Objective:To observe the effects of moxibustion on the hematopoietic function in mice with aplastic anemia(AA)induced by bone marrow(BM)suppression,and to investigate the intervention effects of moxibustion on AA from...Objective:To observe the effects of moxibustion on the hematopoietic function in mice with aplastic anemia(AA)induced by bone marrow(BM)suppression,and to investigate the intervention effects of moxibustion on AA from the perspective of intestinal bacteria.Methods:A total of 24 C57BL/6 J male mice were randomly and evenly divided into control,model and moxibustion groups.The myelosuppression-induced AA model was established by cyclophosphamide(CTX)and cyclosporine(Cs)intraperitoneal injection.Mice in the moxibustion group were intervened in mild moxibustion at unilateral“Zusanli(ST36)”acupoint for 15 min per day,and the sides were switched the next day.The intervention of mild moxibustion lasted 60 days consecutively.The red blood cell(RBC),white blood cell(WBC),platelet(PLT)counts and haemoglobin(Hb)concentration levels of mice in each group were detected by peripheral blood cells count staining,and the BM hematopoietic cells and hematopoietic structures were observed by BM smear Wright-Giemsa staining and HE staining.16SrDNA sequencing was used to analyze the gut bacterial species abundance and diversity in mice from each group.Results:After all the intervention,compared to the control group,the model group had lower levels of RBC,WBC,PLT counts and Hb concentration in peripheral blood(P<0.05)and fewer hematopoietic cells and hematopoietic structures;compared to the model group,moxibustion group had higher levels of RBC,WBC,PLT counts and Hb concentration in peripheral blood(P<0.05),and more BM hematopoietic cells and hematopoietic structures.Gut flora showed that moxibustion increased the species richness and diversity of intestinal bacteria in mice;compared with the control group,the relative abundance of Faecalibaculum and Anaeroplasmataceae in the model group was higher(P<0.05);whereas,the relative abundance of Faecalibaculum and Anaeroplasmataceae in the moxibustion group was lower(P<0.05)when compared with the model group.In addition,Faecalibaculum was significantly correlated with RBC,WBC,PLT count and Hb concentration(P<0.05).Conclusion:Moxibustion can improved BM histology,restored hematopoietic cells function,and increased peripheral blood cells count and Hb concentration in AA mice.The mechanism may be related to the fact that moxibustion regulates the abundance of specific intestinal bacteria to maintain the stability of the flora structure.展开更多
BACKGROUND Colorectal cancer is a common digestive malignancy,and chemotherapy remains a cornerstone of treatment.Myelosuppression,a frequent hematologic toxicity,poses significant clinical challenges.However,no inter...BACKGROUND Colorectal cancer is a common digestive malignancy,and chemotherapy remains a cornerstone of treatment.Myelosuppression,a frequent hematologic toxicity,poses significant clinical challenges.However,no interpretable machine learning-based nomogram exists to predict chemotherapy-induced myelosuppression in colorectal cancer patients.This study aimed to develop and validate an inter-pretable clinic-machine learning nomogram integrating clinical predictors with multiple algorithms via a feature mapping algorithm.The model provides accurate risk estimation and clinical interpretability,supporting individualized prevention strategies and optimizing decision-making in patients receiving first-line chemotherapy.AIM To develop and validate an interpretable clinic-machine learning nomogram predicting chemotherapy-induced myelosuppression in colorectal cancer.METHODS This retrospective study enrolled 855 colorectal cancer patients receiving first-line chemotherapy.Data were split into training(n=612),validation(n=153),and testing(n=90)cohorts.Ten predictors were identified through least absolute shrinkage and selection operator,decision tree,random forest,and expert con-sensus.Ten machine learning algorithms were applied,with performance assessed by area under the receiver operating characteristic curve(AUC),area under the precision-recall curve(AUPRC),calibration,and decision curves.The optimal model was integrated into a clinic-machine learning nomogram via the feature mapping algorithm,which was internally validated for predictive accuracy and clinical utility.(AUPRC),calibration,and decision curves.The optimal model was integrated into a clinic-machine learning nomogram via the feature mapping algorithm,which was internally validated for predictive accuracy and clinical utility.RESULTS A total of 855 colorectal cancer patients were enrolled,with 765 cases(April 2020 to December 2023)used for model training and validation,and 90 cases(January 2024 to July 2024)for internal testing.Baseline clinical features did not differ significantly between training and validation cohorts(P>0.05).Ten predictors were identified through integrated feature selection and expert consensus,including age,body surface area,body mass index,tumor position,albumin,carcinoembryonic antigen,carbohydrate antigen(CA)19-9,CA125,chemotherapy regimen,and chemotherapy cycles.Among ten machine learning algorithms,extreme gradient boosting achieved the best validation performance(AUC=0.97,AUPRC=0.92,sensitivity=0.79,specificity=0.92,accuracy=0.88).Logistic regression confirmed extra trees and random forest as independent predictors,which were incorporated into a clinic-machine learning nomogram.The clinic-machine learning nomogram demonstrated superior discrimination(AUC=0.96,AUPRC=0.93,accuracy=0.90,specificity=0.95),good calibration,and greater net clinical benefit across a wide probability range(10%-90%).Internal testing further confirmed its robustness and generalizability(AUC=0.95).CONCLUSION The clinic-machine learning nomogram accurately predicts chemotherapy-induced myelosuppression in colorectal cancer,providing interpretability and clinical utility to support individualized risk assessment and treatment decision-making.展开更多
Background:Non-small cell lung cancer(NSCLC)patients with leptomeningeal metastasis(LM)have a very poor prognosis.Intrathecal pemetrexed(IP)has shown moderate efficacy in treating patients with NSCLC-LM.Myelosuppressi...Background:Non-small cell lung cancer(NSCLC)patients with leptomeningeal metastasis(LM)have a very poor prognosis.Intrathecal pemetrexed(IP)has shown moderate efficacy in treating patients with NSCLC-LM.Myelosuppression is the most common adverse effect following IP administration.Despite this trend,the specific risk factors contributing to IP-related myelosuppression remain unclear.Methods:This study conducted a retrospective analysis of lung adenocarcinoma(LUAD)patients with LM who received IP treatment at the Second Affiliated Hospital of Nanchang University from April 2017 to April 2024.Risk factors for myelosuppression were identified through univariate and multivariate logistic regression analyses.Non-linear relationships and determined the inflection points were subsequently determined using smooth curve fitting and threshold effect analysis.Results:A total of 95 patients were identified,among whom 64(68.42%)experienced myelosuppression,with 43(45.26%)cases classified as severe myelosuppression.Leukopenia emerged as the most prevalent form of myelosuppression.Age was established as an independent risk factor for both myelosuppression and its severe form.A nonlinear relationship between age and severe myelosuppression was observed.The risk of developing severe myelosuppression increased significantly with age,beyond the turning point of 58 years old(OR 1.28,95%CI 1.08–1.52;p 0.0042).Conclusions:Advanced age is=associated with the occurrence of myelosuppression and severe myelosuppression.The probability of developing severe myelosuppression increases significantly in individuals aged 58 years or older.展开更多
Objective:To assess the effectiveness and safety of the Fuzheng Buxue Dietary Therapy(FBDT)for mitigating myelosuppression caused by chemotherapy containing platinum agents.Methods:In this non-randomized concurrent co...Objective:To assess the effectiveness and safety of the Fuzheng Buxue Dietary Therapy(FBDT)for mitigating myelosuppression caused by chemotherapy containing platinum agents.Methods:In this non-randomized concurrent controlled trial,70 chemotherapy patients were evenly divided into two groups:the FBDT group and a standard care control group.The control group adhered to the standard oncological treatment protocol.Meanwhile,the FBDT group,in addition to the standard regimen,took an additional 300ml of the formula daily with lunch,beginning one week prior to chemotherapy and lasting for two weeks.The study conducted a comprehensive comparative analysis of peripheral blood counts,Traditional Chinese Medicine(TCM)symptom scores,Karnofsky Performance Status(KPS)scores,and the incidence of adverse reactions among patients from both groups.Outcomes:A total of 64 patients completed the study,with 32 in each group.FBDT group exhibited a significantly higher white blood cells recovery level one and three weeks after the chemotherapy compared to control group(3.23±0.68 vs 2.76±0.75(×10^(9)/L);3.92±1.07 vs 3.44±0.91(×10^(9)/L);P<0.05).Furthermore,three weeks after the start of chemotherapy,FBDT group had higher platelet recovery levels than the control group(164.25±54.38 vs 124.81±47.88(×10^(9)/L),P<0.05).Additionally,the TCM syndrome scores in FBDT group were lower(P<0.05),and the KPS scores were significantly higher in FBDT group(P<0.05).No serious adverse events were observed in two groups.Conclusion:FBDT is effective and safe in reducing myelosuppression caused by platinum chemotherapy.Future study should involve larger,multicenter trials to better understand dose-response and overall therapeutic value of FBDT.展开更多
Paeonia lactiflora root(baishao in Chinese) is a commonly used herb in traditional Chinese medicines(TCM). Two isomers, paeoniflorin(PF) and albiflorin(AF), are isolated from P. lactiflora. The present study aimed to ...Paeonia lactiflora root(baishao in Chinese) is a commonly used herb in traditional Chinese medicines(TCM). Two isomers, paeoniflorin(PF) and albiflorin(AF), are isolated from P. lactiflora. The present study aimed to investigate the protective effects of PF and AF on myelosuppression induced by chemotherapy in mice and to explore the underlying mechanisms. The mouse myelosuppression model was established by intraperitoneal(i.p.) injection of cyclophosphamide(CP, 200 mg×kg^(–1)). The blood cell counts were performed. The thymus index and spleen index were also determined and bone morrow histological examination was performed. The levels of tumor necrosis factor-α(TNF-α) in serum and colony-stimulating factor(G-CSF) in plasma were measured by Enzyme-Linked Immunosorbent Assays(ELISA) and the serum levels of interleukin-3(IL-3), granulocyte-macrophagecolony- stimulatingfactor(GM-CSF), and interleukin-6(IL-6) were measured by radioimmunoassay(RIA). The levels of m RNA expression protein of IL-3, GM-CSF and G-CSF in spleen and bone marrow cells were determined respectively. PF and AF significantly increased the white blood cell(WBC) counts and reversed the atrophy of thymus. They also increased the serum levels of GM-CSF and IL-3 and the plasma level of G-CSF and reduced the level of TNF-α in serum.. PF enhanced the m RNA level of IL-3 and AF enhanced the m RNA levels of GM-CSF and G-CSF in the spleen. PF and AF both increased the protein levels of GM-CSF and G-CSF in bone marrow cells. In conclusion, our results demonstrated that PF and AF promoted the recovery of bone marrow hemopoietic function in the mouse myelosuppression model.展开更多
