Publications by authors named "Lai Yue-Yun"

Introduction: Central nervous system leukemia (CNSL) remains a serious complication in patients with acute myeloid leukemia (AML) and an ambiguous prognostic factor for those receiving allo-geneic hematopoiesis stem cell transplantation (allo-HSCT). It is unknown whether using more sensitive tools, such as multiparameter flow cytometry (MFC), to detect blasts in the cerebrospinal fluid (CSF) would have an impact on outcome.

Methods: We retrospectively analyzed the clinical outcomes of 1472 AML patients with or without cytology or MFC positivity in the CSF before transplantation.

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  • Adult acute myeloid leukaemia (AML) patients with complex karyotype (CK) often face poor outcomes, especially when TP53 mutations are present, impacting factors like remission rates and overall survival.
  • A study involving 73 CK-AML patients and additional validation cases found that TP53 mutations significantly worsen prognosis, while other factors like monosomal karyotype (MK) and abnormal chromosome 17 (abn(17p)) have lesser impacts.
  • The findings suggest that TP53 mutations are a crucial and independent marker for predicting adverse outcomes in CK-AML patients, indicating varying risks among these patients.
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Background: Currently, the goal of chronic myeloid leukemia (CML) treatment is normal survival and good quality of life without life-long treatment, namely, "treatment-free remission" (TFR). At present, approximately only 50% of patients with CML with a deep molecular response are able to discontinue tyrosine kinase inhibitor (TKI) without experiencing molecular relapse [MR; loss of major molecular response (MMR)]. In addition, prior interferon (IFN) treatment is associated with a higher rate of TFR.

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Objectives: Ras-related dexamethasone-induced 1 () is abnormally expressed in many solid cancers. However, its potential role in adults with B-cell acute lymphoblastic leukemia (B-ALL) is unclear. Therefore, we aim to clarify the abnormal expression of the tumor-associated biomarker, , as a potential target for diagnosis and prognosis in adult Philadelphia-negative B-ALL.

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Background: Currently, the prognostic stratification and therapeutic evaluation systems for multiple myeloma (MM) lack specific molecular indicators. OC-STAMP is a new gene and is also highly expressed in MM.

Methods: A total of 160 MM patients have been investigated with both quantitative reverse transcription PCR (RT-qPCR), flow cytometry (FCM) and cytogenetic FISH on the same mononuclear cells isolated from bone marrow specimens.

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  • This study analyzed the outcomes of 124 patients with biallelic CEBPA mutations in acute myeloid leukaemia (AML), focusing on relapse rates and survival over a 3-year period.
  • Key findings showed a 30-50% relapse rate, with a cumulative incidence of relapse at 33%, relapse-free survival at 64.7%, and overall survival at 84.3%.
  • Factors influencing outcomes included 'NGS low risk' patients, who had better survival rates, and 'MRD high risk' patients, whose sustained measurable residual disease after treatment indicated poorer prognosis; also, those who underwent allo-HSCT had improved overall survival.
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Many studies have confirmed that overexpressed WT1 exists in leukemic cells, especially in AML. However, the immunophenotypic features of this sort of leukemic cells remain to be unclarified. We retrospectively analyzed the immunophenotype of 283 newly diagnosed AML patients with intermediated and poor cytogenetic risk to evaluate the correlation between phenotype and WT1 overexpression.

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The prognostic significance of Wilms' tumor gene 1 (WT1) expression at diagnosis in adults with B cell precursor acute lymphoblastic leukemia (BCP-ALL) remains poorly understood. A total of 257 adults with Ph-negative BCP-ALL who were consecutively diagnosed and received at least 1 course of induction therapy at our institute were retrospectively analyzed. The WT1 expression patterns were significantly different among the molecularly and cytogenetically defined groups (E2A-PBX1, TEL-AML1, and MLL rearrangements; high hyperdiploidy and B-other).

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  • * Results showed that ploidy significantly impacts overall survival, particularly for R-ISS stage II patients, with non-hyperdiploid individuals having worse outcomes.
  • * The findings indicate that high-risk patients can be identified through karyotyping abnormalities, making conventional karyotyping a valuable tool alongside the R-ISS for prognostic assessment.
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Refinement of risk stratification in Philadelphia chromosome (Ph)-negative B-cell acute lymphoblastic leukaemia (ALL) might aid the identification of patients who are likely to relapse. Abnormal S100 calcium binding protein A16 (S100A16) has been implicated in various cancers, but its function remains unclear. We found S100A16 transcript levels were higher in 130 adults with newly-diagnosed Ph-negative B-cell ALL compared with 33 healthy controls.

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  • - The study aimed to evaluate a flow cytometric scoring system for diagnosing myelodysplastic syndromes (MDS) by analyzing the cell types in 130 MDS patients compared to healthy and pathological controls.
  • - Results showed that a two-parameter scoring system outperformed both a four-parameter system and an erythroid scoring system, achieving a sensitivity of 76.1% and a specificity of 81.5% for low-risk MDS.
  • - Combining scoring systems improved sensitivity to 87.0%, but decreased specificity to 54.6%, suggesting that the two-parameter system alone is effective for accurate low-risk MDS diagnosis.
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  • * Out of the patients, 83 (1.7%) were found to have 19 uncommon transcripts, with e19a2, e13a3/e14a3, and e1a2 being the most common.
  • * Patients with certain uncommon transcripts (e19a2, e1a2) showed poorer treatment responses and survival rates compared to those with more common transcripts, emphasizing the significance of rare transcripts on TKI therapy outcomes.
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Relapse remains one of the major obstacles in Philadelphia chromosome-positive acute lymphoblastic leukemia (PhALL) even after allogeneic hematopoietic stem cell transplantation. The persistence of leukemia-propagating cells (LPCs) may lead to the recurrence of PhALL. Using a xenograft assay, LPCs enrichment in the CD34CD38CD58 fraction in PhALL was recently identified.

