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1.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(9): 882-888, 2021.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-34535201

RESUMO

OBJECTIVES: To evaluate the quality of life and related demographic factors in long-term survivors of childhood non-Hodgkin's lymphoma (NHL). METHODS: A retrospective analysis was performed on the medical and demographic data of the NHL patients who received treatment in the Sun Yat-sen University Cancer Center and achieved long-term survival at follow-up, with an age of <18 years at initial diagnosis and a present age of ≥18 years. A questionnaire survey was performed using 36-Item Short-Form Health Survey (SF-36) and the symptom subscale of the Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (QLQ-C30). The health status of long-term survivors of NHL was evaluated by comparing the scores of various dimensions of the SF-36 scale of general adult population in the United States (American norm) and those of the SF-36 scale of general adult population in Hong Kong, China (Hong Kong norm). The correlation between the score of each dimension of the scale and demographic characteristics was evaluated. The symptoms of long-term NHL survivors were evaluated according to the score of QLQ-C30 scale. RESULTS: A total of 23 patients with NHL with complete follow-up data were enrolled. The pathological types included diffuse large B-cell lymphoma in 10 patients, Burkitt lymphoma in 4 patients, T-cell lymphoblastoma in 5 patients, B-cell lymphoblastoma in 3 patients, and natural killer/T cell lymphoma in 1 patient. All patients received the chemotherapy regimen containing anthracyclines and alkylating agents. The median present age was 26.2 years (range: 16.9-55.8 years), and the median age at initial diagnosis was 10.4 years (range: 2.4-17.6 years). Among the 23 patients, 6 were married and had children and 2 had chronic diseases. There was no significant difference between the long-term survivors and the US norm in role physical, general health, role-emotional, and mental health (P>0.05), while the long-term survivors had significantly better scores of the other dimensions than the US norm (P<0.05). Similar results were obtained for the comparison between the long-term survivors and the China Hong Kong norm. Age at initial diagnosis was negatively correlated with the scores of social functioning, role physical, and general health in the SF-36 scale (P<0.05), and the present age of patients was positively correlated with the score of physical functioning and was negatively correlated with the score of general health (P<0.05). The urban and rural distribution of patients was related to the general health status (P<0.05). In addition, the long-term survivors of childhood NHL had relatively low scores of the symptom domain of QLQ-C30, and few moderate or severe symptoms were found. CONCLUSIONS: Long-term survivors of childhood NHL tend to have a good overall health status, with no significant differences compared with the general population. Age at initial diagnosis is the main demographic factor that affects patients' quality of life. Citation.


Assuntos
Linfoma não Hodgkin , Linfoma , Adolescente , Adulto , Humanos , Linfoma não Hodgkin/tratamento farmacológico , Pessoa de Meia-Idade , Qualidade de Vida , Estudos Retrospectivos , Sobreviventes , Adulto Jovem
2.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 29(2): 469-473, 2021 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-33812417

RESUMO

OBJECTIVE: To investigate the efficacy, safety and prognosis of auto-HSCT between classical and modified conditioning regimen in patients with B-cell non-Hodgkin lymphoma. METHODS: 36 patients diagnosed as B-cell non-Hodgkin lymphoma treated with autologous hematopoietic stem cell transplantation from January 2015 to June 2018 in Tianjin Cancer Hospital were retrospectively analyzed. The patients were divided into two groups: Idarubicin group and non-Idarubicin group. The overall survival (OS), progression-free survival (PFS), adverse reactions and hematopoietic reconstitution time between the two groups were compared. Survival analysis was performed by using the Kaplan-Meier method. Log-rank test was used for comparison between groups, and Cox regression was used for multivariate analysis. RESULTS: The median follow-up time was 29 months. Among these 36 patients with B-cell non-Hodgkin lymphoma before transplantation, 21 patients achieved CR and 15 patients achieved PR. The reconstitution time of neutrophil (P>0.05) and platelet (P>0.05) was not significantly different between Idarubicin and non-Idarubicin group. Also, the adverse reactions were not significantly different between two groups. The addition of idarubicin showed not aggravate the adverse reactions of patients. The OS and PFS of patients with idarubicin was longer than that of patients without idarubicin. The multivariate analysis showed that, the modified conditioning regimen and the remission state before transplantation were closely associated with prognosis. CONCLUSION: The above-mentioned results indicated that the combination of modified conditioning regimen with idarubicin can lengthen the OS and PFS of the patients significantly, and show not aggravate of bone marrow inhibition, moreover, the hematopoietic reconsititution time show not lengthen, which means that it can be a safe and effective choice for autologous HSCT in the patients with B cell non-Hodgkin lymphoma.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Linfoma não Hodgkin , Protocolos de Quimioterapia Combinada Antineoplásica , Linfócitos B , Intervalo Livre de Doença , Humanos , Linfoma não Hodgkin/terapia , Estudos Retrospectivos , Condicionamento Pré-Transplante , Transplante Autólogo , Resultado do Tratamento
3.
J Immunother Cancer ; 9(2)2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33637599

