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1.
Bo Jia Yuankai Shi Suyi Kang Sheng Yang Shaoxuan Hu Yexiong Li Mei Dong Weihu Wang Jianliang Yang Liqiang Zhou Peng Liu Shengyu Zhou Yan Qin Lin Gui Changgong Zhang Hua Lin Shanshan Chen Lin Wang Xiaohui He 《中国癌症研究》2015,27(5):516-523
Background
The role of rituximab in combination with CHOP regimen in patients with stage I diffuse large B-cell lymphoma (DLBCL) remains to be defined. We aimed to compare CHOP plus rituximab (R-CHOP) with CHOP alone and determine the value of radiotherapy in these patients.Methods
Between 2003 and 2009, 140 untreated patients with stage I DLBCL were retrospectively analyzed in this study.Results
Seventy-eight patients were treated in R-CHOP group and 62 in CHOP group. Ninety-one patients received additional radiotherapy at the end of chemotherapy. The different treatment groups were well-balanced with respect to baseline characteristics. Complete response (CR) rate was 77% both in R-CHOP and CHOP groups (P=0.945). After a median follow-up period of 56 months, patients received R-CHOP regimen had similar 5-year progression-free survival (PFS) (76% vs. 85%; log-rank P=0.215) and 5-year overall survival (OS) (90% vs. 96%; log-rank P=0.175) compared with those with CHOP alone. Patients with radiotherapy had significantly increased 5-year PFS compared with those who had chemotherapy alone (86% vs. 71%; log-rank P=0.005). At multivariate analysis, patients who had CR (P=0.008) and received radiotherapy (P=0.003) were significantly associated with superior PFS.Conclusions
CHOP alone could be as effective as R-CHOP regimen and additional radiotherapy would be necessary for stage I or stage I non-bulky DLBCL patients. 相似文献2.
Paul A. Hamlin Sacha Satram‐Hoang Carolina Reyes Khang Q. Hoang Sridhar R. Guduru Sandra Skettino 《The oncologist》2014,19(12):1249-1257
Background.
The incidence of diffuse large B-cell lymphoma (DLBCL) occurs disproportionately in elderly patients. We evaluated real-world treatment patterns and outcomes in elderly DLBCL patients in the U.S.Materials and Methods.
A retrospective cohort analysis of 9,333 DLBCL patients from the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database was conducted. Patients were diagnosed between January 1, 2000, and December 31, 2007; were aged >66 years, and were continuously enrolled in Medicare Part A and B in the year prior to diagnosis. Within 3 months of diagnosis, 4,565 (49%) received rituximab plus chemotherapy (R+chemo), 2,181 (23%) received chemotherapy only, and 467 (5%) received rituximab monotherapy (R-mono). Cox proportional hazards regression assessed overall survival between R+chemo versus chemotherapy only and R-mono versus no treatment.Results.
Overall, 23% of patients received no treatment, and the proportion was higher among those aged >80 years (33%). Patients receiving R+chemo were younger and more likely white compared with those receiving chemotherapy only. Patients receiving R-mono were older and more likely female compared with those not treated. In multivariate analysis, patients receiving chemotherapy only had a twofold increased mortality risk versus R+chemo, and this was confirmed in a subanalysis of patients aged >80 years. A 91% higher mortality risk was noted with receipt of fewer than six cycles versus six cycles of chemotherapy or chemoimmunotherapy. Patients receiving R-mono had a 69% decreased mortality risk compared with patients who were not treated.Conclusion.
This real-world analysis of elderly DLBCL patients confirmed that 23% do not receive treatment. Overall survival is higher for patients receiving R+chemo and R-mono relative to chemotherapy only and no treatment, respectively. Suboptimal durations of therapy with curative intent (fewer than six cycles) were associated with poorer outcomes. 相似文献3.
Hottinger AF George AC Bel M Favet L Combescure C Meier S Grillet S Posfay-Barbe K Kaiser L Siegrist CA Dietrich PY;HN Study Group 《The oncologist》2012,17(3):436-445
Purpose.
To identify the determinants of antibody responses to adjuvanted influenza A/H1N1/09 vaccines in a cohort of cancer outpatients.Patients and Methods.
