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1.
Sphingosine‐1‐phosphate receptor 1 as a prognostic biomarker and therapeutic target for patients with primary testicular diffuse large B‐cell lymphoma
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Risa Koresawa Kazuto Yamazaki Daigo Oka Hideyo Fujiwara Hirotake Nishimura Takashi Akiyama Shuji Hamasaki Hideho Wada Takashi Sugihara Yoshito Sadahira 《British journal of haematology》2016,174(2):264-274
2.
Dok Hyun Yoon Dae Ro Choi Heui June Ahn Shin Kim Dae Ho Lee Sang‐We Kim Bong‐Hee Park Sun Och Yoon Jooryung Huh Sang‐Wook Lee Cheolwon Suh 《European journal of haematology》2010,85(2):149-157
Background: Assessment of tumor cell proliferation based on Ki‐67 expression yielded conflicting prognostic predictions of patients with diffuse large B‐cell lymphoma (DLBCL). The introduction of rituximab to the DLBCL treatment regime has led to alterations in the significance of previous prognostic factors. Methods: We analyzed Ki‐67 expression and its correlation with prognosis in 144 patients with DLBCL treated with rituximab plus CHOP (R‐CHOP) between July 2003 and January 2008. Results: The complete response (CR) rates following R‐CHOP administration were not significantly different, based on Ki‐67 expression status (P = 0.104). However, higher rates of relapse were observed in the high Ki‐67 expression group (Ki‐67 ≥ 85%, n = 46) with 25.0%, compared to 10.0% in the low Ki‐67 expression group (Ki‐67 < 85%, n = 88) (P = 0.040). The 2‐yr event‐free survival (EFS) rates were 44.3% and 74.1% in the high and low Ki‐67 expression groups, respectively (P = 0.011). The 2‐yr overall survival (OS) rate was 66.4% in the high Ki‐67 expression group and 82.2% in the low Ki‐67 expression group (P = 0.016). In multivariate analysis, Ki‐67 expression was a significant prognostic factor for EFS [hazard ratio (HR) = 2.909; 95% confidence interval (CI) 1.261–6.708; P = 0.012]. Ki‐67 was associated with OS but with borderline significance (HR = 2.876; 95% CI, 0.972–8.508; P = 0.056). Conclusion: Elevated Ki‐67 expression seems to be associated with higher relapse after CR and inferior EFS in patients with DLBCL treated with R‐CHOP. 相似文献
3.
Wataru Yamamoto Naoto Tomita Reina Watanabe Yukako Hattori Yuki Nakajima Rie Hyo Chizuko Hashimoto Shigeki Motomura Yoshiaki Ishigatsubo 《European journal of haematology》2010,85(1):6-10
Background: Malignant lymphoma with central nervous system (CNS) involvement has an extremely poor prognosis. We retrospectively studied the risk factors for CNS involvement in patients with diffuse large B‐cell lymphoma (DLBCL) treated by cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or rituximab (R) ‐CHOP chemotherapy. Patients and methods: We studied 375 consecutive patients who were newly diagnosed with DLBCL between 1996 and 2006. Patients with primary CNS involvement and patients who received CNS prophylaxis were excluded. All the patients received CHOP (n = 172) or R‐CHOP (n = 203) chemotherapy. The following variables were assessed for their potential to predict CNS involvement: gender, age, serum lactate dehydrogenase (LDH) level, performance status, clinical stage, number of extranodal involvements, International Prognostic Index (IPI), bone marrow involvement, presence of a bulky mass, presence of B symptom, and treatment. Results: CNS involvement was observed in 13 cases (3.5%). In univariate analysis, LDH more than normal range, LDH more than twice as normal range, high IPI, bone marrow involvement, and systemic relapse were the predictors for CNS involvement. In multivariate analysis, no risk factors were detected for CNS involvement. The use of rituximab did not have an impact on CNS involvement. Conclusions: The incidence of CNS involvement dose not decrease in rituximab‐era. 相似文献
4.
