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Objective:To evaluate the efficacy and safety of mitoxantrone hydrochloride liposome injection in the treatment of peripheral T-cell lymphoma (PTCL) in a real-world setting.Methods:This was a real-world ambispective cohort study (MOMENT study) (Chinese clinical trial registry number: ChiCTR2200062067). Clinical data were collected from 198 patients who received mitoxantrone hydrochloride liposome injection as monotherapy or combination therapy at 37 hospitals from January 2022 to January 2023, including 166 patients in the retrospective cohort and 32 patients in the prospective cohort; 10 patients in the treatment-na?ve group and 188 patients in the relapsed/refractory group. Clinical characteristics, efficacy and adverse events were summarized, and the overall survival (OS) and progression-free survival (PFS) were analyzed.Results:All 198 patients were treated with mitoxantrone hydrochloride liposome injection for a median of 3 cycles (range 1-7 cycles); 28 cases were treated with mitoxantrone hydrochloride liposome injection as monotherapy, and 170 cases were treated with the combination regimen. Among 188 relapsed/refractory patients, 45 cases (23.9%) were in complete remission (CR), 82 cases (43.6%) were in partial remission (PR), and 28 cases (14.9%) were in disease stabilization (SD), and 33 cases (17.6%) were in disease progression (PD), with an objective remission rate (ORR) of 67.6% (127/188). Among 10 treatment-na?ve patients, 4 cases (40.0%) were in CR, 5 cases (50.0%) were in PR, and 1 case (10.0%) was in PD, with an ORR of 90.0% (9/10). The median follow-up time was 2.9 months (95% CI 2.4-3.7 months), and the median PFS and OS of patients in relapsed/refractory and treatment-na?ve groups were not reached. In relapsed/refractory patients, the difference in ORR between patients with different number of treatment lines of mitoxantrone hydrochloride liposome injection [ORR of the second-line, the third-line and ≥the forth-line treatment was 74.4% (67/90), 73.9% (34/46) and 50.0% (26/52)] was statistically significant ( P = 0.008). Of the 198 PTCL patients, 182 cases (91.9%) experienced at least 1 time of treatment-related adverse events, and the incidence rate of ≥grade 3 adverse events was 66.7% (132/198), which was mainly characterized by hematologic adverse events. The ≥ grade 3 hematologic adverse events mainly included decreased lymphocyte count, decreased neutrophil count, decreased white blood cell count, and anemia; non-hematologic adverse events were mostly grade 1-2, mainly including pigmentation disorders and upper respiratory tract infection. Conclusions:The use of mitoxantrone hydrochloride liposome injection-containing regimen in the treatment of PTCL has definite efficacy and is well tolerated, and it is a new therapeutic option for PTCL patients.
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Objective:To compare the efficacy of concurrent and asynchronous radiochemotheray for early extranodal nasal natural killer/T-cell lymphoma (NKTCL).Methods:From 2007 to 2020, 278 patients with early NKTCL treated with comprehensive treatment in the Affiliated Tumor Hospital of Guizhou Medical University were recruited. According to the adjusted Nomogram-revised risk index (NRI) prognostic model, there were 49 cases in the good prognostic group without adverse prognostic factors (age>60 years old, increased serum lactate dehydrogenase (LDH), ECOG score ≥2, primary tumor invasion (PTI), Ann Arbor stage Ⅱ, and 229 cases in the poor prognostic group with any adverse prognostic factors. 145 of these cases were treated with concurrent radiochemotherapy, and 133 of them were treated with asynchronous radiochemotherapy.Results:The 5-year overall survival (OS) rate of the whole group was 71.0%, and the progression-free survival (PFS) rate was 67.6%. The 5-year OS rate in the good prognostic group was 95.6%, and 65.4% in the poor prognostic group ( P<0.001). In the poor prognostic group, the 5-year OS rates of patients with NRI=1(low-and moderate-risk group), NRI=2(moderate-and high-risk group), NRI≥3(high-risk group) were 72.1%, 61.1% and 47.7%, respectively ( P=0.007). There was no significant difference in curative effect between the concurrent and asynchronous radiochemotherapy groups. The 5-year OS rates were 70.6% and 69.8%( P=0.783), and the 5-year PFS rates were 67.6% and 65.2%( P=0.631). Further stratified analysis showed that the 5-year OS rates of patients with NRI=1 receiving concurrent and asynchronous radiochemotherapy were 73.1% and 76.5%( P=0.576), 62.6% and 69.3%( P=0.427) for those with NRI=2, and 58.1% and 42.3% for those with NRI≥3( P=0.954). Conclusions:Comprehensive treatment can significantly improve the prognosis of early NKTCL in the poor prognostic group. In the sequence of radiotherapy and chemotherapy, there is no significant difference in 5-year OS and PFS rates between concurrent and asynchronous radiochemotherapy. Sequential treatment with better tolerance can be adopted for early NKTCL with poor prognosis.
