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1.
PLoS One ; 14(12): e0225938, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31830075

RESUMO

OBJECTIVE: This study is aimed toward establishing a decision-making model with multiple criteria for appraisal and reimbursement to compare the attitudes of different stakeholders toward various dimensions and criteria and to evaluate the five targeted therapies (bevacizumab, cetuximab, panitumumab, aflibercept, and regorafenib) for metastatic colorectal cancer. METHOD: This study is a multi-criteria decision analysis (MCDA) using a model that includes three dimensions and nine criteria. Both the overall and individual scores of the respective targeted therapies in different dimensions and criteria were calculated. A sensitivity analysis was carried out in order to evaluate the robustness of the research results. An interview-based questionnaire survey was applied to obtain the performance information for the targeted therapies and the weights of the dimensions and criteria. RESULTS: Overall, the clinical dimension had the highest weight, followed by the economic dimension, and finally, the social dimension. In the clinical dimension, the "comparative efficacy" criterion had the highest weight; in the economic dimension, the "cost-effectiveness" criterion" was given the greatest importance; in the social dimension, the "social concern and patient needs" criterion was given more emphasis. The overall values ranked from high to low as follows: cetuximab (overall score 3.3666), bevacizumab (3.3043), panitumumab (3.2030), aflibercept (2.8923) and regorafenib (2.8366). CONCLUSIONS: A comprehensive value assessment system combining "multi-dimensional criteria," "multi-perspectives," and an "integrative assessment" is necessary to evaluate the value of medicines. The results showed not only the order of weights of different dimensions or criteria, but also the rankings of the value of the targeted therapies.

2.
Oncol Rep ; 41(1): 213-223, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30542709

RESUMO

Ursodeoxycholic acid (UDCA) is a type of hydrophilic bile acid extracted from animal bile with a wide range of biological functions. The present results demonstrated that UDCA could effectively inhibit the proliferation of two human melanoma cell line (M14 and A375) with time­ and concentration­dependence. Following exposure to various concentrations of UDCA, M14 cells exhibited typical morphological changes and weaker ability of colony forming. Flow cytometry analysis demonstrated that UDCA could induce a decrease of mitochondrial membrane potential and an increase in reactive oxygen species (ROS) levels in M14 cells. The cell cycle was arrested in the G2/M phase, which was confirmed by the decrease of cyclin­dependent kinase 1 and cyclinB1 at the protein level. However, when M14 cells were treated with UDCA and Z­VAD­FMK (caspase inhibitor) synchronously, the apoptosis rate of the cells was reduced significantly. In addition, it was demonstrated that UDCA induced apoptosis of human melanoma M14 cells through the ROS­triggered mitochondrial­associated pathway, which was indicated by the increased expression of cleaved­caspase­3, cleaved­caspase­9, apoptotic protease activating factor­1, cleaved­poly (ADP­ribose) polymerase 1 and the elevation of B cell lymphoma­2 (Bcl­2) associated X protein/Bcl­2 ratio associated with apoptosis. Therefore, UDCA may be a potential drug for the treatment of human melanoma.


Assuntos
Apoptose/efeitos dos fármacos , Mitocôndrias/efeitos dos fármacos , Ácido Ursodesoxicólico/farmacologia , Clorometilcetonas de Aminoácidos/farmacologia , Inibidores de Caspase/farmacologia , Caspases/metabolismo , Linhagem Celular Tumoral , Ensaios de Seleção de Medicamentos Antitumorais , Pontos de Checagem da Fase G2 do Ciclo Celular/efeitos dos fármacos , Humanos , Melanoma/tratamento farmacológico , Potencial da Membrana Mitocondrial/efeitos dos fármacos , Microscopia Eletrônica de Transmissão , Mitocôndrias/metabolismo , Mitocôndrias/ultraestrutura , Espécies Reativas de Oxigênio/metabolismo , Transdução de Sinais/efeitos dos fármacos , Neoplasias Cutâneas/tratamento farmacológico , Ácido Ursodesoxicólico/uso terapêutico
3.
Mar Pollut Bull ; 136: 84-91, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30509845

RESUMO

Many shipwreck events occur in the neighboring areas of Taiwan due to the volume of maritime traffic and geographical conditions around Taiwan. The oil spills from such events can be devastating for the surrounding sea and coastal areas. The government realized the importance of marine pollution prevention and enforced the Marine Pollution Control Act and the Major Marine Oil Pollution Emergency Response Plan to mitigate the impact of oil spill pollution. The T.S. Taipei shipwreck highlighted the effectiveness of the national marine pollution prevention system. Inter-departmental cooperation and collaboration with private sectors are the keys for effective response. This article is the first detailed documentation of an oil spill response for a maritime incident from the beginning to the final termination of shipwreck removal. It shows the people in Taiwan intend to collaborate with other states to make a significant contribution to marine environment conservation and sustainability.


