Leukemia diagnosis and treatment center is a department that mainly treats various acute leukemia, chronic myeloid leukemia and other myeloproliferative diseases. Divided into two wards, * * * has more than 90 treatment beds (including15000 laminar isolation beds; General wards have single rooms, two rooms and three rooms. There are 3 chief physicians, 1 deputy chief physicians and 6 attending physicians. There are more than 30 nursing staff, including deputy chief nurse 1 person and 3 nurses in charge. Leukemia diagnosis and treatment center is the leader of leukemia chemotherapy in China, focusing on the study of pathogenesis, chemotherapy and prognostic factors of leukemia. This paper studied the identification and characteristics of -M2b, a new subtype of acute myeloid leukemia. In 1980s, the comparison between domestic chemotherapy drug homoharringtonine (HHT)+ cytarabine (HA regimen) and international first-line chemotherapy regimen daunorubicin+cytarabine (DA) in the treatment of acute myeloid leukemia (AML) was first completed, and the position of HA regimen in the first-line chemotherapy of AML in China was established. On this basis, the curative effect of three drugs combined chemotherapy (HAD, HAM, HAA, HAE) based on HA in the treatment of AML was discussed, and a systematic treatment plan was formulated, which achieved gratifying results. Statistical analysis of curative effect of 243 cases of newly treated and newly treated AML in recent12 * *: The complete remission (CR) rate was 76.5%; The median disease-free survival (DFS) of patients with complete remission was 29.6(0.5- 153) months, the 3-year DFS rate was 46.2%, and the 5-year DFS rate was 43. 1%. The median overall survival (OS) of 243 patients was 18.6(0.5- 154) months. The three-year OS rate was 37.7%, and the five-year OS rate was 32.7%. According to the results of chromosome karyotype, patients with 184 were divided into three groups: good, medium and poor. The CR rate, median DFS and OS of the three groups were 95.8%, 87 months and 89 months in the good karyotype group, 80%, 13 months and 19 months in the middle karyotype group and 43.8% in the poor karyotype group respectively. The 3-year and 5-year disease-free survival rates of the three groups were 62.65438 0% and 58.5% in the good karyotype group, 35.4% and 33.7% in the medium karyotype group and 65,438 08.8% and 65,438 08.8% in the poor karyotype group, respectively. The 3-year OS rate and 5-year OS rate of the three groups are: good karyotype group 6 1.4% and 57.9%, medium karyotype group 35.7% and 32.3%, poor karyotype group 18.8% and 18.8% respectively. In order to adapt to the national conditions and people's feelings, on the basis of the above summary, the reasonable treatment cycle of AML after remission was discussed. Recently, on the basis of the above experience, the overall treatment scheme of AML has been further improved and perfected, and the group treatment is carried out according to the chromosome karyotype, and high-dose chemotherapy is emphasized to reduce the occurrence of refractory drug-resistant cases, shorten the treatment cycle and improve the long-term survival rate. Our center is also the earliest unit in China to carry out research on refractory and drug-resistant leukemia, and the first clinical study of CSA reversing drug resistance in China was completed here. Recently, the treatment of refractory and drug-resistant AML is mainly discussed by FLAG, MAC and AAC, and preliminary results have been obtained. In addition, many valuable experiences in the treatment and observation of leukemia are summarized, such as the significance of routine bone marrow puncture during induction chemotherapy of acute leukemia, the treatment experience of heterozygous acute leukemia, and how to prevent the damage of chemotherapy drugs to blood vessels.
