Background & Objective: Aplastic anaemia (AA), myelodysplastic syndromes (MDS), and immune thrombocytopenia (ITP) are common haematological disorders. Their early-stage or atypical presentations often manifest solely as isolated thrombocytopenia, posing significant challenges for initial differential diagnosis. This study aimed to develop an accurate and interpretable machine learning-based approach to assist in differentiating these three conditions.Methods: A diagnostic model was developed by integrating routinely available peripheral blood lymphocyte subset parameters and demographic data. To ensure transparency and clinical trust, the SHapley Additive exPlanations (SHAP) method was employed to explain the model's predictions and visualize its decision-making process.Results: The developed machine learning model achieved effective differentiation among AA, MDS, and ITP. The SHAP analysis provided clear, clinically plausible explanations for the model's decisions, aligning with known immunopathological mechanisms. Furthermore, the research outcomes were translated into an interactive diagnostic aid software, facilitating practical clinical application.Conclusion: This study establishes a complete research cycle from methodological innovation and model validation to interpretability analysis and tool development. By leveraging explainable machine learning, it provides a novel, accurate, interpretable, and clinically usable strategy for the intelligent auxiliary differentiation of AA, MDS, and ITP, offering a potential avenue to reduce reliance on invasive diagnostic procedures.

Haploidentical hematopoietic stem cell transplantation (Haplo-HSCT) serves as an alternative treatment for severe aplastic anemia (SAA) patients who undergo transplantation lacking a suitable HLA-identical sibling donor. However, its development has been hindered by graft failure and severe graft-versus-host disease (GVHD). We conducted a prospective study to evaluate the efficacy of the FABT (Fludarabine-ATG-Busulfan-Thiotepa) regimen for aplastic anemia (AA) in Haplo-HSCT. This regimen introduced thiotepa into the protocol for the first time, combined with low-dose ATG (2 mg/kg/day) and the post-transplant cyclophosphamide (PTCy) regimen to prevent GVHD. From April 2022 to June 2024, 36 eligible AA patients were recruited for the study, with a median follow-up duration of 21 (2 to 30) months. None of the 36 patients experienced primary graft failure, and the engraftment rates for neutrophil (NE) and PLT were 100% and 91.7%, respectively. The median time to platelet (PLT) and NE engraftment was 13 (8 to 27) and 14 (8 to 21) days, respectively. The 2-year cumulative incidence of CMV reactivation was only 11.1%, and no CMV disease was observed. The incidence of aGVHD and grade II to IV aGVHD was 27.8% and 8.3%, respectively. Additionally, the incidence of cGVHD was 11.1%, all of which were mild cutaneous rejection. The 2-year OS and 2-year GVHD relapse-free survival (GRFS) were both 91.7%. Surprisingly, patients under 40 years old have a 2-year OS of 100%. Compared to the traditional Baltimore regimen, this approach reduced the incidence of aGVHD, cGVHD, and CMV reactivation, while improving OS and GRFS, which may offer a new option for Haplo-HSCT in AA patients.

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the only curative treatment for aplastic anemia (AA). For patients lacking a matched sibling donor (MSD) or matched unrelated donor (MUD), haploidentical HSCT (haplo-HSCT) has become an alternative with comparable efficacy. However, donor-specific anti-HLA antibodies (DSAs) remain the principal barrier. In this study, we compared transplant outcomes in DSA-positive recipients after desensitization with plasma exchange (PE) combined with anti-B-cell therapy. Between January 2019 and December 2023, we enrolled 30 DSA-positive AA patients who underwent haplo-HSCT at our center. All received a desensitization regimen combining PE with anti-B-cell agents. By propensity-score matching (1:2 ratio, caliper 0.02), we additionally enrolled 60 DSA-negative controls matched for key clinical variables to compare therapeutic efficacy and long-term outcomes between the two groups. This study enrolled 90 AA patients who underwent haplo-HSCT: 30 were DSA-positive and 60 were DSA-negative. Baseline characteristics were comparable between the two groups. After desensitization with PE combined with anti-B-cell agents, the DSA-positive group achieved outcomes equivalent to those of the DSA-negative group. Specifically, EBV reactivation (46.7

