymphoma.Three cases were found from health check,and one case went to hospital because of cough,expectoration and blood in the sputum.Onset time of four cases was from seven months to five years.Four cases had no special physical signs.Inflammation indexes and tumor related indexes were usually normal.Radiological features of the four cases mainly presented nodules or masses.The patients had normal ventilation and diffusion function.The veracious methods included CT-guided percutaneous lung puncture,thoracoscope and thoracotomy.Histopathological finding showed small lymphoid cells with diffuse infiltration and lymphoid hyperplasia.The main treatment was chemotherapy and surgery.They were followed up for 1-8.8 years,three cases were stable,one case was found of suspected recurrence in 4.5 years.Conclusions Primary pulmonary MALT lymphoma is a rare disease,of which clinical manifestation is atypical,mainly occurs in senile females.This disease has insidious onset.Diagnosis should be made by experienced pathology specialists.There is no guidelines for treatment.For asymptomatic patients,the strategy of watch-and-wait can be adopted.When tumor progresses or symptoms occur,the first choice is chemotherapy with chlorambucil,combined with rituximab or not.The tumor has a good prognosis and high relapse rate.

Objective To evaluate the feasibility of using comprehensive geriatric assessment (CGA) in estimating if standard dose treatment is fit for the elderly patients with diffuse large B cell lymphoma.Methods.Comprehensive geriatric assessments including three assessments of activity of daily living,instrumental activity of daily living and comorbidity scoring according to Cumulative Illness Rating Score for Geriatrics were adopted to assess if standard dose treatment is fit for the elderly patients in our prospective study.Thirty seven patients with diffuse large B cell lymphoma,aged ＞70 years were enrolled in the study,and grouped into fit,unfit and frail groups according to comprehensive geriatric assessment scoring and their age.The treatment protocolswere not determined by comprehensive geriatric assessment scores,but by clinical judgments made by clinicians based on their clinical experience and disease features.The clinically effective response and overall survival (OS) were analyzed in the three groups.Results According to CGA scores,patients were grouped into "fit" [21 cases (56.8％)],"unfit" [7 (18.9％)] and "frail" [9 (24.3％)].37 cases received 213 courses of treatment at average 5.76 courses per case.The overall response (complete / partial remission) rates were [85.7％(18/21) vs.28.6％ (2/7) vs.44.4％ (4/9),x2=9.69,P=0.008] and median survival times were (44 months vs.10 months vs.9 months;x2 =7.03,P=0.03) among "fit","unfit" and "frail" groups with statistically significant differences.Total effective rate (achieving all clinical targets) in "fit" group of 21 cases were 100 ％ (12/12)with receiving standard dose therapy,and 66.7％ of(6/9)with low dose therapy(P=0.06).Overall response rate(total/partial remission) [85.7％(18/21) vs.28.6％(2/7) vs.44.4％(4/9),x2=9.69,P=0.008] and median survival (44 months vs.10 months vs.9 months;x2 =7.03,P=0.03) among"fit","unfit" and "frail" groups.In "fit" group,the two-year overall survival was higher in patients receiving standard dose treatment than receivingpalliativetreatment,with statistical significance [83.3 ％ (10/12) vs.33.3 ％ (3/9),P =0.032],without significant hematologic toxicity observed between the subgroups.Conclusions Comprehensive geriatric assessment can identify if elderly patients diffuse large B cell lymphoma can acquire a satisfactory curative effect from a standard dose treatment ofimmunochemotherapy.