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β-thalassemia is a single-gene genetic disease caused by β globin gene mutations leading to the fact that red blood cells are unable to form normal adult hemoglobin, and then patients develop hemolytic anemia. Current treatment regimens mainly include allogenetic hematologic stem cell transplantation, symptomatic regular blood transfusions and the use of iron removers to reduce iron load. Some severe patients have quite poor prognoses and deadly consequences if not treated timely. Genetically modified autohematopoietic stem cells can provide a new treatment option for patients with β thalassemia, which may achieve a long-term and stable increase in hemoglobin level through a single dose, making one-time cure β-thalassemia possible. This paper reviews the key elements of clinical trial design for β-thalassemia gene therapy from the aspects of efficacy evaluation endpoints, clinical trial design, enrollment population, and subject monitoring in order to provide a reference for pharma-therapeutic research and development enterprises.
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Objective:To analyze the efficacy and prognostic factors of induced chemotherapy combined with radiotherapy in the treatment of early stage extranodal natural-killer/T cell lymphoma (ENKTCL).Methods:Two hundred and eighty-seven early stage NKTCL patients were treated in Affiliated Cancer Hospital of Guizhou Medical University from October 2003 to October 2021. All patients were aD ministrated with short courses of induced chemotherapy combined with radiotherapy. Clinical prognostic factors of early stage NKTCL were analyzed. The overall survival (OS) and progression-free survival (PFS) were calculated by Kaplan- Meier method, log-rank test was conducted for univariate analysis and Cox models were performed for multivariate analysis. Results:The 5-year OS and PFS were 72.8% and 68.9% in all patients. According to Nomogram risk index (NRI) prognostic model, 286 patients were divided into the low risk (NRI=0), intermediate low risk (NRI=1), intermediate high risk (NRI=2), high risk (NRI=3) and very high risk (NRI≥4) groups. In these 5 groups, the 5-year OS were 95.6%, 76.3%, 69.5%, 61.0% and 23.3%(all P<0.001), and the 5-year PFS were 93, 2%, 69.8%, 64.6%, 60.2% and 23.3%(all P<0.001), respectively. In the radiotherapy with a dose of ≥50 Gy and<50 Gy groups, the 5-year OS were 73.8% and 65.9%( P=0.123) and the 5-year PFS were 72.8% and 45.3%( P=0.001). According to the response to induced chemotherapy of complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD), the 5-year OS were 85.4%, 74.0%, 61.8% and 28.5%(all P<0.001), and the 5-year PFS were 83.7%, 66.8%, 65.7% and 27.4%(all P<0.001), respectively. Univariate analyses showed that stage Ⅱ, ECOG≥2, primary tumor invasion, radiotherapy dose<50 Gy and short-term efficacy of induced chemotherapy were poor prognostic factors for the 5-year OS and PFS (all P<0.05). Multivariate analyses demonstrated that primary tumor invasion, ECOG≥2 and stage Ⅱ were poor prognostic factors for OS (all P<0.05), and primary tumor invasion and ECOG≥2 were poor prognostic factors for PFS (all P<0.05). Conclusions:Early stage NKTCL patients can obtain high efficacy after induced chemotherapy combined with radiotherapy. Complete response to induced chemotherapy is associated with favorable prognosis.
