Acute lymphoblastic leukemia (ALL) is characterized by immature and poorly differentiated B lymphocytes in large numbers in the blood. B cells are distinct from the cell types involved in their development (common lym...Acute lymphoblastic leukemia (ALL) is characterized by immature and poorly differentiated B lymphocytes in large numbers in the blood. B cells are distinct from the cell types involved in their development (common lymphoid progenitor cells, pro-B cells, pre-B cells, and mature cells). The process of B cell maturation depends on precise communication within the cell: signals activate specific genes that are essential for proper development. Errors in this intricate signaling network can lead to issues with B cell function and contribute to disease. B-lineage acute lymphoid leukemias, malignancies of precursor-stage B lymphoid cells inhibit lymphoid differentiation, leading to abnormal cell proliferation and survival. The process of developing leukemia (leukemogenesis) can be triggered by an overproduction of both hematopoietic stem cells (the cells that form all blood cells) and the immature versions of white blood cells called lymphoblasts. Acute lymphoblastic leukemia (ALL) with the presence of the Philadelphia chromosome (ALL Ph) is classified as a high-risk manifestation of the disease, this chromosome is the product of the reciprocal translocation, whose product is a BCR-ABL fusion protein. It is a highly active tyrosine kinase that can transform hematopoietic cells into cytokine-independent. Hyperphosphorylation cascades inhibit the differentiating function of IKZF1 as a tumor suppressor gene which leads to an abnormal proliferation of B cells due to the presence of the Philadelphia chromosome;it inhibits the differentiating process, leukemogenesis involving immature B cells in the bloodstream can result from the uncontrolled growth and division of hematopoietic stem cells and immature lymphoblasts (the precursors to B cells).展开更多
The truncated chromosome 22 that results from the reciprocal translocation t(9;22)(q34;q11) is known as the Phila?delphia chromosome(Ph) and is a hallmark of chronic myeloid leukemia(CML).In leukemia cells,Ph not only...The truncated chromosome 22 that results from the reciprocal translocation t(9;22)(q34;q11) is known as the Phila?delphia chromosome(Ph) and is a hallmark of chronic myeloid leukemia(CML).In leukemia cells,Ph not only impairs the physiological signaling pathways but also disrupts genomic stability.This aberrant fusion gene encodes the breakpoint cluster region?proto?oncogene tyrosine?protein kinase(BCR?ABL1) oncogenic protein with persistently enhanced tyrosine kinase activity.The kinase activity is responsible for maintaining proliferation,inhibiting differentia?tion,and conferring resistance to cell death.During the progression of CML from the chronic phase to the accelerated phase and then to the blast phase,the expression patterns of different BCR?ABL1 transcripts vary.Each BCR?ABL1 transcript is present in a distinct leukemia phenotype,which predicts both response to therapy and clinical outcome.Besides CML,the Ph is found in acute lymphoblastic leukemia,acute myeloid leukemia,and mixed?phenotype acute leukemia.Here,we provide an overview of the clinical presentation and cellular biology of different phenotypes of Ph?positive leukemia and highlight key findings regarding leukemogenesis.展开更多
Chronic myeloid leukemia(CML)is a myeloproliferative neoplasm and was the first neoplastic disease associated with a well-defined genotypic anomaly―the presence of the Philadelphia chromosome.The advances in cytogene...Chronic myeloid leukemia(CML)is a myeloproliferative neoplasm and was the first neoplastic disease associated with a well-defined genotypic anomaly―the presence of the Philadelphia chromosome.The advances in cytogenetic and molecular assays are of great importance to the diagnosis,prognosis,treatment,and monitoring of CML.The discovery of the breakpoint cluster region(BCR)-Abelson murine leukemia(ABL)1 fusion oncogene has revolutionized the treatment of CML patients by allowing the development of targeted drugs that inhibit the tyrosine kinase activity of the BCR-ABL oncoprotein.Tyrosine kinase inhibitors(known as TKIs)are the standard therapy for CML and greatly increase the survival rates,despite adverse effects and the odds of residual disease after discontinuation of treatment.As therapeutic alternatives,the subsequent TKIs lead to faster and deeper molecular remissions;however,with the emergence of resistance to these drugs,immunotherapy appears as an alternative,which may have a cure potential in these patients.Against this background,this article aims at providing an overview on CML clinical management and a summary on the main targeted drugs available in that context.展开更多
