Xiaoying Zhao

In patients with tumors, inflammation, and blood disorders, hyperferritinemia has been associated with the severity of the underlying disease and is frequently accompanied by a co-occurring low pla...

Objective: The systemic immune-inflammation index (SII) based on neutrophil, platelet and lymphocyte counts, is a prognostic biomarker in some solid cancers. However, the prognostic value of SII has not yet been validated. This study was to evaluate the role of SII in predicting survival for patients with diffuse large B cell lymphoma (DLBCL). Methods: We retrospectively investigated 224 patients with DLBCL between August 2005 and October 2018. Kaplan–Meier analysis and Cox proportional hazard models were used to assess the prognostic value of SII. Results: In the ROC curve analysis, SII had the highest AUC and was more accurate as a prognostic factor. Patients with higher SII tended to have higher level of LDH, more advanced stage, poor PS, and high IPI score compared with low SII group. In univariate analyses, SII, PLR and NLR were all prognostic for progression-free survival and overall survival. Moreover, only SII, older age, HBSAg-positive and IPI were the independent prognostic factors for patients in multivariate analysis. The nomogram based on SII, older age, HBSAg status and IPI showed accurate prognostic ability for predicting 3-years and 5-years survival rates (c-index, 0.791) compared to the IPI alone (c-index, 0.716). Conclusion: SII was a powerful tool for predicting outcome in patients with DLBCL. It might assist the separation of high-risk patients among patients with the same IPI.

Linalool can inhibit the malignant proliferation of numerous human malignant solid tumors, including hepatocellular carcinoma, breast cancer, small cell carcinoma and malignant melanoma. However, the role of linalool in T cell acute lymphoblastic leukaemia (T‑ALL) remains unclear. In the present study, human T‑ALL cell lines (Jurkat, H9, Molt‑4 and Raji cells) and peripheral blood mononuclear cells (PBMCs) from healthy donors were treated with various concentrations of linalool (3.75, 7.50, 15.00, 30.00, 60.00 and 120.00 µM, respectively). A CCK‑8 assay was used to analyse cell viability and it demonstrated that linalool inhib­ited the growth of T‑ALL cells in a dose‑dependent manner, but did not significantly affect normal PBMCs. Flow cytometry was used to detect the cell cycle and apoptosis and demonstrated that linalool reduced the percentage of T‑ALL cells at the G₀/G₁ phase, and induced the apoptosis of T‑ALL cells. RNA sequencing was conducted on an Illumina HiSeq X Series 2500 before and after treatment with linalool followed by Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis. It was demonstrated that the mitogen‑activated protein kinase (MAPK) pathway was involved in the effect of linalool on T‑ALL cells. Real‑time quantitative PCR and western blotting were performed to verify the mRNA and protein levels, respectively of the genes in the signaling pathway identified. In addition, it was found that linalool significantly inhibited phosphorylated (p)‑ERK1/2 protein expression and enhanced p‑JNK protein expression of T‑ALL cells. In conclusion, the present study revealed that linalool inhibits T‑ALL cell survival with involvement of the MAPK signaling pathway. JNK activation and ERK inhibition may play a functional role in apoptosis induction of T‑ALL cells. Linalool may be developed as a novel anti T‑ALL agent.

Background Lymphoid neoplasms in serous effusions are uncommon, and the details of lymphoid neoplasms in serous effusions from China are still unclear. Methods Between January 2004 and December 2019, all patients with lymphoid neoplasms in pleural effusions, ascites, and pericardial effusions in our hospital, were reviewed. Results A total of 65 patients with lymphoid neoplasms were collected during this period. The top three neoplasms were diffuse large B‐cell lymphoma (DLBCL) (n = 20, 30.7%), myeloma (n = 13, 20.0%), and T‐lymphoblastic lymphoma (n = 7, 10.8%). In pleural effusions involving DLBCL, the cytomorphology of DLBCL cells was diverse; most pleural effusions were present during the tumor course (92.9%); bilateral pleural effusions were predominant (57.2%); and the median survival time was only 1.23 months after the effusion. In pleural effusions involving myeloma, 90.9% of cases (10/11) had a high ratio (> 1.0) of immature to mature plasma cells; paraprotein types of IgA (36.4%) and light chain λ (36.4%) were the most frequently found; bilateral pleural effusions were easily found (n = 10, 90.9%); and the median survival time was only 1.4 months after the effusion. Conclusion In pleural effusions involving DLBCL, most of our patients with effusions are present during the tumor course, and bilateral pleural effusions are predominant. In pleural effusions involving myeloma, the paraprotein types of IgA and light chain λ are the most frequently found, and it has a high ratio of immature to mature plasma cells in pleural effusions.