Concordant but not discordant bone marrow involvement in diffuse large B-cell lymphoma predicts a poor clinical outcome independent of the International Prognostic Index 总被引:4,自引:0,他引:4
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In diffuse large B-cell lymphoma (DLBCL), previous studies have suggested that, while concordant bone marrow (BM) involvement confers a poor prognosis, discordant BM involvement does not. Whether this correlation is independent of the non-Hodgkin lymphoma International Prognostic Index (IPI) was previously unknown. We reviewed all DLBCL case histories from 1986 to 1997 at our center with complete staging, IPI data, and follow-up. A total of 55 (11.2%) of 489 patients had BM involvement, including 29 with concordant involvement and 26 with discordant involvement. The 55 patients with BM involvement had a poor prognosis compared with the uninvolved BM group (5-year overall survival [OS], 34.5% versus 46.9%; log-rank P = .019). However, concordant involvement portended a very poor prognosis (5-year OS, 10.3%; P < .001), whereas discordant involvement did not (5-year OS, 61.5%, P value nonsignificant). Compared with the discordant subset, the concordant subset patients were older, had a higher serum lactate dehydrogenase level, and a significantly higher IPI. However, the poor survival associated with concordant BM involvement was independent of the IPI score (P = .002, Cox regression). We conclude that in patients with DLBCL, concordant but not discordant BM involvement confers a very poor clinical outcome. Furthermore, concordant BM involvement is an independent adverse prognostic factor. 相似文献
5.
Li ZM Huang JJ Xia Y Zhu YJ Zhao W Wei WX Jiang WQ Lin TY Huang HQ Guan ZZ 《European journal of haematology》2012,88(6):510-517
Objectives: Rituximab has significantly improved the survival of patients with DLBCL, especially those with non‐germinal center B‐cell‐like (non‐GCB) subtype. The impact of Ki‐67 expression, an index of proliferation, on the clinical outcomes of patients with DLBCL has largely been unexplored. This study aimed to investigate whether Ki‐67 expression is an indicator of outcome in DLBCL patients (especially non‐GCB DLBCL patients) treated with standard chemotherapy combined with rituximab. Methods: Expression of Ki‐67 protein was examined immunohistochemically in 118 tumor specimens from patients newly diagnosed with DLBCL and treated with R‐CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). Results: Overall survival (OS) and progression‐free survival (PFS) were lower in patients with high Ki‐67 expression than in those with low Ki‐67 expression (3‐year OS: 65.2% vs. 81.7%, P = 0.030; 3‐year PFS: 56.4% vs. 73.3%, P = 0.020), similar in patients with GCB subtype and those with the non‐GCB subtype (OS: P = 0.330; PFS: P = 0.287). According to Ki‐67 expression status by immunophenotype subgroups, patients with high Ki‐67 expression in non‐GCB subgroup had the most unfavorable PFS and OS, comparing with the other three subgroups (P = 0.004 and P = 0.002, respectively). In multivariate analysis, non‐GCB with high Ki‐67 expression was an independent prognostic predictor of inferior survival in DLBCL patients treated with R‐CHOP. Conclusion: For DLBCL patients with non‐GCB DLBCL and high Ki‐67 expression, the survival benefit from R‐CHOP therapy is limited. 相似文献
6.
Sverker Hasselblom Ulrika Hansson Markus Olsson Leif Torén Anders Bergström Herman Nilsson‐Ehle Per‐Ola Andersson 《British journal of haematology》2010,149(4):560-568
Chemotherapy and rituximab (R) is current standard therapy in diffuse large B‐cell lymphoma (DLBCL), but a substantial proportion of patients still fail to reach sustained remission. In vitro studies have indicated that rituximab resistance could be accompanied by dysregulated apoptotic pathways, such as the phosphatidylinositol 3‐kinase (PI3K)/AKT signaling pathway, which can be constitutively activated in DLBCL. In this retrospective, immunohistochemical study on 106 patients treated with R‐CHO(E)P (cyclophosphamide, doxorubicin, vincristine, prednisone, rituximab [+etoposide]), we investigated the prognostic role of proteins involved in different apoptotic pathways; phosphorylated AKT (p‐AKT), bcl‐2, MCL1, bcl‐xL, Bax and Bak. High p‐AKT expression (>108 cells/mm2, highest quartile, n = 27) predicted worse progression‐free (PFS) (P = 0·02) and overall (OS) (P = 0·01) survival, independent of International Prognostic Index and sex. Also bcl‐2+ (cut‐off 50%) predicted worse PFS (P = 0·005) and OS (P = 0·05) but after adjustment for clinical factors only the influence on PFS (P = 0·03) remained significant. The prognostic impact of p‐AKT overexpression was independent of bcl‐2 status. MCL1, bcl‐xL, Bax and Bak expression did not add any prognostic information. Our results suggest that high p‐AKT expression predicts worse outcome, possibly indicating that inhibition of the activated PI3K/AKT pathway could be of clinical interest in DLBCL patients. In addition, bcl‐2 status could have prognostic importance also in the era of immunochemotherapy. 相似文献
7.
