Real-World clinical features and survival outcomes associated with primary gastrointestinal natural killer/T-cell lymphoma from 1999 to 2020.

BACKGROUND: Primary gastrointestinal natural killer (NK)/T-cell lymphoma (PGINKTL) is a rare T-/NK-cell lymphoma subtype, and the clinical features and survival outcomes remain largely unknown. METHODS: To summarize the clinical features and survival outcomes of PGINKTL, PGINKTL cases diagnosed at our hospital from May 1999 to December 2020 were reviewed; and the clinical data, information on treatment strategies, and survival were collected. Survival analysis was performed using the Kaplan-Meier method and multivariable Cox proportional hazards regression. We constructed a nomogram to visualize the survival prediction of PGINKTL. The discriminative ability and calibration of the nomogram for prediction were tested using the concordance index (C-index) and calibration plots. RESULTS: The cohort included 81 cases, the median age was 36 years (range, 7-80 years), and the male-to-female ratio was 1.7:1. The most common clinical symptom at the time of diagnosis was abdominal pain (71.6%). The most common lesion site was the colon (59.3%). During a median follow-up period of 37.7 months, the median overall survival (OS) time of 81 patients was 4.0 months (95% confidence interval [CI], 3.1-4.9 months), and the 2-year OS rate was 30.7% (95% CI, 20.3%-40.1%). The multivariate analyses indicated that patients with an Eastern Cooperative Oncology Group (ECOG) performance status (PS) score ≥2, serum lactic dehydrogenase (LDH) level ≥ the upper limit normal (ULN), and perforation had worse OS. We used these data to establish a nomogram to predict survival for PGINKTL. The nomogram displayed good accuracy, with a C-index of 0.726. CONCLUSION: The clinical features and poor outcomes of PGINKTL, which is a rare and fatal lymphoma type, are presented. The proposed nomogram provides an individualized estimate of survival for these patients. In the future, the study focused on exploring a better treatment strategy to improve survival is required in PGINKTL.

Expressions and clinical significance of GAS1, IL-1RAP and PRF1 in patients with ALK positive anaplastic large cell lymphoma / 中华血液学杂志

Objective@#To investigate the expressions of growth arrest-specific protein (GAS1), IL-1 receptor accessory protein (IL-1RAP) and perforin (PRF1) in patients with anaplastic lymphoma kinase positive, anaplastic large cell lymphoma (ALK+ ALCL) and their relationships with clinical significances and the prognoses of ALK+ ALCL.@*Methods@#Twenty-six formalin-fixed paraffin-embedded (FFPE) samples of ALK+ ALCL patients who were diagnosed from January 2011 to September 2016 were collected. Twelve FFPE samples of patients with ALK+ALCL, 13 FFPE samples of patients with peripheral T cell lymphoma (not otherwise specified) (PTCL-NOS) and 8 FFPE samples of patients with angioimmunoblastic T-cell lymphoma (AITL) were used as control groups. RQ-PCR and immunohisto-chemical staining were used to detect the mRNA and protein expressions of GAS1, IL-1RAP and PRF1. The clinical data were analyzed.@*Results@#①The expression levels of GAS1, IL-1RAP and PRF1 gene and protein in ALK+ ALCL group were higher than those of the control groups (P<0.05), but the expression levels had no statistically significant differences between the control groups (P>0.05). ②Patients with elevated lactate dehydrogenase (LDH) (0.77 vs 1.38, z=-3.292, P=0.001) or International prognostic index (IPI)≥3(0.62 vs 1.29, z=-2.495, P=0.013) had lower expression level of GAS1. Patients with stage Ⅲ/Ⅳ disease (0.89 vs 1.18, z=-2.212, P=0.027) or IPI≥3 (0.48 vs 1.13, z=-2.008, P=0.045) had lower expression level of PRF1. IL-1RAP expression level was not associated with clinical features. ③ALK+ ALCL patients in complete remission (CR) group had higher expression levels of GAS1 and PRF1 than patients in non-remission (NR) group (P values were 0.016 and 0.009). ④Kaplan-Meier survival analysis showed that patients with high expression levels of GAS1 and PRF1 had longer median overall survival and progression-free survival than patients with low expression levels of GAS1 and PRF1.@*Conclusion@#GAS1, IL-1RAP and PRF1 could be molecular markers for ALK+ ALCL patients. They have potential diagnostic value and can be used for differential diagnosis in some difficult cases. ALK+ ALCL patients with high expression levels of GAS1 or PRF1 have better curative effects and prognoses.

