ESHAP Salvage Therapy for Relapsed or Refractory Non-Hodgkin's Lymphoma

The ESHAP regimen, a combination of the chemotherapeutic drugs etoposide, methylprednisolone (solumedrol), high-dose cytarabine (ara-C), and cisplatin, has been shown to be active against refractory or relapsed non-Hodgkin's lymphoma (NHL) in therapeutic trials. We undertook this study to determine whether this regimen would be effective and tolerable in Korean patients. A total of 40 patients with refractory or relapsed NHL (8 indolent and 32 aggressive) were enrolled in this study. The overall response rate was 70% (95% confidence interval; 59.8-89.7%); 22.5% of patients achieved a complete response and 47.5% a partial response. The median survival duration was 12 months (95% confidence interval; 5.9-18.1 months) and the median duration of progression-free survival was 9 months (95% confidence interval; 1.1-16.9 months). The median survival duration of patients with relapsed NHL was longer than that of patients with refractory lymphoma (15 months vs 4 months, p=0.02). Myelosuppression was the most frequent complication and treatment-related mortality was noted in two patients. These results suggest that the ESHAP regimen is effective in patients with relapsed NHL who have a sensitive disease. The role of ESHAP chemotherapy in discriminating patients who are more likely to benefit from a subsequent transplant should be evaluated in the future.

Prevalence of anemia in the elderly / 대한내과학회지

BACKGROUND: Anemia is the most common hematologic problem encountered in the elderly. We conducted this prospective study to define the prevalence and characteristics of anemia in the elderly. METHODS: From August 1999 to October 1999, volunteers with age of 60 or more living in southwest area of Seoul, Korea were selected. Hemoglobin, mean corpuscular volume, red cell distribution width and iron profile were evaluated. WHO criteria cut off value of hemoglobin for the diagnosis of anemia was used, 13 g/dL in men and 12 g/dL in women. RESULTS: A total 1716 community residents aged 60 years or older were studied. Male to female ratio was 344:1372, and median age was 70 years (range:60-92). The prevalence of anemia was 10.2% in men (35/344) and 14.1% in women (194/1372). Normocytic anemia was most common, followed by macrocytic and microcytic anemia in order. CONCLUSION: The prevalence of anemia over the age of 60 was 10.2% in men and 14.1% in women and normocytic anemia was the most common type in our series. Considering that macrocytic anemia was more common than microcytic anemia, we suggest that screening profile for the detection of anemia in older persons should include the level of folate and vitamin B12.

Concurrent Chemoradiation Therapy with Cisplatin and Oral Etoposide for Locally Advanced Non-small Cell Lung Cancer / 대한암학회지

PURPOSE: Prognosis of locally advanced inoperable non-small cell lung cancer (NSCLC) treated with radiation therapy alone has been disappointing. In recent years, concurrent chemoradiation therapy has potential of improving both local and metastatic disease-free survival. This phase II study was undertaken to determine the feasibility, toxicity, response rate, local control rate, and survival duration of locally advanced NSCL patients treated with concurrent chemoradiation using cisplatin and oral etoposide. MATERIAL AND METHODS: Forty-seven patients were enrolled and forty-one patients were evaluable. Chemotheray consisted of cisplatin 50 mg/m2/IV on days 1 and 8 and oral etoposide 100 mg/day on days 1 to 5 and 8 to 12 which was repeated, every 4 weeks for two cycles during radiation therapy. Radiation therapy was administered to a total dose of 6300 cGY. RESULTS: Among 41 evaluable patients, six patients achieved complete response, and twenty had partial response, for an overall response rate of 63.4% (95% confidence interval; 48.4% to 75.4%). Stable disease was reported in 10 patients (24.4%) and another 5 (12.2%) showed disease pro gression. Overall survival rate was 76% at 1 year, 34% at 2 years. Median survival duration was 17 months (range; 3 to 41 ). Eighty-three percents of patients had radiation pneumonitis but only one patients needed medical treatment. CONCLUSION: Concurrent chemoradiation therapy with cisplatin and oral etoposide at this level is a well tolerated and feasible.

The Mechanism of Retinoic Acid-induced Growth Suppression in Head and Neck Squamous Cancer Cell Lines / 대한암학회지

PURPOSE: Retinonic acid (RA) has been reported to induce differentiation and growth inhibition in various head and neck squamous cancer cell (HNSCC) lines. We hypothesized that this growth inhi bition might be explained by RA-induced apoptosis on cell cycle arrest mechanism. Therefore, we studied the degree of RA-induced apoptosis with variable RA concentration and exposure duration. MATERIAL AND METHODS: The flow cytometric evaluation of apoptosis degree and cell cycles were carried out with 7-amino actinomycin D (7AAD) and propium iodide (PI) respectively, with var ious RA exposure durations (2, 3, 6 day) and concentrations (conrol, 10 6, 10 7, 10 8, 10 9, 10 10 mole). Two different HNSCC lines (1483, SqCC/Y1) were used and the experiment was repeated twice. RESULTS: The maximal fraction of apoptosis in 1483 and SqCC/Y1 cell lines were observed at same concentration and exposure duration (1483: 6th day & 10 6, mole, and SqCC/Y1: 6th day & 10 6 mole). In our experimental model, RA did not induce specific cell cycle arrest in these HNSCC lines. However we observed S phase fraction increase in SqCC/Y1 cell line after RA treatment. CONCLUSION: We suppossed that in HNSCC lines, RA-induced cell growth inhibition could be explained by not only RA-induced apoptosis but also cell cycle arrest. Futher, in vitro study has been carried out to elucidate the RA-iduced cell growth inhibition mechanism in our laboratory.

Effect of Splenectomy in Adult Patients with Idiopathic Thrombocytopenic Purpura (ITP) / 대한혈액학회지

No abstract available.