Objective: To compare effect of different formulation of Dang-Gui-Bu-Xu-Tang(DCBXT) on myelosuppression mouse. Methods: HPLC was used to measure active ingredients of two DCBXT formulations. Hemopoesic function of bon...Objective: To compare effect of different formulation of Dang-Gui-Bu-Xu-Tang(DCBXT) on myelosuppression mouse. Methods: HPLC was used to measure active ingredients of two DCBXT formulations. Hemopoesic function of bone marrow was measured by hemopoietic progenitor cell culture and peipheral blood count. And hemopoietic factors in bone marrow were tested by ELISA. Results: The content level of astragaloside A in granule formulation was higher than that in decoction and the content ratio of active ingredient was close to 5 : 1. Two DGBXD formulations could significantly improve amount of peripheral blood cells, and bone marrow cells of bone marrow suppression mice (P < 0.05). DGBXD granule formulation significantly increased the colony quantity of all progenitor cell lines and amount of G(2)/M and S phase cells (P < 0.05). It also significantly decreased amount of G(0)/G(1) phase cells in the bone marrow and was more effective (P < 0.05). Conclusions: DGBXT decoction and the granule formulation all can improve the hematopoietic function of bone marrow suppression mouse. They can improve quantities of peripheral blood and nucleated bone marrow cells, and yield of the hematopoietic stem/progenitor cells in vitro colony; balance the expression of cytokine (EPO, TPO and GM-CSF) in bone marrow microenvirement. They can also facilitate hematopoietic stem/progenitor cells to enter the cell cycle. And the effect of granule formulation is more satisfactory.展开更多
Objective The influential factors of chemotherapy-induced myelosuppression in esophageal cancer in central China are unclear.This study aimed to investigate the effect of commonly used chemotherapy regimens on the inc...Objective The influential factors of chemotherapy-induced myelosuppression in esophageal cancer in central China are unclear.This study aimed to investigate the effect of commonly used chemotherapy regimens on the incidence of myelosuppression in clinical treatment of esophageal cancer.Methods In this retrospective study,624 patients with esophageal cancer who received six different chemotherapy regimens between 2013 and 2020 at our institute were included.Chemotherapy consisted of lobaplatin,5-fluorouracil(5-F),lobaplatin and 5-F,nedaplatin,nedaplatin and paclitaxel(PTX),cisplatin and PTX.Multivariable logistic regression analysis was used to explore the risk of myelosuppression among the six different chemotherapy regimens.Results Compared with lobaplatin group,the incidence of myelosuppression in patients treated with chemotherapy regimens of lobaplatin and 5-F,nedaplatin,nedaplatin and PTX and cisplatin and PTX were significantly ameliorated.The dose of lobaplatin was significantly reduced(P=0.007)when lobaplatin was combined with 5-F,and the combination could significantly reduce the risk of myelosuppression(P=0.022).Furthermore,chemotherapeutic regimens,the dose of platinum,hemoglobin and uric acid levels,age,sex,total bilirubin and immune-enhancing drugs were found to be strong predictors of developing myelosuppression.Conclusion Targeted preventive interventions that enhance immune function,reduce uric acid levels and choose combined medication during chemotherapy should be implemented for high-risk patients to reduce the occurrence of myelosuppression.In addition,the dose of lobaplatin should be adjusted when combined with other chemotherapy drugs to reduce the incidence of myelosuppression.展开更多
OBJECTIVE:To explore the inhibitory effect of Zishenshengxue capsule(ZSC) on myelosuppression in mice induced by cyclophosphamide.METHODS:Kunming mice were randomly assigned into a control group,myelosuppression group...OBJECTIVE:To explore the inhibitory effect of Zishenshengxue capsule(ZSC) on myelosuppression in mice induced by cyclophosphamide.METHODS:Kunming mice were randomly assigned into a control group,myelosuppression group,or groups for mice with myelosuppression receiving high dose ZSC,middle dose ZSC,low dose ZSC or Yixuesheng.Myelosuppression was induced by peritoneal injection of cyclophosphamide.ZSC and cyclophosphamide were administered simultaneously.The numbers of peripheral blood cells and bone marrow karyocytes were counted.Cell proliferation activity and colony formation of granulocyte-monocyte series hemopoietic progenitor cells(C-GMs) and cell cycle were detected.RESULTS:The numbers of white blood cells in the middle and high dose ZSC groups were significantly increased at the 12th and 13th day(P<0.01) and bone marrow karyocytes and cell proliferation activity increased in the high dose ZSC group(P<0.01) compared with the myelosuppression group.C-GMs of middle and high dose ZSC groups significantly increased(P<0.01).The percentage of G 1 phase in the high dose ZSC group decreased(P< 0.01) and the percentage of S and G 2 phase increased(P<0.01).CONCLUSION:ZSC increased the numbers of peripheral white blood cells,bone marrow karyocytes and C-GMs.ZSC also increased cell proliferation activity and removed the G 1 phase block.Thus,ZSC could reduce myelosuppression in mice induced by cyclophosphamide.展开更多
Colchicine has been widely used as an anti-gout medication over the past decades.However,it is less commonly used due to its narrow therapeutic range,meaning that its lethal dose is close to its therapeutic dose.The l...Colchicine has been widely used as an anti-gout medication over the past decades.However,it is less commonly used due to its narrow therapeutic range,meaning that its lethal dose is close to its therapeutic dose.The lethal dose of colchicine is considered to be 0.8 mg/kg.As chronic colchicine poisoning has multiple manifestations,it poses a challenge in the clinician’s differential diagnosis.Historically,the drug was important in treating gout;however,clinical studies are currently underway regarding the use of colchicine in patients with coronavirus disease 2019 as well as its use in coronary artery disease,making this drug more important in clinical practice.CASE SUMMARY A 61-year-old male with a history of gout and chronic colchicine intake was admitted to our Emergency Department due to numbness and weakness of the lower limbs.The patient reported a history of colchicine intake for 23 years.After thorough examination,he was diagnosed with colchicine poisoning,manifesting as neuromyopathy,multiple gastric ulcers and myelosuppression.We advised him to stop taking colchicine and drinking alcohol.We also provided a prescription of lansoprazole and mecobalamin,and then asked him to return to the clinic for re-examination.The patient was followed up for 3-mo during which time his gout symptoms were controlled to the point where he was asymptomatic.CONCLUSION Colchicine overdose can mimic the clinical manifestations of several conditions.Physicians easily pay attention to the disease while ignoring the cause of the disease.Thus,the patient’s medication history should never be ignored.展开更多
Objective:To evaluate the effect of acupuncture on myelosuppression after chemotherapy and summarize its acupoint selection strategy.Methods:After a systematic search,an acupoint database on myelosuppression after che...Objective:To evaluate the effect of acupuncture on myelosuppression after chemotherapy and summarize its acupoint selection strategy.Methods:After a systematic search,an acupoint database on myelosuppression after chemotherapy was constructed.A meta-analysis was conducted to assess the efficacy of acupuncture.On this basis,association analysis and cluster analysis were performed to explore the distribution of acupoints in SPSS Modeler18.0 and SPSS 22.0.Results:40 studies with 2988 patients were included.The white blood cell count,platelet count,red blood cell count,and hemoglobin were significantly higher in patients receiving acupuncture versus convention therapy exclusively.The two groups,however,did not differ in neutrophils count.Most acupoints,mainly distributed in the limbs and the back,were from the bladder meridian,the stomach meridian,and the spleen meridian.The lower sea and transport points were the most preferred specific points,in which ST36 and SP6 ranked highest in use.ST36-RN6,SP6-SP10,and ST36-SP10 turned out to be the most significant correlations in association rule mining.In cluster analysis,LI4-RN12,ST36-RN4-RN6 were grouped for their high similarity.Conclusion:For patients with myelosuppression after chemotherapy,acupuncture significantly inhibited the decline in blood cell components(white blood cell count,platelet count,red blood cell count,and hemoglobin)except for neutrophils.As the central combination of acupuncture prescriptions for this population,ST36-SP6-RN6-SP10-RN4 presented promising prospects and deserved more exploration for clinical use.展开更多
Myelosuppression is a common and severe side effect of cancer chemotherapy,with current treatments hindered by limitations such as depletion of hematopoietic reserves,poor patient compliance,delayed therapeutic onset,...Myelosuppression is a common and severe side effect of cancer chemotherapy,with current treatments hindered by limitations such as depletion of hematopoietic reserves,poor patient compliance,delayed therapeutic onset,and high cost.To overcome these challenges,we developed Epimedium-derived nanovesicles(ENVs)from the traditional Chinese medicinal herb Epimedium,addressing the solubility and bioavailability issues associated with conventional extracts.ENVs encapsulate bioactive constituents,including icariin and hematopoiesis-promoting ceramides.In a cyclophosphamide(CTX)-induced myelosuppression mouse model,prophylactic and therapeutic oral administration of ENVs effectively alleviated hematopoietic suppression,significantly outperforming the Epimedium-based herbal extract“Joungal”(Shengbai Formula)despite equivalent icariin content.Notably,ENVs promoted hematopoietic stem cell(HSC)proliferation—an outcome rarely achieved with existing therapies.Mechanistically,ENVs modulated the gut microbiota,enriching lactobacillus species and enhancing lactate production.This microbiota-driven lactate signaling stimulated LepR+mesenchymal stem cells(MSCs)in the bone marrow niche to secrete stromal cellderived factor-1(SDF-1)and stem cell factor(SCF),thereby supporting HSC expansion and restoring hematopoietic function.In vivo safety evaluations confirmed the excellent biocompatibility of ENVs.Our findings uncover a gut-lactate-bone marrow axis through which ENVs enhance hematopoiesis and promote HSC regeneration.This work introduces a cost-effective,scalable,and orally administrable biomaterial platform with strong translational potential for the prevention and treatment of chemotherapy-induced myelosuppression.展开更多