Patients with cancer and controls were enrolled in a prospective single-center field study. Two doses of AS03-adjuvanted pandemic influenza vaccine were administered to patients and one dose was administered to controls. Antibody responses were measured using hemagglutination inhibition and confirmed by microneutralization. Geometric mean titers (GMTs) and seroprotection rates (defined as GMTs ≥40) were compared.Results.
Immunizations were safe and well tolerated in 197 cancer patients (lymphoma, 57; glioma, 26; lung or head and neck, 37; gastrointestinal, 41; breast, 36) and 138 controls. Similar seroprotection rates (82.3% versus 87%) and GMTs (336.9 versus 329.9) were achieved after two doses of adjuvanted vaccine in cancer patients and one dose in controls. Univariate analyses identified older age, prior immunization against seasonal influenza, lymphoma, CD4 count, active chemotherapy, and rituximab and steroid treatments as being associated with weaker antibody responses. However, only age and chemotherapy plus rituximab remained independent determinants of vaccine responses in multivariate analyses.Conclusions.
Two doses of AS03-adjuvanted influenza vaccine elicited potent antibody responses in most cancer patients despite ongoing chemotherapy, with the exception of rituximab-induced B-cell depletion. Oncology patients treated in an outpatient setting benefit from preventive vaccination against influenza with adjuvanted vaccines. 相似文献4.
Gareth Gregory Ashwini Arumugaswamy Teresa Leung Kah-Lok Chan Melody Abikhair Constantine Tam Ashish Bajel Lawrence Cher Andrew Grigg David Ritchie Stephen Opat 《Neuro-oncology》2013,15(8):1068-1073
Background
The optimal treatment strategy in patients with aggressive B cell central nervous system lymphoma suitable to receive intensive therapy is unknown. The benefit of incorporating rituximab in systemic therapy remains unclear. We performed a retrospective study examining the impact of rituximab in the context of concomitant therapies, including methotrexate, cytarabine, and radiotherapy, in patients treated with curative intent at 4 university teaching hospitals during 1996–2011.Methods
A retrospective study of CNS lymphoma cases treated at the participating institutions was performed in accordance with institutional ethical guidelines. Patients were included if they received a diagnosis of primary diffuse large B cell lymphoma of the CNS, were HIV negative, and were treated with curative intent.Results
One hundred twenty patients aged 21–81 years were identified. Rituximab recipients and nonrecipients were similar, except for rituximab recipients being more likely to have received a diagnosis after 2004. The median follow-up of surviving patients was 30 months. The 5-year overall survival was 46%. Univariate analysis revealed age ≤60 years, ECOG performance status ≤1, normal lactate dehydrogenase, diagnosis after 2004, and treatment with cytarabine and rituximab as predictive of favorable overall survival. Multivariate analysis identified age to be an independent predictor of overall survival, with a trend toward improved survival from the other variables that were significant in univariate analyses.Conclusions
In this retrospective analysis, the addition of rituximab to high-dose methotrexate-based chemotherapy in patients with aggressive B cell CNS lymphoma was associated with improved overall survival. Further studies are underway to prospectively validate these findings. 相似文献5.
Vassilakopoulos TP Pangalis GA Katsigiannis A Papageorgiou SG Constantinou N Terpos E Zorbala A Vrakidou E Repoussis P Poziopoulos C Galani Z Dimopoulou MN Kokoris SI Sachanas S Kalpadakis C Dimitriadou EM Siakantaris MP Kyrtsonis MC Dervenoulas J Dimopoulos MA Meletis J Roussou P Panayiotidis P Beris P Angelopoulou MK 《The oncologist》2012,17(2):239-249
More aggressive treatment approaches (methotrexate, cytarabine, cyclophosphamide, vincristine, prednisone, and bleomycin [the MACOP-B regimen] or consolidation with high-dose therapy and autologous stem cell transplantation) have been considered to be superior to cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) in patients with primary mediastinal large B-cell lymphoma (PMLBCL). Rituximab-CHOP (R-CHOP) is the standard of care for diffuse large B-cell lymphoma, whereas efficacy in PMLBCL has not been adequately confirmed.
Patient and Methods.
Seventy-six consecutive PMLBCL patients who received R-CHOP with or without radiotherapy (RT) were compared with 45 consecutive historical controls treated with CHOP with or without RT. Baseline characteristics of the two groups were balanced.Results.
