While much progress has been made in the field of hematopoietic stem cell transplantation （HSCT）, headway in the promotion of recovery following this procedure has been limited. Data regarding the potential of Chine...While much progress has been made in the field of hematopoietic stem cell transplantation （HSCT）, headway in the promotion of recovery following this procedure has been limited. Data regarding the potential of Chinese herbal medicine （CHM） for patients with hematologic disorders who received HSCT are gradually increasing; however, these data are mostly in Chinese. Therefore, we set out to summarize the existing data. We searched PubMed, the Cochrane Library and the China National Knowledge Infrastructure and retrieved 9 clinical studies related to this group of patients, in whom CHM was used as an intervention. Of the 9 papers, 6 were published by the same group of researchers. The focus of the reviewed studies was heterogeneous, and the objectives varied widely. With the exception of one randomized control trial, all of the studies were retrospective and observational; the median number of patients was 11.5, with the largest study containing 104 patients. CHM treatment was largely divided into two stages： （1） pre-HSCT, which was initiated as soon as conditioning chemotherapy was administered and aimed to counterbalance the adverse effects of these potent agents; （2） post-HSCT, which began immediately after transplantation and was intended to promote engraftment, control graft- versus-host disease and prolong survival. In addition, the 9 Chinese materia medica most commonly prescribed （appearing in four studies） were： Shengdihuang （Rehmannia glutinosa）, Baizhu （Atractylodes macrocephala）, Renshen （Panax ginseng）, Dangshen （ Codonopsis pilosula）, Maimendong （ Ophiopogon japonicus）, Danggui （Angelica sinensis）, Taizishen （Pseudostellaria heterophylla）, Huangqi （Astragalus membranaceus） and Ejiao （Equus asinus）.展开更多
Gallbladder stones,a prevalent biliary tract disease,have multifactorial etiologies including metabolic,genetic,and environmental factors.Emerging evidence su-ggests that hematological disorders,particularly those inv...Gallbladder stones,a prevalent biliary tract disease,have multifactorial etiologies including metabolic,genetic,and environmental factors.Emerging evidence su-ggests that hematological disorders,particularly those involving hemolysis or impaired erythropoiesis,may play a significant role in the formation of gallblad-der stones,predominantly pigment stones.This review explores the pathophysio-logical mechanisms linking hematological disorders,such as hemolytic anemias,myeloproliferative disorders,and hematological malignancies,with gallbladder stone development.We also examine the influence of treatments for hemato-logical conditions,such as blood transfusions and chemotherapy,on gallstone risk.Additionally,this article discusses the clinical implications of gallbladder stones in patients with hematological disorders,including diagnostic challenges,management strategies,and surgical considerations.By providing a compre-hensive overview of current knowledge,this review aims to highlight the need for further research into the interplay between hematological disorders and gall-bladder stones,potentially improving preventive and therapeutic strategies in these patient populations.展开更多
<strong>Introduction:</strong> Haematological disorders are common complications of chronic kidney disease (CKD) leading by anemia which increase with the severity of the disease. Objective: Assess the hae...<strong>Introduction:</strong> Haematological disorders are common complications of chronic kidney disease (CKD) leading by anemia which increase with the severity of the disease. Objective: Assess the haematological profile of CKD patients stages 3 to 5 non-dialysed seen at the first nephrology consultation in Cameroon. <strong>Patients and Methods:</strong> A hospital-based cross-sectional study was conducted from February to July 2018 at the nephrology unit of the Yaounde University Teaching Hospital and Douala General Hospital. All adults’ (≥18 years old) patients who provided a written informed consent and attended their first nephrology consultation with a nephrologist diagnosis of CKD stages 3 to 5 non-dialysed were included. Clinical and paraclinical data (serum creatinine, full blood count, reticulocytes count, iron status, vitamin B12 and folates count, and bleeding time) were collected. Parametric, non-parametric and correlations tests were used to compare variables. <strong>Results:</strong> We included 105 (59% males) participants with a mean age of 55.2 ± 13.6 years divided into 20 (19%), 36 (34.3%) and 49 (46.7%) respectively in stage G3, G4 and G5 of CKD. The profile of hematological abnormalities was anemia (86.7%), leucopenia (15.2%), hyperleucocytosis (6.7%), thrombopenia (23.8%), thrombocytosis (3.8%) and prolonged bleeding time (13.3%) without any association with the stage of CKD (p > 0.05). The pattern of anemia was mainly normocytic and normochromic (59.3%) and aregenerative (92.3%) with iron deficiency found in 23 (21.9%) participants. There was no case of vitamin B12 and folates deficiency. Prolonged bleeding time was observed in 14 (13.3%) participants with a weak correlation between platelets count and bleeding time (r = 0.122). <strong>Conclusion:</strong> We observed that aregenerative normocytic normochromic anemia is the leading haematological abnormality during CKD in this setting. None of the full blood count parameters was associated with CKD stages and there was a week correlation between bleeding time and platelet count.展开更多
