Chronic lymphocytic leukemia in the recent 10 years and treatment effects of Fludarabin.

OBJECTIVE: CLL (Chronic Lymphocytic Leukemia) is the most common form of leukemia in the western world and because of prolonged survival of patients, the prevalence is high. Chemotherapy is usually not indicated in early and stable disease and using Chlorambucil with or without steroids has been the drug of choice in the treatment of CLL for many years .Clinical studies have shown that using Fludarabin can cause a complete response in significant number of untreated and/or previously treated CLL patients. The aim of this study is evaluating of CLL patients and determining the effects of treatment with Fludarabin. METHODS: A retrospective (descriptive/cross sectional) study of CLL patients who admitted to Hematology and Oncology Research Center of Tabriz university of Medical Sciences, between 1995-2005 was made and 126 patients enrolled. Collection of data was carried out according to special questionnaire and response to Fludarabin was analyzed by SPSS 11 software. RESULTS: The patients mean age of diagnosis was 63.7 years (SD=8.9), 69.8% were males. Illness and fatigue were the commonest presenting symptoms in 54% and lymphadenopathy was the most common clinical sign in 88.9%.Most of the patients were in stage C in Binet system (52.4%) and/or stage IV in Rai system (44.4%).Chemotherapy with chlorambucil and Prednisolone was the most common regimen used (60.3%) and 49.2% of patients were in partial remission with this treatment. Forty two patients treated with Fludarabin and 50% were in partial remission, 35% in static disease, 10% in progressive disease and 5% in complete remission (P=0.053). CONCLUSION: The median survival with Fludarabin was 43.9 months (SD=27.2) and in the case of Chlorambucil+Prednisolone and CVP or Chop it was 45 months (SD=26.5) and 50 months (SD=32.2), respectively (P>0.05). P value in the relationship with survival and response to Fludarabin was more than 0.05.Above all, Fludarabin is the choice treatment as first and second line therapy, as well as for patients who have failed therapy with standard regimens.

Variation of tumor markers in 277 breast cancer cases.

INTRODUCTION AND PURPOSE: Breast cancer is the most frequently diagnosed cancer in women in the world, Advances in paraclinical methods have resulted in dramatic changes in determining the survival of patients. Serial evaluation of serum levels of tumor markers is one of these methods. METHODS: During 1993-2002, 277 cases with breast cancer after mastectomy were included in this cross sectional study. Data were extracted from the patients records. Characteristics of the patients associated with serum levels of tumor markers like CEA,CA15-3 and receptor markers like ER,PR with P53,Cathepsin-D and HER-2 were evaluated. RESULTS: The most common involved age was in the 4th decade, accounting for 43.3%of the total. Most of the cases (54.3%) had stage II disease; Ductal carcinoma with frequency of 83.3% was the most common pathology involved and bone metastasis with 59% was prominent. There were elevated serum levels of CEA and CA15-3 in 50.6% and 41.7%, respectively. There was no statistical relation between serum levels of these markers with disease stage (CEA: pearson chi-square = 0.133 CAl5-3: Pearson chi-square = 0.064). There was a great increase in serum level of tumor markers during relapse (CEA P = 0.000 CA15-3 P = 0.000). DISCUSSION AND CONCLUSIONS: Because diagnosis of breast cancer is generally at advanced stage in our country, serum levels of tumor markers demonstrate great differences from those published for the Western world. It seems, however, that serum levels of tumor markers might be reliable for predicting relapses.