Preliminary clinical measurement of the expression of B-cell activating factor in Chinese systemic lupus erythematosus patients.

It has recently been found that excessive serum B-cell activating factor (BAFF) production triggers severe autoimmune disorders in mice resembling systemic lupus erythematosus (SLE). Whether such dysregulation in circulating levels of BAFF results from overexpression of BAFF gene in clinical patients with SLE is still unclear. In this study, we investigated the relationship between the expression of BAFF and SLE. Here, circulating levels of BAFF were measured in 59 Chinese patients with SLE using enzyme-linked immunosorbent assay (ELISA). In addition, we have quantified the specific mRNA levels of BAFF in unstimulated peripheral-blood mononuclear cells (PBMNCs) using real-time polymerase chain reaction (PCR). Serum samples of all SLE patients were also assayed for quantitative immunoglobulins (IgG, IgA, IgM) and anti-double-stranded DNA (anti-dsDNA) antibody levels, and compared with samples from 40 healthy control subjects. Serum BAFF levels in all SLE patients were significantly elevated (P<0.001) and correlated with the levels of IgG and the titers of anti-dsDNA antibody (r=0.442, r=0.85, P<0.00). More importantly, 66% (39/59) of these SLE patients had significantly higher levels of blood BAFF mRNA, closely paralleling with serum BAFF levels (r=0.652, P<0.001). Dysregulation of BAFF is relatively common in Chinese patients with SLE. Excessive serum BAFF production may result from overexpression of the BAFF gene. BAFF also plays an important role in activating specific autoreactive B cells and modulating the production of autoantibodies.

Radiotherapy with concomitant weekly docetaxel for Stages III/IV oropharynx carcinoma. Results of the 98-02 GORTEC Phase II trial.

PURPOSE: We designed a prospective Phase II clinical trial to evaluate the addition of weekly chemotherapy using Docetaxel during standard radiation therapy in patients with Stages III and IV oropharynx carcinoma. METHODS: A total of 63 patients have been entered in a Phase II multicenter trial. Radiotherapy delivered, with conventional fractionation, 70 Gy in 35 fractions. Patients received during the period of radiotherapy seven cycles of Docetaxel (20 mg/m2 each week). RESULTS: Radiotherapy compliance was good in respect to total dose, treatment duration, and treatment interruption. The rate of Grade 3 and 4 mucositis was 84%. Grade 3 and 4 skin toxicity occurred in 53% of the patients. Hematologic toxicity was infrequent, with only a 5% rate of Grade 3 or 4 neutropenia. Three-year overall actuarial survival and disease-free survival rates were, respectively, 47% (95% CI = 39-68%) and 39% (95% CI = 30-57%). The local and regional control rate was 64%. CONCLUSION: The adjunction of weekly Docetaxel to conventional radiotherapy is feasible. Mucositis and skin toxicity were the major acute toxic effects. Therapeutic results were similar to those observed with concomitant chemotherapy using platinum and/or 5-FU. Further trials using Docetaxel in combination with other cytotoxic agents are needed.