These valuable treatment experiences have been promoted to varying degrees in China, and many puzzling problems in the field of hematology in China have been solved. Adult acute lymphoblastic leukemia (ALL) has always been a difficult problem in domestic hematology, and its curative effect is not good. On the basis of summing up past experience and referring to international treatment, Leukemia Center has formulated a complete treatment plan suitable for China's national conditions, which has been constantly revised and improved in clinical practice (IH2003 plan has been formed). Statistical analysis of 49 patients in recent 10 years/kloc-0 shows that the total complete remission rate (CR) of induction therapy is 93.7%. The median disease-free survival (DFS) was13 months, and the median OS was17.5 months. The DFS in 3 years and 5 years reached 34. 1% and 20.3% respectively. The total effective rates were 44.2% and 36.5% respectively. For patients with poor prognosis and Ph-positive (BCR/ABL), combination chemotherapy with gleevec or interferon was used to increase CR rate and prolong survival time. The leukemia diagnosis and treatment center has a strong sense of responsibility, and the nursing team is skilled and experienced. It insists on patient-centered work, develops new technologies such as PICC and implantable infusion port, attaches great importance to business learning, and strengthens life care to ensure the smooth progress of clinical treatment. Leukemia diagnosis and treatment center is an important part of the national key discipline and the national clinical pharmacology base of tumor drugs, and it is a doctoral program. In order to be in line with international standards, FAB typing, MICM typing and WHO typing diagnosis of acute leukemia were first carried out in China. Editor-in-chief or participated in the compilation of several monographs on hematology. Completed clinical trials of acridine, methyl indirubin, nordaunorubicin, penem asparaginase, compound yellow belt tablets and other drugs, participated in international multi-center clinical trials of drugs such as AMN 107, gained a lot of valuable experience, and made important contributions to the popularization and application of these drugs in China.
While making achievements in clinical work, the center attaches great importance to basic research and its clinical application. Pharmacokinetic research, drug sensitivity test of acute leukemia in vitro, research on trace residual leukemia, research on leukemia oncogenes and leukemia stem cells were carried out.
The center has experienced and profound academic attainments of old experts; There are also young and middle-aged business backbones with rich clinical experience who have returned to China after studying abroad, as well as energetic doctoral students, master students and young doctors who are eager to learn. At the same time, we also have a nursing team with rich professional nursing experience, skilled technology and good service attitude. We are willing to provide first-class medical care services for leukemia and other blood diseases at home and abroad.
Anemia treatment center
The anemia diagnosis and treatment center mainly studies the pathogenesis, new diagnosis and treatment techniques and strategies of red blood cell system diseases, and treats various types of bone marrow hematopoietic failure syndrome, congenital and acquired hemolytic anemia, polycythemia, various difficult diseases of blood system accompanied with anemia and various internal medical diseases characterized by anemia.
Anemia diagnosis and treatment center consists of two wards, and now has beds 103, including 8 ordinary beds1bed, 20 grass-roots beds and 2 hundred-level laminar beds. It receives about 1000 inpatients from all over the country every year, and the utilization rate of hospital beds is over 95%. The diagnosis and differential diagnosis of anemia are standardized and accurate, and have a long-standing reputation. The curative effect of severe aplastic anemia has been in the leading position in China, and the effective rate of antithymocyte globulin is as high as 70%. In recent years, it is the first in China to explore a new method of treating severe aplastic anemia with large dose of cyclophosphamide. The curative effect of the initial treatment was about 80%, and no serious side effects were found, so many patients with financial difficulties were treated. The use of thousand-level laminar flow wards reduces the incidence of infection, thus reducing the overall treatment cost. In terms of hemolytic diseases, many common and rare congenital or acquired hemolytic anemia have been diagnosed and treated, such as P5'N deficiency and heat-labile polycythemia. Many patients with unclear diagnosis or misdiagnosis have been reasonably diagnosed and treated. In terms of refractory hematological diseases such as myelodysplastic syndrome and myelofibrosis, the center keeps abreast of medical trends at home and abroad, grasps new drugs and therapies, and strives to achieve the best curative effect. The center is second to none in the diagnosis of various intractable diseases in the blood system. Many rare diseases at home and abroad have been diagnosed, such as congenital erythropoietic anemia, antiphospholipid syndrome with hemolytic anemia, large granular lymphoblastic leukemia, thrombotic thrombocytopenic purpura, NK/T cell lymphoma/leukemia, etc. So that patients who are transferred to many hospitals without diagnosis can get a definite diagnosis.
Anemia treatment center has a clinical medical team with exquisite medical skills and noble medical ethics, including 75 medical staff, 20 doctors and 55 nursing staff. There are 4 senior technical titles, 5 intermediate technical titles/kloc-0, and 56 junior technical titles. Among the doctors, there are 7 doctors, 7 masters, 2 tutors and 0/5 graduate students. More than 90% of nursing staff have college education or above. Many members of the department won the title of "honest individual", and the department itself was also rated as "honest department", "advanced group of spiritual civilization at college level" and "Tianjin Municipal Youth Civilization".
