Clinical characteristics and treatment analysis of primary breast lymphoma: 49 cases report / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the morbidity, clinical characteristics, diagnosis, metastasis, treatment and prognosis of primary breast lymphoma (PBL).</p><p><b>METHODS</b>From January 1960 to August 2007, 49 cases with PBL were treated among 22811 cases of breast malignancy and 7337 cases of malignant lymphoma. The clinical data of these 49 patients, included gender, age, pathologic type, breast X ray and B ultrasound examination results, involved lymph nodes and organs, treatment, survival time, were retrospectively analyzed.</p><p><b>RESULTS</b>From 1960 to 2007, the incidence rate of PBL in Tianjin Municipality was 59/10 millions; in details, the incidence rate of PBL for every 10 years was 2/10 millions, 3/10 millions, 0, 13/10 millions and 32/10 millions, respectively. According to circle graph of age, PBL occurred frequently in female aged 30 to 59 years. Most of this group of PBL was non-Hodgkin lymphoma (48 cases). No typical characteristics was found with the examination of breast X ray, B ultrasound and frozen section pathology. Bone marrow (9 cases), lung (7 cases), meninges (4 cases) and ovary (4 cases) were frequently involved organs. The overall 5-year survival rate was 6.1% for the group. The prognosis in patients with radical mastectomy combined chemotherapy was much better than that in patient received super to local mastectomy plus chemotherapy or simple tumor resection plus chemotherapy (5-year survival rates were 21.4%, 0, 0, respectively).</p><p><b>CONCLUSIONS</b>PBL is a kind of rare lymphoma with incidence increasing sharply in the past few decades. The clinical manifestation is atypical. Diagnosis of PBL should adopt histological examination. Radical mastectomy combined chemotherapy could bring better prognosis, but the prognosis is still poor.</p>

High-dose chemotherapy/autologous stem cell transplantation for nasopharyngeal T cell lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate the role of high-dose chemotherapy (HCT)/autologous stem cell transplantation (ASCT) for nasopharyngeal T cell lymphomas.</p><p><b>METHODS</b>A retrospective review of 51 patients who underwent HCT/ASCT between January 1995 and January 2007.</p><p><b>RESULTS</b>Of the 51 patients who underwent ASCT, no treatment-related death was seen; sixteen patients relapsed after transplant, two patients are still alive through salvage chemotherapy 91 months and 56 months after relapse, the other fourteen patients died in tumor progression. 1-year, 3-year and 5-year overall survival (OS) rates were 98.0%, 84.0% and 72.0%, respectively. 1-year, 3-year and 5-year progression-free survival (PFS) rates were 90.2%, 78.4%and 66.7%, respectively. Univariate analysis showed that clinical stage, B symptom and IPI were prognostic factors for patients with nasopharyngeal T cell lymphomas, the P value being 0.041, 0.036 and 0.031, respectively.</p><p><b>CONCLUSION</b>High-dose therapy/autologous stem cell transplantation can improve cure rate and prolong survival time significantly in patients with nasopharyngeal T cell lymphomas.</p>

DNCE regimen for treatment of refractory or relapsed aggressive and highly aggressive non-Hodgkin lymphoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of DNCE [DXM, navelbine (NVB), DDP and Vp-16] regimen and DICE [dexamethasone (DXM), ifosfamide (IFO), cisplatin (DDP) and etoposide (Vp-16)] regimen in the treatment of refractory or relapsed aggressive and highly aggressive non-Hodgkin lymphoma (NHL).</p><p><b>METHODS</b>A total of 69 patients with histopathologically proved advanced aggressive and highly aggressive NHL were randomized into trial group (32 patients treated with DNCE regimen) and control group (37 patients treated with DICE regimen). The control group was given DICE regimen: DXM 20 mg, iv d1 approximately d4; IFO 1 g/m2), iv d1 approximately d4; Mesna 400 mg, iv q8h, d1 approximately d4; DDP 25 mg/m2, iv d1 approximately d4; Vp-16 100 mg/m2, iv d1 approximately d4; one cycle for 21 approximately 28 days. The trial group was given DNCE regimen: DXM 20 mg, iv d1 approximately d4; NVB 25 mg/m2, iv d1 and d5; DDP 25 mg/m2, iv d1 approximately d4; Vp-16 100 mg/m2, iv d1 approximately d4; one cycle for 21 approximately 28 days. Each patient completed at least 2 cycles of treatment.</p><p><b>RESULTS</b>A better efficacy was shown in the complete response rate, partial response rate, and total response rate between DNCE and DICE groups (18.8% vs. 10.8%, 37.5% vs. 35.1%, and 56.3% vs. 45.9%, respectively), but the differences were statistically non-significant (P > 0.05). The 1-, 3-, and 5-year survival rates were not significantly increased in DNCE group compared with that in DICE group (86.5% vs. 87.5%, 58.3% vs. 63.2%, 42.9% vs.38.5%, respectively, P > 0.05). The major side effects were leucopenia, thrombocytopenia, and nausea in both groups. The bone marrow depression in DNCE group was significantly slighter than that in the DICE group (P < 0.05).</p><p><b>CONCLUSION</b>The efficacy of DNCE regimen is as good as DICE regimen, and the bone marrow toxicity is less severe in DNCE group than that in DICE regimen. Therefore, the DNCE regimen is an effective second-line salvage regimen for the treatment of refractory or relapsed aggressive and highly aggressive non-Hodgkin lymphoma.</p>

Treatment outcome and prognosis of autologous hematopoietic stem cell transplantation combined with high dose radiotherapy/chemotherapy in 22 patients with nasal NK/T cell lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To analyze the outcome and prognosis of autologous hematopoietic stem cell transplantation (AHSCT) combined with high dose radiotherapy/chemotherapy in 22 patients with nasal NK/T cell lymphoma.</p><p><b>METHODS</b>From July 1992 to December 2005, 22 patients with nasal NK/T cell lymphoma were diagnosed pathologically. Immunophenotyping was performed in 13 cases. The patients were classified by Ann Arbor staging system and international prognosis index (IPI). The patients received cycles of chemotherapy every other two weeks or combined with radiotherapy for remission induction, followed high dose radiotherapy/chemotherapy, combined with autologous peripheral blood stem cell transplantation (APBSCT), or autologous bone-marrow transplantation (ABMT). Patients were given complementary radiotherapy after transplantation if they did not have it before. Twelve patients of IPI 3 -4 received consolidation chemotherapy, and one of them received the second transplantation.</p><p><b>RESULTS</b>The median follow-up duration was 64 (12 - 168) months. The 5 and 8-year overall survivals (OS) were 79.3% and 64.1%, and disease free survivals (DFS) were 36.4% and 27.3%, respectively. The 5-year OS were as follows: for stage I - II and III - IV disease were 90.0% and 70.0% (P = 0. 041); for patients without and with B symptom were 100.0% and 70.7% (P = 0.045); and for IPI 1 - 2 and 3 - 4 were 100.0% and 60.0% (P = 0.035), respectively. Multivariate analysis by COX regression revealed that disease stage, B symptom and IPI were independent prognostic factors.</p><p><b>CONCLUSION</b>AHSCT combined with high dose radiotherapy/chemotherapy is an effective treatment for patients with poor prognosis nasal NK/T cell lymphoma.</p>