RESUMO

BACKGROUND: The advent of immune checkpoint therapy has been a tremendous advance in cancer treatment. However, the responses are still insufficient in patients with soft tissue sarcoma (STS). We aimed to identify rational combinations to increase the response to immune checkpoint therapy and improve survival. METHODS: Whole-exome sequencing (WES) was performed in 11 patients with liposarcoma. Somatic copy number alterations (SCNAs) were analyzed at the gene level to identify obvious amplification patterns in drug-target genes. The expression and prognostic value of class I histone deacetylases (HDACs) was evaluated in 49 patients with sarcoma in our center and confirmed in 263 sarcoma samples from The Tumor Cancer Genome Atlas (TCGA) database. Q-PCR, flow cytometry and RNA-seq were performed to determine the correlations between class I HDACs, chidamide and PD-L1 in vitro and in vivo. The efficacy of combining chidamide with PD-1 blockade was explored in an immunocompetent murine model and a small cohort of patients with advanced sarcoma. Western blot, ChIP assay and dual luciferase assessment were applied in the mechanistic study. RESULTS: The HDAC gene family was frequently amplified in STS. SCNAs in the HDAC gene family were extensively amplified in 8 of 11 (73%) patients with liposarcoma, based on a drug-target gene set, and we verified amplification in 76.65% (197/257) of cases by analyzing TCGA sarcoma cohort. Class I HDAC expression is associated with a poor prognosis for patients with STS, and its inhibition is responsible for promoting apoptosis and upregulating of programmed cell death ligand 1 (PD-L1). The HDAC class I inhibitor chidamide significantly increases PD-L1 expression, increased the infiltration of CD8+ T cells and reduced the number of MDSCs in the tumor microenvironment. The combination of chidamide with an anti-PD-1 antibody significantly promotes tumor regression and improves survival in a murine model. Moreover, chidamide combined with the anti-PD-1 antibody toripalimab is effective in patients with advanced and metastatic sarcoma, and the side effects are tolerable. Mechanistically, chidamide increases histone acetylation at the PD-L1 gene through the activation of the transcriptional factor STAT1. CONCLUSIONS: The combination of chidamide and anti-programmed cell death 1 (PD-1) therapy represents a potentially important strategy for STS.

4.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(6): 2084-2088, 2020 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-33283746

RESUMO

Exosomes are microvesicles that can be secreting in many kinds of cells, under the condition of normal and pathology. Exosomes contain abundant proteins, miRNAs and RNA fragments, which play an important role in communicating between cells, especially non-contact cells. The interaction between blood tumor cells and immune microenvironment is inseparable from the involvement of exosomes. Exosomes are involved in the interaction among tumor cells, NK cells, T cells, stromal cells and endothelial cells, such as promoting the proliferation of blood tumor cells, helping blood tumor cells to achieve immune evasion, promoting angiogenesis and migration of tumor cells. Therefore, exosomes are closely related to the diagnosis, treatment and prognosis of hematological tumors. In this review, the basic characteristics of exosomes, the important role of exosomes in the immune microenvironment of hematological tumors, and the research progress of exosomes in clinical applications was sammrized briefly.


Assuntos
Exossomos , Neoplasias Hematológicas , Células Endoteliais , Humanos , Neovascularização Patológica , Pesquisa , Microambiente Tumoral
5.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(3): 849-854, 2020 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-32552946