Objective To investigate the correlation between hemoglobin level and health status of the elderly living in communities in Beijing.Methods A random cluster sampling method was used to select residents living in communities of Beijing city,and a cross-sectional study was carried out by questionnaires,scene testing and blood sample collection.WHO-formulated criteria were applied for diagnosing anemia.The health indicators in questionnaires included visual impairment,physical disability,decreased health,self-care,fatigue,anorexia,independent walking distance,exercise frequency,intelligence status and computing power.Results Complete information was obtained in a total of 1 948 elderly people,including 790 cases of male and 1 158 cases of female,with an average age of(73.9±6.1)years and a median age of 74 years(65-100).The mean level of hemoglobin in the 1 948 people was(135.65 ± 14.48) g/L,with (142.56 ± 15.56) g/L in male and (130.95 ± 11.53) g/L in female.Hemoglobin level was significantly lower in female than in men (t =54.739,P＜ 0.01).Hemoglobin level was decreased with aging,and negatively associated with appetite,physical strength,walk assistance,visual acuity and physical ability(r=-0.055,-0.067,-0.071,-0.114,-0.095;P =0.022,0.005,0.004,0.000,0.000),while positively associated with health status,activities in daily life,athletic ability,exercise frequency and intelligence (r =0.073,0.126,0.122,0.066,0.124;P =0.002,0.000,0.000,0.006,0.000).Conclusions The hemoglobin level of the elderly decreases with aging and is associated with health status and quality of life in the elderly,which should be taken care seriously.

Objective To explore the prognostic factors and treatment regimens of diffuse large B-cell lymphoma (DLBCL) in elderly patients.Methods The data of characteristics,treatment regimens and outcomes were collected in elderly patients aged 70 years and over,with newly diagnosed DLBCL from our hospital in the last decade.Then the factors influencing therapeutic response,overall survival and progression-free survival were analyzed.Results A total of 49 patients aged 70 to 92 years (median 76 years) were enrolled in this study.Among them,18 patients were aged 80 years and older;the other 31 patients were aged less than 80 years.The treatment regimen was based on Rituximab (R),Cyclophosphamide (C),Adriamycin (H),Vincristine (O),Prednisone (P) (R-CHOP).For the patients with worse performance status,or≥80 years,50％ 75％ of standard dose of CHOP plus 100％ of Rituximab (R) dose were as starting dose.The complete remission rate was 46.9％ and partial remission rate was 18.4％,the overall effective rate was 65.3％.The 30 cases were in deaths.The median overall survival period was 25 months.The overall survival prolongation was associated with Ann Arbor staging Ⅰ-Ⅱ,serum lactate dehydrogenase less than 245 U/L,age less than 80 years,IPI≤2 and completing 6 cycles of R-CHOP.And multivariate regression analysis showed that serum lactate dehydrogenase less than 245 U/L and 6 cycles of R-CHOP were the independent prognostic factors.Among patients who completed 6 cycles of R-CHOP treatment regimen,there were 7 patients aged over 80 years (38.9％) and 17 patients aged less than 80 years (54.8％).There were no significant differences between different age groups in overall survival (32 months vs.34 months) and in progression free survival (32 months vs.32 months).Conclusions Reduced treatment intensity so as to complete the 6 cycles of R-CHOP treatment regimen could improve the outcomes of older patients who could not tolerance the dose of standard treatment regimen.And 6 cycles of R-CHOP treatment regimen are the independent prognostic factor for survival.

Delayed engraftment and cord graft failure (CGF) are serious complications after unrelated cord blood (UCB) hematopoietic stem cell transplantation (HSCT), particularly when using low-cell-dose UCB units. The haplo-cord HSCT approach allows the use of a lower dose single UCB unit by co-infusion of a CD34(+) selected haploidentical graft, which provides early transient,engraftment while awaiting durable UCB engraftment. We describe the frequency, complications, and risk factors of CGF after reduced-intensity conditioning haplocord HSCT. Among 107 patients who underwent haplo-cord HSCT, 94 were assessable for CGF, defined as <5% cord blood chimerism at day 60 in the myeloid and CD3 compartments, irrespective of neutrophil and platelet counts. CGF occurred in 14 of 94 assessable patients (15%). Median survival after CGF was 12.7 months with haploidentical or mixed haploidentical autologous hematopoiesis persisting in the 7 surviving. Median progression-free survival after CGF was 7.7 months and was not statistically different from those without CGF (10.47 months; P = .18). In univariate analyses, no UCB factors were associated with CGF, including cell dose, cell viability, recipient major ABO mismatch against the UCB unit, or degree of HLA match. We also found no association of CGF with recipient cytomegalovirus serostatus, haploidentical donor age, or day 30 haploidentical chimerism. However, higher haploidentical total nucleated and CD34+ cell doses and day 30 UCB chimerism < 5% in either the myeloid or CD3 compartments were associated with greater risk of CGF. We conclude that assessing chimerism at day 30 may foretell impending CGF, and avoidance of high haploidentical cell doses may reduce risk of CGF after haplo-cord HSCT. However, long-term survival is possible after CGF because of predominant haploidentical or mixed chimerism and hematopoietic function. (C) 2016 American Society for Blood and Marrow Transplantation.