Background and Objectives: Chronic myeloid leukemia (CML) accounts for approximately 15% of newly diagnosed cases of leukemia in adults. In this study, the efficacy of nilotinib at 400 mg BID is compared with imatinib...Background and Objectives: Chronic myeloid leukemia (CML) accounts for approximately 15% of newly diagnosed cases of leukemia in adults. In this study, the efficacy of nilotinib at 400 mg BID is compared with imatinib at 400 mg BID in CML patients with suboptimal molecular response after at least 12 months of daily dose 400 mg of imatinib therapy. Patients and Methods: This study included a total number of 50 patients, divided into two groups (25 patients each). The first group (Group I): Patients received imatinib at 400 mg BID, second group (Group II): Patients had a suboptimal molecular response to imatinib and received nilotinib at 400 mg BID in early chronic phase. During the two years period of data collection, the primary end included median survival. The secondary end included response rate, type of response, duration of response and progression free survival. Also side effects were recorded. Patients were followed up every month by complete and differential blood counts, liver function test, renal function test and (PCR) every three months for two year. Results: Nilotinib group had significantly higher frequency of major molecular response (MMR) where 23 (92%) patients achieved it while only 16 (64%) patients in Imatinib group achieved MMR (P = 0.01). Nilotinib had better toxicities profile than Imatinib. Conclusion: Both Nilotinib and high dose Imatinib achieved response in CML patients with suboptimal response with rapid and deeper molecular response, better survival outcomes and less side effects in nilotinib.展开更多
Cytogenetic abnormalities are the hallmark of leukemias. We report here two cases of unusual cytogenetic abnormalities associated with Philadelphia chromosome, one with mixed phenotypic acute leukemia showing monosomy...Cytogenetic abnormalities are the hallmark of leukemias. We report here two cases of unusual cytogenetic abnormalities associated with Philadelphia chromosome, one with mixed phenotypic acute leukemia showing monosomy 7 and t(9;22)(q34;q11.2) and the other with chronic myeloid leukemia and additional translocation involving chromosomes 10 and 13. Both patients achieved complete remission following imatinib based treatment.展开更多
The Sixth Philadelphia Travel & Adventure Show took place at Pennsylvania Convention Center in Philadelphia, the USA, from March 9 to 1 0. China National Tourist Office, New York, used pandas and Peking Opera symb...The Sixth Philadelphia Travel & Adventure Show took place at Pennsylvania Convention Center in Philadelphia, the USA, from March 9 to 1 0. China National Tourist Office, New York, used pandas and Peking Opera symbolic meaning as the key visual style,"Beautiful China" national tourism brand as the theme to present "China Beyond Imaginations , in Philadelphia, delivered news about tourism in China and caught attention of lots of participants.展开更多
Date: May 17-18, 2019 Venue: National Center for the Performing Arts Prices: RMB 280, 480, 600, 780, 900, 1080, 1280 The Philadelphia Orchestra is one of the preeminent orchestras in the world, renowned for its distin...Date: May 17-18, 2019 Venue: National Center for the Performing Arts Prices: RMB 280, 480, 600, 780, 900, 1080, 1280 The Philadelphia Orchestra is one of the preeminent orchestras in the world, renowned for its distinctive sound, desired for its keen ability to capture the hearts and imaginations of audiences, and admired for a legacy of imagination and innovation on and off the concert stage.展开更多
MUSIC is an internationalart,enabling people allover the world to com-municate with and understand eachother.The first cultural troupe sentby the American government to visitChina 20 years ago was the Philadel-phia Or...MUSIC is an internationalart,enabling people allover the world to com-municate with and understand eachother.The first cultural troupe sentby the American government to visitChina 20 years ago was the Philadel-phia Orchestra.Their perform-ances contributed greatly to Sino-American cultural exchange andpromoted friendship between theAmerican and Chinese people.InMay 1993 the Philadelphia Orches-tra came to China again as theAmerican people’s cultural展开更多
