The Role of Mitochondrial VDAC2 in the Survival and Proliferation of T-Cell Acute Lymphoblastic Leukemia Cells

Background: T-cell acute lymphoblastic leukemia (T-ALL) is an aggressive hematological malignancy with aberrant T-cell developmental arrest. Individuals with relapsed T-ALL have limited therapeutic alternatives and poor prognosis. The mitochondrial function is critical for the T-cell viability. The voltage-dependent anion channel 2 (VDAC2) in the mitochondrial outer membrane, interacts with pro-apoptotic BCL-2 proteins and mediates the apoptosis of several cancer cell lines. Objective: The aim of the current study is to explore the role of VDAC2 in T-ALL cell survival and proliferation. Methods: Publicly available datasets of RNA-seq results were analyzed for expression of VDAC isoforms and T-ALL cell lines were treated with a VDAC2 small molecular inhibitor erastin. A VDAC2 RNA interference (siRNA) was delivered to T-ALL cell lines using a retroviral vector. Functional assays were performed to investigate the VDAC2 siRNA impacts on cell proliferation, apoptosis and survival of T-ALL cells. Results: Our analysis found a high expression of VDAC2 mRNA in various T-ALL cell lines. Public datasets of T-ALL RNA-seq also showed that VDAC2 is highly expressed in T-ALL (116.2 ± 36.7), compared to control groups. Only two T-ALL cell lines showed sensitivity to erastin (20 μM) after 48 hours of incubation, including Jurkat (IC50 = 3.943 μM) and Molt4 (IC50 = 3.286 μM), while another two T-ALL cells (CUTLL1 and RPMI 8402) had unstable IC50. However, five T-ALL cell lines (LOUCY, CCRF-CEM, P12-ICHI, HPB-ALL, and PEER cells) showed resistance to erastin. On the contrary, all T-ALL cell lines genetically inhibited with VDAC2 siRNA led to more than 80% decrease in VDAC2 mRNA levels, and a Conclusion: VDAC2 is highly expressed in T-ALL cells. The inhibition of VDAC2 significantly decreased cell viability, increased apoptosis, reduced cell proliferation and caused cell cycle sub-G1 arrest of T-ALL cells.

Donor-Derived CD19-Targeted T Cell Infusion Eliminates B Cell Acute Lymphoblastic Leukemia Minimal Residual Disease with No Response to Donor Lymphocytes after Allogeneic Hematopoietic Stem Cell Transplantation

Leukemia relapse is still the leading cause of treatment failure after allogeneic hematopoietic stem cell transplantation (allo-HSCT) for B cell acute lymphoblastic leukemia (B-ALL). Relapsed patients with BALL after allo-HSCT have a very short median survival. Minimal residual disease (MRD) is predictive of forthcoming hematological relapse after hematopoietic stem cell transplantation (HSCT);furthermore, eliminating MRD effectively prevents relapse. Donor lymphoblastic infusion (DLI) is the main established approach to treat B-ALL with MRD after allo-HSCT. However, about one-third of patients with MRD are non-responsive to DLI and their prognosis worsens. Although donor-derived cluster of differentiation (CD)19-directed chimeric antigen receptor-modified (CAR) T cells (CART19s) can potentially cure leukemia, the efficiency and safety of infusions with these cells have not yet been investigated in patients with MRD after HSCT. Between September 2014 and February 2018, six patients each received one or more infusions of CART19s from HSCT donors. Five (83.33%) achieved MRD-negative remission, and one case was not responsive to the administration of CAR T cells. Three of the six patients are currently alive without leukemia. No patient developed acute graft-versus-host disease (aGVHD), and no patient died of cytokine release syndrome. Donor-derived CAR T cell infusions seem to be an effective and safe intervention for patients with MRD in B-ALL after allo-HSCT and for those who were not responsive to DLI.

