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[PMID]: 23668213 [Au] Autor: Chen M; Xu Y; Li H; Xie J; Han B; Duan MH; Zhou DB; Wang SJ; Zhao YQ; Zhuang JL [Ti] Title: [Analysis of peripheral blood lymphocyte subsets and relevant prognostic factors of 34 newly diagnosed multiple myeloma patients]. [So] Source: Zhonghua Xue Ye Xue Za Zhi;34(4):355-8, 2013 Apr. [Is] ISSN: 0253-2727 [Cp] Country of publication: China [La] Language: chi [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.3760/cma.j.issn.0253-2727.2013.04.024

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[PMID]: 23668211 [Au] Autor: Tong J; Sun ZM; Liu HL; Geng LQ; Cui DY; Wang XB; Ding KY; Tang BL; Liu X; Zhu WB [Ti] Title: [Analysis of the therapeutic effect and safety of diagnosis and treatment regimen in Chinese adult patients with acute lymphoblastic leukemia--the comparative study of one single centre]. [So] Source: Zhonghua Xue Ye Xue Za Zhi;34(4):349-52, 2013 Apr. [Is] ISSN: 0253-2727 [Cp] Country of publication: China [La] Language: chi [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.3760/cma.j.issn.0253-2727.2013.04.022

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[PMID]: 23668210 [Au] Autor: Lu J; Wang H; Huang XJ [Ad] Address: Peking University People's Hospital, Peking University Institute of Hematology, Beijing 100044, China. [Ti] Title: [Curative effect observation of patients with primary systemic amyloidosis treated by the combination of bortezomib with dexmethasone and cyclophosphamide]. [So] Source: Zhonghua Xue Ye Xue Za Zhi;34(4):345-8, 2013 Apr. [Is] ISSN: 0253-2727 [Cp] Country of publication: China [La] Language: chi [Ab] Abstract: Objective To analyze the efficacy and side effects of the combination regimen containing bortezomib, cyclophosphamide and dexamethasone(BCD) in the treatment of primary systemic amyloidosis (PSA). Methods The clinical manifestation, efficacy and side effects of 22 PSA patients after treatment were retrospectively analyzed. Results Of the 22 PSA patients, 9 were newly diagnosed cases and 13 relapsed cases, 20(90.9%) had symptomatic cardiac involvement and 20 (90.9%) had 2 or more organs involved. The median free light chain were 140 mg/L. There were no specific abnormality was found by G-banding and FISH. RQ-PCR-MAGE C1/CT7/ABL had high positive incidence in amyloidosis and can be observed ahead of the flow cytometry and morphology examination. Hematological response occurred in 88.9% in newly diagnosed patients, with 55.6% organ response, 2 patients occured sudden death during BCD interval. For relapsed patients, the hematological response was 46.2%, with 30.7% organ response. Ten of the 22 PSA patients developed peripheral neurophathy, 1 liver dysfunction, 1 severe infection after intra-tracheal stent. Conclusions BCD produces rapid and high hematological responses in the PSA patients especially in newly diagnosed patients. It is well tolerated with few side effects. MAGE C1/CT7 might be helpful in the early detection of the clonal plasma cell. [Pt] Publication type: ENGLISH ABSTRACT; JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.3760/cma.j.issn.0253-2727.2013.04.021

