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CD43 expression is an adverse prognostic factor in newly diagnosed multiple myeloma Introduction CD43 is an abundant, heavily-glycosylated, cell surface protein expressed on bone marrow hematopoietic stem cells and most white blood cells. Previous studies have found that CD43 also expressed in some types of lymphoma cells and associated with adverse outcomes. However, the prognosis value of CD43 expression in multiple myeloma (MM) remain unknown. Patients and Methods A total of 109 MM patients, newly diagnosed in Nanfang Hospital of Southern Medical University from January 2017 to December 2019, were included in the study. CD43 was detected by flow cytometre as follows: 2 ml of heparin anticoagulated bone marrow was collected from the patients at the time of diagnosis，1×10 6 cells were detected, and a gate was set for identifying abnormal plasma cells characterized by CD138 expression and CD38. CD43 positive was defined as more than 20% of the plasma cells expressed CD43. Results A total of 109 patients with newly diagnosed MM were enrolled in the study, including 77 patients (70.6%) for CD43 positive and 32 patients (29.4%) for CD43 negative . The median age was 58 years, and the male-female ratio was 1.7:1. Patients in the CD43 positive group were more likely to have international staging system (ISS) stage III (67.5% VS 46.9%, P= 0.044), hemoglobin < 85g/L (64.9% VS 37.5%, P= 0.008), 13q deletion (31.4% VS 10.4%), and higher percentage of bone marrow monoclonal plasma cells detected by flow cytometry (5.5% VS 1.4%, P=0.003). Most patients enrolled in the study received bortezomib-based treatment. The very good partial response (VGPR) or better rate after 4 induction cycles was significantly lower in the CD43 positive group than CD43 negative group (35.1% VS 56.3%, P=0.041), and the overall response rate (ORR) in the CD43 positive group was lower than that in CD43 negative group (75.3% VS 84.4%, P=0.299), but no significantly difference. The median follow-up time was 22 months. Patients with CD43 positive had significantly lower PFS (median PFS 24 months VS not reached, P =0.012), and OS (median OS not reached, P = 0.023) than those with CD43 negative. Multivariate analysis indicated that CD43 positive expression was an independent poor risk factor for PFS (HR 2.517 95%CI 1.178-5.376, P = 0.017) and OS (HR 3.664 95%CI 1.100-12.075, P = 0.034). Conclusion Our study showed that CD43 expression was an adverse prognosis for multiple myeloma. Disclosures No relevant conflicts of interest to declare.

The most widespread and harmful mental health issues are anxiety disorders. The COVID-19 pandemic, according to the World Health Organization, has led to a 25% rise in the prevalence of anxiety disorders worldwide in recent years. Due to the exceptional stress brought on by the pandemic's state of social isolation, there has been a significant rise in anxiety disorders. In addition, factors linked to depression and anxiety include loneliness, the fear of illness, suffering and death for oneself and loved ones, bereavement, and financial concerns [1]. Moreover, family factors are closely related to the occurrence and maintenance of anxiety. The family environment and the different ways parents discipline their children can lead to anxiety disorders. Parents, for example, show an overly cautious attitude toward the world, and their children may also be more prone to fear and anxiety than the average person. Because if people learn that the outside world is dangerous, they will naturally limit their exploration and risk-taking behavior. This article is a more comprehensive and in-depth understanding of anxiety disorders and how a family of origin affects anxiety. The methods used are reviewing the most pertinent and current/past literature. The results include defining anxiety disorder, DSM-5 Diagnostic Criteria, Etiology, and Treatment. This research paper could raise public awareness of anxiety disorders and how people can better cope with anxiety disorders in the future.

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