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the primary curative treatment for Aplastic anemia (AA), especially for severe aplastic anemia (SAA). The Baltimore regimen and Fludarabine plus Cyclophosphamide/Antithymocyte globulin (FCA) regimen are commonly used non-ex vivo T-cell depletion regimens, but challenges like graft failure and delayed engraftment persist. We modified the traditional Baltimore regimen into FABT to enhance engraftment and reduce graft-versus-host disease (GVHD) incidence. We retrospectively analyzed 62 AA patients who underwent allo-HSCT with either the FABT (n = 28) or FCA (n = 34) regimen between April 2022 and December 2023. This study compared the efficacy and safety of two regimens for treating AA. No significant differences were observed between the FABT and FCA groups in engraftment, cGVHD, and survival. However, the FABT group showed a significantly lower incidence of aGVHD (10.7

OBJECTIVES:Matched sibling donors (MSDs) were preferred for haematopoietic stem cell transplantation (HSCT) in severe aplastic anaemia (AA) when lacking MSDs, unrelated donors (URDs) and haploidentical (Haplo) donor would be considered, but limited by increased graft-versus-host disease (GVHD) and recommended only in experienced centres. This study aimed to compare the efficacy and safety of umbilical cord blood transfusion added URD-HSCT (URD-cord-HSCT) to MSD-HSCT and Haplo-HSCT in AA patients. METHODS:Patients who underwent URD-cord-HSCT (n = 26), MSD-HSCT (n = 26) or Haplo-HSCT (n = 52) were retrospectively enrolled at 1:1:2 ratio between January 2014 and December 2023. Clinical characteristics, treatment responses and survival outcomes were evaluated. RESULTS:No significant differences in neutrophil and platelet engraftment. The three-year overall survival (OS) rates were 88.0% ± 6.5%, 92.1% ± 5.3% and 74.8% ± 6.0% (p = .10), and the event-free survival (EFS) rates were 77.3% ± 9.4%, 92.1% ± 5.3% and 69.0% ± 6.4% (p = .13) in URD-cord-HSCT, MSD-HSCT and Haplo-HSCT groups, respectively. Fully HLA-matched URD-cord-HSCT (MUD-cord-HSCT) demonstrated superior OS (100%) and EFS (85.7% ± 13.2%) compared to Haplo-HSCT (p = .046, p = .049) and single HLA allele-mismatched URD-cord-HSCT (MMUD-cord-HSCT, p = .04, p = .04). The incidence of mixed chimerism (MC) was significantly lower in the URD-cord-HSCT group compared to the MSD-HSCT group (0% vs. 24.48%, p = .01). MUD-cord-HSCT experiences lower grade II-IV acute GVHD comparing with MMUD-cord-HSCT (p = .02) and Haplo-HSCT (p = .048). CONCLUSIONS:MUD-cord-HSCT provides an optimal solution for MC and GVHD, with outcome comparable or even better than those of MSD-HSCT.KEY MESSAGESThe best choice of alternative donor for aplastic anaemia remains a clinical challenge, unrelated donors (URDs) or haploidentical (Haplo) donor?Umbilical cord blood (UCB) transfusion added matched unrelated donor (MUD) haematopoietic stem cell transplantation (HSCT) exert nearly 0% cumulative incidence of mixed chimerism and grade II-IV acute/chronic GVHD;UCB added MUD-HSCT (MUD-cord-HSCT), which exert 100% three-year overall survival (OS) and 85.7% event free survival (EFS), rather than matched sibling donor (MSD)-HSCT, exert superiority in OS and EFS than mismatched URD (MMUD)-HSCT and haploidentical-HSCT.MUD-cord-HSCT provides an optimal solution for MC and GVHD, with outcome comparable or even better than those of MSD-HSCT.

