Search

"ObjectiveTo investigate the impact of low-dose pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) on grade Ⅲ/Ⅳ myelosuppression following chemotherapy. Methods A total of 80 patients with malignant tumors admitted to the First Affiliated Hospital of Anhui University of Science and Technology from April 2022 to September 2023 were selected as research subjects. The patients were randomly divided into the control group (n=40) and the observation group (n=40). The observation group and the control group received subcutaneous injections of 3.0 mg and 6.0 mg PEG-rhG-CSF, respectively, within 24 to 48 hours after chemotherapy. The incidence and duration of grade Ⅲ/Ⅳ neutropenia, febrile neutropenia (FN), adverse reactions, as well as changes in quality of life ［European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30)］ scores before and after treatment were observed in both groups after medication. Results After medication, there was no significant difference in the incidence of grade Ⅲ/Ⅳ neutropenia or FN between the two groups (P＞0.05). The observation group exhibited higher levels for neutrophils compared to control group ［(1.77±0.70)×109/L vs (1.50±0.41)×109/L, t=2.071, P=0.042］. Grade Ⅲ/Ⅳ neutropenia occurred in 1 case in the control group, which lasted for 1 day, while 3 cases occurred in the observation group, which lasted for 2-4 days. Compared with the control group, the occurrence rate of adverse reactions was lower in the observation group (72.50% vs 90.00%, χ2=4.021, P=0.045), and EORTC QLQ-C30 were higher for patients in the observation group (P＜0.05). Conclusion Low-dose PEG-rhG-CSF demonstrates similar efficacy rates as standard doses for prophylactic managing gradeⅢ/Ⅳ myelosuppression following chemotherapy, but it exhibits a lower incidence rate of adverse reactions and improves quality-of-life of patients."

OBJECTIVE: To compare the efficacy and safety of pegylated recombinant human granulocyte colonystimulating factor (PEG-rhG-CSF) and rhG-CSF in the prevention of chemotherapy-related neutropenia. METHODS: PubMed, Embase, the Cochrane Library, CNKI, Wanfang Data and VIP databases were retrieved to collect randomized controlled trials of PEG-rhG-CSF and rhG-CSF in the prevention of chemotherapy-related neutropenia (intervention measures were PEG-rhG-CSF, control measures were rhG-CSF) until May 2023. Literature screening, information extraction and bias risk assessment were carried out by two researchers independently. Meta-analysis was performed by RevMan 5. 3 statistical software. RESULTS: A total of 41 studies were included. Meta-analysis showed that compared with rhG-CSF, PEG-rhG-CSF could significantly reduce the incidence of neutropenia with fever (FN) after chemotherapy (OR = 0. 64,95% CI = 0. 51-0. 81,P = 0. 000 2) and the incidence of grade III/IV neutropenia (OR = 0. 49,95%CI = 0. 35-0. 69,P<0. 000 1), the differences were statistically significant; however, differences in the duration of grade III/IV neutropenia (MD = - 0. 33, 95% CI = - 0. 68-0. 01, P = 0. 06), the recovery time of neutropenia (MD= -0. 11,95%CI = -0. 32-0. 09,P = 0. 27), the incidence of bone pain or skeletal muscle pain (OR = 0. 81,95%CI = 0. 66-1. 00,P = 0. 05) were not statistically significant. CONCLUSIONS: The efficacy of PEG-rhG-CSF in the prevention of FN and grade III/IV neutropenia after chemotherapy is significantly better than that of rhG-CSF, and PEG-rhG-CSF is feasible as primary prevention. [ABSTRACT FROM AUTHOR]

Objective: To discuss the clinical characteristics, diagnosis, and treatment of ShwachmanDiamond syndrome (SDS), and to enhance the clinicians' awareness of the disease. Methods: The clinical materials of one patient diagnosed with SDS, primarily presented with neutropenia and elevated transaminase levels, confirmed by genetic testing were retrospectively analyzed. The clinical manifestations, genetic features, diagnosis, and treatment methods of SDS were analyzed complemented with the relevant literatures. Results: This patient was a male child, aged 27 months. His initial clinical presentations were neutropenia and elevated transaminase levels. The patient had previously experienced diarrhea when the patient was 3 months old, which improved after treated with oral pancreatic enzyme dispersion. Over the past six months, the patient had recurrent respiratory infections. Upon admission, the examination results showed there was dental enamel hypoplasia, and the imaging results showed the abnormal bone density in the long bones of the limbs. The genetic sequencing results showed a homozygous mutation in the Shwachman-Bodian-Diamond syndrome (SBDS) gene (c. 258+2T>C). During hospitalization, the patient received the hepatoprotective care and granulocyte augmentation supportive treatment, leading to an improvement in his condition, and the patient was discharged. During a one-year follow-up, the patient's condition was stable. Conclusion: The typical presentation of the SDS patient includes diarrhea, liver function abnormalities, hematologic abnormalities, and skeletal anomalies, particularly neutropenia; there may also be developmental delays and involvement of the heart, liver, central nervous system, skeleton, and immune system. The genetic testing of suspected children is crucial, and it can aid in the early diagnosis and treatment of SDS patients. [ABSTRACT FROM AUTHOR]

Objective To explore the risk factors for neutropenia (grade 2 or higher) during postoperative adjuvant radiotherapy for breast cancer. Methods A total of 93 patients with breast cancer treated by postoperative adjuvant radiotherapy in Shaanxi Provincial People’s Hospital from January 2018 to December 2020 were assigned to a control group (no neutropenia or grade 1 neutropenia, n=62) and an observation group (grade 2 or higher neutropenia, n=31). The clinical data of the two groups were analyzed by univariate and logistic regression analyses to determine the independent risk factors for grade 2 or higher neutropenia, and the predictive efficacy of risk factors was established by the receiver operating characteristic (ROC) curve. Results The univariate analysis results showed that there were significant differences between the two groups in molecular types of breast cancer, white blood cell count and absolute neutrophil count at the first visit, proportion of patients with grade 4 myelosuppression during chemotherapy, white blood cell count, absolute neutrophil count, hemoglobin before radiotherapy, planning target volume (PTV), mean radiotherapy dose to the sternum (Dmean), and ratio of volume exposed to radiation greater than 20 Gy to total vo-lume and ratio of volume exposed to radiation greater than 30 Gy to total volume in the sternum (χ2=4.511,9.900,t=2.286-9.900,P733.28 mL and sternum Dmean >2 213.5 cGy are independent risk factors for grade 2 or higher neutropenia during postoperative adjuvant radiotherapy for breast cancer, and the combination of the two indices can improve the predictive efficacy for the occurrence of neutropenia.

OBJECTIVE: To explore the occurrence and characteristics of neutropenia induced by clopidogrel, so as to provide reference for clinical safe drug use. METHODS: PubMed, Embase, CNKI, Wanfang Data and VIP database were retrieved to collect the literature of neutropenia induced by clopidogrel from the establishment of the database to Mar. 2023, and statistical analysis was conducted on patients’ information, drug use, neutrophil count, complications, clinical interventions and outcomes. RESULTS: A total of 29 cases from 27 articles were identified and included in the analysis. There were 18 males (62. 1%) and 11 females (37. 9%). The age of the patients was from 33 to 90 years old, with an average of (68. 1±13. 7) years. And 23 cases (79. 3%) were ≥60 years old. Totally 19 cases (65. 5%) developed neutropenia within 30 d after treatment, 17 cases (58. 6%) suffered severe neutropenia, and 15 cases ( 51. 7%) accompanied with fever. After drug withdrawal, administration of granulocyte colonystimulating factor and broad-spectrum antibiotics, 26 cases (89. 7%) had good prognosis and 3 cases (10. 3%) died. CONCLUSIONS: Neutropenia induced by clopidogrel mostly occurs within 30 d after administration, and is characterized by severe granulocytosis. In the early stage of clinical application of clopidogrel, blood routine monitoring should be strengthened, and once neutropenia is found, the drug should be stopped in time, granulocyte colonystimulating factor and anti-infection therapy can be given if necessary. [ABSTRACT FROM AUTHOR]

Objective Evaluate the value of PEG-rhG-CSF in preventing neutropenia in ovarian epithelial cancer patients after AC regimen chemotherapy. Method A retrospective analysis was conducted on 136 patients with ovarian epithelial cancer who received AC regimen chemotherapy at the Department of Obstetrics and Gynecology, Southern Medical University Nanfang Hospital. The observation group consisted of 87 patients who received prophylactic use of PEG-rhG-CSF after chemotherapy, while the control group consisted of 49 patients who did not use PEG-rhG-CSF. The independent sample T-test, analysis of variance, and Chi-square test were used to compare the differences in neutropenia, neutropenic fever, QOL-C30, liver and kidney function between the two groups. Results The incidence of grade 3-4 neutropenia and febrile neutropenia in the observation group was lower than that in the control group （5.5% vs. 15.9%, 0.8% vs. 2.8%）, and the differences were statistically significant （P < 0.001）; There was no statistically significant difference in the incidence of liver and kidney function damage between the observation group and the control group （3.4% vs. 4.0%, P > 0.05）. No serious adverse reactions occurred between the two groups （P > 0.05）. Quality of life assessment analysis found that the functional area score and overall health status score of the observation group were higher than those of the control group （67.89 ± 13.95 vs. 50.22 ± 15.17, 68.05 ± 17.09 vs. 48.74 ± 20.18）, the difference was statistically significant （P < 0.05）. Conclusion PEG-rhG-CSF has high efficacy and safety in preventing neutropenia after AC regimen chemotherapy for ovarian epithelial cancer, with mild adverse reactions, and can improve the quality of life of ovarian epithelial cancer patients undergoing AC regimen chemotherapy. [ABSTRACT FROM AUTHOR]

Objective To explore the efficacy and safety of polyethylene glycol recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in preventing chemotherapy-induced neutropenia in locally advanced non small cell lung cancer (NSCLC) patients at nutritional risk. Methods A total of 337 locally advanced NSCLC patients at nutritional risk were selected. They were randomly divided into three groups: 112 cases in the non-prophylactic drug group (control group), 112 cases in the prophylactic use of rhG-CSF treatment group (rhG-CSF group), and 113 cases in the prophylactic use of PEG-rhG-CSF treatment group (PEG-rhG-CSF group). The incidence and duration of neutropenia after chemotherapy and the ratio of CD4+/CD8+T cells in peripheral blood were observed. Results The incidences of neutropenia in the control group, rhG-CSF group, and PEG-rhG-CSF group were 67.97%, 41.57%, and 38.98% (P < 0.05), respectively. The incidences of grade Ⅲ-Ⅳ neutropenia in the three groups were 22.39%, 14.25%, and 11.14% (P < 0.05); moreover, the incidence of febrile neutropenia in the three groups was 3.55%, 1.84%, and 1.21% (P < 0.05); in addition, the ratios of CD4+/CD8+T cells in peripheral blood were 1.27±0.44, 1.41±0.52, and 1.49±0.42 (P < 0.05). The duration of grade Ⅲ-Ⅳ neutropenia and the time required for the neutrophil value to reach 2.0×109/L from the lowest value in the PEG-rhG-CSF group were lower than those in the control and rhG-CSF groups (P < 0.05). Conclusion The PEG-rhG-CSF preventive treatment used in the course of chemoradiotherapy in locally advanced NSCLC patients at nutritional risk can reduce the incidence of neutropenia and improve immunologic function. PEG-rhG-CSF preventive treatment is worthy of clinical recommendation.