Long‐term follow‐up of dose‐adjusted EPOCH plus rituximab (DA‐EPOCH‐R) in untreated patients with poor prognosis large B‐cell lymphoma. A phase II study conducted by the Spanish PETHEMA Group
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Noelia Purroy Juan Bergua Laura Gallur Julio Prieto Luis A. Lopez Juan M. Sancho Jose A. García‐Marco Josep Castellví Santiago Montes‐Moreno Ana Batlle Sonia Gonzalez de Villambrosia Fernando Carnicero Lucía Ferrando‐Lamana Miguel A Piris Andrés Lopez 《British journal of haematology》2015,169(2):188-198
This prospective multi‐institutional phase II study was designed to assess the efficacy and safety of dose‐adjusted EPOCH (etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin) plus rituximab (DA‐EPOCH‐R) in untreated patients with poor prognosis large B‐cell lymphomas. Eighty‐one patients diagnosed with diffuse large B‐cell lymphoma (DLBCL, n = 68), primary mediastinal DLBCL (n = 6) and follicular lymphoma Grade 3b (n = 7), with an age‐adjusted International Prognostic Index >1, were eligible for analysis. Median age was 60 years (range: 21–77). Sixty‐five patients (80·2%) achieved complete response. After a median follow‐up time of 64 months, 10‐year event‐free survival and overall survival (OS) were 47·8% and 63·6%, respectively. None of the studied clinical and biological characteristics were associated with poorer outcome. Interestingly, patients with BCL6 rearrangement achieved a 10‐year OS of 100%, while patients with BCL2 rearrangement exhibited a poorer outcome compared to activated B‐cell tumours and germinal centre B‐cell without BCL2 rearranged tumours. Results achieved with DA‐EPOCH‐R showed a good long‐term outcome and a tolerable toxicity profile in high‐risk large B cell lymphoma patients. Outcome was not affected by tumour cell proliferation or by cell of origin, highlighting the requirement of new biological markers for patient subclassification of high‐risk DLBCL patients. 相似文献
8.
Goto N Tsurumi H Kasahara S Kanemura N Hara T Yasuda I Shimizu M Murakami N Sawada M Yamada T Takemura M Seishima M Kito Y Takami T Moriwaki H 《European journal of haematology》2011,87(3):217-227
Background: We have previously reported that serum interleukin‐18 (IL‐18) concentration predicted the clinical outcome of patients with aggressive non‐Hodgkin’s lymphoma treated with cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP). When rituximab (R) was added to this regimen, the prognosis of diffuse large B‐cell lymphoma (DLBCL) was markedly improved. Patients and Methods: In this study, we re‐evaluated the prognostic significance of serum IL‐18 in 227 DLBCL patients. Seventy‐three patients received CHOP before R‐era, and 154 patients received rituximab‐cyclophosphamide, doxorubicin, vincristine, and prednisolone (R‐CHOP) recently. Result: Four‐year overall survival (4‐yr OS) rates for patients in CHOP group with IL‐18 ≥ 720 pg/mL and <720 pg/mL were 8.2% and 67.3% (P < 0.0001), respectively, and 4‐yr OS rates with IL‐18 ≥ 590 and <590 pg/mL in R‐CHOP group were 53.4% and 77.8% (P = 0.0008), respectively. Multivariate analysis revealed that serum IL‐18 correlated most significantly with OS and progression‐free survival (PFS) in both groups (OS: P < 0.0001, PFS: P < 0.0001, in CHOP group; OS: P = 0.0147, PFS: P = 0.0084 in R‐CHOP group). The high serum IL‐18 patients with poor prognostic group in revised IPI or with non‐germinal center B‐cell phenotype had a very poor prognosis. Conclusion: Serum IL‐18 might be a powerful prognostic factor for DLBCL in R‐era. 相似文献
9.