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[PMID]: 23668209 [Au] Autor: Fan JL; Fu WJ; Shi HT; Zhou F; Yuan ZG; Zhang CY; Wei W; Ye F; Zhang H; Hou J [Ad] Address: Department of Hematology, Changzheng Hospital, Second Military Medical University, Military Myeloma and Lymphoma Center, Shanghai 200003, China. [Ti] Title: [Clinical and laboratory features of four cases with IgM multiple myeloma]. [So] Source: Zhonghua Xue Ye Xue Za Zhi;34(4):341-4, 2013 Apr. [Is] ISSN: 0253-2727 [Cp] Country of publication: China [La] Language: chi [Ab] Abstract: Objective To improve the understanding of the clinical and laboratory features of the IgM multiple myeloma (MM). Methods The clinical data of four cases of IgM MM patients were collected, their clinical and laboratory features were summarized and analyzed. Results Four patients met the criteria of IgM MM. They were all male. The age at the diagnosis ranged from 54 to 69 years. The primary symptoms included bone pain, hyperviscosity and bleeding. Three cases had κ-chain and only one case had λ-chain. They were all staged â…¢A according to the Durie-Salmon staging system (DSS). One case staged â… and three cases staged â…¡ according to the international staging system (ISS). The average value of IgM, hemoglobin, serum calcium, creatinine and the proportion of bone marrow plasma cells were 83.6 (52.9-111.0) g/L, 79.5 (61.0-105.0) g/L, 3.20(2.11-6.00) mmol/L, 104.3 (56.0-171.0) µmol/L and 0.558 (0.290-0.775), respectively. Bone destruction was found in 3 cases. Immunophenotypes of bone marrow plasma cells were analyzed in 3 patients. Results showed that these cells expressed CD38 and CD138, and did not express CD19, CD20 and CD117. Chromosome and fluorescence in situ hybridization (FISH) analysis were carried out in 4 cases and found that all of them had IgH translocations and 1q21 amplification, 2 cases had 13q and 17p deletion, and 3 cases had t(11;14). Three patients received bortezomib-based regimens as induction therapy and reached partial response (PR) - very good partial response (VGPR). Followed up to November 30, 2012, the median progress-free survival (PFS) and overall survival (OS) of the 4 cases were only 6.0 (2.5-7.0) months and 17.5 (2.5-27.0) months, respectively. Conclusions IgM MM is very rare and is no more than 0.5% in all types of MM. IgM MM have frequent t(11;14) and amp(1q21). Bortezomib-based regimens are effective for it, however, the disease progresses rapidly and has poor prognosis. [Pt] Publication type: ENGLISH ABSTRACT; JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.3760/cma.j.issn.0253-2727.2013.04.020

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[PMID]: 23668207 [Au] Autor: Qu XY; Zhang SS; Wu S; Hong M; Li JY; Chen LJ; Xu JR [Ad] Address: Department of Hematology, First Affiliated Hospital of Nanjing Medical University，Jiangsu Province Hospital, Nanjing 210029, China. [Ti] Title: [Expression level of microRNA-92a and its clinical significance in multiple myeloma patients]. [So] Source: Zhonghua Xue Ye Xue Za Zhi;34(4):332-6, 2013 Apr. [Is] ISSN: 0253-2727 [Cp] Country of publication: China [La] Language: chi [Ab] Abstract: Objective To investigate the relationship between the expression level of microRNA 92a (miR-92a) and del(13q14) and the prognosis of MM patients, and to explore the pathway that miR-92a involved. Methods Bone marrow samples from 53 newly diagnosed MM patients were collected, del(13q14) was analyzed by interphase fluorescence in situ hybridization in sorted CD138 positive plasma cell. The expression of miR-92a in plasma cells was measured by quantitative real-time PCR. The expression of c-jun was detected by Western blot in miR-92a transfected MM cell lines (LP-1, U266 and JJN3). Results Of the 53 MM patients, del(13q14) was detected in 31 (58.4%) patients. The median levels of miR-92a in MM patients with or without del(13q14) were 27.36±2.61 and 21.87±15.98, respectively (P>0.05). With the median follow-up of 13.5 (0.5-72.5) months, the median duration of progression-free survival of patients with high expression level of miR-92a was significantly shorter than those with low expression level of miR-92a (4.5 months vs 14.0 months, P=0.006). Overexpression of miR-92a in MM cell lines induces time-dependent down-regulation of c-jun. Conclusions High expression of miR-92a was associated with poor prognosis in MM patients. The expression level of miR-92a was not associated with del(13q14), and the effect of miR-92a on the progress of MM might be involved in c-jun pathway. [Pt] Publication type: ENGLISH ABSTRACT; JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.3760/cma.j.issn.0253-2727.2013.04.018

