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Objective@#To evaluate the efficacy and safety of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in prophylaxis neutropenia after chemotherapy in patients with lymphoma.@*Methods@#This was a multicenter, single arm, open, phase Ⅳ clinical trial. Included 410 patients with lymphoma received multiple cycles of chemotherapy and PEG-rhG-CSF was administrated as prophylactic. The primary endpoint was the incidence of Ⅲ/Ⅳ grade neutropenia and febrile neutropenia (FN) after each chemotherapy cycle. Meanwhile the rate of antibiotics application during the whole period of chemotherapy was observed.@*Results@#①Among the 410 patients, 8 cases (1.95%) were contrary to the selected criteria, 35 cases (8.54%) lost, 19 cases (4.63%) experienced adverse events, 12 cases (2.93%) were eligible for the termination criteria, 15 cases (3.66%) develpoed disease progression or recurrence, thus the rest 321 cases (78.29%) were into the Per Protocol Set. ②During the first to fourth treatment cycles, the incidences of grade Ⅳ neutropenia after prophylactic use of PEG-rhG-CSF were 19.14% (49/256) , 12.5% (32/256) , 12.18% (24/197) , 13.61% (20/147) , respectively. The incidences of FN were 3.52% (9/256) , 0.39% (1/256) , 2.54% (5/197) , 2.04% (3/147) , respectively. After secondary prophylactic use of PEG-rhG-CSF, the incidences of Ⅳ grade neutropenia decreased from 61.54% (40/65) in the screening cycle to 16.92% (11/65) , 18.46% (12/65) and 20.75% (11/53) in 1-3 cycles, respectively. The incidences of FN decreased from 16.92% (11/65) in the screening cycle to 1.54% (1/65) , 4.62% (3/65) , 3.77% (2/53) in 1-3 cycles, respectively. ③The proportion of patients who received antibiotic therapy during the whole period of chemotherapy was 34.39% (141/410) . ④The incidence of adverse events associated with PEG-rhG-CSF was 4.63% (19/410) . The most common adverse events were bone pain[3.90% (16/410) ], fatigue (0.49%) and fever (0.24%) .@*Conclusion@#During the chemotherapy in patients with lymphoma, the prophylactic use of PEG-rhG-CSF could effectively reduce the incidences of grade Ⅲ/Ⅳ neutropenia and FN, which ensures that patients with lymphoma receive standard-dose chemotherapy to improve its cure rate.
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Objective To evaluate the effect of single-nucleotide polymorphisms at the miRNA binding site rs3660 in the 3'-untranslated region of the KRT81 gene (miR-SNPs) on the cancer risk and clinical prognosis of non-Hodgkin's lymphomas (NHL).Methods The single-nucleo-tide polymorphisms of rs3660 was genotyped with ligation detection reaction method.The association of rs3660 with NHL survival was calculated with log-rank test using Kaplan-Meier method.Multivariate survival analysis was performed using a Cox proportional hazards model.Results The rs3660 genotype distribution difference was not statistically significant between the case and control group (P =0.50).Patients carrying the rs3660 CG/CC genotype exhibited a significantly longer survival time than patients carrying the GG genotype (P =0.012).In addition,rs3660 was associated independently with the survival of NHL patients in multivariate analysis (RR=0.589,95% CI:0.415-0.832,P =0.004).The association of this miR-SNP with NHL survival was further confirmed in the peripheral T cell lymphoma (PTCL) subtype.Conclusion Our results indicate that KRT81 rs3660 GG type is an independent prognostic marker in NHL.