Anamarija M. Perry Yuridia Alvarado‐Bernal Javier A. Laurini Lynette M. Smith Graham W. Slack King L. Tan Laurie H. Sehn Kai Fu Patricia Aoun Timothy C. Greiner Wing C. Chan Philip J. Bierman Robert G. Bociek James O. Armitage Julie M. Vose Randy D. Gascoyne Dennis D. Weisenburger 《British journal of haematology》2014,165(3):382-391
Diffuse large B‐cell lymphoma (DLBCL) is a heterogeneous disease and “double‐hit” DLBCL, with both MYC and BCL2 translocations has a poor prognosis. In this study, we investigated whether MYC and BCL2 protein expression in tissue would predict survival in DLBCL. The study included 106 cases of de novo DLBCL treated with rituximab and cyclophosphamide, doxorubicin, vincristine and prednisone (R‐CHOP) or CHOP‐like regimens. The results were validated on an independent cohort of 205 DLBCL patients. Patients with low expression of BCL2 (≤30%) and MYC (≤50%) had the best prognosis, whereas those with high BCL2 (>30%) and MYC (>50%) had the worst outcome. In multivariate analysis, the combination of the BCL2 and MYC was an independent predictor of overall survival (OS) and event‐free survival (EFS) (P = 0·015 and P = 0·005, respectively). The risk of death was nine times greater for patients with high BCL2 and MYC compared to those with low expression. High BCL2 and MYC was a strong predictor of poor OS (P < 0·001) and EFS (P = 0·0017) in patients with the germinal centre B‐cell (GCB) type, but not in the non‐GCB type. In DLBCL, high co‐expression of MYC and BCL2 was an independent predictor of poor survival, and could be used to stratify patients for risk‐adapted therapies. 相似文献
10.
M. R. Xie S. B. Xu X. H. Sun L. Ke X. Y. Mei C. Q. Liu D. C. Ma 《Diseases of the esophagus》2015,28(5):476-482
Small cell carcinoma of the esophagus (SCCE) is a rare, highly aggressive tumor characterized by early dissemination and a poor prognosis. Surgery, chemotherapy, and radiotherapy have been used alone or in combination for the treatment of this rare disease. The aim of this retrospective study was to analyze the role of surgery in the management of limited‐stage SCCE at a high‐volume center. We retrospectively evaluated 73 patients with limited‐stage SCCE who received an esophagectomy at our center from January 1994 to December 2011. The clinical characteristics, median survival times (MSTs), overall survival (OS), and relevant prognostic factors were analyzed. The overall MST was 23.0 months, and the 1‐, 2‐, 3‐, and 5‐year OS rates were 61.6%, 47.9%, 22.7%, and 10.6%, respectively. The MST for patients without lymph node involvement (33.0 months) was greater than the MST for patients with lymph node involvement (17.0 months) (P = 0.014). Similarly, patients who underwent radical resection had a greater MST (25.0 months) than patients who underwent palliative resection (7.0 months) (P = 0.004). Patients who received chemotherapy had a greater MST (27.0 months) than patients who did not receive chemotherapy (13.0 months) (P = 0.021). Survival analysis confirmed that a radical operation, chemotherapy, and lymph node involvement were independent prognostic factors. This study suggests that radical resection combined with chemotherapy should be recommended for patients with limited‐stage SCCE, especially patients with negative regional lymph nodes. A lack of lymph node metastasis was a good prognostic factor because patients without lymph node involvement had greater OS. 相似文献
11.