Assuntos
Conservação dos Recursos Hídricos/métodos , Planejamento em Desastres/legislação & jurisprudência , Poluição por Petróleo/prevenção & controle , Navios , Poluição da Água/prevenção & controle , Conservação dos Recursos Hídricos/legislação & jurisprudência , Planejamento em Desastres/organização & administração , Regulamentação Governamental , Cooperação Internacional , Oceanos e Mares , Poluição por Petróleo/análise , Poluição por Petróleo/legislação & jurisprudência , Taiwan , Poluição da Água/análise , Poluição da Água/legislação & jurisprudência
4.
PLoS One ; 13(8): e0202725, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30142174

RESUMO

BACKGROUND: Since 2012, several immune checkpoint inhibitors have been approved by the Taiwan FDA for various types of cancer treatment. However, none of them are covered by Taiwan National Health Insurance due to the fact that they are expensive, and there is a lack of clinical evidence as to their effectiveness. OBJECTIVES: This study was aimed toward an exploration of clinical experiences with use of immune checkpoint inhibitors, including indications, prescription types, drug effectiveness, adverse drug event types, and incidence, all of which shall serve as references for future clinical drug use. METHODS: This is a retrospective study focusing on three immune checkpoint inhibitors (ipilimumab, nivolumab, and pembrolizumab), which are available for cancer treatment in Taiwan. We collected data from medical records for the period from January 1st, 2015 to January 12th, 2017 at National Cheng Kung University Hospital (NCKUH), a medical center in southern Taiwan, and recorded these cases until May 31st, 2017. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan-Meier method, and adverse drug reaction odds ratios were analyzed using a chi-square analysis. RESULTS: The 50 patients under consideration in this study had used any one of the immune checkpoint inhibitors in NCKUH. Non-small cell lung cancer (n = 24, 48%) accounted for the highest percentage, followed by hepatocellular carcinoma (n = 4, 8%). The median OS was not reached, and the PFS for all immunotherapies was 4.9 months. The median OS period and PFS for non-small cell lung cancer (NSCLC) patients were 13 and 4.9 months, respectively, which were similar to those in many clinical trials. For NSCLC patients, the OS and PFS were only 0.63 and 1.37 months for squamous cell type NSCLC, and for patients who were PD-L1 negative, the OS and PFS were only 11.53 and 2.6 months, respectively. The most common adverse events in this study included fatigue (42%), rashes (22%), nausea (20%), and fever (20%), while one patient developed severe deep venous thrombosis and tissue inflammation, which was not confirmed in previous clinical trials. CONCLUSIONS: The histological subtype, the intensity of the PD-L1 expression, and the timing of treatment affected the NSCLC therapeutic results. It is recommended that clinical tests be conducted in order to enhance therapeutic effectiveness. It is expected that more testing, observation-based studies, and research results will validate their efficacy and the tolerance levels of patients.


Assuntos
Antineoplásicos Imunológicos/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Monoclonais Humanizados/efeitos adversos , Anticorpos Monoclonais Humanizados/uso terapêutico , Antineoplásicos Imunológicos/efeitos adversos , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/patologia , Intervalo Livre de Doença , Fadiga/etiologia , Feminino , Humanos , Imunoterapia , Ipilimumab/efeitos adversos , Ipilimumab/uso terapêutico , Estimativa de Kaplan-Meier , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Nivolumabe/efeitos adversos , Nivolumabe/uso terapêutico , Estudos Retrospectivos , Taiwan , Resultado do Tratamento
5.
Sci Total Environ ; 607-608: 786-794, 2017 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-28711008

