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Objective To investigate the therapeutic effect and adverse effects of the teniposide-based regimen in patients with primary central nervous system lymphoma (PCNSL). Methods Between March 2011 and July 2013, 16 patients with PCNSL were diagnosed and treated. The clinical characteristics, diagnosis,therapy, results and adverse effects were analyzed. Results Totally 16 patients were enrolled and diagnosed as primary central nervous system diffuse large B-cell lymphoma. All patients received teniposide-based regimen chemotherapy and 9 patients received teniposide plus rituximab. The overall response rate was 87.5 % (14/16), including 10 cases of CR and 4 cases of PR. With a median follow-up of 13.5 months, the progression-free survival (PFS) and overall survival (OS) rates of 2 years were 29.9 % and 66.7 %, respectively. The mainly hematological adverse events were neutropenia, including grade 3 in 4 cases (25 %) and grade 4 just in one case. There was one case of treatment related death. Conclusions The response rate of teniposide-based regimen for PCNSL is promising. The 2 year PFS and OS rates are even higher than results of traditional high-dose methotrexate regimen. The teniposide-based regimen is well tolerated, and the adverse events are acceptable.
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Objective To analyze the clinical characteristics and recent curative effect of mantle cell lymphoma (MCL) after conventional treatment.Methods Clinical data of 15 MCL patients admitted in the Affiliated Hospital of Academy of Military Medical Sciences between August 2004 and October 2013 were retrospectively analyzed.Results The median age of those patients was 59 and the male to female ratio was 1.5∶1.Fourteen(93%)cases were in Ann-Arbor stages Ⅲ -Ⅳ, 15 cases (100%)primarily with lymph node involvement,7 cases (47%)with bone marrow involvement,4 cases (27%)with gastrointestinal involvement,and 3 cases (20%)with orbit involvement.Less than 40% expression of Ki-67 was observed in 9 cases (60%),while 6 cases were with more than 40% (40%).One case was blastic variant.First-line therapy was CHOP-like regimens,which were combined with rituximab in 8 of the 15 cases.In this study,the median survival time was 12 months (3 -64),and the overal response rate was 80%after induction chemotherapy.The current survival of 7 /9 cases with less than 40% expression of Ki-67 was 8 -64 months,2 /6 cases with more than 40% expression of Ki-67 was 8 and 9 months,respectively.Conclusion MCL mostly occurs in older males.Extranodal invasion is common in MCL as an aggressive tumor.The efficacy of traditional chemotherapy is currently limited.Blastic variant or high expression of Ki-67 is an adverse prognostic indicator.
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Objective:The effect and side effect of the dose-adjusted EPOCH regimen were evaluated perspectively for the pre-liminarily diagnosed angioimmunoblastic T-cell lymphoma. Methods: Nine cases of untreated angioimmunoblastic T-cell lymphoma were diagnosed and enrolled in our department from September 2008 to September 2012. All patients received dose-adjusted EPOCH regimen as first-line chemotherapy. Results: The median age of 9 patients was 54 years. The male-to-female ratio was 2∶1. About 88.9%of all patients were at Ann Arbor stageⅢ/Ⅳ, and 77.8%presented with B symptoms. Anemia was found in 66.7%of 9 patients, and lactate dehydrogenase elevated in 55.6%of patients. After an average of 4.7 cycles of chemotherapy of dose-adjusted EPOCH regi-men, the complete remission rate was 22.2%, and the total response rate was 66.7%. With a median follow-up of 20 months, the 4-year progression-free survival rate was 11.1%, and the overall survival rate was 33.3%. The median survival time was 19 months. The most common adverse events of EPOCH chemotherapy were hematologic toxicity. Grades 3-4 neutropenia and thrombocytopenia were re-ported in 77.8%and 33.3%of patients. Febrile neutropenia was observed in 44.4%of patients. Non-treatment-related mortality was al-so noted. Conclusion: The results of our research showed no clear benefit of treating preliminarily diagnosed angioimmunoblastic T-cell lymphoma with dose-adjusted EPOCH regimen. The main adverse events were hematologic toxicity and could be tolerated.