《British journal of haematology》2017,178(6):927-935
The optimal therapeutic approach for young diffuse large B‐cell lymphoma (DLBCL) patients with high‐intermediate and high‐risk age‐adjusted international prognostic index (aaIPI) remains unknown. Hereby we report a 10‐year single‐centre study of 63 consecutively treated patients. To optimize outcome, two approaches were carried out: Cohort 1 patients received four cycles R‐CHOP‐21 (rituximab, cyclophosphamide, daunorubicin, vincristine, prednisolone over 21 days) followed by first‐line high‐dose chemotherapy with autologous stem‐cell support (HDCT‐ASCT), resulting in 2‐year progression‐free (PFS) and overall survival (OS) of 60·6% and 67·9%. 39·4% of those patients were not transplanted upfront, mainly due to early progressive disease (24·2%). Cohort 2 patients received an early intensified protocol of six cycles of CHOP‐14 (cyclophosphamide, daunorubicin, vincristine, prednisolone over 14 days) with dose‐dense rituximab and high‐dose methotrexate resulting in promising overall response‐ (93·3%) and complete remission (90%) rates and sustained survival (2‐year PFS and OS: 93·3%). In an intention‐to‐treat analysis, 2‐year PFS (60·6% vs. 93·3%, hazard ratio [HR] 7·2, P = 0·009) and OS (69·7% vs. 93·3%, HR 4·95, P = 0·038) differed significantly, in favour of the early intensified protocol (Cohort 2). In a multivariate Cox‐regression model, PFS (HR 8·12, 95% confidence interval [CI] 1·83–35·9, P = 0·006) and OS (HR 5·86, 95% CI 1·28–26·8, P = 0·02) remained superior for Cohort 2 when adjusted for aaIPI3 as the most important prognostic factor. Survival of young poor‐prognosis DLBCL patients appears superior after early therapy intensification. 相似文献
12.
Prognostic value of Waldeyer’s ring involvement of diffuse large B-cell lymphoma treated with R-CHOP
Min-Young Oh Joo-Seop Chung Moo-Kon Song Ho-Jin Shin Ho-Sup Lee Sang-Min Lee Gyeong-Won Lee Su-Ee Lee 《International journal of hematology》2013,97(3):397-402
The objective of present study was to compare the prognosis of diffuse large B-cell lymphoma (DLBCL) with Waldeyer’s ring involvement (WR-DLBCL) to that of nodal DLBCL (N-DLBCL) without WR involvement. Between July 2004 and October 2009, medical records and metabolic tumor volume (MTV) measured by 2-[fluorine-18]-fluoro-2-deoxy-d-glucose (18F-FDG) positron emission tomography /computed tomography were collected from patients confirmed with DLBCL. All patients received six or eight cycles of R-CHOP therapy. One hundred and eight patients were included and categorized into WR-DLBCL and N-DLBCL groups. WR involvement and other prognostic factors were analyzed for survivals. High international prognostic index score and high MTV were independent poor prognostic factors. However, WR involvement was a good prognostic factor only in univariate analysis. This study suggests that tumor burden appeared to be more important than specific organ involvement for the prognosis of DLBCL. 相似文献
13.
Alba M. Redondo Helena Pomares María J. Vidal María J. Pascual Belén Quereda Juan M. Sancho Marta Polo Javier López Eulogio Conde Isidro Jarque Natalia Alonso María J. Ramírez Pascual Fernández María J. Sayas María J. Requena Antonio Salar José D. González Eva González‐Barca Reyes Arranz Dolores Caballero Alejandro Martín 《British journal of haematology》2014,164(5):668-674
The use of highly effective rituximab‐containing therapy for treating diffuse large B‐cell lymphoma (DLBCL) makes it more difficult to salvage relapsed or refractory patients. Autologous stem‐cell transplantation (ASCT) is the reference treatment for these patients, but the impact of previous exposure to rituximab on the subsequent results of ASCT remains unknown. We analysed 248 patients with relapsed or refractory DLBCL or grade 3B follicular lymphoma pre‐treated with rituximab as part of first‐line therapy (R+ group) who received ASCT, in comparison with a control group of 127 patients without previous exposure to rituximab (R? group). The complete remission (CR) rates were similar in both groups. Multivariate analysis identified age‐adjusted International Prognostic Index at diagnosis, extranodal involvement and disease status at transplant, and the number of previous chemotherapy lines as independent factors with a negative influence on CR rate. Compared with R? patients, those in the R+ group had a significantly better progression‐free survival (63% vs. 48% at 5 years) and overall survival (72% vs. 61% at 5 years). This observation was independent of other prognostic factors that affected these outcomes. In conclusion, ASCT is no less effective in patients with relapsed or refractory aggressive B‐cell lymphoma pre‐treated with first‐line rituximab‐containing therapy than in rituximab‐naive patients. 相似文献
14.