Asia 2024'Happy Chinese New Year at University of Malaya On January 17,China Cultural Center in Kuala Lumpur launched the"Happy Chinese NewYear"series of activities at the University of Malaya to celebra...Asia 2024'Happy Chinese New Year at University of Malaya On January 17,China Cultural Center in Kuala Lumpur launched the"Happy Chinese NewYear"series of activities at the University of Malaya to celebrate the upcoming Year of the Dragon in the Chinese Lunar Calendar。展开更多
The‘Spring Cup’Table Tennisand Badminton International Championship Held by China Cultural Centerin Benin。On March 16,China Cultural Center in Benin,together with the Benin Badminton and Table Tennis Association,he...The‘Spring Cup’Table Tennisand Badminton International Championship Held by China Cultural Centerin Benin。On March 16,China Cultural Center in Benin,together with the Benin Badminton and Table Tennis Association,held the 2024"Spring Cup"Table Tennis and Badminton International Championship at the Palace of Arts,Entertainment and Sports in Cotonou.More than 100 athletes from China,Benin,Togo,India and other countries gathered to show their talents.展开更多
Evidence for a mantle and/or basaltic component in KT boundary distal ejecta is apparently inconsistent with ejection from Chicxulub Crater since it is located on;5km thick continental crust(De Paolo et al.,1983;Mont...Evidence for a mantle and/or basaltic component in KT boundary distal ejecta is apparently inconsistent with ejection from Chicxulub Crater since it is located on;5km thick continental crust(De Paolo et al.,1983;Montanari et al.,1983;Hildebrand and Boynton,1988,1990).This evidence,along with ejected terrestrial chromites(Olds et al.,2016)suggest the impact sampled terrestrial mafic and/or ultramafic target rocks which are not known to exist in the Chicxulub target area.Possible resolutions to the paradox are:1)the existence of an unmapped/unknown suture in Yucatan Platform basement,2)an additional small unmapped/unknown impact site on oceanic lithosphere,or 3)an additional large impact on oceanic lithosphere or continental margin transitional to oceanic lithosphere.The third hypothesis is elaborated here since:1)Ophiolites nearest to Chicxulub crater are found in Cuba and apparently were obducted in latest Cretaceous/earliest Danian times(García-Casco,2008),inconsistent with the documented Eocene collision of Cuba with the Bahamas platform;and 2)Cuba hosts the world’s thickest known KT boundary deposits(Iturralde-Vinent,1992;Kiyokawa et al.,2002;Tada et al.,2003).These and geometric considerations suggest oceanic crust and upper mantle rock,exposed as ophiolite in the Greater Antilles island chain,marks the rim of a roughly 700 km diameter impact basin deformed and dismembered from an originally circular form by at least 50 million years of left-lateral shear displacement along the North American-Caribbeantransform plate boundary.展开更多
Background Relapse happens frequently after allogeneic hematopoietic cell transplantation (alIo-HCT) in the patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph^+ ALL). Detection of the...Background Relapse happens frequently after allogeneic hematopoietic cell transplantation (alIo-HCT) in the patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph^+ ALL). Detection of the minimal residual disease (MRD) before and after alIo-HCT is associated with higher relapse rate. Early administration of imatinib after alIo-HCT may prevent recurrent Ph^+ ALL. The aim of this study was to evaluate the safety and efficacy of imatinib in preventing hematological relapse when imatinib was administrated in the first 90 days after alIo-HCT. Methods Patients with Ph^+ ALL that underwent alIo-HCT were enrolled in a prospective study. A TaqMan-based real-time quantitative polymerase chain reaction (RQ-PCR) technique was used to detect the MRD (bcr-abl transcript levels). Imatinib therapy was initiated prior to 90 days after alIo-HCT if the patient's absolute neutrophil count (ANC) was above 1.0×10^9/L (without granulocyte colony-stimulating factor (G-CSF) administration) and the platelet count was greater than 50.0×10^9/L, or if the bcr-abl transcript levels were elevated in two consecutive tests, or if the bcr-abl transcript levels were 