Background: Lymphoid neoplasms in serous effusions (SEs) were uncommon. Currently, most reports of lymphoid neoplasms in SEs were from Western countries, but few reports were from China, and the details were still unclear. Methods: Between January 2004 and December 2019, lymphoid neoplasms diagnosed by cytological methods from specimens of pleural effusions (PEs), ascites, and pericardial effusions in our hospital were reviewed.Results: 59 patients of lymphoid neoplasms were diagnosed by SEs, the top three causes were diffuse large B-cell lymphoma (DLBCL) (n=21, 35.6%), myeloma (n=13, 22.0%), and T-lymphoblastic lymphoma (n=5, 8.5%). In PEs involved with DLBCL, the cytomorphology of DLBCL cells was variable, most PEs were present during tumor course (92.9%), bilateral PEs were the predominance (57.2%), and the median survival time was only 1.23 months after effusion. In PEs involved with myeloma, nearly all cases had a high ratio of immature to mature plasma cells (>1.0), IgA (36.4%) and light chain λ (36.4%) were the most frequently found. Bilateral PEs were easily found (90.9%), and the median survival time was only 1.4 months after effusion. Solitary plasmacytomas with myeloma infiltration in PEs seemed to have a better prognosis than that of plasma cell myeloma.Conclusion: Some differences are found between our patients and those from Western countries, and more studies involving different ethnic populations could help to elucidate the features of lymphoid neoplasms in SEs.

Primary central nervous system lymphoma (PCNSL) is a rare form of extranodal non-Hodgkin’s lymphoma and a limited number of cases have been reported from China. This study aimed to investigate the clinicopathological features of newly diagnosed PCNSLs from a single center in eastern China and to identify the potential prognostic factors for overall survival (OS) and progression-free survival (PFS). All consecutive patients with histopathologically diagnosed PCNSLs at our center between January 2003 and October 2017 were recruited. Demographic and clinicopathological data were collected and reviewed retrospectively. The potential risk factors for OS and PFS were identified using the log-rank test and Cox regression analysis. A total of 167 immunocompetent cases were enrolled. The median age was 58 years (range 17–96 years), and the male:female ratio was 3:2. Headache (n = 65; 39%) and cerebral hemisphere (n = 96; 57%) were the most common presenting complaint and location, respectively. Out of 167 cases, 150 cases were diffuse large B cell lymphomas. With a median follow-up of 25 months (range 1–152 ), the median OS and PFS were 37 months (95% CI, 25–49) and 17 months (95% CI, 13–20), respectively. Residual tumor after operation, chemotherapy without HD-MTX and palliative treatment was revealed as independent prognostic markers. Moreover, ECOG > 3, multifocal lesions, and palliative treatment were revealed as unfavorable independent prognostic markers for PFS. In conclusion, Chinese patients with PCNSL have distinct characteristics. Further studies are warranted to confirm the prognostic value of these factors and to optimize treatments for these patients.