ObjectiveTo investigate the impact of Lineal and Collateral donors on the prognosis of recipients in haplo-HSCT for AA among relatives.MethodsA retrospective analysis of data from AA patients who underwent haplo-HSCT at our center from January 2018 to January 2025. Patients were grouped based on the kinship between donors and recipients (Lineal vs. Collateral), and comparisons were made across key indicators, including engraftment, viral reactivation, GVHD, OS, and GRFS.ResultsThe study included 190 AA patients who received haplo-HSCT. Based on donor type, they were divided into the Lineal group (134 patients) and the Collateral group (56 patients). The results showed that the 3-year OS (92.8% vs. 75.3%, P = 0.004) and 3-year GRFS (78.5% vs. 64.9%, P = 0.062) were relatively higher in the Collateral group compared to the Lineal group. Further analysis revealed that younger donors (age ≤ 40 years) and younger patients (age ≤ 40 years) contributed significantly to improved outcomes in the Collateral group, with both 3-year OS and GRFS being significantly better than in the Lineal group.ConclusionThe study suggests that Collateral donors represent a viable and effective option, particularly in the absence of Lineal donors. The age of the donor and recipient is a critical factor influencing transplantation outcomes, with younger donors and patients potentially enhancing therapeutic efficacy.

INTRODUCTION:Breast Cancer (BC) is one of the most prevalent malignant tumors in women. The incidence of estrogen receptor-positive (ER+) breast cancer is as high as 70%, and it is increasing. Amorphophalli rhizoma (APR) has the potential to be used in breast cancer. AIMS:The objectives of the present study were to explore the impact of different APR extracts on the proliferation, migration, and invasion of ER+BC and to investigate their possible mechanism at the molecular level. METHODS:Various extracts of APR were prepared in different solvents, such as petroleum ether, ethyl acetate, n-butanol, and water. ER+ T47D breast cancer cell lines were acquired and utilized to assess the effect of APR extracts on ER+ BC. Cell viability was assessed using the cell counting kit8 (CCk8) method, while anti-invasive and migratory effects were examined by transwell and wound healing assay. All the extracts were initially screened, and the ethyl acetate fraction (APR-EA) was found to be the most effective. Ultra High-Performance Liquid Chromatography (UHPLC) of APR-EAE extract revealed the presence of various phytochemicals, such as succinic acid, 2-methoxy resorcinol, penicillic acid, morphine, salicylic acid, α-linolenic acid, and linolenic acid. Flow cytometry, western blot, and immunohistochemistry were used to explore molecular mechanisms. RESULTS:APR-EA demonstrated anti-proliferative, anti-migratory, and anti-invasive effects on the ER+ T47D cell line. Thus, APR-EAE might inhibit the expression of P-PI3K/PI3K and PAkt/ Akt proteins, which subsequently represses the expression of ERα. This inhibition affects the downstream expression of the proteins CDK4 and Bcl-2, which are linked to cell growth and apoptosis. CONCLUSION:Additionally, APR-EA might increase the expression of P21 and Bax proteins, which are associated with cell cycle arrest and apoptosis. Overall, these effects contribute to the anti-ER+ breast cancer properties of APR-EA.