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BackgroundAutoimmune neutropenia (AIN) is a common chronic neutropenia in children, but it in children has been rarely reported.ObjectiveTo analyse clinical characteristics, diagnosis, treatment, and follow-up of children with AIN, aiming at providing support for clinicians.MethodsA retrospective design was used. Participants were 22 children with AIN recruited from Department of Pediatrics, Peking University First Hospital from 2012 to 2020. Their clinical and follow-up data were collected and analyzed.ResultsOf the 22 cases, 15 were male and 7 were female; with 6 months as the median initial diagnosis age. Among the results of 82 routine blood tests performed for all cases, severe, moderate and mild neutropenia accounted for 62.2% (51/82) , 30.5% (25/82) , and 7.3% (6/82) , respectively. Two cases (9.1%) were diagnosed with moderate neutropenia and other 20 (90.1%) were diagnosed with severe neutropenia by the lowest absolute neutrophil count (ANC) . Six children (27.3%) also had other clinical manifestations besides neutropenia. Twelve cases (54.5%) underwent the examination of bone marrow cell morphologies. Six cases (27.3%) underwent gene test. 95.5% of the cases had infections, and 54.5% of them had severe infections, but no life-threatening infections. The leading pathogen of infections was virus. The upper respiratory tract was the most common infected area. By the end of September 2021, the ANC of 11 cases returned to the normal level, and the median of AIN of them was 25 (range: 7-42) months.ConclusionMost AIN children had moderate to severe neutropenia, and they were prone to infections mostly caused by virus, and the most usually were upper respiratory tract infections, but rarely life-threatening. The median duration of AIN, a self-limited disease, for our reported cases was 25 months.

Copyright of China Tropical Medicine is the property of China Tropical Medicine Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To explore the efficacy and safety of polyethylene glycol recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in preventing chemotherapy-induced neutropenia in locally advanced non small cell lung cancer (NSCLC) patients at nutritional risk. Methods A total of 337 locally advanced NSCLC patients at nutritional risk were selected. They were randomly divided into three groups: 112 cases in the non-prophylactic drug group (control group), 112 cases in the prophylactic use of rhG-CSF treatment group (rhG-CSF group), and 113 cases in the prophylactic use of PEG-rhG-CSF treatment group (PEG-rhG-CSF group). The incidence and duration of neutropenia after chemotherapy and the ratio of CD4+/CD8+T cells in peripheral blood were observed. Results The incidences of neutropenia in the control group, rhG-CSF group, and PEG-rhG-CSF group were 67.97%, 41.57%, and 38.98% (P<0.05), respectively. The incidences of grade Ⅲ-Ⅳ neutropenia in the three groups were 22.39%, 14.25%, and 11.14% (P<0.05); moreover, the incidence of febrile neutropenia in the three groups was 3.55%, 1.84%, and 1.21% (P<0.05); in addition, the ratios of CD4+/CD8+T cells in peripheral blood were 1.27±0.44, 1.41±0.52, and 1.49±0.42 (P<0.05). The duration of grade Ⅲ-Ⅳ neutropenia and the time required for the neutrophil value to reach 2.0×109/L from the lowest value in the PEG-rhG-CSF group were lower than those in the control and rhG-CSF groups (P<0.05). Conclusion The PEG-rhG-CSF preventive treatment used in the course of chemoradiotherapy in locally advanced NSCLC patients at nutritional risk can reduce the incidence of neutropenia and improve immunologic function. PEG-rhG-CSF preventive treatment is worthy of clinical recommendation. [ABSTRACT FROM AUTHOR]

Objective To study the efficacy and safety of YiQiShengSui (YQSS) formula, a traditional Chinese medicine (TCM) herbal prescription, on neutropenia of epithelial ovarian cancer patients caused by chemotherapy. Methods This was a prospective randomized controlled non-blind clinical study. A total of 60 patients from Obstetrics and Gynecology Hospital of Fudan University were randomly assigned to the research group and the control group with a ratio of 1∶1. During the intermission of chemotherapy, the patients in the control group took recombinant human granulocyte stimulating factor injection (rhG-CSF), the dose of rhG-CSF was 150 μg i.h. q6-24h, according to grade of neutropenia. The patients in the research group took YQSS formula for 21 days along with rhG-CSF in the same period.The changes of white blood cells (WBC), absolute neutrophil count (ANC) of the next chemotherapy, as well as the changes on the 7th day and 10th day after this chemotherapy, duration of chemotherapy interval, treatment time of leukocyte elevation and dosage of rhG-CSF, as well as the hepatic and renal function, and quality of life scale (FACT-G) were observed for safety and efficacy evaluation. Results The levels of WBC and ANC in the research group were higher than those in the control group on the 7th and 10th days after chemotherapy, with statistical significance (P<0.05). Further Logistic multivariate regression analysis showed that YQSS was a significant correlation factor for alleviating moderate and severe ANC reduction on the 10th day after this chemotherapy.The interval time of chemotherapy in the research group and the control group was (22.31±1.25) days and (25.79±4.76) days, respectively, and the treatment time of leukocyte elevation was (4.67±2.11) days and (6.86±2.35) days, respectively, the differences were statistically significant (P<0.05) .The dosage of rhG-CSF in the research group and the control group was (552.6±173.6) μg and (852.6±200.3) μg, respectively, and the difference was statistically significant (P<0.05). There was no statistically significant difference in hepatic and renal function damage between the two groups.The total FACT scale score, physiological status score, affective status score and functional status score of the research group were higher than those of the control group (all P<0.05). Conclusion YQSS combined with rhG-CSF can effectively increase white blood cells, shorten the time between chemotherapy and the treatment time of leukocyte elevation, reduce the dosage of rhG-CSF, and improve the quality of life of patients.The use of YQSS did not increase the damage of hepatic and renal function of patients. [ABSTRACT FROM AUTHOR]

Background and objective Malignant pleural mesothelioma (MPM) is a highly aggressive disease arising from pleural mesothelial cells. Advanced pleural mesothelioma has a poor prognosis, with a median survival of no more than 15 months. First line standard chemotherapy regimen recommended is Pemetrexed based chemotherapy regimen, with or without bevacizumab. There is no consensus on whether patients who have received first-line standard chemotherapy can benefit from pemetrexed maintenance chemotherapy. The study aimed to investigate the efficacy and safety of pemetrexed maintenance therapy (PMT) after treatment with a pemetrexed and platinum regimen for patients with MPM. Methods A total of 40 MPM patients were collected from Cancer Hospital Chinese Academy of Medical Sciences from January 2013 to January 2018, eligible patients were unresectable MPM, without disease progression following 4 to 6 cycles of pemetrexed and platinum, including pemetrexed maintenance therapy group (22 cases) and observation group (18 cases). The last follow-up was conducted in January 2020. The primary endpoint were progression free survival (PFS), and the secondary end points were overall survival (OS), the efficacy, adverse reactions of PMT. Results The median PFS in the PMT arm was longer than that in the observation arm (8.5 mon vs 3 mon, P=0.008), but there was no significant difference in median OS (26.4 mon vs 15.7 mon, P=0.177). Objective response rate (ORR) of two group were 22.7% and 0%, respectively. The grade 3-4 toxicity in PMT group included grade 4 neutropenia in 1 patient (4.5%), grade 3 neutropenia in 1 patient (4.5%), grade 4 anemia in 1 patient (4.5%) and grade 3 nausea and anorexia in 1 patient (4.5%). Conclusions Pemetrexed maintenance therapy following initial pemetrexed and platinum chemotherapy improve PFS in patients with MPM, and is well tolerated. [ABSTRACT FROM AUTHOR]

Topiramate is often used clinically in the treatment of epilepsy and migraine. Decrease of neutrophils is a very rare adverse reaction of topiramate，and no case has been reported in Chinese people or in healthy people.We presented a case with decrease of neutrophils induced by topiramate in a Chinese adult male healthy participant in a bioequivalence（BE）study of topiramate tablets，and discussed the treatment and outcome of this case. It reminds us to pay attention to hematopoietic system related adverse reactions associated with topiramate and the safety of healthy volunteers in clinical trials. It may provide some referential ideas for the early diagnosis and treatment of idiosyncratic drug-induced neutropenia（IDIN）. [ABSTRACT FROM AUTHOR]

