ABSTRACT
Background: non Hodgkin Lymphoma is the most common hematologic malignancy and it is the 6th leading cause of cancer death. Relapses still occur in the majority of patients; overall, more than 30% of DLBCL will ultimately relapse
Aim of study: primary objective was to retrospectively correlate the occurrence of relapsed, refractory and in remission diffused large B cell lymphoma patients to both clinicpathological features of the disease and line of treatment received
Patients and Method: a total of 116 patients with aggressive high grade NHL patients [DLBCL] representing 86.6% of all patients presented to Clinical Oncology Department, Ain Shams University in the period between January 2009 and December 2015. Data were collected between January 2017 until Marsh 2017
Results: the mean age at diagnosis of the studied patients was 45 years. The incidence in male was higher than female [52.6% vs. 47.4%], the majority of the cases didn't have B symptoms [57.7%], high LDH level was measured among the cases [37%]and in only 36 patient's files,16.37% of the cases had positive HCV.The most common stage at diagnosis was stage IV [33.6%]followed by stage III [29.3%]. Based on response to the 1st line chemotherapy, DLBCL patients were further statistically analyzed into three categories:24 refractory patients [20.07%], 43 relapsed patients [37.1%] and 49 patients in remission [non relapsed] [42.2%]. Regarding 1st line treatment regimen by R-Chop, complete response rates were significantly higher in patients who received R-CHOP than in the group who received CHOP alone [57.1% vs 42.8%]. The median disease freesurvival in the relapsed groupwas 8 months. The median survival time for the DLBCL patients was 24 months. The survival rate after 1 year was 83.7%, while after 2 years it was 52.8% and after 3 years it was 21.3%
Conclusion: relapsed and refractory disease continues to represent the most significant challenge in treating NHL, the addition of rituximab to the CHOP regimen increased the CR rate and prolonged eventfree and overall survival
ABSTRACT
It has been suggested that hemoglobin levels of 12-14 g/dL are optimal for tumor oxygenation, radiosensitivity, and prognosis. in this prospective study, we evaluated the effectiveness of epoetin-alpha to maintain hemoglobin levels at 12-14 g/dL during radiotherapy [RT] for patients with FIGO Stage III cervical carcinoma, and we examined the impact of erythropoetin on overall survival [OS], metastatic-free survival [MFS], and local control [LC]. Forty patients, who received RT between January 2002 and June 2004, were included in this prospective, nonrandomized study. Twenty patients received epoetin-alpha [150 lU/kg 3 times per week] during RT [Group A], and 20 patients did not receive epoetin-alpha [Group B]. Epoetin-alpha was started at hemoglobin levels < 13 g/dL and was stopped at hemoglobin levels >/= 14 g/dL. Hemoglobin was measured before RT and once weekly during RT. Both groups were balanced for age, performance status, histology, grading and hemoglobin level before RT. in 11 of 20 patients [55%]from Group A and in 13 out of 20 patients [65%]from Group B had Haemoglobin level < 12 mg/dl prior to radiotherapy. The median change in hemoglobin was + 0.4 g/dL per week in Group A and - 0.4 g/dL per week in Group B. Local Control [LC] was significantly better in Group A [66% vs. 38% at 1 year, respectively P=0.012], a trend was observed for Overall Survival [OS] [59% VS. 33%, respectively; P = 0.08] and Metastatic Free Survival [MFS] did not differ significantly [43% vs. 38%, respectively; P = 0.34]. No epoetin-alpha related toxicity was observed. Epoetin-alpha was effective in maintaining the hemoglobin levels at 12-14 g/dL during RT. The application of epoetin-alpha significantly improved LC, and a trend was observed for OS
Subject(s)
Humans , Female , Treatment Outcome , Hemoglobins , Prospective Studies , Radiotherapy/methods , Radiation Tolerance , Survival , Disease-Free SurvivalABSTRACT
Between 2001 and 2002, 56 patients with refractory or relapsing non-Hodgkin lymphoma after prior anthracycline based chemotherapy were treated with DHAP [dexamethasone, high dose cytarabine and cisplatin]. After 6 cycles, 28.8% of patients [16/56] achieved complete response, while 58.9% [33/56] attained partial response. The overall survival at 2 years was 25%. Myelosuppression was the major toxicity; 24 patients [42.85%] had grade IV neutropenia and 39 patients [69.64%] had grade III-IV thrombocytopenia, but there was no treatment-related death. DHAP regimen is an effective salvage therapy for the patients with relapsed and refractory NHL, but the response duration time is short and long-term prognosis remains poor; high dose chemotherapy with autologous bone marrow transplantation is necessary for improvement in long-term survival