Chronic myeloid leukemia (CML) is a malignant clonal disease of hematopoietic stem cells driven by the BCR-ABL fusion gene. Although tyrosine kinase inhibitors (TKIs) serve as targeted therapies, drug resistance remains one of the key challenges affecting the long-term survival of CML patients. A novel iron-based nano-reagent of Mn-Zn Ferrite was constructed to explore its role in regulating the redox homeostasis of CML cells and to clarify its therapeutic potential in reversing drug resistance in CML. CCK8 experiments were used to evaluate the effect of Mn-Zn Ferrite nanoparticles (Nano-Iron) on the drug sensitivity of adriamycin in K562 cells and adriamycin-resistant K562 cells (K562/ADR). Apoptosis, reactive oxygen species (ROS) levels, superoxide dismutase (SOD) levels in K562 cells and K562/ADR cells were measured after treatment of Nano-Iron and adriamycin. Further detection was conducted on the levels of glutathione (GSH), oxidized glutathione (GSSG) and GSH/GSSG ratio in K562 cells and K562/ADR cells after combined intervention. Meanwhile, the expression of glutathione peroxidase 4 (GPX4) and malondialdehyde (MDA) levels after combined intervention were determined. In vivo experiments involved in constructing systemic metastasis tumor models of K562 and K562/ADR in mice, which were treated with Nano-Iron and adriamycin. On the 10th, 15th and 20th day after tumor formation, in vivo imaging and medial canthal vein blood collection were performed to evaluate the proportion of tumor cells in peripheral blood. All mice were weighed regularly and euthanized when showing mental depression, at the same time, another batch of mice were used to calculate their survival period. Spleens and femurs were collected for hematoxylin–eosin (HE) and GPX4 staining. Mn Zn ferrite (Nano-Iron) enhances the sensitivity of K562/ADR cells to adriamycin. After co-treatment with Nano-Iron and adriamycin, more apoptosis of K562/ADR cells was induced and accompanied with an increase of ROS and MDA levels, as well as a decrease of GSH/GSSG ratio and GPX4 expression. In vivo experiments have shown that the combination therapy of Nano-Iron and adriamycin prolongs the survival period of mice, significantly inhibits the infiltration of tumor cells in the bone marrow and suppresses the expression of GPX4 in the femur of mice. Mn-Zn Ferrite (Nano-Iron) enhances the therapeutic sensitivity of K562/ADR cells to adriamycin by inducing ferroptosis, demonstrating the therapeutic potential in reversing drug resistance.

PM–PLGA–DOX/GEM nanoparticles can enhance anti-tumor immunity by recruiting and activating cytotoxic T lymphocytes based on immunogenic activation and immunosuppressive reversion.

A 52-year-old woman complained of inguinal lymph node enlargement, low fever and night sweats for 20 days. After pathological biopsy and metagenomic sequencing, she was diagnosed as having Bartonella henselae infection. Her lymph nodes were accompanied by multiple ulcers in the affected area and sinus formation. Azithromycin was administered according to the Sanford Guide to Antimicrobial Therapy 2020, combined with wound repair and partial resection of inguinal lymph nodes. The patient showed good recovery after the operation. In all, lymphadenitis associated with B. henselae infection is difficult to diagnose. Lymphadenitis with suppuration and sinus formation needs multidisciplinary consultation. When the causal pathogen is unknown, metagenomic sequencing is recommended for a definite diagnosis.