BACKGROUND The safety and efficacy of recombinant human thrombopoietin(rhTPO)administered after allogeneic hematopoietic stem cell transplantation(allo-HSCT)in children(0-9 years old)and adolescents(10-17 years old)wi...BACKGROUND The safety and efficacy of recombinant human thrombopoietin(rhTPO)administered after allogeneic hematopoietic stem cell transplantation(allo-HSCT)in children(0-9 years old)and adolescents(10-17 years old)with hematological disorders remain unclear.AIM To evaluate the safety and efficacy of rhTPO administered before platelet(PLT)engraftment in pediatric patients with hematological disorders undergoing HSCT,and to investigate its effects on the incidence of graft-vs-host disease(GVHD)and other transplant-related outcomes.METHODS This study enrolled 79 pediatric patients with hematological disorders who received rhTPO after allo-HSCT.The safety and tolerability of rhTPO were evaluated and compared in children(n=36)and adolescents(n=43)with hematological disorders.We also investigated the effects of rhTPO administration on the incidence of GVHD and other transplant-related outcomes.Additionally,we examined the efficacy of rhTPO after allo-HSCT in children and adolescents.RESULTS All of the children and adolescents underwent hematopoietic reconstruction.The median time to PLT engraftment was 16 days for all patients,with 14(range,11-24)days in the 0-to 9-year-old group and 16(range,11-41)days in the 10-to 17-year-old group;the difference was statistically significant(P<0.05).The median time to neutrophil engraftment was 12 days in both groups.The median recovery times for PLT counts of≥20×10^(9)/L and≥50×10^(9)/L in the 0-to 9-year-old group were 10(range,2-20)and 11(range,2-20)days,respectively,and those for the 10-to 17-year-old group were 9(range,4-23)and 12(range,5-34)days,respectively.Children exhibited significantly shorter time to PLT engraftment(14 days vs 16 days)and shorter recovery time to PLT count≥100×10^(9)/L(16 days vs 18 days)(P<0.05)than adolescents.The incidence of acute GVHD in all patients was 53.2%,with a higher incidence in children(61.1%)than in adolescents(46.5%).The incidence of chronic GVHD showed little difference between the two age groups,with an overall incidence of 10.1%.No adverse events,other than bleeding,were observed in either age group.The incidence of bleeding was 20.3%.The median follow-up time for all survivors was 573 days(range:42-1803 days)after transplantation.At the final follow-up,3 patients in the 0-to 9-year-old group died;however,none of these deaths were attributed to allo-HSCT or the use of rhTPO.All patients survived in the 10-to 17-year-old group.CONCLUSION rhTPO was not associated with any significant safety issues and was well tolerated by pediatric and adolescent patients with hematologic diseases who underwent allo-HSCT.Our results suggested that rhTPO may benefit allo-HSCT in children and adolescents by improving PLT recovery.展开更多
Infections are frequent complications in patients with hematological disorders,and pathogen diagnosis remains challenging.Metagenomic next-generation sequencing(mNGS)is an unbiased high-throughput technology that has ...Infections are frequent complications in patients with hematological disorders,and pathogen diagnosis remains challenging.Metagenomic next-generation sequencing(mNGS)is an unbiased high-throughput technology that has been widely applied in the diagnosis of infectious diseases.However,to date,there are no established international guidelines or expert consensuses regarding the use of mNGS to diagnose infections in patients with hematologic disorders.The Anti-Infection Study Group of the Chinese Society of Hematology invited experts in the fields of hematology,microbiology,and mNGS technology to draft an expert consensus focused on clinical indications,sample collection,quality control,and interpretation of results.This consensus will likely contribute to clarifying the medical indications for mNGS testing,optimizing the interpretation of reports,and becoming an inspiration for global practice.展开更多