Background Bile acids (BAs), once often considered tumor-promoting, are now recognized for their complex roles in breast cancer. Their effects are influenced by the gut microbiota and may vary across cancer subtypes and exposure contexts. Objectives This systematic review aims to summarize the current evidence on the clinical relevance, molecular mechanisms, and therapeutic applications of BAs in breast cancer. Methods We performed a systematic literature search of four international (PubMed, Web of Science, Embase, Cochrane Library) and two Chinese (China National Knowledge Infrastructure, Wanfang) databases, along with clinical trial registries, from inception to February 8, 2026. Study selection adhered to PRISMA guidelines, and we focused on original studies investigating the role of BAs in breast cancer pathogenesis, therapy, or drug development. Results Evidence mapping across clinical profiling, receptor biology, direct BA interventions, and translational applications indicates that human BA measurements do not converge on a stable systemic “BA signature”. Our qualitative heterogeneity assessment indicates that the apparent contradictions are largely driven by differences in exposure compartment, comparator definition, analytical platform and BA speciation/coverage, and variable control of clinical confounders and subtype/stage or treatment background. When these sources of heterogeneity are considered, more coherent patterns emerge: receptor studies support context-dependent outputs across tumor subtypes and microenvironmental states, while direct BA interventions report both anti-tumor and pro-tumor phenotypes that depend strongly on BA species/form and concentration, with many in vitro experiments using pharmacologic or supraphysiologic exposures. In translational research, BAs have been explored as active derivatives targeting defined pathways and as enabling components in drug delivery systems. In the latter setting, BAs mainly serve as biocompatible scaffolds to improve delivery of established chemotherapeutics in preclinical models. Conclusion The BA system represents a promising but challenging therapeutic target for breast cancer. However, its clinical translation requires carefully designed strategies to overcome major hurdles. The inherent lack of tissue specificity poses risks for systemic toxicity. Future efforts must focus on developing tumor-targeted approaches, understanding the gut-microbiome-liver-breast axis, and performing subtype-stratified (especially estrogen receptor status-stratified) research to establish robust patient stratification biomarkers and safely realize the potential of BA-based therapies.

Background and AimThis study, alongside clinical specimens, investigated the inhibitory effect of konjac petroleum ether extract on the migration, invasion, and epithelial-mesenchymal transition (EMT) of triple-negative breast cancer (TNBC) cells via the OLFML2A gene, with the objective of elucidating the potential efficacy and mechanism of action of konjac petroleum ether extract.Experimental ProcedureHistopathological examination of OLFML2A was performed on TNBC tumor specimens (n = 8). mRNA and protein levels of OLFML2A and EMT markers (E-cadherin, N-cadherin, vimentin, elastin) were analyzed via qPCR and Western blot. OLFML2A-knockout MDA-MB-231 cells were treated with gradient concentrations of konjac petroleum ether extract. Cell migration (wound healing assay), adhesion, and invasion (Transwell assay) were evaluated, and EMT marker expression was further examined using qPCR, Western blot, and immunofluorescence (n = 3).ResultsIn TNBC patients with high OLFML2A expression, reduced E-cadherin and increased N-cadherin, vimentin, and elastin were observed, while low OLFML2A cases exhibited no significant EMT changes. In MDA-MB-231 cells, OLFML2A knockdown significantly reduced migration and invasion while upregulating E-cadherin and downregulating mesenchymal markers, phenocopying the effects of konjac petroleum ether extract treatment. Konjac extract inhibited cell proliferation with an IC50 of 220 μg/mL at 48 h. The extract inhibited migration and invasion in a dose-dependent manner, with significant effects observed at 200 μg/mL, though potential contributions from cytotoxicity at 300 μg/mL cannot be entirely excluded.ConclusionThe research findings suggest that konjac petroleum ether extract inhibits TNBC cells migration and invasion by modulating OLFML2A to inhibit EMT. These findings highlight its potential as a candidate for further investigation for preventing TNBC metastasis, though the contribution of cytotoxicity at higher concentrations warrants further investigation.

BackgroundTriple-negative breast cancer (TNBC) is recognized as one of the most aggressive and prognostically adverse subtypes of breast cancer. The lack of effective therapeutic targets presents substantial challenges, including impediments in early diagnosis, restricted treatment options, and a pronounced tendency for drug resistance. Despite recent advancements in the diagnosis and management of TNBC, the overall survival rate for patients remains suboptimal. Consequently, gaining a more profound understanding of its biological mechanisms and developing novel therapeutic strategies are imperative scientific priorities in this domain.MethodsOLFML2A was identified as a potential therapeutic target in TNBC through analyses of the Human Protein Atlas and Kaplan-Meier databases. Its functional role was investigated using OLFML2A knockout (KO) and overexpression (OE) models in MDA-MB-231 cells. Effects on proliferation, cell cycle, and apoptosis were assessed by EdU assays, flow cytometry, RT-qPCR, western blotting, and immunofluorescence. Tumor growth and body weight were monitored in vivo, and tumor tissues were examined by H&E staining, RT-qPCR, and western blotting. Proteomic profiling integrated with literature mining identified EZH2 as a key downstream candidate. Their interaction was validated by co-immunoprecipitation, and EZH2 expression and localization under different OLFML2A conditions were analyzed. Rescue experiments using the EZH2 inhibitor GSK126 assessed the functional output of the OLFML2A-EZH2 axis via CCK-8, EdU assays.ResultsOLFML2A acts as an oncogenic gene in triple-negative breast cancer. The silencing of OLFML2A markedly reduced the proliferation of MDA-MB-231 cells, induced cell cycle arrest at the G1 phase, and inhibited tumor growth. In contrast, overexpression of OLFML2A reversed these effects. Comprehensive proteomic and molecular biology analyses further indicated that OLFML2A may play a role in cell cycle regulation through the modulation of EZH2.ConclusionsOur findings suggest that OLFML2A may facilitate cell cycle progression by regulating EZH2, implicating it as a potential therapeutic target for triple-negative breast cancer.