The rate of early treatment failure was much lower with R-CHOP with or without RT (9% versus 30%; p = .004). The 5-year freedom from progression rate after R-CHOP with or without RT was 81%, versus 48% for CHOP with or without RT (p < .0001). The 5-year event-free survival rates were 80% and 47% (p < .0001) and the 5-year overall and lymphoma-specific survival rates were 89% and 69% (p = .003) and 91% and 69% (p = .001), respectively, with only seven of 76 lymphoma-related deaths. Among R-CHOP responders, 52 of 68 received RT.Conclusions.
Based on these results, most patients with PMLBCL appear to be cured by R-CHOP in 21-day cycles with or without RT, which could be the current standard of care. Therefore, the need for more aggressive treatment strategies is questionable unless high-risk patients are adequately defined. Further studies are required to establish the precise role of RT. 相似文献6.
Ker-Kan Tan Terence Jin-Lin Quek Ningyan Wong Kelvin Kaiwen Li Khong-Hee Lim 《Journal of gastrointestinal oncology.》2011,2(1):13-18
Objectives
The aim was to evaluate the outcome of patients who underwent surgery for perforated gastric malignancies.Methods
A review of all patients who underwent surgery for perforated gastric malignancy was performed.Results
Twelve patients (nine gastric adenocarcinoma and three B-cell lymphoma) formed the study group. Ten (83.3%) had subtotal gastrectomy performed, while two (16.7%) underwent total gastrectomy. All eight patients with adenocarcinoma who survived the initial operation fared poorly. The two patients with lymphoma who survived the surgery underwent subsequent chemotherapy has no disease recurrence currently.Conclusion
Surgery in perforated gastric malignancy is fraught with numerous challenges. 相似文献7.
Background:
Rituximab and trastuzumab were the first therapeutic monoclonal antibodies (mAbs) approved in oncology. Both antibodies are delivered by the intravenous (IV) route, but recently subcutaneous (SC) formulations have been developed. Subcutaneous administration of mAbs can offer substantial patient and resource benefits compared with IV, but SC administration of some mAbs can be limited by drug volume. Recombinant human hyaluronidase (rHuPH20) temporarily degrades hyaluronan, allowing SC delivery of drug volumes that might not otherwise be feasible.Methods:
Clinical trials assessing coformulation of rituximab or trastuzumab with rHuPH20 for SC administration were reviewed.Results:
Phase I trials of rituximab SC maintenance therapy in patients with follicular lymphoma and trastuzumab SC in healthy volunteers and patients with early breast cancer have demonstrated substantially shorter administration times and comparable tolerability and pharmacokinetics compared with IV formulations. Rituximab SC 1400-mg and trastuzumab SC 600-mg doses were identified for further study. Phase III clinical data for rituximab SC 1400 mg have shown comparable efficacy to rituximab IV, and initial clinical data suggest comparable efficacy of trastuzumab SC 600 mg and the IV formulation.Conclusion:
Coformulation with rHuPH20 may enable effective, well-tolerated, cost-effective, and convenient SC administration of rituximab and trastuzumab. Additional studies are ongoing. 相似文献8.
Fangfang Lv Zuguang Xia Kai Xue Qunling Zhang Dongmei Ji Junning Cao Xiaonan Hong Ye Guo 《The lancet oncology》2017
Background
Limited stage diffuse large B-cell lymphoma is curable with R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone or prednisolone) immunochemotherapy. For patients achieving complete response by interim 18F-fluorodeoxyglucose PET-CT, a previous study showed therapy could be safely de-escalated by omitting the subsequent chemotherapy or radiotherapy. We aimed to adapt the therapy on the basis of the response as assessed by the interim PET-CT.Methods
We did this phase 2 study in patients with low risk (International Prognostic Index 0–2), limited stage diffuse large B-cell lymphoma. Patients were initially treated with four cycles of R-CHOP. PET-CT scans were done at baseline and after four cycles. Patients with negative PET (Deauville scores 1–2) received two cycles of rituximab monotherapy, unless they had any risk factors (primary mediastinal large B-cell lymphoma, primary extranodal non-Hodgkin lymphoma, and bulky disease). Patients with these risk factors received another two cycles of R-CHOP as routine practice. Patients with partial response received another four cycles of R-CHOP and a repeated PET-CT scan at the end of treatment. Patients with stable and progressive disease were managed by salvage chemotherapy. The primary endpoint was progression-free survival at 3 years. The trial is registered with ClinicalTrials, number NCT0180412.Findings
From December, 2012, to September, 2015, a total of 143 patients were enrolled and we analysed the 129 patients with baseline and interim PET-CT scans for efficacy. By local assessment, 114 PET-CT scans (88%) were reported as negative and 15 (12%) as positive. With a median follow-up time of 28·2 months (range 15·0–47·4), the estimated 3-year progression-free survival was 91%. Patients with negative interim PET-CT scans had a 3-year progression-free survival of 93% compared with 79% for patients with positive results (p=0·062). The estimated 3-year progression-free survival did not differ between patients with nodal and extranodal primaries (92% vs 91%, p=0·978).Interpretation
For patients with limited stage diffuse large B-cell lymphoma, the results of interim PET-CT might predict progression-free survival and adapt the subsequent treatment. For complete response patients without risk factors, the extra two cycles of CHOP might be safely omitted without compromising the efficacy, which needs to be confirmed in a randomised study.Funding
None. 相似文献9.