RESUMO

OBJECTIVE: To analyze the clinical and pathological characteristics of primary gastrointestinal non-Hodgkin's lymphoma (PGI-NHL) patients, and to explore the factors affecting the patients' survival and prognosis. METHODS: The clinical data of 219 patients with PGI-NHL diagnosed in our hospital from March 2009 to April 2016 was collected and retrospectively analyzed. Survival analysis was performed by using the Kaplan-Meier method. Log-rank test was used for comparison among the groups, and Cox regression was used for multivariate analysis. RESULTS: Among the 219 patients with PGI-NHL, 126 patients were males and 93 patients were females. 182 patients were IPI 0 to 2 and 37 patients were IPI 3 to 5. There were 205 cases (93.6%) of B cell phenotype and 14 cases (6.4%) of T cell phenotype. 140 patients (63.9%) were patients with primary gastric NHL, including 85 DLBCL and 19 MALT. 79 cases (36.1%) were patients with primary intestinal NHL, including 46 DLBCL, 4 MALT, 7 FL, 3 MCL and 4 Burkitt lymphoma. 23 cases were HP positive and received anti-HP therapy. 57 cases and 32 cases received surgery and chemotherapy respectively. 84 cases received combination treatment of surgery and chemotherapy and 11 cases received combination treatment of radiotherapy and chemotherapy. Overall survival (OS) of indolent B-cell non-Hodgkin's lymphoma was longer than that of invasive B-cell non-Hodgkin's lymphoma, which shows better prognose. Kaplan-Meier analysis showed that there was no difference between progression-free survival (PFS) and OS in the patients with different origin sites, age and sex. There was no significant difference in PFS between B-cell and T-cell-derived patients, whereas OS of B-cell-derived PGI-NHL patients was longer than that of T-cell-derived PGI-NHL patients. The OS and PFS of patients with IPI 0-2 were longer than those of patients with IPI 3-5. According to Lugano and Ann Arbor staging systems, there was no difference in prognosis of patients between phase I/II and III/IV. The prognosis of patients treated with surgery alone was worse than that of patients treated with combination therapy, and the prognosis of patients with surgery combined with chemotherapy was not significantly different from that of patients with chemotherapy alone. CONCLUSION: B-cell phenotype, indolent and low IPI score lymphoma indicate better prognosis, while that of different origin site, sex and age shows no different in prognosis. Surgery is used only for emergency case or pathological materials, and these patients should be treated with chemotherapy-based combined treatment.


Assuntos
Neoplasias Gastrointestinais , Linfoma não Hodgkin , Protocolos de Quimioterapia Combinada Antineoplásica , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Análise de Sobrevida
6.
Int J Radiat Oncol Biol Phys ; 106(4): 848-856, 2020 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-31794839

RESUMO

PURPOSE: Our purpose was to compare long-term survival outcomes and sequelae between child and adult nasopharyngeal carcinoma (NPC) in the era of intensity modulated radiation therapy. METHODS AND MATERIALS: Data on 285 patients with NPC aged ≤18 years at diagnosis and treated with intensity modulated radiation therapy between January 2004 and November 2016 were retrospectively reviewed. A propensity score matching method was adopted to screen matched adult patients with NPC at a ratio of 1:3. Survival outcomes and treatment-related toxicities between child and adult groups were compared. RESULTS: In total, 159 children and 477 adult patients with NPC were included in this study. The 5-year overall survival, distant metastasis-free survival, locoregional relapse-free survival, and disease-free survival between children and adults were 89.2% versus 83.6% (P = .144), 88.7% versus 83.5% (P = .124), 96.4% versus 89.1% (P = .013), and 86.5% versus 77.3% (P = .021), respectively. Subgroup analyses revealed that the young age was an independent prognostic factor of overall survival, distant metastasis-free survival, and locoregional relapse-free survival in the advanced N stage (N2-3) group and disease-free survival in the advanced T stage (T3-4) group and N2-3 and stage III-IVA groups. The most common sequela was ototoxicity (68.9%) in child patients and xerostomia (70.8%) in adult patients. Adult survivors had a significantly higher incidence of grade 3 to 4 late toxicities in xerostomia (17.6% vs 8.9%; P = .004), skin dystrophy (9.3% vs 3.7%; P = .022), neck fibrosis (8.3% vs 4.4%; P < .001), and radiation encephalopathy (0.8% vs 0; P = .006). Child survivors were more likely to develop grade 3 to 4 growth retardation and endocrine insufficiency (3.0% vs 0.3%; P = .014). CONCLUSIONS: Child patients with NPC achieved significantly better survival outcomes but fewer late toxicities than adult patients. However, we should pay great attention to growth problems of child survivors.