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Objective:To analyze the efficacy and prognostic factors of radiotherapy combined with asparaginase/peaspartase-based chemotherapy regimen in the treatment of early stage extranodal natural-killer/T cell lymphoma of the upper aerodigestive tract (UADT ENKTCL).Methods:267 early stage UADT ENKTCL patients were treated in Guizhou Cancer Hospital from October 2003 to February 2020. Among them, 229 patients received radiotherapy or radiotherapy combined with menpartaminase/permenidase-based chemotherapy regimen and 38 patients were treated with radiotherapy or chemotherapy alone. The overall survival (OS) and progression-free survival (PFS) were calculated by Kaplan- Meier method, log-rank test was conducted for univariate analysis and Cox regression model was performed for multivariate analysis. Results:The 5-year OS and PFS were 67.2% and 61.5% in all patients. The 5-year OS and PFS in patients treated with radiotherapy combined with chemotherapy, radiotherapy alone and chemotherapy alone were 71.7%, 35% and 49%(all P<0.001), and 66.4%, 35% and 28%(all P<0.001), respectively. According to the NRI risk stratification, 246 patients treated with radiotherapy and chemotherapy were divided into the favourable and the unfavourable prognosis groups. The 5-year OS was 93.3% and 64.3%( P<0.001) and the 5-year PFS was 91.1% and 56.7%( P<0.001) in two groups. For patients receiving radiotherapy with a dose ≥50 Gy and<50 Gy, the 5-year OS was 72.4% and 55.7%( P<0.001), and the 5-year PFS was 68.3%, and 36.5%( P<0.001). In the unfavourable prognosis group, the 5-year OS of patients receiving ≥ 4 and<4 cycles of chemotherapy was 65.5% and 59.2%( P=0.049), and the 5-year PFS was 60.7% and 50.6%( P=0.018). Univariate analysis showed that stage Ⅱ, ECOG≥2, primary tumor invasion, radiotherapy alone, NRI≥1(Nomogram-revised risk index), EBV-DNA≥2 750 copies/ml, radiotherapy dose < 50 Gy, and<4 cycles of chemotherapy were associated with unfavorable 5-year OS and PFS (all P<0.05), and CHOP-like regimen was the risk factor of unfavorable 5-year PFS ( P<0.05). Multivariate analysis demonstrated that primary tumor invasion, ECOG≥2, and radiotherapy dose <50 Gy were associated with unfavorable OS and PFS (all P<0.05), and stage Ⅱ was the risk factor of unfavorable 5-year OS ( P<0.05). Conclusions:The prognosis of early stage low-risk UADT ENKTCL of is favourable. Sufficient dose of extended involved-field radiotherapy is an important curative modality in early stage UADT ENKTCL. Compared with radiotherapy alone, radiotherapy combined with chemotherapy can significantly improve the prognosis of early stage UADT ENKTCL patients in the unfavourable prognosis group. Full-course chemotherapy can significantly prolong the long-term survival in the unfavorable prognosis group. The chemotherapy containing asparaginase can significantly enhance the prognosis of patients with early stage UADT ENKTCL.
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Objective:To evaluate the therapeutic efficacy and side effects of P-Gemox regimen combined with intensity modulated radiotherapy in the treatment of extranodal NK/T cell lymphoma, nasal type (ENKTL).Methods:The data of 60 patients with ENKTL confirmed by pathomorphology and immunohistochemistry in Guizhou Cancer Hospital from July 2014 to October 2019 were retrospectively analyzed. All patients received P-Gemox chemotherapy combined with intensity modulated radiotherapy (at least 2 cycles), and the efficacy and adverse reactions were evaluated.Results:The complete remission rate of 60 patients was 65.0% (39/60), the partial remission rate was 25.0% (15/60), and the total effective rate was 90.0% (54/60). The main side reactions were myelosuppression, transaminase elevation and radiation mucositis; most of them were mild to moderate, which were relieved after treatment or the withdrawal of radiotherapy and chemotherapy. No treatment-related death cases were found. The overall survival rate of 1-year, 2-year, 3-year was 91%, 75% and 69%; the progression-free survival rate of 1-year, 2-year, 3-year was 86%, 68% and 62%. During the treatment, 3 cases died due to the progress of the disease and infection. Multivariate analysis showed that with and without hemophagocytic syndrome and radiotherapy dose were related to prognosis (all P < 0.05). Conclusion:P-Gemox, as the first-line induction chemotherapy regimen combined with intensity modulated radiotherapy has good short-term efficacy and safety for patients with ENKTL.