Background There has been continuous debate as to whether Y chromosome loss is an age related phenomenon or a cytogenetic marker indicating a malignant change. This study aimed to investigate the frequency of Y chromo...Background There has been continuous debate as to whether Y chromosome loss is an age related phenomenon or a cytogenetic marker indicating a malignant change. This study aimed to investigate the frequency of Y chromosome loss in the specific patients in order to determine whether it is an age related phenomena or a cytogenetic marker indicating a malignant change. Methods Five hundred and ninety-two male patients with a median age of 59 years old （22-95 years） were included in this study. These patients were divided into two groups： the study group, including 237 patients who had hematological disorders included myeloproliferative disorder （MPD）, myelodysplastic syndrome （MDS）, acute myeloid leukemia （AML）, chronic myeloid leukemia （CML）, multiple myeloma （MM）, and lymphoma and the control group including 355 patients with no evidence of hematological disease. Both conventional cytogenetics and fluorescence in situ hybridization using DNA probes specific for the centromere of chromosomes X or Y were performed according to our standard laboratory protocols. Results Twenty-four out of 237 patients with hematological disorders （10.1%） had Y chromosome loss. Of these 24 patients, 2 patients had AML （5.0% of all AML patients）, 2 patients had CML （5.7% of all CML patients）, 2 patients had MPD （8.0% of all MPD patients）, 3 patients had MM （10.0% of all MM patients）, 5 patients had lymphoma （10.6% of all lymphoma patients） and 10 patients had MDS （16.7% of all MDS patients）. Twenty-one out of these 24 patients had a loss of Y chromosome as the sole anomaly and the remaining three had a loss of Y chromosome accompanied with other structural changes detected by conventional cytogenetic analysis. Fluorescence in situ hybridization （FISH） analysis confirmed the routine cytogenetic results. All 24 patients had a loss of Y chromosome with a range of 17.5%-98.5% of cells. Two of the patients, one with AML and another with CML, had karyotype and FISH testing done both at the initial diagnosis and during remission. The results showed a loss of Y chromosome at initial diagnosis but a normal 46,XY karyotype dunng remission. Only 9 out of 355 patients （2.5%） without evidence of hematological disease had Y chromosome loss, among them 7 patients had cardiovascular diseases and 2 patients had kidney diseases. Comparison of the incidence of Y chromosome loss in patients with hematological disorders or without evidence of hematological disease using statistical analysis showed a statistically significance difference （P〈0.05）. Conclusions The present study demonstrated that the frequency of Y chromosome loss is significantly higher in patients with hematological disorders than in patients without hematological disorders, which indicates that the loss of Y chromosome is associated with a neoplastic change.展开更多
INTRODUCTION Langerhans cell histiocytosis(LCH)is a rare hematologic disorder that affects patients of all ages.While most of our current understanding of LCH comes from studies of pediatric patients,data on adult cas...INTRODUCTION Langerhans cell histiocytosis(LCH)is a rare hematologic disorder that affects patients of all ages.While most of our current understanding of LCH comes from studies of pediatric patients,data on adult cases remain limited.The discovery of the BRAFV600E mutation in approximately 50%of LCH samples established LCH as a neoplastic disease,and subsequent research has identified additional activating mutations in the mitogen-activated protein kinase(MAPK)pathway.Recent advances in our understanding of the disease’s pathogenesis and treatment,combined with its rarity,have highlighted the need for comprehensive guidelines for diagnosing and treating LCH in adults(Figure 1).展开更多
Hematology research has greatly benefited from the integration of diverse biological data resources and advanced machine learning(ML)frameworks.This integration has not only deepened our understanding of blood disease...Hematology research has greatly benefited from the integration of diverse biological data resources and advanced machine learning(ML)frameworks.This integration has not only deepened our understanding of blood diseases such as leukemia and lymphoma,but also enhanced diagnostic accuracy and personalized treatment strategies.By applying ML algorithms to analyze large-scale biological data,researchers can more effectively identify disease patterns,predict treatment responses,and provide new perspectives for the diagnosis and treatment of hematologic disorders.Here,we provide an overview of the current landscape of biological data resources and the application of ML frameworks pertinent to hematology research.展开更多
基金supported by a grant from the China Medical University Hospital(DMR-105-005)