Effects of 13-cis-retinoic acid combined with interferon-α2b in mantle cell lymphoma cell lines (Jeko-1) in vitro / 中华血液学杂志

Objectives@#To explore the effects of 13-cis-retinoic acid (13cRA) alone or combined with interferonα-2b (IFNα-2b) for the inhibition of cell growth and apoptosis induction of mantle cell lymphoma cell lines Jeko-1 cells.@*Methods@#Jeko-1 cells were treated by different concentrations of 13cRA alone or combined with IFN-α2b. CCK-8 was used to measure the inhibition effects by different treatments. Cell cycles were analyzed by flow cytometry. Effects on apoptosis were assessed by staining of Annexin Ⅴ/PI. And the levels of Cyclin D1, caspase-9 and Rb proteins were measured by Western blot method.@*Results@#13cRA alone at different doses and its combination with IFNα-2b inhibited Jeko-1 cells growth and induced apoptosis, but the combination had higher inhibition potential and significant apoptosis rate (P<0.05) . The growth inhibition and apoptosis induction in Jeko-1 cells increased significantly with the elevation of drugs concentration and treating duration (P<0.05) . As well as the percentage of Jeko-1 cells at G1/G2 phases increased (P<0.05) and cells at S phase decreased (P<0.05) , the levels of Cyclin D1 and Rb decreased with elimination caspase-9.@*Conclusion@#13cRA, IFN-α2b and their combined administration inhibited cells growth and induced apoptosis, decreased the cell populations at S phase and blocked the cells at G1/G2 phase. Combination of the drugs may have a cooperated action. The therapeutic synergistic effects of 13cRA and IFN-α2b were assumed to lower the expression of Cyclin D1 and Rb proteins, and induce apoptosis by activating caspase-9 pathway.

Clinical analysis of 135 newly diagnosed patients with Hodgkin lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics, therapeutic effects, long-term survival and prognostic factors of the newly diagnosed patients with Hodgkin lymphoma (HL).</p><p><b>METHODS</b>One hundred and thirty five newly diagnosed HL patients in West China hospital from January 1, 2000 to December 31, 2010 were analyzed retrospectively. Software SPSS18.0 was applied to determine the risk factors for therapeutic results and long term survivals.</p><p><b>RESULTS</b>Of 135 patients, 78 cases were male and 57 female, the median age was 32(7-77) years old, and the median follow-up of 42(12-141) months. The peak age of HL was 20 to 30 years old and lymph node enlargement was the first presenting symptom in 69.63% of the patients. Among the all pathological types of HL, mixed-cellularity subtype (MC) and nodular sclerosing (NS) were the most common types, accounting for 59.7% and 34.0%, respectively. In MC subtypes, 66.2% of patients were male, while in NS subtypes, 61.4% were female. Among the 114 patients with complete follow-up data, 73 patients (64.0%) obtained complete remission and the total response rate was 77.2%. The 2-, 3- and 5-year overall survival (OS) rates were 91.2%, 88.0% and 80.9%, respectively. The progression free survival rates were 76%, 80.3% and 81.6%%, respectively. Among the patients with early unfavorable prognosis, 96.3% of them accepted full course chemotherapy and 13(48.1%) were combined with local radiotherapy. The 3- and 5- year survival rates of early unfavorable patients were higher than that of early favorable and advanced patients, but the difference was not statistically significant. Age≥45 years old and B symptom were adverse factors affecting curative effect for MC and NS subtypes, respectively. Furthermore, Age≥45 years, B symptoms and hepatomegaly were independent risk factors affecting the survival.</p><p><b>CONCLUSION</b>HL is more common in young patients (age<45 years old) and usually diagnosed at the early stage, with predominance of MC subtypes. B symptoms were adverse prognostic factors of therapeutic effects. The standard- dose chemotherapy and suitable courses of treatment combined with radiotherapy may provide the best benefits for the HL patients.</p>

Analysis of survival and prognosis in 409 newly diagnosed patients with diffuse large B-cell lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To Explore the poor prognostic factors of diffuse large B-cell lymphoma (DLBCL).</p><p><b>METHODS</b>The clinical data of 409 newly diagnosed patients with DLBCL from January 2000 to December 2010 were collected, and the prognostic factors by univariate and multivariate stratification were analyzed .</p><p><b>RESULTS</b>Of the 409 DLBCL patients, 244 were males and 165 females, the median age was 56(16-89) years old, the median follow-up time was 23(2-108) months. In univariate analysis, age, clinical stage, B symptoms, ECOG scores, the international prognostic index (IPI) scores, bone marrow involvement, low absolute lymphocyte count (ALC), high LDH, β2-MG>2 times of normal, regimen and therapeutic effect had significant influence on OS and PFS (P<0.05). Multivariate analysis showed that stage III-IV and high LDH were the poor prognostic factors of OS and PFS (P<0.05). When IPI scores were included, low ALC and IPI 3-5 scores were the poor predictors of OS and PFS in CHOP-like group (232 cases), revised IPI (R-IPI) was an independent poor predictors of OS and PFS in RCHOP-like group (177 cases).</p><p><b>CONCLUSION</b>Stage III-IV and high LDH have negative influence on OS and PFS in patients with DLBCL, low ALC and IPI 3-5 scores affect OS and PFS in CHOP-like group, R-IPI affects OS and PFS in RCHOP-like group.</p>