Ryan A. Wilcox 《American journal of hematology》2013,88(1):73-76
Disease overview: Approximately one‐fourth of cutaneous lymphomas are B‐cell derived and are generally classified into three distinct subgroups: primary cutaneous follicle‐center lymphoma (PCFCL), primary cutaneous marginal zone lymphoma (PCMZL), and primary cutaneous diffuse large B‐cell lymphoma, leg type (PCLBCL, LT). Diagnosis: Diagnosis and disease classification is based on histologic review and immunohistochemical staining of an appropriate skin biopsy. Pathologic review and an appropriate staging evaluation are necessary to distinguish primary cutaneous B‐cell lymphomas from systemic B‐cell lymphomas with secondary skin involvement. Risk‐stratification: Disease histology remains the most important prognostic determinant. Both PCFCL and PCMZL are indolent lymphomas that infrequently disseminate to extracutaneous sites and are associated with an excellent long‐term prognosis. In contrast, PCLBCL, LT is an aggressive lymphoma with an inferior prognosis. Risk‐adapted therapy: PCFCL and PCMZL patients with solitary or relatively few skin lesions may be affectively managed with local radiation therapy. Although single‐agent rituximab may be employed for patients with more widespread skin involvement, multiagent chemotherapy is rarely appropriate. In contrast, management of patients with PCLBCL, LT is comparable to the management of patients with systemic DLBCL. © Am. J. Hematol. 2013. © 2012 Wiley Periodicals, Inc. 相似文献
15.
Peter J. Hosein Jocelyn C. Maragulia Matthew P. Salzberg Oliver W. Press Thomas M. Habermann Julie M. Vose Martin Bast Ranjana H. Advani Robert Tibshirani Andrew M. Evens Nahida Islam John P. Leonard Peter Martin Andrew D. Zelenetz Izidore S. Lossos 《British journal of haematology》2014,165(3):358-363
Primary breast diffuse large B‐cell lymphoma (DLBCL) is a rare subtype of non‐Hodgkin lymphoma (NHL) with limited data on pathology and outcome. A multicentre retrospective study was undertaken to determine prognostic factors and the incidence of central nervous system (CNS) relapses. Data was retrospectively collected on patients from 8 US academic centres. Only patients with stage I/II disease (involvement of breast and localized lymph nodes) were included. Histologies apart from primary DLBCL were excluded. Between 1992 and 2012, 76 patients met the eligibility criteria. Most patients (86%) received chemotherapy, and 69% received immunochemotherapy with rituximab; 65% received radiation therapy and 9% received prophylactic CNS chemotherapy. After a median follow‐up of 4·5 years (range 0·6–20·6 years), the Kaplan–Meier estimated median progression‐free survival was 10·4 years (95% confidence interval [CI] 5·8–14·9 years), and the median overall survival was 14·6 years (95% CI 10·2–19 years). Twelve patients (16%) had CNS relapse. A low stage‐modified International Prognostic Index (IPI) was associated with longer overall survival. Rituximab use was not associated with a survival advantage. Primary breast DLBCL has a high rate of CNS relapse. The stage‐modified IPI score is associated with survival. 相似文献
16.
Serum BAFF predicts prognosis better than APRIL in diffuse large B-cell lymphoma patients treated with rituximab plus CHOP chemotherapy 总被引:1,自引:0,他引:1
Kim SJ Lee SJ Choi IY Park Y Choi CW Kim IS Yu W Hwang HS Kim BS 《European journal of haematology》2008,81(3):177-184
Objectives: B-cell activating factor of the tumor necrosis factor family (BAFF) and a proliferation-inducing ligand (APRIL) regulate survival and proliferation of B cells. Thus the association of elevated serum levels of BAFF and APRIL with worse prognosis has been suggested in B-cell lymphoid malignancies. However, the prognostic relevance of BAFF and APRIL is unknown in patients treated with rituximab, a monoclonal antibody targeting B-cell depletion.
Methods: We measured serum levels of BAFF and APRIL by enzyme-linked immunosorbent assay in 66 patients newly diagnosed as diffuse large B-cell lymphoma (DLBCL). All patients were treated with rituximab-CHOP chemotherapy.