Background Cyclophosphamide(CTX)induces myelosuppression,a dose-limiting adverse effect,through direct cytotoxicity to hematopoietic cells and disruption of the stromal microenvironment.Anemoside B4(AB4),a saponin der...Background Cyclophosphamide(CTX)induces myelosuppression,a dose-limiting adverse effect,through direct cytotoxicity to hematopoietic cells and disruption of the stromal microenvironment.Anemoside B4(AB4),a saponin derived from Pulsatilla chinensis,exhibits antioxidant,anti-apoptotic,anti-inflammatory,and immunomodulatory activities;however,its role in protecting bone marrow from CTX-induced injury remains unknown.Objective To investigate the potential of AB4 to mitigate CTX-induced myelosuppression and its underlying mechanisms using C57BL/6J mice.Methods A CTX-induced myelosuppression model was established,with 40 mice randomly assigned to 5 groups(n=8 per group):Control,CTX alone,low-dose AB4(AB4-L),high-dose AB4(AB4-H),and granulocyte colony-stimulating factor(G-CSF,positive control).After 7 days of treatment,the following parameters were assessed:peripheral blood cell counts,spleen and thymus indices,bone marrow histology,levels of cytokines(granulocyte-macrophage colony-stimulating factor(GM-CSF),G-CSF,interleukin-6(IL-6),interleukin-1 beta(IL-1β)).Flow cytometric analysis(bone marrow mesenchymal stem cells(BMSCs)),reactive oxygen species(ROS),cell cycle,apoptosis),molecular assays(superoxide dismutase(SOD),malondialdehyde(MDA)),terminal deoxynucleotidyl transferase dUTP nick end labeling(TUNEL),and western blotting forγ-H2AX,p53,etc.)were also performed.Results Both doses of AB4 significantly increased red blood cell(RBC)and white blood cell(WBC)counts and elevated the thymus index(P<0.05).AB4 normalized hemosiderin deposition and megakaryocyte numbers,reduced the spleen index(P<0.01),increased levels of hematopoietic cytokines and BMSCs(P<0.01),decreased ROS and MDA levels,restored SOD activity,downregulated the expression ofγ-H2AX,p53,BAX,and cleaved caspase-3/9(P<0.01),and alleviated cell cycle arrest and apoptosis(P<0.01).Conclusion AB4 mitigates CTX-induced myelosuppression by preserving the bone marrow microenvironment,reducing oxidative stress and DNA damage,relieving cell cycle arrest,and suppressing apoptosis.These findings suggest AB4 holds promise for alleviating chemotherapy-related hematotoxicity.展开更多
Background: Myelosuppression is a common chemotherapy-related toxicity and hematopoietic stem cells (HSCs)senescence is the main mechanism. Guilu Erxian Glue (GEG) is an effective Chinese herbal prescription for the t...Background: Myelosuppression is a common chemotherapy-related toxicity and hematopoietic stem cells (HSCs)senescence is the main mechanism. Guilu Erxian Glue (GEG) is an effective Chinese herbal prescription for the treatment of myelosuppression in clinical, the potential mechanism needs further investigation.Objective: To explore the protective effect of GEG on HSCs during chemotherapy-induced myelosuppression and its mechanism.Methods: Eighteen H22 hepatoma-bearing mice were divided equally into three groups: control, cisplatin (DDP),and DDP+GEG groups. Peripheral blood cell counts and bone marrow nucleated cell counts were performed.Bone marrow histopathology was assessed by hematoxylin and eosin (H&E) staining. DNA damage was assessed by γ-H2AX immunofluorescence staining. The serum containing GEG was prepared for in vitro experiments. Superoxide dismutase (SOD) activity, cell viability, cell cycle, and aging cells were detected in vivo and in vitro. In addition, western blot, quantitative reverse transcription polymerase chain reaction (qRT-PCR), and chromatin immunoprecipitation (CHIP) assay were applied to explore the molecular mechanism.Results: GEG administration resulted in a significant increase in peripheral blood cells and bone marrow nucleated cells (P < 0.01), and improved the pathological histomorphology of bone marrow. Treatment with GEG or silencing of the p16Ink4a gene enhanced the SOD activity and viability of HSCs, while reducing DDP-induced DNA damage, G2-M cell cycle arrest and senescent cell formation (P < 0.001). GEG decreased both mRNA and protein levels of p16, while increased the protein and mRNA expression levels of CDK4, CDK6, and pRb both in vivo and in vitro experiments (P < 0.05). ChIP-qPCR showed that the p16Ink4apromoter region was enriched with JMJD2and H3K36me2/me3 protein. GEG treatment up-regulated the protein and mRNA expression levels of JMJD2 and simultaneously down-regulated H3K36me2/me3 protein levels.Conclusion: Our findings suggest that GEG exerts regulatory effects on p16ink4a gene expression through modulating the levels of H3K36 methylation. This study provides important mechanistic insights into the effects of GEG on HSCs and suggests potential therapeutic applications for GEG in myelosuppression.展开更多
Background:The disease burden,treatment patterns,and financial costs associated with chemotherapy-induced myelosuppression(CIM)in Chinese patients with extensive-stage small cell lung cancer(ES-SCLC)remain poorly char...Background:The disease burden,treatment patterns,and financial costs associated with chemotherapy-induced myelosuppression(CIM)in Chinese patients with extensive-stage small cell lung cancer(ES-SCLC)remain poorly characterized,particularly in terms of real-world evidence derived from large populations.This study aimed to describe the incidence,treatment patterns,costs,and healthcare resource utilization(HCRU)in Chinese patients with ES-SCLC who develop CIM.Methods:Adults diagnosed with ES-SCLC who started etoposide—platinum(EP)chemotherapy for the first time between January 1,2018 and December 31,2022 were retrospectively identifiedin the Chinese National Cancer Information Database.Baseline demographic and clinical data were collected.Information on CIM-related events,treatment,costs,and HCRU during EP chemotherapy and during follow-up was assessed.Costs and HCRU were compared among patients with grade 3-4 CIM,grade 12 CIM,and no CIM using the KruskalWallis test.Results:In total,7505 patients with ES-SCLC(mean age 61.2 years;17.7%[1332/7505]female;body mass index 23.2±3.3 kg/m^(2))were enrolled.After initiation of EP-based chemotherapy,6901 patients(92.0%)experienced at least one CIM-related event.At least one grade 34 CIM event occurred in 1883 patients(25.1%)and consisted of single-lineage(neutropenia[n=609,8.1%],thrombocytopenia[n=85,1.1%],anemia[n=797,10.6%]),twolineage(n=318,4.2%),and three-lineage(n=74,1.0%)events.Patients receiving immune checkpoint inhibitors(ICIs)plus EP(n=1674)had a significantly higher incidence of at least one CIM during the ICI combination therapy(87.8%[1469/1674]vs.82.8%[4827/5831];χ^(2)=23.43,P<0.0001)and grade 34 CIM(25.7%[430/1674]vs.20.6%[1201/5831];χ^(2)=19.51,P<0.0001)compared to those receiving other EP-basedtherapies duringEP chemotherapy(n=5831).Rates of use of granulocyte colony-stimulating factor,thrombopoietin,interleukin-11,erythropoiesis-stimulating agents,and blood transfusion were 81.1%(n=6087),9.2%(n=691),12.4%(n=927),9.0%(n=678),and 12.1%(n=907),respectively.HCRU and total costs per patient were higher for those with grade 3-4 CIM than for those without CIM or grade 1-2 CIM,and significant differences in the total cost were observed across groups(H=195.54,P<0.0001).Conclusion:Despite the availability of supportive care for CIM in patients with ES-SCLC in China,a considerable clinical and financial burden persists.Strategies that protect bone marrow from progressing to high-grade myelosuppression could reduce the burden on patients and healthcare organizations.展开更多
Objective:The objective is to explore the protective mechanisms of the Fuzheng Buxue recipe(FBR)against chemotherapy-induced myelosuppression(CIM),focusing on its potential to activate the Notch signaling pathway.Mate...Objective:The objective is to explore the protective mechanisms of the Fuzheng Buxue recipe(FBR)against chemotherapy-induced myelosuppression(CIM),focusing on its potential to activate the Notch signaling pathway.Materials and Methods:A rat model of myelosuppression was induced using 5-fluorouracil(5-FU).The rats were divided into five groups:control,CIM,batyl alcohol,low-dose FBR,and high-dose FBR(HD-FBR).After a 14-day treatment period,white blood cell(WBC)count,red blood cell count,platelet count,and hemoglobin levels in all rats were evaluated.Histopathological assessments of the thymus,spleen,and bone marrow were conducted using hematoxylin and eosin staining.In addition,expression levels of Notch1,Notch2,Jagged1,and DLL1 proteins in bone marrow tissues were measured at the protein and mRNA levels using western blotting and reverse transcription-quantitative polymerase chain reaction.Results:The CIM group exhibited significantly lower blood cell counts compared to the control group(P<0.05).The HD-FBR group showed notably normalized WBC counts,similar to the results observed in the batyl alcohol group.HD-FBR treatment also enhanced spleen mass,index,and nodule counts,approaching the levels observed in the control group(P>0.05).5-FU induced damage to immune organs and the bone marrow of rats,but HD-FBR significantly mitigated these pathological alterations.While 5-FU diminished the expression of Notch1,Notch2,Jagged1,and DLL1 proteins and mRNA(P<0.05),HD-FBR counteracted this reduction,leading to significant upregulation(P<0.05).Conclusions:FBR mitigates CIM by activating the Notch signaling pathway,highlighting its potential as a therapeutic strategy.展开更多
Objective To assess the effectiveness of Chinese herbal medicine(CHM)combined with adjuvant chemotherapy on myelosuppression for colorectal cancer(CRC)patients using network meta-analysis(NMA).Methods Literature searc...Objective To assess the effectiveness of Chinese herbal medicine(CHM)combined with adjuvant chemotherapy on myelosuppression for colorectal cancer(CRC)patients using network meta-analysis(NMA).Methods Literature searches in both international(PubMed,Embase,Web of Science,and Cochrane Library)and Chinese(China Science and Technology Journal Database,Wanfang Data,China National Knowledge Infrastructure)databases for relevant randomized controlled trials(RCTs)were conducted from inception until October 10,2022.We included RCTs of patients who received CHM combined with chemotherapy,including FOLFOX,XELOX,FOLFIRI,and other relevant regimens in the CHM treatment group.The outcomes included the incidence of myelosuppression,leukopenia,hemoglobin reduction,and thrombocytopenia.Two reviewers independently screened the databases,extracted the data,and assessed the risk of bias and credibility of evidence.RevMan 5.4.1 software and STATA 14.0 were used to perform the NMA.Results A total of 31 RCTs were included,published from 2008 to 2021 in Chinese.Among these,2,314 participants comparing the following 9 CHMs were identified:Shengbai Recipe(SBR),Bazhen Decoction(BZD),Jianpi Jiedu Recipe(JJR),Jianpi Recipe(JR),Compound Cantharis Capsule(CCC),Zaofan Pill(ZFP),Guilu Erxian Gel(GL),Buzhong Tiaogan Decoction(BZ),and Qiamagu Capsule(QM).The results of NMA found an indirect comparison.Based on the surface under the cumulative ranking curve(SUCRA),the ZFP+chemotherapy group had the lowest incidence of myelosuppression,with an odds ratio(OR)of 0.08[95%confidence interval(CI):0.01,0.76],whereas the GL+chemotherapy group had the lowest incidence of leukopenia,hemoglobin reduction,and thrombocytopenia,with an OR of 5.25(95%CI:2.41,11.43),4.66(95%CI:2.23,9.72),and 0.27(95%CI:0.13,0.54),respectively.Moreover,BZD+chemotherapy could alleviate leukopenia,hemoglobin reduction,and thrombocytopenia(P<0.01).Pairwise comparison showed that there was no difference in the efficacy among the 8 CHMs+chemotherapy group.The comparison and adjustment funnel plot indicated that small-study effect had no impact on these outcomes.Conclusions This NMA provided evidence to support that patients with CRC benefit from receiving different combination of CHM chemotherapies.Among these,GL plus chemotherapy and BZD plus chemotherapy were the more effective for myelosuppression in patients;however,as the qualtiy of evidence is insufficient,further research is needed.(PROSPERO, No. CRD42022369025.展开更多