To investigate the incidence rate and clinical features of children with hepatitis and granulocytopenia and the risk factors for progression to aplastic anemia ( AA). Methods A retrospective analysis was performed for 2944 children, aged,,;;; lS years, who were hospitalized due to abnormal liver function in Pediatric Liver Diseases Treatment and Research Center, The Fifth Medical Center of Chinese PLA General Hospital, from July 2014 to March 2020. Clinical features and prognosis were analyzed for children with new - onset neutropenia ( < 1. 5 x 109 / L) during the course of the disease, and the risk factors for progression to AA were analyzed. The t - test was used for comparison of normally distributed continuous data between groups, and the Wilcoxon rank - sum test was used for comparison of non - normally distributed continuous data between groups; the chi - square test was used for comparison of categorical data between groups. A logistic regression analysis was used to investigate risk factors. Results Among the 2944 children admitted due to abnormal liver function, 3S had hepatitis with granulocytopenia, with an incidence rate of 1. 3% . Among these 3S children, 6S . 4 % (26/ 3S) had drug - induced liver injury, 2. 6% ( l/3S) had autoimmune hepatitis, and 2S . 9% ( 1 l/3S ) had unexplained liver injury; as for blood abnormalities, 21. 1 % (S/3S) had granulocytopenia, 47. 4 % ( 1S/3S) had granulocytopenia and reductions in three lines of blood cells, 7. 9% (3/ 3S) had agranulocytosis, and 23 . 7% ( 9/3S) had agranulocytosis and reductions in three lines of blood cells. Bone marrow cytology showed that among the 3S children, 14 ( 36. S% ) were diagnosed with hepatitis - associated AA ( HAAA ) and 24 ( 63. 2% ) were diagnosed with non - HAAA. In order to analyze the risk factors for HAAA, there were significant differences in CD4 + ( S. 5% vs 17%, P = 0. OOS ) and CD4 +I CDS+ ratio ( 0. 17 vs 0. 47, P = 0. 015 ) between the HAAA group and the non - HAAA group. Further multivariate logistic regression analysis showed that the reduction in CD4 + was a risk factor for HAAA (/3 = - 4. 757, P < 0. 05 ) . All 3S children were given routine liver -protecting, transaminase - lowering, and jaundice clearance treatment. Among the 14 children with HAAA, 6 had gradual recovery of hemogram after immunosuppressant therapy, 7 had gradual recovery of hemogram after allogeneic hematopoietic stem cell transplantation, and 1 died due to severe AA; among the 24 children with non - HAAA, 23 had hemogram gradually returning to normal after treatment, and 1 died of acute liver failure. Conclusion AA should be taken seriously for children with hepatitis and granulocytopenia, especially for those with drug - induced or unexplained liver injury, and the reduction in CD4 + may be used as a predictive factor for AA. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To explore the genetic background for a patient with refractory myelodysplastic/myeloproliferative neoplasm (MDS/MPN) with co-morbid neutrophilia patient., Methods: A MDS/MPN patient who was admitted to the First Affiliated Hospital of Nanjing Medical University in May 2021 was selected as the study subject. RNA sequencing was carried out to identify fusion genes in his peripheral blood mononuclear cells. Fusion gene sequence was searched through transcriptome-wide analysis with a STAR-fusion procedure. The novel fusion genes were verified by quantitative real-time PCR and Sanger sequencing., Results: The patient, a 67-year-old male, had progressive thrombocytopenia. Based on the morphological and molecular examinations, he was diagnosed as MDS/MPN with co-morbid neutropenia, and was treated with demethylating agents and Bcl-2 inhibitors. Seventeen months after the diagnosis, he had progressed to AML. A novel fusion gene NCOR1::GLYR1 was identified by RNA-sequencing in his peripheral blood sample, which was verified by quantitative real-time PCR and Sanger sequencing. The patient had attained morphological remission after a DCAG regimen (a combinatory chemotherapy of decitabine, cytarabine, aclarubicin and granulocyte colony-stimulating factors) plus Chidamide treatment. A significant decrease in the NCOR1::GLYR1 expression was revealed by quantitative real-time PCR at post-chemotherapy evaluation., Conclusion: NCOR1::GLYR1 gene is considered as the pathogenic factor for the MDS/MPN patient with neutropenia.

Objective To investigate the relationship between docetaxel AUC(area under curve) and neutropenia in patients with breast cancer after chemotherapy. Methods We selected 94 patients with breast cancer who accepted AC sequential T chemotherapy regimen as the first-line treatment from December 2016 to July 2017 in the Affiliated Cancer Hospital of Zhengzhou University. The plasma concentration of docetaxel was detected by latex immunoturbidimetry after the docetaxel continuous infusion. Docetaxel AUC was calculated using nonparametric mixed-effects models. A mathematical model predicting decreased percentage of neutrophils using docetaxel AUC was established. Results Individual exposure to docetaxel was highly variable (AUC range=0.7-3.9 mg·h/L, mean value=(2.34±0.7)mg·h/L, inter-individual CV=30%). The average AUC for low (0-2) and high grade (3-4) neutropenia were 2.29 and 2.82 mg·h/L, respectively(P=0.003). The model predicting decreased percentage of neutrophils using docetaxel AUC was set as y=-1.8672x2+25.658x-14.92, r=0.643. Conclusion This research set up a mathematical model to predict decreased percentage of neutrophil, which provide basis for screening high-risk patients who may suffer seriously hematological toxicity and lay a theoretical foundation for individualized dosage based on docetaxel AUC.

Objective To study the efficacy of pegylated recombinant human granulocyte stimulating factor (PEG-rhG-CSF) in the prevention of neutropenia in breast cancer patients for dose intensive adjuvant chemotherapy and to provide the evidence for the clinical application of PEG-rhG-CSF. Methods 37 women with breast cancer were randomly divided into two groups. The experimental group accepting PEG-rhG-CSF prevention after EC-T chemotherapy and the control group accepting rhG-CSF prevention. The efficiency of PEG-rhG-CSF, the incidence and duration of neutropenia in two groups during six cycles of chemotherapy were monitored. Results 37 patients (22 in the experimental group and 15 in the control group) were enrolled in the clinical observation. The incidence of degree 3 and 4 neutropenia in the experimental group was lower than that in the control group during each chemotherapy cycle, and the difference was statistically significant. The difference between the two groups of time from the end of chemotherapy to the lowest absolute value of neutrophils was not statistically significant (P = 0.51). The difference between the two groups of the duration of degree3 and 4 neutropenia was not statistically significant (P = 0.119).There was no significant difference in the quality of life between the two groups. Conclusion PEG-rhG-CSF can reduce the incidence of degree 3 or 4 neutropenia in breast cancer patients for dose intensive adjuvant chemotherapy and the efficacy is better than rhG-CSF, suggesting that PEG-rhG-CSF has the clinical value. [ABSTRACT FROM AUTHOR]

Objective: To investigate the characteristics of cytopenia and its impact on prognosis in patients with relapsed and refractory multiple myeloma (RRMM) after B-cell maturation antigen (BCMA) chimeric antigen receptor T-cell (CAR-T) immunotherapy therapy. Methods: Clinical data of 36 RRMM patients received BCMA CAR-T therapy at the First Affiliated Hospital of Nanjing Medical University from April 2017 to March 2023 were retrospectively collected. Among them, there were 17 males and 19 females, with an age [ M (Q 1 , Q The incidence of cytopenia after BCMA CAR-T cell therapy in 36 RRMM patients reached 100%. The incidence of neutropenia peaked on the 7th and 28th day after cell infusion with a biphasic pattern of change.Patients with all grade neutropenia reached 61.1% (22/36) and grade 3 or higher reached 33.3% (12/36) on the 7th day, while patients with all grade neutropenia reached 67.9% (19/28) and grade 3 or higher reached 28.6% (8/28) on the 28th day ( 3 )] of 62 (53, 67) years. The follow-up deadline was August 31, 2023, and the follow-up time [ M (Q 1 , Q 3 )] was 33 (10, 30) months. The characteristics of cytopenia at different time points before lymphodepleting chemotherapy and after CAR-T cell infusion in all patients were analyzed. Kaplan-Meier method was used to compare the differences in progression-free survival (PFS) and overall survival (OS) in patients with different clinical characteristics. Single-cell sequencing analysis was used to analyze the changes in hematopoietic stem cells in three patients after CAR-T cell therapy. Results: The incidence of cytopenia after BCMA CAR-T cell therapy in 36 RRMM patients reached 100%. The incidence of neutropenia peaked on the 7th and 28th day after cell infusion with a biphasic pattern of change.Patients with all grade neutropenia reached 61.1% (22/36) and grade 3 or higher reached 33.3% (12/36) on the 7th day, while patients with all grade neutropenia reached 67.9% (19/28) and grade 3 or higher reached 28.6% (8/28) on the 28th day ( P< 0.001),respectively. The occurrence rate of lymphopenia reached a peak on the day of CAR-T cell infusion [97.2% (35/36) patients showed lymphopenia, while 80.6% (29/36) patients showed grade 3 or higher lymphopenia] ( P< 0.001).The incidence of all grade of thrombocytopenia and severe thrombocytopenia (grade 3 or higher) peaked on the 14th day after cell infusion, with the rates of 69.4% (25/36) and 30.6% (11/36) respectively, which had a prolonged duration( P< 0.001). Even after 12 months, 40% (8/20) of patients still experienced thrombocytopenia.The incidence of anemia peaked on the 7th and 14th day after cell infusion, with a rate of 100% (36/36) ( P< 0.001). 50% (10/20) of patients still had anemia even 12 months after cell infusion. Kaplan-Meier survival analysis showed that patients with thrombocytopenia < grade 3 had undefined OS, while patients with thrombocytopenia ≥grade 3 had shorter OS [17 (95% CI : 2-32) months, χ 2 =4.154, P =0.042], indicating a poorer prognosis. However, there was no statistically significant difference in the relationship between other cytopenia and survival (all P> 0.05). Single-cell sequencing analysis of bone marrow cells revealed decreased proliferation, increased apoptosis, and cell cycle arrest of hematopoietic stem cells after CAR-T cell infusion. Conclusions: All patients experienced varying degrees of cytopenia after receiving BCMA CAR-T cell infusion, and patients with thrombocytopenia ≥grade 3 had shorter OS and poorer prognosis.

Objective: To investigate the safety and the short-term efficacy of venetoclax combined with azacitidine followed by cladribine (VAC regimen) in children with refractory/ relapsed acute myeloid leukemia (AML)., Methods: The clinical data, treatment outcomes, complications, and blood product consumption of 6 children with refractory/relapsed AML treated with VAC regimen in the Children's Hospital of Soochow University from August 2021 to December 2021 were retrospectively analyzed., Results: Among the 6 children, there were 1 male and 5 females. 5 cases were refractory AML, and 1 case was relapsed AML, which recurred again 16 months after allogeneic hematopoietic stem cell transplantation. 4 children were accompanied by chromosomes or genes that predicted poor prognosis, such as RUNX1, FLT3-ITD, KMT2A exon 2-exon 8 dup, MLL-AF6 , 7q-, KMT2A exon 2-exon 10 dup, etc. After received VAC regimen, 4 cases achieved CR+CRi, 1 case achieved PR (only MRD did not relieve, MRD was 0.59%), and 1 case was NR (but the proportion of bone marrow blasts decreased). All 6 patients had grade Ⅳ neutropenia, and 4 patients had grade Ⅳ thrombocytopenia. During the period of neutropenia, none of the 6 children developed symptoms of infection such as fever, cough, and diarrhea. No treatment-related death occurred., Conclusion: Venetoclax combined with azacitidine followed by cladribine provides a new treatment option for patients with relapsed/refractory AML who have poor efficacy in early induction remission theragy, showing good efficacy and safety.