The Center has undertaken such research projects as "Study on Biological Characteristics of Hematopoietic Stem Cells in Severe Aplastic Anemia", "Study on Syndrome Differentiation and Classification of Chronic Aplastic Anemia and Correlation between Cell and Molecular Biological Material Basis", "Feasibility Study on Transplantation Strategy to Improve the Migration and Hematopoietic Reconstruction Ability of Hematopoietic Stem Cells in Vivo" and "Study on the Source Difference of Homing Ability of Human Hematopoietic Stem Cells in Vivo", so as to deeply study the pathogenesis of anemia and explore new treatment methods and strategies.
Hematopoietic stem cell transplantation center
The research of hematopoietic stem cell transplantation center aims at improving the curative effect of hematopoietic stem cell transplantation on various blood diseases, and carries out research on the best pretreatment scheme suitable for patients with different types of diseases, effective prediction means and effective prevention scheme of disease recurrence, pathogenesis of acute and chronic graft diseases after allogeneic hematopoietic stem cell transplantation, effective prediction methods and treatment methods of acute and chronic graft diseases, effective prevention and treatment methods of invasive aspergillosis after hematopoietic stem cell transplantation, and effective purification methods of autologous transplantation.
Hematopoietic stem cell transplantation center consists of two wards, with 72 ordinary beds, 100 laminar flow 12 bed, 1000 laminar flow 12 bed. Treat patients with acute and chronic leukemia, severe aplastic anemia, myelodysplastic syndrome, myelodysplastic disease and various hematological diseases.
Hematopoietic stem cell transplantation center was established in 1980s, and it took the lead in developing autologous bone marrow transplantation to treat acute leukemia in China. The classical pretreatment schemes of whole body radiotherapy plus cyclophosphamide and medulla plus cyclophosphamide were systematically studied, which proved that China people are also suitable for international standard dose of pre-transplant pretreatment. In addition, remarkable achievements have been made in the fields of allogeneic hematopoietic stem cell transplantation, autologous hematopoietic stem cell transplantation, haploid hematopoietic stem cell transplantation and hematological diseases. The long-term disease-free survival rate of patients with various acute and chronic leukemia, severe aplastic anemia, lymphoma, multiple myeloma and myelodysplastic syndrome has reached the international advanced level, and some of them have reached the international leading level.
We will carry out HLA-compatible sibling donor allogeneic hematopoietic stem cell transplantation, unrelated donor hematopoietic stem cell transplantation, ploidy hematopoietic stem cell transplantation, umbilical cord blood hematopoietic stem cell transplantation, autologous hematopoietic stem cell transplantation and half-length alternate radiotherapy to treat patients with hematological diseases such as acute and chronic leukemia, severe aplastic anemia, paroxysmal nocturnal hemoglobinuria, lymphoma, multiple myeloma and myelodysplastic syndrome. As of August 2007, 532 patients with various blood diseases have received transplantation. The long-term disease-free survival rate of HLA-matched sibling donor allogeneic hematopoietic stem cell transplantation for chronic myeloid leukemia is 80%, and the long-term disease-free survival rate of HLA-matched sibling donor allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia and acute lymphoblastic leukemia in the first remission stage is 60%-65%. The long-term disease-free survival rate of HLA-matched sibling donor allogeneic hematopoietic stem cell transplantation for myelodysplastic syndrome is 47%. The long-term disease-free survival rate of patients with severe aplastic anemia treated by HLA-matched sibling donor allogeneic hematopoietic stem cell transplantation is 865438 0%. The long-term disease-free survival rate of autologous hematopoietic stem cell transplantation in the first remission stage of acute non-lymphocytic leukemia is 55%, and the long-term disease-free survival rate of autologous hematopoietic stem cell transplantation in the first remission stage of acute lymphocytic leukemia is 60%. The long-term disease-free survival rate of acute lymphoblastic leukemia in the first complete remission period was 42%.
Hematopoietic stem cell transplantation center has a medical team with strong technical responsibility, exquisite skills and rich experience, including 82 medical staff, including 3 chief physicians, 2 deputy chief physicians, 6 attending physicians, 9 doctors, 6 masters, 2 deputy chief nurses, nearly 70 medical technicians, doctoral supervisors 1 person, and master students.
