This study sought to analyze the clinical features and prognosis of multiple myeloma with isolated extramedullary relapse and with the absence of systemic progression.The clinical features and outcome were retrospecti...This study sought to analyze the clinical features and prognosis of multiple myeloma with isolated extramedullary relapse and with the absence of systemic progression.The clinical features and outcome were retrospectively analyzed in six multiple myeloma patients.These patients had secretory multiple myeloma at diagnosis.When relapsed,the dissociation between medullary and extramedullary response was detected.The serum or urine monoclonal component was extremely low or absent.The plasma cells in bone marrow were 〈5%.All patients received new targeted therapies（thalidomide or bortezomib） before extramedullary relapse.It is difficult to achieve second remission for them.Even in those showing response,the duration of response was extremely short.The median of overall survival from diagnosis and from extramedullary relapse was 19 months and 6 months,respectively.The overall survival was significantly shorter compared to the patients without extramedullary involvement（84 months,P= 0.001）.These patients exhibited a special and rare relapse pattern.Patients with this relapse pattern were resistant to current therapies,including novel targeted agents and associated with poor prognosis.展开更多
It is generally accepted that adult bone marrow（BM） contains both hematopoietic stem cells（HSCs） and mesenchymal stem cells （MSCs）. Recently, a rare population of stem cells different from HSCs and MSCs were ide...It is generally accepted that adult bone marrow（BM） contains both hematopoietic stem cells（HSCs） and mesenchymal stem cells （MSCs）. Recently, a rare population of stem cells different from HSCs and MSCs were identified in murine BM and human cord blood （CB）, named as very small embryonic like（VSEL） stem cells. These cells are tiny round and CXCR4^＋ Sca-1^＋ Lin^- CD45^-, expressing SSEA-1/4, Oct-4 and Nanog, which have potent of differentiation into all three germ-layer lineages, such as cardiornyocytes, neural and pancreatic ceils.展开更多
Corona virus disease 2019(COVID-19)due to severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection has affected the whole world.Acquired thrombotic thrombocytopenic purpura(TTP)has been reported after admi...Corona virus disease 2019(COVID-19)due to severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection has affected the whole world.Acquired thrombotic thrombocytopenic purpura(TTP)has been reported after administration of mRNA-or adenoviral vector-based COVID-19 vaccines,including Ad26.COV2-S,BNT162b2,mRNA-1273,and ChAdOx1 nCov-19.However,whether inactivated vaccines,such as CoronaVac,could cause TTP and whether the symptoms in TTPs caused by inactivated vaccines are different from previously reported cases are unknown.In this study,two cases were reported.Both cases developed TTP after the second CoronaVac vaccination shot,but not the first.They demonstrated symptoms of fever,neurological abnormalities,renal dysfunction,thrombocytopenia,and hemolysis.Both patients achieved complete remission through several sessions of plasma exchanges and immune suppression.The incidence of TTP in Nanjing area was analyzed.The number of patients with TTP was 12 in 2019,6 in 2020,16 in 2021,and 19 in 2022.To the authors’knowledge,this report is the first report of TTP associated with inactivated COVID-19 vaccine(CoronaVac).The rarity and delayed onset may be due to the relatively milder immune response caused by the inactivated vaccines than mRNA-based ones.Timely plasma exchange is a vital treatment for CoronaVac-related TTP,similar to activated vaccine-related TTP.展开更多
基金supported by Foundation of NationalNatural Science Foundation of China(81241074,81071946 and 81302040)Natural Science Foundation of Jiangsu Province(BK2012485)+4 种基金Jiangsu Province's Medical Elite Program(RC201148)a Project Funded by the Priority Academic Program Development of Jiangsu Higher Education Institutionsthe Program for Development of Innovative Research Team in the First Affiliated Hospital of NJMUClinical Research Program from Health Ministry of China(Key project 2010to 2012)Scientific Research Program for Public Interests from the Health Ministry of China(No.201202017)
文摘This study sought to analyze the clinical features and prognosis of multiple myeloma with isolated extramedullary relapse and with the absence of systemic progression.The clinical features and outcome were retrospectively analyzed in six multiple myeloma patients.These patients had secretory multiple myeloma at diagnosis.When relapsed,the dissociation between medullary and extramedullary response was detected.The serum or urine monoclonal component was extremely low or absent.The plasma cells in bone marrow were 〈5%.All patients received new targeted therapies（thalidomide or bortezomib） before extramedullary relapse.It is difficult to achieve second remission for them.Even in those showing response,the duration of response was extremely short.The median of overall survival from diagnosis and from extramedullary relapse was 19 months and 6 months,respectively.The overall survival was significantly shorter compared to the patients without extramedullary involvement（84 months,P= 0.001）.These patients exhibited a special and rare relapse pattern.Patients with this relapse pattern were resistant to current therapies,including novel targeted agents and associated with poor prognosis.
文摘It is generally accepted that adult bone marrow（BM） contains both hematopoietic stem cells（HSCs） and mesenchymal stem cells （MSCs）. Recently, a rare population of stem cells different from HSCs and MSCs were identified in murine BM and human cord blood （CB）, named as very small embryonic like（VSEL） stem cells. These cells are tiny round and CXCR4^＋ Sca-1^＋ Lin^- CD45^-, expressing SSEA-1/4, Oct-4 and Nanog, which have potent of differentiation into all three germ-layer lineages, such as cardiornyocytes, neural and pancreatic ceils.
基金supported by the National Natural Science Foundation of China(Nos.81700130,82370134,92169114,81802932)the Natural Science Fund for Distinguished Young Scholars of Hubei Province(No.2022CFA054)the National Key Research and Development Program of China(No.2018YFE0113600).
文摘Corona virus disease 2019(COVID-19)due to severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection has affected the whole world.Acquired thrombotic thrombocytopenic purpura(TTP)has been reported after administration of mRNA-or adenoviral vector-based COVID-19 vaccines,including Ad26.COV2-S,BNT162b2,mRNA-1273,and ChAdOx1 nCov-19.However,whether inactivated vaccines,such as CoronaVac,could cause TTP and whether the symptoms in TTPs caused by inactivated vaccines are different from previously reported cases are unknown.In this study,two cases were reported.Both cases developed TTP after the second CoronaVac vaccination shot,but not the first.They demonstrated symptoms of fever,neurological abnormalities,renal dysfunction,thrombocytopenia,and hemolysis.Both patients achieved complete remission through several sessions of plasma exchanges and immune suppression.The incidence of TTP in Nanjing area was analyzed.The number of patients with TTP was 12 in 2019,6 in 2020,16 in 2021,and 19 in 2022.To the authors’knowledge,this report is the first report of TTP associated with inactivated COVID-19 vaccine(CoronaVac).The rarity and delayed onset may be due to the relatively milder immune response caused by the inactivated vaccines than mRNA-based ones.Timely plasma exchange is a vital treatment for CoronaVac-related TTP,similar to activated vaccine-related TTP.