Haploidentical hematopoietic stem cell transplantation (HID-HSCT) is a critical therapeutic option for severe aplastic anemia (SAA) patients lacking HLA-matched donors. However, its application has been limited by graft failure and graft-versus-host disease (GVHD). The co-infusion of mesenchymal stem cells (MSCs) or umbilical cord blood cells (UCBs) has emerged as a crucial area to enhance transplant outcomes. This single-center retrospective study evaluates the clinical outcomes of HID-HSCT combined with UCBs and MSCs co-infusion in 108 patients. Patients underwent HID-HSCT between January 2018 and January 2025, with 40 receiving co-infusion of UCBs and MSCs. Transplantation outcomes, including neutrophil and platelet engraftment, GVHD incidence, viral reactivation rates, and long-term survival, were compared. Results showed no significant differences in engraftment or GVHD rates between groups. However, the Co-infusion group exhibited a declining trend in grade II-IV aGVHD and significantly improved 5-year overall survival (OS) and graft-versus-host disease-free, relapse-free survival (GRFS). These findings suggest that UCBs and MSCs co-infusion may enhance long-term survival and quality of life in patients undergoing HID-HSCT, offering a promising strategy for clinical haploidentical transplantation. However, the lack of prospective design and standardized protocols limits the conclusions. Future studies should focus on optimizing co-infusion strategies to improve clinical outcomes in haploidentical transplantation.

To compare the efficacy and safety of the FABT regimen versus the conventional FCA regimen in patients under 40 years old with aplastic anemia (AA) underwent haploidentical hematopoietic stem cell transplantation (haplo-HSCT). This single-center retrospective study included 75 AA patients under 40 years old who underwent haplo-HSCT between January 2021 and January 2025. Patients were categorized into the Fludarabine-ATG-Busulfan-Thiotepa (FABT) group (n = 25) and the Fludarabine-Cyclophosphamide-ATG (FCA) group (n = 50) based on their conditioning regimen. The FABT regimen featured reduced-dose busulfan, fludarabine, cyclophosphamide, thiotepa, and low-dose anti-thymocyte globulin (ATG), followed by post-transplant cyclophosphamide (PTCy), calcineurin inhibitors, and mycophenolate mofetil for Graft-versus-host disease (GVHD) prophylaxis. Primary endpoints were GVHD-free/relapse-free survival (GRFS) and overall survival (OS). Secondary endpoints included engraftment rates, incidence of acute and chronic GVHD, viral reactivation and treatment response. The 3-year GRFS was significantly higher in the FABT group compared to the FCA group (96

