Effects of rituximab combined with CHOP chemotherapy on serum TK-1 and VEGF levels in patients with non-Hodgkin's lymphoma / 国际检验医学杂志

Objective To study the effects of rituximab combined with CHOP chemotherapy on serum Thymidine kinase 1 (TK-1) and vascular endothelial growth factor (VEGF) in patients with non-Hodgkin lymphoma,and to provide guidance for clinical research.Methods A total of 24 patients with non-Hodgkin's lymphoma treated in our hospital from January 2013 to March 2016 were randomly divided into the control group and the observation group,and each with 12 cases.All patients were examined before and after treatment,the control group was only treated with CHOP chemotherapy,and the observation group was treated with rituximab combined with CHOP chemotherapy.The patients were followed up within 1-2 years after treatment.The therapeutic effects of all patients were observed,the TK-1 and VEGF levels were measured and the incidence rate of adverse reactions was recorded.Results The efficiency rates of patients in the observation group and the control group were 66.67％ and 50.00％,respectively after treatment,and the observation group was significantly better than the control group,the difference was statistically significant (P＜0.05);the TK-1 and VEGF levels of the two groups were significantly decreased after treatment (P＜0.05),there was a statistically significant difference.But the two indexes of observation group was significantly lower than the control group,the difference was significant (P＜0.05);the control group showed 1 case of liver dysfunc tion after treatment,4 cases of gastrointestinal dysfunction,1 case of decreased white blood cells,while the observation group were 1,3 and 1 case,respectively.There were no significant differences between two groups (P＞0.05).Conclusion With the treatment of rituximab combined with CHOP chemotherapy,serum TK-1 and VEGF levels of patients with non-Hodgkin lymphoma decreased significantly,the poor prognosis has been significantly improved,and this treatment is worth popularizing in clinical application.

Patterns of Neutropenia and Risk Factors for Febrile Neutropenia of Diffuse Large B-Cell Lymphoma Patients Treated with Rituximab-CHOP

Febrile neutropenia (FN) is the major toxicity of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) regimen in the treatment of diffuse large B-cell lymphoma (DLBCL). The prediction of neutropenia and FN is mandatory to continue the planned R-CHOP therapy resulting in successful anti-cancer treatment. The clinical features and patterns of neutropenia and FN from 181 DLBCL patients treated with R-CHOP were analyzed retrospectively. Sixty percent (60.2%) of patients experienced at least one episode of grade 4 neutropenia. Among them, 42.2% of episodes progressed to FN. Forty-eight percent (48.8%) of patients with FN was experienced their first FN during the first cycle of R-CHOP. All those patients never experienced FN again during the rest cycles of R-CHOP. Female, higher stage, international prognostic index (IPI), age > or =65 yr, comorbidities, bone marrow involvement, and baseline serum albumin < or =3.5 mg/dL were significant risk factors for FN by univariate analysis. Among these variables, comorbidities (P=0.009), bone marrow involvement (P=0.006), and female gender (P=0.024) were independent risk factors for FN based on multivariate analysis. On observing the patterns of neutropenia and FN, primary prophylaxis of granulocyte colony-stimulating factor (G-CSF) and antibiotics should be considered particularly in female patients, patients with comorbidities, or when there is bone marrow involvement of disease.

A supplementary report on the toxic manifestations of CHOP regimen in subjects with intermediate grade NHL.

Cancer chemotherapy engenders a gamut of unpredictable and perilous toxicities, which can cause substantial mortality, morbidity, and results in escalated healthcare costs due to increased requirement for ameliorative treat-ments and toxicity-related hospitalization. The main objective of this article is to report a range of adverse effects of CHOP regimen in patients with intermediate grade Non-Hodgkin’s Lymphoma (NHL). This randomized prospective study was conducted on de novo intermediate grade NHL patients, aged >20≤60 years, receiving CHOP chemotherapy regimen. Out of 30 patients who satisfied the inclusion criteria, only 25 patients completed 6 cycles of chemotherapy and were evaluated for various toxicities. Evaluation of all the 25 subjects showed that, in comparison with the baseline, most patients exhibited toxic damages. The hepatopancreatic, dermatological, vascular and nephrological damages, eventually resulted in weight loss, hepatomegaly, alopecia, hypotension, as well as abnormal levels of serum liver markers, serum creatinine and blood glucose. But, the necessity to interrupt the CHOP treatment did not arise in any of the patients. Thus, in this study combination chemotherapy with CHOP protocol was well tolerated by majority of the subjects.