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  • Acute myeloid leukemia (ICR-AML) patients need to be grouped based on gene expression levels to predict outcomes, particularly focusing on the EVI1 transcript.
  • A study involving 191 adult patients showed that an EVI1 level of 1.0% was the key cutoff for predicting relapse and poor survival rates, identifying 12% of these patients as high-risk.
  • High EVI1 expression (≥1.0%) is an independent risk factor for worse relapse-free, disease-free, and overall survival rates in ICR-AML patients undergoing chemotherapy, indicating the need for tailored treatment approaches.
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The pathogenesis of corticosteroid-resistant immune thrombocytopenia (ITP), a clinically challenging condition in which patients exhibit either no response to corticosteroids or are corticosteroid-dependent, remains poorly understood. Murine studies suggest that bone marrow (BM) endothelial progenitor cells (EPCs) play a crucial role in regulating megakaryocytopoiesis. However, little is known regarding the number and function of BM EPCs or how to improve impaired BM EPCs in corticosteroid-resistant ITP patients.

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Patients with standard-risk adult acute lymphoblastic leukemia (ALL) treated with chemotherapy do not have satisfactory outcomes. To more precisely classify ALL patients and optimize treatment, we re-evaluated the risk stratification system by examining CD20 expression and other classic risk factors at diagnosis. We retrospectively analyzed response to induction chemotherapy of 217 consecutive patients with newly diagnosed Philadelphia-negative B cell precursor-ALL.

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Background: Azacitidine safety and efficacy were established in studies of mainly Caucasian patients. Differences in drug metabolism enzymes between Caucasian and East Asian populations prevent extrapolation of drug effects between these groups. This phase 2 study evaluated azacitidine safety, efficacy and pharmacokinetics in patients with higher-risk myelodysplastic syndromes (HR-MDS) in mainland China.

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Background: As one of the major treatment obstacles in Philadelphia chromosome-positive acute lymphoblastic leukemia (PhALL), relapse of PhALL may result from the persistence of leukemia-propagating cells (LPCs). Research using a xenograft mouse assay recently determined that LPCs were enriched in the CD34CD38CD58 fraction in human PhALL. Additionally, a cohort study demonstrated that PhALL patients with a LPCs phenotype at diagnosis exhibited a significantly higher cumulative incidence of relapse than those with the other cell phenotypes even with uniform front-line imatinib-based therapy pre- and post-allotransplant, thus highlighting the need for novel LPCs-based therapeutic strategies.

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Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains an important curative option for children with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) who have a poor response to chemotherapy plus imatinib. For such children, if there are no matched related or unrelated donors, alternative donor transplantation may be a choice. The role of haploidentical donor (HID) HSCT in pediatric patients with Ph+ ALL has not been reported.

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Objective: To investigate the efficiency of direct fluorescence in situ hybridization (D-FISH) versus FISH on CD138 immunomagnetic sorting myeloma cells (MACS-FISH) to detect the cytogenetic abnormalities of multiple myeloma.

Methods: Thirty-one patients with multiple myeloma (MM) were detected by D-FISH and MACS-FISH, using 5 probes, including 1q21, D13S319, RB1, IgH, P53. The IgH rearrangement positive patients were further examined by 3 IgH rearrangement subtype FISH probes including IgH/FGFR3, IgH/MAF and IgH/CCND1.

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Relapse is the major cause of treatment-failure in adults with B-cell acute lymphoblastic leukemia (ALL) achieving complete remission after induction chemotherapy. Greater precision identifying persons likely to relapse is important. We did bio-informatics analyses of transcriptomic data to identify mRNA transcripts aberrantly-expressed in B-cell ALL.

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To investigate the impact of the combination of early molecular and cytogenetic responses on the achievement of MR4.5, 228 newly diagnosed chronic phase chronic myeloid leukemia patients treated with imatinib were categorized into 3-month and 6-month concordant optimal, discordant, concordant warning, and failure groups. Among them, 85.

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Background: Acute myeloid leukemia (AML) with t(8;21) is a heterogeneous disease. Identifying AML patients with t(8;21) who have a poor prognosis despite achieving remission is important for determining the best subsequent therapy. This study aimed to evaluate the impact of Wilm tumor gene-1 (WT1) transcript levels and cellular homolog of the viral oncogene v-KIT receptor tyrosine kinase (C-KIT) mutations at diagnosis, and RUNX1-RUNX1T1 transcript levels after the second consolidation chemotherapy cycle on outcomes.

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The SET nuclear proto-oncogene (SET)-nucleoporin (NUP)214 fusion gene, which results from cryptic t(9;9)(q34;q34) or del(9)(q34.11q34.13), is a rare genetic event in hematological malignancies.

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