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[PMID]: 23668206 [Au] Autor: Wang HH; Li J; Liu JR; Zheng D; Gu JL; Yan MS; Zou WY; Xu DR [Ad] Address: Department of Hematology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China. [Ti] Title: [Clinical significance of abnormal protein bands in multiple myeloma treated with bortezomib-based induction regimen and autologous stem cell transplantation]. [So] Source: Zhonghua Xue Ye Xue Za Zhi;34(4):327-31, 2013 Apr. [Is] ISSN: 0253-2727 [Cp] Country of publication: China [La] Language: chi [Ab] Abstract: Objective To study the clinical significance of abnormal protein bands (APB) in multiple myeloma (MM) patients treated with bortezomib-based induction regimen and autologous stem cell transplantation (ASCT). Methods Sixty-eight MM patients submitted to bortezomib-based induction therapy and ASCT from January 2007 to July 2012 were retrospectively studied. Monoclonal protein was detected by immunofixation electrophoresis (IFE). Results Of all 68 patients, 33 (48.5%) patients had APB. At the first emergence of an APB, two patients with light chain type achieved CR and before transplantation, and thirty-one patients were after transplantation with median time of 104 (ranged 33-404) days. The median duration of APB appearance was 105 (ranged 35-801) days. Patients who developed APB compared with those without APB, had a significantly higher CR plus very good partial response (VGPR) rates (100.0% vs 85.7%%, P=0.017) and CR rates (87.9% vs 62.9%) (P=0.03). There were no significant differences in gender, age, HGB, ALB, ß2-microglobulin, M protein type, Durie-Salmon and ISS stages, the case number of first line or second line treatment, induction courses of bortezomib-based regimen, and the mode of ASCT. With a median follow-up of 33.4 (ranged 7.0-71.7) months, patients with APB tended to have a longer overall survival (OS) versus non-APB patients, although no significant difference obtained (P＞0.05). Among APB patients, OS was longer in patients whose appearance of APB occurred ＜6 months after transplantation than those ≥ 6 months, but the significant difference was not obtained yet (P＞0.05). Conclusions Patients who developed APB had a significantly better response to bortezomib-based induction regimen followed ASCT. APB emergence has a good prognostic significance. [Pt] Publication type: ENGLISH ABSTRACT; JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.3760/cma.j.issn.0253-2727.2013.04.017

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[PMID]: 23668204 [Au] Autor: Liu JR; Li J; Shang JJ; Zheng D; Gu JL; Zou WY; Xu DR [Ad] Address: Department of Hematology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China. [Ti] Title: [Observation of humoral immunity reconstitution and its relationship with infection after autologous hematopoietic stem cell transplantation for patients with multiple myeloma]. [So] Source: Zhonghua Xue Ye Xue Za Zhi;34(4):317-22, 2013 Apr. [Is] ISSN: 0253-2727 [Cp] Country of publication: China [La] Language: chi [Ab] Abstract: Objective To study the humoral immunity reconstitution and its relationship with infection in patients with multiple myeloma (MM) after undergoing autologous hematopoietic stem cell transplantation (auto-HSCT). Methods Forty-two MM patients undergoing auto-HSCT were included in this study. Peripheral blood were obtained for immunoglobulin detection, including IgG, IgA and IgM before transplantation and 1, 3, 6, 12, 18 and 24 months after transplantation. The time, type, pathogen of infection between 1 and 24 month after transplantation were analyzed. Results The level of IgA at 6 month [(0.75±0.59) g/L] after auto-HSCT was lower than that of pre-auto-HSCT [(1.04±0.70) g/L], and reached the level of pre-auto-HSCT at 9 months [(0.99±0.52) g/L] after auto-HSCT. The level of IgM reached the level of pre-auto-HSCT [(0.45±0.26) g/L] at 3 months after auto-ASCT [(0.50±0.26) g/L]. The level of IgG reached the level of pre-auto-HSCT [(9.80±2.98) g/L] at 1 month after auto-HSCT [(11.09±2.69) g/L], and higher than that of pre-auto-HSCT at 9 months after auto-HSCT [(12.07±3.57) g/L]. The level of IgG with IgG-type MM was higher than that of patients with light-chain type and IgD-type MM at 6, 9 and 12 months after auto-HSCT. The IgA level of patients who obtained complete remission (CR) is much higher than that of patients who obtained nCR in IgG-type patients. The incidence of infection in 6 month after auto-HSCT was higher than that of (6-12) month and >12 month after auto-HSCT. The incidence of infection was strongly negative correlated with IgA (r =-0.943, P=0.005) and IgG (r=-0.943, P=0.005) level. The frequency of viral infection was also negatively correlated with IgA and IgG. Conclusion The reconstitution time of IgG, IgA and IgM was different in MM patients after auto-HSCT. IgG recovered first, then IgM, and IgM the last. The incidence of infection was negatively correlated with IgA and IgG. With the recovery of IgG and IgA, the incidence of infection was decreased accordingly. [Pt] Publication type: ENGLISH ABSTRACT; JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.3760/cma.j.issn.0253-2727.2013.04.015