〉10.2 after the initial engraftment. The initial daily dose of imatinib was 400 mg/d for adults and 260 mg/m^2 for children (younger than 17 years). Imatinib was administered for at least I month and the bcr-abl TaqMan results were negative for 3 consecutive tests, or complete molecular remission (CR^mol) was sustained for at least 3 months. Results From May 2005 to October 2008, 29 patients were enrolled in this study, of whom, 19 patients were male and 10 were female. The median age of the enrolled patients was 33 years (range 6-50 years). Imatinib therapy was started at a median time of 60 days (range 20-122 days) post HCT (only one patient started Imatinib therapy at 122nd day after HCT). Twenty-five adult patients could tolerate a dose of 300-400 mg/d of imatinib, and three children tolerated a dose of 260 mg·m^2·d^-1. Sixty-eight percent of the patients experienced various adverse events during imatinib therapy, hematological toxicity being the most common adverse event. The median duration of imatinib treatment was 3 months (range 7 days-18 months). During the median follow-up of 24 months (range 16.0-54.5 months), 3 out of 27 patients that could be evaluated for efficacy died from relapse. The 3-year probability of relapse for the evaluated patients was (11.34-0.61)%. The relapse rates among the subgroup of positive and negative bcr-abl patients before allo-HCT were 13.6% and 0, respectively (P 〉0.05). The relapse rates among the subgroups of bcr-abl positive and negative patients after alIo-HCT were 20.0% and 5.9%, respectively (P 〉0.05). The relapse rates among the patients in first complete remission (CR1) and second complete remission/non-remission (CR2/NR) before transplantation were 0 and 31.4%, respectively (P 〈0.05). The 3-year probability of overall survival (OS) and disease-free survival (DFS) for the all enrolled patients were (75.3±8.1)%. The 3-year probabilities for OS and DFS among the subgroup of patients in CR1 and CR2/NR before transplantation were (87.7±8.2)% and (54.6±15.0)%, respectively (P 〈0.05). Conclusions Administration of irnatinib at a dose of 300-400 mg/d in the first 90 days after allo-HCT is feasible in Ph^+ ALL patients. With this treatment, bcr-abl positive patients before or after transplantation do not have a higher relapse rate after allo-HCT compared with the bcr-abl negative patients. Because of lower relapse rate and better OS and DFS, we recommend that Ph^+ ALL patients receive allo-HCT in CRI.展开更多
A CALLG2008 protocol was developed by the Chinese Acute Lymphoblastic Leukemia Cooperative Group for adult acute lymphoblastic leukemia (ALL). We retrospectively analyzed 153 newly diagnosed adult patients with Phil...A CALLG2008 protocol was developed by the Chinese Acute Lymphoblastic Leukemia Cooperative Group for adult acute lymphoblastic leukemia (ALL). We retrospectively analyzed 153 newly diagnosed adult patients with Philadelphia chromosome (Ph)-positive ALL enrolled into imatinib (400 mg/d) plus CALLG2008 regimen between 2009 and 2015. The median age was 40 years (range, 18-68 years), with 81 (52.3%) males. The overall hematologic complete remission (CR) rate was 96.7% after induction. With a median follow-up of 24.2 months, the estimated 3-year overall survival (OS) and event-free survival (EFS) rates were 49.5% (95% confidence interval (CI): 38.5%-59.5%) and 49.2% (95% CI: 38.3%-59.2%), respectively. Fifty-eight (36 with haploidentical donor) patients underwent allogeneic hematopoietic stem call transplantation (allo-HSCT) in first CR. Among the patients in CR1 after induction, both the 3-year OS and EFS were significantly better in the allo-HSCT group than in the without alIo-HSCT group (73.2%, 95% CI: 58.3%-83.5% vs. 22.2%, 95% CI: 8.7%-39.6% and 66.5%, 95% CI: 50.7%-78.2% vs. 16.1%, 95% CI: 5.1%-32.7%, respectively). Multivariate analysis showed that alIo-HSCT and achievement of major molecular response were associated with favorable OS or EFS independently. Interestingly, in the alIo-HSCT cohort, the donor type (haploidentical versus matched donors) had no significant impact on EFS or OS. All these results suggested that imatinib plus CALLG2008 was an effective protocol for Ph-positive ALL. Haploidentical donors can also be a reasonable alternative expedient donor pool.展开更多
