Hematologic malignancies,including leukemia,lymphoma,and multiple myeloma,are hazardous diseases characterized by the uncontrolled proliferation of cancer cells.Dysregulated cell cycle resulting from genetic and epige...Hematologic malignancies,including leukemia,lymphoma,and multiple myeloma,are hazardous diseases characterized by the uncontrolled proliferation of cancer cells.Dysregulated cell cycle resulting from genetic and epigenetic abnormalities constitutes one of the central events.Importantly,cyclin-dependent kinases(CDKs),complexed with their functional partner cyclins,play dominating roles in cell cycle control.Yet,efforts in translating CDK inhibitors into clinical benefits have demonstrated disappointing outcomes.Recently,mounting evidence highlights the emerging significance of WEE1 G2 checkpoint kinase(WEE1)to modulate CDK activity,and correspondingly,a variety of therapeutic inhibitors have been developed to achieve clinical benefits.Thus,WEE1 may become a promising target to modulate the abnormal cell cycle.However,its function in hematologic diseases remains poorly elucidated.In this review,focusing on hematologic malignancies,we describe the biological structure of WEE1,emphasize the latest reported function of WEE1 in the carcinogenesis,progression,as well as prognosis,and finally summarize the therapeutic strategies by targeting WEE1.展开更多
Immuno-positron emission tomography(immuno-PET)is an innovative medical imaging technique that combines antibodies(Abs)or other immune-targeting molecules with positron-emitting radionuclides.By targeting antigens tha...Immuno-positron emission tomography(immuno-PET)is an innovative medical imaging technique that combines antibodies(Abs)or other immune-targeting molecules with positron-emitting radionuclides.By targeting antigens that are highly expressed in hematologic malignancies,immuno-PET has transformed diagnostic capabilities and enables precise monitoring of therapeutic responses through highly sensitive and specific tumor cell detection.Additionally,it plays a critical role in advancing therapeutic approaches by seamlessly linking diagnostic imaging with personalized treatment strategies.Its non-invasive nature and ability to provide whole-body imaging offer significant advantages over traditional diagnostic methods,especially for detecting minimal residual disease and guiding adaptive therapeutic interventions.In Ab-based immuno-PET,positronemitting radionuclides must have a half-life sufficient for slower pharmacokinetics and blood clearance of Abs.Recent studies have highlighted the advantages of long-lived radionuclides,such as 89Zr,which exhibit low positron energy and enable high sensitivity and resolution,making them particularly effective for tumor visualization and characterization.This review explores the current applications,recent advancements,and potential of immuno-PET for hematologic malignancies,emphasizing its pivotal role in improving patient outcomes and advancing precision medicine.展开更多
With the advances in allogeneic hematopoietic cell transplantation(allo-HCT)and supportive care,the number of allo-HCT for elderly patients has been increasing in recent years.However,the advanced donor age limits the...With the advances in allogeneic hematopoietic cell transplantation(allo-HCT)and supportive care,the number of allo-HCT for elderly patients has been increasing in recent years.However,the advanced donor age limits the availability of human leukocyte antigen(HLA)-matched sibling donors(MSD)for elderly individuals.展开更多
Since 1968 when the first successful hematopoietic stem cell transplantation(HSCT) was performed, transplant technique has developed rapidly for more than 50 years. In the past 20 years, the significant breakthroughs ...Since 1968 when the first successful hematopoietic stem cell transplantation(HSCT) was performed, transplant technique has developed rapidly for more than 50 years. In the past 20 years, the significant breakthroughs and widely use of haploidentical-related donor HSCT(e.g. Beijing Protocol) make everyone can have a donor(1), and the novel, reduced-toxicity transplant regimens help elderly patients receive HSCT safely(2).展开更多
Hematologic malignancies are one of the most common malignant tumors caused by the clonal proliferation and differentiation of hematopoietic and lymphoid stem cells.The examination of bone marrow cells combined with i...Hematologic malignancies are one of the most common malignant tumors caused by the clonal proliferation and differentiation of hematopoietic and lymphoid stem cells.The examination of bone marrow cells combined with immunodeficiency typing is of great significance to the diagnostic type,treatment and prognosis of hematologic malignancies.Super-resolution fluorescence microscopy(SRM)is a special kind of optical microscopy technology,which breaks the resolution limit and was awarded the Nobel Prize in Chemistry in 2014.With the development of SRM,many related technologies have been applied to the diagnosis and treatment of clinical diseases.It was reported that a major type of SRM technique,single molecule localization microscopy(SMLM),is more sensitive than flow cytometry(FC)in detecting cell membrane antigens'expression,thus enabling better chances in detecting antigens on hematopoietic cells than traditional analytic tools.Furthermore,SRM may be applied to clinical pathology and may guide precision medicine and personalized medicine for clone hematopoietic cell diseases.In this paper,we mainly discuss the application of SRM in clone hematological malignancies.展开更多
Multiplex reverse transcription-polymerase chain reaction （M-RT-PCR） has been proved to possess great clinical potential for simultaneous screening of 29 chromosomal translocations in acute leukemia. To evaluate the...Multiplex reverse transcription-polymerase chain reaction （M-RT-PCR） has been proved to possess great clinical potential for simultaneous screening of 29 chromosomal translocations in acute leukemia. To evaluate the clinical value of M-RT-PCR in hematologic malignancies, bone marrow samples from 90 patients with various hematologic malignancies, including 25 acute myelogenous leukemia （AML）, 22 acute lymphoblastic leukemia （ALL）, 27 chronic myelogenous leukemia （CML）, 4 myeloproliferative diseases （MPD）, 3 chronic lymphoblastic leukemia （CLL）, 3 non-Hodgkin＇s lymphoma （NHL）, 3 myelodysplastic syndrome （MDS）, 2 multiple myeloma （MM） and 1 malignant histocytosis （MH） were subjected to both M-RT-PCR and chromosome karyotypic analysis. Some of cases were subjected to follow-up examination of M-RT-PCR during the period of clinical complete remission （CR） for detection of minimal residual leukemia. In our hand, 12 of 29 chromosomal translocation transcripts including TEL/PDGFR, DEK/CAN, MLL/AF6, AMLI/ETO, MLL/AF9, BCR/ABL, MLL/MLL, PML/RARα, TLS/ERG, E2A/HLF, EVⅡ and HOXⅡ were detected in 57 cases （63.3 %） of the 90 samples, which were in consistence with the results of karyotypic analysis. Furthermore, M-RT-PCR had also shown good clinical relevance when used as an approach to detect minimal residual leukemia. We concluded that M-RT-PCR could be used as an efficient and fast diagnostic tool not only in the initial diagnosis of hematologic malignancies but also in subsequent monitor of minimal residual leukemia.展开更多