Medical staff adhere to the patient-centered, and strive to improve the patient's medical environment, with the aim of improving service quality, improving curative effect and ensuring medical safety. At the same time, actively cooperate with Tianjin Red Cross to carry out publicity activities of donating hematopoietic stem cells, and assist Tianjin Red Cross to collect hematopoietic stem cells for voluntary donors. More than 30 medical technicians in the transplant center actively registered to donate hematopoietic stem cells.
Hematopoietic stem cell transplantation center carried out in vitro purification research of hematopoietic stem cell transplantation, and successively used monoclonal antibody, INW2 and other in vitro purification treatments, CD34 positive cells sorting and other methods to purify hematopoietic stem cell transplantation, and studied the appropriate pretreatment scheme, pre-transplant intensive consolidation treatment, post-transplant maintenance chemotherapy and immunotherapy, so that the curative effect of autologous transplantation of acute leukemia reached the international leading level. In addition, the high risk factors, predictive indexes and effective prevention and treatment schemes of graft-versus-host disease after allogeneic hematopoietic stem cell transplantation; Risk factors of leukemia recurrence after transplantation, detection of residual disease and effective treatment of early recurrence after transplantation; The effective prevention and treatment strategies of invasive fungal infection, interstitial pneumonia, hepatic vein occlusion and other complications after transplantation were systematically studied, and good results were achieved. At present, he is responsible for "the repair effect of mesenchymal stem cells and hematopoietic stem cells on injured myocardium", "the role of allogeneic NK cells in allogeneic hematopoietic stem cell transplantation" and "the risk factors and prevention strategies of invasive aspergillosis after allogeneic hematopoietic stem cell transplantation".
Thrombosis hemostasis treatment center
Thrombotic hemostasis diagnosis and treatment center mainly carries out research on new treatment strategies for thrombotic diseases and hemorrhagic diseases, physiological and pathological characteristics of megakaryocytes and platelets, and regulation mechanism of angiogenesis.
There are 46 beds in the thrombus hemostasis center. Treat all kinds of hereditary and acquired hemorrhagic diseases, and treat all kinds of rare and difficult diseases referred from all over the country.
The center has 2 chief physicians, 2 attending physicians and 4 residents. Nurses 13, doctoral supervisors 1 0, doctoral students 10, and master students 5.
Thrombotic Hemostasis Center is the executive department of the national member unit of the World Hemophilia Alliance (China) and the leading unit of the China Hemophilia Clinical Cooperation Network. In the prevention and treatment of hemophilia, he was responsible for organizing the translation of four volumes of hemophilia brochures and popular science books such as Living with Hemophilia by Dr. Peter Jones, a medical consultant of the World Hemophilia Alliance, and distributing them to hemophiliacs free of charge. As the lead unit, with the support of the World Hemophilia Alliance, it is responsible for organizing and implementing the national registration of hemophilia, which is progressing smoothly at present.
For the first time, the Center for Thrombosis and Hemostasis found two polymorphic sites with high heterozygosity in China human coagulation factor ⅸ gene. It is found for the first time in the world that the serum leptin level in patients with chronic ITP is higher than that in normal people, and the CD8+T cells in patients with chronic ITP have Tc 1 polarization, which may be caused by the down-regulation of GATA-3. The above results have been published in foreign SCI journals. At present, he is responsible for the role of DNA methylation in the pathogenesis of chronic ITP, the relationship between epigenetic factors and ITP, the role of epigenetic factors in the pathogenesis of chronic ITP, the accurate diagnosis and targeted intervention of idiopathic thrombocytopenic purpura, and the Bayer Hemophilia Award (Clinical Scholarship Award, 2007), "Study on the Relationship between Endothelial Progenitor Cell Decrease and Atherosclerosis", "Basic Study on Oral Treatment of Hemophilia B with Attenuated Salmonella as Gene Carrier", "Investigation on Thrombosis in China", NNHF grants: Improve the diagnosis, treatment and cognitive level of hemophilia in China through screening and education. (2007. 1-2009.6438+02) and other research projects.
Blood disease emergency center
Blood emergency center is an important place to diagnose and rescue acute, critical and severe patients related to blood, and its main task is to comprehensively treat dying patients.
