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Objective:To investigate prognostic factors of the T-cell non-Hodgkin’s lymphoma (T-NHL),and to study the clinical efficacy of CHOPE plus L-asparaginase (L-ASP)regimen for T-NHL.Methods:Retrospective analyses were made of 61 T-NHL patients who were treated from July 2007 to August 2013.Randomly divided into two groups CHOPE and CHOPE +L group (Based on CHOPE,added with L-ASP on the 1st,3rd,5th,7th,9th and 11th day).Results:Of the 61 patients evaluatd with the median survival was 22 (3 -65)months,the complete remission rate was 52.50%,the partial remission rate 29.51%,and the response rate 80.01%.The complete remission rate was 57.89%,and the patial remission rate 84.21% in CHOPE +L and the complete remission rate 43.48%,the response rate 78.26% in CHOPE,respectively (both P >0.05).The 1-,2-,and 5-year overall survival rates were 91.0%,87.6% and 65.7% respectively (P >0.05 ).But the overall survival rate in CHOPE +L was significantly higher than that in CHOPE group in extranodal NK/T-cell lymphoma,nasal type (ENKTCL)(P <0.05 ).The analysis of the prognostic factors indicated that ENKTCL,the outside junction lesions,and the CR rate were poor factors with statistic significance in T-NHL.Conclusion:CHOPE +L regimen has better efficacy for ENKTCL,but whether CHOPE +L regimen is used in the treatment of T-NHL,large prospective clinical trials are worth for further investigation.
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Objective:To search for differences in early immune reconstitution after allogenic or autolo-gous hematopoietic stem cell transplantation (HSCT).Methods:The peripheral blood (PB)from 31 adult patients undergoing allogenic HSCT (allo-HSCT,1 5 patients)or autologous HSCT (auto-HSCT, 1 6 patients)for the treatment of hematological malignancies and from 20 related healthy controls (HC) from December 201 1 to August 201 4 was used to analyze the kinetic recovery of lymphocyte subsets by means of flow cytometry during 1 2 months after HSCT.The T cell receptor rearrangement excision circle (TREC)levels among CD3 + T cells were measured in the patients and HC to evaluate the thymic-dependent T cell reconstitution.Results:The allo-and auto-HSCT recipients did not differ significantly in CD4 + T cells,CD8 na?ve T cells,effecter memory T cells (TEM),CD4 central memory T cells (TCM),mid-activated T cells and dendritic cells (DC)during the follow-up (P >0.05).But they both differed significantly from HC (P 0.05).B cells in both the groups were lower than those in HC (P 0.05). Conclusion:The differences of the nature and the speed of lymphocyte reconstitution observed between the two patents groups were minor.This leads us to conclude that in allografted patients,immune recons-titution and subpopulations of peripheral blood lymphocytes are probably not related to the allogenicity of the graft,but due to the impaired thymus functions and slow differentiation of T lymphocytes in thymus.
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Hodgkin lymphoma (HL) is a type of malignant tumor originating from the lymphoid hematopoietic tissues.Its typical pathological feature is the existence of R-S cells in the background of the different types of inflammatory cells.HL represents about 10 ％ of the total lymphoma and has good treatment outcome with 80 ％-90 ％ cure rate.However,there are still about 10 ％ of patients with refractory or relapsed lymphoma,which has become research focus of HL.In recent years,along with the application of molecular biology techniques,radiotherapy,chemotherapy and targeted therapy in treating HL,significant progress has been made in pathogenesis,prognosis and treatment of HL.