RESUMO

Water availability, resulting from either a lack of water or poor water quality is a key factor contributing to regional water stress. This study proposes a set of sector-wise characterization factors (CFs), namely consumptive and degradative water stresses, to assess the impact of water withdrawals with a life cycle assessment approach. These CFs consider water availability, water quality, and competition for water between domestic, agricultural and industrial sectors and ecosystem at the watershed level. CFs were applied to a case study of regional water management of industrial water withdrawals in Taiwan to show that both regional or seasonal decrease in water availability contributes to a high consumptive water stress, whereas water scarcity due to degraded water quality not meeting sector standards has little influence on increased degradative water stress. Degradative water stress was observed more in the agricultural sector than in the industrial sector, which implies that the agriculture sector may have water quality concerns. Reducing water intensity and alleviating regional scale water stresses of watersheds are suggested as approaches to decrease the impact of both consumptive and degradative water use. The results from this study may enable a more detailed sector-wise analysis of water stress and influence water resource management policies.

6.
Bioresour Technol ; 245(Pt B): 1641-1644, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28684180

RESUMO

In this study, stepwise increases in linalool production were obtained by combining metabolic engineering and process optimization of an unconventional oleaginous yeast Yarrowia lipolytica. The linalool synthetic pathway was successfully constructed by heterologously expressing a codon-optimized linalool synthase gene from Actinidia arguta in Y. lipolytica. To enhance linalool productivity, key genes involved in the mevalonate pathway were overexpressed in different combinations. Moreover, the overexpression of mutant ERG20F88W-N119W gene resulted in further linalool production. A maximum linalool titre of 6.96±0.29mg/L was achieved in shake flasks, which was the highest level ever reported in yeasts.


Assuntos
Engenharia Metabólica , Monoterpenos , Yarrowia , Saccharomyces cerevisiae
7.
Nanoscale Res Lett ; 11(1): 327, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27405466

RESUMO

We propose a novel mirror-image nanoepsilon (MINE) structure to achieve highly localized and enhanced near field at its gap and systematically investigate its plasmonic behaviors. The MINE can be regarded as a combination of two fundamental plasmonic nanostructures: a nanorod dimer and nanoring. By adapting a nanoring surrounding a nanorod dimer structure, the nanorod is regarded as a bridge pulling the charges from the nanoring to the nanorod, which induces stronger plasmon coupling in the gap to boost local near-field enhancement. Two resonance peaks are identified as the symmetric and anti-symmetric modes according to the symmetries of the charge distributions on the ring and rod dimer in the MINE. The symmetric mode in the MINE structure is preferred because its charge distribution leads to stronger near-field enhancement with a concentrated distribution around the gap. In addition, we investigate the influence of geometry on the optical properties of MINE structures by performing experiments and simulations. These results indicate that the MINE possesses highly tunable optical properties and that significant near-field enhancement at the gap region and rod tips can be realized by the gap and lightning-rod effects. The results improve understanding of such complex systems, and it is expected to guide and facilitate the design of optimum MINE structures for various plasmonic applications.

8.
Chemistry ; 22(6): 1926-1930, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26752423

RESUMO

Platinum(II)-sulindac complexes [{η2 -C5 H4 SN(O)}Pt(DMSO){O(C=O)Sulindac}], [{η2 -C5 H4 SN(O)}PtCl{(S=O)Sulindac}], [{η2 -C5 H4 SN(O)}PtCl{(S=O)Sulindac-succinimide}], and [{η2 -C5 H4 SN(O)}PtCl{(S=O)Sulindac-thymidine}] were synthesized that exhibited IC50 values of 2.9-4.8 µm against human oral cancer cells OECM1. The poly(lactic-co-glycolic acid) (PLGA) encapsulated [{η2 -C5 H4 SN(O)}PtCl{(S=O)Sulindac}] also showed cytotoxic activity although less potent than the pristine species.

9.
Opt Express ; 24(5): 5125-5135, 2016 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-29092340

RESUMO

Aluminum-doped zinc oxide (AZO) is well known as transparent conducting material for electro-optical devices, but is rarely used as plasmonic material, particularly on the localized surface plasmon resonance (LSPR) behavior of AZO nanostructure and its plasmonic devices. In this study, we systematically investigate the plasmonic behaviors of AZO thin films and patterned AZO nanostructures with various structural dimensions under different annealing treatments. We find that AZO film can possess highly-tunable, metal-like, and low-loss plasmonic property and the LSPR characteristic of AZO nanostructure is observed in the near-infrared (NIR) region under proper annealing conditions. Finally, environmental index sensing is performed to demonstrate the capability of AZO nanostructure for optical sensing application. High index sensitivity of 873 nm per refractive index unit (RIU) variation is obtained in experiment.