The risk of reactivation in patients with chronic or past/resolved hepatitis B virus(HBV)infection receiving chemotherapy or immunosuppressive drugs is a wellknown possibility.The indication of antiviral prophylaxis w...The risk of reactivation in patients with chronic or past/resolved hepatitis B virus(HBV)infection receiving chemotherapy or immunosuppressive drugs is a wellknown possibility.The indication of antiviral prophylaxis with nucleo(t)side analogue is given according to the risk of HBV reactivation of the prescribed therapy.Though the advent of new drugs is occurring in all the field of medicine,in the setting of hematologic malignancies the last few years have been characterized by several drug classes and innovative cellular treatment.As novel therapies,there are few data about the rate of HBV reactivation and the decision of starting or not an antiviral prophylaxis could be challenging.Moreover,patients are often treated with a combination of different drugs,so evaluating the actual role of these new therapies in increasing the risk of HBV reactivation is difficult.First results are now available,but further studies are still needed.Patients with chronic HBV infection[hepatitis B surface antigen(HBsAg)positive]are reasonably all treated.Past/resolved HBV patients(HBsAg negative)are the actual area of uncertainty where it could be difficult choosing between prophylaxis and pre-emptive strategy.展开更多
Background:Chimeric antigen receptor T(CAR-T)cell therapy has achieved marked therapeutic success in ameliorating hematological malignancies.However,there is an extant void in the clinical guidelines concerning the mo...Background:Chimeric antigen receptor T(CAR-T)cell therapy has achieved marked therapeutic success in ameliorating hematological malignancies.However,there is an extant void in the clinical guidelines concerning the most effective chemotherapy regimen prior to chimeric antigen receptor T(CAR-T)cell therapy,as well as the optimal timing for CAR-T cell infusion post-chemotherapy.Materials and Methods:We employed cell-derived tumor xenograft(CDX)murine models to delineate the optimal pre-conditioning chemotherapy regimen and timing for CAR-T cell treatment.Furthermore,transcriptome sequencing was implemented to identify the therapeutic targets and elucidate the underlying mechanisms governing the treatment regimen.Results:Our preclinical in vivo evaluation determined that a combination of cyclophosphamide and fludarabine,followed by the infusion of CD19 CAR-T cells five days subsequent to the chemotherapy,exerts the most efficacious therapeutic effect in B-cell hematological malignancies.Concurrently,RNA-seq data indicated that the therapeutic efficacy predominantly perturbs tumor cell metabolism,primarily through the inhibition of key mitochondrial targets,such as C-Jun Kinase enzyme(C-JUN).Conclusion:In summary,the present study offers critical clinical guidance and serves as an authoritative reference for the deployment of CD19 CAR-T cell therapy in the treatment of B-cell hematological malignancies.展开更多
Circulating free nucleic acids; cell free DNA and circulating micro-RNA, are found in the plasma of patients with hematologic and solid malignancies at levels higher than that of healthy individuals. In patients with ...Circulating free nucleic acids; cell free DNA and circulating micro-RNA, are found in the plasma of patients with hematologic and solid malignancies at levels higher than that of healthy individuals. In patients with hematologic malignancy cell free DNA reflects the underlying tumor mutational profile, whilst micro-RNAs reflect genetic interference mechanisms within a tumor and potentially the surrounding microenvironment and immune effector cells. These circulating nucleic acids offer a potentially simple, non-invasive, repeatable analysis that can aid in diagnosis, prognosis and therapeutic decisions in cancer treatment.展开更多
BACKGROUND The presence of renal cell carcinoma(RCC)and hematologic malignancies(HM)in the same patient is rarely observed.Three primary findings have been described in these patients,including male gender and lymphoi...BACKGROUND The presence of renal cell carcinoma(RCC)and hematologic malignancies(HM)in the same patient is rarely observed.Three primary findings have been described in these patients,including male gender and lymphoid malignancy predominance,and the HM are usually diagnosed before or simultaneously with the RCC.There is a lack of evidence about clinical outcomes in this setting.We report the common characteristics of 9 patients diagnosed with concurrent RCC and HM and their clinical course and response to treatment.CASE SUMMARY Four(44%)patients were diagnosed with RCC prior to the HM,the diagnosis was simultaneous in 4(44%)patients,and 1(11%)patient was diagnosed with the HM prior to the RCC.No patients were treated with cytotoxic chemotherapy or radiation between the diagnosis of RCC and HM.Several unique features were seen in our case series,such as 3 simultaneous cancers in 1(11%)patient,a splenectomy leading to remission of diffuse large B cell lymphoma without the use of chemotherapy in 1(11%)patient,chemotherapy and rituximab for lymphoma resulting in a complete response in primary RCC in 1(11%)patient,and immunotherapy providing an excellent response for primary renal leiomyosarcoma in 1(11%)patient.CONCLUSION These findings highlight the potential role of immune system dysregulation in patients with the diagnosis of RCC and HM whereby the first malignancy predisposes to the second through an immunomodulatory effect.HM have the potential of being confused with lymph node metastasis from kidney cancer.Lymph node biopsy may be necessary at the time of initial diagnosis or in cases of mixed response to therapy.Long-term medical surveillance is warranted when a patient is diagnosed with RCC or HM.Clinicians should be aware of the higher prevalence of male gender and lymphoid malignancy with concurrent RCC and HM and that either of these conditions may be diagnosed first or they may be diagnosed simultaneously.展开更多
Objective: The human cluster of differentiation(CD)300A, a type-I transmembrane protein with immunoreceptor tyrosine-based inhibitory motifs, was investigated as a potential immune checkpoint for human natural killer(...Objective: The human cluster of differentiation(CD)300A, a type-I transmembrane protein with immunoreceptor tyrosine-based inhibitory motifs, was investigated as a potential immune checkpoint for human natural killer(NK) cells targeting hematologic malignancies(HMs).Methods: We implemented a stimulation system involving the CD300A ligand, phosphatidylserine(PS), exposed to the outer surface of malignant cells. Additionally, we utilized CD300A overexpression, a CD300A blocking system, and a xenotransplantation model to evaluate the impact of CD300A on NK cell efficacy against HMs in in vitro and in vivo settings. Furthermore, we explored the association between CD300A and HM progression in patients.Results: Our findings indicated that PS hampers the function of NK cells. Increased CD300A expression inhibited HM lysis by NK cells. CD300A overexpression shortened the survival of HM-xenografted mice by impairing transplanted NK cells. Blocking PS–CD300A signals with antibodies significantly amplified the expression of lysis function-related proteins and effector cytokines in NK cells, thereby augmenting the ability to lyse HMs. Clinically, heightened CD300A expression correlated with shorter survival and an “exhausted” phenotype of intratumoral NK cells in patients with HMs or solid tumors.Conclusions: These results propose CD300A as a potential target for invigorating NK cell-based treatments against HMs.展开更多
