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Objective:To investigate the impact of malnutrition diagnosed with Global Leadership Initiative on Malnutrition (GLIM) criteria on the outcomes of patients with primary gastrointestinal lymphoma (PGIL).Methods:Patients with PGIL admitted into Gansu Provincial People's Hospital from January 2014 to July 2022 were retrospectively enrolled. Nutritional risk screening was conducted using Nutritional Risk Screening 2002 (NRS 2002) scale, and malnutrition was diagnosed as per GLIM criteria. Kaplan-Meier survival analysis and multivariate Cox regression analysis were performed to investigate the effect of malnutrition as per GLIM criteria on the outcomes of PGIL patients.Results:A total of 82 patients were included. The phenotypic parameters, including body mass index (BMI), arm circumference, leg circumference and grip strength, were at significantly lower levels in the 28 malnourished patients, compared with the other non-malnourished patients. The median overall survival of patients with malnutrition as per GLIM criteria was 10 months, while that of patients without malnutrition was 41 months, showing significant differences between groups. The univariate analysis revealed that age, loss of muscle mass, tumor stage based on Lugano classification and malnutrition as per GLIM criteria were the impacting factors for survival in patients with PGIL. The multivariate analysis further demonstrated that tumor stage based on Lugano classification and malnutrition as per GLIM criteria were the independent impacting factors for survival in patients with PGIL.Conclusion:Malnutrition based on GLIM criteria is an independent risk factor for unfavorable outcomes in patients with PGIL and could be utilized as a prognostic indicator.
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Objective:To investigate the efficacy and safety of BeEAM (bendamustine+cytarabine+etoposide+melphalan) regimen in pretreatment of autologous hematopoietic stem cell transplantation for patients with lymphoma.Methods:The clinical data of 15 patients with lymphoma who underwent autologous hematopoietic stem cell transplantation after pretreatment with BeEAM regimen from January 2020 to February 2021 in Gansu Provincial Hospital were retrospectively analyzed. The transplant-related adverse reactions and hematopoietic reconstitution were evaluated.Results:During the pretreatment process of 15 patients, 13 patients had gastrointestinal adverse reactions such as nausea, vomiting and diarrhea, 2 patients had hypokalemia, and 1 patient had abnormal liver function, but all of them were grade 1-2, and no grade 3-4 adverse reactions occurred. One patient had poor platelet implantation, and the remaining 14 patients all achieved hematopoietic reconstruction. After transplantation, the median time of peripheral blood neutrophils and platelets good implantation in patients was 10 d (9-14 d) and 11 d (9-17 d), respectively. Until March 2021, all patients were alive during follow-up.Conclusions:The efficacy of BeEAM regimen in pretreatment of autologous hematopoietic stem cell transplantation for patients with lymphoma is good, and the adverse reactions are tolerable.
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Objective:To investigate the early efficacy and safety of pomalidomide-based regimen in relapsed/refractory multiple myeloma (MM) in the real world.Methods:The clinical data of 15 patients with relapsed/refractory MM treated with pomalidomide-based regimen who were admitted to Gansu Provincial Hospital from January 2021 to July 2021 were retrospectively analyzed, and the early efficacy and safety were also evaluated.Results:There were 8 males and 7 females, and the median age of onset of 15 patients was 60 years (43-83 years); the median time for the diagnosis of relapse and refractory was 15 months (4-84 months). All 15 patients previously received bortezomib-based treatment regimens, 9 patients previously received lenalidomide treatment, and 7 cases received autologous hematopoietic stem cell transplantation. All patients received pomalidomide-based regimen combined with two-drug or three-drug regimen (pomalidomide combined with bortezomib,daratumumab,bendamustine, dexamethasone, cyclophosphamide or lenalidomide). The median treatment cycle was 2 cycles (2-4 cycles). After 2 cycles of treatment, the therapeutic efficacy was evaluated; the overall response rate was 73% (11/15), including 3 cases of complete remission, 3 cases of very good partial remission, and 5 cases of partial remission. Hematological toxicity occurred in 9 patients, of which 5 cases had grade 3-4 hematological toxicity, 4 cases had grade 1-2 hematological toxicity, and other adverse reactions were mild and tolerable.Conclusion:Pomalidomide-based regimen is effective and safe for relapsed/refractory MM patients.
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Objective To investigate the safety and efficacy of microwave ablation guided with laparoscopy and transvaginal ultrasound in the treatment of adenomyosis.Methods Seventy patients with 89 lesions of adenomyosis were treated with laparoscopy and transvaginal ultrasound guided microwave ablation.Intraoperative and postoperative complications were observed.The differences in dysmenorrhea score,menstrual flow and dysmenorrhea time before and after treatment were compared.Ultrasound examinations were performed 1,3 and 6 months after treatment to measure the volumes of uterus and adenomyosis lesions.Results Outflow liquid from vagina 1-3 days after treatment was found in 1 patient,and mild vaginal bleeding was found in 3 patients.No serious complication occurred in the other 66 patients.Compared with preoperation,the dysmenorrhea score,menstrual flow and dysmenorrhea time decreased in all patients after treatment (all P＜0.01).The volumes of uterus and adenomyosis lesions 1,3 and 6 months after treatment were significantly less than those before treatment (all P＜0.01).Conclusion Laparoscopy and transvaginal ultrasound guided microwave ablation is a safe and efficient therapy for adenomyosis.
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Purpose To explore the short-term clinical efficacy and application value of transvaginal sonography-guided laparoscopic percutaneous microwave coagulation therapy in the treatment of uterine adenomyoma.Materials and Methods Forty patients with uterine adenomyoma who visited the Central Hospital of Wuhan from October 2015 to October 2016 were selected in this study.These patients were invalid in traditional treatment for severe dysmenorrheal,but still unwilling to excise uterus.Microwave needles were placed into uterine adenomyoma to conduct percutaneous microwave coagulation therapy under the whole-process monitoring and guidance of laparoscope and transvaginal ultrasonography.Results All of 64 nidi in the 40 patients were ablated successfully,and none had damage to peripheral vital organs or vessels.Intraoperative hemorrhagic volume was extremely small.Postoperative menstrual blood volume and dysmenorrheal severity were improved notably,but none had obvious recurrence until now.The uterine volumes at postoperative one,three and six months as well as one year were (135.0±73.2) cm3,(108.2 ± 62.9) cm3,(91.4 ± 58.4) cm3,and (84.8 ± 50.0) cm3,respectively,all were evidently smaller than the (207.2± 97.4) cm3 before operation (P＜0.01).The n idus sizes at postoperative one,three and six months as well as one year were (42.3±34.2) cm3,(30.6±27.4) cm3,(24.7±23.0) cm3 and (23.0± 19.4) cm3,respectively,all were evidently smaller than the (67.9±48.2) cm3 before operation (P＜0.01).There were also significant differences in laboratory examinations of CA125 and CA199 before and after operation (P＜0.01).Conclusion Percutaneous microwave coagulation therapy as a non-invasive technique that can both maintain patients' uteruses and resolve their pain,is more safe and real-time under the monitoring of laparoscope,thus being promising as a new routine for the treatment of uterine adenomyoma.