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of China Medical University is the property of Journal of China Medical University Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate pathogenic bacteria distribution and antibiotics resistance in febrile neutropenic patients with lymphoma which might provide rationale for optimizing drug selection in improving the outcome of anti-infection therapy. Methods Pathogenic bacteria isolated from febrile neutropenic patients with lymphoma hospitalized in the departments of hematology in 12 Shanghai tertiary hospitals from Jan., 2012 to Dec., 2014 were retrospectively identified and systemically analyzed for its distribution and characteristics of antibiotics resistance. Results A total of 108 clinical isolates were collected from the febrile neutropenic patients with lymphoma, including 41 Gram-positive (G+) and 67 Gram-negative (G-) bacteria accounted for 37.96% and 62.04%, respectively. Enterobacteriaceae was the most common G- bacteria accounted for 34.26%, while Staphylococcus was ranked in the first of all G+ pathogens accounted for 24.07%. The majority of pathogenic bacteria were clinically isolated from respiratory tract secretions specimens added up to 60 isolates accounted for 55.56%, followed by strains isolated from wound and catheter secretions as well as blood amounted to 19, 12 and 10 isolates accounted for 17.59%, 11.11% and 9.26%, respectively. K lebsiella pneumonia and Klebsiella acid were the most common strains isolated from respiratory tract and wound secretions specimens, while Escherichia coli and Staphylococcal were mainly isolated from catheter and blood samples. G+ bacteria were found to some extent be resistant to penicillin, erythromycin, levofloxacin, cephalosporins as well as gentamicin, while sensitivity rate of G+ strains to fosfomycin, vancomycin, teicoplanin and linezolid were approximately around 92.9%-100%. Meanwhile, G- pathogens were shown to be sensitive to amikacin, meropenem, imipenem, cefoperazone/shubatan and piperacillin/tazobactam despite being resistant to penicillin and cephalosporins. Conclusions G- bacteria were the most common pathogens in febrile neutropenic patients with lymphoma, among which being multidrug resistance. Linezolid, vancomycin and teicoplanin could be recommended as empirical agents for G+ bacterial infection, while imipenem, meropenem and amikacin could be served as optimal antibiotics for G- strains infection. [ABSTRACT FROM AUTHOR]

Objective To investigate the association between the time of neutrophils to the lowest and prognosis of patients with esophageal squamous cell carcinoma (ESCC) treated with non-operative therapy. Methods The clinical data of 325 non-operative treated ESCC patients were collected in this study. The X-title software was applied to establish optimal threshold of neutrophil reduction to the lowest value. According to the optimal threshold, the patients were divided into early group (115 cases) and late group (210 cases). The clinical features and survival time of the two groups were compared, and the factors of prognosis were analyzed by Cox regression model with univariate and multivariate analysis. Results The X-title software demonstrated the optimal cutoff values for the time of neutrophils to the lowest was 39 days. The median overall survival time was 21.0 months in the early group which was significantly higher than that in the late group (16.0 months). Multivariate Cox regression analysis showed that the treatment methods and the time of neutrophils to the lowest were independent factors for overall survival of patients with ESCC treated by non-surgical therapy. Compared with radiotherapy alone, concurrent chemoradiation could benefit the survival (HR=0.64, P=0.026). The prognosis of patients in the late group of neutrophils to the lowest (HR=1.38, P=0.038) was poor compared with the early group. Furthermore, stratified by treatment methods, the overall survival of two groups showed statistically significant difference only in patients received concurrent chemoradiation. The mortality risk in the late group was higher than that in the early group (HR=3.53, P=0.010). Conclusion The time of neutrophils to the lowest is an independent prognosis factor for non-operative treated ESCC patients. The prognosis of patients in the early group is better than that in the late group. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between UGT1A1*6, UGT1A1*28, UGT1A1*60 and UGT1A1*93 polymorphisms and irinotecan-induced severe adverse reactions(grade 3-4 delayed diarrhea and neutropenia) in Chinese cancer patients. Methods: A total of 141 cancer patients treated with irinotecan were enrolled in this study. Peripheral venous blood was collected and genomic DNA was extracted. The genetic polymorphisms of UGT1A1*6, UGT1A1*28, UGT1A1*60 and UGT1A1*93 were analyzed by PCR and direct sequencing. The adverse reactions during chemotherapy were observed and recorded. The incidence of severe adverse reactions was compared among patients with different genotypes. Results: Among 141 patients, the cases with UGT1A1*6 GG, GA and AA genotypes were 71, 54 and 16, while those with UGT1A1*28 TA6/6, TA6/7 and TA7/7 genotypes were 105, 33 and 3, respectively. The cases with UGT1A1*60 AA, AC and CC genotypes were 52, 80 and 9, while those with UGT1A1*93 GG, GA and AA genotypes were 105, 32 and 4, respectively. The patients with grade 3-4 delayed diarrhea and neutropenia were 23 and 56, respectively. Multivariate logistic regression analysis showed that UGT1A1*6 and UGT1A1*60 genetic polymorphisms were independent factors influencing the occurrence of grade 3-4 delayed diarrhea. The risk of grade 3-4 delayed diarrhea in homozygous AA carriers of UGT1A1*6 increased 3.79 times compared with that in wild-type GG carriers (95%CI: 1.35-10.67). Moreover, the risk of grade 3-4 delayed diarrhea in homozygous CC carriers of UGT1A1*60 was 20.42 times compared with that in wild-type AA carriers (95%CI: 3.52-118.33). In addition, UGT1A1*28 genetic polymorphism was an independent factor of the occurrence of grade 3-4 neutropenia. The patients with homozygous TA7/7 carriers of UGT1A1*28 had an 1.61 times higher risk of grade 3-4 neutropenia compared with those with wild-type TA6/6 carriers (95%CI: 1.44-12.65). There was no correlation between UGT1A1*93 genetic polymorphism and severe adverse reactions caused by irinotecan. Conclusion: The cancer patients who carried UGT1A1*6, UGT1A1*28 and UGT1A1*60 gene polymorphisms have high risk of severe adverse events caused by irinotecan-based chemotherapy. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Practical Oncology Journal is the property of Journal of Practical Oncology Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Neutropenia is the most common hematologic toxicity of myelosuppressive chemotherapy and radiotherapy. The degree and duration of neutropenia are directly related to the risk of infection and even death, which can also affect the relative dose intensity of chemotherapy and the prognosis of patients. At present, clinicians tend to underestimate the harm of neutropenia, and are in lack of knowledge on granulocyte colony-stimulating factor(G-CSF), especially on prevention and treatment of neutropenia. Based on clinical evidence, the Chinese Society of Clinical Oncology’ (CSCO) develops guidelines on the assessment, prevention and treatment of neutropenia and the application of G-CSF. It suggests a hierarchical management concept for neutropenia and establishes a clinical path of prevention and treatment, in order to provide guidance for standardized management of neutropenia and the rational use of G-CSF. [ABSTRACT FROM AUTHOR]

Objective: To assess the efficacy and safety of polymyxin B in neutropenic patients with hematologic disorders who had refractory gram-negative bacterial bloodstream infection. Methods: From August 2021 to July 2022, we retrospectively analyzed neutropenic patients with refractory gram-negative bacterial bloodstream infection who were treated with polymyxin B in the Department of Hematology of the First Affiliated Hospital of the Soochow University between August 2021 to July 2022. The cumulative response rate was then computed. Results: The study included 27 neutropenic patients with refractory gram-negative bacterial bloodstream infections. Polymyxin B therapy was effective in 22 of 27 patients. The median time between the onset of fever and the delivery of polymyxin B was 3 days [interquartile range ( IQR ) : 2-5]. The median duration of polymyxin B treatment was 7 days ( IQR : 5-11). Polymyxin B therapy had a median antipyretic time of 37 h ( IQR : 32-70). The incidence of acute renal dysfunction was 14.8% (four out of 27 cases), all classified as "injury" according to RIFLE criteria. The incidence of hyperpigmentation was 59.3%. Conclusion: Polymyxin B is a viable treatment option for granulocytopenia patients with refractory gram-negative bacterial bloodstream infections.

Objective: To analyze the short-time efficacy of empagliflozin in the treatment of glycogen storage disease type Ⅰb (GSD Ⅰb). Methods: In this prospective open-label single-arm study, the data of 4 patients were collected from the pediatric department in Peking Union Medical College Hospital from December 2020 to December 2022. All of them were diagnosed by gene sequencing and had neutropenia. These patients received empagliflozin treatment. Their clinical symptoms such as height and weight increase, abdominal pain, diarrhea, oral ulcer, infection times, and drug applications were recorded at 2 weeks, 1 month, 2 months, 3 months, 6 months, 9 months, 12 months, and 15 months after treatment to assess the therapeutic effect. The liquid chromatography-tandem mass spectrometry method was used to monitor the changes in 1, 5-anhydroglucitol (1, 5AG) concentration in plasma. At the same time, adverse reactions such as hypoglycemia and urinary tract infection were closely followed up and monitored. Results: The 4 patients with GSD Ⅰb were 15, 14, 4 and 14 years old, respectively at the beginning of empagliflozin treatment, and were followed up for 15, 15, 12 and 6 months, respectively. Maintenance dose range of empagliflozin was 0.24-0.39 mg/(kg·d). The frequency of diarrhea and abdominal pain decreased in cases 2, 3, and 4 at 1, 2 and 3 months of treatment, respectively. Their height and weight increased at different degrees.The absolute count of neutrophils increased from 0.84×10 9 , 0.50×10 9 , 0.48×10 9 , 0.48×10 9 /L to 1.48×10 9 , 3.04×10 9 , 1.10×10 9 , 0.73×10 9 /L, respectively. Granulocyte colony-stimulating factor was gradually reduced in 1 patients and stopped in 3 patient. Plasma 1, 5 AG levels in 2 children were significantly decreased after administration of empagliflozin (from 46.3 mg/L to 9.6 mg/L in case 2, and from 56.1 mg/L to 15.0 mg/L in case 3). All 4 patients had no adverse reactions such as hypoglycemia, abnormal liver or kidney function, or urinary system infection. Conclusion: In short-term observation, empagliflozin can improve the symptoms of GSD Ⅰb oral ulcers, abdominal pain, diarrhea, and recurrent infection, also can alleviate neutropenia and decrease 1, 5AG concentration in plasma, with favorable safety.

Background and objective Squamous cell carcinoma (SCC) is a common pathological type of non-small cell lung cancer, and advanced lung SCC is incurable. Chemotherapy combined with anti-angiogenesis agents can pro-long the patients' survival time. The aim of the study was to analyze the efficacy and safety of recombinant human endostatin (Endostar) in treating advanced lung SCC. Methods We retrospectively analyzed the short-term efficacy and toxicity of recombinant human endostatin combined with traditional chemotherapy regimens in treating 15 advanced lung squamous cell carcinoma patients in Department of Medical Oncology retrospectively, Cancer Hospital, Chinese Academy of Medical Sciences from November 2011 to May 2015. Treatment-related survival was also analyzed. Results Among the evaluble 14 patients, the best overall response was partial response in 5 patients (35.7%), stable disease in 7 patients (50.0%), and progressive disease in 2 patients (14.3%). The objective response rate (ORR) was 35.7%, and disease control rate (DCR) was 85.7%. The median progression-free survival (PFS) was 9.3 months. The main grade 3 toxicity was neutropenia (2/15, 13.3%) and vomiting (1/15, 6.7%). Conclusion Chemotherapy combined with recombinant human endostatin enabled good objective response in advanced SCC patients and had well security. [ABSTRACT FROM AUTHOR]