Sirtuin 1(SIRT1)is a protein deacetylase,which regulates various physiological activities by deacetylating different protein substrates.An increasing number of studies have revealed critical roles of SIRT1 in differen...Sirtuin 1(SIRT1)is a protein deacetylase,which regulates various physiological activities by deacetylating different protein substrates.An increasing number of studies have revealed critical roles of SIRT1 in different aspects of cancers including metabolism,proliferation,genomic instability,and chemotherapy resistance.Depending on the protein targets in a certain oncogenic context,SIRT1 may play a unique role in each individual blood cancer subtype.Our previous work showed that activation of SIRT1 in primitive leukemia cells of acute myeloid leukemia(AML)and chronic myelogenous leukemia(CML)promotes disease maintenance.On the other hand,an SIRT1 agonist was shown to disrupt maintenance of myelodysplastic syndrome(MDS)stem cells and holds promise as a potential therapeutic approach.Herein,we present a concise summary of the different functions of SIRT1 in hematologic malignancies.展开更多
Invasive fungal infections are a major challenging problem in the management of febrile neutropenia (FN) in patients with hematologic malignancies. Liposomal amphotericin B (L-AmB) or micafungin (MCFG) has been widely...Invasive fungal infections are a major challenging problem in the management of febrile neutropenia (FN) in patients with hematologic malignancies. Liposomal amphotericin B (L-AmB) or micafungin (MCFG) has been widely used as a first-line empirical antifungal therapy for suspected fungal infection in such patients. However, there are several issues in patients receiving these agents: drug related toxicities for L-AmB and breakthrough fungal infections for MCFG. In order to make the best use of these 2 agents, we conducted a prospective study of sequential therapy from MCFG to L-AmB, and evaluated the efficacy and safety of this strategy in FN patients with hematologic malignancies. A total of 18 patients were enrolled, and 11 patients who fulfilled the protocol defined criteria were evaluated. Underlying diseases consisted of acute leukemia (n = 9), non-Hodgkin lymphoma (n = 1), and myelodysplastic syndrome (n = 1). Treatment success was achieved in 8 patients (72.7%). Drug-related adverse events occurred in 8 patients (72.7%). All of those adverse events except one case were below grade 2. Three patients required discontinuation of L-AmB. Although our empirical antifungal sequential therapy seems to be encouraging for antibiotics-refractory FN in patients with hematologic malignancies, further investigation in large-scale studies is warranted.展开更多
Objective To investigate the clinical features and prognosis of Pseudomonas aeruginosa infection in patients with hematologic malignancies.Methods This study retrospectively analyzed the clinical data of 197 patients ...Objective To investigate the clinical features and prognosis of Pseudomonas aeruginosa infection in patients with hematologic malignancies.Methods This study retrospectively analyzed the clinical data of 197 patients with hematologic malignancies complicated with P.aeruginosa infection who were hospitalized in the Department of Hematology from January 01,2019,to December 31,2021.Patients were categorized into a susceptible group(CSPA infection group)and a drugresistant group(CRPA infection group)based on their sensitivity to carbapenems,comparing the differences in clinical features between the two groups,and analyzing the risk factors and prognosis of CRPA infection.Results Logistic regression analysis revealed that hospitalization days>50 days(P=0.010,OR=3.581,95%CI 1.356-9.457),history of antibiotic exposure(P=0.008,0R=4.394,95%CI1.358-6.238),more than two courses of chemotherapy before infection(P=0.006,0R=2.911,95%CI 1.358-6.238)were independent risk factors for developing CRPA.The mortality rates were 12.8%(18/140)and 28.1%(16/57)in patients with CRPA and CSPA,respectively(P=0.010).Logistic regression analysis revealed that bloodstream infection(BSI)(P=0.039,OR=5.286,95%CI 1.091-25.621)was an independent risk factor for hematologic malignancies and death from CRPA infection.Conclusion Hospitalization>50 days,history of antibiotic exposure,and>2 courses of chemotherapy before infection are independent risk factors for CRPA infection.Hematologic malignancies with CRPA infection have a high mortality rate,of which BSI is an independent risk factor for 30-day mortality from hematologic malignancies with CRPA infection.展开更多
HDAC7,a member of class IIa HDACs,plays a pivotal regulatory role in tumor,immune,fibrosis,and angiogenesis,rendering it a potential therapeutic target.Nevertheless,due to the high similarity in the enzyme active site...HDAC7,a member of class IIa HDACs,plays a pivotal regulatory role in tumor,immune,fibrosis,and angiogenesis,rendering it a potential therapeutic target.Nevertheless,due to the high similarity in the enzyme active sites of class IIa HDACs,inhibitors encounter challenges in discerning differences among them.Furthermore,the substitution of key residue in the active pocket of class IIa HDACs renders them pseudo-enzymes,leading to a limited impact of enzymatic inhibitors on their function.In this study,proteolysis targeting chimera(PROTAC)technology was employed to develop HDAC7 drugs.We developed an exceedingly selective HDAC7 PROTAC degrader B14 which showcased superior inhibitory effects on cell proliferation compared to TMP269 in various diffuse large B cell lymphoma(DLBCL)and acute myeloid leukemia(AML)cells.Subsequent investigations unveiled that B14 disrupts BCL6 forming a transcriptional inhibition complex by degrading HDAC7,thereby exerting proliferative inhibition in DLBCL.Our study broadened the understanding of the non-enzymatic functions of HDAC7 and underscored the importance of HDAC7 in the treatment of hematologic malignancies,particularly in DLBCL and AML.展开更多
