Background. Aplastic anaemia (AA) is a highly prevalent blood disorder in the East and Southeast Asian countries, and a proportion of the patients is poorly treated with immunosuppressive agents. This study is aimed at exploring the effects of sodium copper chlorophyllin (SCC) on rats with AA and at providing the theoretical basis for the treatment of AA using traditional Chinese medicine. Methods. A rat model of AA was induced by combining 5-fluorouracil with busulfan, and different groups were treated with 25mg/kg cyclosporin A (CsA) and low-, medium-, and high-dose SCC (25-, 50-, and 100-mg/kg; L-, M-, and H-SCC, respectively). A comparative analysis of peripheral blood counts, T-cell subsets, cytokine levels, bone marrow pathology, and APO-1 expression in mesenchymal stem cells in each group was conducted. Results. SCC can increase the platelet count and haemoglobin concentration in the peripheral blood of AA rats, whereas bone marrow biopsies revealed that the number of nucleated cells and megakaryocytes of SCC-treated rats increased compared with the model group. This was particularly evident in the H-SCC group. As regards the correction of immune function, unlike CsA, which reduced the absolute CD8+ T-cell count, SCC corrected the imbalanced CD4/CD8 ratio by increasing the absolute CD4+ T-cell count, whereas SCC increased the number of regulatory T-cells and reduced the level of interferon-γ in AA rats. When comparing the expression of APO-1 in the MSCs, results of the reverse-transcriptase polymerase chain reaction and Western blot analysis showed that SCC can increase the expression of APO-1 both at the mRNA and protein levels. Conclusion. We found that SCC can improve haematopoietic function and regress immune disorders in AA rats, which enhanced the expression of APO-1 in bone marrow MSCs. This may be one of the mechanisms of SCC in treating AA.

Early T-cell precursor acute lymphoblastic leukemia (ETP-ALL) is a highly aggressive subtype of T-ALL. No standard chemotherapy regimen exists for patients with recurrent/refractory (R/R) ETP-ALL; in these patients, the primary goal of salvage therapy is to achieve remission as a foundation for consolidation and intensification treatments. This study reports cases of two patients with R/R ETP-ALL who underwent salvage therapy of venetoclax combined with the CAG regimen and achieved complete remission in the bone marrow. Flow cytometry results were negative for minimal residual disease. Both patients were bridged to allogeneic hematopoietic stem cell transplantation (HSCT) and in complete remission over a 3-year follow-up period. These cases show that the use of venetoclax combined with the CAG regimen may offer patients with R/R ETP-ALL an opportunity for allogeneic HSCT.

Introduction Early antibacterial treatment is critical for patients with hematologic malignancies (HMs) and sepsis. Droplet digital polymerase chain reaction (ddPCR) can rapidly detect pathogens and antimicrobial resistance (AMR) genes, but its clinical value in HMs is unknown. This study aimed to systematically evaluate the role of ddPCR in diagnosis, clinical outcomes, and antimicrobial stewardship. Methods From January 2023 to March 2025, 400 patients with hematologic malignancies (HMs) and sepsis were enrolled in the study. Of these, 150 received both ddPCR and blood culture (BC), while 250 underwent BC alone. Using propensity score matching (PSM), as well as subgroup and sensitivity analyses, we evaluated ten indicators, including 28-day mortality, treatment efficacy, and antibiotic use density (AUD). Results ddPCR showed a 49.33% positive rate (vs. BC’s 17.50%, P < 0.01) with a 4.06-h diagnostic turnaround (vs. 72.47 h for BC, P < 0.01), achieving 70.37% sensitivity and 55.28% specificity. The ddPCR group had lower 28-day mortality (HR = 0.55, P = 0.01), higher clinical response rates, and greater inflammatory marker decline. Antimicrobial optimization via ddPCR improved efficacy to 85.11%, with reduced AUD (OR = − 28.93, P < 0.01), the quantity and proportion of combined antimicrobial usage. However, a non-significant difference was observed in the proportion of antibacterial treatment costs (P = 0.14). PSM and sensitivity analysis results were consistent, indicating data robustness. Conclusions ddPCR outperforms BC in diagnostic efficiency for patients with HMs and sepsis, accelerating pathogen and AMR genes identification, optimizing antibacterial therapy and management, improving clinical effectiveness, and reducing 28-day all-cause mortality. The findings support the application of ddPCR in immunosuppressed populations. Graphical Abstract

Certain types of primary tumor, particularly triple primary tumors with germline mutations, are rare. The present study reports a novel case of the metachronous occurrence of three pathological conditions, namely, non‑small‑cell lung cancer (NSCLC), early T cell precursor acute lymphoblastic leukemia (ETP‑ALL) and SCLC. The present study used next‑generation sequencing to aid diagnosis. A 44‑year‑old male patient presented to The First Affiliated Hospital Zhejiang University School of Medicine (Hangzhou, China) in September 2016.) with a nodule in the right lower lung during an annual checkup. Then, the patient was diagnosed with poorly differentiated NSCLC (T1N2M0; stage IIIA) and underwent surgical resection and biopsy. In September 2018, the patient was diagnosed with ETP‑ALL with superficial lymphadenopathy. Germline testing demonstrated germ cell variants of ERCC excision repair 6, chromatin remodeling factor (ERCC6; c.1322A>G) and LYL1 basic helix‑loop‑helix family member (LYL1; c.587T>A). In November 2020, the patient was diagnosed with SCLC by bronchoscopic biopsy following allogeneic hematopoietic stem cell transplantation. The patient was diagnosed with lung cancer in October 2016 and the treatment were: surgery, chemotherapy, radiotherapy, and targeted therapy. In October 2018, the patient was diagnosed with ETP‑ALL and the treatment were: chemotherapy and allogeneic hematopoietic stem cell transplantation. In November 2020, the patient was diagnosed with small cell lung cancer and received chemotherapy and radiotherapy. The patient died at September 2022. The present case highlighted the importance of monitoring germline mutations in patients and their families to facilitate early diagnosis, appropriate treatment and prognostic evolution in the face of rapid recurrent cancer.

Rationale: Carbapenem-resistant Klebsiella pneumoniae (CRKP) bloodstream infections are a severe complication resulting from granulocyte deficiency following chemotherapy for hematologic malignancies and have a high mortality rate. However, reports of disseminated organ infections secondary to bloodstream infections are rare. Patient concerns and diagnoses: We report 2 cases of patients with acute lymphoblastic leukemia who both developed CRKP bloodstream infections during the granulocyte deficiency stage following chemotherapy, with 1 case of secondary bacterial liver abscess and 1 case of secondary septic arthritis. Interventions and outcomes: Based on the results of drug sensitivity testing, both patients were treated with ceftazidime–avibactam, and the infections were rapidly and effectively controlled without significant adverse effects. Lessons: Ceftazidime–avibactam exhibited satisfactory efficacy and safety in the 2 cases of disseminated organ infection secondary to CRKP bloodstream infection following chemotherapy for acute lymphoblastic leukemia.