Objective To explore the clinical characteristics and prognostic value of monosomal karyotype（MK）patients in adult acute myeloid leukemia（AML）.Methods We retrospectively studied 45 patients of MK+in newly-diagnosed adult AML in our center from Oct 2000 to Dec2012.Clinical characteristics,cytogenetic data and prognostic features were analyzed in the cohort of MK+patients.Results MK was found in 45 patients（19.0%）

Objective To investigate the methylation status in the promoter region of Dickkopf-3 (Dkk3) gene in patients with myelodysplastic syndromes (MDS),and to initially explore the relationship between the methylation of this gene and survival time.Methods Methylation-specific PCR (MSP) was applied to measure the promoter methylation of Dkk3 gene in 43 bone marrow or peripheral blood samples of MDS patients.As controls,70 normal peripheral blood samples from general outpatients were examined.Results In 43 patients with MDS,7 patients (16.3 ％) showed Dkk3 gene methylation.And 5 of them were semi-methylation status,2 of them were exhaustive methylation status.In 70 controls,1 showed Dkk3 gene semi-methylation.The frequency of methylation in MDS patients was significantly higher than that of controls (x2 =8.93,P =0.005).In the Dkk3 methylation group,2/7 were from bone marrow and 5/7 were from peripheral blood.Meanwhile,2 patients were RA,1 patient was RCMD,4 patients were RAEB.There was no significant difference between the different sample source (bone marrow or peripheral blood) for the results of the methylation status (x2 =0.051,P =0.821).Either between the different sex,age,type,chromosome and WPSS score (P ＞ 0.05).The progress of disease didn't influence the methylation frequency (P ＞ 0.05).The smvival analysis showed no relationship between the methylation of this gene and smvival time.Conclusions In this MDS group,there is high level of methyl-modification in Dkk3 gene.The methylation of Dkk3 might be one of the molecular mechanisms that contribute to the progress of patients with MDS.The peripheral blood sample maybe a better substitute in detective of Dkk3 with MDS.