Resveratrol Induces Apoptosis and Autophagy in T-cell Acute Lymphoblastic Leukemia Cells by Inhibiting Akt/mTOR and Activating p38-MAPK

Objective To explore the effects of resveratrol-induced apoptosis and autophagy in T-cell acute lymphoblastic leukemia （T-ALL） cells and potential molecular mechanisms. Methods The anti-proliferation effect of resveratrol-induced, apoptosis and autophagy on T-ALL cells were detected by using MTI- test, immunofluorescence, electronic microscope, and flow cytometry, respectively. Western blotting was performed for detecting changes of apoptosis-associated proteins, cell cycle regulatory proteins and state of activation of Akt, mTOR, p70S6K, 4E-BP1, and p38-MAPK. Results Resveratrol inhibited the proliferation and dose and time-dependent manner. It also induced cyclin-dependent kinase （CDK） inhibitors p21 and induced apoptosis and autophagy in T-ALL cells in a cell cycle arrest at G0/G1 phase via up regulating p27 and down regulating cyclin A and cyclin D1. Western blotting revealed that resveratrol significantly decreased the expression of antiapoptotic proteins （Mcl-1 and Bcl-2） and increased the expression of proapoptotic proteins （Bax, Bim, and Bad）, and induced cleaved-caspase-3 in a time-dependent manner. Significant increase in ratio of LC3-11/LC3-1 and Beclin 1 was also detected. Furthermore, resveratrol induced significant dephosphorylation of Akt, mTOR, p70S6K, and 4E-BP1, but enhanced specific phosphorylation of p38-MAPK which could be blocked by SB203580. When autophagy was suppressed by 3-MA, apoptosis in T-ALL cells induced by resveratrol was enhanced. Conclusion Our findings have suggested that resveratrol induces cell cycle arrest, apoptosis, and autophagy in T-ALL cells through inhibiting Akt/mTOR/p7OS6K/4E-BP1 and activating p38-MAPK signaling pathways. Autophagy might play a role as a self-defense mechanism in T-ALL cells treated by resveratrol. Therefore, the reasonable inhibition of autophagy in T-ALL cells may serve as a promising strategy for resveratrol induced apoptosis and can be used as adjuvant chemotherapy for T-ALL.

Establishment of Reproducible Xenotransplantation Model of T Cell Acute Lymphoblastic Leukemia in NOD/SCID Mice

T cell acute lymphoblastic leukemia(T-ALL) is an aggressive leukemia.However the poor prognosis and low morbidity restrict further analysis of the disease.Therefore there is an increasing demand to develop animal models for identifying novel therapeutic approaches.In this study,we inoculated the anti-mouse CD122 monoclonal antibody conditioned NOD/SCID mice with the leukemia cells from 9 T-ALL patients and 1 cell line via the tail vein.Four of the 9 patients and the cell line were successfully engrafted.Flow cytometry detected high percentage of human CD45 + cells in recipient mice.Immunohistochemistry showed infiltration of human CD45 + cells in different organs.Serial transplantation was also achieved.In vivo drug treatment showed that dexamethasone could extend survival,which was consistent with clinical observation.These results demonstrated that we successfully established 5 xenotransplantation models of T-ALL in anti-mCD122 mAb conditioned NOD/SCID mice,which recapitulated the characteristics of original disease.

A facile,branched DNA assay to quantitatively measure glucocorticoid receptor auto-regulation in T-cell acute lymphoblastic leukemia

Glucocorticoid(GC) steroid hormones are used to treat acute lymphoblastic leukemia(ALL) because of their pro-apoptotic effects in hematopoietic cells.However,not all leukemia cells are sensitive to GC,and no assay to stratify patients is available.In the GC-sensitive T-cell ALL cell line CEM-C7,auto-up-regulation of RNA transcripts for the glucocorticoid receptor(GR) correlates with increased apoptotic response.This study aimed to determine if a facile assay of GR transcript levels might be promising for stratifying ALL patients into hormone-sensitive and hormone-resistant populations.The GR transcript profiles of various lymphoid cell lines and 4 bone marrow samples from patients with T-cell ALL were analyzed using both an optimized branched DNA(bDNA) assay and a real-time quantitative reverse transcription-polymerase chain reaction assay.There were significant correlations between both assay platforms when measuring total GR(exon 5/6) transcripts in various cell lines and patient samples,but not for a probe set that detects a specific,low abundance GR transcript(exon 1A3).Our results suggest that the bDNA platform is reproducible and precise when measuring total GR transcripts and,with further development,may ultimately offer a simple clinical assay to aid in the prediction of GC-sensitivity in ALL patients.

