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Objective:To investigate the efficacy and safety of polatuzumab vedotin (pola) in treatment of patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL).Methods:The clinical data of 1 DLBCL patient receiving multiple treatments in Jiangsu Cancer Hospital in May 2016 were retrospectively analyzed, and the related literature was reviewed.Results:The patient, a 57-year-old male, was diagnosed with DLBCL in May 2016. Since June 2016, he had received treatments with four lines including anti-CD20 monoclonal antibody combined with chemotherapy, chemotherapy only and chimeric antigen receptor T cell (CAR-T). However, the disease relapsed or progressed after all treatments. Therefore, the patient had received 6 cycles of pola combined with rituximab since December 2019. Unexpected adverse events were not found during the treatment. The evaluation of clinical efficacy was complete remission after the end of treatment. The progression-free survival time was more than 13 months with follow-up until January 2021.Conclusion:Pola initially shows good efficacy and safety in treatment of patients with relapsed/refractory DLBCL.
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<p><b>OBJECTIVE</b>A prospective, multicenter and non-interventional prospective study was conducted to evaluate the clinical features of rituximab combined with chemotherapy (R-Chemo) as first-line treatment on newly diagnosed Chinese patients with diffuse large B-cell lymphoma (DLBCL).</p><p><b>METHODS</b>This was a single arm, prospective, observational multicenter and phase IV clinical trial for 279 patients, who were newly diagnosed as CD20-positive DLBCL from 24 medical centers in China 2011 and 2012, no special exclusion criteria were used. All patients received rituximab based R-Chemo regimes, such as R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisolone) and other regimes as the first-line treatment. The treatment strategies were determined by physicians and patients without detailed description for treatment course, dose, interval time and examination. Clinical response and safety of all patients were investigated in 120 days after completion of last dose of rituximab.</p><p><b>RESULTS</b>Of 279 patients, 258 with stage I-IV who received at least 1 cycle of rituximab treatment and completed at least one time of tumor assessment were enrolled into intention-to-treat analysis, including 148 male and 110 female. The median age of all patients was 57.2(12.8-88.4) years. ECOG performance statuses of 0 or 1 were observed in 91.1% of patients, international prognostic index levels in the low-risk and low-middle-risk groups in 76.4% of patients, the tumor diameters smaller than 7.5 cm in 69.0% of patients. All patients received 6 median cycles of R-Chemo treatment every 24.4 days. R-CHOP treatment was shown to improve the clinical response with overall response rates of 94.2%. Common adverse events included anemia, marrow failure, leukopenia, thrombocytopenia, digestive diseases, infection and liver toxicity. All adverse events are manageable.</p><p><b>CONCLUSION</b>Non-interventional clinical trial of R-Chemo remains the standard first-line treatment for newly diagnosed patients with DLBCL in real clinical practice, which is consistent with international treatment recommendations for DLBCL patients. R-Chemo can provide the clinical evidence and benefit as the first-line standard treatment for Chinese patients with DLBCL.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Antibodies, Monoclonal, Murine-Derived , Therapeutic Uses , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Lymphoma, Large B-Cell, Diffuse , Drug Therapy , Prospective Studies , Rituximab , Treatment OutcomeABSTRACT
Anti-CD20 monoclonal antibody rituximab has become an essential component of treatment regimens for B-cell non-Hodgkin lymphoma(NHL).It is routinely incorporated into all phases of conventional treatment of B-cell NHL,but the precise mechanisms of action of rituximab in human remain unknown.This article will clarify the mechanisms of action of rituximab,the incidence and potential mechanisms of resistance.Finally,the novel approaches to modulate the antibody,the tumor cell,and the host immunologic environment to overcome rituximab resistance are discussed.
