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Objective To analyze the clinical characteristics,treatment regimens and influencing factors of prognosis of patients with mantle cell lymphoma(MCL).Methods The clinical data of 41 patients with MCL was collected.These patients were initially diagnosed and treated in the Fifth Medical Center of Chinese PLA General Hospital between August 2004 and December 2019.The clinical features,therapeutic efficacy and prognosis-related factors were clarified.Results The median duration of follow-up was 68(1-165)months.The 3-year progression free survival(PFS)and overall survival(OS)were 37.29%and 62.75%respectively.Based on univariate analysis,B symptoms,Eastern Cooperative Oncology Group(ECOG)scores,the mantle cell lymphoma international prognostic index(MIPI),relapse and refractory state and the therapeutic effect were statistically significant for progression free survival.B symptoms,R-chemotherapy and therapeutic effect were statistically significant for overall survival.In multivariate analysis,B symptoms and the MIPI were statistically significant for progression free survival.B symptoms,R-chemotherapy and therapeutic effect were statistically significant for overall survival.There were statistically significant differences in 3-year OS between patients with different MIPI and MIPI-C scores.Conclusion Mantle cell lymphoma mostly occurs in elder males,and is more likely to be detected in late the stage.B symptoms,R-chemotherapy and therapeutic effect are independent prognostic factors for patients with MCL.The MIPI and MIPI-C scores have clinical guidance significance for patient survival.
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Objective:To investigate the clinicopathological features, treatment and prognosis of patients with angioimmunoblastic T-cell lymphoma (AILT) complicated with Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (DLBCL).Methods:The clinical data of 2 cases of AILT with EBV-positive DLBCL in the Fifth Medical Center of PLA General Hospital were retrospectively analyzed, and the literature was reviewed.Results:One case of complex lymphoma (CL) developed from low fever with systemic superficial lymphadenopathy, the right axillary tumor biopsy showed that AILT complicated with EBV-positive DLBCL. After 8 cycles of chemotherapy, the patient reached unconfirmed complete remission, then received maintenance treatment with chidamide and survived until the deadline. Another case of discordant lymphoma began with subcutaneous nodules and then developed progressive enlargement of superficial lymph nodes. The pathological examination of subcutaneous nodule diagnosed as DLBCL, and the pathological examination of right inguinal lymph node diagnosed as AITL. After 7 cycles of chemotherapy, the patient died of hemophagocytic syndrome.Conclusions:AILT with EBV-positive DLBCL is rare. The main clinical symptom is AITL and the immunophenotypic characteristic indicates the presence of T cells and B cells. At the same time, the prognosis is poor, and the treatment strategy mainly depends on the lymphoma type with unfavorable prognosis.
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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 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: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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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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Objective To explore the clinicopathological features and safety of surgical treatment in aged patients with primary hepatocellular carcinoma (HCC). Methods The clinical data of 316 patients with HCC undergoing hepatectomy in our hospital from December 2005 to December 2008 were retrospectively analyzed. The patients were divided into an aged group (≥60 years,n= 72) and a non-aged group (<60 years, n=244). The clinicopathological data and surgical outcomes were compared between the 2 groups. Results The aged group presented less hepatitis B surface antigen (HBsAg) positive rates and vascular invasion and a lower alpha-fetoprotein (AFP) value when compared with the non-aged group (P<0.05). No significant differences were found in the extent of hepatectomy, operative duration, intraoperative blood loss, blood transfusion requirements, incidence of postoperative complication and mortality rate between the 2 groups (P>0.05). Conclusion The aged patients with HCC were characterized by less HBsAg positive rate, vascular invasion and lower alphafetoprotein (AFP) value. Surgical resection for HCC in aged patients is safe. The attitude toward surgical treatment of aged patients with HCC should be active.
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Objective To investigate ultrasound guidended nerve block of femoral nerve in emergency operation.Methods 40 patients who planned to accept surgery of feet,lower limb under knee.They were randomly devided into 2 groups:ultrasound guidended group and the control group.Femoral nerve and Sciatic nerve were blocked by ultrasound guidended technique or classic landmark technique.1.5% lidocaine was administered for nerve block.Sensory block was observed every 5 minutes in 30 minutes.Onset time,effect of anesthesia,algesia time and complications were recorded.T-test and varience difference were applied.Results The onset time of local anesthetics was faster in the ultrasound guided group than that of the control group.Effect of analgesia was better in in the ultrasound guided group than that of the control group. Conclusion Nerve block of femoral nerve and the sciatic nerve guided by ultrasound was better than the classic technique.
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AIM: To find the optimum extraction of volatile oil. METHOD: To extract the volatile oil by steam distillation or supercritical fluid extraction (SFE). RESULT: (1) The optimum extraction of volatile oil extracting by steam distillation is: Ligustricum Chuanxiong Hort.:Soak time 12 hrs, thin powder, extract time 3hrs, and to add water with 1∶10; Alpinia Officinarum Hance: Soak time 0 hr, thick powder, extract time 3 hrs, and to add water with 1∶10; Curcuma Wenyujin Y.H. chen C. Ling: Soak time 24hrs, mild powder, extract time 1.5hrs, and to add water with 1∶5; Notopterygium incisum Ting: Soak time 0 hr, thick powder, extract time 3 hrs, and to add water with 1∶10. (2) The best condition of volatile oil extracting by SFE is: Ligustricum Chuanxiong Hort.: 60℃, thin powder, press 25MPa, extract time 1.5hrs; Alpinia Officinarum Hance: 60℃, mild powder, press 25MPa, extract time 0.5hr; Curcuma Wenyujin Y.H. chen C. Ling: 60℃, thin powder, press 20MPa, extract time 1 hr; Notopterygium incisum Ting: 60℃, thin powder, press 25MPa, extract time 1hr. CONCLUSION: Supercritical fluid extraction (SFE) is superior to steam distillation.
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The effects of hypoxia and endotoxin, acting alone or in combination, on pulmonary pressor response and lung fluid exchange were studied in 9 conscious goats. Hypoxia(simulating a high altitude of 4,000 m for 5 hours) elevated the pulmonary arterial pressure, but exerted no effect on lung lymph flow, the protein concentration ratio between lymph and plasma, and the clearance rate of lung lymph protein. Three stages were noted after endotoxin injection; the phase of pulmonary hypertension, the phase of pulmonary microvascular injury, and the phase of increased pulmonary microvascular permeability. No obvious difference was observed when endotoxin was acting alone or in combination with hypoxia.The results suggest that 1) the mechanism of pulmonary pressor response induced by hypoxia is somewhat different from that induced by endotoxin, 2)no obvious increase in pulmonary microvascular permeability was noticed during hypobaric hypoxia, and 3) alveolar hypoxia could not enhance the endotoxin-induced lung injury.