文摘While much progress has been made in the field of hematopoietic stem cell transplantation （HSCT）, headway in the promotion of recovery following this procedure has been limited. Data regarding the potential of Chinese herbal medicine （CHM） for patients with hematologic disorders who received HSCT are gradually increasing; however, these data are mostly in Chinese. Therefore, we set out to summarize the existing data. We searched PubMed, the Cochrane Library and the China National Knowledge Infrastructure and retrieved 9 clinical studies related to this group of patients, in whom CHM was used as an intervention. Of the 9 papers, 6 were published by the same group of researchers. The focus of the reviewed studies was heterogeneous, and the objectives varied widely. With the exception of one randomized control trial, all of the studies were retrospective and observational; the median number of patients was 11.5, with the largest study containing 104 patients. CHM treatment was largely divided into two stages： （1） pre-HSCT, which was initiated as soon as conditioning chemotherapy was administered and aimed to counterbalance the adverse effects of these potent agents; （2） post-HSCT, which began immediately after transplantation and was intended to promote engraftment, control graft- versus-host disease and prolong survival. In addition, the 9 Chinese materia medica most commonly prescribed （appearing in four studies） were： Shengdihuang （Rehmannia glutinosa）, Baizhu （Atractylodes macrocephala）, Renshen （Panax ginseng）, Dangshen （ Codonopsis pilosula）, Maimendong （ Ophiopogon japonicus）, Danggui （Angelica sinensis）, Taizishen （Pseudostellaria heterophylla）, Huangqi （Astragalus membranaceus） and Ejiao （Equus asinus）.
文摘Gallbladder stones,a prevalent biliary tract disease,have multifactorial etiologies including metabolic,genetic,and environmental factors.Emerging evidence su-ggests that hematological disorders,particularly those involving hemolysis or impaired erythropoiesis,may play a significant role in the formation of gallblad-der stones,predominantly pigment stones.This review explores the pathophysio-logical mechanisms linking hematological disorders,such as hemolytic anemias,myeloproliferative disorders,and hematological malignancies,with gallbladder stone development.We also examine the influence of treatments for hemato-logical conditions,such as blood transfusions and chemotherapy,on gallstone risk.Additionally,this article discusses the clinical implications of gallbladder stones in patients with hematological disorders,including diagnostic challenges,management strategies,and surgical considerations.By providing a compre-hensive overview of current knowledge,this review aims to highlight the need for further research into the interplay between hematological disorders and gall-bladder stones,potentially improving preventive and therapeutic strategies in these patient populations.
文摘<strong>Introduction:</strong> Haematological disorders are common complications of chronic kidney disease (CKD) leading by anemia which increase with the severity of the disease. Objective: Assess the haematological profile of CKD patients stages 3 to 5 non-dialysed seen at the first nephrology consultation in Cameroon. <strong>Patients and Methods:</strong> A hospital-based cross-sectional study was conducted from February to July 2018 at the nephrology unit of the Yaounde University Teaching Hospital and Douala General Hospital. All adults’ (≥18 years old) patients who provided a written informed consent and attended their first nephrology consultation with a nephrologist diagnosis of CKD stages 3 to 5 non-dialysed were included. Clinical and paraclinical data (serum creatinine, full blood count, reticulocytes count, iron status, vitamin B12 and folates count, and bleeding time) were collected. Parametric, non-parametric and correlations tests were used to compare variables. <strong>Results:</strong> We included 105 (59% males) participants with a mean age of 55.2 ± 13.6 years divided into 20 (19%), 36 (34.3%) and 49 (46.7%) respectively in stage G3, G4 and G5 of CKD. The profile of hematological abnormalities was anemia (86.7%), leucopenia (15.2%), hyperleucocytosis (6.7%), thrombopenia (23.8%), thrombocytosis (3.8%) and prolonged bleeding time (13.3%) without any association with the stage of CKD (p > 0.05). The pattern of anemia was mainly normocytic and normochromic (59.3%) and aregenerative (92.3%) with iron deficiency found in 23 (21.9%) participants. There was no case of vitamin B12 and folates deficiency. Prolonged bleeding time was observed in 14 (13.3%) participants with a weak correlation between platelets count and bleeding time (r = 0.122). <strong>Conclusion:</strong> We observed that aregenerative normocytic normochromic anemia is the leading haematological abnormality during CKD in this setting. None of the full blood count parameters was associated with CKD stages and there was a week correlation between bleeding time and platelet count.