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Objective: To investigate the etiological role of polymorphism IVS1+9C→G in hMSH2 gene in gastric cancers. Methods: A case-control study has been taken on subjects included 72 sporadic gastric, 71 familial gastric cancers and 126 healthy individual controls. Genomic DNA was extracted from peripheral white cell of all subjects. The polymorphism was detected by a PCR-based DHPLC analysis and verified by DNA sequencing. Results: The polymorphism IVS1+9C→G in hMSH2 gene was detected in 33.3%(42/126) Healthy individuals, 40.3%((29/72 ))sporadic gastric and 43.7%(31/71 )familial gastric cancers. Significant difference existed between cancers at young age (
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<p><b>OBJECTIVE</b>To investigate the possibility and short-term effect of high dose chemotherapy with peripheral blood stem cell support in the preoperative therapy of breast cancer, and-its influence on the following operation and would healing.</p><p><b>METHODS</b>Three patients with T(3)N(1)M(0) (III(a)), T(4)N(1)M(0) (III(b)), T(4)N(1)M(1) (IV) of breast cancer were diagnosed histopathologically. After receiving HDC/APBSCT, the 3 patients were operated on. HDC/APBSCT process included 2 cycles of FEC induction chemotherapy; PBSC mobilization, APBSC collection and cryopreservation and PBSC infusion; and high-dose chemotherapy, APBSC infusion and supportive therapy. The therapy consisted of CTX2.5 g/m(2), VP-16 600 mg/m(2), and cerboplatin 600 mg/m(2) delivered on day 1, APBSC infusion 48 h later, rhG-CSF (150 microg, BID) was administered 4 h after infusion of APBSC until WBC was higher than 10 x 10(9)/L. During HDC/APBSCT, the patients were protected in the air laminar flow room with supportive therapy of antibiotics, anti-virus and anti-fungus drugs. They left the air laminar flow room after their WBC was greater than 2 x 10(9)/L. Case 1 was treated by radical mastectomy, Case 2 by improved radical mastectomy, Case 3 by improved radical mastectomy and transplantation of skin for the large area.</p><p><b>RESULTS</b>Rapid recovery of bone marrow function was observed in all 3 patients. Operation was performed 4 weeks after HDC/PBSCT in Cases 1, 2 and 33 days in Case 3. No influence was seen on operative procedure and would healing, especially in Case 3 with a large area of skin transplantation. Two patients with stage III(a) and III(b) have been alive since the treatment for 30 months and the other with stage IV died of brain metastasis 16 months later.</p><p><b>CONCLUSIONS</b>HDC/APBSCT as a preoperative therapy for breast cancer has no influence on the coming surgery and would healing, even on skin transplantation for a large area. It has a practical response in stage III(a) and III(b), but it is still controversial in stage IV. This method as a salvage therapy for patients with breast cancer of intemuediate or stage.</p>
Subject(s)
Adult , Female , Humans , Middle Aged , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Breast Neoplasms , Therapeutics , Combined Modality Therapy , Hematopoietic Stem Cell Transplantation , Mastectomy, Radical , Neoplasm Staging , Preoperative Care , Salvage TherapyABSTRACT
Extracellular matrix plays an important role in maintaining organic structure and function, cellular proliferation and differentiation of normal aorta. Extracellular matrix proteolysis and remodeling of aortic wall resulting from degradation of matrix proteins characterize abdominal aortic aneurysm (AAA). Matrix metalloproteinase and its inhibitor have been implicated as potentially important in this disease, and MMP/TIMP ratios may be the key of AAA formation and development.
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To explore the pathogenesis and treatment of fever, leukocytosis and thrombocytopenia after endovascular graft exclusion for aortic aneurysm or aortic dissection, 67 patients with infrarenal aortic aneurysm (38) and thoracic aortic dissection (29),were studied,and then received successful endovascular graft exclusion with Dacron covered stent grafts. Sepsis syndrome evaluation (physical examination, analysis of peripheral blood WBC, platelet and urine, chest radiograph, urine and blood cultures) was performed for all patients with postoperative temperature(T) higher than 38 5℃. Fever, leukocytosis and thrombocytopenia in peripheral blood were found in most patients, whose T, WBC and platelet returned to normal between 1 and 2 weeks. Sepsis evaluations failed to identify any source of infection in all patients. These results showed that fever and leukocytosis after endovascular stent graft repair for aortic aneurysm are resulted from systemic inflammatory response syndrome.
