Background: Pediatric acute myeloid leukemia (AML) with t(8;21) (q22;q22) is classified as a low-risk group. However, relapse is still the main factor affecting survival. We aimed to investigate the effect of allogeneic hematopoietic stem cell transplantation (allo-HSCT) on reducing recurrence and improving the survival of high-risk pediatric t(8;21) AML based on minimal residual disease (MRD)-guided treatment, and to further explore the prognostic factors to guide risk stratification treatment and identify who will benefit from allo-HSCT. Methods: Overall, 129 newly diagnosed pediatric t(8;21) AML patients were included in this study. Patients were divided into high-risk and low-risk group according to RUNX1-RUNX1T1 transcript levels after 2 cycles of consolidation chemotherapy. High-risk patients were divided into HSCT group and chemotherapy group according to their treatment choices. The characteristics and outcomes of 125 patients were analyzed.

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BackgroundThe presence of minimal residual disease (MRD) is an independent risk factor for poor prognosis in patients with acute lymphoblastic leukemia (ALL). Moreover, the role of chimeric antigen receptor T-cell (CAR-T) therapy in patients with MRD is currently unclear.MethodsWe conducted a prospective study to investigate the role of CAR-T therapy in patients with persistent/recurrent MRD-positive ALL in first remission.ResultsA total of 77 patients who had persistent/recurrent MRD were included. Of these patients, 43 were enrolled in the CAR-T group, 20 received chemotherapy as a bridge to allogeneic hematopoietic cell transplantation (allo-HSCT), and 14 patients received intensified chemotherapy. MRD negativity was achieved in 90.7% of the patients after CAR-T infusion. Patients who received CAR-T therapy had a higher 3-year leukemia-free survival (LFS) than patients who did not (77.8% vs. 51.1%, P = 0.033). Furthermore, patients in the CAR-T group had a higher 3-year LFS than those in the chemotherapy bridge-to-allo-HSCT group [77.8% (95% CI, 64.8–90.7%) vs. 68.7% (95% CI, 47.7–89.6%), P = 0.575] and had a significantly higher 3-year LFS than those in the intensified chemotherapy group [77.8% (95% CI, 64.8–90.7%) vs. 28.6% (95% CI, 4.9–52.3%), P = 0.001]. Among the patients who received CAR-T therapy, eight were not bridged to allo-HSCT, and six (75%) remained in remission with a median follow-up of 23.0 months after CAR-T infusion.ConclusionsOur findings show that CAR-T therapy can effectively eliminate MRD and improve survival in patients with a suboptimal MRD response.

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In this study, by comparing the four groups of sausages, namely, CO (without starter culture), LB (with Lactobacillus sakei), LS (with L. sakei 3X-2B + Staphylococcus xylosus SZ-8), and LSS (with L. sakei 3X-2B + S. xylosus SZ-8 + S. carnosus SZ-2), the effects of mixed starter cultures on physical–chemical quality, proteolysis, and biogenic amines (BAs) during fermentation and ripening were investigated. Inoculation of the mixed starter cultures increased the number of lactic acid bacteria and staphylococci in sausages during fermentation and ripening for 0 to 5 days. The L. sakei 3X-2B + S. xylosus SZ-8 + S. carnosus SZ-2 mixed starter accelerated the rate of acid production and water activity reduction of sausages and improved the redness value. Compared with CO, the mixed starter effectively inhibited Enterobacteriaceae. At the end of ripening, the LSS group was approximately 1.25 CFU/g, which was less than the CO group, thereby reducing the total volatile basic nitrogen (TVB-N) in the LSS group. The free amino acids in the LS and LSS groups (224.97 and 235.53 mg/kg dry sausage, respectively) were significantly (p < 0.001) higher than that in the CO group (170.93 mg/kg dry sausage). The level of histamine, cadaverine, putrescine, and common BAs showed an opposite trend to the increase of the corresponding precursor amino acid content, which were significantly lower (p < 0.001) in the LS and LSS sausages than in CO. This study showed that L. sakei 3X-2B + S. xylosus SZ-8 + S. carnosus SZ-2 is a potential mixed starter for fermented meat products.

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