10.
Asian Pac J Cancer Prev ; 16(15): 6311-6, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26434835

RESUMO

BACKGROUND: In mainland China, awareness of disease of elderly cancer patients largely relies on the patients' families. We developed a staged procedure to improve their awareness of disease. MATERIALS AND METHODS: Participants were 224 elderly cancer patients from 9 leading hospitals across Southern China. A questionnaire was given to the oncologists in charge of each patient to evaluate the interaction between family and patients, patient awareness of their disease and participation in medical decision-making. After first cycles of treatment, increased information of disease was given to patients with cooperation of the family. Then patient awareness of their disease and participation in medical decision-making was documented. RESULTS: Among the 224 cancer elderly patients, 26 (11.6%) made decisions by themselves and 125 (55.8%) delegated their rights of decision- making to their family. Subordinate family members tended to play a passive role in decision-making significantly. Patients participating more in medical decision-making tended to know more about their disease. However, in contrast to the awareness of disease, patient awareness of violation of medical recommendations was reversely associated with their participation in medical decision-making. Improvement in awareness of diagnosis, stages and prognosis was achieved in about 20% elderly cancer patients. About 5% participated more actively in medical decision-making. CONCLUSIONS: Chinese elderly cancer patient awareness of disease and participation in medical decision-making is limited and relies on their family status. The staged procedure we developed to improve patient awareness of disease proved effective.


Assuntos
Tomada de Decisões , Relações Familiares , Conhecimentos, Atitudes e Prática em Saúde , Neoplasias/patologia , Neoplasias/terapia , Educação de Pacientes como Assunto/métodos , Idoso , Idoso de 80 Anos ou mais , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias/diagnóstico , Participação do Paciente , Prognóstico
11.
Opt Express ; 23(19): A1245-52, 2015 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-26406753

RESUMO

The contribution of graphene oxide (GO) on photocatalytic effects of Cu(x)O on plasmonic Au is investigated. It is found that the H(2) evolution rate from pure water is enhanced 1.4 fold using the visible-active Cu(x)O/GO photocatalyst, as compared with Cu(x)O without GO. In addition, the intensity of photoluminescence of Cu(x)O/GO can be enhanced as much as 2.85 fold as compared with Cu(x)O without GO. The enhancement is due to the negative fixed charge in GO, which can passivate the surface of Cu(x)O and suppress recombination of minority electrons at the surface. The results from optical characterization in this study can help to prove the proposed mechanism of passivation.

12.
Cell ; 161(4): 762-73, 2015 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-25957684

RESUMO

Transcription through immunoglobulin switch (S) regions is essential for class switch recombination (CSR), but no molecular function of the transcripts has been described. Likewise, recruitment of activation-induced cytidine deaminase (AID) to S regions is critical for CSR; however, the underlying mechanism has not been fully elucidated. Here, we demonstrate that intronic switch RNA acts in trans to target AID to S region DNA. AID binds directly to switch RNA through G-quadruplexes formed by the RNA molecules. Disruption of this interaction by mutation of a key residue in the putative RNA-binding domain of AID impairs recruitment of AID to S region DNA, thereby abolishing CSR. Additionally, inhibition of RNA lariat processing leads to loss of AID localization to S regions and compromises CSR; both defects can be rescued by exogenous expression of switch transcripts in a sequence-specific manner. These studies uncover an RNA-mediated mechanism of targeting AID to DNA.