The outcome of disease relapse after allogeneic stem cell transplantation (allo-SCT) remains very poor. Second SCT has achieved long term survival in select pts. We retrospectively analyzed the outcomes of 65 pts who underwent 2rd SCT for disease relapse at University of Chicago between September 2002 and September 2013. All except 4 pts received T cell depleted (TCD) SCT as 1st SCT mainly with fludarabine (flu)/clofarabine-melphalan (mel) -alemtuzumab; flu-busulfan-alemtuzumab for MRD or MUD, and flu-mel-ATG for haplo-cord SCT. The majority of pts had AML (n=46) and high risk MDS (n=5). The median age at 2nd allo-SCT was 47ys (11-73). 33 pts, 21 pts and 11 pts received MRD, MUD and Haplo-Cord SCT respectively for 2nd SCT. 13 pts (20%) achieved CR before 2nd SCT. 71% pts received TCD conditioning for 2nd SCT. 98% (n=64) and 72% (n=47) pts achieved neutrophil and platelet engraftment at a median time of 11 and 18 days, respectively, following the 2nd SCT. With a median fellow up of 23 (5.5-140) months for survivors after 2nd SCT, the estimated 1 year PFS was 29.2% and 1 year OS was 33.8%. The day 100 treatment related mortality (TRM) rate was 28%, and the cumulative incidence of aGVHD and cGVHD were 23% and 8%, respectively. Not surprisingly, the majority of pts died from disease relapse (22/47, 47%), followed by infection (11/47, 23%) and GVHD (6/47, 13%). In the univariate analysis, pts with remission duration after 1st SCT >=12 months or CR status before 2nd SCT had significantly better PFS (P=0.001 and 0.009) and OS (P=0.001 and 0.013). The differences of 1 year PFS and OS stratified by these two variables were very striking. The 1 years PFS for pts in CR was 62% compared to 21% for pts not in CR; and 1 year PFS for pts with remission duration >=12 months after 1st SCT was 57% comparing around 14% for pts <12 months. On the other hand, donor type (MRD vs. MUD vs. haplo-cord), conditioning (RIC vs. myeloablative) had no influence on PFS and OS. While age (<=60 vs. >60) had no influence on 1 year PFS (P=0.083), younger pts had better 3 year PFS (P=0.026); Alemtuzumab use (n=37 vs. n=16 without alemtuzumab) in the 2nd SCT conditioning for related donors significantly worsened 3 years PFS (44% vs. 8%; P=0.027) but not 1 year PFS, and it had no effect on OS. A scoring system using age (<=60 vs. >60), disease status before 2nd SCT (CR vs. non-CR), and remission duration after 1st SCT (<6, 6-12 and >=12 months) was generated to attempt to classify the pts into different risk categories. The groups of 0 (n=5), 1-2 (n=34), 3-4 (n=26) could separate the 1 year PFS (80% vs. 32.3% vs. 15.4%) and OS (100% vs. 35.3 vs. 19.2%) nicely. Although the numbers are small, pts with a score of 0 (<=60 yrs, in CR, and >=12 months remission duration after 1st SCT) had excellent outcomes with 1 year PFS of 80%, and 1 year OS of 100%. In conclusion, 2nd allo-SCT is a viable option for disease relapse after TCD allo-SCT with acceptable GVHD and good engraftment for those entering transplant in remission and/or remission duration >=12 months after 1st SCT. Abstract 2509. TablePatient Outcomes after 2nd SCTAll pts CR not in CR Remission duration >=12 months Remission duration 6-12 monthsRemission duration <6 months score of 0 score of 1-2 score of >=3 Pts number (n)651352231527534261 yearPFS29.2%61.5%21.2%56.5%13.3%14.8%80%32.3%15.4%3 year PFS21.5%53.8%13.5%43.5%6.7%11.1%80%20.6%11.5%1 year OS33.8%69.2%25%60.9%20%18.5%100%35.3%19.2%3 year OS23.1%46.2%17.3%43.5%6.7%14.8%80%20.6%15.4%