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Objective To analyze the clinical characteristics , diagnosis, therapy and prognosis of new diagnosed pri-mary gastric diffuse large B cell lymphoma ( PGDLBCL) and to discuss the efficacy of rituximab .Methods Between Jan 2005 and May 2012 , twenty-six new-diagnosed PGDLBCL patients were reviewed retrospectively .The clinical characteris-tics, diagnosis, therapy, results and prognostic factors were analyzed .Results There were 14 males and 12 females.Their age ranged from 25 to 82 (median, 50.1) years old.The most common symptom was stomachache .Treatment strategies were chemotherapy alone ( n=9) [ scheduled as cyclophosphamide , doxorubicin , vincristine and prednisone ( CHOP) and CHOP-like] and chemotherapy combined with rituximab (n=17), followed by radiotherapy of the stomach with or without regional nodes .All clinical and pathological features were similar between the two groups .The median follow-up time was 40 months.The overall response rate was 100%(9/9)in CHOP group, including 55.56%(5/9) CR, and 93.75%(15/16) in RCHOP group including 50%(8/16) CR (P>0.05).The total PFS and OS of 5 years were 60.3%and 74.4%respectively.The PFS in CHOP group and RCHOP group was 66.7% and 58.9%, respectively,and the OS was 66.7%and 84.6%, respectively.Although the OS of RCHOP group was much better than that of CHOP group , there was no sta-tistically significant difference.Univariate analysis showed that IPI (P<0.05) and Lugano staging (P<0.05) were inde-pendent factors of survival in patients with PGDLBCL .Conclusion Chemotherapy could be the first-line therapy of PGDL-BCL.The overall survival rate might be increased by adding rituximab to chemotherapy .The Lugano stage and IPI are im-portant prognostic factors .
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This paper explored the curative effect of combined modality therapy and extended field radiotherapy for early-stage Hodgkin's Lymphoma. 104 cases of early-stage Hodgkin's Lymphoma from Jan 1987 to Dec 2010 in PLA Hospital 307 were retrospectively analyzed, including 76 cases in combined modality therapy group and 28 cases in extended field radiotherapy group, and the long-term efficacy and toxicity of two therapy modalities were evaluated. The results showed that the median survival time of 104 cases was 85.42 months, the complete remission rates of combined modality therapy and extended field radiotherapy groups were 72.4 and 71.4 respectively (P = 0.924); the overall response rates of combined modality therapy and extended field radiotherapy groups were 97.4 and 96.4 respectively (P = 0.779); the 5-year overall survival (OS) rates in the 2 groups were 89.5 and 89.1 respectively, and the 8-year OS rates of the 2 groups were 81.3 and 70.6. No statistical difference was found in above-mentioned 2 groups. Moreover, the 5-year progression free survival (PFS) rates of these 2 groups were 84.2 and 69.0 (P = 0.04), and 8-year PFS rates of these 2 groups were 80.0 and 55.5 (P = 0.04) respectively, the 5-year relapse rates of these 2 groups were 28.1 and 45.6 (P = 0.023) respectively. It is concluded that the combined modality therapy can raise the PFS rate and reduce the relapse rate as compared with extended field radiotherapy for early-stage Hodgkin's Lymphoma, but there is no difference in the overall survival rate between the 2 groups.
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Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Young Adult , Antineoplastic Combined Chemotherapy Protocols , Combined Modality Therapy , Hodgkin Disease , Drug Therapy , Radiotherapy , Retrospective Studies , Survival Rate , Treatment OutcomeABSTRACT
This study was designed to compare the curative effect, prognosis and safety of different preconditioning regimens for patients who received autologous hematopoietic stem cell transplantation (AHSCT) for malignant lymphoma (ML). The clinical data of 100 ML patients (Sep 1992 to Aug 2010 in 307 Hospital) were retrospectively analyzed, and were divided into two groups by different preconditioning regimens: the high-dose chemotherapy preconditioning group and high-dose chemotherapy/radiotherapy preconditioning group. The overall survival (OS) rate, progress free survival (PFS) rate and adverse effect were analyzed. The results showed that until Feb 2011, the median follow-up was 33.5 months. All patients were engrafted and their hematopoiesis was reconstituted. The median time of WBC recovery up to > 1.0×1.0(9)/L in high-dose chemotherapy preconditioning group and high-dose chemotherapy/radiotherapy preconditioning group were (6.0 ± 0.4) d and (8.2 ± 0.4) d, platelet up to > 20.0×1.0(9)/L in two groups were (7.1 ± 0.8) d and (11.4 ± 2.5) d (P < 0.05). The 3-year OS rate of the two groups were 67.3% and 68.9%. 5-year OS rates of two groups were 62.8% and 60.6%, 10-year OS rates of two groups were 57.6% and 56.2% respectively; 3-year PFS of two group were 63.6% and 63.2%, 5-year of two group were 59.4% and 58.3%, 10-year of two group were 50.8% and 55.3% respectively (P > 0.05). Meanwhile, the incidence of fever, infection, bleeding, secondary cancer between two groups was not significant different (P > 0.05). It is concluded that the hematopoietic reconstitution of high-dose chemotherapy/radiotherapy preconditioning group is later than that of high-dose chemotherapy preconditioning group. However, there is no significant difference in curative effect and prognosis between the two groups.
