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PURPOSE: Rituximab with cyclophosphamide, doxorubicin, vincristine, and prednisone administered every 3 weeks (R-CHOP-21) is the standard care for diffuse large B-cell lymphoma (DLBCL). It is unknown whether the dose-dense R-CHOP (R-CHOP-14) could improve the outcome of the disease in Asian population. MATERIALS AND METHODS: Newly diagnosed DLBCL patients were centrally, randomly assigned (1:1) to receive R-CHOP-14 or R-CHOP-21. R-CHOP-14 was administered every 2 weeks, and R-CHOP-21 was administered every 3 weeks. Primary end point was disease-free survival (DFS). Secondary end points included overall survival (OS), progression-free survival (PFS), response rate and toxicities. RESULTS: Seven hundred and two patients were randomly assigned to receive R-CHOP-14 (n=349) or R-CHOP-21 (n=353). With a median follow-up of 45.6 months, the two groups did not differ significantly in 3-year DFS (79.6% for R-CHOP-14 vs. 83.2% for R-CHOP-21, p=0.311), 3-year OS (77.5% for R-CHOP-14 vs. 77.6% for R-CHOP-21, p=0.903), or 3-year PFS (63.2% for R-CHOP-14 vs. 66.1% for R-CHOP-21, p=0.447). Patients with an International Prognostic Index (IPI) score ≥ 2 had a poorer prognosis compared to those with an IPI score < 2. Grade 3/4 hematologic and non-hematologic toxicities were manageable and similar between R-CHOP-14 and R-CHOP-21. CONCLUSION: R-CHOP-14 did not improve the outcome of DLBCL compared to R-CHOP-21 in Asian population. With manageable and similar toxicities, both of the two regimens were suitable for Asian DLBCL patients. For high-risk patients with IPI ≥ 2, new combination regimens based on R-CHOP deserve further investigation to improve efficacy.
Subject(s)
Humans , Asian People , B-Lymphocytes , Cyclophosphamide , Disease-Free Survival , Doxorubicin , Follow-Up Studies , Lymphoma, B-Cell , Prednisone , Prognosis , Rituximab , VincristineABSTRACT
Non-small cell lung cancer (NSCLC) is one of the most common malignant tumors,and more than half of newly diagnosed patients with NSCLC are stage Ⅲ B or Ⅳ.Maintenance treatment has been intensively investigated in the field in order to improve time to recurrence and survival time.This paper reviewed recent advances in the maintenance treatment for NSCLC.
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Background and purpose:Majority of patients with B cell lymphoma often achieve complete clinical remission after systemic treatment, but half of the patients ultimately relapse. The residual neoplastic cells, commonly called ‘minimal residual disease’ (MRD), are thought to be the source of relapse. But not all of the patients whose results of IgH rearrangement were positive had relapse or distant involvement. It was thought that the patients whose IgH rearrangement was positive relapsed or not may be associated with the quantity of IgH rearrangement. The study tried to investigate the feasibility and clinical significance of detecting immunoglobulin heavy chain gene in DLBCL by SYBR Green RT-FQ-PCR. Methods:Fifty-seven bone marrow specimens from 44 patients diagnosed with DLBCL were used to detect IgH-R. Namalwa cell line and U-937 cell line were used for positive and negative control respectively. The ?-actin gene was chosen as inter control. DNA was isolated by phenol-chloroform-isoamyl alcohol and then was amplified by SYBR Green RT-FQ-PCR targeting the IgH-R CDR Ⅲ.Results:Melting curve analysis could confirm the specificity of IgH-R. The positive rate detected by RT-FQ-PCR was 63.2%. The positive results of IgH/?-actin were between 0.01 and 4131.69, and the median was 0.42. There was a significant difference between stage Ⅰ/Ⅱ and stage Ⅲ/Ⅳ in IgH-R quantity (P=0.018). Nonparametric test showed that there was a significant difference between patients with normal LDH and patients with elevated LDH (P=0.046).Conclusions:SYBR Green RT-FQ-PCR is a valuable, feasible and sensitive tool to detect IgH rearrangement in DLBCL. Detecting IgH-R using RT-FQ-PCR can help staging more accurately.
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Purpose:To investigate the expression and clinical significance of nm23 H 1 and nm23 H 2 in human breast cancer. Methods:A semi quantitative reverse transcription polymerase chain reaction was performed to detect the expression of nm23 H 1 and nm23 H 2 mRNA in thirty human breast cancer specimens. To evaluate the relationship between nm23 gene and breast cancer metastasis t test, F test and multivariate analysis were used.Results:The nm23 H 1 mRNA level in primary breast cancer tissue with lymph node positive was lower than that with lymph node negative. The nm23 H 1 mRNA level in breast cancer with Ⅰ,Ⅱstage was higher than that with Ⅲ stage. Lymph node metastasis was the only parameter that was significantly correlated with the nm23 H 1 expression. There was no significant relation between nm23 H 2 and tumor size, lymph node status, TNM stage, hormone receptor and menopausal status.Conclusions:nm23 H 1 mRNA show a significant inverse correlation with lymph node metastasis. nm23 H 1 appears to play a more important role than nm23 H 2 in breast cancer. nm23 H 1 mRNA expression may be a predictor of lymph node metastasis.