ATP binding cassette C1 (ABCC1/MRP1)-mediated drug efflux contributes to disease progression in T-lineage acute lymphoblastic leukemia

Purpose: In acute lymphoblastic leukemia (ALL), multidrug resistance is often mediated by AT- Pase Binding Cassette (ABC) proteins, which principally involve ABCC1 (multidrug resistance protein 1, MRP1) and ABCB1 (multidrug resistance 1, MDR1). However, direct comparisons between the differential effects of ABCC1 and ABCB1 have been difficult, since identical cell lines with differential expression of these transporters have not been developed. Experimental Design: In this study, we developed and compared the biological profiles of Jurkat cell lines that selectively over-expressed ABCC1 and ABCB1. Vincristine (VCR) plays an important role in the treatment of T-lineage ALL (T-ALL), and is often the first drug given to newly-diagnosed patients. Because of its importance in treatment, we provide descalating, sub-lethal doses of VCR to Jurkat cells, and extended our observations to expression profiling of newly diagnosed patients with T-ALL. Results: We found that VCR-resistant cells over-expressed ABCC1 nearly 30-fold. The calcein AM assay confirmed that VCR-resistant cells actively extruded VCR, and that ABCC1-mediated drug resistance conferred a different spectrum of multidrug resistance than other T-ALL induction agents. siRNA experiments that blocked ABCC1 export confirmed that VCR resistance could be reversed in vitro. Analyses of T-lymphoblasts obtained from 100 newly diagnosed T-ALL patients treated on Children’s Oncology Group Phase III studies 9404 and AALL0434 that induction failure could be could be partially explained by the over-expression of ABCC1 and ABCB1. Conclusions: Taken together, these results suggest that over-expression of ABC transporters plays a contributing role in mediating treatment failure in T-ALL, and underscore the need to employ alternate treatment approaches in patients for whom induction failed or for those with relapsed disease.

Rearranged Patterns of IgH and TcRγ Genes in Patients with Acute Lymphoblastic Leukemia

The rearrangement of immunoglobulin heavy chain gene(IgH) and T cell receptor γgene (ToRγ)was studied in 30 patients with acute lymphoblastic leukemia(ALL) by the polymerase chain reaction (PCR). 19 cases was found to have rearrangement of IgH gene,12 of TcRγ. Most of IgH rearrangement was characterized by one or two specific bands while some had more than two. Rearrangement of TcRγgene appeared as one specific band. A slight difference in number, size and lightness of bands was found among the patients. 4 different kinds of rearrangement were observed in the detection of IgH rearrangement in combination with TcRγgene. The rearranged patterns of IgH and TcRγgene as well as the clinical significance were discussed.

Adult Acute T Cell Leukemia Presenting as Acute Renal Failure, Parotid Swelling and Loss of Vision

A rare case of T cell acute lymphoblastic leukemia presenting with loss of vision, parotid swelling, hematuria and acute renal failure has been presented in a 40-year-old male. Acute T cell Lymphoblastic Leukemia should also be kept in differential diagnosis of hematuria, acute renal failure and loss of vision.