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Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Combined Modality Therapy , Hematopoietic Stem Cell Transplantation , Lymphoma , General Surgery , Therapeutics , Prognosis , Retrospective Studies , Transplantation Conditioning , Methods , Transplantation, AutologousABSTRACT
ObjectiveTo observe the activity and safety of a novel combination therapy for patients with recurrent or refractory aggressive non-Hodgkin lymphoma (NHL).MethodsSix consecutive patients with recurrent or refractory aggressive NHL were treated with B-VIP regimen,boanmycin (5 mg/m2 on Days 1,4,8,12 and 15),vincristine (1.4 mg/m2 on Days 1,8 and 15),ifosfamide (1.2 g/m2 on Days 1,2,3 and 15,16,17) and prednisone (50 mg on Days 1 to 10),every 21 days.All the patients had received ≥5 cycles (average 8.3 cycles) of previous chemotherapy.ResultsSix patients (100 ％) were evaluable for response.The overall objective response rate was 66.7 ％ (4 patients),including 1 case complete (CR) and 3 cases partial responses.Myelosuppression was the most frequent serious complication of this regimen.ConclusionIn the current study,B-VIP was a highly active and safe combination therapy for patients with refractory disease with a poor prognosis or for patients with multiply recurrent aggressive NHL.
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This study was aimed to investigate the differences of therapeutic efficiencies, side effects and recovery rates of immune function in refractory lymphoma patients treated with autologous peripheral blood hematopoietic stem cell transplantation (APBHSCT), autologous bone marrow transplantation (ABMT) and combination of APBHSCT with ABMT (APBHSCT + ABMT) by retrospective analysis, and to evaluate the merits and demerits of 3 kinds of transplantation for treatment of refractory lymphoma. 68 patients with malignant lymphoma were treated with autologous hematopoietic stem cells transplantation. Out of 68 patients 10 cases were treated with autologous bone marrow transplantation (ABMT), 46 cases were treated with autologous peripheral blood hematopoietic stem cell transplantation (APBHSCT), and 12 cases were treated with autologous peripheral blood hematopoietic stem cells transplantation combined with autologous bone marrow transplantation (APBHSCT + ABMT). The results indicated that the therapeutic response rates and survival rates at 1, 3, 5 years for each transplant regimen were 90% and 75%, 57.1%, 33.3%; 86.4% and 74.4%, 54.2%, 38.1%; 83.3% and 72.7%, 55.6%, 40%. The times of ANC > or = 0.5 x 10(9)/L were 13, 11 and 9 days, times of platelet >/= 20 x 10(9)/L were 17, 14 and 10 days. The recovery rates of T cell subtypes in patients received ABMT, APBHSCT and APBHSCT + ABMT on 3 months, 6 months, 1 year were (0%, 33.3%, 60%), (10.8%, 32%, 73.9%), (27.3%, 55.6%, 85.7%) respectively. In conclusion, the efficacy and side effects of APBHSCT + ABMT as compared with ABMT and APBHSCT are roughly the same, but ABMT + APBHSCT can result in more rapid hematopoietic reconstitution and less restrictions with contributes to widen choice of transplant regimen for patients with alder age and impaired hematopoietic functions.
