ABSTRACT
This study aimed to investigate the prevalence, clinical characteristics, and prognostic impact of 1p32.3 deletion in patients with newly diagnosed multiple myeloma (MM). A retrospective analysis was conducted on 411 patients with newly diagnosed MM; among which, 270 received bortezomib-based therapies, and 141 received thalidomide-based therapies. Fluorescence in situ hybridization (FISH) was performed to detect six cytogenetic abnormalities, namely, del(1p32.3), gain(1q21), del(17p13), del(13q14), t(4;14), and t(11;14). Results showed that 8.3% of patients with MM were detected with del(1p32.3) and had significantly more bone marrow plasma cells (P = 0.025), higher β2-microglobulin levels (P = 0.036), and higher lactate dehydrogenase levels (P = 0.042) than those without del(1p32.3). Univariate analysis showed that patients with del(1p32.3) under thalidomide-based therapies (median PFS 11.6 vs. 31.2 months, P = 0.002; median OS 16.8 vs. 45.9 months, P < 0.001) were strongly associated with short progression-free survival (PFS) (P = 0.002) and overall survival (OS) (P < 0.001). Multivariate analysis revealed that del(1p32.3) remained a powerful independent factor with worse PFS (P = 0.006) and OS (P = 0.016) for patients under thalidomide-based treatments. Patients with del(1p32.3) under bortezomib-based treatments tended to have short PFS and OS. In conclusion, del(1p32.3) is associated with short PFS and OS in patients with MM who received thalidomide- or bortezomib-based treatments.
ABSTRACT
Objective@#To study the clinical features, therapeutic effects, prognostic factors of 140 patents with mantle cell lymphoma (MCL).@*Methods@#Clinical data of 140 MCL patients admitted from June 2009 to January 2016 in our hospital were retrospectively analyzed.@*Results@#The median age of 140 patients was 59 years with a ratio of 6∶1 for men and women. There were 134 cases (95.7%) in Ann-Arbor stage Ⅲ-Ⅳ, 37 cases (26.4%) with B symptoms, 61 cases (43.6%) with bone marrow involvement and 38 cases (27.1%) with enlarged spleen. The overall response rate (ORR), 3-year survival rate and progression-free survival rate in the treatment group with rituximab were 87.1%, 68.1% and 59.5% respectively, which were significantly higher than those in the rituximab-free treatment group (66.6%, 51.5% and 31.7%, respectively). The difference was statistically significant (all P<0.05). Among patients treated with rituximab, the complete remission rates (70.8% and 77.8%) of R-HyperCVAD/MA and VcR-CAP regimens were higher than those of R-CHOP regimen (39.0%, both P<0.05). However, there was no significant difference in the overall response rate, overall survival rate and progression-free survival rate (all P>0.05). Univariate analysis showed that age, Ki-67 index, B symptoms, bone marrow invasion, platelet count, LDH, β2-MG and MIPI scores were associated with overall survival (all P<0.05). Multivariate analysis showed that age (HR=4.940, 95% CI: 2.347 to 10.397), B symptom (HR=2.900, 95% CI: 1.517-5.544), β2-MG (HR=2.945, 95% CI: 1.656-5.238), Ki-67 index (HR=4.915, 95% CI: 2.554-9.456) and treatment with rituximab-containing regimen (HR=2.450, 95% CI: 1.352-4.440) were independent factors for OS.@*Conclusions@#Most patients with MCL were older adults and usually had bone marrow involvement and spleen involvement. Rituximab combined with chemotherapy (especially R-HyprCVAD/MA and VcR-CAP) had better clinical efficacy than conventional chemotherapy.
ABSTRACT
Objective To observe the efficacy of liposomal doxorubicin combined with cyclophosphamide, vincristine and prednisone in the treatment of refractory Non-Hodgkin’s lymphoma.Methods Liposomal doxorubicin (40mg/m2) was given by intravenous drip in the 1st day. Cyclophosphamide (750mg/m2) was given by intravenous injection in the 1st day. Vincristine (2mg) was given by intravenous injection in the 1st day. Prednisone (100mg/m2) was given orally from the 1st to the 5th day. A cycle was repeated every 3 to 4 weeks. Every patient took at least 2 cycles of the regimen.Results A total of 13 patients were assessed in the group. Among them, 7 were completely release (53.8), 4 were partially release (30.67) and 2 remained the same (15.35). The B symptom of 7 patients in the 9 with that disappeared, and that of the other 2 patients was improved obviously. The most common adverse effects were slight gastrointestinal reactions and the grade Ⅲ bone marrow suppression in a few patients. Conclusion The regimen of liposomal doxorubicin combined with cyclophosphamide, vincristine and prednisone is effective in the treatment of refractory Non-Hodgkin’s lymphoma with tolerable toxicity. It may be a salvage chemotherapeutic regimen deserving further study.