Pub Date : 2025-01-01DOI: 10.1016/j.lrr.2025.100537
Sona Rezaei , Mohammad Mohammadzadeh-Vardin , Keyvan Amirshahrokhi , Mojtaba Amani
Acute myeloid leukemia (AML) often relapses post-chemotherapy due to leukemia stem cells (LSCs), which rely on mitochondria for energy, ROS regulation, and apoptosis. Targeting mitochondrial pathways may overcome LSC resistance. This study evaluated Cytarabine (Ara-C), 2-Deoxy-d-Glucose (2-DG), and their combination on AML-derived KG1-a cells using MTT assays, showing reduced viability with combined treatment. The Magnetic sorting isolated CD34+ (stem-like) and CD34- cells. Flow cytometry revealed increased ROS and decreased mitochondrial membrane potential (MMP) in KG1-a and CD34+ cells with 2-DG and Ara-C, suggesting a promising strategy to target resistant LSCs in AML therapy.
{"title":"The synergistic effect of 2-deoxy-D-glucose and cytarabine on mitochondria of stem-like cells derived from KG1-a","authors":"Sona Rezaei , Mohammad Mohammadzadeh-Vardin , Keyvan Amirshahrokhi , Mojtaba Amani","doi":"10.1016/j.lrr.2025.100537","DOIUrl":"10.1016/j.lrr.2025.100537","url":null,"abstract":"<div><div>Acute myeloid leukemia (AML) often relapses post-chemotherapy due to leukemia stem cells (LSCs), which rely on mitochondria for energy, ROS regulation, and apoptosis. Targeting mitochondrial pathways may overcome LSC resistance. This study evaluated Cytarabine (Ara-C), 2-Deoxy-d-Glucose (2-DG), and their combination on AML-derived KG1-a cells using MTT assays, showing reduced viability with combined treatment. The Magnetic sorting isolated CD34+ (stem-like) and CD34- cells. Flow cytometry revealed increased ROS and decreased mitochondrial membrane potential (MMP) in KG1-a and CD34+ cells with 2-DG and Ara-C, suggesting a promising strategy to target resistant LSCs in AML therapy.</div></div>","PeriodicalId":38435,"journal":{"name":"Leukemia Research Reports","volume":"24 ","pages":"Article 100537"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.lrr.2025.100536
Huan Liu , Yunxia Sun , Liangliang Li , Yurong Zhang , Yaxiong Zhou , Pengyun Zeng , Lingling Yue
The use of TKIs has significantly improved the prognosis of CML. However, a small subset of patients still experience poor outcomes. We present a rare case of Ph-AML following a diagnosis of CML. The patient achieved CCyR and MMR after 4 months of nilotinib therapy, with sustained deep remission for 3 years. Unexpectedly, the disease developed rapidly to AML. Further investigations revealed the emergence of CCA/Ph- and gene mutations. We retrospectively analyzed previous CML patients with BCR::ABL1 and Ph-negative status in blast crisis from our database and conducted a comprehensive review of the relevant literature.
{"title":"Rapid development of Philadelphia chromosome-negative AML in a CML patient with sustained major molecular response to tyrosine kinase inhibitor therapy","authors":"Huan Liu , Yunxia Sun , Liangliang Li , Yurong Zhang , Yaxiong Zhou , Pengyun Zeng , Lingling Yue","doi":"10.1016/j.lrr.2025.100536","DOIUrl":"10.1016/j.lrr.2025.100536","url":null,"abstract":"<div><div>The use of TKIs has significantly improved the prognosis of CML. However, a small subset of patients still experience poor outcomes. We present a rare case of Ph-AML following a diagnosis of CML. The patient achieved CCyR and MMR after 4 months of nilotinib therapy, with sustained deep remission for 3 years. Unexpectedly, the disease developed rapidly to AML. Further investigations revealed the emergence of CCA/Ph- and gene mutations. We retrospectively analyzed previous CML patients with <em>BCR::ABL1</em> and Ph-negative status in blast crisis from our database and conducted a comprehensive review of the relevant literature.</div></div>","PeriodicalId":38435,"journal":{"name":"Leukemia Research Reports","volume":"24 ","pages":"Article 100536"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.lrr.2025.100538
Mustapha Mechtoune , Fatima Zahra Lahlimi , Illias Tazi , Hanane Rais , Houda Jouihri , Mohammed el Fadli
The association of cutaneous B-cell lymphoma and dermatofibrosarcoma is exceptional. We report the case of a 44-year-old patient with a history of Darier-Ferrand dermatofibrosarcoma who presented with cutaneous B-cell lymphoma characterized by large atypical skin lesions with an aggressive course. The patient was treated with a combination of RCHOP-type chemotherapy and surgical treatment. We shed light on this very rare association whose prognosis depends on early diagnosis and adequate management.