文摘BACKGROUND The safety and efficacy of recombinant human thrombopoietin(rhTPO)administered after allogeneic hematopoietic stem cell transplantation(allo-HSCT)in children(0-9 years old)and adolescents(10-17 years old)with hematological disorders remain unclear.AIM To evaluate the safety and efficacy of rhTPO administered before platelet(PLT)engraftment in pediatric patients with hematological disorders undergoing HSCT,and to investigate its effects on the incidence of graft-vs-host disease(GVHD)and other transplant-related outcomes.METHODS This study enrolled 79 pediatric patients with hematological disorders who received rhTPO after allo-HSCT.The safety and tolerability of rhTPO were evaluated and compared in children(n=36)and adolescents(n=43)with hematological disorders.We also investigated the effects of rhTPO administration on the incidence of GVHD and other transplant-related outcomes.Additionally,we examined the efficacy of rhTPO after allo-HSCT in children and adolescents.RESULTS All of the children and adolescents underwent hematopoietic reconstruction.The median time to PLT engraftment was 16 days for all patients,with 14(range,11-24)days in the 0-to 9-year-old group and 16(range,11-41)days in the 10-to 17-year-old group;the difference was statistically significant(P<0.05).The median time to neutrophil engraftment was 12 days in both groups.The median recovery times for PLT counts of≥20×10^(9)/L and≥50×10^(9)/L in the 0-to 9-year-old group were 10(range,2-20)and 11(range,2-20)days,respectively,and those for the 10-to 17-year-old group were 9(range,4-23)and 12(range,5-34)days,respectively.Children exhibited significantly shorter time to PLT engraftment(14 days vs 16 days)and shorter recovery time to PLT count≥100×10^(9)/L(16 days vs 18 days)(P<0.05)than adolescents.The incidence of acute GVHD in all patients was 53.2%,with a higher incidence in children(61.1%)than in adolescents(46.5%).The incidence of chronic GVHD showed little difference between the two age groups,with an overall incidence of 10.1%.No adverse events,other than bleeding,were observed in either age group.The incidence of bleeding was 20.3%.The median follow-up time for all survivors was 573 days(range:42-1803 days)after transplantation.At the final follow-up,3 patients in the 0-to 9-year-old group died;however,none of these deaths were attributed to allo-HSCT or the use of rhTPO.All patients survived in the 10-to 17-year-old group.CONCLUSION rhTPO was not associated with any significant safety issues and was well tolerated by pediatric and adolescent patients with hematologic diseases who underwent allo-HSCT.Our results suggested that rhTPO may benefit allo-HSCT in children and adolescents by improving PLT recovery.
基金supported by the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(grants 2021-I2M-1-017,2023-I2M-2-007)the National Natural Sciences Foundation of China(82470208)the National Key R&D Program of China(2024YFC2510500).
文摘Infections are frequent complications in patients with hematological disorders,and pathogen diagnosis remains challenging.Metagenomic next-generation sequencing(mNGS)is an unbiased high-throughput technology that has been widely applied in the diagnosis of infectious diseases.However,to date,there are no established international guidelines or expert consensuses regarding the use of mNGS to diagnose infections in patients with hematologic disorders.The Anti-Infection Study Group of the Chinese Society of Hematology invited experts in the fields of hematology,microbiology,and mNGS technology to draft an expert consensus focused on clinical indications,sample collection,quality control,and interpretation of results.This consensus will likely contribute to clarifying the medical indications for mNGS testing,optimizing the interpretation of reports,and becoming an inspiration for global practice.
基金This study was supported by the Scientific Research Foundation for the Returned Overseas Chinese Scholars, State Education Ministry (No. (2004)527)the Natural Science Foundation of Science and Technology of Liaoning Province (No. 20072105)the Administration of the Education Department of Liaoning Province (No. 20060983).