Assuntos
Citidina Desaminase/metabolismo , Switching de Imunoglobulina , RNA Guia/metabolismo , Animais , Quadruplex G , Íntrons , Proteínas Ligantes de Maltose/metabolismo , Camundongos , Processamento Pós-Transcricional do RNA , RNA Guia/genética
13.
PLoS Genet ; 7(9): e1002297, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21980301

RESUMO

Immense diversity of prion strains is observed, but its underlying mechanism is less clear. Three [PSI] prion strains--named VH, VK, and VL--were previously isolated in the wild-type yeast genetic background. Here we report the generation and characterization of eight new [PSI] isolates, obtained by propagating the wild-type strains with Sup35 proteins containing single amino-acid alterations. The VH strain splits into two distinct strains when propagated in each of the three genetic backgrounds, harboring respectively single mutations of N21L, R28P, and Gi47 (i.e. insertion of a glycine residue at position 47) on the Sup35 N-terminal prion-forming segment. The six new strains exhibit complex inter-conversion patterns, and one of them continuously mutates into another. However, when they are introduced back into the wild-type background, all 6 strains revert to the VH strain. We obtain two more [PSI] isolates by propagating VK and VL with the Gi47 and N21L backgrounds, respectively. The two isolates do not transmit to other mutant backgrounds but revert to their parental strains in the wild-type background. Our data indicate that a large number of [PSI] strains can be built on three basic Sup35 amyloid structures. It is proposed that the three basic structures differ by chain folding topologies, and sub-strains with the same topology differ in distinct ways by local structural adjustments. This "large number of variations on a small number of basic themes" may also be operative in generating strain diversities in other prion elements. It thus suggests a possible general scheme to classify a multitude of prion strains.


Assuntos
Fatores de Terminação de Peptídeos/química , Príons/química , Proteínas de Saccharomyces cerevisiae/química , Saccharomyces cerevisiae/genética , Saccharomyces cerevisiae/metabolismo , Alelos , Amiloide/química , Amiloide/genética , Variação Genética , Haploidia , Heterozigoto , Homozigoto , Fatores de Terminação de Peptídeos/genética , Príons/genética , Proteínas Recombinantes/genética , Proteínas de Saccharomyces cerevisiae/genética , Esferoplastos/genética
14.
Neurobiol Learn Mem ; 93(1): 8-18, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19660564

RESUMO

In this study, we investigated whether stress can enhance the toxicity of oligomer Abeta(1-40) in the mouse brain. Stress was applied to the animals, consisting of a 2-day inescapable foot shock followed by 3-weekly situation reminders (SRs). We found that stress significantly affected not only the amygdala-dependent (anxiety) but also the hippocampal-dependent (spatial learning and memory) behaviors through the oxidative damage caused in these two regions. However, oligomer Abeta(1-40) treatment alone did not induce behavioral impairment. In addition, combined oligomer Abeta(1-40) and stress treatment increased the glucocorticoid receptor (GR)/mineralocorticoid receptor (MR) ratio and the expression of corticotrophin releasing factor 1 (CRF-1) receptor in the hippocampus. Changes in the components of the hypothalamic-pituitary-adrenal (HPA) axis, such as the GR/MR ratio and CRF-1 level, were observed, accompanied by increasing Abeta accumulation, oxidative stress, nuclear transcription factor (NF-kappaB) hypoactivity, and apoptotic signaling in the hippocampus, and decreasing calbindin D28K and NMDA receptor 2A/2B (NR2A/2B) in the hippocampus, along with alteration of the cholinergic neurons (ChAT) in the medium septum/diagnoid band (MS/DB), noradrenergic neurons (TH) in the locus coeruleus (LC), and serotonergic neurons (5-HT) in the Raphe nucleus. Therefore, apoptosis and synaptic dysfunction in the hippocampus severely induced the impairment of spatial learning and memory. These results suggest that stress may play an important role in the early stages of Alzheimer's disease (AD), and an antioxidant strategy might be a potential therapeutic approach for stress-mediated disorders.


Assuntos
Peptídeos beta-Amiloides/metabolismo , Transtornos da Memória/fisiopatologia , Fragmentos de Peptídeos/metabolismo , Percepção Espacial/fisiologia , Estresse Psicológico/fisiopatologia , Animais , Modelos Animais de Doenças , Eletrochoque , Hipocampo/fisiopatologia , Aprendizagem/fisiologia , Locus Cerúleo/fisiopatologia , Masculino , Memória/fisiologia , Camundongos , Camundongos Endogâmicos C57BL , Neurônios/fisiologia , Distribuição Aleatória , Núcleos da Rafe/fisiopatologia
15.
Proc Natl Acad Sci U S A ; 105(36): 13345-50, 2008 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-18757753

