Aim: To explore the clinical characteristics of acute myeloid leukemia(AML) with DNMT3A R882 mutation.Methods: The clinical data of 168 AML patients undergoing detection of DNMT3A R882 loci mutation were collected retrospectively.Gene sequencing after PCR was used to detect the DNMT3A R882 loci mutation,as well as CEBPA, NPM1 and FLT3-ITD mutations.The expressions of 18 antigens on leukemic blasts were assessed by 4 color flow cytometry.The prognosis was analyzed using K-M curve.Results: DNMT3A R882 mutation was detected in 24 patients(14.29%).Compared with the patients without DNMT3A R882 mutation, the patients with DNMT3A R882 mutation tended to be more older, with higher white blood and platelet counts, with higher expressions of CD33 and CD11b and poorer expression of CD34, and more companied with NPM1 and FLT3-ITD mutations.The patients with DNMT3A R882 mutation had a shorter median event-free survival time than those without(62 d vs 277 d), but there was no significant difference in complete response rate after the first course of treatment.Conclusion: The AML patients with DNMT3A R882 mutation have obvious clinical features and a poor prognosis.

Objective To investigate the influence of hepatitis B virus (HBV) infection on liver function in acute lymphoblastic leukemia (ALL) patients after chemotherapy.Methods Among the 247 ALL patients, the biomarkers of HBV were detected by ELISA, the copies of HBV-DNA were determined by real-time polymerase chain reaction (PCR), and the liver function indexes were determined by biochemical analysis.Results Fourteen out of 247 ALL patients (5.67%) were HBsAg-positive, and the liver function in 9 cases(64.29%) out of 14 ALL patients infected with hepatitis B virus were abnormal within one course of chemotherapy (28 days).The increase of ALT was(198.75±290.88) U/L, and the increase of ALP was (44.00±117.38) U/L.The liver function in 87 out of 233 ALL patients (37.34%) without hepatitis B virus infection were abnormal within one course of chemotherapy(28 days).The increase of ALT was (46.49±100.02) U/L, and the increase of ALP was (22.68±87.14) U/L.The HBV-DNA copies were increased more than 2log10UI/ml in one patient infected with hepatitis B virus (HBV).Conclusions The liver function of HBsAg+ALL patients were more common to be injured than HBsAg-ALL patients within one course of chemotherapy, and the liver function is more serious injured in HBsAg+ALL patients.Chemotherapy may reactivate hepatitis B virus in ALL patients.

左旋门冬酰胺酶(L-asparaginase,L-Asp)是治疗急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)的经典药物,其作用原理是耗竭患者体内L天冬酰胺从而阻断肿瘤细胞的蛋白质合成,抑制肿瘤细胞代谢[1-2].但因其外源性蛋白质的特性,常引发机体过敏、骨髓抑制、凝血功能异常、生化指标异常、胃肠道不适等药物相关不良反应,影响药物的继续应用[3-6].

急性白血病经化疗后引起骨髓抑制，由于血小板重度减少，常常以出血为主要并发症，并发动脉血栓形成者鲜有报道。我们收治1例急性淋巴细胞白血病患者，在化疗过程中发生脑梗死，经积极抢救后成功恢复。

目的 探讨以骨髓坏死为首发表现的急性白血病(acute leukemia,AL)患者的临床特征与预后.方法 回顾性分析15例以骨髓坏死为首发表现的AL患者的临床资料.结果 15例患者主要临床表现为发热、骨痛、贫血、血小板减少等,骨髓检查均可见典型的骨髓造血组织及基质组织坏死;起病至确诊骨髓坏死的中位时间为12 d,发现骨髓坏死至确诊AL的中位时间为43 d,其中2例诊断骨髓坏死至AL确诊时间2个月以上;治疗后,10例达持续完全缓解,未再出现骨髓坏死;15例随访1～14个月,1 a总生存率为64.6％.结论 对骨髓坏死患者应高度警惕AL,AL诊治是否及时、有效是影响患者预后的重要因素.

Aim: To detect the quantity of T cell subsets expressing C-C chemokine receptor type 6(CCR6) or CCR7 in the grafts and analyze their correlation with the occurrence of acute graft-versus-host disease(GVHD).Methods: Fifty-two pairs of healthy donor and their recipients with family donor allogenetic hematopoietic stem cell transplantation(allo-HSCT) were included in this study.All the recipients were injected recombinant human granulocyte colony-stimulating factor(rhG-CSF) for mobilizing. The quantity of T cells expressing CCR6 or CCR7 in rhG-CSF mobilized bone marrow grafts(G-BM) and peripheral blood grafts (G-PB) were detected and compared.The correlation of the quantity of each subset cells with the cumulative incidence of gradesⅡto Ⅳ acute GVHD in recipients was analyzed.Results: After rhG-CSF mobilization, G-PB had obviously more T cells than G-BM(P <0.05).CD4+CCR6+, CD8+CCR6+, CD4+CCR7+ and CD8+CCR7+ T cells in G-PB were approximately 15 -25 times more than those in G-BM.And the absolute counts of the above T cell subsets were not risk factors for acute GVHD(P >0.05).Conclusion: The quantity of T cell subsets may not be related to the occurrence of acute GVHD.

Objective To explore the influence of soybean flavone to the activity of hexokinase in SMMC7721 cell lines of human liver cancer and the level of CD133 protein in cancer stem cell.Methods Culturing SMMC7721 cells of human liver cancer,and treating them with soybean flavone.The numbers of living cells were detected by MTT method.The activity of hexokinase in SMMC7721 cell lines of human liver cancer and the level of CD133 protein in cancer stem cell were respectively measured by Kit of hexokinase and by Western blot method.Results Soybean flavone had an inhibition to SMMC7721 cell lines of human liver cancer.At the same time,soybean flavone also lowered the activity of hexokinase in SMMC7721 cell lines of human liver cancer and the level of CD133 protein in cancer stem cell.Conclusion Soybean flavone can inhibit the proliferation of SMMC7721 cell lines of human liver cancer and the activity of hexokinase in the cells,and lower the level of CD133 protein in cancer stem cells.