Absolute Monocyte and Platelet Counts May Provide Additional Prognostic Information in Primary Gastric Diffuse Large B-cell Lymphoma Patients Treated with Rituximab and CHOP.

INTRODUCTION: Primary gastric diffuse large B cell lymphoma (PG-DLBCL) is the most common histological subtype of primary gastric lymphoma. The standard of care of PG-DLBCL patients is the combination rituximab-based immunochemotherapy (R-CHOP). Re-cently, different host-related factors have been shown to have significant prognostic significance in non-Hodgkin lymphoma. However, data regarding their prognostic contribution to PG-DLBCL are limited. AIM: To assess the prognostic impact of a panel of simple, cost-effective laboratory variables which are easy to apply in routine labora-tory use for R-CHOP-treated PG-DLBCL patients in an attempt to identify those among them that are high-risk category. MATERIALS AND METHODS: We retrospectively assessed the possible prognostic impact of different laboratory markers in 42 R-CHOP treated PG-DLBCL patients treated between 2004 and 2014 and followed at a single institution. RESULTS: The estimated 5-year overall (OS) and progression-free survival (PFS) of the whole group were 80.9% and 78%, respectively. The absolute monocyte and platelet counts in univariate analysis predicted PFS and OS when analyzed as continuous and dichotomized variables. On multivariate analysis performed with factors included in the stage-modified International Prognostic Index (m-IPI), the absolute monocyte and platelet counts remained independent predictors of PFS and OS. Therefore, the absolute monocyte and platelet counts were combined to generate a prognostic index that identified patients with an especially poor overall survival. CONCLUSIONS: This prognostic index was independent of the m-IPI and could provide additional prognostic information for better stratification of these patients.

Lipid-modifying and pleiotropic effects of gemfibrozil, simvastatin and pravastatin in patients with dyslipidemia.

AIM: To assess the lipid-modifying and pleiotropic effects of drugs of the statin group (simvastatin and pravastatin) and the fibrate group (gemfibrozil) in dyslipidemia patients. PATIENTS AND METHODS: Fifty eight patients with primary dysli pidemia were recruited for a 12-week treatment. Forty two patients were allocated to be treated with statins (20 mg): 24 with simvastatin and 18 with pravastatin. Sixteen patients received gemfibrozil in a dose of 900 mg daily. Using enzyme, colorimetric, turbidimetric, immunoenzyme and chromogenic substrate methods, we studied the following laboratory parameters: 1) lipid parameters - total cholesterol, LDL and HDL cholesterol, triglycerides, apoli poprotein A-I, apoli poprotein B, anticardioli pin antibodies and lipid indices; 2) hemostasis, fibrinolysis and blood rheology parameters - platelet count, ADP-induced platelet aggregation, fibrinogen, platelet factor 4,antithrombin III activity, alpha2-anti plasmin concentrations, alpha2-macroglobulin, alpha1-antitripsin, plasma viscosity and hematocrit. RESULTS: Gemfibrozil elevated significantly apolipoprotein A-I, but decreased the total cholesterol, LDL cholesterol, triglycerides, the lipid indices, the ADP-induced platelet aggregation, plasminogen, alpha2-antiplasmin and hematocrit. Simvastatin treatment of patients reduced the total cholesterol, LDL cholesterol, triglycerides, two of the lipid indices, plasma viscosity and hematocrit. Pravastatin produced the same changes in the lipid parameters, but decreased apolipoprotein A-I. Plasminogen, alpha2-antiplasmin and rheological parameters decreased while antithrombin III increased. CONCLUSION: The lipid-modifying treatment with statins and fibrates, in addition to the effect on lipid metabolism, exerts a pleiotropic effect on hemostasis, fibrinolysis and blood rheology parameters.