BACKGROUND Platelet transfusion is of great significance in the treatment of thrombocytopenia caused by myelosuppression during intensive chemotherapy in patients with acute leukemia.In recent years,with platelet tran...BACKGROUND Platelet transfusion is of great significance in the treatment of thrombocytopenia caused by myelosuppression during intensive chemotherapy in patients with acute leukemia.In recent years,with platelet transfusion increasing,ineffective platelet transfusion has become increasingly prominent.Generally speaking,platelet antibodies can be produced after repeated transfusion,thus rendering subsequent platelet transfusion ineffective.We report a case of first platelet transfusion refractoriness(PTR)in a patient with acute myelocytic leukemia(AML).Due to the rarity of such cases in clinical practice,there have been no relevant case reports so far.CASE SUMMARY A 51-year-old female patient attended the hospital due to throat pain and abnormal blood cells for 4 d.Her diagnosis was acute myelocytic leukemia[M2 type Fms related receptor tyrosine kinase 3,Isocitrate Dehydrogenase 1,Nucleophosmin 1,Neuroblastoma RAS viral oncogene homolog(+)high-risk group].She was treated with"IA"(IDA 10 mg day 1-3 and Ara-C 0.2 g day 1-5)chemotherapy.When her condition improved,the patient was discharged from the hospital,instructed to take medicine as prescribed by the doctor after discharge,and returned to the hospital for further chemotherapy on time.CONCLUSION We report a rare case of first platelet transfusion failure in a patient with AML during induction chemotherapy,which may be related to the production of platelet antibodies induced by antibiotics and excessive tumor load.This also suggests that we should consider the influence of antibiotics when the rare situation of first platelet transfusion failure occurs in patients with AML.When platelet antibodies are produced,immunoglobulins can be used to block antibodies,thereby reducing platelet destruction.For patients with PTR,both immune and non-immune factors need to be considered and combined in clinical practice along with individualized treatment to effectively solve the problem.展开更多
Objective:To study the different influence of idarubicin + Arac (IA) therapy and daunorubicin + Arac (DA) therapy on malignant molecule expression of acute myelocytic leukemia. Methods: A total of 56 patients who were...Objective:To study the different influence of idarubicin + Arac (IA) therapy and daunorubicin + Arac (DA) therapy on malignant molecule expression of acute myelocytic leukemia. Methods: A total of 56 patients who were diagnosed with acute myelocytic leukemia in Kashgar Prefecture First People's Hospital between January 2014 and September 2017 were selected as the research subjects and randomly divided into IA group and DA group, and the expression levels of proliferation genes, apoptosis genes and invasion genes in bone marrow tissue were determined after they accepted two courses of different chemotherapy regimens. Results:After two courses of chemotherapy, Daxx, CDX2, MCL1, BCL2, SOX4, S100A6, MMP9, N-cadherin, ICAM-1 and SDF-1 protein expression in bone marrow tissue of IA group were significantly lower than those of DA group whereas SHIP1, Bax and C/EBP protein expression were significantly higher than those of DA group.Conclusion:IA solution for acute myelocytic leukemia can be more effective than DA solution to inhibit the expression of proliferation and invasion genes and increase the expression of apoptosis genes.展开更多
基金Supported by Innovation Platform and Talent Program of Hunan Province,No.2021SK4050.
文摘BACKGROUND Platelet transfusion is of great significance in the treatment of thrombocytopenia caused by myelosuppression during intensive chemotherapy in patients with acute leukemia.In recent years,with platelet transfusion increasing,ineffective platelet transfusion has become increasingly prominent.Generally speaking,platelet antibodies can be produced after repeated transfusion,thus rendering subsequent platelet transfusion ineffective.We report a case of first platelet transfusion refractoriness(PTR)in a patient with acute myelocytic leukemia(AML).Due to the rarity of such cases in clinical practice,there have been no relevant case reports so far.CASE SUMMARY A 51-year-old female patient attended the hospital due to throat pain and abnormal blood cells for 4 d.Her diagnosis was acute myelocytic leukemia[M2 type Fms related receptor tyrosine kinase 3,Isocitrate Dehydrogenase 1,Nucleophosmin 1,Neuroblastoma RAS viral oncogene homolog(+)high-risk group].She was treated with"IA"(IDA 10 mg day 1-3 and Ara-C 0.2 g day 1-5)chemotherapy.When her condition improved,the patient was discharged from the hospital,instructed to take medicine as prescribed by the doctor after discharge,and returned to the hospital for further chemotherapy on time.CONCLUSION We report a rare case of first platelet transfusion failure in a patient with AML during induction chemotherapy,which may be related to the production of platelet antibodies induced by antibiotics and excessive tumor load.This also suggests that we should consider the influence of antibiotics when the rare situation of first platelet transfusion failure occurs in patients with AML.When platelet antibodies are produced,immunoglobulins can be used to block antibodies,thereby reducing platelet destruction.For patients with PTR,both immune and non-immune factors need to be considered and combined in clinical practice along with individualized treatment to effectively solve the problem.
文摘Objective:To study the different influence of idarubicin + Arac (IA) therapy and daunorubicin + Arac (DA) therapy on malignant molecule expression of acute myelocytic leukemia. Methods: A total of 56 patients who were diagnosed with acute myelocytic leukemia in Kashgar Prefecture First People's Hospital between January 2014 and September 2017 were selected as the research subjects and randomly divided into IA group and DA group, and the expression levels of proliferation genes, apoptosis genes and invasion genes in bone marrow tissue were determined after they accepted two courses of different chemotherapy regimens. Results:After two courses of chemotherapy, Daxx, CDX2, MCL1, BCL2, SOX4, S100A6, MMP9, N-cadherin, ICAM-1 and SDF-1 protein expression in bone marrow tissue of IA group were significantly lower than those of DA group whereas SHIP1, Bax and C/EBP protein expression were significantly higher than those of DA group.Conclusion:IA solution for acute myelocytic leukemia can be more effective than DA solution to inhibit the expression of proliferation and invasion genes and increase the expression of apoptosis genes.