Background:Patients with hemato-oncological malignancies may respond insufficiently to vaccination,especially in terms of antibody titer.The antibody response depends on the type of malignancy as well as the type and ...Background:Patients with hemato-oncological malignancies may respond insufficiently to vaccination,especially in terms of antibody titer.The antibody response depends on the type of malignancy as well as the type and timing of treatment.We intended to evaluate this using real-world data from patients of our regional hospital.This study also considers the role of immune status,including T-cell activation markers,in predicting vaccination success.Methods:Seventeen patients of our hospital having a hematological malignancy were included in this study,including myeloma,lymphoma,as well as acute myeloid leukemia(AML)and chronic lymphoid leukemia(CLL).All patients were vaccinated against Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2)using Tozinameran following current recommendations.Circulating antibodies directed against the spike protein of SARS-CoV-2 were determined by a commercial immune assay.Immune status was determined from peripheral blood by flow cytometry.Both parameters were followed in fifteen patients who provided sufficient follow-up data for up to one year.Patients were categorized as responders or non-responders,and differences in diagnosis,treatment,and immune status were analyzed.Results:Antibody response depended on both diagnosis and treatment.Active treatment directed against B-cells,such as anti-Cluster of Differentiation 20(CD20)therapy,was associated with weak seroconversion.For CD38-as well as proteasome-directed therapies,the data suggest that responders as well as non-responders exist.Notably,low peripheral B-cell numbers and high CD3+HLADR+cell counts correlated withweak seroconversion upon vaccination.Conclusions:We suggest that peripheral immune status can be applied as a predictive biomarker for seroconversion upon vaccinations.展开更多
Hematological malignancies encompass a diverse range of blood-related cancers characterized by abnormal blood cell production.These cancers,classified by the World Health Organization based on lineage,cell origin,and ...Hematological malignancies encompass a diverse range of blood-related cancers characterized by abnormal blood cell production.These cancers,classified by the World Health Organization based on lineage,cell origin,and progression,provide a more comprehensive framework for understanding cancer biology.This classification has significantly advanced cancer research,particularly in genetic analyses for diagnosis and treatment.Despite recent clinical improvements,challenges,such as relapse,resistance,and high mortality,remain unresolved.Tumor necrosis factor-related apoptosis-inducing ligand(TRAIL),a protein that induces apoptosis in cancer cells without affecting normal cells,has emerged as a promising therapeutic target.However,its clinical efficacy is limited by factors,such as tumor heterogeneity and resistance to TRAIL signaling.This review examines the mechanisms of TRAIL in hematological malignancies,factors contributing to resistance,and the current state of preclinical and clinical research,highlighting potential strategies to enhance TRAIL-based therapies in blood cancers.展开更多
Arginine methylation is a common posttranslational modification that governs important cellular processes and impacts development,cell growth,proliferation,and differentiation.Arginine methylation is catalyzed by prot...Arginine methylation is a common posttranslational modification that governs important cellular processes and impacts development,cell growth,proliferation,and differentiation.Arginine methylation is catalyzed by protein arginine methyltransferases(PRMTs),which are classified as type I and type II enzymes responsible for the formation of asymmetric and symmetric dimethylarginine,respectively.PRMT5 is the main type II enzyme that catalyzes symmetric dimethylarginine of histone proteins to induce gene silencing by generating repressive histone marks,including H2AR3me2s,H3R8me2s,and H4R3me2s.PRMT5 can also methylate nonhistone proteins such as the transcription factors p53,E2F1 and p65.Modifications of these proteins by PRMT5 are involved in diverse cellular processes,including transcription,translation,DNA repair,RNA processing,and metabolism.A growing literature demonstrates that PRMT5 expression is upregulated in hematologic malignancies,including leukemia and lymphoma,where PRMT5 regulates gene expression to promote cancer cell proliferation.Targeting PRMT5 by specific inhibitors has emerged as a potential therapeutic strategy to treat these diseases.展开更多
Background Intensive treatment such as autologous peripheral blood stem cell （PBSC） transplantation is an important therapeutic strategy in many hematologic malignancies.A number of factors have been reported to imp...Background Intensive treatment such as autologous peripheral blood stem cell （PBSC） transplantation is an important therapeutic strategy in many hematologic malignancies.A number of factors have been reported to impact PBSC mobilization,but the predictive factors varied from one study to another.This retrospective study assessed our current mobilization and collection protocols,and explored the factors predictive of PBSC mobilization in patients with hematologic malignancies.Methods Data of 64 consecutive patients with hematologic malignancies （multiple myeloma,n=22; acute leukemia,n=27; lymphoma,n=15） who underwent PBSC mobilization for over 1 year were analyzed.Four patients with response to treatment of near complete remission or better were administered granulocyte colony-stimulating factor （G-CSF） to mobilize PBSCs.Sixty patients received G-CSF followed by chemotherapy mobilizing regimens.Poor mobilization （PM） was defined as when ≤2.0×106 CD34＋ cells/kg body weight were collected within three leukapheresis procedures.Results The incidence of PM at the first mobilization attempt was 19% （12/64）.The PM group was older than the non-PM group （median age,51 vs.40 years; P=0.013）.In univariate analysis,there were no significant differences in gender,diagnosis,and body weight between the PM and non-PM groups.A combination of chemotherapy and G-CSF was more effective than G-CSF alone as a mobilizing regimen （P=0.019）.Grade Ⅲ or Ⅳ hematopoietic toxicity of chemotherapy had no significant effect on the mobilization efficacy.Supportive care and the incidence of febrile neutropenia were not significantly different between the two groups.In multivariate analysis,age （odds ratio （OR）,9.536;P=-0.002） and number of previous chemotherapy courses （OR 3.132; P=0.024） were two independent negative predictive factors for CD34＋ cell yield.PM patients could be managed well by remobilization.Conclusion Older age and a heavy load of previous chemotherapy are the negative risk factors for PBSC mobilization.展开更多
Most tumor suppressor and growth-regulating proteins are transported via the plasmic nuclear transporter exportin 1(XPO1).Many malignancies have excessive XPO1 expression,which is associated with disease progression a...Most tumor suppressor and growth-regulating proteins are transported via the plasmic nuclear transporter exportin 1(XPO1).Many malignancies have excessive XPO1 expression,which is associated with disease progression and resistance to therapy.A novel class of anticancer medication called selective inhibitor of nuclear export(SINE)can down-regulate the levels of a number of antigenic proteins in the cytoplasm,activate tumor suppressor and other growth regulating proteins,and promote the nuclear retention and apoptosis of tumor cells.This article discusses the function of XPO1 in drug resistance and tumor development as well as the advancement of XPO1 inhibitor research for the treatment of hematological cancers.展开更多