The emergency center for hematological diseases has advanced automatic analysis electrocardiogram, multi-parameter ECG monitor, ventilator, defibrillator, gastric lavage machine, surgical bag, various stretchers for puncture and drainage, various dressings and handling, oxygen inhalation and oxygen inhalation equipment. There is an emergency room with 16 observation beds. Emergency diagnosis and treatment of blood diseases (red cell diseases, white cell diseases, bleeding and coagulation diseases, etc.). ), rescue of critically ill patients, observation of emergency inpatients, blood component infusion, anti-infection treatment, low-dose chemotherapy, intrathecal injection and other emergency treatment.
The Emergency Center of Hematology has a strong sense of responsibility, skilled and experienced medical team, which consists of 2 chief physicians, 3 attending physicians, 4 senior residents, 4 deputy chief nurses 1, 4 head nurses, 9 nurses 1. Medical staff have received formal first-aid knowledge training and have rich experience in clinical hematology, with accurate diagnosis, quick response and decisive measures. Is a diligent, united and cooperative team.
Myelodysplastic Syndrome (MDS) Treatment Center
The diagnosis and treatment center of myelodysplastic syndrome focuses on new strategies for diagnosis and treatment of myelodysplastic syndrome, myelodysplastic diseases and acute myeloid leukemia.
There are 49 beds in the ward, including 1000-level laminar isolation beds 10. It has reached the international advanced level in the diagnosis and treatment of myelodysplastic syndrome, myeloproliferative diseases and acute myeloid leukemia. There are 2 chief physicians, deputy chief physicians 1, 3 attending physicians, 6 residents, 9 nurses 1, doctoral supervisors1,4 doctoral students and 7 master students in the center.
Our center is the first in China to carry out WHO classification diagnosis of myelodysplastic syndrome and individualized treatment according to the international prognosis scoring system. The treatment scheme of cyclosporine combined with thalidomide for myelodysplastic syndrome in low-risk group proposed by our center has been widely used in the whole country. With i( 17)(q 10) and t (1; 3)(p36； Q2 1) and der (1; 7)(q 10； P 10), as an independent clinical pathogenic disease, has basically been recognized by international peers.
Rare myeloproliferative diseases such as 8p 1 1 syndrome and chronic eosinophilic leukemia with periodic fluctuations in peripheral blood were reported for the first time in China. The clinical and genetic characteristics of chronic eosinophilic leukemia/hypereosinophilic syndrome were systematically studied. Gleevec is the first drug to treat chronic eosinophilic leukemia in China, and its therapeutic mechanism has been deeply studied.
For the first time in China, the proportion of leukemia cells in the induction treatment of acute myeloid leukemia is regarded as an independent prognostic indicator, and the treatment plan can be adjusted accordingly. This paper reports the first clinical series of systematic treatment of acute promyelocytic leukemia in China. The 5-year disease-free survival rate is 82%, reaching the international level.
The genetic susceptibility genes of myeloid tumors were systematically studied, and it was confirmed that the genetic susceptibility backgrounds of myelodysplastic syndrome, chronic myeloid leukemia and acute myeloid cells were different. Individualized therapy under the guidance of pharmacogenomics is the first in China. This strategy can further improve the clinical efficacy, reduce adverse drug reactions and save medical expenses.
Lymphoma treatment center
Lymphoma diagnosis and treatment center is a center for the diagnosis, treatment and research of malignant lymphoproliferative diseases such as malignant lymphoma, multiple myeloma, adult acute lymphoblastic leukemia and chronic lymphoblastic leukemia (WHO200 1 classified as lymphoma). To carry out research on the pathogenesis, pathological diagnosis, clinical diagnosis and clinical treatment technology of malignant lymphoma.
The center consists of two wards, namely, the conventional treatment ward and the intensive treatment and transplantation ward. There are 72 open beds in the center, including 46 conventional treatment wards and 26 intensive and transplant wards, including 5 laminar flows of 100 and 5 laminar flows of 1000. Treating patients with malignant lymphoproliferative diseases such as malignant lymphoma, multiple myeloma, adult acute lymphoblastic leukemia and chronic lymphoblastic leukemia.