Background and objective Surgical resection remains the mainstay of treatment for patients with early-staged thymic tumors, while chemotherapy is most commonly used in stage IV cases. As for locally advanced thymic tumors, especially those unsuitable for surgery, the optimal therapy is still controversial. Tus, we conducted this retrospective study by comparing three nonsurgical treatment modalities to find some clues. Methods Three treatment modalities were used in 42 patients from October 2000 to December 2010, including radiotherapy (RT) alone, sequential chemoradiation (SCRT) and concurrent chemoradiation (CCRT). Objective response rate (ORR), overall survival (OS) and toxicity of the three regimens were compared accordingly. Results The ORR in all 42 patients was 61.9%, and 5-year OS was 46%. The ORR of RT, SCRT and CCRT were 43.8%, 50% and 87.5%, respectively (RT vs SCRT, P=0.692; RT vs CCRT, P=0.009; SCRT vs CCRT, P=0.051). The 5-year OS of RT, SCRT and CCRT were 30%, 50% and 61.9%, respectively (RT vs SCRT, P=0.230; RT vs CCRT, P=0.011; SCRT vs CCRT, P=0.282). Eleven patients developed neutropenia of grade 3-4, with 7 in CCRT group and 4 in SCRT, respectively. Nine patients experienced esophagitis of grade 3 with 2 in RT, 3 in SCRT and 4 in CCRT. There were also two cases of grade 3 radiation induced pneumonitis in CCRT group. No life-threatening side effects were noted. Conclusion When used to treat locally advanced thymic tumors unsuitable for surgery, CCRT performed more favorably than RT alone or SCRT in both tumor response and long time survival, but probably with the increasing risk of pulmonary damage. CCRT may offer the best chance of disease control in the management of locally advanced disease. [ABSTRACT FROM AUTHOR]

Ｏｂｊｅｃｔｉｖｅ　Ｔｏ ａｎａｌｙｚｅ ｔｈｅ ｄｕｒａｔｉｏｎ ｏｆ ｐｒｅｖｅｎｔｉｖｅ ｆｉｌｇｒａｓｔｉｍ ａｄｍｉｎｉｓｔｒａｔｉｏｎ ａｓ ｓｕｐｐｏｒｔ ｆｏｒ ｃｈｅｍｏｔｈｅｒａｐｙ ａｎｄ ｉｔｓ ａｆｆｅｃｔｉｎｇ ｆａｃｔｏｒｓ． Ｍｅｔｈｏｄｓ　Ｓｉｎｇｌｅ ｉｎｓｔｉｔｕｔｉｏｎａｌ ｄａｔａ ｆｒｏｍ ａ ｐｈａｓｅ Ⅱ ｃｌｉｎｉｃａｌ ｔｒｉａｌ ａｎｄ ａ ｐｈａｓｅ Ⅲ ｃｌｉｎｉｃａｌ ｔｒｉａｌ ｏｆ ｐｅｇｙｌａｔｅｄ ｆｉｌｇｒａｓｔｉｍ ｗｅｒｅ ｃｏｍｂｉｎｅｄ． Ｉｎ ｔｈｅ ｔｗｏ ｒａｎｄｏｍｉｚｅｄ ｃｒｏｓｓ⁃ｏｖｅｒ ｔｒｉａｌｓ， ｐａｔｉｅｎｔｓ ｗｉｔｈ ｐｒｅｖｉｏｕｓｌｙ ｕｎｔｒｅａｔｅｄ ｃａｎｃｅｒ ｒｅｃｅｉｖｅｄ ｔｗｏ ｃｙｃｌｅｓ ｏｆ ｃｈｅｍｏｔｈｅｒａｐｙ ｏｆ ｔｈｅ ｓａｍｅ ｒｅｇｉｍｅｎ． Ｉｎ ｔｈｅ ｓｔｕｄｙ ｇｒｏｕｐ， ｔｈｅ ｐａｔｉｅｎｔｓ ｒｅｃｅｉｖｅｄ ａ ｓｉｎｇｌｅ ｓｕｂｃｕｔａｎｅｏｕｓ ｉｎｊｅｃｔｉｏｎ ｏｆ １００ μｇ／ ｋｇ ｐｅｇｙｌａｔｅｄ ｆｉｌｇｒａｓｔｉｍ， ａｎｄ ｉｎ ｔｈｅ ｃｏｎｔｒｏｌ ｇｒｏｕｐ， ｔｈｅｙ ｒｅｃｅｉｖｅｄ ｄａｉｌｙ ｓｕｂｃｕｔａｎｅｏｕｓ ｉｎｊｅｃｔｉｏｎｓ ｏｆ ５ μｇ／ ｋｇ ｆｉｌｇｒａｓｔｉｍ． Ｒｅｓｕｌｔｓ 　Ｉｎ ５３ ｃｈｅｍｏｔｈｅｒａｐｙ ｃｙｃｌｅｓ， ｔｈｅ ｍｅｄｉａｎ ｄｕｒａｔｉｏｎ ｏｆ ｆｉｌｇｒａｓｔｉｍ ａｄｍｉｎｉｓｔｒａｔｉｏｎ ｗａｓ （９．５７±２．１０）ｄ． ８３．０％ （４４／５３） ｏｆ ｔｈｅｍ ｒｅｃｅｉｖｅｄ ｆｉｌｇｒａｓｔｉｍ ｆｏｒ ７⁃１１ ｄａｙｓ． Ｐａｔｉｅｎｔｓ ｗｉｔｈ ｂａｓｅｌｉｎｅ ａｂｓｏｌｕｔｅ ｎｅｕｔｒｏｐｈｉｌ ｃｏｕｎｔ ｏｆ ＜４×１０９ ／ Ｌ ｏｒ ｂｏｄｙ ｍａｓｓ ｉｎｄｅｘ ｌｅｓｓ ｔｈａｎ ２２ ｒｅｃｅｉｖｅｄ ａ ｌｏｎｇｅｒ ｆｉｌｇｒａｓｔｉｍ ｐｒｏｐｈｙｌａｘｉｓ（Ｐ ＜０．０５）． Ｒｅｓｕｌｔｓ ｏｆ ｍｕｌｔｉｖａｒｉａｔｅ ａｎａｌｙｓｉｓ ｓｈｏｗｅｄ ｔｈａｔ ｔｈｅ ｂａｓｅｌｉｎｅ ａｂｓｏｌｕｔｅ ｎｅｕｔｒｏｐｈｉｌ ｃｏｕｎｔ ｉｓ ａｓｓｏｃｉａｔｅｄ ｗｉｔｈ ｔｈｅ ｔｉｍｅ ｏｆ ｆｉｌｇｒａｓｔｉｍ ａｄｍｉｎｉｓｔｒａｔｉｏｎ（Ｐ ＝ ０．０１９）． Ｔｈｅ ｍｏｓｔ ｃｏｍｍｏｎ ａｄｖｅｒｓｅ ｅｖｅｎｔ ｏｆ ｒｈＧ⁃ＣＳＦ ｗａｓ ｓｋｅｌｅｔａｌ ｐａｉｎ， ｇｅｎｅｒａｌｌｙ ｍｉｌｄ ａｎｄ ｎｏ ｔｒｅａｔｍｅｎｔ⁃ｒｅｌａｔｅｄ ｄｅａｔｈ ｏｃｃｕｒｒｅｄ． Ｃｏｎｃｌｕｓｉｏｎｓ 　Ｔｈｅ ｍｅｄｉａｎ ｄｕｒａｔｉｏｎ ｏｆ ｆｉｌｇｒａｓｔｉｍ ｓｕｐｐｏｒｔ ｆｏｒ ｃｈｅｍｏｔｈｅｒａｐｙ ｗａｓ １０ ｄａｙｓ． Ｐａｔｉｅｎｔｓ ｗｉｔｈ ｌｏｗｅｒ ｂａｓｅｌｉｎｅ ｎｅｕｔｒｏｐｈｉｌ ｃｏｕｎｔ ｒｅｑｕｉｒｅ ａ ｌｏｎｇｅｒ ｆｉｌｇｒａｓｔｉｍ ｐｒｏｐｈｙｌａｘｉｓ． Ｔｒｉａｌ ｒｅｇｉｓｔｒａｔｉｏｎ： ＣｌｉｎｉｃａｌＴｒｉａｌｓ．ｇｏｖ ｉｄｅｎｔｉｆｉｅｒ， ＮＣＴ０１２８５２１９ [ABSTRACT FROM AUTHOR]

