Serum LDH level may predict outcome of chronic lymphocytic leukemia patients with a 17p deletion： a retrospective analysis of prognostic factors in China

Objective： This study aims to evaluate the natural history of patients with chronic lymphocytic leukemia （CLL） and a 17p deletion （17p-） and identify the predictive factors within this subgroup. Methods： The sample of patients with CLL were analyzed by fluorescence in situ hybridization for deletions in chromosome bands 1 lq22, 13q14 and 17p13; trisomy of bands 12q13; and translocation involving band 14q32. The data from 456 patients with or without a 17p- were retrospectively collected and analyzed. Results： The overall response rate （ORR） in patients with a 17p- was 56.9%, and patients with a high percentage of 17p- （defined as more than 25% of cells harbouring a 17p-） had a lower ORR. The median overall survival （OS） in patients with a 17p- was 78.0 months, which was significantly shorter than the OS in patients without this genetic abnormality （median 162.0 months, P〈0.001）. Within the subgroup with a 17p-, the progression-free survival was significantly shorter in patients at Binet stage B-C and patients with elevated lactate dehydrogenase （LDH）, B symptoms, unmutated IGHVand a high percentage of 17p-. Conclusions： These results indicated that patients with a 17p- CLL have a variable prognosis that might be predicted using simple clinical and laboratory characteristics.

Understanding the impact of mountain landscapes on water balance in the upper Heihe River watershed in northwestern China

Estimating the impact of mountain landscape on hydrology or water balance is essential for the sus- tainable development strategies of water resources. Specifically, understanding how the change of each landscape influences hydrological components will greatly improve the predictability of hydrological responses to mountain landscape changes and thus can help the government make sounder decisions. In the paper, we used the VIC （Variable Infiltration Capacity） model to conduct hydrological modeling in the upper Heihe River watershed, along with a frozen-soil module and a glacier melting module to improve the simulation. The improved model performed satisfactorily. We concluded that there are differences in the runoff generation of mountain landscape both in space and time. About 50% of the total runoff at the catchment outlet were generated in mid-mountain zone （2,900-4,000 m asl）, and water was mainly consumed in low mountain region （1,700-2,900 m asl） because of the higher requirements of trees and grasses. The runoff coefficient was 0.37 in the upper Heihe River watershed. Barren landscape produced the largest runoff yields （52.46% of the total runoff） in the upper Heihe River watershed, fol- lowed by grassland （34.15%）, shrub （9.02%）, glacier （3.57%）, and forest （0.49%）. In order to simulate the impact of landscape change on hydrological components, three landscape change scenarios were designed in the study. Scenario 1, 2 and 3 were to convert all shady slope landscapes at 2,000-3,300 m, 2,000-3,700 m, and 2,000-4,000 m asl respectively to forest lands, with forest coverage rate increased to 12.4%, 28.5% and 42.0%, respectively. The runoff at the catchment outlet correspondingly declined by 3.5%, 13.1% and 24.2% under the three scenarios. The forest landscape is very important in water conservation as it reduced the flood peak and increased the base flow. The mountains as ＂water towers＂ play important roles in water resources generation and the impact of mountain landscapes on hydrology is significant.

20例伴MYC BCL2和(或)BCL6重排的高级别B细胞淋巴瘤患者的临床特征及预后分析

目的:分析伴MYC、BCL2和(或)BCL6重排的高级别B细胞淋巴瘤(high-grade B-cell lymphoma,HGBL-DH/TH)患者的临床特点、治疗及预后。方法:回顾性分析2015年1月至2020年11月在中国医学科学院血液病医院诊治的20例HGBLDH/TH患者临床、病理资料及治疗转归。结果:20例患者中位年龄52(23~68)岁,男性占55%。75%患者Ann Arbor分期为Ⅲ~Ⅳ期,80%伴有结外侵犯,75%乳酸脱氢酶水平升高。所有患者诱导治疗最佳客观缓解率(objective response rate,ORR)和完全缓解率(complete response,CR)分别为75%和60%,中位随访27.7(3.8~74.6)个月,2年无进展生存(progression-free survival,PFS)率和总生存(overall survival,OS)率分别为55.0%和59.1%。局限期患者疗效优于进展期患者,两组最佳ORR分别为100.0%和61.5%,2年OS率分别为100.0%和45.7%。诱导治疗获得首次CR(first complete response,CR1)的12例患者中,除1例早期复发外均维持持续缓解状态(continuous complete response,CCR),其OS明显优于未达CR患者(P<0.001),2年OS率分别为91.7%和25.0%。复发或难治性(refractory/relapsed,R/R)患者预后极差,8例患者中仅1例挽救治疗获得CCR,其余7例患者均因疾病进展死亡。结论:本研究显示HGBL-DH/TH具有Ann Arbor分期晚、结外侵犯常见、LDH水平异常、总生存期短等特点。局限期相对进展期患者疗效更好。CR1患者生存良好,而R/R患者缺乏有效的挽救治疗,预后较差。

Coarse fragment content influences estimates of soil C and N stocks of alpine grassland on the northeastern edge of Qinghai-Tibetan Plateau,China