Rachel J. David Andrea Baran Kah Poh Loh Carla Casulo Paul M. Barr Jonathan W. Friedberg Patrick M. Reagan 《Clinical Lymphoma, Myeloma & Leukemia》2018,18(12):781-787
Introduction
Certain aggressive non-Hodgkin lymphoma subtypes are increasingly being treated with infusional DA-EPOCH-R (dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab), which requires a central venous catheter. This study aims to identify the rates and predictors of line-associated complications (LACs) associated with DA-EPOCH-R therapy in NHL.Patients and Methods
We retrospectively identified all patients treated with DA-EPOCH-R at our institution between March 2011 and July 2016. We also identified a concurrent cohort of patients with diffuse large B-cell lymphoma treated with R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone).Results
Forty-three patients received DA-EPOCH-R during the study period; 17 (39.5%; 95% confidence interval, 0.25-0.56) patients experienced at least 1 LAC (including venous thromboembolism, chemotherapy extravasation, and line-associated infection). Forty-four patients received R-CHOP during the study period; 8 (18.2%; 95% confidence interval, 0.08-0.32) patients experienced at least 1 complication. Compared with the R-CHOP cohort, patients treated with DA-EPOCH-R experienced a significantly higher rate of these complications (P = .03). In the DA-EPOCH-R cohort, grade 3 toxicity was seen in 41% (7/17). In univariate analysis, body mass index ≥ 35 kg/m2 and using a peripherally inserted central catheter line were significantly associated with an increased risk of venous thromboembolism (P = .04 and P = .02, respectively).Conclusions
Forty percent of patients receiving DA-EPOCH-R therapy developed LACs, almost one-half of whom experienced grade 3 toxicities. The complication rate was significantly greater in patients undergoing therapy with DA-EPOCH-R compared with those undergoing R-CHOP therapy. Clinicians need to balance these risks when selecting therapy. Future studies are needed to evaluate prophylactic anticoagulation strategies in this population. 相似文献10.
Yazeed Sawalha Brian T. Hill Lisa A. Rybicki Danyu Sun Robert M. Dean Deepa Jagadeesh Betty K. Hamilton Aaron T. Gerds Ronald M. Sobecks Steven Andresen Hien K. Liu Navneet S. Majhail Brad Pohlman Matt E. Kalaycio Brian J. Bolwell Mitchell R. Smith 《Clinical Lymphoma, Myeloma & Leukemia》2018,18(1):e95-e102
Background
Young fit patients with mantle cell lymphoma (MCL) are commonly treated with induction chemotherapy followed by high-dose chemotherapy and autologous hematopoietic cell transplantation (AHCT). Induction regimens with modifications of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) and/or incorporation of high-dose cytarabine (HDAC) appear more effective than R-CHOP alone.Patients and Methods
We adopted a modification of the Nordic protocol using standard, rather than higher dose R-CHOP, alternating with HDAC (rituximab plus HDAC), for 3 cycles each or, for patients already treated with R-CHOP alone before referral for AHCT, an additional 2 cycles of rituximab plus HDAC. We herein report our experience with 28 patients treated with this regimen who proceeded to AHCT, and compare their outcomes with patients treated with either standard-dose R-CHOP (n = 38) or R-HCVAD/MA (cyclophosphamide, vincristine, doxorubicin, dexamethasone alternating with methotrexate, and cytarabine; n = 21), before AHCT.Results
With a median follow-up duration of 26 months, our data show that this modification of the Nordic regimen is a highly effective pre-AHCT first-line therapy for MCL (3-year progression-free and overall survival rates of 69% and 75%, respectively).Conclusion
By using a less intense induction, this regimen can serve as a platform for combined use of novel agents, with less risk of additive toxicity. 相似文献11.