IGLL1基因在儿童T-ALL中的表达及临床意义

目的:检测儿童T系急性淋巴细胞白血病(T-ALL)患者骨髓标本中IGLL1(immunoglobulin lambda-like polypeptide 1)m RNA的相对表达量,并与儿童T-ALL的临床特征及预后进行相关分析,明确IGLL1在儿童T-ALL中的临床意义。方法:选取2012年6月至2017年12月期间就诊于苏州大学附属儿童医院的初诊T-ALL且接受CCLG-ALL 2008方案治疗的患儿56例。采用转录组测序技术检测T-ALL患儿中IGLL1基因的转录水平,按照IGLL1转录水平的25%(cutoff value:448)将患儿分为IGLL1低表达组(17例)和IGLL1高表达组(39例)。结合临床资料,分析IGLL1在T-ALL患儿中的表达水平与预后的相关性。结果:IGLL1的转录水平与患儿性别、年龄、骨髓原始细胞数、初诊白细胞(WBC)数等临床特点没有相关性,IGLL1高表达组患者较IGLL1低表达组患者5年总生存率明显提高(76.9%±6.7%vs 47.1%±12.1%,P=0.018)。进一步比较IGLL1高表达患者与低表达患者的无复发生存率(RFS),发现IGLL1高表达组患者5年无复发生存率要高于IGLL1低表达组(80.6%±6.6%vs 54.9%±14.0%),但两组间无复发生存率差异无统计学意义(P=0.095)。将临床常见预后因素(年龄、性别、初诊WBC计数、强的松D7th治疗反应、治疗后D15th骨髓反应情况)及IGLL1表达水平进行多因素COX分析,结果显示,IGLL1表达量(P=0.012)和强的松治疗反应(P=0.017)是影响儿童T-ALL患者总体生存的独立危险因素。结论:在儿童T-ALL中,IGLL1基因高表达组患儿的总生存率明显高于低表达组患儿,且IGLL1基因表达水平是影响儿童T-ALL患者生存的独立因素,提示IGLL1是儿童T-ALL患儿临床预后良好的指标。

磷脂酶C通过抑制T-ALL细胞凋亡发挥促癌作用

目的:探讨磷脂酶C(PLC)家族各成员在急性T淋巴细胞白血病(T-ALL)进展中的作用。方法:泛PLC抑制剂U73122和Edelfosine处理T-ALL细胞,AnnexinV-PE/7-AAD双染法检测细胞凋亡。Cox回归和Kaplan-Meier法分析PLC蛋白对T-ALL患者无事件生存率(EFS)的影响。单因素方差分析PLC在各亚型T-ALL中的表达。构建PLCβ1、PLCγ1、PLCη1siRNA逆转录质粒,HEK-293T细胞包装逆转录病毒感染T-ALL细胞。利用RT-PCR和Westernblot检测基因表达。结果:4种T-ALL细胞系中,P12-ICH和CCRF-CEM对U73122和Edelfosine敏感,Jurkat和MOLT4对其耐药。TARGET-ALL数据库中,PLCβ1、PLCγ1、PLCη1高表达T-ALL患者预后不良,PLCβ1、PLCγ1、PLCη1在T-ALL各亚型中分布不均。在P12-ICH和CCRF-CEM中,PLCβ1、PLCγ1和PLCη1分别维持白血病细胞生存,而在MOLT4中,PLCβ1、PLCγ1和PLCη1对细胞生存无影响。结论:PLCβ1、PLCγ1和PLCη1能维持T-ALL细胞株体外生长,促进T-ALL恶性进展,是潜在的治疗靶点。

ADAMDEC1通过激活Wnt/β-catenin信号转导通路促进T-ALL细胞的增殖

目的研究去整联蛋白金属蛋白酶家族癸蛋白1(a disintegrin and metalloprotease like decysin 1,ADAMDEC1)对T细胞急性淋巴细胞白血病(T-cell acute lymphoblastic leukemia,T-ALL)细胞生物学行为的影响及其潜在的分子机制。方法qRT-RCR和Western blot检测ADAMDEC1在人T淋巴细胞H9与T-ALL细胞Jurkat和CCRF-CEM的表达。CCK-8法检测ADAMDEC1siRNA干扰表达后T-ALL细胞增殖的变化。流式细胞术检测ADAMDEC1siRNA干扰后T-ALL细胞凋亡情况。Western blot检测干扰ADAMDEC1后凋亡及Wnt/β-catenin通路相关分子蛋白水平的变化。结果ADAMDEC1在CCRF-CEM和Jurkat细胞中高表达。干扰ADAMDEC1后CCRFCEM和Jurkat细胞增殖能力降低,细胞凋亡率增高。干扰ADAMDEC1可促进GSK-3β的表达,抑制β-catenin、p-GSK-3β和c-Myc的蛋白水平。Wnt/β-catenin通路激活剂CHIR-99021可部分地逆转干扰ADAMDEC1对T-ALL细胞增殖和凋亡的影响。结论干扰ADAMDEC1后通过抑制Wnt/β-catenin通路,进而抑制T-ALL细胞增殖,诱导细胞凋亡。