Ｏｂｊｅｃｔｉｖｅ 　Ｔｏ ｅｘｐｌｏｒｅ ｔｈｅ ｓａｆｅｔｙ ａｎｄ ｅｆｆｉｃａｃｙ ｏｆ ｐｅｇｙｌａｔｅｄ ｒｅｃｏｍｂｉｎａｎｔ ｈｕｍａｎ ｇｒａｎｕｌｏｃｙｔｅ ｃｏｌｏｎｙ⁃ｓｔｉｍｕｌａｔｉｎｇ ｆａｃｔｏｒ （ＰＥＧ⁃ｒｈＧ⁃ＣＳＦ） ｉｎ ｐｒｅｖｅｎｔｉｎｇ ｃｈｅｍｏｔｈｅｒａｐｙ⁃ｉｎｄｕｃｅｄ ｎｅｕｔｒｏｐｅｎｉａ ｉｎ ｐａｔｉｅｎｔｓ ｗｉｔｈ ｂｒｅａｓｔ ｃａｎｃｅｒ ａｎｄ ｎｏｎ⁃ｓｍａｌｌ ｃｅｌｌ ｌｕｎｇ ｃａｎｃｅｒ （ＮＳＣＬＣ）， ａｎｄ ｔｏ ｐｒｏｖｉｄｅ ｔｈｅ ｂａｓｉｓ ｆｏｒ ｃｌｉｎｉｃａｌ ａｐｐｌｉｃａｔｉｏｎ． Ｍｅｔｈｏｄｓ 　Ａｃｃｏｒｄｉｎｇ ｔｏ ｔｈｅ ｐｒｉｎｃｉｐｌｅ ｏｆ ｏｐｅｎ⁃ｌａｂｅｌ， ｒａｎｄｏｍｉｚｅｄ， ｐａｒａｌｌｅｌ⁃ｇｒｏｕｐ ｃｏｎｔｒｏｌｌｅｄ ｃｌｉｎｉｃａｌ ｔｒｉａｌ， ａｌｌ ｐａｔｉｅｎｔｓ ｗｅｒｅ ｒａｎｄｏｍｉｚｅｄ ｂｙ １ ∶ １ ∶ １ ｉｎｔｏ ｔｈｒｅｅ ｇｒｏｕｐｓ ｔｏ ｒｅｃｅｉｖｅ ＰＥＧ⁃ｒｈＧ⁃ＣＳＦ １００ μｇ／ ｋｇ， ＰＥＧ⁃ｒｈＧ⁃ＣＳＦ ６ ｍｇ， ｏｒ ｒｈＧ⁃ＣＳＦ ５ μｇ／ ｋｇ， ｒｅｓｐｅｃｔｉｖｅｌｙ． Ｔｈｅ ｐａｔｉｅｎｔｓ ｗｉｔｈ ｂｒｅａｓｔ ｃａｎｃｅｒ ｒｅｃｅｉｖｅｄ ｔｗｏ ｃｈｅｍｏｔｈｅｒａｐｙ ｃｙｃｌｅｓ， ａｎｄ ｔｈｅ ＮＳＣＬＣ ｐａｔｉｅｎｔｓ ｒｅｃｅｉｖｅｄ １⁃２ ｃｙｃｌｅｓ ｏｆ ｃｈｅｍｏｔｈｅｒａｐｙ ａｃｃｏｒｄｉｎｇ ｔｏ ｔｈｅｉｒ ｃｏｎｄｉｔｉｏｎ． Ａｌｌ ｐａｔｉｅｎｔｓ ｗｅｒｅ ｔｒｅａｔｅｄ ｗｉｔｈ ｔｈｅ ｃｏｍｂｉｎａｔｉｏｎ ｃｈｅｍｏｔｈｅｒａｐｙ ｏｆ ＴＡＣ （ｄｏｃｅｔａｘｅｌ＋ｅｐｉｒｕｂｉｃｉｎ＋ｃｙｃｌｏｐｈｏｓｐｈａｍｉｄｅ） ｏｒ ＴＡ （ ｄｏｃｅｔａｘｅｌ ＋ ｅｐｉｒｕｂｉｃｉｎ）， ｏｒ ｔｈｅ ｃｈｅｍｏｔｈｅｒａｐｙ ｏｆ ｄｏｃｅｔａｘｅｌ ｃｏｍｂｉｎｅｄ ｗｉｔｈ ｃａｒｂｏｐｌａｔｉｎ， ｗｉｔｈ ａ ２１ ｄａｙ ｃｙｃｌｅ． Ｒｅｓｕｌｔｓ　Ｔｈｅ ｄｕｒａｔｉｏｎ ｏｆ ｇｒａｄｅ ３⁃４ ｎｅｕｔｒｏｐｅｎｉａ ｉｎ ｔｈｅ ＰＥＧ⁃ｒｈＧ⁃ＣＳＦ １００ μｇ／ ｋｇ ａｎｄ ＰＥＧ⁃ｒｈＧ⁃ＣＳＦ ６ ｍｇ ｇｒｏｕｐｓ ｗｅｒｅ ｓｉｍｉｌａｒ ｗｉｔｈ ｔｈａｔ ｉｎ ｔｈｅ ｒｈＧ⁃ＣＳＦ ５ μｇ／ ｋｇ ｇｒｏｕｐ （Ｐ＞０．０５ ｆｏｒ ａｌｌ）． Ｔｈｅ ｉｎｃｉｄｅｎｃｅ ｒａｔｅ ｏｆ ｇｒａｄｅ ３⁃４ ｎｅｕｔｒｏｐｅｎｉａ ｉｎ ｔｈｅ ＰＥＧ⁃ｒｈＧ⁃ＣＳＦ １００ μｇ／ ｋｇ ｇｒｏｕｐ， ＰＥＧ⁃ｒｈＧ⁃ＣＳＦ ６ ｍｇ ｇｒｏｕｐ， ａｎｄ Ｇ⁃ＣＳＦ ５ μｇ／ ｋｇ ｇｒｏｕｐ ｗｅｒｅ ６９．７％， ６８．４％， ａｎｄ ６９．５％， ｒｅｓｐｅｃｔｉｖｅｌｙ， ｗｉｔｈ ａ ｎｏｎ⁃ｓｉｇｎｉｆｉｃａｎｔ ｄｉｆｆｅｒｅｎｃｅ ａｍｏｎｇ ｔｈｅ ｔｈｒｅｅ ｇｒｏｕｐｓ （Ｐ ＝ ０．９６３）． Ｔｈｅ ｉｎｃｉｄｅｎｃｅ ｒａｔｅ ｏｆ ｆｅｂｒｉｌｅ ｎｅｕｔｒｏｐｅｎｉａ ｉｎ ｔｈｅ ＰＥＧ⁃ｒｈＧ⁃ＣＳＦ １００ μｇ／ ｋｇ ｇｒｏｕｐ， ＰＥＧ⁃ｒｈＧ⁃ＣＳＦ ６ ｍｇ ｇｒｏｕｐ ａｎｄ Ｇ⁃ＣＳＦ ５ μｇ／ ｋｇ ｇｒｏｕｐ ｗｅｒｅ ６．１％， ６．４％， ａｎｄ ５．５％， ｒｅｓｐｅｃｔｉｖｅｌｙ， ｓｈｏｗｉｎｇ ｎｏ ｓｉｇｎｉｆｉｃａｎｔ ｄｉｆｆｅｒｅｎｃｅ ａｍｏｎｇ ｔｈｅｍ （Ｐ ＝０．９３５）． Ｔｈｅ ｉｎｃｉｄｅｎｃｅ ｒａｔｅ ｏｆ ａｄｖｅｒｓｅ ｅｖｅｎｔｓ ｉｎ ｔｈｅ ＰＥＧ⁃ｒｈＧ⁃ＣＳＦ １００ μｇ／ ｋｇ ｇｒｏｕｐ， ＰＥＧ⁃ｒｈＧ⁃ＣＳＦ ６ ｍｇ ｇｒｏｕｐ ａｎｄ Ｇ⁃ＣＳＦ ５ μｇ ／ ｋｇ ｇｒｏｕｐ ｗｅｒｅ ６．７％， ４．１％， ａｎｄ ５．５％， ｒｅｓｐｅｃｔｉｖｅｌｙ， ｓｈｏｗｉｎｇ ａ ｎｏｎ⁃ｓｉｇｎｉｆｉｃａｎｔ ｄｉｆｆｅｒｅｎｃｅ ａｍｏｎｇ ｔｈｅｍ （Ｐ ＝０．５８１）． Ｃｏｎｃｌｕｓｉｏｎｓ Ｉｎ ｐａｔｉｅｎｔｓ ｗｉｔｈ ｂｒｅａｓｔ ｃａｎｃｅｒ ａｎｄ ｎｏｎ⁃ｓｍａｌｌ ｃｅｌｌ ｌｕｎｇ ｃａｎｃｅｒ （ＮＳＣＬＣ） ｕｎｄｅｒｇｏｉｎｇ ＴＡＣ／ ＴＡ ｃｈｅｍｏｔｈｅｒａｐｙ， ａ ｓｉｎｇｌｅ １００ μｇ／ ｋｇ ｉｎｊｅｃｔｉｏｎ ｏｒ ａ ｓｉｎｇｌｅ ｆｉｘｅｄ ６ ｍｇ ｄｏｓｅ ｏｆ ＰＥＧ⁃ｒｈＧ⁃ＣＳＦ ａｔ ４８ ｈｏｕｒｓ ａｆｔｅｒ ｃｈｅｍｏｔｈｅｒａｐｙ ｓｈｏｗ ｄｅｆｉｎｉｔｅ ｔｈｅｒａｐｅｕｔｉｃ ｅｆｆｅｃｔ ｗｉｔｈ ａ ｌｏｗ ｉｎｃｉｄｅｎｃｅ ｏｆ ａｄｖｅｒｓｅ ｅｖｅｎｔｓ ａｎｄ ｍｉｌｄ ａｄｖｅｒｓｅ ｒｅａｃｔｉｏｎｓ． Ｃｏｍｐａｒｅｄ ｗｉｔｈ ｔｈｅ ｃｏｎｔｉｎｕｏｕｓ ｄａｉｌｙ ｉｎｊｅｃｔｉｏｎ ｏｆ ｒｈＧ⁃ＣＳＦ ５ μｇ／ ｋｇ／ ｄ， ａ ｓｉｎｇｌｅ １００ μｇ／ ｋｇ ｉｎｊｅｃｔｉｏｎ ｏｒ ａ ｓｉｎｇｌｅ ｆｉｘｅｄ ６ ｍｇ ｄｏｓｅ ｏｆ ＰＥＧ⁃ｒｈＧ⁃ＣＳＦ ｈａｓ ｓｉｍｉｌａｒ ｅｆｆｅｃｔ ａｎｄ ｉｓ ｍｏｒｅ ａｄｖａｎｔａｇｅｏｕｓ ｉｎ ｐｒｅｖｅｎｔｉｎｇ ｃｈｅｍｏｔｈｅｒａｐｙ⁃ｉｎｄｕｃｅｄ ｎｅｕｔｒｏｐｅｎｉａ． [ABSTRACT FROM AUTHOR]

To investigate the clinical and immunological features of dermatomyositis (DM) complicated with macrophage activation syndrome (MAS). The demographic and clinical characteristics of five patients diagnosed with DM complicated with MAS hospitalized in the Department of Rheumatology and Immunology, Peking University People ' s Hospital from 2011 to 2021 were collected. The results of clinical manifestations, laboratory tests, immunological features, treatments and prognosis were analyzed and summarized. In this study, five female patients in Peking University People's Hospital with an average age of 63.8 (44.0-83.0) years and an average disease duration of 16.1 (1.5-48.0) months. All the patients had typical DM rash (such as heliotrope sign, V/shawl sign or Gottron's sign/papules). They all had muscle involvement (including myalgia or muscle weakness). Two patients had positive myositis-specific antibodies (MSAs), in which case 1 had anti-TIF1-γ antibody and case 5 had anti-NXP-2 antibody. Four patients had interstitial lung disease except case 3. All of the cases developed MAS in the active stage of DM. Common manifestations of MAS in these five patients included high-grade fever, cytopenia, decreased fibrinogen, elevated ferritin and increased soluble CD25. Case 1 presented with neutropenia (0.6×10 9 /L), thrombocytopenia (26.0×10 9 /L), hypofibrinogenemia (0.9 g/L), markedly elevated ferritin (26 331.0 μg/L), decreased NK cell activity. Case 2 had anaemia (hemoglobin 81.0 g/L), thrombocytopenia (55.0×10 9 /L), hypertriglyceridemia (4.7 mmol/L), hypofibrinogenemia (1.2 g/L), elevated ferritin (>100 000.0 μg/L), hemophagocytosis in bone marrow. Case 3 had anaemia (hemoglobin 88 g/L), decreased fibrinogen (1.9 g/L), increased ferritin (>27 759.0 μg/L), splenomegaly, hemophagocytosis in bone marrow. Case 4 suffered from neutropenia(0.3×10 9 /L), anaemia(hemoglobin 78 g/L), hypertriglyceridemia (4.2 mmol/L), hypofibrinogenemia (0.9 g/L), increased ferritin (>100 000.0 μg/L), and decreased NK cell activity. Case 5 presented anaemia (hemoglobin 60.0 g/L), thrombocytopenia (67.0×10 9 /L), hypertriglyceridemia (12.7 mmol/L), decreased fibrinogen (1.1 g/L), and elevated ferritin (>923.0 μg/L). All the patients were treated with methylprednisone pulse therapy (200-500 mg) combined with cyclosporine while case 5 received rituximab after methylprednisone pulses. In addition, case 3 also received the combination of mycophenolate mofetil. Case 1 was given etoposide while case 4 was treated with cyclophosphamide and repeated plasmapheresis at the same time. Moreover, intravenous immunoglobulin was added meantime apart from case 3. The condition of four patients improved significantly, nevertheless case 4 experienced recurred pulmonary symptoms and died of respiratory failure. As for complications about infection, case 2 had bacterial infection with high level procalcitonin (PCT) before MAS treatment and condition was improved after empiric antibacterial therapy. Case 3 had cytomegalovirus DNAemia before diagnosis of MAS and viral titer turned negative after ganciclovir therapy. After treatment of MAS, four patients developed cytomegalovirus DNAemia except case 3, in which case 5 was co-infected with bacteria. To sum, DM complicated with MAS is relatively rare, and its patients are of ten in life-threatening condition. Early detection, treatment and prevention of infection during treatment are critical to improve the prognosis.