基金supported by grants from the National Natural Science Foundation of China(No.81920108004,82270127,82203880)the Hunan Provincial Natural Science Foundation of China(No.2023JJ30928,2024JJ3037)+2 种基金the Changsha Municipal Natural Sci-Science Foundation(No.kq2208382)the Fellowship of the China Postdoctoral Science Foundation(No.2023T160740)the Hunan Province Clinical Medical Technology Innovation Guidance Project(No.2021SK50917,2023SK4056)。
文摘Hematologic malignancies,including leukemia,lymphoma,and multiple myeloma,are hazardous diseases characterized by the uncontrolled proliferation of cancer cells.Dysregulated cell cycle resulting from genetic and epigenetic abnormalities constitutes one of the central events.Importantly,cyclin-dependent kinases(CDKs),complexed with their functional partner cyclins,play dominating roles in cell cycle control.Yet,efforts in translating CDK inhibitors into clinical benefits have demonstrated disappointing outcomes.Recently,mounting evidence highlights the emerging significance of WEE1 G2 checkpoint kinase(WEE1)to modulate CDK activity,and correspondingly,a variety of therapeutic inhibitors have been developed to achieve clinical benefits.Thus,WEE1 may become a promising target to modulate the abnormal cell cycle.However,its function in hematologic diseases remains poorly elucidated.In this review,focusing on hematologic malignancies,we describe the biological structure of WEE1,emphasize the latest reported function of WEE1 in the carcinogenesis,progression,as well as prognosis,and finally summarize the therapeutic strategies by targeting WEE1.
文摘Immuno-positron emission tomography(immuno-PET)is an innovative medical imaging technique that combines antibodies(Abs)or other immune-targeting molecules with positron-emitting radionuclides.By targeting antigens that are highly expressed in hematologic malignancies,immuno-PET has transformed diagnostic capabilities and enables precise monitoring of therapeutic responses through highly sensitive and specific tumor cell detection.Additionally,it plays a critical role in advancing therapeutic approaches by seamlessly linking diagnostic imaging with personalized treatment strategies.Its non-invasive nature and ability to provide whole-body imaging offer significant advantages over traditional diagnostic methods,especially for detecting minimal residual disease and guiding adaptive therapeutic interventions.In Ab-based immuno-PET,positronemitting radionuclides must have a half-life sufficient for slower pharmacokinetics and blood clearance of Abs.Recent studies have highlighted the advantages of long-lived radionuclides,such as 89Zr,which exhibit low positron energy and enable high sensitivity and resolution,making them particularly effective for tumor visualization and characterization.This review explores the current applications,recent advancements,and potential of immuno-PET for hematologic malignancies,emphasizing its pivotal role in improving patient outcomes and advancing precision medicine.
基金supported by National Natural Science Foundation of China(No.82370215,82020108003,and 82330008)Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD),Jiangsu Provincial Medical Innovation Center(No.CXZX202201)Science and Technology Program of Suzhou(No.SKY2023047)。
文摘With the advances in allogeneic hematopoietic cell transplantation(allo-HCT)and supportive care,the number of allo-HCT for elderly patients has been increasing in recent years.However,the advanced donor age limits the availability of human leukocyte antigen(HLA)-matched sibling donors(MSD)for elderly individuals.
文摘Since 1968 when the first successful hematopoietic stem cell transplantation(HSCT) was performed, transplant technique has developed rapidly for more than 50 years. In the past 20 years, the significant breakthroughs and widely use of haploidentical-related donor HSCT(e.g. Beijing Protocol) make everyone can have a donor(1), and the novel, reduced-toxicity transplant regimens help elderly patients receive HSCT safely(2).
基金This work was supported by the Innovation Fund of WNLO(2018WNLOKF023)the Start-up Fund of Hainan University(KYQD(ZR)-20077).
文摘Hematologic malignancies are one of the most common malignant tumors caused by the clonal proliferation and differentiation of hematopoietic and lymphoid stem cells.The examination of bone marrow cells combined with immunodeficiency typing is of great significance to the diagnostic type,treatment and prognosis of hematologic malignancies.Super-resolution fluorescence microscopy(SRM)is a special kind of optical microscopy technology,which breaks the resolution limit and was awarded the Nobel Prize in Chemistry in 2014.With the development of SRM,many related technologies have been applied to the diagnosis and treatment of clinical diseases.It was reported that a major type of SRM technique,single molecule localization microscopy(SMLM),is more sensitive than flow cytometry(FC)in detecting cell membrane antigens'expression,thus enabling better chances in detecting antigens on hematopoietic cells than traditional analytic tools.Furthermore,SRM may be applied to clinical pathology and may guide precision medicine and personalized medicine for clone hematopoietic cell diseases.In this paper,we mainly discuss the application of SRM in clone hematological malignancies.
文摘Multiplex reverse transcription-polymerase chain reaction （M-RT-PCR） has been proved to possess great clinical potential for simultaneous screening of 29 chromosomal translocations in acute leukemia. To evaluate the clinical value of M-RT-PCR in hematologic malignancies, bone marrow samples from 90 patients with various hematologic malignancies, including 25 acute myelogenous leukemia （AML）, 22 acute lymphoblastic leukemia （ALL）, 27 chronic myelogenous leukemia （CML）, 4 myeloproliferative diseases （MPD）, 3 chronic lymphoblastic leukemia （CLL）, 3 non-Hodgkin＇s lymphoma （NHL）, 3 myelodysplastic syndrome （MDS）, 2 multiple myeloma （MM） and 1 malignant histocytosis （MH） were subjected to both M-RT-PCR and chromosome karyotypic analysis. Some of cases were subjected to follow-up examination of M-RT-PCR during the period of clinical complete remission （CR） for detection of minimal residual leukemia. In our hand, 12 of 29 chromosomal translocation transcripts including TEL/PDGFR, DEK/CAN, MLL/AF6, AMLI/ETO, MLL/AF9, BCR/ABL, MLL/MLL, PML/RARα, TLS/ERG, E2A/HLF, EVⅡ and HOXⅡ were detected in 57 cases （63.3 %） of the 90 samples, which were in consistence with the results of karyotypic analysis. Furthermore, M-RT-PCR had also shown good clinical relevance when used as an approach to detect minimal residual leukemia. We concluded that M-RT-PCR could be used as an efficient and fast diagnostic tool not only in the initial diagnosis of hematologic malignancies but also in subsequent monitor of minimal residual leukemia.