Objective: To observe the clinical efficacy of grain-sized moxibustion in treating chemotherapy-induced myelosuppression for non-small cell lung cancer (NSCLC) and its effect on quality of life (QOL). Methods: Eighty ...Objective: To observe the clinical efficacy of grain-sized moxibustion in treating chemotherapy-induced myelosuppression for non-small cell lung cancer (NSCLC) and its effect on quality of life (QOL). Methods: Eighty NSCLC patients admitted to the Inpatient Department of Zhejiang Cancer Hospital between September 2016 and March 2018 were recruited and divided into an observation group and a control group by random number method, with 40 cases in each group. The two groups both received chemotherapy with paclitaxel plus cisplatin (TP regimen). The control group received oral administration of leucogen tablets starting from the first day of chemotherapy, 20 mg each time, three times a day, for consecutive 14 d;the observation group was additionally given grain-sized moxibustion, once a day, five days per week at a two-day interval, until the fourteenth day. The myelosuppression severity was observed and compared between the two groups prior to chemotherapy, at the 3rd, 7th and 14th days of chemotherapy;the QOL in the two groups was evaluated before chemotherapy, at the 14th and 21st days of chemotherapy. Results: Regarding myelosuppression, the peripheral blood indicators increased significantly at the 3rd day of chemotherapy in both groups (P<0.05 or P<0.01);at the 7th and 14th days of chemotherapy, the peripheral blood indicators presented a decreasing tendency in the two groups, but the level in the observation group was still significantly higher than that before chemotherapy (P<0.01);at the 3rd, 7th and 14th days of chemotherapy, the peripheral blood indicators in the observation group were higher than those in the control group (P<0.05 or P<0.01);the occurrence rate of myelosuppression in the observation group was significantly lower than that in the control group (P<0.01). The QOL score in the observation group was markedly higher than that in the control group at the 14th and 21st days of chemotherapy (both P<0.05). Conclusion: Grain-sized moxibustion can effectively improve myelosuppression after chemotherapy for NSCLC, reducing its occurrence and enhancing the patient's QOL.展开更多
Objective To explore the protective effects of tannins in Sanguisorba Radix （TSR） on myelosuppression mice induced by cyclophosphamide （CTX）. Methods TSR was ig given at the dose of 20 mg/kg for 10 d after ip admi...Objective To explore the protective effects of tannins in Sanguisorba Radix （TSR） on myelosuppression mice induced by cyclophosphamide （CTX）. Methods TSR was ig given at the dose of 20 mg/kg for 10 d after ip administration of CTX （200 mg/kg）. Results TSR could significantly increase the numbers of white blood ceils, red blood cells, and platelets of myelosuppression in mice. And it could accelerate bone marrow haemopoietic stem/progenitor cells （HSPCs） in myelosuppression mice and enhance cell proliferation by promoting cell cycles from G0/G1 phase to access into S and G2/M phases, then the reduced number of HSPCs induced by CTX was reversed. Moreover, TSR could increase the mRNA and protein expression levels of O（6）-methylguanine- DNA methyltransferase （MGMT） in HSPCs of myelosuppression mice. Concision TSR has a protective function against CTX-induced myelosuppression. The mechanism might be related to protecting hematopoietic stem cells of bone marrow, stimulating hematopoiesis recovery, as well as preventing the apoptosis of hematopoietic stem cells induced by CTX.展开更多
Objective： To study the efficacy and safety of Shuanghuang Shengbai Granule（双黄升白颗粒, SSG）, a traditional Chinese herbal medicine, on myelosuppression of cancer patients caused by chemotherapy. Methods： A tota...Objective： To study the efficacy and safety of Shuanghuang Shengbai Granule（双黄升白颗粒, SSG）, a traditional Chinese herbal medicine, on myelosuppression of cancer patients caused by chemotherapy. Methods： A total of 330 patients were randomly assigned to the treatment group（220 cases, analysed 209 cases） and the control group（110 cases, analysed 102 cases） with a 2：1 ratio by envelope method. The patients in the treatment group at the first day of chemotherapy started to take SSG for 14 days, while the patients in the control group took Leucogon Tablets. The changes of the blood routine, clinical symptoms and immune function in both groups were observed for safety and efficacy evaluation. Results： At the 7th day of chemotherapy, the white blood cells（WBCs） level in the treatment group was significantly higher than that in the control group（P〈0.05）. After treatment, the WBCs rate in the normal range accounted for 50.2% in the treatment group, the myelosuppression of WBCs and neutrophil were mainly grade Ⅰ, while 8.1% and 5.7% of patients emerged grade Ⅲ and grade Ⅳ myelosuppression, respectively. The incidence of myelosuppression of the treatment group was significantly lower than that of the control group（P〈0.05）. The total effective rate of Chinese medicine syndrome in the treatment group was significantly higher than that in the control group（84.2% vs. 72.5%, P〈0.05）. The immune cell levels in both groups were maintained in the normal range. Compared with that before treatment, the levels of CD3~＋ and CD4~＋ cells were significantly increased in the treatment group after treatment（P〈0.05）. The discrepancy of CD3~＋ and CD4~＋ cell activity before and after treatment in both groups were significantly different（P〈0.05）. No obvious adverse event occurred in both groups. Conclusion： SSG had a protection effect on bone marrow suppression, and alleviated the clinical symptoms together with clinical safety.展开更多
Background and Objectives:To evaluate the potential benefits of Bacteroides fragilis 839(BF839),a nextgeneration probiotics,in reducing myelosuppression and gastrointestinal toxicity associated with chemotherapy in br...Background and Objectives:To evaluate the potential benefits of Bacteroides fragilis 839(BF839),a nextgeneration probiotics,in reducing myelosuppression and gastrointestinal toxicity associated with chemotherapy in breast cancer patient.Methods and Study Design:40 women with early breast cancer were randomly assigned to the BF839(n=20)or placebo(n=20)during the administration of adjuvant chemotherapy(4 cycles of epirubicin 100mg/m^(2) and cyclophosphamide 600mg/m^(2)).Myelosuppression and gastrointestinal adverse effects were monitored in both groups.Results:Throughout the four treatment cycles,the percentage of patients experiencing myelosuppression was 42.5%in the BF839 group,significantly lower than the 66.3%observed in the control group(p=0.003).Two patients in the BF839 group and three patients in the placebo group received recombinant human granulocyte colony-stimulating factor(rhG-CSF)due to leukopenia/neutropenia.When considering an ITT analysis,which included all patients regardless of rhG-CSF treatment,the BF839 group exhibited less reduction from baseline in white blood cells(-0.31±1.19 vs-1.15±0.77,p=0.012)and neutrophils(0.06±1.00 vs-0.84±0.85,p=0.004)compared to the placebo group.The difference became even more significant when excluding the patients who received rhG-CSF injections.Throughout the four treatment cycles,compared to the placebo group,the BF839 group had significantly lower rates of 3-4 grade nausea(35.0%vs 71.3%,p=0.001),vomiting(20.0%vs 45.0%,p=0.001),and diarrhea(15.0%vs 30.0%,p=0.023).Conclusions:These findings suggest that BF839 has the potential to effectively mitigate myelosuppression and gastrointestinal toxicity associated with chemotherapy in breast cancer patients.展开更多
基金Supported by the State Administration of Traditional Chinese Medicine high-level key disciplines construction project:zyyzdxk-2023068Three-year Action Plan for Shanghai TCM Development and Inheritance Program:ZY(2021-2023)-0302。
文摘Objective:To observe the effects of moxibustion on the hematopoietic function in mice with aplastic anemia(AA)induced by bone marrow(BM)suppression,and to investigate the intervention effects of moxibustion on AA from the perspective of intestinal bacteria.Methods:A total of 24 C57BL/6 J male mice were randomly and evenly divided into control,model and moxibustion groups.The myelosuppression-induced AA model was established by cyclophosphamide(CTX)and cyclosporine(Cs)intraperitoneal injection.Mice in the moxibustion group were intervened in mild moxibustion at unilateral“Zusanli(ST36)”acupoint for 15 min per day,and the sides were switched the next day.The intervention of mild moxibustion lasted 60 days consecutively.The red blood cell(RBC),white blood cell(WBC),platelet(PLT)counts and haemoglobin(Hb)concentration levels of mice in each group were detected by peripheral blood cells count staining,and the BM hematopoietic cells and hematopoietic structures were observed by BM smear Wright-Giemsa staining and HE staining.16SrDNA sequencing was used to analyze the gut bacterial species abundance and diversity in mice from each group.Results:After all the intervention,compared to the control group,the model group had lower levels of RBC,WBC,PLT counts and Hb concentration in peripheral blood(P<0.05)and fewer hematopoietic cells and hematopoietic structures;compared to the model group,moxibustion group had higher levels of RBC,WBC,PLT counts and Hb concentration in peripheral blood(P<0.05),and more BM hematopoietic cells and hematopoietic structures.Gut flora showed that moxibustion increased the species richness and diversity of intestinal bacteria in mice;compared with the control group,the relative abundance of Faecalibaculum and Anaeroplasmataceae in the model group was higher(P<0.05);whereas,the relative abundance of Faecalibaculum and Anaeroplasmataceae in the moxibustion group was lower(P<0.05)when compared with the model group.In addition,Faecalibaculum was significantly correlated with RBC,WBC,PLT count and Hb concentration(P<0.05).Conclusion:Moxibustion can improved BM histology,restored hematopoietic cells function,and increased peripheral blood cells count and Hb concentration in AA mice.The mechanism may be related to the fact that moxibustion regulates the abundance of specific intestinal bacteria to maintain the stability of the flora structure.