Abstract Allogeneic hematopoietic stem-cell transplantation (allo-HSCT) is the only curative therapy for severe aplastic anemia (SAA), yet the prognostic impact of the diagnostic-to-transplant interval on first allo-HSCT remains contentious. To determine whether a waiting time > 1 year from diagnosis to first allo-HSCT compromises engraftment, virus reactivation, GVHD, OS and GRFS in SAA. A single-center retrospective cohort study of 255 consecutive SAA patients receiving their first allo-HSCT between 2018 and 2025. After 1:2 propensity-score matching (caliiper 0.2), patients were stratified into Early (≤ 1 year, n = 170) and Delayed (> 1 year, n = 85) groups. Baseline characteristics were well balanced. The Early group exhibited a significantly lower CMV reactivation rate (24.1% vs. 40.0%, P = 0.008). No significant differences were observed in grade II-IV aGVHD, cGVHD, 5-year OS or GRFS. Subgroup analyses demonstrated superior survival among patients aged ≤ 40 years, those with MSD donors and received FABT-based regimen. Early allo-HSCT improves transplant outcomes in SAA by reducing CMV reactivation, especially in very severe cases. Eligible patients should be referred promptly and transplanted without delay.

Metaplastic breast cancer (MpBC) is a rare and aggressive subtype of breast cancer with a poor prognosis. Recent studies have shown that anti-PD-1 therapy is effective in treating this type of cancer. We described a rare case of MpBC during lactation that worsened quickly post-surgery. Despite receiving chemotherapy and immunotherapy, the patient passed away from respiratory failure caused by tumor compression. Subsequent genetic testing revealed the presence of the resistance gene CDKN2A. Lactating women should promptly get checked for abnormal breast symptoms to catch breast cancer early. More research is needed to determine how effective anti-PD-1 therapy is for MpBC. PD-L1 is not usually tested in clinical settings, but it's important to check for CDKN2A when looking at resistance targets for PD-L1.

BackgroundCytomegalovirus (CMV) infection remains a critical cause of mortality after allogeneic hematopoietic stem cell transplantation, despite significant advancements in CMV prevention and treatment with the introduction and widespread use of letermovir. However, in China, due to limitations in the availability and cost of medications, some patients still face challenges in accessing letermovir. For this subset of the population, exploring the risk factors for CMV infection remains significant in predicting its occurrence.MethodsTherefore, a retrospective analysis was conducted on 88 haploidentical hematopoietic stem cell transplant recipients over 4 years.ResultsOur study results indicate that chronic graft-versus-host disease (cGVHD) is an independent risk factor for CMV infection following haploidentical hematopoietic stem cell transplantation (Haplo-HSCT). Survival analysis reveals lower survival rates in the refractory CMV infection (RCI) group compared to the non-RCI group, with patients having lower viral loads demonstrating higher rates of seroconversion and improved survival under the same treatment regimen.ConclusionStrengthening the monitoring of CMV-DNA in post-transplant patients, actively promoting hematopoietic recovery, preventing the occurrence of CMV infection, and controlling the development of CMV infection can lead to better survival outcomes for patients with aplastic anemia undergoing Haplo-HSCT.