文摘The risk of reactivation in patients with chronic or past/resolved hepatitis B virus(HBV)infection receiving chemotherapy or immunosuppressive drugs is a wellknown possibility.The indication of antiviral prophylaxis with nucleo(t)side analogue is given according to the risk of HBV reactivation of the prescribed therapy.Though the advent of new drugs is occurring in all the field of medicine,in the setting of hematologic malignancies the last few years have been characterized by several drug classes and innovative cellular treatment.As novel therapies,there are few data about the rate of HBV reactivation and the decision of starting or not an antiviral prophylaxis could be challenging.Moreover,patients are often treated with a combination of different drugs,so evaluating the actual role of these new therapies in increasing the risk of HBV reactivation is difficult.First results are now available,but further studies are still needed.Patients with chronic HBV infection[hepatitis B surface antigen(HBsAg)positive]are reasonably all treated.Past/resolved HBV patients(HBsAg negative)are the actual area of uncertainty where it could be difficult choosing between prophylaxis and pre-emptive strategy.
基金National Natural Science Foundation of China(No.82370164)Sanming Project of Medicine in Shenzhen(No.SZSM202011004)Shenzhen Science and Technology Innovation Commission(JCYJ20180307150419435 and JCYJ20210324123004011).
文摘Background:Chimeric antigen receptor T(CAR-T)cell therapy has achieved marked therapeutic success in ameliorating hematological malignancies.However,there is an extant void in the clinical guidelines concerning the most effective chemotherapy regimen prior to chimeric antigen receptor T(CAR-T)cell therapy,as well as the optimal timing for CAR-T cell infusion post-chemotherapy.Materials and Methods:We employed cell-derived tumor xenograft(CDX)murine models to delineate the optimal pre-conditioning chemotherapy regimen and timing for CAR-T cell treatment.Furthermore,transcriptome sequencing was implemented to identify the therapeutic targets and elucidate the underlying mechanisms governing the treatment regimen.Results:Our preclinical in vivo evaluation determined that a combination of cyclophosphamide and fludarabine,followed by the infusion of CD19 CAR-T cells five days subsequent to the chemotherapy,exerts the most efficacious therapeutic effect in B-cell hematological malignancies.Concurrently,RNA-seq data indicated that the therapeutic efficacy predominantly perturbs tumor cell metabolism,primarily through the inhibition of key mitochondrial targets,such as C-Jun Kinase enzyme(C-JUN).Conclusion:In summary,the present study offers critical clinical guidance and serves as an authoritative reference for the deployment of CD19 CAR-T cell therapy in the treatment of B-cell hematological malignancies.
文摘Circulating free nucleic acids; cell free DNA and circulating micro-RNA, are found in the plasma of patients with hematologic and solid malignancies at levels higher than that of healthy individuals. In patients with hematologic malignancy cell free DNA reflects the underlying tumor mutational profile, whilst micro-RNAs reflect genetic interference mechanisms within a tumor and potentially the surrounding microenvironment and immune effector cells. These circulating nucleic acids offer a potentially simple, non-invasive, repeatable analysis that can aid in diagnosis, prognosis and therapeutic decisions in cancer treatment.
文摘BACKGROUND The presence of renal cell carcinoma(RCC)and hematologic malignancies(HM)in the same patient is rarely observed.Three primary findings have been described in these patients,including male gender and lymphoid malignancy predominance,and the HM are usually diagnosed before or simultaneously with the RCC.There is a lack of evidence about clinical outcomes in this setting.We report the common characteristics of 9 patients diagnosed with concurrent RCC and HM and their clinical course and response to treatment.CASE SUMMARY Four(44%)patients were diagnosed with RCC prior to the HM,the diagnosis was simultaneous in 4(44%)patients,and 1(11%)patient was diagnosed with the HM prior to the RCC.No patients were treated with cytotoxic chemotherapy or radiation between the diagnosis of RCC and HM.Several unique features were seen in our case series,such as 3 simultaneous cancers in 1(11%)patient,a splenectomy leading to remission of diffuse large B cell lymphoma without the use of chemotherapy in 1(11%)patient,chemotherapy and rituximab for lymphoma resulting in a complete response in primary RCC in 1(11%)patient,and immunotherapy providing an excellent response for primary renal leiomyosarcoma in 1(11%)patient.CONCLUSION These findings highlight the potential role of immune system dysregulation in patients with the diagnosis of RCC and HM whereby the first malignancy predisposes to the second through an immunomodulatory effect.HM have the potential of being confused with lymph node metastasis from kidney cancer.Lymph node biopsy may be necessary at the time of initial diagnosis or in cases of mixed response to therapy.Long-term medical surveillance is warranted when a patient is diagnosed with RCC or HM.Clinicians should be aware of the higher prevalence of male gender and lymphoid malignancy with concurrent RCC and HM and that either of these conditions may be diagnosed first or they may be diagnosed simultaneously.