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[PMID]: 23668203 [Au] Autor: Zhang CY; Fu WJ; Xi H; Zhou LL; Jiang H; Du J; Fan JL; Li R; Jin LN; Zeng TM; Hou J [Ad] Address: Myeloma & Lymphoma Center, Department of Hematology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China. [Ti] Title: [Busulfan, cyclophosphamide and etoposide as conditioning for autologous stem cell transplantation in multiple myeloma]. [So] Source: Zhonghua Xue Ye Xue Za Zhi;34(4):313-6, 2013 Apr. [Is] ISSN: 0253-2727 [Cp] Country of publication: China [La] Language: chi [Ab] Abstract: Objective To evaluate the efficacy and safety of dose-reduced intravenous busulfan, cyclophosphamide and etoposide (BCV) as conditioning for autologous stem cell transplantation (ASCT) in multiple myeloma (MM). Methods From September 2007 to September 2010, thirty-two ASCT-eligible patients with MM received high dose melphalan (HDM) as conditioning in our center. Median age was 53.5 (30-63) years. From October 2010 to October 2012, thirty-eight patients conditioned by BCV regimen (intravenous busulfan, total doses 9.6 mg/kg), whose median age was 54(35-64) years. Results There were no statistical differences in clinical characteristics between the two groups, including myeloma isotype, Durie-Salmon staging, international staging system(ISS), and patients received the first line, second line or more than third line therapy. The median time to neutrophil and platelet engraftment were 10.5 vs 11 days (P=0.057) and 11 vs 12 days (P=0.100) in the BCV and HDM groups, respectively. The toxicity of two conditioning regimens had no significant difference. None of hepatic veno-occlusive disease and early transplant related mortality was observed. Although overall response rates showed no significant difference between two groups (P>0.05), the CR rates increased from 44.74% pre-ASCT to 63.18% post-ASCT in the BCV group, while 37.50% to 59.38% in the HDM group. During the median follow-up of 16 months (range 2-27) in BCV group, ten patients (26.32%) developed progressive disease and PFS at 12 months were 71.37%. Conclusions In this study, the dose-reduced intravenous busulfan, cyclophosphamide and etoposide (BCV) conditioning was demonstrated an effective and safety regimen for ASCT-eligible patients with MM. However, the long term observation is needed. [Pt] Publication type: ENGLISH ABSTRACT; JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.3760/cma.j.issn.0253-2727.2013.04.014

