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BACKGROUND@#Among malignant tumors, lung cancer has the highest mortality rate. Small cell lung cancer (SCLC) is a kind of malignant lung cancer. Its doubling time is very fast. Patients are prone to drug resistance during treatment, and their condition often deteriorates rapidly after recurrence. Except for topotecan, there is a lack of effective second-line single-agent chemotherapy. This study aims to analysis the efficacy and safety of irinotecan (CPT-11) in the second-line treatment of refractory and relapsed SCLC.@*METHODS@#A total of 107 SCLC patients were collected from the Department of Oncology, Jilin Guowen Hospital, who were diagnosed from April 2012 to March 2020, relapsed within 6 months after first-line treatment, and received second-line chemotherapy with single-agent CPT-11. Follow-up until November 2020, calculate the patient's progression free survival (PFS) and overall survival (OS), and summarize the effects and adverse reactions of CPT-11 chemotherapy.@*RESULTS@#The patient's median PFS was 3.8 (3.4-4.4) months, median OS was 8.1 (6.5-10.9) months, objective response rate (ORR) was 16.82% (18/107), and DCR was 55.14% (59/107). The incidence of grade 3-4 adverse reactions in patients was relatively low. Among them, neutropenia was 13.08%, delayed diarrhea was 7.48%, nausea and vomiting was 17.76%, and liver function impairment was 6.54%. The influencing factors of PFS in single-agent CPT-11 second-line chemotherapy were gender (P=0.001), NSE (P=0.029), and effusion (P=0.040). While the influencing factors of OS were NSE level only (P=0.033).@*CONCLUSIONS@#For patients with refractory relapsed SCLC, CPT-11 single-agent second-line chemotherapy has a certain effect, is well tolerated, and is worthy of promotion. .
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Chimeric antigen receptor T-cell strategy targeting CD19 (CART19) has prominent anti-tumor effect for relapsed/refractory B-cell lymphomas. CART19-associated complications have been gradually recognized, however, late-onset complications have not been extensively studied. Herein, for the first time we report a diffuse large B-cell lymphoma patient with terminal ileum involvement obtained rapid remission and developed spontaneous terminal ileal perforation 38 days following CART19 infusion. The late-onset perforation reminds us that, for the safety of CART treatment, more cautions are warranted for the management of delayed GI complications.
Assuntos
Humanos , Linfócitos B , Íleo , Linfoma de Células B , Receptores de Antígenos , Linfócitos TRESUMO
Objective To observe the treatment results of 44 consecutive patients with refractory/relapse acute myeloid leukemia( AML) not in remission who received allogeneic hematopoietic stem cell transplantation ( allo-HSCT ) following decitabine (DAC)-intensified conditioning regimen (18) and idarubicin(IDA)-intensified conditioning regimen (26). Methods We conducted a retrospective study to evaluate the outcome of 44 consecutive patients with refractory/relapse AML not in remission who received allo-HSCT from 2009 July to 2016 May.Eighteen of them were given DAC-intensified conditioning regimen and 26 of them were given IDA-intensified conditioning regimen prior to allo-HSCT.The effects of DAC and IDA intensified conditioning regimen on the patients ' engraftment, transplant-related mortality, survival and occurrence of graft versus host disease(GVHD)were analyzed.Results and Conclusion In the DAC group, 7(38.9％) patients had acute GVHD (aGVHD).Among them,2 patients had grade Ⅰ aGVHD,5 patients had grade Ⅱ aGVHD.In the IDA group, 16(61.5％)patients had aGVHD.Among them,9 patients had grade Ⅰ aGVHD, 6 patients had grade Ⅱ aGVHD and 1 patient had grade ⅢaGVHD.In the IDA group, 9 of 26(34.6％) patients experienced leukemia relapse , all of them died due to the lack of effective therapies .In the DAC group, 4 of 18(22.2％) patients experienced leukemia relapse, 2 of them got long-term survival throughout salvage therapies .For the DAC group and IDA group , the 1-year probabilities of overall survival (OS) and leukemia-free survival (LFS) were 65.0％ versus 57.7％ (P=0.602) and 53.5％versus 57.7％(P=0.910), respectively.DAC-intensified conditioning regimen before allo-HSCT in the treatment of refractory/relapse AML is safe and effective.
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Background and purpose: High-dose chemotherapy followed by autologous stem cell transplantation (auto-HSCT) is considered as the ifrst line treatment for patients with relapse/refractory lymphoma after conventional chemotherapy. However, most of these patients still relapse the second time. The purpose of this study was to analyze the efifcacy of the consolidation chemotherapy after autologous stem cell transplantation (HSCT) refractory/relapse lymphoma in high risk. Methods:A total of 38 patients with relapsed/refractory lymphoma including Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) were included, who were underwent auto-HSCT in our transplan-tation department from Jan. 2010 to Dec. 2013. In treatment group, 19 patients received 2 courses of consolidation che-motherapy after auto-HSCT every 2 to 3 months, with the regimen of mini-BEAM or modiifed mini-CBV. Another 19 patients had no chemotherapy after auto-HSCT as control group. Results:The median follow-up duration was 17.2 and 7.5 months in the treatment and control group respectively. The follow-up data demonstrated prolonged progression-free survival (PFS) in the treatment group than the control group [24.7 months vs 7.8 months, P=0.029 under intend-to-treat analysis ITT;24.7 months vs 5.2 months, P=0.01 under per protocol analysis(pp)]. There is also a trend of improved overall survival (OS) in the treatment group (P=0.055, ITT). Conclusion:Consolidation chemotherapy after auto-HSCT for refractory/relapsed lymphoma patients delay the relapse and tend to improve the overall relapse rate.