ABSTRACT
Background and purpose:The prognostic capability of traditional prognostic index like follicular lymphoma international prognostic index (FLIPI) is limited in the rituximab era. This study was to investigate the prognostic significance of peripheral blood absolute lymphocyte count/absolute monocyte count (ALC/AMC) in Chinese patients with follicular lymphoma (FL).Methods:This study retrospectively analyzed 136 newly diagnosed FL patients who received rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP)-like chemotherapy in Department of Hematology, Ruijin Hospital from Jan. 2003 to Dec. 2013, and further classified these patients according to FLIPI scoring system.Results:According to FLIPI, 61 patients (44.9%) were stratified into the low-risk (0-1 points) group, 42 cases (30.9%) into the intermediate-risk (2 points) group, and 33 cases (24.2%) into the high-risk (3-5 points) group. The overall response rate and 2-year progression-free survival (PFS) of the 3 risk groups were 88.5%, 95.2%, and 78.8% (P=0.090), and 91.4%, 74.6%, and 47.8% (log-rank=23.3,P<0.001), respectively. The overall response rate and 2-year PFS for patients with ALC/AMC≥4.7 and <4.7 were 91.9%, 68.6% (P=0.005) and 96.0%, 69.7% (log-rank=13.0,P<0.001), respectively. In the multivariate study, ALC/AMC≥4.7 was independent of FLIPI and was able to distinguish the FLIPI low-risk and intermediate-risk patients (log-rank=7.535,P=0.006).Conclusion:For FL patients treated with R-CHOP-like regimens, ALC/AMC is a simple and effective biomarker reflecting tumor microenvironment and human immunity, and could be considered for prognosis evaluation.
ABSTRACT
<p><b>OBJECTIVE</b>To compare the clinical efficacy and safety among different chemotherapeutic regimens in treatment of refractory/relapsed acute myeloid leukemia (AML).</p><p><b>METHODS</b>The clinical data of 67 refractory/relapsed AML patients enrolled from September 2008 to April 2013 were collected. The differences of clinical outcome and adverse events among the patients treated with decitabine combined with DAG regimen, CAG regimen or "3+7" regimen were analyzed.</p><p><b>RESULTS</b>Among 19 patients in decitabine treatment group, 5 (26.3%) achieved complete remission (CR), 4 (21.1%) partial remission (PR), with overall response rate (ORR) of 47.4 %. Of 26 patients in CAG regimen group, 8 (30.8%) achieved CR, 1 (3.8%) PR, with ORR of 34.6%. Of 22 patients in "3+7" regimen group, 4 (18.2%) achieved CR, with ORR of 18.2%. The ORR of decitabine group was significantly higher than that of "3+7" group (P<0.05). However, no significant difference of ORR was observed among the three groups (P>0.05). It was interesting to note that in decitabine group, the marrow blast counts were lower in CR patients compared with those in non-CR patients (P<0.05), while this was not found in "3+7" group (P>0.05) and CAG regimen group (P>0.05). Adverse events in the three groups were similar, mainly including myelosuppression, pulmonary infection, nausea, vomiting and liver dysfunction, and could be well tolerated. Followed- up to September 2013, the median overall survival (OS) of decitabine group, CAG regimen group and "3+7" group after relapse was 7.5, 4 and 3 months, respectively (P>0.05), while significant difference was obtained between decitabine group and "3+7" regimen group (P<0.05).</p><p><b>CONCLUSION</b>Decitabine combined with DAG regimen is effective and well tolerated in refractory/relapsed AML patients who were unsuitable for intensive chemotherapy and hematopoietic stem cell transplantation, and the patients with low marrow blast counts are more suitable for the application of decitabine combined with DAG regimen.</p>