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Objective@#To observe the clinical efficacy and prognosis of DA-EPOCH regimen combined with or without rituximab [(R)-DA-EPOCH regimen] in treatment of young newly diagnosed patients with middle and high-risk diffuse large B-cell lymphoma (DLBCL).@*Methods@#The clinical data of 107 young newly diagnosed middle to high-risk DLBCL patients treated with (R)-DA-EPOCH regimen at Guizhou Cancer Hospital between November 2014 and December 2018 were retrospectively analyzed. The efficacies were analyzed by grouping according to rituximab (65 cases in R-DA-EPOCH group and 42 cases in DA-EPOCH group), and according to involved-filed radiotherapy (IFRT) after chemotherapy (99 cases with chemotherapy indications including 59 cases with IFRT and 40 cases without IFRT).@*Results@#The objective response rate (ORR) was 86.0% (92/107). The 1-, 2-year overall survival (OS) rate was 90.6% and 75.3%. The 1-, 2-year progression-free survival (PFS) rate was 79.1% and 56.5%. The ORR, 1-year OS rate, 2-year OS rate, 1-year PFS rate and 2-year PFS rate in R-DA-EPOCH group were higher than those in DA-EPOCH group [87.7% (57/65) vs. 83.3% (35/42), 94.8% vs. 84.9%, 80.4% vs. 68.2%, 90.5% vs. 77.0%, 61.0% vs. 50.8%, respectively), but there were no statistical differences (all P > 0.05). The ORR of IFRT group and non-IFRT group was 98.2% (56/57) and 80.0% (32/40) (χ 2 = 7.225, P = 0.007). The 2-year OS rate was 86.0% and 63.3% (P < 0.05). Main adverse reactions caused by radiotherapy were local skin mucosa reactions of grade Ⅰ-Ⅱ [42.4% (25/59)]. Multivariate analysis showed that albumin value after treatment was an independent prognosis factor affecting OS rate (95% CI 2.709-21.433, P < 0.01). Gender (95% CI 0.020-0.318, P < 0.01), albumin level (95% CI 2.097-12.219, P < 0.01), Beta 2 microglobulin level (95% CI 0.080-0.602, P < 0.01) and absolute lymphocyte count/absolute monocyte count (95% CI 0.113-0.720, P < 0.01) after treatment were independent prognosis factors affecting PFS rate.@*Conclusions@#The young newly diagnosed patients with middle and high-risk DLBCL are highly heterogeneous. Rituximab combined with DA-EPOCH regimen can improve the efficacy of patients. IFRT after chemotherapy may increase the short-term efficacy and OS, and the adverse reactions are tolerant.
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Objective@#This study aimed to evaluate the role of extended involved-field intensity modulated radiation therapy (IMRT) for patients with early stage extranodal nasal-type NK/T-cell lymphoma (NKTCL) in a single center, and to explore the long-term effect of risk-adaptive therapy.@*Methods@#Among 238 patients with early stage NKTCL, there were 191 in high-risk group [any risk factor of age > 60, elevated serum lactate dehydrogenase (LDH), Eastern Cooperative Oncology Group (ECOG) score≥2, primary tumor invasion, or Ann Arbor stage Ⅱ] and 47 in low-risk group (no risk factor). A total of 204 patients received radiotherapy combined with chemotherapy, 15 received radiotherapy alone and 19 received chemotherapy alone. One-hundred and eighty-six patients had radiotherapy at a dose ≥50 Gy and 159 patients received chemotherapy with asparaginase-based regimen.@*Results@#The 5-year overall survival (OS) rate and progression- free survival (PFS)rate of all patients were 66.2% and 57.5%. Five-year OS and PFS rates in low-risk group were 91.8% and 88.0%, while 59.3% and 49.3% in high-risk group. The survival of patients in low-risk group were better than those in high-risk group (both P<0.001). The five-year OS rate in combined therapy group, radiotherapy group and chemotherapy group were 71.7%, 52.3% and 20.7%, respectively (P<0.001). The five-year PFS rate were 63.5%, 23.3% and 24.1%, respectively (P<0.001). Among 219 patients receiving radiotherapy, the 5-year OS and PFS rate of patients with primary site radiotherapy dose ≥ 50 Gy were 72.6% and 66.1%, higher than those of patients with a dose <50 Gy (57.3% and 30.9%, respectively; P=0.031, P<0.001). In the high-risk group, the 5-year OS and PFS rate of the patients who received radiotherapy combined with more than 4 cycles of chemotherapy were 66.5% and 62.6%, higher than those of patients received less than 4 cycles of chemotherapy (56.7% and 46.4%, P=0.045 and 0.020, respectively). Cox multivariate analysis showed that ECOG score (HR=2.208, P=0.001), primary site (HR=4.887, P<0.001), primary tumor invasion (HR=3.265, P=0.001) and radiation dose (HR=1.895, P=0.011) were independent factors of OS in early NKTCL patients.@*Conclusion@#Extended-involved field IMRT with radiation dose more than 50 Gy was the main treatment for patients with early stage NKTCL. Radiotherapy combined with adequate cycle chemotherapy significantly improved prognosis of high-risk patients.