RESUMO

Amyloid polymorphism underlies the prion strain phenomenon where a single protein polypeptide adopts different chain-folding patterns to form self-propagating cross-beta structures. Three strains of the yeast prion [PSI], namely [VH], [VK], and [VL], have been previously characterized and are amyloid conformers of the yeast translation termination factor Sup35. Here we define specific sequences of the Sup35 protein that are necessary for in vivo propagation of each of these prion strains. By sequential substitution of residues 5-55 of Sup35 by proline and insertion of glycine at alternate sites in this segment, specific mutations have been identified that interfere selectively with the propagation of each of the three prion strains in yeast: the [VH] strain requires amino acid residues 7-21; [VK] requires residues 9-37; and [VL] requires residues 5 to at least 52. Minimal polypeptide segments capable of encoding prion conformations were defined by assembly of recombinant Sup35 fragments on purified prion nuclei to form amyloid fibers in vitro, whose infectivity was assayed in yeast. For the [VK] and [VL] strains, the minimal fragments approximately coincide with the strain-specific sequences defined by mutations of the N-terminal portion of the intact Sup35 (1-685); and for the [VH] strain, a longer Sup (1-53) fragment is required. Polymorphic structures of other amyloids might similarly involve different stretches of polypeptides to form cross-beta amyloid cores with distinct molecular recognition surfaces.


Assuntos
Príons/química , Príons/metabolismo , Proteínas de Saccharomyces cerevisiae/química , Proteínas de Saccharomyces cerevisiae/metabolismo , Saccharomyces cerevisiae/metabolismo , Sequência de Aminoácidos , Benzotiazóis , Glicina/química , Fatores de Terminação de Peptídeos , Príons/classificação , Príons/genética , Prolina/química , Saccharomyces cerevisiae/genética , Proteínas de Saccharomyces cerevisiae/classificação , Proteínas de Saccharomyces cerevisiae/genética , Tiazóis/metabolismo
16.
Eur J Haematol ; 77(5): 365-71, 2006 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-16879606

RESUMO

OBJECTIVES: This study was designed to evaluate the efficacy and toxicity of the modified B-Non-Hodgkin's Lymphoma (NHL)-Berlin-Frankfurt-Münster (BFM)-90-based protocol in Chinese children and adolescents with Burkitt's lymphoma and large cell lymphoma. METHODS: From September 1997 to August 2005, 55 untreated patients (age less than 20 yr) from a single institution were enrolled. The patients were stratified by risk factors (stage, LDH level and chemotherapy response). All patients were treated with a modified B-NHL-BFM 90 protocol. RESULTS: The median age of the patients was 8 yr (range 1.5-20 yr). Of these patients, 22 (40%) had Burkitt's lymphoma (BKL), 22 (40%) had diffuse large B-cell lymphoma (DLBL) and 11 (20%) had anaplastic large T-cell lymphoma (ALCL). Complete remission (CR) occurred in 45 patients (83%), partial remission (PR) in eight patients (14.5%), and progressive disease (PD) in one patient (1.8%). At a median follow up of 24 months, the event free survival (EFS) for all patients was 85% +/- 5% with 100% for group R1, 84% +/- 7% for group R2 and 72% +/- 13% for group R3, and most notably, 80% +/- 6% for stage III/IV at diagnosis. There was no statistically significant difference (P = 0.96) in EFS among BKL and DLBL and ALCL. The major toxicity complications were myelosuppression and mucositis, but these conditions were tolerated and manageable. CONCLUSIONS: This modified NHL-BFM-90 protocol is very effective for Chinese children and adolescents with BKL and large cell lymphomas, and represented an increase in the cure rates in childhood NHL in China.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Linfoma de Burkitt/tratamento farmacológico , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma de Células T/tratamento farmacológico , Adolescente , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Asparaginase/administração & dosagem , Asparaginase/efeitos adversos , Linfoma de Burkitt/mortalidade , Criança , Pré-Escolar , China , Daunorrubicina/administração & dosagem , Daunorrubicina/efeitos adversos , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Lactente , Linfoma Difuso de Grandes Células B/mortalidade , Linfoma de Células T/mortalidade , Masculino , Mucosite/induzido quimicamente , Prednisona/administração & dosagem , Prednisona/efeitos adversos , Estudos Retrospectivos , Resultado do Tratamento , Vincristina/administração & dosagem , Vincristina/efeitos adversos
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