基金Supported by the Beijing Municipal Natural Science Foundation,No.7252262High Level Chinese Medical Hospital Promotion Project,No.HLCMHPP2023085+2 种基金National Natural Science Foundation of China,No.82174463National Administration of Traditional Chinese Medicine,No.ZYYCXTD-C-C202205China Academy of Chinese Medical Sciences,No.CI2021A01804 and No.2022S469.
文摘BACKGROUND Colorectal cancer is a common digestive malignancy,and chemotherapy remains a cornerstone of treatment.Myelosuppression,a frequent hematologic toxicity,poses significant clinical challenges.However,no interpretable machine learning-based nomogram exists to predict chemotherapy-induced myelosuppression in colorectal cancer patients.This study aimed to develop and validate an inter-pretable clinic-machine learning nomogram integrating clinical predictors with multiple algorithms via a feature mapping algorithm.The model provides accurate risk estimation and clinical interpretability,supporting individualized prevention strategies and optimizing decision-making in patients receiving first-line chemotherapy.AIM To develop and validate an interpretable clinic-machine learning nomogram predicting chemotherapy-induced myelosuppression in colorectal cancer.METHODS This retrospective study enrolled 855 colorectal cancer patients receiving first-line chemotherapy.Data were split into training(n=612),validation(n=153),and testing(n=90)cohorts.Ten predictors were identified through least absolute shrinkage and selection operator,decision tree,random forest,and expert con-sensus.Ten machine learning algorithms were applied,with performance assessed by area under the receiver operating characteristic curve(AUC),area under the precision-recall curve(AUPRC),calibration,and decision curves.The optimal model was integrated into a clinic-machine learning nomogram via the feature mapping algorithm,which was internally validated for predictive accuracy and clinical utility.(AUPRC),calibration,and decision curves.The optimal model was integrated into a clinic-machine learning nomogram via the feature mapping algorithm,which was internally validated for predictive accuracy and clinical utility.RESULTS A total of 855 colorectal cancer patients were enrolled,with 765 cases(April 2020 to December 2023)used for model training and validation,and 90 cases(January 2024 to July 2024)for internal testing.Baseline clinical features did not differ significantly between training and validation cohorts(P>0.05).Ten predictors were identified through integrated feature selection and expert consensus,including age,body surface area,body mass index,tumor position,albumin,carcinoembryonic antigen,carbohydrate antigen(CA)19-9,CA125,chemotherapy regimen,and chemotherapy cycles.Among ten machine learning algorithms,extreme gradient boosting achieved the best validation performance(AUC=0.97,AUPRC=0.92,sensitivity=0.79,specificity=0.92,accuracy=0.88).Logistic regression confirmed extra trees and random forest as independent predictors,which were incorporated into a clinic-machine learning nomogram.The clinic-machine learning nomogram demonstrated superior discrimination(AUC=0.96,AUPRC=0.93,accuracy=0.90,specificity=0.95),good calibration,and greater net clinical benefit across a wide probability range(10%-90%).Internal testing further confirmed its robustness and generalizability(AUC=0.95).CONCLUSION The clinic-machine learning nomogram accurately predicts chemotherapy-induced myelosuppression in colorectal cancer,providing interpretability and clinical utility to support individualized risk assessment and treatment decision-making.
基金funded by the National Natural Science Foundation of China(grant number 82360629,awarded to ZZM)the Jiangxi Provincial Health Department Project(grant number 202410026,awarded to ZZM,202510363,awarded to HYQ).
文摘Background:Non-small cell lung cancer(NSCLC)patients with leptomeningeal metastasis(LM)have a very poor prognosis.Intrathecal pemetrexed(IP)has shown moderate efficacy in treating patients with NSCLC-LM.Myelosuppression is the most common adverse effect following IP administration.Despite this trend,the specific risk factors contributing to IP-related myelosuppression remain unclear.Methods:This study conducted a retrospective analysis of lung adenocarcinoma(LUAD)patients with LM who received IP treatment at the Second Affiliated Hospital of Nanchang University from April 2017 to April 2024.Risk factors for myelosuppression were identified through univariate and multivariate logistic regression analyses.Non-linear relationships and determined the inflection points were subsequently determined using smooth curve fitting and threshold effect analysis.Results:A total of 95 patients were identified,among whom 64(68.42%)experienced myelosuppression,with 43(45.26%)cases classified as severe myelosuppression.Leukopenia emerged as the most prevalent form of myelosuppression.Age was established as an independent risk factor for both myelosuppression and its severe form.A nonlinear relationship between age and severe myelosuppression was observed.The risk of developing severe myelosuppression increased significantly with age,beyond the turning point of 58 years old(OR 1.28,95%CI 1.08–1.52;p 0.0042).Conclusions:Advanced age is=associated with the occurrence of myelosuppression and severe myelosuppression.The probability of developing severe myelosuppression increases significantly in individuals aged 58 years or older.
基金supported by National Natural Science Foundation of China(82205237)Matching Project for the Youth Fund of the National Natural Science Foundation at Nanjing University of Chinese Medicine(XPT82205237)Jiangsu Provincial Department of Health Medical Science Research Project(Z2021065).
文摘Objective:To assess the effectiveness and safety of the Fuzheng Buxue Dietary Therapy(FBDT)for mitigating myelosuppression caused by chemotherapy containing platinum agents.Methods:In this non-randomized concurrent controlled trial,70 chemotherapy patients were evenly divided into two groups:the FBDT group and a standard care control group.The control group adhered to the standard oncological treatment protocol.Meanwhile,the FBDT group,in addition to the standard regimen,took an additional 300ml of the formula daily with lunch,beginning one week prior to chemotherapy and lasting for two weeks.The study conducted a comprehensive comparative analysis of peripheral blood counts,Traditional Chinese Medicine(TCM)symptom scores,Karnofsky Performance Status(KPS)scores,and the incidence of adverse reactions among patients from both groups.Outcomes:A total of 64 patients completed the study,with 32 in each group.FBDT group exhibited a significantly higher white blood cells recovery level one and three weeks after the chemotherapy compared to control group(3.23±0.68 vs 2.76±0.75(×10^(9)/L);3.92±1.07 vs 3.44±0.91(×10^(9)/L);P<0.05).Furthermore,three weeks after the start of chemotherapy,FBDT group had higher platelet recovery levels than the control group(164.25±54.38 vs 124.81±47.88(×10^(9)/L),P<0.05).Additionally,the TCM syndrome scores in FBDT group were lower(P<0.05),and the KPS scores were significantly higher in FBDT group(P<0.05).No serious adverse events were observed in two groups.Conclusion:FBDT is effective and safe in reducing myelosuppression caused by platinum chemotherapy.Future study should involve larger,multicenter trials to better understand dose-response and overall therapeutic value of FBDT.
