Expression of miRNA-21 in mucosa-associated lymphoid tissue lymphomas and its relationship with CHOP regimen / 白血病·淋巴瘤

Objective To investigate the expression of miRNA (miR-21) in mucosa-associated lymphoid tissue(MALT) lymphomas and its relationship with the effects in CHOP regimen. Methods Lymph gland tissues and preoperative peripheral blood of 52 patients pathologically diagnosed with MALT lymphoma in Department of Hematology of Affiliated Hospital of Hebei University of Engineering from January 2015 to December 2017 were collected; meanwhile, 10 tissues from patients with lymphadenitis and 20 peripheral serum from healthy examination patients were also collected. Quantitative real-time polymerase chain reaction (qPCR) was used to compare the lymph gland tissues in MALT lymphoma patients and lymphadenitis patients, and the expression of miR-21 in peripheral serum of MALT lymphoma and healthy people. The selected 20 cases of MALT lymphoma were given CHOP regimen treatment for 6 cycles, and then the efficiency and inefficiency were compared; at the same time, the expression of miR-21 in peripheral serum of the patients in the effective group was detected. Results The relative expression of miR-21 of lymph node tissues in lymphadenitis patients and MALT lymphoma patients was 1.03±0.12 and 4.53±0.73 respectively, and the relative expression of miR-21 in preoperative peripheral serum of healthy people and MALT lymphoma patients was 0.83±0.04 and 3 . 87 ± 0 . 21 respectively , and the differences were statistically significant (P ＝ 0.047, P ＝ 0.044). After 6 cycles of CHOP regimen, the total effect rate of MALT lymphoma was 70 % (14/20), and the relative expression of miR-21 in preoperative and postoperative peripheral serum for the patients who obtained the effective results after CHOP regimen was 3.95 ±0.08 and 1.62 ±0.41, and the differences were statistically significant (P＝ 0.035). Conclusions The expression of miR-21 has a certain correlation with the occurrence and development of MALT lymphoma. Furthermore, the serum miR-21 expression may be related to the effect of CHOP regimen chemotherapy in MALT lymphoma.

Clinical curative effect of rhGM -CSF joint R -CHOP regimen in the treatment of diffuse large B cell lymphoma / 中国基层医药

Objective To study the clinical curative effect of the recombinant human granulocyte-macro-phage colony-stimulating factor ( rhGM -CSF) joint R-CHOP regimen in the treatment of diffuse large B cell lymphoma (DLBCL).Methods 72 hospitalized patients with DLBCL were chosen from January 2014 to January 2015.The patients were randomly divided into joint CHOP rituxan group ( R-CHOP group,36 cases) and the joint treatment group (36 cases) .The R-CHOP group was treated by R-CHOP regimen,the joint group was given rhGM-CSF on the basis of R-CHOP treatment.Before chemotherapy and 15 days,1 month,3 months after chemotherapy, the peripheral blood was collected,and the monocytes were separated,flow cytometry was used to count HLA-DR, CD197 marked M1 cells and CD68,CDl63 marked M2 cells.4 months after chemotherapy,the curative effect was evaluated.Results 4 months after treatment,the ORR of joint group (91.67%) was significantly higher than that of R-CHOP group (75.00%),and the difference was statistically significant (χ2 =4.372,P<0.05).After treatment, the adverse reactions of joint group,the liver function injuryⅠ-Ⅱlevel 8.33%,Ⅲ-Ⅳlevel 0.00%;White blood cells reduceⅠ-Ⅱlevel 25.00%,Ⅲ-Ⅳ level 5.56%;Thrombocytopenia Ⅰ-Ⅱ level 19.44%,Ⅲ-Ⅳ level;8.33%;Nausea and vomitingⅠ-Ⅱ level 8.33%,Ⅲ-Ⅳ level 0.00%.The adverse reactions after treatment of R-CHOP group,the liver function injury Ⅰ-Ⅱ level 13.89%,grade Ⅲ-Ⅳ2.78%;White blood cells reduceⅠ-Ⅱlevel 36.11%,Ⅲ-Ⅳlevel 11.11%;ThrombocytopeniaⅠ-Ⅱlevel 33.33%,Ⅲ-Ⅳlevel 2.78%;Nau-sea and vomitingⅠ-Ⅱ level 13.89%,Ⅲ-Ⅳ level 0.00%.The increased ratio of TAM quantity in combined treatment group (63.89%) was significantly more than R-CHOP group (38.89%),the difference was statistically significant (χ2 =7.938,P <0.05).In joint group,the positive expression rates of CD68 (46.11%),IL -6 (44.44%),IL-8 (58.33%) were significantly higher than those of R-CHOP group[CD68 (13.89%),IL-6 (19.44%),IL-8 (38.89%)],the differences were statistically significant (χ2 =3.278,3.278,4.489,all P<0.05).Conclusion R-CHOP joint rhGM -CSF has better curative effect than R-CHOP plan and less adverse reaction,and under the induction of rhGM -CSF,mononuclear cells can develop into M1 macrophages,in DLBCL microenvironment,to induce TAM to M1 M2 type in reverse polarization,improve the microenvironment of DLBCL and provide chance for cure of DLBCL.