Assuntos
Carcinoma Nasofaríngeo/radioterapia , Radioterapia de Intensidade Modulada , Adolescente , Adulto , Criança , Progressão da Doença , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma Nasofaríngeo/patologia , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
7.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 27(1): 52-60, 2019 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-30738447

RESUMO

OBJECTIVE: To compare the prognostic value of different staging systems in primary intestinal diffuse large B cell lymphoma(PI-DLPCL), and their correlation with clinicopathological characteristics,treatment and prognosis of PI-DLBCL. METHODS: A total of 68 patients with PI-DLBCL were recruited from January 2009 to July 2017. All the patients underwent staging by using TNM, Lugano, Blackledge and Musshoff system, survival curves for the PI-DLBCL patients were plotted using the Kaplan-Meier method and were judged by the log-rank test. The accuracy of each staging system for predicting survival of PI-DLBCL patients was evaluated by calculating the area under curve(AUC) of the receiver operating characteristic(ROC). The correlation of the 4 staging systems, clinical features patients and treatment regimes with PFS and OS were analysed. RESULTS: The median follow-up time was 52 (1-105) months, the median PFS time was 41(1-86) months, patients did not reached the median OS time. The most frequently involved site was ileocecal (30.9%), followed by small intestine (29.4%) and colon (29.4%), multiple sites involvement (7.4%) and rectum (2.94%).The PFS and OS rates at 5-year were 44.9% and 51.1%, respectively. Kaplan-Meier survival curves and log-rank test results showed that using different staging systems to describe the cumulative retention rates of PFS and OS in PI-DLBCL patients, none of the 4 staging systems can distinguish the survival curves of each stage significantly. The results of ROC curve showed that the prediction ability of the Lugano staging system was better than other staging system for 1 year PFS (AUC=0.826;P=0.015)and 1 year OS(AUC=0-792;P=0.001) in PI-DLBCL patients. The 3 year PFS rate in the operation+chemo or radio-therapy group (62 cases) and the single operation group (6 cases) were 53.9% and 16. 7%,respectively(P=0.116),The 3 year OS rate were 66.7% and 16.7%(P=0.015),respectively. Patients who received chemotherapy combined with rituximab had a higher 3-year PFS(66.0% vs 44.0%,P=0.139) and 3.year OS(70.2% vs.39.2%,P=0.148).The patients with ileocecal lesion had higher PFS rate and OS rate than other sites(P<0.05). Multivariate Cox regression analysis indicated that only bone marrow invasion was an independent prognostic factor in patients with PFS. CONCLUSION: Bone marrow invasion is an independent risk factor for PFS in patients with PI-DLBCL , according to this limited preliminary data,Lugano staging system for stratifying and predicting the prognosis of PI-DLBCL patients is better than other staging system.


Assuntos
Linfoma Difuso de Grandes Células B , Protocolos de Quimioterapia Combinada Antineoplásica , Ciclofosfamida , Intervalo Livre de Doença , Humanos , Estimativa de Kaplan-Meier , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Rituximab
8.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 27(1): 96-103, 2019 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-30738454

RESUMO

OBJECTIVE: To evaluate the quality of life (QOL) on patients with multiple myeloma(MM) during maintenance therapy and to explore the related factors important for QOL. METHODS: The demography, clinical and laboratorial data of 66 MM patients during maintenance therapy were collected and explored by using a cross-sectional question naire(EORTC QLQ C30 V 3.0). The statistical analysis was performed using Nowegram normal mode(NM) and reference values(RV) of MM patients which were used as control. RESULTS: In comparison with Nowegran normal mode, the scores of general health status, physical function, role function and social function of patients during maintenance therapy were lower than those of normal mode (61.3, 73.9, 65.4 and 65.2 vs 75.3, 89.9, 83.3 and 85.8 respectively), while the scores of constipation and financial difficulty were higher than those of normal mode(16.7 and 44.4 vs 10.7 and 9.7 respectively) (P<0.05). In comparison with reference values, the scores of general health status, emotional and coguitive functions of patients during maintenance therapy were significantly higher than those of reference values(61.3, 81.7 and 84.3 vs 55.7, 71.3 and 78.1 respectively) (P<0.05). In addition, the maintenance therapy yet decreasd the scores of fatigue, nausea and vomiting, pain, dyspnoea, insomnia, appetite loss and constipation of patients, but increased the score of financial difficulty of patients (P<0.05). The age of initial diagnosis, serum LDH level, peripheral neuropathy, high ratio of own expense and underlying diseases were main factors affecting the general health status of patients (P<0.05), while the decrease of Hb level, increase of blood Ca++ level and accompanied genetic changes negatively influence the QOL (P<0.05), while the high culture level showed positive effect on QOL (P<0.05). The choise of drugs for maintenace (therapy thalidomide and bortezomib) not had significant effect on QOL of patients. CONCLUSION: The maintenance therapy can improve the QOL of MM patients, the age at initial diagnses, serum LDH level, peripheral neuropathy and high ratio of own expence are the main factors affecting the QOL of MM patients.