Philadelphia chromosome-positive acute myeloid leukemia is controversial and difficult to distinguish from the blast phase of chronic myeloid leukemia. As a myeloid neoplasm, rare cases of this leukemia manifest multi...Philadelphia chromosome-positive acute myeloid leukemia is controversial and difficult to distinguish from the blast phase of chronic myeloid leukemia. As a myeloid neoplasm, rare cases of this leukemia manifest multiple soft-tissue tumors or bone lyric lesions. In this paper, we describe a 49-year-old male patient who had an abrupt onset with sharp chest pain, fever, fatigue, emaciation, and splenomegaly. 18F-fluoro-deoxy-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) result showed diffuse and uneven hypermetabolic lesions in the bone marrow with peripheral bone marrow expansion, multiple soft tissue neoplasms with high 18F-FDG uptake, and lyric bone lesions. Bone marrow smear and biopsy detected aberrant blast cells expressing myeloid rather than lymphoid immunophenotype marker. For the existence of Philadelphia chromosome and BCR-ABL1 fusion gene together with complex chromosome abnormalities, a diagnosis of Philadelphia-positive acute myeloid leukemia was made, although the type (de novo or blast crisis) remained unclear.展开更多
文摘Acute lymphoblastic leukemia (ALL) is characterized by immature and poorly differentiated B lymphocytes in large numbers in the blood. B cells are distinct from the cell types involved in their development (common lymphoid progenitor cells, pro-B cells, pre-B cells, and mature cells). The process of B cell maturation depends on precise communication within the cell: signals activate specific genes that are essential for proper development. Errors in this intricate signaling network can lead to issues with B cell function and contribute to disease. B-lineage acute lymphoid leukemias, malignancies of precursor-stage B lymphoid cells inhibit lymphoid differentiation, leading to abnormal cell proliferation and survival. The process of developing leukemia (leukemogenesis) can be triggered by an overproduction of both hematopoietic stem cells (the cells that form all blood cells) and the immature versions of white blood cells called lymphoblasts. Acute lymphoblastic leukemia (ALL) with the presence of the Philadelphia chromosome (ALL Ph) is classified as a high-risk manifestation of the disease, this chromosome is the product of the reciprocal translocation, whose product is a BCR-ABL fusion protein. It is a highly active tyrosine kinase that can transform hematopoietic cells into cytokine-independent. Hyperphosphorylation cascades inhibit the differentiating function of IKZF1 as a tumor suppressor gene which leads to an abnormal proliferation of B cells due to the presence of the Philadelphia chromosome;it inhibits the differentiating process, leukemogenesis involving immature B cells in the bloodstream can result from the uncontrolled growth and division of hematopoietic stem cells and immature lymphoblasts (the precursors to B cells).
基金supported by the China Central Budget Recruitment Program of High?Level Overseas Talent (GDW 201221022066 to Q.Liu)the National Basic Research Program of China (973 Program:No.2012CB967000 to Q.Liu)+2 种基金the National Natural Science Foundation of China (NNSF No.81130040 to Q.Liu and No.81201686 to J.Xu)the Program for Changjiang Scholars and Innovative Research Team in Universities (ITR 13049 to Q.Liu)the Liaoning (NSF 2014029102 to Q.Liu)
文摘The truncated chromosome 22 that results from the reciprocal translocation t(9;22)(q34;q11) is known as the Phila?delphia chromosome(Ph) and is a hallmark of chronic myeloid leukemia(CML).In leukemia cells,Ph not only impairs the physiological signaling pathways but also disrupts genomic stability.This aberrant fusion gene encodes the breakpoint cluster region?proto?oncogene tyrosine?protein kinase(BCR?ABL1) oncogenic protein with persistently enhanced tyrosine kinase activity.The kinase activity is responsible for maintaining proliferation,inhibiting differentia?tion,and conferring resistance to cell death.During the progression of CML from the chronic phase to the accelerated phase and then to the blast phase,the expression patterns of different BCR?ABL1 transcripts vary.Each BCR?ABL1 transcript is present in a distinct leukemia phenotype,which predicts both response to therapy and clinical outcome.Besides CML,the Ph is found in acute lymphoblastic leukemia,acute myeloid leukemia,and mixed?phenotype acute leukemia.Here,we provide an overview of the clinical presentation and cellular biology of different phenotypes of Ph?positive leukemia and highlight key findings regarding leukemogenesis.