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<p><b>OBJECTIVE</b>A prospective, multicenter and non-interventional prospective study was conducted to evaluate the clinical features of rituximab combined with chemotherapy (R-Chemo) as first-line treatment on newly diagnosed Chinese patients with diffuse large B-cell lymphoma (DLBCL).</p><p><b>METHODS</b>This was a single arm, prospective, observational multicenter and phase IV clinical trial for 279 patients, who were newly diagnosed as CD20-positive DLBCL from 24 medical centers in China 2011 and 2012, no special exclusion criteria were used. All patients received rituximab based R-Chemo regimes, such as R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisolone) and other regimes as the first-line treatment. The treatment strategies were determined by physicians and patients without detailed description for treatment course, dose, interval time and examination. Clinical response and safety of all patients were investigated in 120 days after completion of last dose of rituximab.</p><p><b>RESULTS</b>Of 279 patients, 258 with stage I-IV who received at least 1 cycle of rituximab treatment and completed at least one time of tumor assessment were enrolled into intention-to-treat analysis, including 148 male and 110 female. The median age of all patients was 57.2(12.8-88.4) years. ECOG performance statuses of 0 or 1 were observed in 91.1% of patients, international prognostic index levels in the low-risk and low-middle-risk groups in 76.4% of patients, the tumor diameters smaller than 7.5 cm in 69.0% of patients. All patients received 6 median cycles of R-Chemo treatment every 24.4 days. R-CHOP treatment was shown to improve the clinical response with overall response rates of 94.2%. Common adverse events included anemia, marrow failure, leukopenia, thrombocytopenia, digestive diseases, infection and liver toxicity. All adverse events are manageable.</p><p><b>CONCLUSION</b>Non-interventional clinical trial of R-Chemo remains the standard first-line treatment for newly diagnosed patients with DLBCL in real clinical practice, which is consistent with international treatment recommendations for DLBCL patients. R-Chemo can provide the clinical evidence and benefit as the first-line standard treatment for Chinese patients with DLBCL.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Antibodies, Monoclonal, Murine-Derived , Therapeutic Uses , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Lymphoma, Large B-Cell, Diffuse , Drug Therapy , Prospective Studies , Rituximab , Treatment OutcomeABSTRACT
Pregnancy complicated by non-Hodgkin's lymphoma (NHL) has rarely been reported. Few reports in the medical liter-ature focus on pregnancy complicated by both NHL and hepatitis B virus infection. A multidisciplinary discussion is conducted concern-ing the treatment of the patient. The standard treatment procedure for pregnancy complicated by non-Hodgkin's lymphoma and the cre-ation of a multidisciplinary team were also discussed.
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Histone methyltransferase modulates heterochromatin formation,genomic imprinting and genetic transcription by regulating the combination of histones and DNA.As encoding genes of histone methyltransferase,mixed-lineage leukemia (MLL) genes are found to have close relationship with tumors.Recently,MLL2,a member of this family,has been found highly expressed anomalously in breast cancer,colorectal cancer and lymphoma.Whether MLL2 participates in the progression of cancer,the time phase of its participation and its specific role are still remained to further study.
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Primary breast lymphoma (PBL) is a kind of rare primary extranodal lymphoma, which is of relatively poor prognosis and so far there is no unified treatment. In the case diagnosed by Our hospital where one patient recurring breast diffuse large B cell lymphoma (DLBCL) many times, has been treated with good therapeutic effect through surgery, chemotherapy, targeted drug therapy and radiotherapy. A multidisciplinary discussion is made concerning the treatment of the patient in this article for the purpose of further discussing the standard treatment procedure for PBL and promoting multi-disciplinary team.
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Objective To observe ultrasonic and PET/CT features of malignant lymphoma after chemotherapy and to determine the value in assessment of lymphoma treatment response.Methods Seventy-seven lymph nodes in 32 patients were observed and measured with color Doppler ultrasound and PET/CT after chemotherapy comparing with pathologic results.Results Seventy-two lymph nodes were exactly certified by ultrasound(94.8%),and seventy-five nodes were exactly confirmed by PET/CT(97.4%).There were significant differences in L/S,blood supply type,Vmax,Vmin,RI(P<0.05)between nodes groups with and without residual tumor.The PET/CT inspection demonstrates that lymph nodes with residual tumor was in the high metabolism condition.The positive nodes'index of ultrasound were connected with their metabolism condition.Conclusions The two methods all have high rate of accuracy.Ultrasound can be used as normal method in assessment of lymphoma treatment response.