Results: The mean (±standard deviation) serum level of BAFF (1 970.21 ± 1 979.45 pg/mL) was higher in DLBCL than in controls (861.03 ± 194.92 pg/mL, Mann–Whitney U -test, P < 0.001). When the patients were dichotomized into high and low BAFF group based on the median value (1 258.00 pg/mL), high BAFF group had less numbers of complete responders to rituximab-CHOP, and more relapses or progression after or during treatment. In multivariate analysis, serum BAFF was an independent prognostic factor for overall survival and progression-free survival ( P < 0.05). Although serum levels of APRIL was also higher than controls (10.60 ± 19.08 ng/mL vs. 1.10 ± 0.30 ng/mL, P = 0.023), it failed to show prognostic significance.
Conclusions: Serum BAFF may be a useful indicator predicting prognosis in DLBCL patients treated with rituximab-containing chemotherapy. 相似文献
Methods: We measured serum levels of BAFF and APRIL by enzyme-linked immunosorbent assay in 66 patients newly diagnosed as diffuse large B-cell lymphoma (DLBCL). All patients were treated with rituximab-CHOP chemotherapy.
Results: The mean (±standard deviation) serum level of BAFF (1 970.21 ± 1 979.45 pg/mL) was higher in DLBCL than in controls (861.03 ± 194.92 pg/mL, Mann–Whitney U -test, P < 0.001). When the patients were dichotomized into high and low BAFF group based on the median value (1 258.00 pg/mL), high BAFF group had less numbers of complete responders to rituximab-CHOP, and more relapses or progression after or during treatment. In multivariate analysis, serum BAFF was an independent prognostic factor for overall survival and progression-free survival ( P < 0.05). Although serum levels of APRIL was also higher than controls (10.60 ± 19.08 ng/mL vs. 1.10 ± 0.30 ng/mL, P = 0.023), it failed to show prognostic significance.
Conclusions: Serum BAFF may be a useful indicator predicting prognosis in DLBCL patients treated with rituximab-containing chemotherapy. 相似文献
17.
Takeshi Yoshikawa Takeshi Hara Hisashi Tsurumi Naoe Goto Masato Hoshi Junichi Kitagawa Nobuhiro Kanemura Senji Kasahara Hiroyasu Ito Masao Takemura Kuniaki Saito Mitsuru Seishima Tsuyoshi Takami Hisataka Moriwaki 《European journal of haematology》2010,84(4):304-309
Purpose: Introduction of rituximab has largely improved the prognosis of patients with diffuse large B‐cell lymphoma(DLBCL). Such change in therapeutic outcome necessitates the identification of additional prognostic factors to conventional indexes that have been validated for CHOP without rituximab. Indoleamine 2,3‐dioxygenase (IDO) exerts intense immunomodulatory effects because of enzymatic activities that catalyze the breakdown of the essential amino acid L‐tryptophan. The activity of IDO can be estimated by measuring the serum concentration of L ‐kynurenine. Here, we investigated the role of L ‐kynurenine as a prognostic marker in R‐CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone) therapy. Experimental design: Data from 73 consecutive patients treated with eight cycles of R‐CHOP or R‐THP (tetrahydropyranyl adriamycin)‐COP between December 2002 and March 2007 were analyzed. L ‐kynurenine concentrations in serum samples obtained at admission were measured by high‐performance liquid chromatography. Results: The median serum L ‐kynurenine level was 1.575 μm (range 0.537–9.588). The complete response (CR) rates of patients with L ‐kynurenine <1.5 and ≥1.5 μm were 83% and 61%, respectively (P < 0.05). The three‐yr overall survival (OS) rates for patients with L ‐kynurenine <1.5 and ≥1.5 μm were 89% and 58%, respectively (P < 0.005). In addition, higher age, poor performance status, elevated serum lactate dehydrogenase, and unfavorable as well as revised International Prognosis Index were significantly worse factors for CR rate and OS. Multivariate analyses revealed only L ‐kynurenine as an independent prognostic factor for OS. Conclusions: Serum L ‐kynurenine might be a novel prognostic factor to determine the treatment outcome of DLBCL with the R‐CHOP regimen. 相似文献
18.