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[PMID]: 23668202 [Au] Autor: Lu J; Hou J; Zhang CY; Yuan ZG; Lan HF; Zhou F; Fan JL; Zhou LL; Du J; Jiang H; Jin LN; Zeng TM; Fu WJ [Ad] Address: Department of Hematology, The Myeloma & Lymphoma Center, Changzheng Hospital, The Second Military Medical University, Shanghai 200003, China. [Ti] Title: [The efficacy and safety analysis of bortezomib retreatment in 76 patients with relapsed/refractory multiple myeloma]. [So] Source: Zhonghua Xue Ye Xue Za Zhi;34(4):309-12, 2013 Apr. [Is] ISSN: 0253-2727 [Cp] Country of publication: China [La] Language: chi [Ab] Abstract: Objective To evaluate the efficacy and safety of bortezomib retreatment in 76 patients with relapsed/refractory multiple myeloma (MM), who previously responded to bortezomib. Methods Retrospective analysis of 76 MM patients, who had achieved at least a partial response (PR) on initial bortezomib therapy in our hospital from May 2006 to August 2011, received bortezomib retreatment when they relapsed or progressed. Results The overall response rate (ORR) was 60.5%, among them 6.5% patients achieved CR, 5.8% patients achieved very good partial response (VGPR), 38.2% patients achieved PR. Then we further stratified all patients into 3 groups according to the response of initial bortezomib therapy, including CR group, VGPR group and PR group. After bortezomib retreatment, the ORR of the 3 groups was 84.6%, 73.1% and 43.2%, respectively. According to the response of bortezomib retreatment, the patients were divided into 2 groups: group 1 who at least achieved PR, group 2 who showed no response. The median progression-free survival (PFS) after bortezomib retreatment for group 1 and 2 was 7(1-39) and 5(1-14) months, respectively (P>0.05), while the median overall survival (OS) after bortezomib retreatment was 16(2-64) and 8(1-28) months, respectively (P<0.05). Adverse events (AE) were identified in 88% patients during bortezomib retreatment, including neutropenia, diarrhea and thrombocytopenia, only 9.2%(7 patients) reached â…¢-â…£ grade of AE. Severe peripheral neuropathy occurred in only one patient. Conclusion Bortezomib retreatment regimen is demonstrated a higher response rate in patients who achieved deeper response in initial treatment, with no more adverse events. [Pt] Publication type: ENGLISH ABSTRACT; JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.3760/cma.j.issn.0253-2727.2013.04.013

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[PMID]: 23668201 [Au] Autor: Xu Y; An G; Deng SH; Sui WW; Feng XY; Li F; Hao M; Wang YF; Qiu LG [Ad] Address: Sate Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China. [Ti] Title: [Clinical feature and efficacy of patients with multiple myeloma and renal impairment treated with bortezomib based chemotherapy]. [So] Source: Zhonghua Xue Ye Xue Za Zhi;34(4):304-8, 2013 Apr. [Is] ISSN: 0253-2727 [Cp] Country of publication: China [La] Language: chi [Ab] Abstract: Objective To explore the efficacy and safety of bortezomib (btz) based chemotherapy in multiple myeloma (MM) patients with renal-function impairment (RI). Methods Fifty-six MM patients with impaired renal function treated with bortazomib based regimens in our single center were retrospectively analyzed. Results The median age was 59 (ranged 30-77) years. 39.3% were κ-restricted MM, while 57.1% were λ-restricted MM. Nine patients were IgD-MM, and 14 were light chain MM. Median creatinine clearance (CrCl) was 25.33 (7.23-59.55) ml/min. The number of patients with mild, moderate and severe RI was 6, 35 and 15, respectively. Overall response rate of MM was 82.4% (≥MR), including 32.4% complete response (CR), 17.6% very good partial response (VGPR) and 26.5% partial response (PR). The rate of renal response was 89.3%, including 62.5% CR, 14.3% PR and 12.5% minor response (MR). A median time of optimal response was 25.5 (ranged 5-240) days. There was no significant difference in the median overall survival and the time to progress in different RI groups. Adverse events observed were similar to those patients with normal renal function previously reported. Most adverse events were manageable, 55.6% patients developed peripheral neuropathy and 10 patients discontinued bortezomib. Conclusion The incidence of RI is higher in patients with IgD-MM and λ restricted MM. Bortezomib based treatment is a highly effective and safe option in MM patients with impaired renal function. In this analysis, renal function was improved in a substantial proportion of patients. Peripheral neuropathy is the major adverse events which limit its use in MM patients. [Pt] Publication type: ENGLISH ABSTRACT; JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.3760/cma.j.issn.0253-2727.2013.04.012

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