Malignant lymphoma (ML): According to the pathological type, staging and prognosis score of patients, individualized treatment strategies and schemes are designed, and comprehensive treatment including conventional chemotherapy, immunotherapy, intensive chemotherapy and autologous or allogeneic hematopoietic stem cell transplantation is carried out. In recent years, we reported the treatment of the largest series (150 cases) of high-risk advanced invasive non-Hodgkin's lymphoma (NHL) invading bone marrow in China. The expected disease-free survival rate of B-cell NHL patients treated by CD20 monoclonal antibody combined with intensive therapy (immunotherapy) or autologous hematopoietic stem cell transplantation is over 65%, and the disease-free survival rate of T-cell NHL patients with poor prognosis after intensive chemotherapy is 45%.
Multiple myeloma (MM): At present, our center has become one of the largest centers in China with the highest level of diagnosis and treatment, and the level of diagnosis and treatment has reached the international advanced level. Since 2003, autologous hematopoietic stem cell transplantation has been regarded as a part of the first-line treatment for patients under 60 years old, and BDHMM03 scheme has been designed for prospective clinical research. At present, the remission rate (≥ partial remission) of newly diagnosed MM is above 80%, in which the complete or near complete remission rate (≥nCR) is above 40%, while the complete remission rate of patients undergoing autologous hematopoietic stem cell transplantation is above 60%. After 2003, the median survival time of MM treated in this center has exceeded 42 months, which is significantly higher than that of 27 months in 2002, reaching the international advanced level in the same period.
Adult acute lymphoblastic leukemia (ALL): The treatment of adult acute lymphoblastic leukemia is the traditional dominant field of lymphoma center. After more than ten years of research, we have explored a complete set of standardized holistic treatment strategies and programs for adult all, including induced remission, autologous or allogeneic hematopoietic stem cell transplantation after early intensive treatment, combined with systematic prevention and treatment of meningeal leukemia and maintenance/immunotherapy after transplantation. The five-year leukemia-free survival rate (LFS) of patients who completed the holistic treatment reached 60.5% 12.5%. This is by far the most systematic treatment scheme for adult ALL in China, and its curative effect is at the leading level in China, reaching the international advanced level.
Chronic lymphocytic hematopathy (CLL): The Center recently followed up and analyzed nearly 400 CLL cases diagnosed and treated in our hospital 1980-2006, reported the largest CLL case series in China, and found some clinical and biological characteristics of CLL in China, which laid a good foundation for further basic and clinical research of CLL.
The center has a high-quality medical team with more than 20 doctors, including 2 chief physicians, 3 deputy chief physicians, 5 attending physicians and 2 residents10-/kloc-0. More than 70% of doctors have master's and doctor's degrees. There are more than 30 nurses, including 6 nurses in charge, and more than 70% of them have college and undergraduate degrees; There are three laboratory researchers and technicians. Doctoral supervisor 1 person, 8 doctoral students and 6 master students.
As a demonstration department of holistic nursing in hematological hospital, the center has done a lot of pioneering work in establishing a holistic nursing model for patients with hematological diseases, which has won unanimous praise from patients, hospitals, Tianjin Nursing Association and superior leaders. The center actively carried out the construction of spiritual civilization and the creation of the "Youth Civilization", and was awarded the "Youth Civilization" by the Central Committee of the Communist Youth League and the Ministry of Health in 2005.
At present, the lymphoma diagnosis and treatment center undertakes the research on the key technology of umbilical cord blood hematopoietic stem cell transplantation, the expression and significance of -caterin in malignant hematological diseases, and the significance of multiple myeloma cell and molecular genetics and its prognosis stratification. At the same time, imatinib, bortezomib (velcade) combined with autologous hematopoietic stem cell transplantation, and rituximab (rituximab) combined treatment of Ph+ acute lymphoblastic leukemia were carried out.
Children's blood disease treatment center
The diagnosis and treatment center for children's hematological diseases takes the pathogenesis, diagnosis and treatment of various children's hematological diseases as the main research content, and makes systematic diagnosis and treatment plans according to different children's hematological diseases, and regularly revises and improves them according to the principles of evidence-based medicine.
There are two wards under the Children's Hematology Clinic Center, and * * * has more than 80 treatment beds, including 6 beds with thousand-level laminar flow isolation, to treat all kinds of children's hematological diseases, including all kinds of children's acute leukemia and children's bone marrow failure diseases.