Abstract PURPOSE: Delayed engraftment and cord graft failure (CGF) are serious and often fatal complications after unrelated cord blood (UCB) hematopoietic cell transplantation (HCT), precluding use of low cell dose UCB. The haplo-cord HCT approach allows the use of a lower dose single UCB unit by co-infusion of a CD34+ selected haploidentical graft. Although haplo-cord HCT aims to achieve durable UCB hematopoiesis, the haplo graft provides early temporary engraftment. We describe the frequency, complications and risk factors of CGF after haplo-cord HCT after reduced-intensity conditioning (RIC). PATIENTS AND METHODS: Adult hematologic malignancy patients from the University of Chicago or the Weil Cornell medical centers who underwent haplo-cord HCT between 2007 and 2013 were included. Conditioning consisted of fludarabine, melphalan, and rATG (and TBI 400 cGY if high CNS relapse risk), followed by infusion of a CD34+ selected G-CSF mobilized haploidentical graft and the best HLA matched single UCB unit of at least 0.5 or 1.0 x 10^7 total nucleated cells (TNC)/kg, depending on the protocol. CGF was defined as <5% cord blood chimerism by Day 60 in the unfractionated or CD3 compartments irrespective of neutrophil or platelet counts. Death before Day 60 excluded patients from the primary outcome of CGF at Day 60. Univariate analyses were performed to identify potential risk factors for CGF: Fisher's Exact test for dichotomous and logistic regression for continuous predictor variables. RESULTS: 107 patients were evaluated. Chimerism data were not available on two, and 11 (10.3%) died before Day 60, leaving 94 evaluable patients for CGF. Diseases indications were: AML (51%), ALL, (12%), MDS (11%), and other (25%). Median age of patients was 50 years (range 18-73) and many had active disease at HCT (47%). The mean UCB collected dose was 2.1x10^7 TNC/kg (range 0.77-8.3x10^7 TNC/kg) and HLA cord match was 4/6 in 24% and 5/6 or 6/6 in 73%. Few patients had UCB doses below 1x10^7 TNC/kg (N=5). CGF occurred in 14 of 94 (15%) evaluable patients. Of these, 7 died within 1 year of transplant date. The causes of deaths were: poor graft function (N=2), infection (N=2), relapse or progressive disease (N=2) and unknown (N=1). The other 7 remain alive (range: 7 months to 5.5 years) with haplo-derived or mixed haplo-recipient hematopoiesis. Four are in remission and three have relapsed disease. Median survival for the CGF group was 12.7 months. In univariate analyses, no UCB factor, including cell doses, major ABO mismatch, donor specific antibodies, CMV status, and HLA-match, was associated with CGF. (Table) However, higher haploidentical TNC and CD34+ doses were associated with greater risk of CGF. CONCLUSION: Approximately 15% of patients experienced CGF after haplo-cord HCT. Most have died or relapsed, but some have had relatively long-term survival due to sustained haploidentical hematopoiesis. Avoidance of high haploidentical cell doses may reduce risk of CGF. We were unable to identify other determinants of CGF. In ongoing studies, we have limited the haplo graft to <5 x10^6 CD34+/kg and are testing the use of lower UCB cell doses when large units can not be identified. Additional follow-up is needed to determine if sustained or greater cord chimerism improves long-term outcomes compared to haplo chimerism after RIC haplo-cord SCT. Table: Graft Composition and Association with Cord Graft Failure (CGF) at Day 60 No CGF CGF p-value Evaluable Patients, N=94 N=80 N=14 Cord Blood Unit: Mean/Value (+/-SD or %) Mean/Value (+/-SD or %) Cord Bank Reported (post-processing): TNC/kg x 10^7 2.1 (+/-1.1) 1.9 (+/-0.63) 0.61 TNC/kg<1.5x10^7, N=92 27 (35%) 3 (21%) 0.54 CD34+/kg x 10^5 0.88 (+/- 0.71) 0.98 (+/- 0.80) 0.65 Viability (%) 95.6 (+/-4.7) 96.9 (+/-4.6) 0.38 Viability <85%, N=82 1 (1.5%) 1 (7%) 0.31 Post Wash: TNC/kg x 10^7 1.5 (+/-0.72) 1.4 (+/-0.43) 0.72 TNC/Kg<1.5x10^7, N=92 47 (60%) 8 (57%) 1.0 Viability (%) 91.8 (+/-5.3) 91.9 (+/-5.3) 0.96 Viability <85%, N=92 6 (8%) 2 (14%) 0.3 Haploidentical Graft: TNC/kg x 10^6 3.8 (+/-1.6) 5.0 (+/-2.2) 0.03 CD34+/kg x 10^6 3.8 (+/-1.6) 4.8 (+/-2.2) 0.055 CD34+/kg <3.0 x 10^6, N=92 30 (38%) 2 (14%) 0.13 CD3/kg x 10^4 1.2 (+/-3) 0.53 (+/-0.6) 0.29 Disclosures Larson: Novartis: Consultancy, Research Funding. Stock:Sigma-Tau: Membership on an entity's Board of Directors or advisory committees, Research Funding. Artz:Miltenyi: Research Funding.