基金supported by the National Key R&D Program of China (2019YFA0508502/3 and 2021YFC2300604)the Natural Science Foundation of China (Reference numbers 82388201, 82241216, and 32270963)+1 种基金the Research Funds of Center for Advanced Interdisciplinary Science and Biomedicine of IHM (QYZD20220008)the Anhui Key Research and Development Plan (Reference number 2023z04020011)。
文摘Objective: The human cluster of differentiation(CD)300A, a type-I transmembrane protein with immunoreceptor tyrosine-based inhibitory motifs, was investigated as a potential immune checkpoint for human natural killer(NK) cells targeting hematologic malignancies(HMs).Methods: We implemented a stimulation system involving the CD300A ligand, phosphatidylserine(PS), exposed to the outer surface of malignant cells. Additionally, we utilized CD300A overexpression, a CD300A blocking system, and a xenotransplantation model to evaluate the impact of CD300A on NK cell efficacy against HMs in in vitro and in vivo settings. Furthermore, we explored the association between CD300A and HM progression in patients.Results: Our findings indicated that PS hampers the function of NK cells. Increased CD300A expression inhibited HM lysis by NK cells. CD300A overexpression shortened the survival of HM-xenografted mice by impairing transplanted NK cells. Blocking PS–CD300A signals with antibodies significantly amplified the expression of lysis function-related proteins and effector cytokines in NK cells, thereby augmenting the ability to lyse HMs. Clinically, heightened CD300A expression correlated with shorter survival and an “exhausted” phenotype of intratumoral NK cells in patients with HMs or solid tumors.Conclusions: These results propose CD300A as a potential target for invigorating NK cell-based treatments against HMs.
基金supported by the National Institutes of Health(No.R01HL141336),the Margaret E.Early Medical Research Trust Award,the Stop Cancer Research Career Development Award,V Scholar Award of Cancer Research,and the Gehr Family Center for Leukemia Research,USA
文摘Sirtuin 1(SIRT1)is a protein deacetylase,which regulates various physiological activities by deacetylating different protein substrates.An increasing number of studies have revealed critical roles of SIRT1 in different aspects of cancers including metabolism,proliferation,genomic instability,and chemotherapy resistance.Depending on the protein targets in a certain oncogenic context,SIRT1 may play a unique role in each individual blood cancer subtype.Our previous work showed that activation of SIRT1 in primitive leukemia cells of acute myeloid leukemia(AML)and chronic myelogenous leukemia(CML)promotes disease maintenance.On the other hand,an SIRT1 agonist was shown to disrupt maintenance of myelodysplastic syndrome(MDS)stem cells and holds promise as a potential therapeutic approach.Herein,we present a concise summary of the different functions of SIRT1 in hematologic malignancies.
文摘Invasive fungal infections are a major challenging problem in the management of febrile neutropenia (FN) in patients with hematologic malignancies. Liposomal amphotericin B (L-AmB) or micafungin (MCFG) has been widely used as a first-line empirical antifungal therapy for suspected fungal infection in such patients. However, there are several issues in patients receiving these agents: drug related toxicities for L-AmB and breakthrough fungal infections for MCFG. In order to make the best use of these 2 agents, we conducted a prospective study of sequential therapy from MCFG to L-AmB, and evaluated the efficacy and safety of this strategy in FN patients with hematologic malignancies. A total of 18 patients were enrolled, and 11 patients who fulfilled the protocol defined criteria were evaluated. Underlying diseases consisted of acute leukemia (n = 9), non-Hodgkin lymphoma (n = 1), and myelodysplastic syndrome (n = 1). Treatment success was achieved in 8 patients (72.7%). Drug-related adverse events occurred in 8 patients (72.7%). All of those adverse events except one case were below grade 2. Three patients required discontinuation of L-AmB. Although our empirical antifungal sequential therapy seems to be encouraging for antibiotics-refractory FN in patients with hematologic malignancies, further investigation in large-scale studies is warranted.
文摘Objective To investigate the clinical features and prognosis of Pseudomonas aeruginosa infection in patients with hematologic malignancies.Methods This study retrospectively analyzed the clinical data of 197 patients with hematologic malignancies complicated with P.aeruginosa infection who were hospitalized in the Department of Hematology from January 01,2019,to December 31,2021.Patients were categorized into a susceptible group(CSPA infection group)and a drugresistant group(CRPA infection group)based on their sensitivity to carbapenems,comparing the differences in clinical features between the two groups,and analyzing the risk factors and prognosis of CRPA infection.Results Logistic regression analysis revealed that hospitalization days>50 days(P=0.010,OR=3.581,95%CI 1.356-9.457),history of antibiotic exposure(P=0.008,0R=4.394,95%CI1.358-6.238),more than two courses of chemotherapy before infection(P=0.006,0R=2.911,95%CI 1.358-6.238)were independent risk factors for developing CRPA.The mortality rates were 12.8%(18/140)and 28.1%(16/57)in patients with CRPA and CSPA,respectively(P=0.010).Logistic regression analysis revealed that bloodstream infection(BSI)(P=0.039,OR=5.286,95%CI 1.091-25.621)was an independent risk factor for hematologic malignancies and death from CRPA infection.Conclusion Hospitalization>50 days,history of antibiotic exposure,and>2 courses of chemotherapy before infection are independent risk factors for CRPA infection.Hematologic malignancies with CRPA infection have a high mortality rate,of which BSI is an independent risk factor for 30-day mortality from hematologic malignancies with CRPA infection.
基金support from the National Natural Science Foundation of China(Nos.82173660,82103975)Zhejiang Provincial Key Research&Development Plan(No.2023C03111,China)+1 种基金the Natural Science Fund for Distinguished Young Scholars of Zhejiang Province(Nos.LR21H300003,LR22H310002,China)the Natural Science Foundation of Zhejiang Province(No.LQ21H300005,China).
文摘HDAC7,a member of class IIa HDACs,plays a pivotal regulatory role in tumor,immune,fibrosis,and angiogenesis,rendering it a potential therapeutic target.Nevertheless,due to the high similarity in the enzyme active sites of class IIa HDACs,inhibitors encounter challenges in discerning differences among them.Furthermore,the substitution of key residue in the active pocket of class IIa HDACs renders them pseudo-enzymes,leading to a limited impact of enzymatic inhibitors on their function.In this study,proteolysis targeting chimera(PROTAC)technology was employed to develop HDAC7 drugs.We developed an exceedingly selective HDAC7 PROTAC degrader B14 which showcased superior inhibitory effects on cell proliferation compared to TMP269 in various diffuse large B cell lymphoma(DLBCL)and acute myeloid leukemia(AML)cells.Subsequent investigations unveiled that B14 disrupts BCL6 forming a transcriptional inhibition complex by degrading HDAC7,thereby exerting proliferative inhibition in DLBCL.Our study broadened the understanding of the non-enzymatic functions of HDAC7 and underscored the importance of HDAC7 in the treatment of hematologic malignancies,particularly in DLBCL and AML.
基金supported by a grant of the Deutsche Forschungsgemeinschaft(DFG)to G.B.(#405833349).