Assuntos
Mieloma Múltiplo , Qualidade de Vida , Estudos Transversais , Humanos , Mieloma Múltiplo/terapia , Talidomida
9.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 26(6): 1668-1674, 2018 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-30501702

RESUMO

OBJECTIVE: To evaluate the therapeutic effect and adverse reactions of the maintenance therapies with Thalidomine or Bortezomib in the patients with newly diagnosed multiple myeloma (MM), so as to provide a reference for clinical treatment. METHODS: A retrospective analysis was conducted to compare the progression-free survival (PFS), overall survival (OS) and adverse reaction rate of 23 MM patients received the maintenance therapies of Bortezomib and of 68 MM patients received maintenance therapy of Thalidomine. RESULTS: The maintenance therapy with Bortezomib could extend the PFS of MM patients as compared with Thalidomine (PFS rate of patients on the maintenance therapy of Bortezomib in 12th, and 24th month was 100%, 88.89%, and that of Thalidomine-treated group was 72.31%, 47.54%). What's more, some specific patients could get better 2-year PFS rate in Bortezomib group than that in Thalidomine group, such as older than 65 years old, after autologous hematopoietic stem cell transplantation(ASCT), having genetic changes, extramedullary lesions, poor renal function, low serum free light chain ratio, high ß2-MG, anemia, high LDH, VGPR of induction and consolidation therapy. The OS rate of Bortezomib on 18th, 24th and 30th month was 100%, 88.89%, 80% verus 91.52%,83.63%,72.90% of the group with thalidemide at the same time. As for 2-year OS rate, the Bortezomib group was higher than Thalidomine without statistical differences. However, the patients such as older than 65 years old, poor renal function and with extramedullary lesions, would also get higher 2-year OS rate from Bortezomi. Bortezomib and thalidomide could cause bone marrow suppression, peripheral neuritis and other adverse reactions. CONCLUSION: The efficacy of maintenance therapy with Bortezomib is superior to thalidomide. As a conclusion, bortezomib is a better option for maintenance therapy of MM patient.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Mieloma Múltiplo , Idoso , Ácidos Borônicos , Bortezomib/administração & dosagem , Intervalo Livre de Doença , Humanos , Mieloma Múltiplo/tratamento farmacológico , Pirazinas , Estudos Retrospectivos , Talidomida/administração & dosagem , Transplante Autólogo , Resultado do Tratamento
10.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 26(6): 1841-1846, 2018 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-30501731

RESUMO

Diffuse large B cell lymphoma(DLBCL)is the most common non-Hodgkin's lymphoma in adults,accounting for 30%-40% of non-Hodgkin's lymphoma in adults. The treatments of this lymphoma mainly include chemotherapy,radiotherapy and autologous hematopoietic stem cell transplantation. A large amount of studies show that autologous hematopoietic stem cell transplantation considered as the main treatmant approach can be used for primary high-risk young and relapsed or refractory DLBCL patients. Many scholars have evaluated the effectiveness of autologous hematopoietic stem cell transplantation for primarily high-risk young and relapsed or refractory DLBCL patients,and tried to improve the effectiveness of transplantation that showed some advantagcs for DLBCL patients.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Linfoma Difuso de Grandes Células B , Protocolos de Quimioterapia Combinada Antineoplásica , Humanos , Linfoma Difuso de Grandes Células B/terapia , Condicionamento Pré-Transplante , Transplante Autólogo , Resultado do Tratamento
11.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 26(5): 1396-1402, 2018 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-30295257

RESUMO

OBJECTIVE: To evaluate the therapeutic efficacy and prognosis of autologous stem Hematopoietic cell transplantation (auto-HSCT) in multiple myeloma (MM) patients. METHODS: A retrospective study was conducted for 56 patients diagnosed with MM and then received auto-HSCT in our hospital from December 2008 to September 2016. RESULTS: All the patients successfully underwent hematopoietic reconstruction without transplantation-related mortality (TRM). The complete response (CR) rate of all the patients after induction chemotherapy was 23.2% (13/56), while the CR rate of these patients with auto-HSCT increased to 78.6% (44/56) (P<0.01). The CR plus VGPR (very good partial response) rates of these 56 patients after induction chemotherapy and auto-HSCT were 53.6%(30/56)and 94.6%(53/56) respectively (P<0.01). The median progression-free survival (PFS) time and median overall survival (OS) time were 37 and 71 months, respectively. The median PFS time in the patients with induction therapy containing bortezomib was 37 months, however, the median OS time did not reach to 71 months; the median PFS (P<0.01) and the median OS (P<0.01) in the patients with the induction chemotherapy without bortezomib was 27 and 51 months, respectively. Univariate analysis demonstrated that the patients maintained CR or VGPR after auto-HSCT or with less than 6 cycles of induction chemotherapy significantly correlated with PFS (P<0.01). CONCLUSION: auto-HSCT can further increase the CR rate, prolong PFS and OS time. Sequential auto-HSCT after bortezomib-based therapy is the first line therapy for the transplant-eligible MM patients. Maintenance treatment is beneficial to the sustained CR+VGPR patients after auto-HSCT.