基金supported by the National Nature Science Foundation of China(Nos.81473370,81173569)
文摘Paeonia lactiflora root(baishao in Chinese) is a commonly used herb in traditional Chinese medicines(TCM). Two isomers, paeoniflorin(PF) and albiflorin(AF), are isolated from P. lactiflora. The present study aimed to investigate the protective effects of PF and AF on myelosuppression induced by chemotherapy in mice and to explore the underlying mechanisms. The mouse myelosuppression model was established by intraperitoneal(i.p.) injection of cyclophosphamide(CP, 200 mg×kg^(–1)). The blood cell counts were performed. The thymus index and spleen index were also determined and bone morrow histological examination was performed. The levels of tumor necrosis factor-α(TNF-α) in serum and colony-stimulating factor(G-CSF) in plasma were measured by Enzyme-Linked Immunosorbent Assays(ELISA) and the serum levels of interleukin-3(IL-3), granulocyte-macrophagecolony- stimulatingfactor(GM-CSF), and interleukin-6(IL-6) were measured by radioimmunoassay(RIA). The levels of m RNA expression protein of IL-3, GM-CSF and G-CSF in spleen and bone marrow cells were determined respectively. PF and AF significantly increased the white blood cell(WBC) counts and reversed the atrophy of thymus. They also increased the serum levels of GM-CSF and IL-3 and the plasma level of G-CSF and reduced the level of TNF-α in serum.. PF enhanced the m RNA level of IL-3 and AF enhanced the m RNA levels of GM-CSF and G-CSF in the spleen. PF and AF both increased the protein levels of GM-CSF and G-CSF in bone marrow cells. In conclusion, our results demonstrated that PF and AF promoted the recovery of bone marrow hemopoietic function in the mouse myelosuppression model.
基金the Sanjiu Modern Medicine Ltd.for providing fund and DGBXT granule formula
文摘Objective: To compare effect of different formulation of Dang-Gui-Bu-Xu-Tang(DCBXT) on myelosuppression mouse. Methods: HPLC was used to measure active ingredients of two DCBXT formulations. Hemopoesic function of bone marrow was measured by hemopoietic progenitor cell culture and peipheral blood count. And hemopoietic factors in bone marrow were tested by ELISA. Results: The content level of astragaloside A in granule formulation was higher than that in decoction and the content ratio of active ingredient was close to 5 : 1. Two DGBXD formulations could significantly improve amount of peripheral blood cells, and bone marrow cells of bone marrow suppression mice (P < 0.05). DGBXD granule formulation significantly increased the colony quantity of all progenitor cell lines and amount of G(2)/M and S phase cells (P < 0.05). It also significantly decreased amount of G(0)/G(1) phase cells in the bone marrow and was more effective (P < 0.05). Conclusions: DGBXT decoction and the granule formulation all can improve the hematopoietic function of bone marrow suppression mouse. They can improve quantities of peripheral blood and nucleated bone marrow cells, and yield of the hematopoietic stem/progenitor cells in vitro colony; balance the expression of cytokine (EPO, TPO and GM-CSF) in bone marrow microenvirement. They can also facilitate hematopoietic stem/progenitor cells to enter the cell cycle. And the effect of granule formulation is more satisfactory.
基金the National Key R&D Programmes(NKPs)of China(No.2017YFC0909900).
文摘Objective The influential factors of chemotherapy-induced myelosuppression in esophageal cancer in central China are unclear.This study aimed to investigate the effect of commonly used chemotherapy regimens on the incidence of myelosuppression in clinical treatment of esophageal cancer.Methods In this retrospective study,624 patients with esophageal cancer who received six different chemotherapy regimens between 2013 and 2020 at our institute were included.Chemotherapy consisted of lobaplatin,5-fluorouracil(5-F),lobaplatin and 5-F,nedaplatin,nedaplatin and paclitaxel(PTX),cisplatin and PTX.Multivariable logistic regression analysis was used to explore the risk of myelosuppression among the six different chemotherapy regimens.Results Compared with lobaplatin group,the incidence of myelosuppression in patients treated with chemotherapy regimens of lobaplatin and 5-F,nedaplatin,nedaplatin and PTX and cisplatin and PTX were significantly ameliorated.The dose of lobaplatin was significantly reduced(P=0.007)when lobaplatin was combined with 5-F,and the combination could significantly reduce the risk of myelosuppression(P=0.022).Furthermore,chemotherapeutic regimens,the dose of platinum,hemoglobin and uric acid levels,age,sex,total bilirubin and immune-enhancing drugs were found to be strong predictors of developing myelosuppression.Conclusion Targeted preventive interventions that enhance immune function,reduce uric acid levels and choose combined medication during chemotherapy should be implemented for high-risk patients to reduce the occurrence of myelosuppression.In addition,the dose of lobaplatin should be adjusted when combined with other chemotherapy drugs to reduce the incidence of myelosuppression.
基金Supported by Heilongjiang Science and Technology Program (No. 2004 G0076-00)
文摘OBJECTIVE:To explore the inhibitory effect of Zishenshengxue capsule(ZSC) on myelosuppression in mice induced by cyclophosphamide.METHODS:Kunming mice were randomly assigned into a control group,myelosuppression group,or groups for mice with myelosuppression receiving high dose ZSC,middle dose ZSC,low dose ZSC or Yixuesheng.Myelosuppression was induced by peritoneal injection of cyclophosphamide.ZSC and cyclophosphamide were administered simultaneously.The numbers of peripheral blood cells and bone marrow karyocytes were counted.Cell proliferation activity and colony formation of granulocyte-monocyte series hemopoietic progenitor cells(C-GMs) and cell cycle were detected.RESULTS:The numbers of white blood cells in the middle and high dose ZSC groups were significantly increased at the 12th and 13th day(P<0.01) and bone marrow karyocytes and cell proliferation activity increased in the high dose ZSC group(P<0.01) compared with the myelosuppression group.C-GMs of middle and high dose ZSC groups significantly increased(P<0.01).The percentage of G 1 phase in the high dose ZSC group decreased(P< 0.01) and the percentage of S and G 2 phase increased(P<0.01).CONCLUSION:ZSC increased the numbers of peripheral white blood cells,bone marrow karyocytes and C-GMs.ZSC also increased cell proliferation activity and removed the G 1 phase block.Thus,ZSC could reduce myelosuppression in mice induced by cyclophosphamide.
文摘Colchicine has been widely used as an anti-gout medication over the past decades.However,it is less commonly used due to its narrow therapeutic range,meaning that its lethal dose is close to its therapeutic dose.The lethal dose of colchicine is considered to be 0.8 mg/kg.As chronic colchicine poisoning has multiple manifestations,it poses a challenge in the clinician’s differential diagnosis.Historically,the drug was important in treating gout;however,clinical studies are currently underway regarding the use of colchicine in patients with coronavirus disease 2019 as well as its use in coronary artery disease,making this drug more important in clinical practice.CASE SUMMARY A 61-year-old male with a history of gout and chronic colchicine intake was admitted to our Emergency Department due to numbness and weakness of the lower limbs.The patient reported a history of colchicine intake for 23 years.After thorough examination,he was diagnosed with colchicine poisoning,manifesting as neuromyopathy,multiple gastric ulcers and myelosuppression.We advised him to stop taking colchicine and drinking alcohol.We also provided a prescription of lansoprazole and mecobalamin,and then asked him to return to the clinic for re-examination.The patient was followed up for 3-mo during which time his gout symptoms were controlled to the point where he was asymptomatic.CONCLUSION Colchicine overdose can mimic the clinical manifestations of several conditions.Physicians easily pay attention to the disease while ignoring the cause of the disease.Thus,the patient’s medication history should never be ignored.
基金supported by the Natural Science Foundation of China(Grant Nos.81703839,81874411).
文摘Objective:To evaluate the effect of acupuncture on myelosuppression after chemotherapy and summarize its acupoint selection strategy.Methods:After a systematic search,an acupoint database on myelosuppression after chemotherapy was constructed.A meta-analysis was conducted to assess the efficacy of acupuncture.On this basis,association analysis and cluster analysis were performed to explore the distribution of acupoints in SPSS Modeler18.0 and SPSS 22.0.Results:40 studies with 2988 patients were included.The white blood cell count,platelet count,red blood cell count,and hemoglobin were significantly higher in patients receiving acupuncture versus convention therapy exclusively.The two groups,however,did not differ in neutrophils count.Most acupoints,mainly distributed in the limbs and the back,were from the bladder meridian,the stomach meridian,and the spleen meridian.The lower sea and transport points were the most preferred specific points,in which ST36 and SP6 ranked highest in use.ST36-RN6,SP6-SP10,and ST36-SP10 turned out to be the most significant correlations in association rule mining.In cluster analysis,LI4-RN12,ST36-RN4-RN6 were grouped for their high similarity.Conclusion:For patients with myelosuppression after chemotherapy,acupuncture significantly inhibited the decline in blood cell components(white blood cell count,platelet count,red blood cell count,and hemoglobin)except for neutrophils.As the central combination of acupuncture prescriptions for this population,ST36-SP6-RN6-SP10-RN4 presented promising prospects and deserved more exploration for clinical use.
基金supported by National Natural Science Foundation of China(Nos.82104445 and 82470182]Basic Scientific Research Funds of Department of Education of Zhejiang Province(No.KYZD2024013)+2 种基金The Startup Foundation of Zhejiang Provincial People’s Hospital(Nos.C-2023-QDJJ12 and C-2024-ZZJJ05)Science and Technology Plan Project of Traditional Chinese Medicine in Zhejiang Province(No.2025ZR007)The National Administration of Traditional Chinese Medicine(No.GZY-ZJ-KJ-24044).
文摘Myelosuppression is a common and severe side effect of cancer chemotherapy,with current treatments hindered by limitations such as depletion of hematopoietic reserves,poor patient compliance,delayed therapeutic onset,and high cost.To overcome these challenges,we developed Epimedium-derived nanovesicles(ENVs)from the traditional Chinese medicinal herb Epimedium,addressing the solubility and bioavailability issues associated with conventional extracts.ENVs encapsulate bioactive constituents,including icariin and hematopoiesis-promoting ceramides.In a cyclophosphamide(CTX)-induced myelosuppression mouse model,prophylactic and therapeutic oral administration of ENVs effectively alleviated hematopoietic suppression,significantly outperforming the Epimedium-based herbal extract“Joungal”(Shengbai Formula)despite equivalent icariin content.Notably,ENVs promoted hematopoietic stem cell(HSC)proliferation—an outcome rarely achieved with existing therapies.Mechanistically,ENVs modulated the gut microbiota,enriching lactobacillus species and enhancing lactate production.This microbiota-driven lactate signaling stimulated LepR+mesenchymal stem cells(MSCs)in the bone marrow niche to secrete stromal cellderived factor-1(SDF-1)and stem cell factor(SCF),thereby supporting HSC expansion and restoring hematopoietic function.In vivo safety evaluations confirmed the excellent biocompatibility of ENVs.Our findings uncover a gut-lactate-bone marrow axis through which ENVs enhance hematopoiesis and promote HSC regeneration.This work introduces a cost-effective,scalable,and orally administrable biomaterial platform with strong translational potential for the prevention and treatment of chemotherapy-induced myelosuppression.