{"title":"Le lymphome cutanée primitif diffus à grandes cellules B : à propos d’un cas Primary cutaneous diffuse large B-cell lymphoma: a case report","authors":"Mustapha Mechtoune , Fatima Zahra Lahlimi , Illias Tazi , Hanane Rais , Houda Jouihri , Mohammed el Fadli","doi":"10.1016/j.lrr.2025.100538","DOIUrl":"10.1016/j.lrr.2025.100538","url":null,"abstract":"<div><div>The association of cutaneous B-cell lymphoma and dermatofibrosarcoma is exceptional. We report the case of a 44-year-old patient with a history of Darier-Ferrand dermatofibrosarcoma who presented with cutaneous B-cell lymphoma characterized by large atypical skin lesions with an aggressive course. The patient was treated with a combination of RCHOP-type chemotherapy and surgical treatment. We shed light on this very rare association whose prognosis depends on early diagnosis and adequate management.</div></div>","PeriodicalId":38435,"journal":{"name":"Leukemia Research Reports","volume":"24 ","pages":"Article 100538"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.lrr.2025.100504
Saja Asakrah , Kristin K. Deeb , Nikolaos Papadantonakis , George Deeb
Myeloid malignancies following treatment for plasma cell neoplasms (PCN) are infrequent but is a serious complication, often exhibiting complex karyotype and TP53 mutations. Plasma cell myeloma lineage switch to a myeloid malignancy with evident clonal relatedness is seldomly reported. Here, we report a unique case of acute myeloid leukemia with monocytic differentiation that shares clonal features with an antecedent plasma cell myeloma with t(4;14)(FGFR3::IGH). This phenomenon differs from therapy-related myeloid neoplasm arising from an unrelated clone and underscores the need to elucidate the role of mutations in pathways such as MAPK (e.g., BRAF and KRAS) into lineage plasticity.
{"title":"Trans-differentiation of plasma cell neoplasm to acute myeloid leukemia with monocytic features: Case report of divergent phenotype with identical genotype","authors":"Saja Asakrah , Kristin K. Deeb , Nikolaos Papadantonakis , George Deeb","doi":"10.1016/j.lrr.2025.100504","DOIUrl":"10.1016/j.lrr.2025.100504","url":null,"abstract":"<div><div>Myeloid malignancies following treatment for plasma cell neoplasms (PCN) are infrequent but is a serious complication, often exhibiting complex karyotype and <em>TP53</em> mutations. Plasma cell myeloma lineage switch to a myeloid malignancy with evident clonal relatedness is seldomly reported. Here, we report a unique case of acute myeloid leukemia with monocytic differentiation that shares clonal features with an antecedent plasma cell myeloma with t(4;14)(<em>FGFR3::IGH</em>). This phenomenon differs from therapy-related myeloid neoplasm arising from an unrelated clone and underscores the need to elucidate the role of mutations in pathways such as MAPK (e.g., <em>BRAF</em> and <em>KRAS</em>) into lineage plasticity.</div></div>","PeriodicalId":38435,"journal":{"name":"Leukemia Research Reports","volume":"23 ","pages":"Article 100504"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143479979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.lrr.2025.100507
Mohamed I Sharif, Ahmad S. Alotaibi, Ruah Alyamany, Ali Alahmari, Hanan Alkhaldi, Ayman Saad, Mansour Alfayez
Acute myeloid leukemia (AML) is a heterogeneous disease with diverse molecular cytogenetic characteristics. Philadelphia-positive acute myeloid leukemia, a rare subtype of AML, is traditionally considered a high-risk, with the standard recommendation being an allogeneic hematopoietic cell transplant (HCT) in first remission. More recently, with better characterization and understanding of AML biology, novel therapies have been introduced. Drawing parallels from the advances seen in Philadelphia-positive acute lymphoblastic leukemia (ALL), the question arises whether potent tyrosine kinase inhibitors (TKI), such as ponatinib, in combination with AML-directed therapies, could be used in Philadelphia-positive AML, potentially eliminating the need for HCT in the first remission.