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Objective@#To analyze the clinical efficacy and prognostic factors of patients with early-stage diffuse large B-cell lymphoma of Waldeyer′s ring (WR-DLBCL) treated with CHOP-based chemotherapy.@*Methods@#A total of 137 patients diagnosed with WR-DLBCL admitted to our hospitalfrom 2006 to 2018 were enrolled, including 22 patients with stage Ⅰ and 115 patients with stage Ⅱ WR-DLBCL. All patients received CHOP-based chemotherapy, of whom 62 receiving rituximab and 87 receiving involved-field radiotherapy. The overall survival (OS), progression-free survival (PFS) and local recurrence-free survival (LRRFS) were calculated by Kaplan-Meier method. Log-rank test, was conducted for univariate analysis and Cox’s regression model was performed for multivariate analysis.@*Results@#The 5-year OS, PFS, and LRFFS in the whole group were 78.6%, 69.5% and 83.2%, and 87.5%, 80.2%, 90.9% in the comprehensive treatment group, and 64.2%, 53.6% 72.9% in the chemotherapy group, respectively. Univariate analysis showed that lactate dehydrogenase (LDH), international prognostic index score, large mass, rituximab, chemotherapy cycle and comprehensive treatment were the prognostic factors of OS and PFS. In addition, LDH, large mass and comprehensive treatment were the prognostic factors associated with LRFFS. Multivariate analysis demonstrated that LDH, comprehensive treatment mode and rituximab were the prognostic factors of OS. LDH and comprehensive treatment mode were the prognostic factors associated with PFS. LDH was a prognostic factor of LRFFS.@*Conclusion@#Patients with early-stage WR-BLBCL obtain excellent clinical prognosis. In the era of rituximab treatment, chemotherapy combined with radiotherapy remains an efficacious treatment of early-stage WR-BLBCL.