Dear Editor, Venetoclax and azacitidine (VA) is now a leading initial therapy for elderly acute myeloid leukemia (AML) patients ineligible for intensive chemotherapy [1]. Real-world data suggests that compared with conventional intensive chemotherapy, venetoclax plus azacitidine has similar outcomes in AML patients, especially older patients [2-4]. The VA regimen is also feasible in AML patients suitable for intensive chemotherapy [5, 6]. The VIALE-A trial showed encouraging results, with 43.4% of patients reaching complete remission (CR) or CR with incomplete hematologic recovery (CRi) after one cycle. The optimal CR/CRi rate was 66.4%, and median overall survival (OS) was 14.7 months [1]. Meanwhile, many large-scale trial data showed that venetoclax and azacitidine enabled about 60% of newly diagnosed AML patients to achieve CR/Cri [2-4]. Therefore, enhancing CR rates and survival outcomes in elderly AML patients at diagnosis is essential. Granulocyte colony-stimulating factor (G-CSF), a pharmacologic agent that induces neutrophil mobilization, has shown clear efficacy in several intensive regimens, such as FLAG and CAG [7, 8]. Thus, we launched this clinical trial to assess the VAG regimen's effectiveness and safety. A total of 38 eligible was enrolled in this single-arm, multicenter, prospective, phase 2 study (The Chinese Clinical Trial Registry: ChiCTR2200063954). The main eligibility criterion included a confirmed diagnosis of newly diagnosed AML according to the European Leukemia Net (ELN) 2022 guidelines [9]. For patients 75 or with specific comorbidities (cardiac, pulmonary, renal, or hepatic dysfunction, other conditions), standard induction therapy is not recommended. Exclusion criteria included prior hypomethylating agents, venetoclax, or chemotherapy for myelodysplastic syndrome, acute promyelocytic leukemia, myeloproliferative neoplasms, central nervous system leukemia, as well as positive for hepatitis B/C virus, and human immunodeficiency virus. The protocol was ethically approved by the First Affiliated Hospital of Xi'an Jiaotong University, with researchers following the Helsinki Declaration. All participants signed informed consent. All patients received induction treatment with venetoclax orally once daily (escalating from 100 to 400 mg over days 1-21), azacitidine subcutaneously (75 mg/m 2 , days 1-7), and G-CSF subcutaneously (5 µg/kg/d, days 1-7). Bone marrow examinations were conducted between days 28 and 42 after induction therapy. If CR or CRi was achieved, the patient continued consolidation treatment with venetoclax (400 mg, days 1-14), azacitidine (75 mg/m 2 , days 1-7), and G-CSF (5 µg/kg/d, days 1-7). Consolidation therapy at least included 7 cycles.

Background: In diffuse large B-cell lymphoma (DLBCL), bone marrow (BM) involvement includes two types that are concordant involvement and discordant involvement. It has been reported that concordant BM involvement has a worse prognosis than discordant involvement in previous studies. However, the prognostic effects of concordant or discordant BM involvement on DLBCL still need further research. In this work, DLBCL cases with BM involvement were collected and analyzed to better reflect the prognostic implications of concordant and discordant BM involvement. Methods: We reviewed the cases with newly diagnosed DLBCL and BM involvement from April 2018 to April 2022 in Northern Jiangsu People’s Hospital. Overall survival (OS) and progression-free survival (PFS) were accessed by the Kaplan-Meier method and compared between groups by the log-rank test. A multivariate regression analysis based on Cox proportional hazard model was used to test the independent effect of each variable on survival. Results: In total, 32 patients were included and 15 (46.9%) patients had concordant BM involvement and 17 (53.1%) patients had discordant BM involvement. Compared with the discordant group, the concordant group tended to be older and had elevated lactate dehydrogenase level. The outcome of patients with concordant BM involvement was worse than the discordant subset, including OS (P=0.04) and PFS (P=0.03). Furthermore, the discordant BM involvement was excluded to acquire a BM-adjusted International Prognostic Index (IPI) score. The significance of BM-adjusted IPI scores to predict OS was improved greatly compared with the previous IPI scores (P=0.053 vs. P=0.16). Multivariate analysis showed that the BM-adjusted IPI was an independent predictor for OS [hazard ratio =3.406; 95% confidence interval (CI): 1.145–10.127; P=0.03]. Conclusions: These results highlight the requirement for identifying BM infiltration type accurately and then adjusting the IPI score by excluding discordant BM involvement since concordant involvement can partly predict a poor prognosis of DLBCL with BM involvement other than discordant involvement.