ABSTRACT
Objective:To explore the therapeutic effects and adverse reactions of the liposomal doxorubicin-based regimens in the treatment of adult patients with T-cell lymphoma.Methods:The clinical data of patients with T-cell lymphoma who were diagnosed and treated in Beijing Shijitan Hospital of Capital Medical University from August 2012 to May 2016 was retrospectively analyzed. All patients received chemotherapy containing liposomal doxorubicin. The clinical manifestations, treatment results, and adverse reactions were observed.Results:A total of 16 patients were enrolled, with a median age of 50.5 years old (16-81 years old), of which 7 patients were newly treated and 9 patients were retreated (including 5 refractory patients). Eleven of the 16 patients were evaluated for efficacy, including 4 cases of complete remission (CR) and 4 cases of partial remission (PR), the overall response rate was 72.8% (8/11). With a median follow-up of 11 months, the 2-year progression-free survival rate and overall survival rate were 42.4% and 41.6%. All 5 primary skin T-cell lymphoma patients were refractory or relapsed with 1 case of CR and 4 cases of PR after treatment. The adverse reactions were acceptable.Conclusions:The remission rate of liposomal doxorubicin-based regimens for treatment of adult patients with T-cell lymphoma is promising, especially for newly-treated patients. Primary skin T-cell lymphoma patients might be more likely to benefit from liposomal doxorubicin-based regimens.
ABSTRACT
Objective To analyze the clinical characteristics and recent curative effect of mantle cell lymphoma (MCL) after conventional treatment.Methods Clinical data of 15 MCL patients admitted in the Affiliated Hospital of Academy of Military Medical Sciences between August 2004 and October 2013 were retrospectively analyzed.Results The median age of those patients was 59 and the male to female ratio was 1.5∶1.Fourteen(93%)cases were in Ann-Arbor stages Ⅲ -Ⅳ, 15 cases (100%)primarily with lymph node involvement,7 cases (47%)with bone marrow involvement,4 cases (27%)with gastrointestinal involvement,and 3 cases (20%)with orbit involvement.Less than 40% expression of Ki-67 was observed in 9 cases (60%),while 6 cases were with more than 40% (40%).One case was blastic variant.First-line therapy was CHOP-like regimens,which were combined with rituximab in 8 of the 15 cases.In this study,the median survival time was 12 months (3 -64),and the overal response rate was 80%after induction chemotherapy.The current survival of 7 /9 cases with less than 40% expression of Ki-67 was 8 -64 months,2 /6 cases with more than 40% expression of Ki-67 was 8 and 9 months,respectively.Conclusion MCL mostly occurs in older males.Extranodal invasion is common in MCL as an aggressive tumor.The efficacy of traditional chemotherapy is currently limited.Blastic variant or high expression of Ki-67 is an adverse prognostic indicator.
ABSTRACT
Objective To investigate the therapeutic effect and adverse effects of the teniposide-based regimen in patients with primary central nervous system lymphoma (PCNSL). Methods Between March 2011 and July 2013, 16 patients with PCNSL were diagnosed and treated. The clinical characteristics, diagnosis,therapy, results and adverse effects were analyzed. Results Totally 16 patients were enrolled and diagnosed as primary central nervous system diffuse large B-cell lymphoma. All patients received teniposide-based regimen chemotherapy and 9 patients received teniposide plus rituximab. The overall response rate was 87.5 % (14/16), including 10 cases of CR and 4 cases of PR. With a median follow-up of 13.5 months, the progression-free survival (PFS) and overall survival (OS) rates of 2 years were 29.9 % and 66.7 %, respectively. The mainly hematological adverse events were neutropenia, including grade 3 in 4 cases (25 %) and grade 4 just in one case. There was one case of treatment related death. Conclusions The response rate of teniposide-based regimen for PCNSL is promising. The 2 year PFS and OS rates are even higher than results of traditional high-dose methotrexate regimen. The teniposide-based regimen is well tolerated, and the adverse events are acceptable.