基金supported by Bagui Youth Outstanding Talent Cultivation Project(2024&2025)Project of Guangxi Young Qihuang Scholar[Grant number GXQH202408]+6 种基金Guangxi Natural Science[Grant number 2024JJA140449]Young Talent Research Funding ProjectYoung Elite Scientists Sponsorship Program by GXAST[Grant number 2025YESSGX031]the Doctoral Foundation of Guangxi University of Chinese Medicine[Grant number 2022BS008]GL Special project of youth science and technology innovation ability improvement plan[Grant number YXY0000305]Guangxi University of Chinese Medicine Outstanding Youth Fund Project[Grant number 2023JQ002]Young Scientists Fund of the National Natural Science Foundation of China[Grant number NSFC,82404938,China]。
文摘Background Cyclophosphamide(CTX)induces myelosuppression,a dose-limiting adverse effect,through direct cytotoxicity to hematopoietic cells and disruption of the stromal microenvironment.Anemoside B4(AB4),a saponin derived from Pulsatilla chinensis,exhibits antioxidant,anti-apoptotic,anti-inflammatory,and immunomodulatory activities;however,its role in protecting bone marrow from CTX-induced injury remains unknown.Objective To investigate the potential of AB4 to mitigate CTX-induced myelosuppression and its underlying mechanisms using C57BL/6J mice.Methods A CTX-induced myelosuppression model was established,with 40 mice randomly assigned to 5 groups(n=8 per group):Control,CTX alone,low-dose AB4(AB4-L),high-dose AB4(AB4-H),and granulocyte colony-stimulating factor(G-CSF,positive control).After 7 days of treatment,the following parameters were assessed:peripheral blood cell counts,spleen and thymus indices,bone marrow histology,levels of cytokines(granulocyte-macrophage colony-stimulating factor(GM-CSF),G-CSF,interleukin-6(IL-6),interleukin-1 beta(IL-1β)).Flow cytometric analysis(bone marrow mesenchymal stem cells(BMSCs)),reactive oxygen species(ROS),cell cycle,apoptosis),molecular assays(superoxide dismutase(SOD),malondialdehyde(MDA)),terminal deoxynucleotidyl transferase dUTP nick end labeling(TUNEL),and western blotting forγ-H2AX,p53,etc.)were also performed.Results Both doses of AB4 significantly increased red blood cell(RBC)and white blood cell(WBC)counts and elevated the thymus index(P<0.05).AB4 normalized hemosiderin deposition and megakaryocyte numbers,reduced the spleen index(P<0.01),increased levels of hematopoietic cytokines and BMSCs(P<0.01),decreased ROS and MDA levels,restored SOD activity,downregulated the expression ofγ-H2AX,p53,BAX,and cleaved caspase-3/9(P<0.01),and alleviated cell cycle arrest and apoptosis(P<0.01).Conclusion AB4 mitigates CTX-induced myelosuppression by preserving the bone marrow microenvironment,reducing oxidative stress and DNA damage,relieving cell cycle arrest,and suppressing apoptosis.These findings suggest AB4 holds promise for alleviating chemotherapy-related hematotoxicity.
基金supported by the Natural Science Foundation of Zhejiang Province of China (No.LY24H270010)the National Natural Science Foundation of China (No.81904197)。
文摘Background: Myelosuppression is a common chemotherapy-related toxicity and hematopoietic stem cells (HSCs)senescence is the main mechanism. Guilu Erxian Glue (GEG) is an effective Chinese herbal prescription for the treatment of myelosuppression in clinical, the potential mechanism needs further investigation.Objective: To explore the protective effect of GEG on HSCs during chemotherapy-induced myelosuppression and its mechanism.Methods: Eighteen H22 hepatoma-bearing mice were divided equally into three groups: control, cisplatin (DDP),and DDP+GEG groups. Peripheral blood cell counts and bone marrow nucleated cell counts were performed.Bone marrow histopathology was assessed by hematoxylin and eosin (H&E) staining. DNA damage was assessed by γ-H2AX immunofluorescence staining. The serum containing GEG was prepared for in vitro experiments. Superoxide dismutase (SOD) activity, cell viability, cell cycle, and aging cells were detected in vivo and in vitro. In addition, western blot, quantitative reverse transcription polymerase chain reaction (qRT-PCR), and chromatin immunoprecipitation (CHIP) assay were applied to explore the molecular mechanism.Results: GEG administration resulted in a significant increase in peripheral blood cells and bone marrow nucleated cells (P < 0.01), and improved the pathological histomorphology of bone marrow. Treatment with GEG or silencing of the p16Ink4a gene enhanced the SOD activity and viability of HSCs, while reducing DDP-induced DNA damage, G2-M cell cycle arrest and senescent cell formation (P < 0.001). GEG decreased both mRNA and protein levels of p16, while increased the protein and mRNA expression levels of CDK4, CDK6, and pRb both in vivo and in vitro experiments (P < 0.05). ChIP-qPCR showed that the p16Ink4apromoter region was enriched with JMJD2and H3K36me2/me3 protein. GEG treatment up-regulated the protein and mRNA expression levels of JMJD2 and simultaneously down-regulated H3K36me2/me3 protein levels.Conclusion: Our findings suggest that GEG exerts regulatory effects on p16ink4a gene expression through modulating the levels of H3K36 methylation. This study provides important mechanistic insights into the effects of GEG on HSCs and suggests potential therapeutic applications for GEG in myelosuppression.
基金funded by the National Key Reseach&Development Program of China(No.2022YFC2505000)the Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(No.CIFMS 2022-I2M-1-O09)+2 种基金the National Natural Science Foundation of China(NSFC)Special Program(No.82241229)the Y&M Cultivation Project of Cancer Hospital Chinese Academy of Medical Sciences(No.CICAMS-MOY&M-202402)Simcere Zaiming Pharmaceutical Co.,Ltd.
文摘Background:The disease burden,treatment patterns,and financial costs associated with chemotherapy-induced myelosuppression(CIM)in Chinese patients with extensive-stage small cell lung cancer(ES-SCLC)remain poorly characterized,particularly in terms of real-world evidence derived from large populations.This study aimed to describe the incidence,treatment patterns,costs,and healthcare resource utilization(HCRU)in Chinese patients with ES-SCLC who develop CIM.Methods:Adults diagnosed with ES-SCLC who started etoposide—platinum(EP)chemotherapy for the first time between January 1,2018 and December 31,2022 were retrospectively identifiedin the Chinese National Cancer Information Database.Baseline demographic and clinical data were collected.Information on CIM-related events,treatment,costs,and HCRU during EP chemotherapy and during follow-up was assessed.Costs and HCRU were compared among patients with grade 3-4 CIM,grade 12 CIM,and no CIM using the KruskalWallis test.Results:In total,7505 patients with ES-SCLC(mean age 61.2 years;17.7%[1332/7505]female;body mass index 23.2±3.3 kg/m^(2))were enrolled.After initiation of EP-based chemotherapy,6901 patients(92.0%)experienced at least one CIM-related event.At least one grade 34 CIM event occurred in 1883 patients(25.1%)and consisted of single-lineage(neutropenia[n=609,8.1%],thrombocytopenia[n=85,1.1%],anemia[n=797,10.6%]),twolineage(n=318,4.2%),and three-lineage(n=74,1.0%)events.Patients receiving immune checkpoint inhibitors(ICIs)plus EP(n=1674)had a significantly higher incidence of at least one CIM during the ICI combination therapy(87.8%[1469/1674]vs.82.8%[4827/5831];χ^(2)=23.43,P<0.0001)and grade 34 CIM(25.7%[430/1674]vs.20.6%[1201/5831];χ^(2)=19.51,P<0.0001)compared to those receiving other EP-basedtherapies duringEP chemotherapy(n=5831).Rates of use of granulocyte colony-stimulating factor,thrombopoietin,interleukin-11,erythropoiesis-stimulating agents,and blood transfusion were 81.1%(n=6087),9.2%(n=691),12.4%(n=927),9.0%(n=678),and 12.1%(n=907),respectively.HCRU and total costs per patient were higher for those with grade 3-4 CIM than for those without CIM or grade 1-2 CIM,and significant differences in the total cost were observed across groups(H=195.54,P<0.0001).Conclusion:Despite the availability of supportive care for CIM in patients with ES-SCLC in China,a considerable clinical and financial burden persists.Strategies that protect bone marrow from progressing to high-grade myelosuppression could reduce the burden on patients and healthcare organizations.
基金supported by the National Natural Science Foundation of China(82205237)the Matching Project for the Youth Fund of the National Natural Science Foundation of Nanjing University of Chinese Medicine(XPT82205237)the Jiangsu Provincial Department of Health Medical Science Research Project(Z2021065)。
文摘Objective:The objective is to explore the protective mechanisms of the Fuzheng Buxue recipe(FBR)against chemotherapy-induced myelosuppression(CIM),focusing on its potential to activate the Notch signaling pathway.Materials and Methods:A rat model of myelosuppression was induced using 5-fluorouracil(5-FU).The rats were divided into five groups:control,CIM,batyl alcohol,low-dose FBR,and high-dose FBR(HD-FBR).After a 14-day treatment period,white blood cell(WBC)count,red blood cell count,platelet count,and hemoglobin levels in all rats were evaluated.Histopathological assessments of the thymus,spleen,and bone marrow were conducted using hematoxylin and eosin staining.In addition,expression levels of Notch1,Notch2,Jagged1,and DLL1 proteins in bone marrow tissues were measured at the protein and mRNA levels using western blotting and reverse transcription-quantitative polymerase chain reaction.Results:The CIM group exhibited significantly lower blood cell counts compared to the control group(P<0.05).The HD-FBR group showed notably normalized WBC counts,similar to the results observed in the batyl alcohol group.HD-FBR treatment also enhanced spleen mass,index,and nodule counts,approaching the levels observed in the control group(P>0.05).5-FU induced damage to immune organs and the bone marrow of rats,but HD-FBR significantly mitigated these pathological alterations.While 5-FU diminished the expression of Notch1,Notch2,Jagged1,and DLL1 proteins and mRNA(P<0.05),HD-FBR counteracted this reduction,leading to significant upregulation(P<0.05).Conclusions:FBR mitigates CIM by activating the Notch signaling pathway,highlighting its potential as a therapeutic strategy.