文摘Background There has been continuous debate as to whether Y chromosome loss is an age related phenomenon or a cytogenetic marker indicating a malignant change. This study aimed to investigate the frequency of Y chromosome loss in the specific patients in order to determine whether it is an age related phenomena or a cytogenetic marker indicating a malignant change. Methods Five hundred and ninety-two male patients with a median age of 59 years old （22-95 years） were included in this study. These patients were divided into two groups： the study group, including 237 patients who had hematological disorders included myeloproliferative disorder （MPD）, myelodysplastic syndrome （MDS）, acute myeloid leukemia （AML）, chronic myeloid leukemia （CML）, multiple myeloma （MM）, and lymphoma and the control group including 355 patients with no evidence of hematological disease. Both conventional cytogenetics and fluorescence in situ hybridization using DNA probes specific for the centromere of chromosomes X or Y were performed according to our standard laboratory protocols. Results Twenty-four out of 237 patients with hematological disorders （10.1%） had Y chromosome loss. Of these 24 patients, 2 patients had AML （5.0% of all AML patients）, 2 patients had CML （5.7% of all CML patients）, 2 patients had MPD （8.0% of all MPD patients）, 3 patients had MM （10.0% of all MM patients）, 5 patients had lymphoma （10.6% of all lymphoma patients） and 10 patients had MDS （16.7% of all MDS patients）. Twenty-one out of these 24 patients had a loss of Y chromosome as the sole anomaly and the remaining three had a loss of Y chromosome accompanied with other structural changes detected by conventional cytogenetic analysis. Fluorescence in situ hybridization （FISH） analysis confirmed the routine cytogenetic results. All 24 patients had a loss of Y chromosome with a range of 17.5%-98.5% of cells. Two of the patients, one with AML and another with CML, had karyotype and FISH testing done both at the initial diagnosis and during remission. The results showed a loss of Y chromosome at initial diagnosis but a normal 46,XY karyotype dunng remission. Only 9 out of 355 patients （2.5%） without evidence of hematological disease had Y chromosome loss, among them 7 patients had cardiovascular diseases and 2 patients had kidney diseases. Comparison of the incidence of Y chromosome loss in patients with hematological disorders or without evidence of hematological disease using statistical analysis showed a statistically significance difference （P〈0.05）. Conclusions The present study demonstrated that the frequency of Y chromosome loss is significantly higher in patients with hematological disorders than in patients without hematological disorders, which indicates that the loss of Y chromosome is associated with a neoplastic change.
基金supported by the National Natural Science Foundation of China(grant no.82370179)the Beijing Natural Science Haidian Frontier Foundation(L222081)+1 种基金National High Level Hospital Clinical Research Funding(2025-PUMCHD-003,2022-PUMCH-B-070)the Peking Union Medical College Hospital Talent Cultivation Program(category C,UBJ10707).
文摘INTRODUCTION Langerhans cell histiocytosis(LCH)is a rare hematologic disorder that affects patients of all ages.While most of our current understanding of LCH comes from studies of pediatric patients,data on adult cases remain limited.The discovery of the BRAFV600E mutation in approximately 50%of LCH samples established LCH as a neoplastic disease,and subsequent research has identified additional activating mutations in the mitogen-activated protein kinase(MAPK)pathway.Recent advances in our understanding of the disease’s pathogenesis and treatment,combined with its rarity,have highlighted the need for comprehensive guidelines for diagnosing and treating LCH in adults(Figure 1).
基金supported by grants from the National Key R&D Project of China(Grant Nos.2021YFC2500300,2022YFA0806300,and 2019YFA0801800)the National Natural Science Foundation of China(Grant Nos.82370106 and 82070109)the Guangdong Basic and Applied Basic Research Foundation,China(Grant Nos.2024A1515011769,2022A1515011253,and 2021A1515110653).
文摘Hematology research has greatly benefited from the integration of diverse biological data resources and advanced machine learning(ML)frameworks.This integration has not only deepened our understanding of blood diseases such as leukemia and lymphoma,but also enhanced diagnostic accuracy and personalized treatment strategies.By applying ML algorithms to analyze large-scale biological data,researchers can more effectively identify disease patterns,predict treatment responses,and provide new perspectives for the diagnosis and treatment of hematologic disorders.Here,we provide an overview of the current landscape of biological data resources and the application of ML frameworks pertinent to hematology research.
