Clinicopathological characteristics and treatment outcome in obese patients with diffuse large B-cell lymphoma.

BACKGROUND: Aberrant MYC and BCL2 expression, cell of origin (COO), and National Comprehensive Cancer Network international prognostic index (NCCN-IPI) are commonly used for risk assessment and treatment decision in patients with diffuse large B-cell lymphoma (DLBCL). Although obesity has been shown to be of predictive value in DLBCL patients, it remains unclear whether it retains its prognostic relevance after those aforementioned novel factors being taken into consideration. METHODS: Patients with DLBCL were identified retrospectively in a single institute and data were collected through electronic databases and pharmacy records. RESULTS: Fifteen (17.6%) out of the 85 patients with DLBCL in our cohort were categorized as obese. They had lower platelet counts, were younger and more likely to harbor either BCL2- or MYC-overexpressing tumors. The NCCN-IPI scores, COO, and other clinical parameters were not significantly different between obese and non-obese patients. In spite that obesity adversely affected the treatment response to immunochemotherapy, multivariate analysis showed that only NCCN-IPI risk categories [hazard ratio (HR) 2.83 for high-intermediate or high-risk, versus low-intermediate or low-risk, P=0.034] and BCL2/MYC expressional status (HR 4.12 for BCL2high and/or MYChigh, versus both low expressors, P=0.004) independently predicted progression-free survival (PFS) outcome, whereas obesity lost its prognostic value in this regard (HR 1.81 for obese patients, P=0.242). Similarly, high-intermediate to high NCCN-IPI risk (HR 3.11, P=0.034) and increased expression in either BCL2 or MYC (HR 5.63, P=0.001) both portended an inferior overall survival (OS), but the presence of obesity did not affect the outcome (HR 1.65, P=0.352). CONCLUSIONS: Our study has demonstrated that, for the first time, obesity increases the frequency of BCL2- or MYC-overexpressing tumors in patients with DLBCL.

Oral Chinese herbal medicine in combination with phototherapy for vitiligo: A systematic review and meta-analysis of randomized controlled trials.

AIMS: The aim of this study was to assess the effects of oral Chinese herbal medicine (CHM) combined with phototherapy for vitiligo. METHODS: We undertook a meta-analysis of relevant randomized controlled trials (RCTs) and searched eight bibliographic databases from inception to December 2015. RESULTS: A total of 5 RCTs with 513 participants which assessed the efficacy of oral CHM in combination with narrow-band ultraviolet B (NB-UVB) in treating vitiligo were included. The meta-analysis revealed a superior effectiveness in those receiving oral CHM plus NB-UVB when compared to phototherapy alone (risk difference 0.22, 95% confidence interval 0.14 to 0.29, P<0.00001). Only mild adverse events were reported without significant renal or liver function impairment. CONCLUSIONS: The current evidence demonstrates that oral CHM in combination with NB-UVB has a superior effectiveness in terms of repigmentation rate of vitiligo when compared to NB-UVB alone. Although the overall quality of included trials was low, oral CHM in combination with NB-UVB may be an alternative option of treatment for vitiligo. As to safety, there were only mild adverse events reported without significant renal or liver function impairment. However, there is limited available evidence of long-term follow-up and poor methodological quality of the available trials. Well-designed RCTs of adequate length and sample size that include life quality as an outcome are warranted.

Protocatechuic Acid Inhibits Inflammatory Responses in LPS-Stimulated BV2 Microglia via NF-κB and MAPKs Signaling Pathways.

Protocatechuic acid (PA), a major metabolite of anthocyanins, has been reported to possess antioxidant and anti-inflammatory activities. However, the effects of PA on LPS-induced inflammatory responses in microglia have not been reported. The aim of this study was to investigate the anti-inflammatory effects and molecular mechanisms of PA on LPS-stimulated BV2 microglia. The production of inflammatory mediators TNF-α, IL-6, IL-1ß, and PGE2 were detected by ELISA. TLR4, NF-κB and MAPKs activation were detected by western blotting. Our results demonstrated that PA dose-dependently inhibited LPS-induced TNF-α, IL-6, IL-1ß, and PGE2 production. In addition, PA suppressed LPS-induced TLR4 expression, NF-κB and MAPKs activation, which resulted in the inhibition of inflammatory mediators. In conclusion, these results suggested that PA exhibited anti-inflammatory effects on LPS-stimulated BV2 microglia and the mechanisms were involved in the inhibition of TLR4-mediated NF-κB and MAPKs signaling pathways.

Prognostic impact of hepatitis C virus infection in patients with diffuse large B-cell lymphoma treated with immunochemotherapy in the context of a novel prognostic index.

OBJECTIVE: Patients with hepatitis C virus (HCV) infection have been associated with development of diffuse large B-cell lymphoma (DLBCL), yet its impact on several clinical aspects, including phenotypic characteristics and treatment-related toxicities as well as survival outcome after rituximab-based immunochemotherapy, remains controversial. METHODS: To elucidate the characteristics of HCV-positive DLBCL in the context of a new prognostic model, the National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI), we retrospectively analyzed DLBCL patients diagnosed and treated with immunochemotherapy at our institute during the last decade. RESULTS: In all, HCV infection was identified in 22 (17.7%) of 124 DLBCL patients. Except for being more likely to present with an advanced stage of disease, patients with HCV infection were phenotypically indistinguishable from HCV-negative cases. Multivariate analysis showed 3 factors independently predicted a dismal overall survival (OS) outcome: lower albumin level (<3 g/dL vs. ≥3 g/dL, p<0.001; HR=13.21, 95% CI=2.69-64.98, p=0.001), presence of HCV infection (vs. HCV-negative; HR=9.75, 95% CI=1.97-48.34, p=0.005), and poor NCCN-IPI risk (high-intermediate or high vs. low-intermediate or low; HR=5.56, 95% CI=1.17-26.55, p=0.031). CONCLUSIONS: Our study has demonstrated that HCV infection status and low serum albumin level add important prognostic values to the newly proposed NCCN-IPI model for patients with DLBCL.