Platinum Combination Chemotherapy Is Poorly Tolerated in Malnourished Advanced Lung Cancer Patients with Poor Performance Status.

This study aimed to explore the tolerability and safety of platinum combination chemotherapy in malnourished patients with advanced non-small cell lung cancer (NSCLC) and poor performance status (PS). We retrospectively reviewed NSCLC patients with a PS of 2 who received first-line platinum combination chemotherapy at the Shizuoka Cancer Center between December 2009 and December 2014. Nutritional status was classified using the Glasgow Prognostic Score (GPS), which is an indicator of systemic inflammation and malnutrition. The malnourished group included patients with a GPS of 2, and the well-nourished group included patients with a GPS of 0-1. Among the 31 consecutive eligible patients, the malnourished group completed fewer chemotherapy cycles than the well-nourished group (median: 2 cycles vs. 4 cycles, p = 0.0091). Hematological and non-hematological toxicities were similar in both groups. The malnourished group also experienced poorer outcomes than the well-nourished group (response rate: 0% vs. 25%; median progression-free survival: 1.7 months vs. 4.9 months, p = 0.018; and median overall survival: 5.7 months vs. 8.3 months, p = 0.028). Malnutrition might decrease the tolerability and efficacy of platinum combination chemotherapy for patients with advanced NSCLC and poor PS.

Efficacy and Safety of a Weekly Cyclophosphamide-Bortezomib-Dexamethasone Regimen as Induction Therapy Prior to Autologous Stem Cell Transplantation in Japanese Patients with Newly Diagnosed Multiple Myeloma: A Phase 2 Multicenter Trial.

We assessed the efficacy and safety of weekly cyclophosphamide-bortezomib-dexamethasone (CBD) induction prior to autologous stem cell transplantation (ASCT) in newly diagnosed Japanese patients with multiple myeloma (MM). This regimen consisted of four 28-day cycles of once-weekly oral cyclophosphamide (300 mg/m2), subcutaneous bortezomib (1.3 mg/m2), and oral dexamethasone (40 mg). Responding patients underwent stem cell collection followed by ASCT. The primary endpoint was the postinduction rate of achieving a near complete response (nCR) or better. Among the 38 enrolled patients, a complete response (CR), an nCR, a very good partial response (VGPR), and a partial response (PR) were achieved in 10.5, 2.6, 23.7, and 36.8% of cases, respectively. A grade 4 hematological adverse event (AE) was observed in 1 patient. Grade 3-4 infection, including febrile neutropenia, was observed in 4 patients (10.5%). Although 2 patients dropped out due to AE, 94.7% of the patients completed the induction phase. However, because of a poor response to induction chemotherapy (

Central Nervous System Lymphoma Harboring the JAK2 V617F Mutation That Developed after a 20-year History of Polycythemia Vera.

A 78-year-old man who had a 20-year history of polycythemia vera (PV) with a JAK2 V617F mutation presented with gradually progressive disturbance of consciousness. Hyper-intense lesions in the peri-lateral ventricular area and left cerebellar hemisphere were observed by T2-weighted and fluid-attenuated inversion recovery magnetic resonance imaging. Cytologic and genetic analyses of the lymphoma cells obtained from his cerebrospinal fluid established the diagnosis of B-cell lymphoma. No lesions outside of the brain were recognized. Because of his poor general condition, he was not treated actively. A postmortem analysis revealed a JAK2 V617F mutation in the lymphoma cells, suggesting their origin was a PV clone.