文摘Chronic myeloid leukemia(CML)is a myeloproliferative neoplasm and was the first neoplastic disease associated with a well-defined genotypic anomaly―the presence of the Philadelphia chromosome.The advances in cytogenetic and molecular assays are of great importance to the diagnosis,prognosis,treatment,and monitoring of CML.The discovery of the breakpoint cluster region(BCR)-Abelson murine leukemia(ABL)1 fusion oncogene has revolutionized the treatment of CML patients by allowing the development of targeted drugs that inhibit the tyrosine kinase activity of the BCR-ABL oncoprotein.Tyrosine kinase inhibitors(known as TKIs)are the standard therapy for CML and greatly increase the survival rates,despite adverse effects and the odds of residual disease after discontinuation of treatment.As therapeutic alternatives,the subsequent TKIs lead to faster and deeper molecular remissions;however,with the emergence of resistance to these drugs,immunotherapy appears as an alternative,which may have a cure potential in these patients.Against this background,this article aims at providing an overview on CML clinical management and a summary on the main targeted drugs available in that context.
文摘Background and Objectives: Chronic myeloid leukemia (CML) accounts for approximately 15% of newly diagnosed cases of leukemia in adults. In this study, the efficacy of nilotinib at 400 mg BID is compared with imatinib at 400 mg BID in CML patients with suboptimal molecular response after at least 12 months of daily dose 400 mg of imatinib therapy. Patients and Methods: This study included a total number of 50 patients, divided into two groups (25 patients each). The first group (Group I): Patients received imatinib at 400 mg BID, second group (Group II): Patients had a suboptimal molecular response to imatinib and received nilotinib at 400 mg BID in early chronic phase. During the two years period of data collection, the primary end included median survival. The secondary end included response rate, type of response, duration of response and progression free survival. Also side effects were recorded. Patients were followed up every month by complete and differential blood counts, liver function test, renal function test and (PCR) every three months for two year. Results: Nilotinib group had significantly higher frequency of major molecular response (MMR) where 23 (92%) patients achieved it while only 16 (64%) patients in Imatinib group achieved MMR (P = 0.01). Nilotinib had better toxicities profile than Imatinib. Conclusion: Both Nilotinib and high dose Imatinib achieved response in CML patients with suboptimal response with rapid and deeper molecular response, better survival outcomes and less side effects in nilotinib.
文摘Cytogenetic abnormalities are the hallmark of leukemias. We report here two cases of unusual cytogenetic abnormalities associated with Philadelphia chromosome, one with mixed phenotypic acute leukemia showing monosomy 7 and t(9;22)(q34;q11.2) and the other with chronic myeloid leukemia and additional translocation involving chromosomes 10 and 13. Both patients achieved complete remission following imatinib based treatment.
文摘The Sixth Philadelphia Travel & Adventure Show took place at Pennsylvania Convention Center in Philadelphia, the USA, from March 9 to 1 0. China National Tourist Office, New York, used pandas and Peking Opera symbolic meaning as the key visual style,"Beautiful China" national tourism brand as the theme to present "China Beyond Imaginations , in Philadelphia, delivered news about tourism in China and caught attention of lots of participants.
文摘Date: May 17-18, 2019 Venue: National Center for the Performing Arts Prices: RMB 280, 480, 600, 780, 900, 1080, 1280 The Philadelphia Orchestra is one of the preeminent orchestras in the world, renowned for its distinctive sound, desired for its keen ability to capture the hearts and imaginations of audiences, and admired for a legacy of imagination and innovation on and off the concert stage.