Prophylactic Effect of Pegfilgrastim on Febrile Neutropenia in Patients with Non-Hodgikin's Lymphoma

OBJECTIVE: Pegfilgrastim is recently introduced that is long acting G-CSF for prophylaxis of febrile neutropenia. Treatment of non-Hodgikin's lymphoma (NHL) with R-CHOP is classified with relative high risk of febrile neutropenia. The study evaluated the prophylactic effect of pegfilgrastim to reduce the incidence of febrile neutropenia associated with R-CHOP of patient in NHL. And the risk factors associated with the incidence of FN and related events were evaluated. METHODS: This retrospective study reviews the Electronic Medical Record of 68 NHL patients who received R-CHOP chemotherapy in single center between September 2013 and August 2014. These patients were classified who receive prophylaxis pegfilgrastim or no prophylaxis. RESULTS: Sixty eight patients received R-CHOP with NHL. In 144 cycles of patients receiving pegfilgrastim, compared with no prophylaxis 178 cycles, had a lower incidence of febrile neutropenia (5.5% vs. 23.6%, p = 0.001), grade 3 or grade 4 neutropenia (14.4% vs. 89.8%, p or = 65 (OR: 5.87, 95% CI 1.07-32.27, p = 0.042), IPI > or = 3 (OR: 7.2, 95% CI 1.31-39.6, p = 0.023), S.alb < 3.5 g/dL (OR: 31.01, 95% CI 6.32-152.17, p < 0.0001). In multiple logistic regression analysis, lower baseline serum albumin (OR: 21.1, 95% CI 3.8-116.98, p = 0.001) was significantly associated with occurrence of febrile neutropenia. CONCLUSION: The study recommends prophylactic pegfilgrastim through risk assessment of febrile neutropenia in patients with non-Hodgikin's lymphoma receiving R-CHOP.

Clinical features and survival outcomes of patients with diffuse large B-cell lymphoma: analysis of web-based data from the Korean Lymphoma Working Party Registry

BACKGROUND: This study aimed to survey the clinical spectrum of diffuse large B-cell lymphoma (DLBCL) in terms of epidemiology, pathologic subtypes, stage, and prognostic index as well as treatment outcomes. METHODS: In 2007-2008, 13 university hospitals evenly distributed in the Korean peninsula contributed to the online registry of DLBCL at www.lymphoma.or.kr and filed a total of 1,665 cases of DLBCL recorded since 1990. RESULTS: Our analysis showed a higher prevalence of DLBCL in male than in female individuals (M:F=958:707), and extranodal disease was more common than primary nodular disease (53% vs. 47%). Among the 1,544 patients who had been treated with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) or rituximab-CHOP (R-CHOP) therapy with or without radiation, 993 (63.9%) were alive, with 80% free of disease, 417 were dead (26.8%), with 13% free of disease, and 144 (9.3%) were lost to follow-up, with 23% free of disease. Age below 60 years, stage at diagnosis, international prognostic index (IPI) score regardless of age, and addition of rituximab to CHOP therapy in low- and low-intermediate-risk groups according to IPI scores significantly increased survival duration. CONCLUSION: The epidemiology, clinical spectrum, and biological behavior of DLBCL in Korea are similar to those observed in Western countries, and the advent of rituximab improved survival.