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<p><b>OBJECTIVE</b>To analyze the clinical and pathological features, molecular biological markers and prognosis of primary gastrointestinal diffuse large B-cell lymphoma (DLBCL).</p><p><b>METHODS</b>A retrospective study was conducted in 92 cases of primary gastrointestinal DLBCL. The data of clinical characteristics, pathological and immunohistochemical features were analyzed. The relationship between different factors at diagnosis and prognosis were studied.</p><p><b>RESULTS</b>Of the 92 patients, the male-female ratio was 1.56:1 with a median age of 59(7-89) years. The most frequently involved site was stomach (50.0%), followed by small intestine (15.2%), colon (12.0%), ileocecum (10.9%) and multiple gastrointestinal tract involvements (9.8%). The ratio of non-germinal center B cell (non-GCB) subtype to germinal center B cell (GCB) was 2:1. Among the cases, Ki-67 had a high level expression with a median positive rate >80%. Positive expression of Bcl-2 was detected in 52.1% cases (25/48). Evidence of Helicobacter pylori (Hp) infections was detected in 34.0% cases with stomach involvement. Of the patients, 75 were included in a follow-up study with a median time of 48 months (3-130 months). The complete remission(CR)rate was 66.7%(50/75),the partial remission (PR) rate was 22.7% (17/75) and the overall response rate was 89.4% (67/75). The 1-, 3- and 5- year survival rates of the patients were 85.3%, 66.2% and 60.5%, respectively. The incidence of secondary malignancy after chemotherapy was 2.7%. The multivariate analysis indicated that primary colic DLBCL or multiple involvements of gastrointestinal tract and low serum albumin level (<35 g/L) at diagnosis were independently associated with poor outcome. Patients who received chemotherapy combined with rituximab (43 cases) had a higher CR rate (79.1% vs 46.9%, P=0.008) and 5-year overall survival (77.5% vs 53.1%, P=0.0045) than those without rituximab (32 case).</p><p><b>CONCLUSION</b>Primary gastrointestinal DLBCL was a highly invasive and heterogeneous malignancy. In our data, the proportion of non-GCB subtype was higher. Primary colic DLBCL and those with multiple involvements of gastrointestinal tract had poor survival. Low serum albumin at diagnosis indicated poor outcome. Rituximab treatment in addition to chemotherapy might help to improve the clinical outcome. Further prospective trails were needed to confirm our results.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Gastrointestinal Neoplasms , Diagnosis , Mortality , Pathology , Lymphoma, Large B-Cell, Diffuse , Diagnosis , Mortality , Pathology , Prognosis , Retrospective Studies , Survival RateABSTRACT
<p><b>OBJECTIVE</b>To investigate cellular immune function and its clinical significance in patients with multiple myeloma (MM).</p><p><b>METHODS</b>45 MM patients were divided into three groups:newly diagnosed (n=18), stable stage (n=17) and relapsed/refractory (n=10). The frequencies of T cell subtypes, natural killer (NK) cells, dendritic cells (DC), helper T cells (including Th1 and Th2), regulatory T cells(Treg) and Th17 cells in peripheral blood were detected by flow cytometry. Serum concentrations of β2 microglobulin (β2-MG), lactate dehydrogenase (LDH) and hemoglobin (Hb) were also detected, respectively.</p><p><b>RESULTS</b>Compared with controls and stable stage group, the ratios of CD4+/CD8+, DC1/DC2, and Th1/Th2, the numbers of Treg and NK cells were significantly lower in newly diagnosed group. However, the ratio of IL-17A/Treg was significantly higher in newly diagnosed group (P<0.05). Compared with stable stage group, the ratios of CD4+/CD8+, DC1/DC2 and Th1/Th2 were significantly lower, and the ratio of IL-17A/Treg was significantly higher in relapsed/refractory group (P<0.05). In higher ISS stages, the ratios of CD4+/CD8+ and Th1/Th2 were significantly lower and the ratio of IL-17A/Treg was significantly higher (P<0.05). There were negative correlations between the ratios of CD4+/CD8+, DC1/DC2, Th1/Th2 and the levels of β2-MG and LDH, respectively (P<0.05). The ratio of IL-17A/Treg was positively correlated with the levels of β2-MG and LDH (P<0.05). They were no correlated with the level of Hb (P>0.05).</p><p><b>CONCLUSION</b>The abnormal ratios of CD4+/CD8+, DC1/DC2, Th1/Th2 and IL-17A/Treg were closely related with disease condition stages, treatment outcomes, progression and prognosis in MM patients.</p>