文摘MUSIC is an internationalart,enabling people allover the world to com-municate with and understand eachother.The first cultural troupe sentby the American government to visitChina 20 years ago was the Philadel-phia Orchestra.Their perform-ances contributed greatly to Sino-American cultural exchange andpromoted friendship between theAmerican and Chinese people.InMay 1993 the Philadelphia Orches-tra came to China again as theAmerican people’s cultural
文摘Asia 2024'Happy Chinese New Year at University of Malaya On January 17,China Cultural Center in Kuala Lumpur launched the"Happy Chinese NewYear"series of activities at the University of Malaya to celebrate the upcoming Year of the Dragon in the Chinese Lunar Calendar。
文摘The‘Spring Cup’Table Tennisand Badminton International Championship Held by China Cultural Centerin Benin。On March 16,China Cultural Center in Benin,together with the Benin Badminton and Table Tennis Association,held the 2024"Spring Cup"Table Tennis and Badminton International Championship at the Palace of Arts,Entertainment and Sports in Cotonou.More than 100 athletes from China,Benin,Togo,India and other countries gathered to show their talents.
文摘Evidence for a mantle and/or basaltic component in KT boundary distal ejecta is apparently inconsistent with ejection from Chicxulub Crater since it is located on;5km thick continental crust(De Paolo et al.,1983;Montanari et al.,1983;Hildebrand and Boynton,1988,1990).This evidence,along with ejected terrestrial chromites(Olds et al.,2016)suggest the impact sampled terrestrial mafic and/or ultramafic target rocks which are not known to exist in the Chicxulub target area.Possible resolutions to the paradox are:1)the existence of an unmapped/unknown suture in Yucatan Platform basement,2)an additional small unmapped/unknown impact site on oceanic lithosphere,or 3)an additional large impact on oceanic lithosphere or continental margin transitional to oceanic lithosphere.The third hypothesis is elaborated here since:1)Ophiolites nearest to Chicxulub crater are found in Cuba and apparently were obducted in latest Cretaceous/earliest Danian times(García-Casco,2008),inconsistent with the documented Eocene collision of Cuba with the Bahamas platform;and 2)Cuba hosts the world’s thickest known KT boundary deposits(Iturralde-Vinent,1992;Kiyokawa et al.,2002;Tada et al.,2003).These and geometric considerations suggest oceanic crust and upper mantle rock,exposed as ophiolite in the Greater Antilles island chain,marks the rim of a roughly 700 km diameter impact basin deformed and dismembered from an originally circular form by at least 50 million years of left-lateral shear displacement along the North American-Caribbeantransform plate boundary.
文摘Background Relapse happens frequently after allogeneic hematopoietic cell transplantation (alIo-HCT) in the patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph^+ ALL). Detection of the minimal residual disease (MRD) before and after alIo-HCT is associated with higher relapse rate. Early administration of imatinib after alIo-HCT may prevent recurrent Ph^+ ALL. The aim of this study was to evaluate the safety and efficacy of imatinib in preventing hematological relapse when imatinib was administrated in the first 90 days after alIo-HCT. Methods Patients with Ph^+ ALL that underwent alIo-HCT were enrolled in a prospective study. A TaqMan-based real-time quantitative polymerase chain reaction (RQ-PCR) technique was used to detect the MRD (bcr-abl transcript levels). Imatinib therapy was initiated prior to 90 days after alIo-HCT if the patient's absolute neutrophil count (ANC) was above 1.0×10^9/L (without granulocyte colony-stimulating factor (G-CSF) administration) and the platelet count was greater than 50.0×10^9/L, or if the bcr-abl transcript levels were elevated in two consecutive tests, or if the bcr-abl transcript levels were 〉10.2 after the initial engraftment. The initial daily dose of imatinib was 400 mg/d for adults and 260 mg/m^2 for children (younger than 17 years). Imatinib was administered for at least I month and the bcr-abl TaqMan results were negative for 3 consecutive tests, or complete molecular remission (CR^mol) was sustained for at least 3 months. Results From May 2005 to October 2008, 29 patients were enrolled in this study, of whom, 19 patients were male and 10 were female. The median age of the enrolled patients was 33 years (range 6-50 years). Imatinib therapy was started at a median time of 60 days (range 20-122 