儿童急性T淋巴细胞白血病的临床特征及预后——福建地区多中心数据分析

目的:评估儿童急性T淋巴细胞白血病(T-ALL)的疗效,并探讨影响预后的危险因素。方法:回顾性分析2011年4月至2020年12月福建地区5家医院收治的127例初诊T-ALL患儿的临床资料,与同期急性前体B淋巴细胞白血病(B-ALL)患儿相比较,并采用Kaplan-Meier法分析评估患儿总生存率(OS)和无事件生存率(EFS),COX比例风险回归模型分析预后影响因素。116例规范治疗的T-ALL患儿中,78例接受CCLG-ALL 2008方案治疗,38例接受CCCG-ALL 2015方案治疗,对比两组的疗效及严重不良事件发生率。结果:T-ALL患儿中男性、年龄≥10岁、初诊白细胞数≥50×10^(9)/L、合并中枢神经系统白血病、诱导治疗中微小残留病≥1%、诱导结束时微小残留病≥0.01%的患儿比例均显著高于B-ALL患儿(P<0.05)。T-ALL患儿预期10年EFS及OS分别为59.7%和66.0%,均显著低于B-ALL患儿(P<0.001)。COX分析显示,初诊白细胞数≥100×10^(9)/L、诱导结束时未达完全缓解是更差预后的独立危险因素。CCCG-ALL 2015组与CCLG-ALL 2008组相比,感染相关严重不良事件发生率更低(15.8%vs 34.6%,P=0.042),而EFS及OS更高(73.9%vs 57.2%,PEFS=0.090;86.5%vs 62.3%,POS=0.023)。结论:T-ALL较B-ALL预后差,初诊白细胞数≥100×10^(9)/L、诱导结束时未达完全缓解(尤其是纵隔肿物未消失)为其预后不良危险因素。CCCG-ALL 2015方案可能降低感染相关严重不良事件发生率并提高疗效。

白藜芦醇抑制Notch1信号通路对抗小鼠急性T淋巴细胞白血病

目的:观察白藜芦醇(Res)对急性T淋巴细胞白血病(T-ALL)小鼠的影响,并进一步探讨其对Notch1信号通路的作用机制。方法:将25只6-8周龄雌性C57BL/6小鼠随机分为正常对照组、T-ALL组和Res组,其中Res组又进一步分为low-Res(L-Res)、middle-Res(M-Res)和high-Res(H-Res)3个浓度给药组。应用流式细胞术和瑞氏-吉姆萨染色法检测外周血及脾细胞悬液中白血病细胞百分比,HE染色法观察脾脏和骨髓组织病理形态,RT-q PCR法检测脾脏组织中Notch1、Hes-1、c-Myc、mi R-19b和PTEN m RNA表达水平,Western blot法检测Notch1、Hes-1、c-Myc、p-PTEN和PTEN蛋白表达水平。结果:与对照组相比,T-ALL组小鼠外周血中白血病细胞明显增多,脾脏及骨髓组织中白血病细胞弥漫性浸润,脾脏中Notch1、Hes-1、c-Myc、mi R-19b m RNA表达水平和Notch1、Hes-1、c-Myc蛋白表达水平均明显增高(P<0.01),PTEN m RNA及其蛋白水平显著降低(P<0.01),经白藜芦醇处理后,H-Res组以上各项指标较T-ALL组均获得逆转。结论:白藜芦醇具有抗小鼠T-ALL的作用,其机制可能通过抑制Notch1信号通路发挥作用。