Efficacy of Rituximab Combined with CHOP for B Cell Non-Hodgkin's Lymphoma / 中国肿瘤临床

Objective: To evaluate the therapeutic effects of Rituximab combined with CHOP on B cell non-Hodgkin's lymphoma. Methods: A prospective study with concurrent control group was carried out. A total of 60 cases of B cell non-Hodgkin's lympoma were divided into 2 groups. The 30 cases in the research group received Rituximab combined with CHOP regimen. The 30 cases in the control group were treated with CHOP regimen alone. CHOP regimen (Cyclophospham 600mg/m~2 IV, Vincristine 1.4mg/m~2 Ⅳ, and Adriamy-cin piarubicin 50mg/m~2 IV) was administered on the first day of chemotherapy course. Prednisone 100mg/m~2 was administered orally from the first day to the fifth day. The cycle was repeated every 21 days and the patients received at least 3-6 cycles of chemotherapy. The therapeutic effect was assessed. Results: The complete remission (CR) rate and total response rate were 66.7% (20/30) and 90.0% (27/30) in the research group and 39.97% (12/30) and 56.7% (17/30) in the control group. The therapeutic differences between the two groups showed a statistical significance (P＜0.05). Conclusion: Compared with CHOP regimen chemotherapy, Rituximab combined with CHOP regimen shows better therapeutic effect. The side effects in the research group are similar to those in the control group. Rituximab combined with CHOP regimen can be the first choice in the treatment for B cell non-Hodgkin's lymphoma.

A Case of Primary Pancreatic Non-Hodgkin's Lymphoma

Primary pancreatic lymphoma is rare, comprising 0.2~4.9% of all pancreatic malignancies and less than 1% of cases of non-Hodgkin's lymphoma. Many patients are diagnosed with lymphoma after radical resection. We report a rare presentation of diffuse large B cell lymphoma, appearing as a primary tumor of the pancreas. A 61-year old female was admitted to the hospital with the complaint of right upper abdominal pain. Computed tomography of the abdomen showed a well defined mass located at the head of the pancreas. A frozen section of pancreas, during laparotomy, revealed lymphoma. The patient received 6 cycles of chemotherapy and is currently in complete remission. This case underscores the importance of differentiating primary lymphoma from the more common adenocarcinoma of the pancreas as treatment and prognosis differ significantly. Primary pancreatic lymphoma should be considered in the differential diagnosis of pancreatic tumors and an attempt to obtain a tissue diagnosis is always necessary before proceeding to radical surgery, especially on young patients.

Comparison of fludarabine plus mitoxantrone combination therapy with CHOP for malignant lymphoma / 中国实用内科杂志

Objective To investigate the efficacy and safety of fludarabine plus mitoxantrone combination chemotherapy for malignant lymphoma compared with CHOP regimen.Methods Sixty-six patients with malignant lymphoma were divided into fludarabine group and CHOP group.The efficacy and toxicities of these two regimens were analyzed and compared between the two groups.Results The overall response(OR)was 81.5% in fludarabine group,while was 48.7% in CHOP;for the patients in late-stage,with B cell lymphoma,with T cell lymphoma and with high serum LDH level,the OR in fludarabine group was higher than in CHOP group obstructively,being 62.5% and 35.7%.Conclusion Fludarabine combination chemotherapy,as a first line regimen in treating first-treated lymphoma,recrudescent lymphoma,intractable lymphoma and lymphoma in late stage,possesses higher efficacy,safety and tolerance than CHOP regimen.