The Children's Hematological Diagnosis and Treatment Center conducted the following research:
1. The study on the characteristics of extramedullary infiltration in children with acute leukemia found that mediastinal infiltration is the most common extramedullary infiltration in children with newly diagnosed acute lymphoblastic leukemia (ALL), especially in children with T-ALL. The common sites of extramedullary infiltration in children with newly diagnosed acute myeloid leukemia are central nervous system, skin, eyes and pleura. And most of them appear in t (8; 21) Children with chromosomal abnormalities in M2, M4 and M5. At the initial diagnosis, the central nervous system infiltration of AML was more common than other diseases, with a median age of 65,438 0.2 years. It is more common in men with high white blood cells, and the infiltration of central nervous system is T (8; 2 1) abnormal M2 children. During the treatment, extramedullary recurrence mainly occurred in CNSL of all children, and the incidence rate was 14. 5%. This result shows that the extramedullary infiltration of acute leukemia in children and adolescents is at T- ALL and T (8; 2 1) is associated with poor prognosis. It provides a theoretical basis for early intensive treatment of children with this kind of leukemia, reducing extramedullary recurrence and improving disease-free survival rate.
2. Cytogenetic study of children's acute lymphoblastic leukemia T (12; 2 1) and tel 2am 1 fusion genes showed t (12; 2 1) Chromosome abnormality is the most common chromosomal translocation among all children in China. It is the immunophenotype of non-T cell line, mainly ALL, and most of them are accompanied by the deletion of TEL allele. There is no significant difference in clinical manifestations and short-term efficacy between children with other non-T cell lines and children with ALL. It has different characteristics from foreign reports: older onset age, low M platelet count, high rearrangement rate and normal karyotype. Through the comparative analysis of children's Ph chromosome positive ALL(Ph+ cALL) and adults' Ph chromosome positive ALL(Ph+ aALL), it is concluded for the first time that children and adults with Ph chromosome positive have similar biological characteristics, and the difference of CD34 expression between adult group and the whole patient group can indirectly reflect the difference of prognosis related factors of Ph+ aALL and cALL.
3. Clinical efficacy of childhood acute leukemia
Based on the work of cytomorphology, immunology, cytogenetics and molecular biology (MICM), the risk group therapy for children with ALL was carried out. The total complete remission rate was over 95%, and the EFS and OS of the standard risk group were 965,438 0.5% and 84.5% respectively. The 3-year EFS and OS of the high-risk group were 55.6% and 73.9%, respectively, which were equivalent to the results reported internationally. Children with acute myeloid leukemia were divided into groups according to cytogenetic abnormalities. Yes, use t (15; 17) translocation (low risk group) AML received intensive treatment to reduce toxicity (anthracycline drugs alone). The total course of treatment was 12 months, and the cumulative recurrence rate in five years was 16%. The main causes of treatment failure are leukocytosis and early death caused by abnormal coagulation. Within five years, the cumulative EFS, DFS and OS were 72.3%, 85.0% and 85.8% respectively. The total treatment cost was significantly reduced and the quality of life was significantly improved. Yes, use t (8; 2 1) translocation (intermediate risk group) AML received early intensive treatment. Within 4 years, EFS, DFS and OS were (25.9 9.6)%, (28.410.4)% and (37.910.3)% respectively. The above information is about the study of children's myeloid leukemia with a large number of cases, and the results of these works have reached the best level reported internationally.
In addition, the center also carried out ATG combined with immunotherapy to treat severe aplastic anemia, with an effective rate of 80%. Over the years, many difficult cases of hematological diseases in children have been diagnosed and treated, such as CDA (erythroproliferative anemia in children) and γδT cell lymphoma in liver and spleen in children.
Children's Blood Center has a first-class high-quality medical team in China, specializing in pediatrics and hematology. Chief physician 1 person, 2 deputy chief physicians, 4 attending physicians, 6 residents1person and 6 masters. Doctoral supervisor 1 person. There are 28 nursing groups. There are 2 doctoral students and 3 master students.
At present, he is undertaking scientific research projects such as "Comparison of Prognosis of Children's Acute Lymphoblastic Leukemia" and "Study on Diagnosis, Standardized Treatment and Prognosis Evaluation of Children's Hematological Diseases".