基金Supported by Project of Qihuang Scholar(No.010120006)the National Natural Science Foundation of China(No.82174461)the Capital Health Development Scientific Research Project(No.2022-1-41-71)。
文摘Objective To assess the effectiveness of Chinese herbal medicine(CHM)combined with adjuvant chemotherapy on myelosuppression for colorectal cancer(CRC)patients using network meta-analysis(NMA).Methods Literature searches in both international(PubMed,Embase,Web of Science,and Cochrane Library)and Chinese(China Science and Technology Journal Database,Wanfang Data,China National Knowledge Infrastructure)databases for relevant randomized controlled trials(RCTs)were conducted from inception until October 10,2022.We included RCTs of patients who received CHM combined with chemotherapy,including FOLFOX,XELOX,FOLFIRI,and other relevant regimens in the CHM treatment group.The outcomes included the incidence of myelosuppression,leukopenia,hemoglobin reduction,and thrombocytopenia.Two reviewers independently screened the databases,extracted the data,and assessed the risk of bias and credibility of evidence.RevMan 5.4.1 software and STATA 14.0 were used to perform the NMA.Results A total of 31 RCTs were included,published from 2008 to 2021 in Chinese.Among these,2,314 participants comparing the following 9 CHMs were identified:Shengbai Recipe(SBR),Bazhen Decoction(BZD),Jianpi Jiedu Recipe(JJR),Jianpi Recipe(JR),Compound Cantharis Capsule(CCC),Zaofan Pill(ZFP),Guilu Erxian Gel(GL),Buzhong Tiaogan Decoction(BZ),and Qiamagu Capsule(QM).The results of NMA found an indirect comparison.Based on the surface under the cumulative ranking curve(SUCRA),the ZFP+chemotherapy group had the lowest incidence of myelosuppression,with an odds ratio(OR)of 0.08[95%confidence interval(CI):0.01,0.76],whereas the GL+chemotherapy group had the lowest incidence of leukopenia,hemoglobin reduction,and thrombocytopenia,with an OR of 5.25(95%CI:2.41,11.43),4.66(95%CI:2.23,9.72),and 0.27(95%CI:0.13,0.54),respectively.Moreover,BZD+chemotherapy could alleviate leukopenia,hemoglobin reduction,and thrombocytopenia(P<0.01).Pairwise comparison showed that there was no difference in the efficacy among the 8 CHMs+chemotherapy group.The comparison and adjustment funnel plot indicated that small-study effect had no impact on these outcomes.Conclusions This NMA provided evidence to support that patients with CRC benefit from receiving different combination of CHM chemotherapies.Among these,GL plus chemotherapy and BZD plus chemotherapy were the more effective for myelosuppression in patients;however,as the qualtiy of evidence is insufficient,further research is needed.(PROSPERO, No. CRD42022369025.
文摘Objective: To observe the clinical efficacy of grain-sized moxibustion in treating chemotherapy-induced myelosuppression for non-small cell lung cancer (NSCLC) and its effect on quality of life (QOL). Methods: Eighty NSCLC patients admitted to the Inpatient Department of Zhejiang Cancer Hospital between September 2016 and March 2018 were recruited and divided into an observation group and a control group by random number method, with 40 cases in each group. The two groups both received chemotherapy with paclitaxel plus cisplatin (TP regimen). The control group received oral administration of leucogen tablets starting from the first day of chemotherapy, 20 mg each time, three times a day, for consecutive 14 d;the observation group was additionally given grain-sized moxibustion, once a day, five days per week at a two-day interval, until the fourteenth day. The myelosuppression severity was observed and compared between the two groups prior to chemotherapy, at the 3rd, 7th and 14th days of chemotherapy;the QOL in the two groups was evaluated before chemotherapy, at the 14th and 21st days of chemotherapy. Results: Regarding myelosuppression, the peripheral blood indicators increased significantly at the 3rd day of chemotherapy in both groups (P<0.05 or P<0.01);at the 7th and 14th days of chemotherapy, the peripheral blood indicators presented a decreasing tendency in the two groups, but the level in the observation group was still significantly higher than that before chemotherapy (P<0.01);at the 3rd, 7th and 14th days of chemotherapy, the peripheral blood indicators in the observation group were higher than those in the control group (P<0.05 or P<0.01);the occurrence rate of myelosuppression in the observation group was significantly lower than that in the control group (P<0.01). The QOL score in the observation group was markedly higher than that in the control group at the 14th and 21st days of chemotherapy (both P<0.05). Conclusion: Grain-sized moxibustion can effectively improve myelosuppression after chemotherapy for NSCLC, reducing its occurrence and enhancing the patient's QOL.
基金Natural Science Fundation of China(No.81373976)Major and special project of National science and technology(No.2013ZX09103002-013)
文摘Objective To explore the protective effects of tannins in Sanguisorba Radix （TSR） on myelosuppression mice induced by cyclophosphamide （CTX）. Methods TSR was ig given at the dose of 20 mg/kg for 10 d after ip administration of CTX （200 mg/kg）. Results TSR could significantly increase the numbers of white blood ceils, red blood cells, and platelets of myelosuppression in mice. And it could accelerate bone marrow haemopoietic stem/progenitor cells （HSPCs） in myelosuppression mice and enhance cell proliferation by promoting cell cycles from G0/G1 phase to access into S and G2/M phases, then the reduced number of HSPCs induced by CTX was reversed. Moreover, TSR could increase the mRNA and protein expression levels of O（6）-methylguanine- DNA methyltransferase （MGMT） in HSPCs of myelosuppression mice. Concision TSR has a protective function against CTX-induced myelosuppression. The mechanism might be related to protecting hematopoietic stem cells of bone marrow, stimulating hematopoiesis recovery, as well as preventing the apoptosis of hematopoietic stem cells induced by CTX.
基金Supported by National Natural Science Foundation of China(No.81202670)Project of Longhua Medical Team Shanghai,China(No.LYTD-18)
文摘Objective： To study the efficacy and safety of Shuanghuang Shengbai Granule（双黄升白颗粒, SSG）, a traditional Chinese herbal medicine, on myelosuppression of cancer patients caused by chemotherapy. Methods： A total of 330 patients were randomly assigned to the treatment group（220 cases, analysed 209 cases） and the control group（110 cases, analysed 102 cases） with a 2：1 ratio by envelope method. The patients in the treatment group at the first day of chemotherapy started to take SSG for 14 days, while the patients in the control group took Leucogon Tablets. The changes of the blood routine, clinical symptoms and immune function in both groups were observed for safety and efficacy evaluation. Results： At the 7th day of chemotherapy, the white blood cells（WBCs） level in the treatment group was significantly higher than that in the control group（P〈0.05）. After treatment, the WBCs rate in the normal range accounted for 50.2% in the treatment group, the myelosuppression of WBCs and neutrophil were mainly grade Ⅰ, while 8.1% and 5.7% of patients emerged grade Ⅲ and grade Ⅳ myelosuppression, respectively. The incidence of myelosuppression of the treatment group was significantly lower than that of the control group（P〈0.05）. The total effective rate of Chinese medicine syndrome in the treatment group was significantly higher than that in the control group（84.2% vs. 72.5%, P〈0.05）. The immune cell levels in both groups were maintained in the normal range. Compared with that before treatment, the levels of CD3~＋ and CD4~＋ cells were significantly increased in the treatment group after treatment（P〈0.05）. The discrepancy of CD3~＋ and CD4~＋ cell activity before and after treatment in both groups were significantly different（P〈0.05）. No obvious adverse event occurred in both groups. Conclusion： SSG had a protection effect on bone marrow suppression, and alleviated the clinical symptoms together with clinical safety.
文摘Background and Objectives:To evaluate the potential benefits of Bacteroides fragilis 839(BF839),a nextgeneration probiotics,in reducing myelosuppression and gastrointestinal toxicity associated with chemotherapy in breast cancer patient.Methods and Study Design:40 women with early breast cancer were randomly assigned to the BF839(n=20)or placebo(n=20)during the administration of adjuvant chemotherapy(4 cycles of epirubicin 100mg/m^(2) and cyclophosphamide 600mg/m^(2)).Myelosuppression and gastrointestinal adverse effects were monitored in both groups.Results:Throughout the four treatment cycles,the percentage of patients experiencing myelosuppression was 42.5%in the BF839 group,significantly lower than the 66.3%observed in the control group(p=0.003).Two patients in the BF839 group and three patients in the placebo group received recombinant human granulocyte colony-stimulating factor(rhG-CSF)due to leukopenia/neutropenia.When considering an ITT analysis,which included all patients regardless of rhG-CSF treatment,the BF839 group exhibited less reduction from baseline in white blood cells(-0.31±1.19 vs-1.15±0.77,p=0.012)and neutrophils(0.06±1.00 vs-0.84±0.85,p=0.004)compared to the placebo group.The difference became even more significant when excluding the patients who received rhG-CSF injections.Throughout the four treatment cycles,compared to the placebo group,the BF839 group had significantly lower rates of 3-4 grade nausea(35.0%vs 71.3%,p=0.001),vomiting(20.0%vs 45.0%,p=0.001),and diarrhea(15.0%vs 30.0%,p=0.023).Conclusions:These findings suggest that BF839 has the potential to effectively mitigate myelosuppression and gastrointestinal toxicity associated with chemotherapy in breast cancer patients.