Programmed cell death receptor 1 ligand 1 (PD-L1) expression in various tumors, including hematologic malignancies, has recently become a research topic of great interest. We performed a meta-analysis to evaluate the prognostic and clinicopathological value of PD-L1 expressed in tumor cells of patients with diffuse large B-cell lymphoma (DLBCL). Relevant studies were identified from PubMed, EMBASE, Web of Science and the Cochrane Library. The hazard ratio (HR) and 95% confidence interval (95% CI) were used for analyzing survival outcomes, and the odds ratio (OR) was used for analyzing clinicopathological parameters. Pooled results showed that tumor cell PD-L1 expression is associated with poor overall survival (OS) (HR = 2.128, 95% CI: 1.341–3.378, P = 0.001), the non-germinal center B-cell-like subtype (OR = 2.891, 95% CI: 2.087–4.003, P < 0.000), high international prognostic index score (3–5) (OR = 1.552, 95% CI: 1.111–2.169, P = 0.010), B symptoms (OR = 1.495, 95% Cl: 1.109–2.015, P = 0.008), positive MUM1 expression (OR = 3.365, 95% Cl: 1.578–7.175, P = 0.002) and negative BCL6 expression (OR = 0.414, 95% Cl: 0.217–0.792, P = 0.008). Sensitivity analysis showed that there was no publication bias among these studies. Our meta-analysis supported the idea that tumor cell PD-L1 expression may represent a promising biomarker for predicting poor prognosis and is associated with adverse clinicopathologic features in DLBCL patients.

Introduction: AML with inv(3)(q21.3q26.2) or t(3;3)(q21.3;q26.2) [inv(3)/t(3;3)] was very rare. Currently, most reports of AML‐inv(3)/t(3;3) were from Western countries, and few reports were from Asian countries. Racial differences in patients with AML‐inv(3)/t(3;3) are still unknown.Methods: Between January 1996 and April 2018, a total of 37 AML cases with inv(3)/t(3;3) were studied retrospectively. They were collected from 2229 primary AML cases performed with conventional cytogenetic analysis (37/2229, 1.66%).Results: Here, some differences were found by comparing our data with those from Western countries. In our series, AML with inv(3)(q21q26) had a lower incidence than that with t(3;3)(q21;q26) (11 vs 26 cases). Our patients seemed to be more younger (median, 43 years) and have lower hemoglobin concentrations (median, 73 g/L) and higher platelet count (median, 351 × 10⁹/L). A higher incidence of acute monoblastic and monocytic leukemia (45.9%) was observed in our patients. Immunophenotypic studies showed that CD38 (30.8%) was not so frequently expressed as that in the earlier reports. Mutations analysis showed a high frequency of NRAS mutations (45.0%), followed by SF3B1(15.0%), GATA2(15.0%), FLT3‐ITD(10.0%), C‐Kit/D816(5.0%), and CEBPA(5.0%), without mutation of NPM1(Exon12)or JAK2V617.Conclusion: Ethnic differences do exist between the Chinese and Western patients with AML‐inv(3)/t(3;3), and more attention should be paid involving different ethnic populations and geographic regions.

Protein arginine methyltransferase 1 (PRMT1) is the predominant asymmetric (type I) methyltransferase in mammalian cells. Mounting evidence suggested that PRMT1 is essential to embryonic development and tumor pathogenesis, but its role in normal adult hematopoiesis is less studied. We used a Prmt1 conditional knockout (KO) mouse model to identify the role of PRMT1 in normal adult hematopoiesis. The results indicated that deletion of PRMT1 results in anemia and leukopenia, reducing terminal erythroid and lymphocyte differentiation. Additionally, we found a significant decrease of megakaryocyte progenitors (MkPs) compared with similarly treated littermate control mice. The frequency of short-term hematopoietic stem cells (ST-HSCs) and granulocyte-macrophage progenitors (GMPs) populations were significantly lower in PRMT1^f/f/Mx1-CRE bone marrow (BM) compared with littermate control mice. Importantly, in-vitro replating assays and BM transplantation results revealed that PRMT1 KO results in reduced hematopoietic stem and progenitor cells (HSPCs) self-renewal capacity. Thus, we conclude that PRMT1 is required for hematopoietic differentiation and the competitive fitness of HSPCs, and we believed that PRMT1 serves as a key epigenetic regulator of normal hematopoiesis that occurs throughout life.