Richter's transformation to diffuse large B‐cell lymphoma: A retrospective study reporting clinical data,outcome, and the benefit of adding rituximab to chemotherapy,from the Israeli CLL Study Group
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Tamar Tadmor Lev Shvidel Osnat Bairey Neta Goldschmidt Rosa Ruchlemer Riva Fineman Naomi Rahimi‐Levene Yair Herishanu Mona Yuklea Ariela Arad Ariel Aviv Aaron Polliack On behalf of the Israeli CLL Study Group 《American journal of hematology》2014,89(11):E218-E222
Richter's syndrome (RS) is the rare development of an aggressive lymphoid malignancy in a patient with pre‐existing chronic lymphocytic leukemia (CLL). Data on RS is sparse and mostly derived from case reports or small series of patients and only a few larger cohorts have been published. The purpose of this large retrospective study was to summarize our national experience with RS in CLL, examine possible risk factors, and analyze relevant demographic, laboratory and clinical parameters, including results of therapy and outcome. We first evaluated data obtained from 119 patients with RS diagnosed during 1971–2010 from 12 medical centers in Israel. The final cohort summarized consisted of 81 patients with RS who developed only diffuse large B‐cell lymphoma (DLBCL) after exclusion all cases with insufficient data and those who were not DLBCL. Median overall survival from time of diagnosis of RS was 8 months; after applying the Richter score, patients could be stratified into three prognostic groups, while all other clinical and laboratory parameters evaluated had no prognostic significance. Prior therapy for CLL had no impact on RS survival (P = 0.8) and patients with therapy “naïve” RS and those who had already received chemotherapy prior to developing RS, had the same survival. The addition of rituximab to chemotherapy for RS improved 2 years overall survival from 19% in the chemotherapy alone arm to 42% (P value of 0.001). Although prognosis of patients with RS remains dismal, this retrospective observation provides support for the use of chemo‐immunotherapy in DLBCL‐RS. Am. J. Hematol. 89:E218–E222, 2014. © 2014 Wiley Periodicals, Inc. 相似文献
19.
Kawano R Ohshima K Karube K Yamaguchi T Kohno S Suzumiya J Kikuchi M Tamura K 《British journal of haematology》2004,127(3):305-307
The expression and prognostic significance of hepatocyte growth factor (HGF) and its receptor c-MET (MET proto-oncogene) was analysed in 96 cases of diffuse large B-cell lymphoma (DLBCL). Tissue sections were immunohistochemically stained for HGF and c-Met. The prognosis of HGF-positive and c-Met-positive cases was significantly worse than negative cases (HGF: P = 0.0036; c-Met: P = 0.0002). In addition, in the low-risk international prognostic index group, HGF-negative and c-Met-negative cases had a significantly better prognosis than positive cases (HGF: P = 0.0009; c-Met: P < 0.0001). Our results suggest that HGF/c-MET is a useful clinical marker of prognosis for patients with DLBCL. 相似文献
20.
Nuclear factor‐κB (NF‐κB) is expressed in many types of cancers. It has been suggested that the expression of NF‐κB is associated with poor prognosis and resistance to chemoradiation therapies. This study evaluated the relationship between the expression of NF‐κB and the prognosis and sensitivity of esophageal squamous cell carcinoma (ESCC) to chemotherapy. One hundred and nine ESCC specimens, from patients who had undergone radical esophagectomy, were divided into two groups depending on the expression of NF‐κB. Surgical data and prognosis were compared between the two groups. NF‐κB‐positive tumors were detected in 61.5% of the cases. In 69 patients with stage II and III disease, 41 patients who were NF‐κB‐positive showed poor survival. The sensitivity of esophageal squamous cell carcinoma cell lines to 5‐fluorouracil (5‐FU) was analyzed by their NF‐κB expression, and the effect of 5‐FU was evaluated on the proliferation and activity of two cell lines of cultured ESCCs expressing NF‐κB. ESCCs with activated NF‐κB had poor sensitivity to 5‐FU. These results suggest that the increased expression of NF‐κB is associated with poor prognosis in patients with ESCC. NF‐κB may be a target for ESCC therapy because of its selective expression in this type of cancer. 相似文献