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Objective:To investigate the clinical efficacy and safety of ZR2 (zevalin + lenalidomide + rituximab) regimen in the treatment of elderly patients with diffuse large B-cell lymphoma (DLBCL).Methods:A retrospective case series study was conducted. The clinical data of 16 elderly (>65 years old) non-germinal center B-cell-like DLBCL patients treated with ZR2 regimen at the Taixing People's Hospital from January 2021 to March 2023 were retrospectively analyzed. The efficacy, adverse reactions and prognosis of patients were observed.Results:Of the 16 patients, 11 were male and 5 were female, with the age [ M ( Q1, Q3)] of 76 years old (70 years old, 78 years old), and 10 cases were Ann Arbor stage Ⅲ-Ⅳ. Among the 16 patients, 9 achieved complete remission, 4 patients achieved partial remission. All 16 patients experienced varying degrees of reversible bone marrow suppression, grade Ⅲ-Ⅳ hematologic adverse reactions included neutropenia (7 cases) and thrombocytopenia (2 cases), and the bone marrow hematopoiesis recovered after treatment with granulocyte colony-stimulating factor and thrombopoietin. The main ≥grade Ⅱ non-hematologic adverse reactions were gastrointestinal reactions (5 cases), liver function abnormalities (3 cases) and peripheral neuropathy (2 cases), which were improved after the appropriate treatment. Two patients discontinued the treatment of this regimen due to disease progression, and 1 patient died from complications after 2 cycles of treatment. No deep vein thrombosis, cardiac toxicity or renal toxicity occurred during the treatment process. Conclusions:The ZR2 regimen is effective in the treatment of elderly DLBCL patients with tolerable adverse reactions.
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Objective To analyze the relationship between the expression of WT1 gene in bone marrow mononuclear cells and the cytogenetic characteristics, curative effect and prognosis in patients with myelodysplastic syndromes (MDS). Methods The quantitative expression of WT1 gene was detected by real-time quantitative polymerase chain reaction (RQ-PCR) in bone marrow mononuclear cells of 115 MDS patients who were admitted to Taixing People's Hospital from August 2010 to March 2018, and the relationship between the expression of WT1 gene and the cytogenetic characteristics, curative effect and prognosis were evaluated. Results WT1 gene was highly expressed in 80 cases (69.6 %), lowly expressed in 15 cases (13.0 %), and unexpressed in 20 cases (17.4 %). Of the 80 patients with high WT1 expression, 56 cases (70.0 %) were refractory anemia with excess blasts (RAEB), and 22 cases (27.7 %) were refractory cytopenia with multilineage dysplasia (RCMD). In 55 patients with very poor cytogenetic prognosis, 44 patients had high expression of WT1 gene, and in 28 patients with poor prognosis, 19 patients had high expression of WT1 gene. The complete remission rate of WT1 gene high expression group [12.5 % (10/80)] was lower than that of low expression group [26.7 % (4/15)] and unexpressed group [40.0 % (8/20)], and the difference of complete remission rate between the three groups was statistically significant (χ2＝ 8.96, P< 0.05). Conclusion MDS patients with high expression of WT1 gene have low remission rate and poor prognosis.