BACKGROUND Plasma cell leukemia(PCL) is diagnosed by the presence of an absolute plasma cell count of > 2 × 109/L or 20% plasma cells in the peripheral blood. Because the incidence of PCL is relatively low, ou...BACKGROUND Plasma cell leukemia(PCL) is diagnosed by the presence of an absolute plasma cell count of > 2 × 109/L or 20% plasma cells in the peripheral blood. Because the incidence of PCL is relatively low, our case report study presents a rare opportunity to describe the clinical and pathological characteristics of this leukemia, as well as different modalities of treatment and outcomes of primary PCL(pPCL).CASE SUMMARY A 56-year-old male with a history of hypertension complained of pain in the left flank area which started four months prior to admission. On admission, his vital signs were stable, and physical examination was completely benign. Laboratory evaluation showed hemoglobin of 5.1 g/dL, white blood cell count of 6.6 cells per cubic millimeter with 16% atypical lymphocytes, and platelet count of 51000 per microliter. Peripheral smear showed more than 10%-15% of plasma cells(Figure1), and flow cytometry of peripheral blood confirmed PCL with 24% plasma cells CD138+. Bone marrow biopsy demonstrated 80% plasma cells(38+, 138+, 117+,10-, 19-, 20-, 56-) with 90% cellularity. The Oncology team was consulted, and VCD therapy was started. After completing therapy at 1, 4, 8, and 11 d, the patient was discharged home. The patient was being considered for a bone marrow transplant evaluation within two months of discharge.CONCLUSION PCL is a rare and aggressive form of leukemia with a poor prognosis. Multicenter studies and clinical trials should be conducted to develop accurate criteria for the initial diagnosis and prompt treatment of this disease.展开更多
背景:冻存能够较好地保证血管结构的完整性,如何改善移植后排斥反应的问题受到越来越多的关注。目的:综述不同冷冻技术降低同种异体血管移植排斥反应的研究进展,以期为临床研究提供参考。方法:系统检索中英文数据库CNKI、万方和PubMed...背景:冻存能够较好地保证血管结构的完整性,如何改善移植后排斥反应的问题受到越来越多的关注。目的:综述不同冷冻技术降低同种异体血管移植排斥反应的研究进展,以期为临床研究提供参考。方法:系统检索中英文数据库CNKI、万方和PubMed以及在线网站Baidu和Google Scholar自建库以来发表的降低同种异体血管移植排斥反应的相关文献。中文检索关键词:心血管疾病、内皮细胞、低温冻存、血管移植、免疫原性、排斥反应,同种异体移植和冷冻保护剂;英文检索关键词:cardiovascular disease、endothelial cells、cryopreservation、blood vessel transplantation or vascular graft、Immunogenicity、immune rejection、allograft or allogeneic transplantation or allograft transplantation and cryoprotectant。按照纳入排除标准共选取68篇文献进行综述。结果与结论:①综述发现通过改进现有冷冻技术能够降低同种异体血管移植排斥反应,其中主要涉及冻融方式和冻存保护剂的选择。②现有研究提示冻干法优于低温冻存,但限于条件未能广泛开展,现仍以低温冻存为主,其中玻璃化冻存、缓慢复温和使用不锈钢乃至含银材料效果优于程序式冻存及快速复温。③渗透性和非渗透性冻存保护剂的联合选择,可以在降低其毒性的同时,进一步减少排斥反应的发生。展开更多
文摘BACKGROUND Plasma cell leukemia(PCL) is diagnosed by the presence of an absolute plasma cell count of > 2 × 109/L or 20% plasma cells in the peripheral blood. Because the incidence of PCL is relatively low, our case report study presents a rare opportunity to describe the clinical and pathological characteristics of this leukemia, as well as different modalities of treatment and outcomes of primary PCL(pPCL).CASE SUMMARY A 56-year-old male with a history of hypertension complained of pain in the left flank area which started four months prior to admission. On admission, his vital signs were stable, and physical examination was completely benign. Laboratory evaluation showed hemoglobin of 5.1 g/dL, white blood cell count of 6.6 cells per cubic millimeter with 16% atypical lymphocytes, and platelet count of 51000 per microliter. Peripheral smear showed more than 10%-15% of plasma cells(Figure1), and flow cytometry of peripheral blood confirmed PCL with 24% plasma cells CD138+. Bone marrow biopsy demonstrated 80% plasma cells(38+, 138+, 117+,10-, 19-, 20-, 56-) with 90% cellularity. The Oncology team was consulted, and VCD therapy was started. After completing therapy at 1, 4, 8, and 11 d, the patient was discharged home. The patient was being considered for a bone marrow transplant evaluation within two months of discharge.CONCLUSION PCL is a rare and aggressive form of leukemia with a poor prognosis. Multicenter studies and clinical trials should be conducted to develop accurate criteria for the initial diagnosis and prompt treatment of this disease.
文摘背景:冻存能够较好地保证血管结构的完整性,如何改善移植后排斥反应的问题受到越来越多的关注。目的:综述不同冷冻技术降低同种异体血管移植排斥反应的研究进展,以期为临床研究提供参考。方法:系统检索中英文数据库CNKI、万方和PubMed以及在线网站Baidu和Google Scholar自建库以来发表的降低同种异体血管移植排斥反应的相关文献。中文检索关键词:心血管疾病、内皮细胞、低温冻存、血管移植、免疫原性、排斥反应,同种异体移植和冷冻保护剂;英文检索关键词:cardiovascular disease、endothelial cells、cryopreservation、blood vessel transplantation or vascular graft、Immunogenicity、immune rejection、allograft or allogeneic transplantation or allograft transplantation and cryoprotectant。按照纳入排除标准共选取68篇文献进行综述。结果与结论:①综述发现通过改进现有冷冻技术能够降低同种异体血管移植排斥反应,其中主要涉及冻融方式和冻存保护剂的选择。②现有研究提示冻干法优于低温冻存,但限于条件未能广泛开展,现仍以低温冻存为主,其中玻璃化冻存、缓慢复温和使用不锈钢乃至含银材料效果优于程序式冻存及快速复温。③渗透性和非渗透性冻存保护剂的联合选择,可以在降低其毒性的同时,进一步减少排斥反应的发生。