In this report, we review the literature on Philadelphia-positive AML, study a case where HCT was omitted, and explore potential signals that could support successful HCT omission.
{"title":"The road not taken: Exploring non-transplant options in De Novo philadelphia positive acute myeloid leukemia","authors":"Mohamed I Sharif, Ahmad S. Alotaibi, Ruah Alyamany, Ali Alahmari, Hanan Alkhaldi, Ayman Saad, Mansour Alfayez","doi":"10.1016/j.lrr.2025.100507","DOIUrl":"10.1016/j.lrr.2025.100507","url":null,"abstract":"<div><div>Acute myeloid leukemia (AML) is a heterogeneous disease with diverse molecular cytogenetic characteristics. Philadelphia-positive acute myeloid leukemia, a rare subtype of AML, is traditionally considered a high-risk, with the standard recommendation being an allogeneic hematopoietic cell transplant (HCT) in first remission. More recently, with better characterization and understanding of AML biology, novel therapies have been introduced. Drawing parallels from the advances seen in Philadelphia-positive acute lymphoblastic leukemia (ALL), the question arises whether potent tyrosine kinase inhibitors (TKI), such as ponatinib, in combination with AML-directed therapies, could be used in Philadelphia-positive AML, potentially eliminating the need for HCT in the first remission.</div><div>In this report, we review the literature on Philadelphia-positive AML, study a case where HCT was omitted, and explore potential signals that could support successful HCT omission.</div></div>","PeriodicalId":38435,"journal":{"name":"Leukemia Research Reports","volume":"23 ","pages":"Article 100507"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acquired factor VII deficiency remains a rare pathology. Only 5 prior reported cases of aFVIID associated with acute myeloid leukemia (AML) have been described in the literature. Despite the rarity of these occurrences, these cases hold significant clinical and scientific implications given the need to understand the physopathology and to establish a therapeutic protocol ensuring better management.
Case presentation
A 38-year-old Arab male with AML was diagnosed at our Department of Clinical Hematology. The initial coagulation panel at admission revealed slightly low prothrombin ratio (PT) of 56 %, while the international normalized ratio (INR) and partial thromboplastin time (PTT) were within normal. Prothrombin complex coagulation factor dosing (PCCFD) confirmed an isolated reduction in the FVII in repeated samples, indicating an isolated deficiency. This patient did not present severe bleeding syndrome and had received conventional chemotherapy (cytarabine (Cytarabine)+ idarubicin). The evolution was marked by cytological remission (CR) with correction of coagulation disorders.
Conclusion
In conclusion, the intricate relationship between isolated aFVIID and AML remains mysterious. Researchers are essential to unravel the intricacies of this rare hematological condition. Further exploration into the molecular mechanisms, prognostic implications, and evolving treatment modalities is crucial to enhance the precision and efficacy of therapeutic interventions.