多中心成人早期前体T细胞白血病/淋巴瘤的临床特征及预后研究

目的:对3个血液学中心的成人早期前体T细胞白血病/淋巴瘤(ETP-ALL/LBL)患者进行回顾性分析,总结其临床特点、治疗及预后影响因素。方法:收集2006年1月至2019年1月来自北京大学第三医院、解放军第一医学中心和中国医学科学院血液学研究所3个血液研究中心共113例T淋巴母细胞白血病/淋巴瘤(T-ALL/LBL)患者的临床数据资料,对其中ETP-ALL/LBL及非ETP-ALL/LBL患者的临床特征及预后进行分析比较。结果:113例T-ALL/LBL患者中,13例诊断为ETP-ALL/LBL(11.5%),其中男性患者11例(84.6%),中位年龄28(18-53)岁。与非ETP-ALL/LBL患者相比,ETP-ALL/LBL患者在年龄、性别、纵隔大包块发生率、临床分期、IPI评分、白细胞水平、乳酸脱氢酶水平方面差异无统计学意义。在13例ETP-ALL/LBL患者中,9例(69.2%)获得完全缓解,ETP-ALL/LBL患者较非ETP-ALL/LBL患者化疗诱导缓解率无统计学差异。在单纯化疗未进行异基因造血干细胞移植的患者中,ETP-ALL/LBL组较非ETP-ALL/LBL组显示出更差的5年生存率(0 vs 7.1%,P=0.008),而在进行异基因造血干细胞移植的患者中,两组5年生存率无统计学差异(37.5%vs 40.2%,P>0.05)。多因素Cox回归分析提示,诱导治疗达到完全缓解、异基因造血干细胞移植以及乳酸脱氢酶水平为影响T-ALL/LBL的独立预后因素。结论:ETP-ALL/LBL较其他类型T-ALL/LBL患者诱导化疗反应率无显著差异,诱导缓解后续贯异基因造血干细胞移植巩固治疗对于提高ETP-ALL/LBL患者远期生存率具有重要意义。

CAR-T细胞治疗老年急性B淋巴细胞白血病的临床研究

目的 探讨CAR-T细胞疗法治疗老年急性B淋巴细胞白血病(B-ALL)患者的安全性和有效性。方法 回顾性分析2020年5月—2022年12月苏州大学附属第一医院收治的接受CAR-T治疗的21例老年急性B淋巴细胞白血病患者的临床及随访资料,探讨CAR-T的有效性及安全性。结果 21例老年B-ALL患者CAR-T治疗后细胞因子释放综合征(cytokine release syndrome,CRS),中性粒细胞减少症和中性粒细胞缺乏症发生率分别为:38.1%(8/21),42.9%(9/21)和28.6%(6/21);与CAR-T回输前相比,CAR-T后一周白细胞绝对计数无显著差异,一个月后显著升高(P<0.001),中性粒细胞计数在CAR-T后一周和一个月均无显著差异(P>0.05),C反应蛋白在CAR-T后7天显著升高,30天后显著降低(-3 d vs 7 d,P=0.007;30 d vs 7 d,P=0.000 6);首次输注CAR-T后完全缓解率(complete remission,CR)为85.7%(18/21),中位随访时间为17个月;CAR-T后无进展生存率(progression-free survival,PFS)为81.0%,与性别、CAR-T细胞类型、费城染色体、高肿瘤负荷、桥接造血干细胞移植(HSCT)、治疗次数、LDH值以及血小板计数均无相关性(P>0.05),中位PFS为13个月;R/R B-ALL患者CAR-T治疗后CR率为75%(6/8),PFS率为67.5%,中位PFS时间为12个月;回输CAR-T后复发时间平均为10.2个月。结论 CAR-T细胞疗法用于治疗老年B-ALL患者具有较好的缓解率,为预后差的老年B-ALL患者提供有潜能的治疗手段。