文摘Background:Patients with hemato-oncological malignancies may respond insufficiently to vaccination,especially in terms of antibody titer.The antibody response depends on the type of malignancy as well as the type and timing of treatment.We intended to evaluate this using real-world data from patients of our regional hospital.This study also considers the role of immune status,including T-cell activation markers,in predicting vaccination success.Methods:Seventeen patients of our hospital having a hematological malignancy were included in this study,including myeloma,lymphoma,as well as acute myeloid leukemia(AML)and chronic lymphoid leukemia(CLL).All patients were vaccinated against Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2)using Tozinameran following current recommendations.Circulating antibodies directed against the spike protein of SARS-CoV-2 were determined by a commercial immune assay.Immune status was determined from peripheral blood by flow cytometry.Both parameters were followed in fifteen patients who provided sufficient follow-up data for up to one year.Patients were categorized as responders or non-responders,and differences in diagnosis,treatment,and immune status were analyzed.Results:Antibody response depended on both diagnosis and treatment.Active treatment directed against B-cells,such as anti-Cluster of Differentiation 20(CD20)therapy,was associated with weak seroconversion.For CD38-as well as proteasome-directed therapies,the data suggest that responders as well as non-responders exist.Notably,low peripheral B-cell numbers and high CD3+HLADR+cell counts correlated withweak seroconversion upon vaccination.Conclusions:We suggest that peripheral immune status can be applied as a predictive biomarker for seroconversion upon vaccinations.
基金supported by the National Natural Science Foundation of China(Grant No.82102777)Zhengzhou University Graduate Independent Innovation Project(Grant No.20230410)+1 种基金the Science and Technology Research Program in Henan Province(Grant No.222102310071)Henan Province Medical Science and Technology Research Project(Grant No.LHGJ20210281).
文摘Hematological malignancies encompass a diverse range of blood-related cancers characterized by abnormal blood cell production.These cancers,classified by the World Health Organization based on lineage,cell origin,and progression,provide a more comprehensive framework for understanding cancer biology.This classification has significantly advanced cancer research,particularly in genetic analyses for diagnosis and treatment.Despite recent clinical improvements,challenges,such as relapse,resistance,and high mortality,remain unresolved.Tumor necrosis factor-related apoptosis-inducing ligand(TRAIL),a protein that induces apoptosis in cancer cells without affecting normal cells,has emerged as a promising therapeutic target.However,its clinical efficacy is limited by factors,such as tumor heterogeneity and resistance to TRAIL signaling.This review examines the mechanisms of TRAIL in hematological malignancies,factors contributing to resistance,and the current state of preclinical and clinical research,highlighting potential strategies to enhance TRAIL-based therapies in blood cancers.
文摘Arginine methylation is a common posttranslational modification that governs important cellular processes and impacts development,cell growth,proliferation,and differentiation.Arginine methylation is catalyzed by protein arginine methyltransferases(PRMTs),which are classified as type I and type II enzymes responsible for the formation of asymmetric and symmetric dimethylarginine,respectively.PRMT5 is the main type II enzyme that catalyzes symmetric dimethylarginine of histone proteins to induce gene silencing by generating repressive histone marks,including H2AR3me2s,H3R8me2s,and H4R3me2s.PRMT5 can also methylate nonhistone proteins such as the transcription factors p53,E2F1 and p65.Modifications of these proteins by PRMT5 are involved in diverse cellular processes,including transcription,translation,DNA repair,RNA processing,and metabolism.A growing literature demonstrates that PRMT5 expression is upregulated in hematologic malignancies,including leukemia and lymphoma,where PRMT5 regulates gene expression to promote cancer cell proliferation.Targeting PRMT5 by specific inhibitors has emerged as a potential therapeutic strategy to treat these diseases.
文摘Background Intensive treatment such as autologous peripheral blood stem cell （PBSC） transplantation is an important therapeutic strategy in many hematologic malignancies.A number of factors have been reported to impact PBSC mobilization,but the predictive factors varied from one study to another.This retrospective study assessed our current mobilization and collection protocols,and explored the factors predictive of PBSC mobilization in patients with hematologic malignancies.Methods Data of 64 consecutive patients with hematologic malignancies （multiple myeloma,n=22; acute leukemia,n=27; lymphoma,n=15） who underwent PBSC mobilization for over 1 year were analyzed.Four patients with response to treatment of near complete remission or better were administered granulocyte colony-stimulating factor （G-CSF） to mobilize PBSCs.Sixty patients received G-CSF followed by chemotherapy mobilizing regimens.Poor mobilization （PM） was defined as when ≤2.0×106 CD34＋ cells/kg body weight were collected within three leukapheresis procedures.Results The incidence of PM at the first mobilization attempt was 19% （12/64）.The PM group was older than the non-PM group （median age,51 vs.40 years; P=0.013）.In univariate analysis,there were no significant differences in gender,diagnosis,and body weight between the PM and non-PM groups.A combination of chemotherapy and G-CSF was more effective than G-CSF alone as a mobilizing regimen （P=0.019）.Grade Ⅲ or Ⅳ hematopoietic toxicity of chemotherapy had no significant effect on the mobilization efficacy.Supportive care and the incidence of febrile neutropenia were not significantly different between the two groups.In multivariate analysis,age （odds ratio （OR）,9.536;P=-0.002） and number of previous chemotherapy courses （OR 3.132; P=0.024） were two independent negative predictive factors for CD34＋ cell yield.PM patients could be managed well by remobilization.Conclusion Older age and a heavy load of previous chemotherapy are the negative risk factors for PBSC mobilization.
基金National Natural Science Foundation Project(No.81970190)Shaanxi Provincial Social Development Public Relations Key Project(No.2019ZDLSF02-02)National Medical Center Transformation Project(No.2020ZKMC01)。
文摘Most tumor suppressor and growth-regulating proteins are transported via the plasmic nuclear transporter exportin 1(XPO1).Many malignancies have excessive XPO1 expression,which is associated with disease progression and resistance to therapy.A novel class of anticancer medication called selective inhibitor of nuclear export(SINE)can down-regulate the levels of a number of antigenic proteins in the cytoplasm,activate tumor suppressor and other growth regulating proteins,and promote the nuclear retention and apoptosis of tumor cells.This article discusses the function of XPO1 in drug resistance and tumor development as well as the advancement of XPO1 inhibitor research for the treatment of hematological cancers.