A supplementary report on the toxic manifestations of CHOP regimen in subjects with intermediate grade NHL.

Cancer chemotherapy engenders a gamut of unpredictable and perilous toxicities, which can cause substantial mortality, morbidity, and results in escalated healthcare costs due to increased requirement for ameliorative treat-ments and toxicity-related hospitalization. The main objective of this article is to report a range of adverse effects of CHOP regimen in patients with intermediate grade Non-Hodgkin’s Lymphoma (NHL). This randomized prospective study was conducted on de novo intermediate grade NHL patients, aged >20≤60 years, receiving CHOP chemotherapy regimen. Out of 30 patients who satisfied the inclusion criteria, only 25 patients completed 6 cycles of chemotherapy and were evaluated for various toxicities. Evaluation of all the 25 subjects showed that, in comparison with the baseline, most patients exhibited toxic damages. The hepatopancreatic, dermatological, vascular and nephrological damages, eventually resulted in weight loss, hepatomegaly, alopecia, hypotension, as well as abnormal levels of serum liver markers, serum creatinine and blood glucose. But, the necessity to interrupt the CHOP treatment did not arise in any of the patients. Thus, in this study combination chemotherapy with CHOP protocol was well tolerated by majority of the subjects.

Diagnosis and treatment of 17 primary testicular lymphoma cases / 国际外科学杂志

Objective Concluding the clinical feature and prognosis of primary testicular lymphoma to improve the understanding of this disease.Methods During 1995 and 2010,17 cases of primary testicular lymphoma treated in Beijing Friendship Hospital of Capital Medical University were retrospectively analyzed of its clinical features,diagnosis,treatment and prognosis.Results Seventeen patients with a mean age of 68 years complained the testicular sohd mass as their first symptoms.The mean tumor diameter was 4.7 cm,and all patients underwent orchidectomy,and testicular non- Hodgkin's lymphoma was confirmed by pathologic examination.Fourteen cases were diffuse large B cell type and 3 cases were anaplastic large cell type.The clinical stage of all the patients was IE.Fourteen cases were followed up (3 cases were lost)with mean follow-up time of 37.8 months by outpatient interview and telephone,all patients were treated with CHOP chemotherapy,and some of them were combined with rituximab and preventive lowdose pelvic radiotherapy.Five cases died of other chronic medical complications,1 case with contralateral testicular metastasis received surgery again.There were 9 tumor free survival cases in total.Conclusion Primary testicular lymphoma is rare and more common in older men.Postoperative pathologic diagnosis is gold standard.The systemic treatment and individual therapy is the first choice for primary testicular lymphoma.

Prognostic Value of Immunohistochemical Biomarkers at Different Cut-off Values in Patients with Diffuse Large B-cell Lymphoma Treated with CHOP Chemotherapy

Many predictive models have been proposed for better stratification of diffuse large B-cell lymphoma (DLBCL). Hans' algorithm has been widely used as standard to sub-classify DLBCL into germinal center B-cell (GCB) and non-GCB origins. However, there have been disagreements in the literature regarding its prognostic significance. Here, we retrospectively analyzed Hans' algorithm and the individual immunohistochemical biomarkers at different cut-off values (5%, 30%, 50% or 75%) in 94 Korean patients with DLBCL treated with combination chemotherapy with cyclophosphamide, daunorubicin, vincristine, and prednisone. No significant differences were observed between the GCB (18 patients, 19.1%) and non-GCB (76, 80.9%) groups. Among individual biomarkers, CD10 negativity (cut point: 30%) and bcl-6 positivity (cut point: 5%) were independent good prognostic markers in progression-free survival (PFS), whereas bcl-6 (cut point: 5%) positivity was an independent good prognostic marker in overall survival irrelevant of international prognostic index. The present study showed the lack of predictability of Hans' algorithm in DLBCL patients, and that CD10, Bcl-6 may have diverse prognostic significance at different cut-off values. Our results suggest that the proposed cut-off value may not be applied universally, and that the optimal cut-off value may need to be optimized for individual laboratory.