阿魏酸通过调节PTEN/PI3K/AKT信号通路抑制急性T淋巴细胞白血病进展

目的探究阿魏酸是否可通过调控PTEN/PI3K/AKT信号通路在体内外抑制急性T淋巴细胞白血病进展。方法将急性T淋巴细胞白血病Jurkat细胞分为对照组、阿魏酸处理组和LY294002处理组进行体外实验,对照组正常培养;阿魏酸处理组分别给予不同浓度(1.25、2.5、5、10、20、40、80、160µmol/L)阿魏酸,采用CCK-8法检测细胞增殖能力,筛选实验浓度;LY294002处理组给予50µmol/L PI3K/AKT抑制剂LY294002,采用克隆形成实验、流式细胞术、Transwell实验检测细胞增殖、凋亡、侵袭情况,采用Western blot检测核蛋白Ki67、增殖细胞核抗原(PCNA)、cleaved caspase-3、cleaved caspase-9、E-cadherin、N-cadherin、Vimentin、PTEN、p-PI3K、PI3K、p-AKT和AKT蛋白相对表达量。使用30只雄性BALB/c裸鼠建立移植瘤裸鼠模型,平均分为正常组和阿魏酸处理组进行体内实验,正常组接种Jurkat细胞后以生理盐水灌胃,阿魏酸处理组接种Jurkat细胞后以75 mg/kg阿魏酸灌胃,比较移植瘤质量和体积变化,并检测肿瘤组织中Ki67、cleaved caspase-3/caspase-3、E-cadherin、N-cadherin、PTEN、p-PI3K、PI3K、p-AKT和AKT水平。结果体外实验中,与对照组比较,5、10、20µmol/L阿魏酸处理组和LY294002处理组细胞克隆形成率、细胞侵袭数、Ki67、PCNA、N-cadherin、Vimentin、p-PI3K/PI3K、p-AKT/AKT明显降低/减少(P<0.05),细胞凋亡率、cleaved caspase-3/caspase-3、cleaved caspase-9/caspase-9、E-cadherin、PTEN明显升高(P<0.05)。体内实验中,与正常组比较,阿魏酸处理组裸鼠肿瘤质量减轻,肿瘤体积减小,肿瘤组织中Ki67、N-cadherin、p-PI3K/PI3K、p-AKT/AKT明显降低,cleaved caspase-3/caspase-3、E-cadherin、PTEN明显升高,差异均有统计学意义(P<0.05)。结论阿魏酸在体内外均可抑制急性T淋巴细胞白血病Jurkat细胞的增殖及侵袭,并诱导细胞凋亡,其作用机制可能与调控PTEN/PI3K/AKT信号通路有关。

1例急性T淋巴细胞白血病病人应用大剂量甲氨蝶呤并发失禁性皮炎的护理

总结1例应用大剂量甲氨蝶呤后出院化疗相关性腹泻引起失禁性皮炎的急性T淋巴细胞白血病病人的护理经验。病人重度肥胖,活动受限,在使用大剂量甲氨蝶呤后出现化疗相关性腹泻并发失禁性皮炎,针对病人粒细胞缺乏和皮肤破溃的状况,制订个体化护理干预方案,采用降低黏膜损伤、抗感染和促进皮肤黏膜愈合的方法,使用不同的药物和敷料护理,病人失禁性皮炎痊愈,最终好转出院。

T-ALL及T细胞株相关TCR Vβ基因谱系和克隆性分析

目的 了解T细胞 急性淋巴细胞白血病 (T ALL)患者外周血中的T细胞及T细胞株的TCRVβ基因谱系及其克隆性增殖情况。方法 利用RT PCR方法扩增 6个不同的T细胞株和 6例初发未治T ALL病人外周血单个核细胞中 2 4个TCRVβ基因的互补决定区 3(CDR3) ,PCR产物进一步经荧光标记和基因扫描分析CDR3长度而确定T细胞的克隆性 ,部分T细胞株的单克隆PCR产物进一步进行序列分析。结果 与正常人外周血表达全部 2 4个Vβ亚家族不同 ,6例T ALL病人分别表达 5～ 12个Vβ亚家族。 6例病人均存在 1个或多个Vβ亚家族的寡克隆或双克隆增殖T细胞 ,另外 ,还有一些Vβ亚家族多克隆模式发生改变 ,呈现寡克隆性增殖的趋势。T细胞株多显示为表达一个Vβ亚家族的单克隆T细胞 ,不同T细胞株的CDR3长度和序列不尽相同。结论 T ALL患者外周血T细胞的TCRVβ谱系出现限制性改变 ,均可检测到克隆性增殖T细胞 ,尚需进一步鉴定其性质 (肿瘤性或抗原特异性增殖 ) 。