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Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Bone Marrow Transplantation , Lymphoma , General Surgery , Peripheral Blood Stem Cell Transplantation , Retrospective Studies , Transplantation, AutologousABSTRACT
<p><b>OBJECTIVE</b>To observe the effect of thalidomide in preventing nausea and vomiting induced by emetogenic cisplatin (CDDP) chemotherapy in patients with advanced non-small cell lung cancer.</p><p><b>METHODS</b>This study was carried out as a prospective, randomized control clinical trial. 61 patients with advanced non-small cell lung cancer were scheduled to receive chemotherapy (gemcitabin 1000 mg/m(2) i.v. gtt d1, 8 and CDDP 75 mg/m(2) i.v. gtt d1, GP regimen). The patients were randomly divided into a treatment and control groups. All patients in both groups received ramosetron 0.3 mg intravenously (i.v.) and metoclopramide 20 mg intramuscularly (i.m.) 30 min prior to chemotherapy to prevent nausea and emesis on day 1. In the treatment group, addition of thalidomide (50 mg p.o. bid) were administered on days 1 to 5 after the start of chemotherapy.</p><p><b>RESULTS</b>Acute nausea was effectively controlled in 74.2% of the patients in the control group and in 90.0% of treatment group. Acute vomiting was effectively controlled in 90.3% of the patients in the control group and in 93.3% of treatment group. No statistically significant differences showed in effective control of acute nausea and vomiting between the 2 groups (P = 0.108; P = 1.000). Delayed nausea was effectively controlled in 19.4% of the patients in control group and in 56.7% in the treatment group. Delayed vomiting was effectively controlled in 48.4% of the patients in control group and 76.7% in treatment group. Statistically there was a significant differences in effective control of delayed nausea and vomiting between the 2 groups (P = 0.003, P = 0.023). Both antiemetic regimens were well tolerated, and no significant difference was observed in adverse events between the 2 groups (P > 0.05).</p><p><b>CONCLUSION</b>Our results demonstrate that thalidomide is highly effective in controlling delayed nausea and vomiting episodes in patients induced by moderately emetogenic chemotherapy. Moreover, no serious toxic effects are induced by this treatment.</p>
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Female , Humans , Male , Middle Aged , Antiemetics , Therapeutic Uses , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Carcinoma, Non-Small-Cell Lung , Drug Therapy , Pathology , Cisplatin , Deoxycytidine , Lung Neoplasms , Drug Therapy , Pathology , Nausea , Neoplasm Staging , Prospective Studies , Thalidomide , Therapeutic Uses , VomitingABSTRACT
<p><b>OBJECTIVE</b>To evaluate the occurrence and management of complications following minimally invasive percutaneous nephrolithotomy (MPCNL).</p><p><b>METHODS</b>The data of 4326 cases of MPCNL from January 2001 to February 2006 were reviewed, including 2451 male cases and 1875 female cases. Their age ranged from 4 to 82 years with a mean of 42 years. Of 4326 cases, 1221 cases had simple nephrolithiasis, 1735 staghorn nephrolithiasis, 386 upper ureterolithiasis, 90 serious stone street after extracorporeal shock wave lithotripsy, and 894 residual calculi after open surgery.</p><p><b>RESULTS</b>Among the 4326 cases of MPCNL, complications occurred in 445 cases (10.3%). Of the 445 cases, 20 had massive hemorrhage, 13 pleural injuries, 1 colonic perforation, 343 fever attacks (T > 38 degrees C), 13 septic shocks, 16 perinephric urinoma, 9 perinephric abscess, 26 renal perforating injuries, 1 guide wire misled into inferior vena cava, 3 died.</p><p><b>CONCLUSIONS</b>MPCNL is a minimally invasive operation. However, serious complications would occur if the procedure were ignored. The improvement in the prevention and management of complications can promote the application of this procedure.</p>
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Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Follow-Up Studies , Kidney Calculi , General Surgery , Nephrostomy, Percutaneous , Methods , Postoperative Complications , Therapeutics , Ureteral Calculi , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To evaluate the endourological technique in the treatment of bilateral malignant ureteric obstruction.</p><p><b>METHODS</b>The data of 43 patients (totally, 70 cases) with bilateral malignant ureteric obstruction treated with endoluminal therapy were reviewed retrospectively. Of 70 cases, 38 were treated by retrograde double-J stenting, 24 by minimally invasive percutaneous nephrotomy (MPCN) and 8 by antegrade double-J stenting.