Assuntos
Mieloma Múltiplo , Protocolos de Quimioterapia Combinada Antineoplásica , Transplante de Células-Tronco Hematopoéticas , Humanos , Mieloma Múltiplo/terapia , Estudos Retrospectivos , Transplante Autólogo , Resultado do Tratamento
12.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 26(2): 603-608, 2018 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-29665940

RESUMO

Diffuse large B-cell lymphoma (DLBCL) is biologically aggressive and most common pathological type of non-Hodgkin's lymphoma (NHL), and about one-third of these patients are refractory or relapsed ultimately. Based on the molecular heterogeneity, DLBCL can be divided into 3 main molecular subtypes: germinal center B-cell like (GCB), activated B-cell like (ABC) and primary mediastinal B-cell lymphoma (PMBL). Arising from B cells at distinct stages of differentiation, these subtypes are also diverse in mechanisms of oncogenic activation. So targeting specific oncogene addictions within the DLBCL subtypes offers a more-precise approach to therapy in comparison with the traditional chemotherapies, undoubtedly bringing a bright hope for the treatment of relapsed/refractory DLBCL. In this article, the advances in diagnosis and therapy of GCB-DLBCL, ABC-DLBCL and PMBL relapsed/refractory diffuse large B-cell lymphoma are summarized.


Assuntos
Linfoma Difuso de Grandes Células B , Protocolos de Quimioterapia Combinada Antineoplásica , Linfócitos B , Humanos , Neoplasias do Mediastino
13.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 25(4): 1232-1236, 2017 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-28823299

RESUMO

The pathogenesis of diffuse large B-cell lymphoma(DLBCL) has not been fully elucidated, but people realized that the occurrence of DLBCL is caused by the mutual change of genetics and epigenetics with the rapid development of modern biological technology. Epigenetics is to explore the expression changes of genes and proteins without the changes of gene sequences, and this change is reversible and can be inherited. In this review, the latest advances of epigenetic changes in DNA methylation, microRNA regulation, and histone modification for DLBCL are summarized, so as to provide a new strategy to study the early diagnosis, treatment and prognosis of DLBCL.


Assuntos
Epigênese Genética , Linfoma Difuso de Grandes Células B , Metilação de DNA , Regulação Neoplásica da Expressão Gênica , Humanos , MicroRNAs , Prognóstico
14.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 25(2): 600-603, 2017 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-28446319

RESUMO

Splenic marginal zone lymphoma (SMZL) is an uncommon indolent B-cell non-Hodgkin's lymphoma. The clinical features of SMZL are splenomegaly, lymphocytosis and cytopenia in peripheral blood. Immunopheno-typically, the neoplastic cells are typically positive for CD45, CD20, CD79a, PAX5, IgD, BCL-2. The previous common used treatment is splenectomy and chemotherapy. Nowadays, rituximab-based chemotherapy regimens has improved the curative effect dramaticlly. IFN-α with or without ribavirin can be used to treat the patients with HCV infection. Some new target agents such as Bruton tyrosine kinase, NOTCH inhibitor, CAL-101 are under clinical research. This review mainly discuss the progress in the treatment of SMZL.


Assuntos
Linfoma de Zona Marginal Tipo Células B/tratamento farmacológico , Neoplasias Esplênicas/tratamento farmacológico , Antígenos CD20 , Humanos , Linfoma de Zona Marginal Tipo Células B/cirurgia , Rituximab , Esplenectomia , Neoplasias Esplênicas/cirurgia
15.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 25(1): 126-132, 2017 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-28245388