T-ALL患者骨髓CD_(34)^+细胞的Hes1基因表达、数量、增殖变化及机制探讨

目的观察急性T淋巴细胞白血病(T-ALL)患者骨髓CD+34细胞Hes1基因表达、数量、增殖的变化,并探讨其机制。方法收集8例初治T-ALL患者及4例正常供者(健康对照)骨髓样本,real time PCR检测Hes1基因的表达,密度梯度离心法获取单个核细胞,流式细胞术检测CD+34细胞比例及其细胞周期,免疫磁珠法分选CD+34细胞,体外集落形成实验(CFC)检测其增殖能力。构建Hes1基因过表达逆转录病毒载体,感染正常供者骨髓CD+34细胞后,流式细胞术分析其细胞周期的改变,CFC检测其增殖的改变。结果 T-ALL患者、健康对照CD+34细胞Hes1基因表达分别为3.3±0.8、1,两者比较,P<0.05;CD+34细胞比例分别为0.02%±0.003%、0.06%±0.005%,两者比较,P<0.05;CD+34细胞处于S期的细胞比例分别为16.2%±0.98%、28.0%±1.12%,两者比较,P<0.05;G0期比例分别为19.0%±0.9%、9.0%±0.5%,两者比较,P<0.05;且患者来源CD+34细胞的体外集落形成减少。提高正常CD+34细胞中Hes1基因的表达后,细胞增殖减少,进入静止期。结论 T-ALL患者CD+34细胞比例下降,进入静止期,体外扩增能力下降,这可能与Hes1基因的表达上调有关。

Notch1基因在T-ALL患者中的表达及其对NF-κB通路的影响

目的:探讨Notch1基因在急性T淋巴细胞白血病(T-ALL)患者外周血单个核细胞(PBMC)中的表达及其对NF-κB通路的作用。方法:选取T-ALL患者67例作为试验组,以67例健康体检者作为对照。采用qRT-PCR分析PBMC中Notch1和NF-κB通路(IκBα、IKKβ)mRNA表达量,分析Notch1的表达水平与T-ALL患者临床指标和预后之间的关联,以及Notch1与NF-κB通路mRNA表达水平的关联。沉默Jurkat细胞中的Notch1基因,qRT-PCR分析Notch1、IκBα和IKKβ mRNA表达,Western blot分析Notch1、磷酸化IκBα(p-IκBα)和磷酸化IKKβ(p-IKKβ)蛋白表达。结果:T-ALL组PBMC中Notch1 mRNA表达水平高于健康组,差异有统计学意义(P<0.05)。Notch1表达水平与LDH水平、白细胞水平和危险度分级之间呈显著正相关(r=0.102,P=0.025;r=0.247,P=0.019;r=0.429,P=0.006),而与年龄和性别无显著相关性。Notch1与IκBα mRNA水平呈显著负相关(r=-0.754,P=0.039),与IKKβ mRNA水平呈显著正相关(r=0.738,P=0.002)。Notch1低表达组中位总生存时间为(18.5±2.2)个月,显著长于高表达组的(12.7±3.4)个月(χ;=1.677,P=0.038)。沉默Notch1可显著上调IκBα mRNA和p-IκBα蛋白水平(P<0.05),显著下调IKKβ mRNA和p-IKKβ蛋白水平(P<0.05)。结论:Notch1基因在T-ALL患者血浆PBMC中高表达,与患者LDH水平、白细胞水平和危险度分级等临床指标和生存率相关,Notch1可能通过NF-κB通路发挥作用。