</p><p><b>RESULTS</b>All patients were followed up for an average of 12 months. The retrograde double-J stenting, MPCN and antegrade double-J stenting was successfully performed in 50.0% (19/38), 100.0% (24/24) and 62.5% (5/8), respectively. Technical failures in placing retrograde double-J stent were too difficult to identify the ureteric orifice (13/38) or failing to cross the obstruction site because of severe extraluminal compression (6/38). Failure in placing antegrade double-J stent was due to severe extraluminal compression (3/8). Dislodgment of nephrostomy tubes (11/19) was the major factor which limited the application of MPCN.</p><p><b>CONCLUSION</b>It is safe and effective to treat malignant ureteric obstruction with endourological technique, and suggested initially with retrograde double-J stenting. If malignant ureteric orifice occlusion or a severe extraluminal compression is showed in the imaging, MPCN or antegrade double-J stenting may be selected according to the site and the extent of obstruction.</p>
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Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Follow-Up Studies , Nephrostomy, Percutaneous , Methods , Prostatic Neoplasms , Retrospective Studies , Stents , Stomach Neoplasms , Treatment Failure , Treatment Outcome , Ureteral Obstruction , General Surgery , Urinary Bladder Neoplasms , Uterine Cervical NeoplasmsABSTRACT
Objective To investigate the correlation between nuclear factor(NF)-?B and inflammation of cell in adriamycin-induced nephritic rats,and the intervention of antisense oligonucleotide targeting NF-?B to adriamycin-induced nephritic rats by measuring the expression of NF-?B p65 in renal cortex and the secretions of interleukin-6(IL-6),tumor necrosis factor-?(TNF-?)in serum.Methods Thirty male SD rats were divided into 5 groups(6 rats in each group):group A(sham operation),group B(glomerulosclerosis),group C(sense oligonucleotide),group D(non-sense oligonucleotide),group E(antisense oligonucleotide).Glomerulosclerosis models were made for SD rats by unilateral nephrectomy and being injected with adriamycin into caudal vein.In the 8th week,various medicine applys to correspon-ding group for intervention.At the 4th day and 8th day after intervention,the excretion amounts of 24 hours urine protein were determined.Hematoxylin-Eosin(HE) staining was used to observe the renal pathological changes.Using image analysis system to calculate glomerulosclerosis index(GI).The expression of NF-?B p65 in renal cortex was measured by immunohistochemistry staining,the secretions of IL-6,TNF-? in serum were performed by means of enzyme-linked immunosorbnent assay,respectively.Results At different time points,the expressions of active-NF-?B p65,IL-6,TNF-? in group E were significantly lower than those in group B.The intervention effects of antisense oligonucleotides at the 8th day were stronger than that at the 4th day.Conclusions NF-?B is significantly correlated with glomerulosclerosis and inflammations of glomerular intrinsic cells.Using NF-?B antisense oligonucleotide to be injected into renal artery can block directly the translation of NF-?B gene,delay inflammations of glomerular intrinsic cells and the progressions of glomerulosclerosis.
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The effects of hypoxia on the level of reactive oxygen species (ROS), IkappaBalpha tyrosine phosphorylation, transcription of P65 mRNA and NF-kappaB activation in isolated rat peritoneal macrophages were investigated by DCFH-DA fluorescence spectrophotometry, Western blotting and RT-PCR. The results obtained are as follows. (1) During hypoxia, the levels of intracellular ROS began to increase at 1 h, then reached a peak at 2 h, and began to decrease after 3 h. IkappaBalpha tyrosine phosphorylation began to rise after 2 h hypoxia and was the highest after 3 h hypoxia. After 4 h hypoxia it decreased gradually. NF-kappaB activation began to increase after 3 h hypoxia, and reached a peak after 4 h hypoxia. (2) When antioxidant NAC (500 mmol/L) was added into the medium, the level of IkappaBalpha phosphorylation showed no significant changes during hypoxia. After adding protein tyrosine kinase inhibitor genistein (200 micromol/L), NF-kappaB activation induced by hypoxia was blocked significantly. (3) The expression of p65 mRNA was also elevated markedly during hypoxia. These results suggest that hypoxia may lead to IkappaBalpha phosphorylation and NF-kappaB activation through intracellular ROS, and that the regulation of NF-kappaB activity may involve IkappaBalpha phosphorylation and the expressions of each subunit gene of NF-kappaB.