RESUMO

BACKGROUND: A survey of early stage follicular lymphoma(FL) revealed that the rigorously staged FL patients at first diagnosis had a better outcome as compared with non-rigorous staged FL patients, but there were no similar reports in China. OBJECTIVE: To explore the relationship between the rigorous staging at first diagnosis and the prognosis of FL patients at different stages. METHODS: The clinical data of 111 patients with newly diagnosed FL from 2008 to 2014 year were collected and analyzed. The rigorous staging included: (1) bone marrow aspiration and biopsy, (2) imaging examination of whole body including CT and ultrasounic scan, or PET/CT, either or both is defined as rigorous staging, or else as non-rigorous staging. RESULTS: The FL patients at I-II stages by rigorous staging showed a superior progression-free survival(PFS) compared with non-rigorous staging patients(P=0.048). For all the patients, the age, serum LDH, bone marrow lesion and more than 3 foci of diameter larger than 3 cm correlated with prognosis in univariate analysis, and multivariate analysis revealed that the age, serum LDH and bone marrow imolvement were the independent prognostic factors. CONCLUSION: Rigorous staging leads to better outcomes, suggesting that accurate and appropriate testing is important for the patients at the first treatment. The close correlation of bone marrow with prognosis indicates that the evaluation of bone marrow is very important for the daily clinical practice.


Assuntos
Linfoma Folicular/diagnóstico , Estadiamento de Neoplasias , China , Humanos , Linfoma Folicular/patologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Prognóstico , Estudos Retrospectivos
16.
Chin Med J (Engl) ; 130(2): 130-134, 2017 01 20.
Artigo em Inglês | MEDLINE | ID: mdl-28091402

RESUMO

BACKGROUND: Elderly multiple myeloma (MM) patients often tend to suffer a variety of diseases, so the treatment of choice is very difficult for the elderly myeloma patients. The overall survival (OS) time and side effects with elderly patients are unclear in China. The study tried to find out the role of geriatric assessment in the Chinese elderly MM. METHODS: We retrospectively analyzed the data of 628 newly diagnosed patients from six hospitals from June 2011 to June 2013. A geriatric assessment had been performed to assess comorbidities, cognitive, and physical status for these patients. The primary endpoint was to evaluate different physical states of elderly patients with OS time and treatment-related side effects. RESULTS: An additive scoring system (range: 0-5), based on age, Katz's Activity of Daily Living (ADL) and Lawton's Instrumental Activity of Daily Living (IADL) ≤5 and Charlson Comorbidity Index (CCI) was developed to identify three groups: fit (score = 0); intermediate-fitness (score = 1); and frail (score ≥2). The 3-year OS was 63% in fit patients, 63% in intermediate-fitness patients, and 49% in frail patients ≥3 hematologic adverse events (AEs) were documented in 45 (35.4%) fit, 34 (34%) intermediate-fitness, and 121 (30.2%) frail patients. The risk of a grade ≥3 hematologic AEs was not significantly increase in intermediate-fitness (hazard ratios [HR]: 0.99, 95% confidence interval [CI]: 0.54-1.47, P = 1.000) and in frail patients (HR: 1.16, 95% CI: 0.70-1.93, P = 0.558) compared with fit ones. CONCLUSIONS: MM occurs earlier in life and being advanced when the diagnosis is made in the mainland of China. The overall survival in frailty with International Staging System (ISS) II/III was the worst in all patients.


Assuntos
Avaliação Geriátrica/métodos , Mieloma Múltiplo/mortalidade , Mieloma Múltiplo/fisiopatologia , Atividades Cotidianas , Idoso , China , Cognição/fisiologia , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Mieloma Múltiplo/psicologia , Estudos Retrospectivos
17.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 24(3): 945-8, 2016 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-27342539

RESUMO

Multiple myeloma (MM) is a malignancy of terminally differentiated monoclonal B cells, which is characterized by the presentation of malignant plasma cell within the bone marrow and the secretion of monoclonal immunoglobulin. Extramedullary disease (EMD) may be found either at diagnosis or during therapy of these patients. For the patients with EMD, the response to conventional chemotherapy is poor and the prognosis is unfavorable. This review mainly discusses the research progress in the pathogenesis, the clinical feature, the therapy and the prognosis of MM with EMD.


Assuntos
Medula Óssea/patologia , Mieloma Múltiplo/patologia , Plasmócitos/patologia , Humanos , Prognóstico
18.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 24(2): 438-43, 2016 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-27151006

RESUMO

OBJECTIVE: To investigate the clinical characteristics and prognostic factors of patients with peripheral T cell lymphoma (PTCL). METHODS: The clinical data of 46 elderly PTCL patients admitted in Tianjin Medical University Cancer Hospital from April 2008 to August 2014 were collected, the clinical features, prognostic factors and treatments, as well as followed-up outcome were analyzed retrospectively. Survival analysis was performed by Kaplan-Meier method, and the COX proportional hazard model was used to perform multivariate analysis. RESULTS: The median survival time was 11 months, and the expected 1-year, 2-year and 3-year overall survival rate (OS) was 50%, 36% and 33%, respectively. Univariate analysis showed that the age, ECOG score, Charlson Comorbidity Index Score, the efficacy and course of chemotherapy were all the prognostic indicators affecting the OS and progression free survival (PFS) in this cohort of elderly patients. Multivariate analysis indicated that ECOG score and course of chemotherapy were the independent prognostic indicators affecting the OS and PFS (P < 0.05). CONCLUSION: ECOG score and course of chemotherapy are of great significance for predicting the prognosis in elderly PTCL patients. The elderly patients's general condition and completion of a certain intensity of chemotherapy are an important measure to prolong survival time in elderly PTCL patients.