{"title":"Acute myeloid leukemia: A rare cause of acquired isolated factor VII deficiency","authors":"Zaineb Mlayah, Haifa Hafsa, Alaa Ghorbel, Nader Slama, Sara Boukhris, Mohamed-Adnene Laatiri","doi":"10.1016/j.lrr.2025.100516","DOIUrl":"10.1016/j.lrr.2025.100516","url":null,"abstract":"<div><h3>Background</h3><div>Acquired factor VII deficiency remains a rare pathology. Only 5 prior reported cases of aFVIID associated with acute myeloid leukemia (AML) have been described in the literature. Despite the rarity of these occurrences, these cases hold significant clinical and scientific implications given the need to understand the physopathology and to establish a therapeutic protocol ensuring better management.</div></div><div><h3>Case presentation</h3><div>A 38-year-old Arab male with AML was diagnosed at our Department of Clinical Hematology. The initial coagulation panel at admission revealed slightly low prothrombin ratio (PT) of 56 %, while the international normalized ratio (INR) and partial thromboplastin time (PTT) were within normal. Prothrombin complex coagulation factor dosing (PCCFD) confirmed an isolated reduction in the FVII in repeated samples, indicating an isolated deficiency. This patient did not present severe bleeding syndrome and had received conventional chemotherapy (cytarabine (Cytarabine)+ idarubicin). The evolution was marked by cytological remission (CR) with correction of coagulation disorders.</div></div><div><h3>Conclusion</h3><div>In conclusion, the intricate relationship between isolated aFVIID and AML remains mysterious. Researchers are essential to unravel the intricacies of this rare hematological condition. Further exploration into the molecular mechanisms, prognostic implications, and evolving treatment modalities is crucial to enhance the precision and efficacy of therapeutic interventions.</div></div>","PeriodicalId":38435,"journal":{"name":"Leukemia Research Reports","volume":"23 ","pages":"Article 100516"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.lrr.2024.100497
Kiyotaka Kawauchi , Toshie Ogasawara
Primary effusion lymphoma (PEL)-like lymphoma is a rare variant of PEL that exhibits diverse clinical behaviors, ranging from mild to aggressive disease courses. The clinicopathological features and effective treatments for this type of lymphoma have not been well defined. We found that proteasome inhibitors were effective in inhibiting the growth and survival of OGU1 cells, which were derived from a patient with aggressive PEL-like lymphoma, highlighting the critical role of proteasome activity in the proliferation of PEL-like lymphoma cells. This suggests that proteasome inhibitors, such as bortezomib, could be promising therapeutic options for patients who respond poorly to conventional chemotherapy.
{"title":"Proteasome inhibitors prevent tumor cell proliferation in HHV-8-unrelated PEL-like lymphoma","authors":"Kiyotaka Kawauchi , Toshie Ogasawara","doi":"10.1016/j.lrr.2024.100497","DOIUrl":"10.1016/j.lrr.2024.100497","url":null,"abstract":"<div><div>Primary effusion lymphoma (PEL)-like lymphoma is a rare variant of PEL that exhibits diverse clinical behaviors, ranging from mild to aggressive disease courses. The clinicopathological features and effective treatments for this type of lymphoma have not been well defined. We found that proteasome inhibitors were effective in inhibiting the growth and survival of OGU1 cells, which were derived from a patient with aggressive PEL-like lymphoma, highlighting the critical role of proteasome activity in the proliferation of PEL-like lymphoma cells. This suggests that proteasome inhibitors, such as bortezomib, could be promising therapeutic options for patients who respond poorly to conventional chemotherapy.</div></div>","PeriodicalId":38435,"journal":{"name":"Leukemia Research Reports","volume":"23 ","pages":"Article 100497"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11750559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.lrr.2025.100528
Seyedeh Kosar Rahimpour , Yasin Mirazimi , Seyedeh Zahra Shahrokhi , Mohammad Sayyadi , Maryam Kargar , Mohammad Rafiee
Acute Myeloid Leukemia (AML) demands precise diagnostic and prognostic tools for accurate detection and personalized-treatment strategies. Using Real-Time PCR, we investigated the RAF1, miR-146 b-3p, and Circ-RPL15 network expression in AML. Because RAF1 is a crucial gene involved in various ways, it is considered a potential biomarker for prognosis and diagnosis. While no significant correlation was found within the network, RAF1 expression showed a marked difference between groups. ROC curve analysis for RAF1 demonstrated promising diagnostic performance, and our bioinformatics investigations supported its strong prognostic potential. Identifying such biomarkers can aid in developing better management based on patients' characteristics.