Subject(s)
Humans , Dendritic Cells , Flow Cytometry , Immunity, Cellular , Interleukin-17 , Multiple Myeloma , T-Lymphocytes, Helper-Inducer , T-Lymphocytes, RegulatoryABSTRACT
Objective To evaluate the survival status and efficacy,prognosis and safety of several combined chemotherapies in previously untreated patients with follicular lymphoma (FL).Methods Clinical data of 62 previously untreated FL patients were analyzed retrospectively,in order to analyse survival status and to compare the efficacy and safety of different combined chemotherapies.Results The percent of FL patients achieved complete response (CR) after initial therapy was 80.0 ％ (44/55),while achieved for more than 5 years accounted for 23.6 ％ (13/55).Ten-year overall survival (OS) rate was 77.8 ％.The relapse rate was 34.5 ％,and the OS rate in patients with recurrence was significantly lower than in non-recurrence patients (93.8 ％ vs 61.6 ％,P =0.012).The disease-free survival (DFS) and progression-free survival (PFS)rates in FC/FMD (fludarabine,cyclophosphamide/fludarabine,mitoxantrone,dexamethasone) group comparing with CHOP (cyclophosphamide,epirubicin,vincristine,prednisone)-like group were significantly higher (80.0 ％ vs 21.1％ and 80.0 ％ vs 29.2 ％,P ＜ 0.05),but the differences had no statistical significance when adding rituximab (88.9 ％ vs 72.7 ％ and 90.0 ％ vs 73.5 ％,P ＞ 0.05).The OS,DFS and PFS rates in rituximab group were higher than those in the group without it (96.4 ％,79.2 ％ and 79.2 ％ vs 82.9 ％,39.3 ％ and 44.5 ％,P ＜ 0.05).The DFS and PFS rates in fludarabine group comparing with the group without it were significantly higher (86.2 ％ vs 49.4 ％,87.1％ vs 52.7 ％,P ＜ 0.05),but the differences between OS rates had no statistical significance (92.9 ％ vs 89.1％,P ＞ 0.05).The major adverse effects were hematologic toxicity,infection,nausea/vomiting and abnormal liver function.The hematologic toxicity of chemotherapies including fludarabine was stronger,but well-tolerated.Conclusion With initial combined chemotherapies,the CR rate of FL could receive a higher level.It is considered that chemotherapy might cure a part of FL patients thoroughly.Rituximab could increase the OS time significantly.FC/FMD regimen could increase the PFS time,comparing with CHOP-like regimen,while the difference has no statistical significance when adding rituximab.Systemic chemotherapies are well tolerated.
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In recent years,PET-CT plays an important role in Hodgkin' s lymphoma (HL).It has emerged as the most accurate tool for staging,treatment monitoring,and response evaluation in HL.PET-CT has high sensitivity and specificity.It provides an opportunity to monitor the quality of response during treatment,permits separation of node from involved regions,and adds prognostic information.PET-CT has become integral to modern lymphoma management,but as a relatively new imaging technique it is still being studied and neither its full potential nor major limitations have been fully understood.The recent observations from clinical trials and clinical experiences with PET-CT in the 54th ASH annual meeting are discussed to explore its advantages and limitations.
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Objective To investigate the related factors of relapsed refractory Hodgkin lymphoma (HL),analysis treatment and adverse reactions.Methods Clinical features and treatment outcome of 62 HL patients were analyzed retrospectively.Results Of the 62 HL patients,12 patients(19.35 ％) were relapsed refractory HL.Pathologic type (P =0.026),lymph node area ≥ 3 (P =0.030) and large mass (P =0.006) were important factors for relapsed and refractory.The median overall survival time of relapsed refractory HL was 69.5 months (27-129 months).The 5 year overall survival (OS) rates in relapsed refractory HL and others were 66.7 ％ and 88.8 ％ respectively (P =0.117).The 5 year event-free survival (EFS) rates in relapsed refractory HL were 52.4 ％ and others 87.9 ％ respectively (P =0.006).Conclusion Pathologic type,lymph node area ≥3 and large mass are closely related with refractory refractory.HL.At the same time,recurrence in the short-term (＜ 1 year) is the independent prognostic factor for patients with relapsed refractory HL.