Background:Breast cancer is the second most common cancer worldwide. Chemotherapy often causes dyslipidemia and obesity in breast cancer patients. Monitoring lipid profiles and body mass index (BMI) is crucial to evaluate chemotherapy's metabolic side effects, identify interventions to mitigate them, and understand health risks linked to weight changes during treatment. Shenling Baizhu Powder (SLBZP), a traditional Chinese medicine (TCM), treats spleen-stomach ailments by boosting spleen function, enhancing qi, and reducing dampness. SLBZP has potential benefits in managing chemotherapy-induced dyslipidemia and improving overall metabolic health in cancer patients. This study retrospectively examined the effects of SLBZP on blood lipid levels and BMI in breast cancer patients undergoing adjuvant chemotherapy. Methods:This study reviewed the medical records of patients who were diagnosed with breast cancer at the Breast Surgery Department of Zhejiang Provincial Hospital of Traditional Chinese Medicine from January 2022 to December 2023. Based on the inclusion criteria, a total of 180 eligible patients were included and divided into an observational group (which received SLBZP) and a control group (which did not receive SLBZP) during chemotherapy. Patients' clinical data, including age at diagnosis, menopausal status, tumor location, smoking and drinking habits, tumor molecular type, tumor node metastasis (TNM) stage, chemotherapy drugs, targeted therapy, lipid levels, and BMI before and after chemotherapy, were collected. Statistical analyses were conducted using SPSS 25.0. Results:After chemotherapy, the control group showed significant increases in total cholesterol (TC) (P=0.03), triglyceride (TG) (P=0.001), low-density lipoprotein cholesterol (LDL-C) (P=0.02), and apolipoprotein B (ApoB) (P=0.01) levels. In the observational group, the TC, TG, and LDL-C levels remained stable (P>0.05), but the high-density lipoprotein cholesterol (HDL-C) (P=0.001) and apolipoprotein A1 (ApoA1) (P<0.001) levels significantly decreased, and BMI (P=0.02) significantly increased. The subgroup analysis revealed that the taxane followed by anthracycline subgroup showed significant increases in BMI (P=0.007) and significant decreases in the HDL-C (P=0.007) and ApoA1 (P<0.001) levels, while the taxane subgroup showed a significant decrease in the HDL-C level post-chemotherapy (P=0.003). In the control group, the TG (P=0.002) and LDL-C (P=0.02) levels were significantly elevated in the taxane followed by anthracycline subgroup post-chemotherapy. No significant changes were observed in BMI or the other lipid indexes in the remaining chemotherapy drug regime subgroups (P>0.05). Conclusions:Chemotherapy increased the TC, TG, LDL-C, and ApoB levels in breast cancer patients, but SLBZP mitigated dyslipidemia. The patients who received SLBZP also showed increased BMI post-chemotherapy, which was likely due to reduced gastrointestinal side effects. Taxane-based chemotherapy drugs had greater effects on blood lipids and BMI, while anthracycline-based drugs did not significantly affect blood lipids and BMI.

BackgroundHaploidentical hematopoietic stem cell transplantation (HID-HSCT) serves as an alternative treatment for severe aplastic anemia (SAA) patients lacking a suitable HLA-identical sibling donor. Compared to HLA-matched HSCT, HID-HSCT has higher rates of graft failure (GF) and graft-versus-host disease (GVHD). Recent studies suggest promising clinical outcomes when Mesenchymal stem cells (MSCs) are combined with HID-HSCT for SAA treatment.MethodsThis study retrospectively analyzed clinical data from 190 SAA patients who underwent HID-HSCT with or without MSCs co-infusion. Patients were divided into two groups: the HID group (100 patients receiving only HID-HSCT) and the HID+MSC group (90 patients receiving HID-HSCT combined with MSC co-infusion).ResultsThe analysis revealed that the HID+MSC group had a significantly higher 5-year overall survival rate compared to the HID group (86.6% vs. 75.0%, p = 0.036) and a significantly improved GRFS rate (76.6% vs. 64.0%, p = 0.048). While MSCs co-infusion did not significantly reduce the incidence of aGVHD or cGVHD, a downward trend was observed, particularly for cGVHD (16.6% vs. 26.0%). Both groups showed high cumulative engraftment rates for NE and PLT within 28 days post-transplant, with no significant differences. Regarding viral reactivation, EBV and CMV reactivation rates were similar between the two groups, though four patients in the HID group developed EBV-associated PTLD.ConclusionThis study demonstrates that combining HID-HSCT with MSCs co-infusion is a safe and effective therapeutic strategy that significantly improves survival rates and quality of life in SAA patients.

Objectives To evaluate the prognostic value of the Molecular International Prognostic Scoring System (IPSS-M) compared to the Revised International Prognostic Scoring System (IPSS-R) in patients with myelodysplastic neoplasms (MDS) in the Jiangnan region of China.Methods A retrospective multicenter study analyzed data from 113 MDS patients across 10 centers in Jiangnan from 2019 to 2022. Patients were stratified using both IPSS-R and IPSS-M for prognostic comparison.Results Reclassification revealed that 63.7% of patients were shifted from their initial IPSS-R stratifications to IPSS-M categories. Survival analysis indicated significant differences in overall survival (OS) across risk groups, with shorter survival observed in higher-risk and older cohorts. Factors influencing OS included age (≥60), bone marrow blast percentage, IPSS-R chromosomal classification, and gene mutations. Receiver operating characteristic (ROC) analysis yielded areas under the curve (AUC) of 0.629 for IPSS-R and 0.705 for IPSS-M.Discussion This study reinforces the utility of IPSS-M for MDS prognosis, particularly in older patients, while acknowledging limitations such as a modest case number and variability in genetic testing methods.Conclusion IPSS-M demonstrates enhanced prognostic capability over IPSS-R for MDS patients, necessitating further validation in larger cohorts.