{"title":"Diagnostic and prognostic relevance of RAF1 gene in acute myeloid leukemia","authors":"Seyedeh Kosar Rahimpour , Yasin Mirazimi , Seyedeh Zahra Shahrokhi , Mohammad Sayyadi , Maryam Kargar , Mohammad Rafiee","doi":"10.1016/j.lrr.2025.100528","DOIUrl":"10.1016/j.lrr.2025.100528","url":null,"abstract":"<div><div>Acute Myeloid Leukemia (AML) demands precise diagnostic and prognostic tools for accurate detection and personalized-treatment strategies. Using Real-Time PCR, we investigated the RAF1, miR-146 b-3p, and Circ-RPL15 network expression in AML. Because RAF1 is a crucial gene involved in various ways, it is considered a potential biomarker for prognosis and diagnosis. While no significant correlation was found within the network, RAF1 expression showed a marked difference between groups. ROC curve analysis for RAF1 demonstrated promising diagnostic performance, and our bioinformatics investigations supported its strong prognostic potential. Identifying such biomarkers can aid in developing better management based on patients' characteristics.</div></div>","PeriodicalId":38435,"journal":{"name":"Leukemia Research Reports","volume":"24 ","pages":"Article 100528"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144654378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.lrr.2025.100527
Zsolt Szakács , Tamás Habon , László Kereskai , László Gopcsa , Hussain Alizadeh
Background
Clinical presentation in acute myeloid leukaemia (AML) can result in a wide variety of clinical phenotypes.
Case Report
We report the case of a 34-year-old woman who presented with severe peri‑myocarditis and concomitant AML. The patient was treated with 5-azacitidine and venetoclax followed by haploidentical allogenic haematopoetic stem cell transplantation. Unfortunately, the patient developed febrile neutropenia and died because of overwhelming neutropenic sepsis. On autopsy, no evidence of AML was identified neither in bone marrow nor in cardiac tissue.
Conclusion
With this case report, we would like to emphasize the possibility of cardiac involvement in AML as well as the potential application of novel therapeutic agents in AML patients unfit for intensive chemotherapy.
{"title":"Case report: A young woman with acute peri‑myocarditis and acute myeloid leukaemia with myelodysplasia-related changes","authors":"Zsolt Szakács , Tamás Habon , László Kereskai , László Gopcsa , Hussain Alizadeh","doi":"10.1016/j.lrr.2025.100527","DOIUrl":"10.1016/j.lrr.2025.100527","url":null,"abstract":"<div><h3>Background</h3><div>Clinical presentation in acute myeloid leukaemia (AML) can result in a wide variety of clinical phenotypes.</div></div><div><h3>Case Report</h3><div>We report the case of a 34-year-old woman who presented with severe peri‑myocarditis and concomitant AML. The patient was treated with 5-azacitidine and venetoclax followed by haploidentical allogenic haematopoetic stem cell transplantation. Unfortunately, the patient developed febrile neutropenia and died because of overwhelming neutropenic sepsis. On autopsy, no evidence of AML was identified neither in bone marrow nor in cardiac tissue.</div></div><div><h3>Conclusion</h3><div>With this case report, we would like to emphasize the possibility of cardiac involvement in AML as well as the potential application of novel therapeutic agents in AML patients unfit for intensive chemotherapy.</div></div>","PeriodicalId":38435,"journal":{"name":"Leukemia Research Reports","volume":"24 ","pages":"Article 100527"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144654380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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