days) post HCT (only one patient started Imatinib therapy at 122nd day after HCT). Twenty-five adult patients could tolerate a dose of 300-400 mg/d of imatinib, and three children tolerated a dose of 260 mg·m^2·d^-1. Sixty-eight percent of the patients experienced various adverse events during imatinib therapy, hematological toxicity being the most common adverse event. The median duration of imatinib treatment was 3 months (range 7 days-18 months). During the median follow-up of 24 months (range 16.0-54.5 months), 3 out of 27 patients that could be evaluated for efficacy died from relapse. The 3-year probability of relapse for the evaluated patients was (11.34-0.61)%. The relapse rates among the subgroup of positive and negative bcr-abl patients before allo-HCT were 13.6% and 0, respectively (P 〉0.05). The relapse rates among the subgroups of bcr-abl positive and negative patients after alIo-HCT were 20.0% and 5.9%, respectively (P 〉0.05). The relapse rates among the patients in first complete remission (CR1) and second complete remission/non-remission (CR2/NR) before transplantation were 0 and 31.4%, respectively (P 〈0.05). The 3-year probability of overall survival (OS) and disease-free survival (DFS) for the all enrolled patients were (75.3±8.1)%. The 3-year probabilities for OS and DFS among the subgroup of patients in CR1 and CR2/NR before transplantation were (87.7±8.2)% and (54.6±15.0)%, respectively (P 〈0.05). Conclusions Administration of irnatinib at a dose of 300-400 mg/d in the first 90 days after allo-HCT is feasible in Ph^+ ALL patients. With this treatment, bcr-abl positive patients before or after transplantation do not have a higher relapse rate after allo-HCT compared with the bcr-abl negative patients. Because of lower relapse rate and better OS and DFS, we recommend that Ph^+ ALL patients receive allo-HCT in CRI.
文摘A CALLG2008 protocol was developed by the Chinese Acute Lymphoblastic Leukemia Cooperative Group for adult acute lymphoblastic leukemia (ALL). We retrospectively analyzed 153 newly diagnosed adult patients with Philadelphia chromosome (Ph)-positive ALL enrolled into imatinib (400 mg/d) plus CALLG2008 regimen between 2009 and 2015. The median age was 40 years (range, 18-68 years), with 81 (52.3%) males. The overall hematologic complete remission (CR) rate was 96.7% after induction. With a median follow-up of 24.2 months, the estimated 3-year overall survival (OS) and event-free survival (EFS) rates were 49.5% (95% confidence interval (CI): 38.5%-59.5%) and 49.2% (95% CI: 38.3%-59.2%), respectively. Fifty-eight (36 with haploidentical donor) patients underwent allogeneic hematopoietic stem call transplantation (allo-HSCT) in first CR. Among the patients in CR1 after induction, both the 3-year OS and EFS were significantly better in the allo-HSCT group than in the without alIo-HSCT group (73.2%, 95% CI: 58.3%-83.5% vs. 22.2%, 95% CI: 8.7%-39.6% and 66.5%, 95% CI: 50.7%-78.2% vs. 16.1%, 95% CI: 5.1%-32.7%, respectively). Multivariate analysis showed that alIo-HSCT and achievement of major molecular response were associated with favorable OS or EFS independently. Interestingly, in the alIo-HSCT cohort, the donor type (haploidentical versus matched donors) had no significant impact on EFS or OS. All these results suggested that imatinib plus CALLG2008 was an effective protocol for Ph-positive ALL. Haploidentical donors can also be a reasonable alternative expedient donor pool.
文摘Philadelphia chromosome-positive acute myeloid leukemia is controversial and difficult to distinguish from the blast phase of chronic myeloid leukemia. As a myeloid neoplasm, rare cases of this leukemia manifest multiple soft-tissue tumors or bone lyric lesions. In this paper, we describe a 49-year-old male patient who had an abrupt onset with sharp chest pain, fever, fatigue, emaciation, and splenomegaly. 18F-fluoro-deoxy-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) result showed diffuse and uneven hypermetabolic lesions in the bone marrow with peripheral bone marrow expansion, multiple soft tissue neoplasms with high 18F-FDG uptake, and lyric bone lesions. Bone marrow smear and biopsy detected aberrant blast cells expressing myeloid rather than lymphoid immunophenotype marker. For the existence of Philadelphia chromosome and BCR-ABL1 fusion gene together with complex chromosome abnormalities, a diagnosis of Philadelphia-positive acute myeloid leukemia was made, although the type (de novo or blast crisis) remained unclear.