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Objective To evaluate the efficacy of extended-field intensity-modulated radiotherapy (IMRT) in the treatment of patients with early-stage NK/T cell lymphoma (NKTCL),and to examine the clinical characteristics and the effect of treatment factors on the prognosis of these patients.Methods The clinical data of 165 patients with early-stage NKTCL who underwent extended-field IMRT with (n=158,95.8%) or without chemotherapy (n=7,4.2%) were reviewed.Of these 165 patients,140(84.8%) received a radiation dose of ≥50 Gy to the primary lesion,and 25 patients (15.2%) received a radiation dose of<50 Gy.Most patients (n=147,89.1%) were treated with L-asparaginase-based chemotherapy regimens,whereas only 11 patients (6.7%) were treated with doxorubicin-based CHOP/CHOP-like regimens.In addition,109 patients (66.1%) received ≥4 cycles of chemotherapy.Locoregional control (LRC),overall survival (OS),and progression-free survival (PFS) rates were calculated using the Kaplan-Meier method,and the log-rank test was used for survival comparison and univariate prognostic analysis.A multivariate prognostic analysis was performed using the Cox model.Results The 5-year sample size 55.The 5-year OS,PFS,and LRC rates of all patients were 74.2%,72.5%,84.4%,respectively.The patients who received a dose of ≥50 Gy had a significantly higher 5-year LRC rate than those with<50 Gy (91.8% vs.39.7%,P=0.000).The 5-year OS was significantly higher in the low-risk early-stage group than in the high-risk early-stage group (P=0.002).For the high-risk early-stage NKTCL group,patients who received ≥4 cycles of chemotherapy had significantly higher 5-year OS and PFS than those who received<4 cycles of chemotherapy (5-year OS:71.3% vs.59.5%,P=0.032;5-year PFS:70.4% vs.54.4%,P=0.009).In addition,multivariate analysis showed that ECOG≥2,primary tumor invasion (PTI),and Ann Arbor stage Ⅱ were associated with poor OS (P=0.006,0.002,0.014),and ECOG≥2 and PTI were associated with reduced LRC (P=0.004,0.016).Furthermore,ECOG≥2,PTI,Ann Arbor stage Ⅱ,and extranasal primary site were associated with lower PFS (P=0.045,0.003,0.030,0.032).Conclusions Extended-field IMRT at a dose of ≥50 Gy can lead to favorable LRC,OS,and PFS in patients with early-stage NKTCL.However,it is less effective against distant early-stage NKTCL in patients with poor prognosis.Nevertheless,≥4 cycles of chemotherapy can significantly improve the OS and PFS of patients with early-stage NKTCL.
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Objective To compare the advantages and disadvantages of smear immunohistochemistry and biopsy of bone marrow in the detection of non-Hodgkin lymphoma (NHL) infiltration. Methods 60 newly diagnosed patients with NHL were collected. Smear immunohistochemistry and biopsy of bone marrow were applied to detect bone marrow involvement in those patients. The relations between the results of two detection methods and the relevant clinical characteristics, such as age, blood routine examination, lactic dehydrogenase, extensive infiltration, B symptom, performance status, clinical stage and so on were analyzed. Results Positive rate of bone marrow involvement in bone marrow smear immunohistochemistry group was higher than that in bone marrow biopsy group [10.0 % (6/60) vs. 3.3 % (2/60), P=0.008]. When detection on B cell infiltration, positive rates were 6.6 % (4/60) and 3.3 % (2/60) in smear immunohisto chemistry group and biopsy group, respectively (P=0.007), and when detection on T cell infiltration, the positive rates were 3.3%(2/60) and 0 (0/60), respectively. Furthermore, two detection method was not correlated with related clinical characteristics, such as bone marrow biopsy, immunohistochemistry, gender, age, Karnofsky score, B symptom, extranodal involvement, lactic dehydrogenase, thrombocyte, Hb, neutrophils, lymphocyte and staging (all P>0.05). Conclusions The positive rate of bone marrow smear immunohistochemistry is superior to bone marrow biopsy in the detection of bone marrow involvement of NHL. As for the immunophenotyping of NHL, sensitive rate of bone marrow smear immunohistochemistry is also better than that of bone marrow biopsy.
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Objective To study the clinical characteristics, diagnosis, treatment and prognosis of primary pulmonary peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS). Methods Two cases of primary pulmonary PTCL-NOS were studied and relevant literature were reviewed. Results Case 1 diagnosed as primary pulmonary PTCL-NOS was a 44 years old woman and disease progressed after GLD (Gem+L-OHP+ DXM) chemotherapy regimen. At last, the patient died of respiratory failure after one month. Case 2 diagnosed as primary pulmonary PTCL-NOS was a 46 years old man and reach partial response after CHOP regimen, and still alive now.Conclusion Primary pulmonary PTCL-NOS is very rare. It is easy to be misdiagnosed due to non-specific clinical and imaging manifestations. Acquiring enough tissue specimens for pathologic examination is the key to a definitive diagnosis. At present, there is no standard chemotherapy regimen for these patients, the prognosis is relatively poor.