Soil organic carbon(SOC)and total nitrogen(TN)stocks are usually calculated with samples collected using core samplers.Although the calculation considers the effects of gravel in soil samples,other coarse fragments such as stones or boulders in soil may not be collected due to the restricted diameter of core samplers.This would cause an incorrect estimation of soil bulk density and ultimately SOC and TN stocks.In this study,we compared the relative volume of coarse fragment and bulk density of fine earth determined by large size soil sampler with three core samplers.We also investigated the uncertainties in estimation of SOC and TN stocks caused by this soil sampler procedure in three typical alpine grasslands on the northeast edge of the Qinghai-Tibetan Plateau(QTP),China.Results show that(1)the relative volume and size of coarse fragment collected by large size sampler were significantly(p<0.05)higher and larger than those of core samplers,while bulk density of fine earth,SOC and TN stocks show opposite patterns in all grassland types;(2)SOC and TN stocks determined by core samplers were 17%-45%and 18%-46%higher than larger size sampler for three typical alpine grasslands;and(3)bulk density of fine earth,SOC and TN stocks exponentially decreased with the increasing of coarse fragment content.We concluded that core sampler methods significantly underestimated the volume occupied by coarse fragment but overestimated SOC and TN stocks.Thus,corrections should be made to the results from core samplers using large size samplers on regions with gravel and stone-rich soils in future studies.

Benefit of rituximab maintenance is associated with Follicular Lymphoma International Prognostic Index in patients with follicular lymphoma

Rituximab maintenance(RM)prolongs the progression-free survival(PFS)of responding patients with follicular lymphoma(FL),but the maintenance efficacy in different Follicular Lymphoma International Prognostic Index(FLIPI)risk group is still confusing.We performed a retrospective analysis of the effect of RM treatments in patients with FL responding to induction therapy based on their FLIPI risk assessment carried out prior to treatment.We identified 93 patients between 2013 and 2019 who received RM every 3 months for≥4 doses(RM group),and 60 patients who did not accept RM or received rituximab less than 4 doses(control group).After a median follow-up of 39 months,neither median overall survival(OS)nor PFS was reached for the entire population.The PFS was significantly prolonged in the RM group compared to the control group(median PFS NA vs 83.1 months,P=.00027).When the population was divided into the 3 FLIPI risk groups,the PFS differed significantly(4-year PFS rates,97.5%vs 88.8%vs 72.3%,P=.01)according to group.There was no significant difference in PFS for FLIPI low-risk patients with RM compared to the control group(4-year PFS rates,100%vs 93.8%,P=.23).However,the PFS of the RM group was significantly prolonged for FLIPI intermediate-risk(4-year PFS rates,100%vs 70.3%,P=.00077)and high-risk patients(4-year PFS rates,86.7%vs 57.1%,P=.023).These data suggest that standard RM significantly prolongs the PFS of patients assigned to intermediate-and high-risk FLIPI groups but not to low-risk FLIPI group,and pending larger-scale studies to validate.

Cytogenetic aberrations of lymphoplasmacytic lymphoma/ Waldenström’s macroglobulinemia in Chinese patients

To the Editor:As a rare indolent B cell non-Hodgkin lymphoma,lymphoplasmacytic lymphoma/Waldenström’s macroglobulinemia(LPL/WM)has unique clinical and biological characteristics.[1]However,due to the difficulties in obtaining tumor metaphase for karyotyping and slow cell proliferation,only very few studies have detected the cytogenetic aberration of LPL/WM.[2,3]In addition,6q deletion is the most common cytogenetic aberration in WM,with an incidence rate of about 50%.[2]Nevertheless,other cytogenetic aberrations remain largely unclear,and the prognostic role of cytogenetic aberrations needs to be further explored.In the present study,we systematically analyzed 305 LPL/WM cases in China,focusing on the characteristics and cytogenetic aberrations in Chinese patients.

Exosome miRNAs profiling in serum and prognostic evaluation in patients with multiple myeloma

MicroRNAs(MiRNAs)carried by exosomes play pivotal roles in the crosstalk between cell components in the tumor microenvironment.Our study aimed at identifying the expression profile of exosomal miRNAs(exo-miRNAs)in the serum of multiple myeloma(MM)patients and investigating the regulation networks and their potential functions by integrated bioinformatics analysis.Exosomes in serum from 19 newly diagnosed MM patients and 9 healthy donors were isolated and the miRNA profile was investigated by small RNA sequencing.Differential expression of exo-miRNAs was calculated and target genes of miRNAs were predicted.CytoHubba was applied to identify the hub miRNAs and core target genes.The LASSO Cox regression model was used to develop the prognostic model,and the ESTIMATE immune score was calculated to investigate the correlation between the model and immune status in MM patients.The top six hub differentially expressed serum exo-miRNAs were identified.513 target genes of the six hub exo-miRNAs were confirmed to be differentially expressed in MM cells in the Zhan Myeloma microarray dataset.Functional enrichment analysis indicated that these target genes were mainly involved in mRNA splicing,cellular response to stress,and deubiquitination.13 core exo-miRNA target genes were applied to create a novel prognostic signature to provide risk stratification for MM patients,which is associated with the immune microenvironment of MM patients.Our study comprehensively investigated the exo-miRNA profiles in MM patients.A novel prognostic signature was constructed to facilitate the risk stratification of MM patients with distinct outcomes.