Assuntos
Linfoma de Células T Periférico/diagnóstico , Linfoma de Células T Periférico/patologia , Idoso , Intervalo Livre de Doença , Humanos , Estimativa de Kaplan-Meier , Análise Multivariada , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Taxa de Sobrevida
19.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 23(5): 1296-300, 2015 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-26524026

RESUMO

OBJECTIVE: To analyze the clinical characteristics and prognostic factors of the newly diagnosed Hodgkin's lymphoma (HL) patients. METHOD: The clinical data of 223 patients with pathologically confirmed and newly diagnosed HL (since January 2001 to December 2012) were collected from Tianjin Medical University Cancer Hospital. The patients' route features, laboratory examination results, clinical manifestations and short-term efficacy were analyzed. Furthermore, the Log-rank test and Cox proportional hazard model were applied to analyze the prognosis. All data were analyzed with SPSS software version 1.0 and graphPad Prism 5. RESULTS: Among the 223 newly diagnosed HL patients, the ratio of male to female was approximately 1.25:1 and the median age was 40 years old (range 3-84 years). The median survival period is 62 months (range 8-189 months). The 5-year overall survival (OS) rate was 92.8% for all 223 HL patients. Multivariate analysis showed that HL originated from mediastinal lymph node region, the extranodal sites were involved, lactate dehydrogenase (LDH) level increased and CR2 was unable to fulfil the CR/CRu which are independent prognostic factors of HL patients (P < 0.05). Therefore, according to the above-mentioned adverse prognostic factors, 223 cases of HL patients were regrouped as low, intermediate and high risk. The HL 5-year OS rate of three groups were 100%, 96.9% and 42.9%, OS in each group was significantly different (P < 0.05). CONCLUSION: HL displays a high incidence in young male patients but the curative efficacy is optimal and the survival period is long. The HL originated at mediastinal lymph node region, involved extranodal sites, lactate dehydrogenase (LDH) level increased and CR2 is unable to fulfil the CR/CRu which are independent prognostic factors of HL patients. According to the above-mentioned factors for the initial treatment of patients with HL, risk discrimination can predict the prognosis of patients with HL to a certain extent.


Assuntos
Doença de Hodgkin/diagnóstico , Doença de Hodgkin/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Incidência , L-Lactato Desidrogenase/metabolismo , Linfonodos/patologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Modelos de Riscos Proporcionais , Taxa de Sobrevida , Adulto Jovem
20.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 23(4): 1156-60, 2015 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-26314464

RESUMO

OBJECTIVE: To investigate the clinical characteristics, treatment and prognosis of solitary myeloid sarcoma (MS). METHODS: The clinical data of 14 solitary MS patients were retrospectively analysed, including their clinical features and treatment, and were evaluated. RESULTS: A total of 14 cases of solitary MS mainly occurred in middle-aged population with the median age 41 years old (17-62 years old). The involved sites were more extensive, including breast, testis, spinal canal, skin, gastrointestinal system, nose and so on. The poorly differentiated cells of small to medium size showed diffuse distribution, relatively consistent morphology and a higher ratio of cytoplasm. The nucleus is in round or oval shape with fine and dense chromatin. Pathological mitosis was easily observed. Expression of MPO, lysozyme, CD43, myeloid-derived cells were positive. Treatment methods included surgery, chemotherapy and stem cell transplantation. Median survival time of 14 patients was 22.5 months; overall survival (OS) was 35.7% (5/14), median disease-free survival reached to 10.4 months on averge (3.5 months to 16 months), and 2-year overall survival (OS) was 50.3%. CONCLUSION: The incidence of solitary MS is low, with a tendency progressing to leukemia, the chemotherapy regimen of anthracycline+cytarabine combined with radiotherapy can achieve better clinical efficacy.


Assuntos
Sarcoma Mieloide , Adolescente , Adulto , Citarabina , Intervalo Livre de Doença , Humanos , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Transplante de Células-Tronco , Adulto Jovem
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