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Objective To observe the primary clinical effect of concurrent radiochemotherapy for patients with nasal cavity natural killer (NK)/T cell lymphoma and to analyze the prognostic factors.Methods 31 primary untreated patients with stage Ⅱ nasal cavity NK/T cell lymphoma were enrolled for this study.All patients underwent concurrent radiochemotherapy with intensity-modulated radiotherapy technique + asparaginase based chemotherapeutic agents and adjuvant chemotherapy.Results The main toxicities were mouth mucocitis,myelosuppression and xerosmia at grade 1 or 2.31 patients achieved good clinical shortterm effect with high local complete remission rate at the 3rd month after radiotherapy [83.9 ％ (26/31)],and the 2-year overall survival rate was 77 ％.Univariate and multivariate analysis suggested IPI score and clinical short-term effect were the significant independent survival prognostic factors (P ＜ 0.05).Conclusions Concurrent radiochemotherapy for stage Ⅱ nasal cavity NK/T cell lymphoma can be well tolerated by patients with mild toxicities,and can improve both clinical short-term effect and overall survival by high local complete remission rate.IPI score and clinical short-term effect are the important survival prognostic factors.
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Objective To compare the effectiveness,correlativity,and acceptability of the three methods:bone marrow smear,biopsy and flow cytometry in diagnosis of lymphoma patients with bone marrow involvement.Methods 68 cases of early stage lymphoma were studied by observing and comparing positive rates of the three methods:bone marrow smear,biopsy and flow cytometry.Results After confirming the bone marrow involvement,the positive rates for the 68 cases using bone marrow smear,biopsy and flow cytometry were 16.2 ％ (11/68),33.8 ％ (23/68) and 10.3 ％ (7/68) respectively.Bone marrow biopsy had the highest positive rate compared to the other methods.It was statistically significant when comparing the differences of the 3 methods (P ＜ 0.05).According to the correlativity analysis of the 3 methods,bone marrow smear and biopsy correlated with each other (P =0.002),while flow cytometery did not (P =0.270).Conclusions Morphological examination of the bone marrow smear is a fundamental method to test bone marrow involvement in lymphoma.Bone marrow biopsy creates the highest positive rate and has clear advantage compared to the other methods,however,bone marrow smear must be used at the same time as a complement.
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A method for the quantitative monitoring of sulfadiazine (SD) residues in pork was established by molecular imprinted column coupling with high performance liquid chromatography (HPLC).The molecular imprinted column was selected as an extraction device.To obtain the optimum extraction efficiency,several parameters related to the molecular imprinted column,including column solvent,flow-rate,eluent of the sample matrix and eluent volume,were investigated.The sample solution was directly injected into the device for the extraction after simple extraction.Under the optimum conditions,the relative standard deviations (RSD) was ≤6.1％ and the recoveries for SD were higher than 75.6％.In comparison with the AL-SPE column,the MIP-SPE column had good reusability and extraction efficiency.This method was successfully applied to the determination snlfadiazine residues in pork.
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ObjectiveTo compare the yield rate of rats islets between different collagenase digestion groups.MethodsThe SD rats were randomly divided into two groups as following by using random digits table:collagenase P group (pancreas digested by 1 mg/ml collagenase P) and type Ⅴ collagenase group (pancreas digested by 1 mg/ml type Ⅴ collagenase).After pancreas digestion,rat islet cells in two groups were culture,purified and stained with DTZ.The mean islet number and islet equivalent (IEQ) before and after purification were measured under an inverted microscope.The viability of purified islets was assessed by fluorescence staining of aridine orange (AO) and propidium iodide (PI) under the fluorescence microscopy.After purification and culture for two days,islets function was evaluated by insulin releasing tests in the two groups.ResultsBefore purification,there was no significant difference in the islets number obtained from the pancreas between two groups (P＞0.05),but there was significant difference in the IEQ (P＜0.05).After purification,the islets number in type Ⅴcollagenase group and collagenase P group was (485 ± 113)/pancrease and (643 ± 82)/pancrease,and IEQ was (674 ± 157)/pancreas and (989 ± 126)/pancreas,respectively (P＜0.05).Islet viability in type Ⅴcollagenase group and collagenase P group was (96.13 ±1.13) ％ and (96.38 ± 0.92) ％ respectively (P＞0.05).The results of insulin releasing tests revealed there was no significant difference in islet function stimulated by hypoglycemia and hyperglycemia between two groups (P＞0.05).ConclusionTwo types of collagenase are suitable for the islets digestion in rats.The stability of digestion and yield rate of purified islets in collagenase P group are higher than in type Ⅴ collagenase group.