Background: Hyperlipidemia (HLP) is highly prevalent in China, and this prevalence is increasing annually, particularly among younger populations. The extract of Amorphophallus konjac (APK), a traditional food and medicinal plant in China, has shown potential hypoglycemic and antitumor effects. However, the therapeutic efficacy and underlying mechanisms of its water extract (APKW) in HLP remain unclear.Method: An HLP model was established in mice by feeding them a high-fat diet. The mice were then treated with APKW (12 g/kg and 6 g/kg) for 14 weeks. Efficacy was assessed through measurements of body weight, serum and hepatic lipid profiles, and histopathological examination. Gut microbiota composition was analyzed using 16S rRNA sequencing, while bile acid (BA) levels in serum and feces were determined through UPLC-MS. Finally, the expression of genes and proteins involved in the FXR/FGF15 and GATA4/ASBT signaling pathways in the ileum or liver was analyzed through qPCR and western blotting.Results: APKW treatment significantly reduced serum levels of total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol. Hepatic levels of TC and TG were also lowered, accompanied by improved liver histopathology. Moreover, 16S rRNA sequencing unveiled that APKW increased the abundance of g_Lactobacillus and g_Ileibacterium while reducing the abundance of g_Monoglobuss. Bile acid profiling showed reduced serum levels of cholic acid (CA), chenodeoxycholic acid (CDCA), lithocholic acid, and ursodeoxycholic acid, as well as declined fecal levels of CA, CDCA, taurocholic acid, taurochenodeoxycholic acid, glycoursodeoxycholic acid, and deoxycholic acid. The western blotting, PCR, and immunofluorescence results revealed that APKW inhibited the intestinal FXR-FGF15 signaling pathway and ASBT expression while upregulating hepatic expression of CYP7A1, FGFR4, and FXR. This suggests enhanced hepatic BA synthesis, reduced ileal BA reabsorption, decreased hepatic cholesterol levels, and suppressed lipogenesis.Conclusion: This study is the first to demonstrate that APKW ameliorates HLP by remodeling gut microbiota, regulating BA metabolism, and modulating the FXR/FGF15 and GATA4/ASBT signaling pathways.

Background:Breast cancer has emerged as the predominant malignant neoplasm globally, with potential implications for patient prognosis based on blood lipid profiles. This study aims to systematically review and meta-analyze the influence of lipid levels on the prognostic outcomes of individuals with breast cancer. Methods:A thorough search was performed across multiple academic databases, including Embase, Cochrane, PubMed, Web of Science, CNKI, and Wanfang Database, up to March 2024. A meta-analysis was conducted to assess the impact of total cholesterol (TC), triglycerides (TG), low-density lipoprotein-cholesterol (LDL-C), and high-density lipoprotein-cholesterol (HDL-C) on the prognosis of Breast Cancer. The primary outcome measure was hazard ratios (HR) for overall survival (OS) and/or disease-free survival (DFS). Results:Eight studies meeting inclusion criteria from a total of 13,292 were included in the meta-analysis. The systematic review and meta-analysis demonstrate an association between lower HDL-C levels and poorer survival outcomes. However, the statistical analysis did not find significant associations between HDL-C, TG, and LDL-C levels and the prognosis of breast cancer patients. Conclusion:While our analysis reveals a link between reduced HDL-C levels and unfavorable survival outcomes, the statistical evidence does not support significant connections between HDL-C, TG, and LDL-C concentrations and the prognostic landscape for breast cancer patients. Further research is warranted to explore these relationships more comprehensively. Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO, identifier CRD42021297118.