Background and objective Gefitinib and Pemetrexed are drugs used as second-line therapy for advanced non-small cell lung cancer (NSCLC), although studies comparing the two drugs are limited. The aim of this study is to explore the effects, safety, and quality of life (QoL) of Gefitinib and Pemetrexed on patients with advanced non-squamous NSCLC. Methods Forty-six advanced non-squamous NSCLC patients who failed to first-line therapy were randomly divided into two groups with 23 patients each, one using oral Gefitinib (Gefitinib group) and the other using intravenous injection Pemetrexed (Pemetrexed group). The effects, safety, and QoL were determined and analyzed. Results For the Pemetrexed group, objective response rate (ORR) was 13.0% (3/23), disease control rate (DCR) was 30.4% (7/23), and median progression-free survival (mPFS) was 3.1 months. In the Gefitinib group, ORR was 17.3% (4/23), DCR was 39.1% (9/23), and mPFS was 4.4 months. Compared with the Pemetrexed group, the ORR, DCR, and mPFS in the Gefitinib group exhibited no statistical significance (P>0.05). Furthermore, the most common toxicities in the Pemetrexed group were neutropenia (n=9, 39.13%) and fatigue (n=8, 34.78%), whereas those in the in Gefitinib group were skin rash (n=8, 34.78%) and diarrhea (n=4, 17.39%).Compared with baseline, the QoL improved in both groups but to different degrees. Likewise, emotional, functional well-being, and QoL aspects specifically related to lung cancer were better improved in the Gefitinib group than in the Pemetrexed group (P<0.05). Conclusion The effects of Pemetrexed and Gefitinib as second line therapy were similar, although with different AEs. Both drugs could improve the QoL, but Gefitinib showed better overall results than Pemetrexed. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of recombinant human granulocyte colony stimulating factor (rhG-CSF) on the clinical efficacy and flow cytometry (FCM) minimal residual disease (MRD) of patients with acute myeloid leukemia (AML) after initial induction therapy in the real world., Methods: The clinical data of 44 AML patients who were diagnosed for the first time in the Department of Hematology, The Second Hospital of Anhui Medical University, and received the initial induction therapy were retrospectively analyzed. According to whether rhG-CSF was used after treatment, these patients were divided into control group and therapy group. The complete remission (CR) rate, duration of neutropenia, incidence of infection, duration of fever, cost of antibiotics drugs, length of hospital stay, FCM MRD, and relapse-free survival (RFS) time were compared between the two groups., Results: The CR rate in the control group was 60%, and 74% in the therapy group (P=0.3429). The duration of neutropenia was (21.28±7.91) days in the control group and (14.79±3.07) days in the therapy group (P=0.0016). The duration of fever was (12.80±7.31) days in the control group and (9.11±7.48) days in the therapy group (P=0.0136). While, there were no statistically significant differences between the two groups in the incidence of infection, cost of antibacterial drugs, length of hospital stay and RFS time (all P>0.05). In addition, it is particularly noteworthy that among the patients who finally obtained CR in the therapy group, 66% of them had myeloid precursor cells detected by peripheral blood FCM (accounting for 2.25%±0.99%) at the time of the first release of neutropenia, which was easy to be misdiagnosed as MRD positive., Conclusion: rhG-CSF not only don't affect the clinical remission rate after the initial induction treatment of AML, but also significantly shortens the time of duration of neutropenia and fever, however, it may affect the analysis of peripheral blood FCM MRD detection results when the neutropenia is released for the first time.

Background and objective The efficacy of complete resection of the cancer for patients with stage IIIa non-small cell lung cancer (NSCLC) is limited. Synthetic therapy is taken the lead in advocating at present. However, the value of post-operative radiotherapy is not still clear. The aim of this study is to evaluate the survival time and side effects of postoperative chemotherapy or chemoradiotherapy in the treatment of stage IIIa NSCLC. Methods Between December 2003 and June 2007, 52 cases that have completed followed-up data with stage IIIa of NSCLC received in the First Affiliated Hospital of Dalian Medical University. Twenty-three patients received postoperative chemoradiotherapy (group A) and 29 patients received postoperative chemotherapy combined with radiotherapy (group B). Group A adopted platinum-based combination chemotherapy for 4-6 cycles. The chemotherapeutics included gemcitabine, vinorelbine and docetaxel. Group B used chemotherapy for 2-4 cycles and then received 3-dimensional conformal radiotherapy (3D-CRT). The prescribe dose of target volume was 50 Gy. The chemotherapy was same as for group A and needed 4 cycles in all. The impact of postoperative adjuvant treatment on survival and toxicity was observed in patients with stage IIIa NSCLC and the reason of disease progression was analyzed. Results The median survival was 32.5 months in group A and 31.9 months in group B (P=0.371). Progression-free survival extended about 6 months (P=0.044). The survival rate was 87% at 1 year, 0.1% at 2 year, 33% at 3 year for group A compared with 93%, 69%, 45% for group B. The major side effects were hematological and gastrointestinal toxicities, including nausea, vomiting and neutropenia. There was no significant difference in these toxicities between the two groups (P>0.05). Radioactive esophageal infection occurred in 17.2% of the patients. Acute and late radioactive lung infection occurred in 13.8% and 27.6% of the patients. All these toxicities were below degree 2. Distant metastases were the main reason of disease progression. There was no significant difference in the rates of local recurrence and metastases between the two groups (P>0.05). Conclusion Combined modality therapy should be the main therapy of stage IIIa NSCLC. The addition of radiotherapy can effectively prolong progression-free survival and don't highly increase the toxicities. [ABSTRACT FROM AUTHOR]

Background and objective The platinum-based plus a third-generation agent doublet chemotherapy regimen has been recommended as the standard first-line chemotherapy for advanced NSCLC by ASCO and NCCN. This study was aimed to evaluate the clinical efficacy and side effects of the Platinum plus Taxanes or other novel agent. Methods The databases PubMed, CENTRAL, EMBASE and Chinese Biomedical Literature database were retrieved by using the key words "non small cell lung cancer" or "Carcinoma, Non Small Cell Lung" so as to search the studies about the randomized controlled clinical trials, which compared Platinum plus Taxanes with Platinum plus other novel agents. A meta-analysis was conducted and the quality scores were evaluated according to the improved Jadad's score. Results Nine randomized controlled clinical trials with 4 703 patients were included. The overall response rate and 1 year survival rate of the two groups were not significantly different (RR=1.00, 95%CI: 0.91-1.11, P=0.95; RR=0.98, 95%CI: 0.84-1.15, P=0.83). The incidence rate of grade 3-4 leukopenia, neutropenia, anemia, nausea and vomiting in TP is much lower than that in platinum plus other novel agent. Sub-group analysis showed that the overall response rate and 1 year survival rate of TP aren't statistically different from NP or GP. The incidence rate of grade 3-4 leukopenia, neutropenia and anemia in TP is statistically lower than that in NP. The incidence rate of grade 3-4 anemia and thrombocytopenia in TP is statistically lower than that in GP. Conclusion The clinical efficacy of TP and platinum plus other novel agent is quite similar, but quite different from each other in side effects, which provides important evidence on selecting individual chemotherapy regimen. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy and toxicity profiles of idarubicin, cytarabine, and cyclophosphamide (IAC) in relapse/refractory acute myeloid leukemia (AML) . Methods: This study was a prospective, randomized controlled clinical trial with the registration number NCT02937662. The patients were randomly divided into two groups. The experimental group was treated with an IAC regimen, and the regimen of the control group was selected by doctors according to medication experience. After salvage chemotherapy, allogeneic hematopoietic stem cell transplantation (allo-HSCT) was conducted as far as possible according to the situation of the patients. We aimed to observe the efficacy, safety, and toxicity of the IAC regimen in relapse/refractory AML and to explore which is the better regimen. Results: Forty-two patients were enrolled in the clinical trial, with a median age of 36 years (IAC group, 22 cases and control groups, 20 cases) . ①The objective response rate was 71.4% in the IAC group and 40.0% in the control group ( P =0.062) ; the complete remission (CR) rate was 66.7% in the IAC group and 40.0% in the control group ( P =0.121) . The median follow-up time of surviving patients was 10.5 (range:1.7-32.8) months; the median overall survival (OS) was 14.1 (range: 0.6-49.1) months in the IAC group and 9.9 (range: 2.0-53.8) months in the control group ( P =0.305) . The 1-year OS was 54.5% (95% CI 33.7%-75.3%) in the IAC group and 48.2% (95% CI 25.9%-70.5%) in the control group ( P =0.305) , with no significant difference between these two regimens. ②The main hematologic adverse events (AEs) were anemia, thrombocytopenia, and neutropenia. The incidence of grade 3-4 hematologic AEs in the two groups was 100% (22/22) in the IAC group and 95% (19/20) in the control group. The median time of neutropenia after chemotherapy in the IAC group and control group was 20 (IQR: 8-30) and 14 (IQR: 5-50) days, respectively ( P =0.023) . ③The CR rate of the early relapse (relapse within 12 months) group was 46.7% and that of the late relapse (relapse after 12 months) group was 72.7% ( P =0.17) . The median OS time of early recurrence was 9.9 (range:1.7-53.8) months, and that of late recurrence patients was 19.3 (range: 0.6-40.8) months ( P =0.420) , with no significant differences between the two groups. The 1-year OS rates were 45.3% (95% CI 27.2%-63.3%) and 66.7% (95% CI 40.0%-93.4%) , respectively ( P =0.420) . Survival analysis showed that the 1-year OS rates of the hematopoietic stem cell transplantation group and non-hematopoietic stem cell transplantation group were 87.5% (95% CI 71.2%-100%) and 6.3% (95% CI 5.7%-18.3%) , respectively. The OS rate of the hematopoietic stem cell transplantation group was significantly higher than that of the non-hematopoietic stem cell transplantation group ( P <0.001) . Conclusion: The IAC regimen is a well-tolerated and effective regimen in relapsed/refractory AML; this regimen had similar efficacy and safety with the regimen selected according to the doctor's experience for treating relapsed/refractory AML. For relapsed/refractory patients with AML, allogeneic hematopoietic stem cell transplantation should be attempted as soon as possible to achieve long-term survival.