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Objective To investigate the clinicopathological characteristics and treatment of nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL). Methods Seven patients were confirmed as NLPHL by pathologic immunohistochemistry. Six patients received combined-modality therapy of chemotherapy and involved field, and the other one received single chemotherapy. Results The 3-year local control rate and overall survival rate were 100 % and 86 %, respectively. Only one case died of pulmonary infection following chemotherapy. Conclusion These patients with NLPHL has favorable prognosis, tolerance and less toxicity for combined-modality therapy. However the management of toxicity following treatment should be noted.
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Aim To study the mechanism of inhibition of basic fibroblast growth factor (bFGF) related signal transduction by lidamycin in cancer cells. Methods MTT assay was used to determine the growth inhibitory effect of lidamycin (LDM) and adriamycin (ADR) in several cancer cell lines. The inhibition of bFGF bound to its receptor by LDM was measured with [ 125I ]-bFGF binding assay.Intracellular Ca2+ stimulated by bFGF was measured by Fura-3. The formation of bFGF- receptor immune complex and the inhibitory effect of LDM on the activity of PKC isoenzymes induced by bFGF in cancer cells were identified by Western blotting analysis. Results LDM displayed extremely potent growth inhibitory effect on several cancer cell lines in a dose-dependent manner. A comparison of the IC50 values showed that the effect of LDM was 1 000-fold more potent than that of ADR. LDM blocked the specific by anti-FGFR specific antibody, LDM inhibited the formation of bFGF-receptor immune complex. bFGF demonstrated that LDM inhibited the activity of PKC isoenzymes in cancer cells stimulated with bFGF.Conclusion The blocking of bFGF receptors in the signal transduction pathway may be involved in the effect of LDM on cancer cells.
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AIM To study the apoptosis-inducing and growth-inhibitory effect of rhein, an herb-derived compound, and its combination with mitomycin C (MMC) on cultured tumor cells. METHODS MTT assays were used to determine the inhibition of proliferation by drugs in several tumor cell lines. Nucleoside transport and DNA synthesis inhibition were determined by ［3H］ thymidine transport and incorporation assays. Flow cytometry, electrophoresis on agarose gels and morphological assesment were applied to analyze the apoptotic changes. RESULTS The IC50 values of nucleoside transport was 19.1 μg*mL-1 and that of the DNA synthesis inhibited by rhein was 27.4 μg*mL-1. In MTT assay the IC50 values of rhein for KB, hepatoma BEL-7402 and mammary carcinoma MCF-7 cells were 11.5 μg*mL-1, 14.0 μg*mL-1 and 18.4 μg*mL-1 respectively. Synergistic effect of rhein and MMC was found in all the three cell lines. As found, rhein induced apoptosis in KB cells, and the increase of apoptotic cells reached 71.0% at 96 h. The combination of rhein and MMC enhanced the induction of apoptosis significantly. CONCLUSION These results suggest that rhein, as a biochemical modulator, might be potentially useful in cancer chemotherapy.
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Objective To investigate the effect of insulin glaring(IG)and neutral protamine hagedorn(NPH)on metabolic control and islet cell function in type 2 diabetic patients who secondly failed to sulfonylureas(SU)treatment.Methods Fifty-two diabetic patients with second SU failure were studied in our hospital during May,2004 to Nov,2004,and they were divided into two groups:twenty treated with glipizide extended release tablets(GERT)plus IG injection,while thirty-two with GERT plus NPH.Fasting and postprandial blood glucose,HbA_1c,fasting and postprandial C-peptide were determined in all patients at different following points.Results Blood glucose decreased obviously and similarly in two groups;however,hypoglycemia occurred less in IG group.Interestingly,fasting and postprandial C-peptide significantly increased in IG group,but didn't change in NPH group.Conclusion Combination treatment with IG or NPH has good effect on metabolic control in second SU failure patients;and moreover,IG improves B-cell function.