A Case of Primary Cutaneous CD4+ Small/Medium-sized Pleomorphic T-cell Lymphoma / 대한피부과학회지

Primary cutaneous CD4+ small/medium-sized pleomorphic T-cell lymphoma (CSMTCL) is a rare disease constituting 2% of all cutaneous T-cell lymphomas. In most cases, CSMTCL occurs as a solitary lesion and has an indolent course. Here we present a 42-year-old woman with multiple, localized, recurrent, erythematous papules and macules that developed after combination chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP).

Intracranial Relapse of Intravascular Large B-Cell Lymphoma After Completion of CHOP Chemotherapy / 대한혈액학회지

Intravascular large B-cell lymphoma (IVLBL) is a rare neoplasm characterized by proliferation of lymphoma cells within the lumina of small vessels. Neurological and skin involvements usually predominate. We would describe a 78-year-old woman presented with fever, multiple erythematous skin lesions, and language disturbance. The skin biopsy of breast revealed IVLBL and malignant cells were also seen in the bone marrow. Shortly after completion of six cycles of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) with clinical response, intracranial relapse with multiple brain masses occurred. The palliative whole brain radiation therapy was given and intensive chemotherapy should be investigated in the case presented here.

Diffuse Large B-cell Lymphoma Successfully Treated in a Pregnant Patient / 대한산부인과학회잡지

The concurrence of lymphoma with pregnancy has been rare but is most commonly associated with an aggressive histology and disseminated disease. Thus, extensive staging is required, and either local radiotherapy or systemic chemotherapy is indicated as soon as possible. We have experienced a case of diffuse, large B-cell lymphoma, stage III2 diagnosed at 31 weeks of gestational age. During pregnancy period, CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) chemotherapy was performed and complete remission of disease was attained. The infant was successfully delivered at 34 weeks in gestation without any gross anomaly or combined disease. We report a case of diffuse large B-cell lymphoma successfully treated with combination chemotherapy during pregnancy and a brief review of the literatures.

Primary CHOP Chemotherapy Followed by Involved Field Radiation Therapy in Clinical Stage I or II Aggressive Non-Hodgkin's Lymphomas / 대한암학회지

PURPOSE: Although radiation therapy had been the treatment of choice for localized non-Hodgkin's lymphoma(NHL), recent studies have revealed that treatment result after radiation therapy alone is not successful for localized aggressive NHL, if it is not pathologically but clinically staged. A prospective phase II trial was conducted to evaluate the therapeutic results of 4 cycles of CHOP chemotherapy followed by involved field radiation therapy in clinically staged localized aggressive NHL. MATERIALS AND METHODS: Patients with a diagnosis of aggressive NHL(all intermediate grade and immunoblastic histology in NCI working formulation), Ann Arbor stage I or II without poor prognostic factors(presence of B symptoms, bulky diseases, or 2 or more extranodal involvement) were treated with 4 cycles of CHOP(cyclophosphamide, doxorubicin, vincristine, prednisolone) followed by involved field radiation therapy of 3,000~6,000(median: 4,500) cGy. RESULTS: Between April 1990 and March 1995, 62 consecutive patients entered this trial. Forty six patients with measurable diseases were evaluable for response. Complete response was achieved in 41(89.1%) patients after CHOP chemotherapy and 4 more patients after subsequent radiation therapy, making total CR rate of 98%. Progression free survival(PFS) of all 62 patients were 2.2+~73+ months and 5 year PFS rate was 64.6%. Overall survival(OS) were 2.4+~75+ months and 5 year OS rate was 75.2%. Old age (> 60) was the only significant prognostic factor, which-affected overall survival negatively. Treatment was relatively well tolerated, but 3 patients died associated with treatment. CONCLUSIONS: Four cycles of CHOP chemotherapy followed by involved field radiation therapy is highly curative and safe treatment for clinically staged, localized aggressive NHLs.