Objective: To explore the effect of age on the time of neutropenia after initial induction therapy for newly diagnosed acute myeloid leukemia (AML) patients., Methods: Data of 18-65 years old AML patients treated in our hospital from Junuary 2015 to July 2020 were retrospectively analyzed. The clinical characteristics, time of neutropenia after initial induction treatment, early responses, and related influencing factors for the time of neutropenia were analyzed and compared between 18-40 years old group and 41-65 years old group., Results: There were 112 patients enrolled in this study, including 66 (58.9%) males, and their median age was 46 years old. Compared with 18-40 years old group, the incidence of FLT3-ITD gene mutation increased (P=0.039) but core binding factor (CBF) decreased (P=0.003) significantly in 41-65 years old group. The incidence of neutropenia was 97.3%, and the average time was (18.70±1.192) days. The time of neutropenia was (21.43±1.736) days in 41-65 years old group, which was longer than (14.91±1.356) days in 18-40 years old group (P=0.006). The time of neutropenia in CBF positive group was shorter than that in negative group (P=0.012), as well as in patients with remission (CR+CRi) (≤ 2 courses) than those with non-remission (NR) (P=0.024), while in high-risk group was longer than that in low-risk group (P=0.040). Multivariate analysis showed that age, FLT3-ITD gene mutation positive, and non-remission (NR) after two courses of treatment were independent risk factors for the time of neutropenia., Conclusion: In non-elderly patients with newly diagnosed AML, age is an influencing factor for the time of neutropenia. Key words　　;

Background: Malignant pleural mesothelioma (MPM) is a highly aggressive disease arising from pleural mesothelial cells. Advanced pleural mesothelioma has a poor prognosis, with a median survival of no more than 15 months. First line standard chemotherapy regimen recommended is Pemetrexed based chemotherapy regimen, with or without bevacizumab. There is no consensus on whether patients who have received first-line standard chemotherapy can benefit from pemetrexed maintenance chemotherapy. The study aimed to investigate the efficacy and safety of pemetrexed maintenance therapy (PMT) after treatment with a pemetrexed and platinum regimen for patients with MPM., Methods: A total of 40 MPM patients were collected from Cancer Hospital Chinese Academy of Medical Sciences from January 2013 to January 2018, eligible patients were unresectable MPM, without disease progression following 4 to 6 cycles of pemetrexed and platinum, including pemetrexed maintenance therapy group (22 cases) and observation group (18 cases). The last follow-up was conducted in January 2020. The primary endpoint were progression free survival (PFS), and the secondary end points were overall survival (OS), the efficacy, adverse reactions of PMT., Results: The median PFS in the PMT arm was longer than that in the observation arm (8.5 mon vs 3 mon, P=0.008), but there was no significant difference in median OS (26.4 mon vs 15.7 mon, P=0.177). Objective response rate (ORR) of two group were 22.7% and 0%, respectively. The grade 3-4 toxicity in PMT group included grade 4 neutropenia in 1 patient (4.5%), grade 3 neutropenia in 1 patient (4.5%), grade 4 anemia in 1 patient (4.5%) and grade 3 nausea and anorexia in 1 patient (4.5%)., Conclusions: Pemetrexed maintenance therapy following initial pemetrexed and platinum chemotherapy improve PFS in patients with MPM, and is well tolerated.

Objective: To investigate the correlation between UGT1A1 polymorphisms and the irinotecan plus S-1 regimen-induced toxicities in Chinese advanced esophageal squamous cell carcinoma (ESCC) patients. Methods: A total of 46 recurrent or metastatic ESCC patients selected from ESWN 01 trial were randomly assigned to irinotecan plus S-1 group [intravenous infusion of irinotecan (160 mg/m(2)) on day 1 and oral S-1 (80-120 mg) on days 1-10, repeated every 14 days]. Peripheral venous blood at baseline was collected and genomic DNA was extracted. The genetic polymorphisms of UGT1A1*6 and UGT1A1*28 were analyzed by polymerase chain reaction (PCR) amplification. Irinotecan plus S-1 regimen-induced toxicities of patients with different UGT1A1 polymorphisms were observed. The correlation between UGT1A1 polymorphisms and the adverse effects was analyzed. Results: Among the 46 patients, the numbers of UGT1A1*6 wild type genotype (GG), mutant heterozygote (GA) and mutant homozygote (AA) were 30, 15 and 1, while those with UGT1A1*28 wild type genotype (TA6/6), mutant heterozygote (TA6/7) and mutant homozygote (TA7/7) were 36, 8 and 2, respectively. Only one patient with UGT1A1*6 AA genotype occurred grade 3 diarrhea, while one of the 2 patients with UGT1A1*28 TA7/7 genotype occurred grade 4 diarrhea. No neutropenia was observed in the patient with UGT1A1*6 AA genotype, however, both of the two patients with UGT1A1*28 TA7/7 genotype occurred grade 3-4 neutropenia. Patients with UGT1A1*28 genetic polymorphism (TA 6/7 or TA7/7) had a higher response rate compared with wild-type TA6/6 carriers. (55.6% versus 26.5%). Conclusions: The homozygous genotype of UGT1A1*6 AA and UGT1A1*28 TA7/7 are rare (<5%) in Chinese ESCC population. Not all homozygous AA and TA7/7 carriers occur severe dose limited toxicities (DLT) when treated with irinotecan (160 mg/m(2)) plus S-1 regimen for 2 weeks. However, it's still necessary torigorously observe the occurrence of severe diarrhea and neutropenia in patients with UGT1A1*6 AA and UGT1A1*28 TA7/7 and adjust the dose timely.

Objective: To study the risk factors and treatment for neutropenia of late newborns (NLN)., Methods: Related clinical data were collected from the preterm infants and critically ill neonates who were admitted to the neonatal intensive care unit from July 2019 to January 2020. A total of 46 newborns with a blood absolute neutrophil count (ANC) of < 1.5×10 9 /L for two consecutive times at weeks 2-4 after birth were enrolled as the NLN group. A total of 92 late newborns with a blood ANC of ≥ 1.5×10 9 /L, matched at a ratio of 1:2, were enrolled as the control group. Possible risk factors associated with NLN and the treatment process were recorded. A logistic regression analysis was performed to identify the risk factors for NLN., Results: Among the 46 neonates in the NLN group, 29 had a gestational age of < 32 weeks, 14 had a gestational age of 32-37 weeks, and 3 had a gestational age of > 37 weeks. There was no significant difference between the two groups in the incidence rates of gestational hypertension, premature rupture of membranes > 18 hours and intrauterine distress, 5-minute Apgar score, the duration of positive pressure ventilation, the incidence rate of early-onset sepsis, and the type of initially used antibiotics ( P > 0.05). Compared with the control group, the NLN group had a higher incidence rate of late-onset sepsis and a longer duration of antibiotic use ( P < 0.05). Late-onset sepsis and prolonged duration of antibiotic use were independent risk factors for NLN ( P < 0.05). With the presence of late-onset sepsis, the risk of NLN was increased by 1.537 times in neonates, and the risk of NLN was increased by 76.9% for every 3-day increase in the duration of antibiotic use. The mean age at the diagnosis of NLN was (21±6) days for the 46 neonates in the NLN group. Thirteen neonates with NLN were administered with recombinant human granulocyte colony-stimulating factor (G-CSF, 10 μg/kg) once or twice. O the 13 neonates, 6 had an ANC of < 0.5×10 9 /L and 7 had a gestational age of < 32 weeks or severe disease conditions. After treatment the ANC returned to > 1.0×10 9 /L in the 13 neonates. No drug-related adverse reactions were found. After the diagnosis of NLN, 2 neonates developed sepsis, and the remaining 44 neonates did not develop any common purulent infections., Conclusions: The risk of NLN increases with the presence of late-onset sepsis and the increase in the duration of antibiotic use. NLN is generally a benign process. G-CSF appears to be safe and effective for NLN with severe disease conditions or severe reduction in ANC.

Objective: To study the pharmacokinetic characteristics, clinical effect, and safety of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in children with acute lymphoblastic leukemia (ALL)., Methods: A prospective study was performed on children with ALL who cyclophosphamide, cytarabine, and 6-mercaptopurine were used for consolidation therapy. PEG-rhG-CSF (PEG-rhG-CSF group) or rhG-CSF (rhG-CSF group) was injected after chemotherapy. The plasma concentration of PEG-rhG-CSF was measured, and clinical outcome and safety were observed for both groups., Results: A total of 17 children with ALL were enrolled, with 9 children in the PEG-rhG-CSF group and 8 children in the rhG-CSF group. In the PEG-rhG-CSF group, the peak concentration of PEG-rhG-CSF was 348.2 ng/mL (range 114.7-552.0 ng/mL), the time to peak was 48 hours (range 12-72 hours), and the half life was 14.1 hours (range 11.1-18.1 hours). The plasma concentration curve of PEG-rhG-CSF was consistent with the mechanism of neutrophil-mediated clearance. Compared with the rhG-CSF group, the PEG-rhG-CSF group had a significantly shorter median time to absolute neutrophil count (ANC) recovery (P<0.05). There were no significant differences between the two groups in ANC nadir, incidence rate of febrile neutropenia, duration of grade IV neutropenia, incidence rate of infection, and length of hospital stay. No bone pain or muscle soreness was observed in either group (P>0.05)., Conclusions: The pharmacokinetic characteristics of PEG-rhG-CSF in children with ALL receiving consolidation chemotherapy are consistent with the mechanism of neutrophil-mediated clearance, with a short half life and fast recovery of ANC, and there are no significant differences in safety between PEG-rhG-CSF and rhG-CSF.

In order to clearly define the features of Shwachman-Diamond syndrome (SDS) in Chinese children, this article analyzes and summarizes the epidemiology, clinical features, and key points in the diagnosis and treatment of SDS in Chinese children with review of the clinical data of 27 children with SDS from related articles published previously. A comparative analysis was made between the Chinese and international data related to childhood SDS. The results showed a male/female ratio of about 2:1 in the Chinese children with SDS, with an age of onset of <1 month to 5 years (median 1 month) and an age of 3 months to 12 years (median 12 months) at the time of confirmed diagnosis. Reductions in peripheral blood cells due to myelopoiesis inhibition were observed in all 27 children with SDS, among whom 93% had neutropenia. Chronic diarrhea (85%), liver damage (78%), and short stature (83%) were the three main clinical features of SDS. Supplementation of pancreatin and component blood transfusion may temporarily alleviate the disease, while allogeneic hematopoietic stem cell transplantation is still an effective radical treatment. The comparative analysis of the Chinese and oversea data showed that compared with those in the European and American countries, the children with SDS in China had significantly higher incidence rates of chronic diarrhea, reductions in peripheral blood cells (three lineages), and liver damage, and there were also differences in the type of mutant genes.