ABSTRACT
Objective:The effect and side effect of the dose-adjusted EPOCH regimen were evaluated perspectively for the pre-liminarily diagnosed angioimmunoblastic T-cell lymphoma. Methods: Nine cases of untreated angioimmunoblastic T-cell lymphoma were diagnosed and enrolled in our department from September 2008 to September 2012. All patients received dose-adjusted EPOCH regimen as first-line chemotherapy. Results: The median age of 9 patients was 54 years. The male-to-female ratio was 2∶1. About 88.9%of all patients were at Ann Arbor stageⅢ/Ⅳ, and 77.8%presented with B symptoms. Anemia was found in 66.7%of 9 patients, and lactate dehydrogenase elevated in 55.6%of patients. After an average of 4.7 cycles of chemotherapy of dose-adjusted EPOCH regi-men, the complete remission rate was 22.2%, and the total response rate was 66.7%. With a median follow-up of 20 months, the 4-year progression-free survival rate was 11.1%, and the overall survival rate was 33.3%. The median survival time was 19 months. The most common adverse events of EPOCH chemotherapy were hematologic toxicity. Grades 3-4 neutropenia and thrombocytopenia were re-ported in 77.8%and 33.3%of patients. Febrile neutropenia was observed in 44.4%of patients. Non-treatment-related mortality was al-so noted. Conclusion: The results of our research showed no clear benefit of treating preliminarily diagnosed angioimmunoblastic T-cell lymphoma with dose-adjusted EPOCH regimen. The main adverse events were hematologic toxicity and could be tolerated.
ABSTRACT
Objective To analyze the clinical characteristics , diagnosis, therapy and prognosis of new diagnosed pri-mary gastric diffuse large B cell lymphoma ( PGDLBCL) and to discuss the efficacy of rituximab .Methods Between Jan 2005 and May 2012 , twenty-six new-diagnosed PGDLBCL patients were reviewed retrospectively .The clinical characteris-tics, diagnosis, therapy, results and prognostic factors were analyzed .Results There were 14 males and 12 females.Their age ranged from 25 to 82 (median, 50.1) years old.The most common symptom was stomachache .Treatment strategies were chemotherapy alone ( n=9) [ scheduled as cyclophosphamide , doxorubicin , vincristine and prednisone ( CHOP) and CHOP-like] and chemotherapy combined with rituximab (n=17), followed by radiotherapy of the stomach with or without regional nodes .All clinical and pathological features were similar between the two groups .The median follow-up time was 40 months.The overall response rate was 100%(9/9)in CHOP group, including 55.56%(5/9) CR, and 93.75%(15/16) in RCHOP group including 50%(8/16) CR (P>0.05).The total PFS and OS of 5 years were 60.3%and 74.4%respectively.The PFS in CHOP group and RCHOP group was 66.7% and 58.9%, respectively,and the OS was 66.7%and 84.6%, respectively.Although the OS of RCHOP group was much better than that of CHOP group , there was no sta-tistically significant difference.Univariate analysis showed that IPI (P<0.05) and Lugano staging (P<0.05) were inde-pendent factors of survival in patients with PGDLBCL .Conclusion Chemotherapy could be the first-line therapy of PGDL-BCL.The overall survival rate might be increased by adding rituximab to chemotherapy .The Lugano stage and IPI are im-portant prognostic factors .
ABSTRACT
Mantle cell lymphoma is an incurable subtype of non-Hodgkin lymphoma. This review focuses on its treatment progress, including high-dose chemotherapy combining rituximab, radioimmunotberapy, autologous stem cell transplatation, allogenetic stem cell transplatation and targeting therapy. Comparing from the disappointed result of regular chemotherapy, adding rituximab or high-dose regimen could improve the effect. And the radioimmunotherapy has also got some potential results. Autologous stem cell transplantation could increase the survival rate, but non-myeloablative allogenetic stem cell transplantation should be considered on relapsed patients. Till now diverse targeted medicine came into clinical trials and some of them seems competent in mantle cell lymphoma.
ABSTRACT
Objective:To analyze whether the DNA vaccine against the CDR3 regio n of immunoglobulin heavy chain of the human B-cell lymphoma could elicit the s p ecific idiotypic antibody,the authors established a model with the human B-cell lymphoma c ell line Namalwa.The CDR3 gene fragment of Namalwa membranous immunoglobulin hea vy chain was amplified.The sequenced CDR3 fragment was used as the antigen gene to construct the DNA vaccine plasmid. Methods:The authors acquired the CDR3 gene fragment using Ig superfamily primers by means of RT-PCR and the murine monocyte chemot ic protein(MCP-3) as the adjuvant molecular.The fused gene fragment of CDR3 and MCP-3 was obtained by recombinant PCR and then cloned into the eukaryonic plas mid vector pcDNA3.1 to construct the DNA vaccine plamid.Then the vaccine plasmid was transiently expressed in the eukaryonic cell COS-7. Results:The authors acquired th e DNA vaccine plasmid in which the mIgCDR3 of the Namalwa cell was used as the a ntigen gene by the molecular biology. Conclusion:The transient transfection assa y proved that the recombinant plasmid could express in eukaryonic cells in right way.They have constructed an expression plasmid containing fused MCP3-CDR3 seq uen ce which could be used in further study of DNA vaccine against B-cell lymphoma in vivo. [