李斯特菌是一类较小的短棒状革兰阳性厌氧菌，广泛存在于自然界中，健康人粪便中的携带率为0.6％～16％，70％的人可短期带菌。该菌可污染奶制品、肉类、水产品和新鲜蔬菜，并通过人的摄入引发感染甚至爆发，称为李斯特菌病（ listeriosis／listeria disease ，LD）。李斯特菌分为7类，其中对人致病的为单核细胞增生性李斯特菌（亦称产单核细胞／单核细胞增多性李斯特菌）。近30年来北美和西欧等发达国家对LD报道较多，其临床病死率高达20％～30％［1］，部分发生在移植病房，与患者免疫缺陷状态有关，并已有抗生素耐药的报道。目前，国际上对单增李斯特菌非常重视，将其列为20世纪90年代食品四大致病菌（致病性大肠杆菌、肉毒梭菌、亲水气单胞菌和单核细胞增生性李斯特菌）之一，并建立了全球监测网。我国对李斯特菌的研究起步较晚，主要集中在食品检测方面，临床报道较少，多为散发个案［2-3］。我院血液肿瘤病房2009年2月余内检出3例单增李斯特菌败血症，其中1例尚合并脑膜炎，且集中于2个房间内，是为爆发，3个月后同一男病房内再次检出1例败血症，考虑为环境接触所致。为提高对LD的认识，我们回顾分析了这4例患者的临床资料，并对相关文献进行复习。

<正>急性髓系白血病(acute myeloid leukemia,AML)是最常见的成人急性白血病,尽管50%～80%的AML患者会获得血液学缓解(complete remission,CR),但其中多数最终会复发。近10年来学者们在该病发病机制、预后分层及微小残留病监测等方面均

Objective To evaluate the application of 18fluoro-deoxyglucose positron emission tomography (FDG-PET) to the staging and predicting outcome in patients with lymphoma.Methods 41 patients with newly diagnosed lymphoma (median age 57 years) were explored with FDG-PET prior to and after 4 cycles of chemotherapy.With a median follow-up of 30 months (range 10-68 months),the value of FDG-PET to staging and predicting clinical outcome was assessed. Results The maximum standardized uptake value (SUVmax) of nodal and extranodal lesions was 9.7±6.9 and 8.4±6.8 respectively prior to treatment.There were significant difference (P＜0.05) in aggressive non-Hodgkin's lymphoma and indolent non-Hodgkin's lymphoma,no significant difference (P＞0.05) in non-Hodgkin's lymphoma and Hodgkin's lymphoma (HL), B-cell neoplasms and T-cell neoplasms,germinal center B-cell-like DLBCL and activated B-cell-like DLBCL. In 41 patients, 22 patients (54 ％)were detected extranodal focus by FDG-PET before chemotherapy. FDG-PET imaging upstaged in 6(15％)of initial lymphoma patients.There were 15 patients (37 ％) in stage Ⅰ and Ⅱ and 26 patients(63 ％)in stage Ⅲ and Ⅳ by FDC-PET scan.1 patient (7 ％) in stage Ⅰ and Ⅱ,6 patient (23 ％) in stage Ⅲ and Ⅳ died of disease progression during follow-up.After 4 cycles of chemotherapy,the FDG-PET was negative in 41％(17/41),positive in 59 ％(24/41) respectively.1 patient(6 ％)died of disease relapse among 17 patients who were FDG-PET negative, 6 patient (25 ％)died of disease progression among 24 patients who were FDG-PET positive during follow-up. Conclusion FDG-PET scanning plays an important role in the pretreatment staging and prediction of the prognosis after 4 cycles of chemotherapy in patients with lymphoma.Thus it may offer the potential for change in treatment paradigms.

Objective To investigate the methylation status in the promoter region of secreted frizzled related protein 5(SFRP5) gene in acute myeloid leukemia(AML).Methods MSP method was applied to examine the promoter methylation of SFRP5 gene in 99 bone marrow or peripheral blood samples of AML patients.As controls,70 normal peripheral blood samples from volunteers of general outpatients were examined.Results All 113 samples were involved in the results analysis.In 99 patients of AML,10 samples(10.1%) showed SFRP5 gene methylation.In 70 controls,1 sample(1.4%) showed SFRP5 gene methylation.And all of them were semi-methylation status.The frequency of SFRP5 gene methylation in AML patients was significantly higher than that in controls(P<0.05).There was no significant difference between the different age groups and gender for the results of the methylation status in AML(P>0.05).The methylation status of SFRP5 gene was associated with the clinical classification of AML(P<0.05).Conclusion The methylation status of SFRP5 gene was correlated with AML.The methylation of SFRP5 gene may be one of the molecular mechanisms of AML.