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Objective To evaluate heparanase inhibitor PI-88 in the inhibition of abdominal aortic aneurysm(AAA) formation. Methods A guinea pig-to-SD rat transplantation model of AAA was established for the observation of therapeutic effects of PI-88 given by continuously administration within 4 weeks after abdominal aortic transplantation. Abdominal aortic diameter, the degree of inflammatory infiltration, microvessel density and the expression of heparanase were determined by immunohistochemistry and Northern blot analysis. Results In contrast to the positive controls, the diameter and inflammatory cell infiltration of graft decreased remarkably after administrating PI-88, and the expression of heparanase and microvessel density decreased accordingly, although still upregulated when compared with negative control. Conclusions PI-88 could prevent formation of AAA by inhibiting heparanase activation.
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Objective: To better understand homing potentiality of hematopoietic stem cells (HSC) in human umbilial cord blood (UCB) and the mechanism of dextran sulfate (DS) mobilization. Methods: Sub lethally irradiated or DS pretreated severe combined immunodeficient (SCID) mice were transplanted with UCB, which was cryopreserved at -80℃.Human cells in recipient mice were detected by flow cytometry and CFU GM assay from each host organ. Results: In contrast with the controls, engraftment after irradiation or administration of DS resulted in a higher percentage of CD45 +,CD34 +,CD19 + cells produced in SCID mice. While comparison between the experimental groups, higher implantation level was obtained in the former if equivalent donor cells were used in both groups. Conclusion:DS is a safe and effective pretreatment, which can mobilize HSC, but also vocate niches for transplanted HSC homing. [
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AIM:To study phenotypic changes of vascular smooth muscle cells (VSMC) in abdominal aortic aneurysmal (AAA) pathogenesis. METHODS: Tissue samples of human infrarenal aneurysmal and normal aorta(NA), and arterial occlusive diseases(AOD) were evaluated. Monoclonic antibodies of ?-smooth muscle actin(?-SMA), desmin and smooth muscle myosin heavy chain isoforms (SM1, SM2 and SMemb) were used in immunohistochemistry to determine VSMC isoforms. Immunohistochemical results were analyzed with the use of computer-generated image technique. Ultrstructures of VSMC in three tissues above were observed by electron microscope. RESULTS: In control AOD and NA, VSMC in the media were strongly immunostained for ?-SMA, desmin, SM1 and SM2. Immunoreactivity for SMemb was faint or weakly positive in AOD, but negative in NA. In AAA,the balance shifts to SMemb predominance with suppressed ?-SMA, SM1 and SM2 and negative desmin, while in ruptured aneurysmal walls, the expression of SM2 and SMemb were decreased compared with the non-ruptured aneurysmal walls. CONCLUSION:Phenotypic changes of VSMC are concerned with abdominal aortic structure lesion and remodeling, which contributes to AAA formation and development.
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Dynamic interactions between cells and underlying extracellular matrices are crucial for development, maintenance of cellular function, and response of tissure to injury and infection. Heparan sulfate proteoglycans(HSPG)are found in extracellular matrices and on the surface of most nuclrarated cells, and play critical roles in cell-cell and cell-matrix signal transduction by binding many molecules, such as growth factors and cytokines. Most of the biological properties of HSPG are conferred by heparan sulfate side chains, which can be degraded by heparanase. Changes of heparanase expression and activity may affect the biological processes above, which enables extravasation of inflammation cells, metastasis and neoangiogenesis of tumor cells invasion.
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Extracellular matrix plays an important role in maintaining organic structure and function, cellular proliferation and differentiation of normal aorta. Extracellular matrix proteolysis and remodeling of aortic wall resulting from degradation of matrix proteins characterize abdominal aortic aneurysm (AAA). Matrix metalloproteinase and its inhibitor have been implicated as potentially important in this disease, and MMP/TIMP ratios may be the key of AAA formation and development. [