A.T. Sumbul F. Kose L. O?uzkurt C. Karadeniz N.E. Kocer O. Ozyilkan 《Case reports in oncology》2012,5(2):275-279
Purpose
To present a case of spontaneous aortic rupture in the course of mantle cell lymphoma and successful management with endovascular repair.Case Report
A 69-year-old woman presented with a cervical mass. The patient was found to have stage IIIA and Mantle Cell Lymphoma International Prognostic Index (MIPI) 4. She was placed in an intermediate-risk group. The patient received an initial cycle of systemic chemotherapy consisting of rituximab, anthracycline, vincristine and methyl prednisolone. During follow-up, she developed abdominal aortic rupture secondary to intramural hematoma which was successfully managed with endovascular exclusion.Conclusion
Hemodynamic changes can be seen during the course of lymphoma subsequent to systemic chemotherapy. These changes might be related to the spontaneous rupture of the main vessels. Endovascular repair may be a more appropriate treatment option than open surgery, especially in a patient with multiple comorbidities.Key Words: Systemic chemotherapy, Abdominal aortic rupture, Lymphoma, Endovascular stent-graft repair 相似文献12.
BoJia ;YuankaiShi ;MeiDong ;FengyiFeng ;ShengYang ;HuaLin ;LiqiangZhou ;ShengyuZhou ;ShanshanChen ;JianliangYang ;PengLiu ;YanQin ;ChanggongZhang ;LinGui ;LinWang ;XueWang ;XiaohuiHe 《中国癌症研究》2014,26(4):459-465
Objective: To assess the clinical features, survival and prognostic factors of primary testicular diffuse large B-cell lymphoma (DLBCL). Methods: A retrospective study of 37 patients with primary testicular DLBCL was carried out from November 2003 to May 2012. Their clinical features, survival and prognostic factors were analyzed. Results: During a median follow-up period of 39.8 months (5.4-93.0 months), the median progression-free survival (PFS) was 26.2 months (95% CI:0-65 months) and the 3-year overall survival (OS) rate was 78.4%. Within the whole cohort, the factors significantly associated with a superior PFS were limited stage (stage Ⅰ/Ⅱ), lactate dehydrogenase (LDH) ≤245 U/L, international prognostic index (IPI) ≤1, primary tumor diameter 〈7.5 cm, and patients who had complete response (CR) and received doxoruhicin-contained chemotherapy (P〈0.05). There was a trend toward superior outcome for patients who received combined therapy (surgery/ chemotherapy/radiotherapy) (P=0.055). Patients who had CR, primary tumor diameter 〈7.5 cm and IPI score ≤1 were significantly associated with longer PFS at multivariate analysis. Conclusions: Primary testicular DLBCL had poorer survival. CR, primary tumor diameter and IPI were independent prognostic factors. The combined therapy of orchectomy, doxorubicin-contained chemotherapy and contralateral testicular radiotherapy (RT) seemed to improve survival. 相似文献
13.
Assessment of circulating biomarkers for potential pharmacodynamic utility in patients with lymphoma
Greystoke A O'Connor JP Linton K Taylor MB Cummings J Ward T Maders F Hughes A Ranson M Illidge TM Radford J Dive C 《British journal of cancer》2011,104(4):719-725
Purpose:
Treatment efficacy and toxicity are difficult to predict in lymphoma patients. In this study, the utility of circulating biomarkers in predicting and/or monitoring treatment efficacy/toxicity were investigated.Patients and methods
Circulating biomarkers of cell death (nucleosomal DNA (nDNA) and cytokeratin 18 (CK18)), and circulating FLT3 ligand, a potential biomarker of myelosuppression, were assessed before and serially after standard chemotherapy in 49 patients with Hodgkin and non-Hodgkin lymphoma. Cytokeratin 18 is not expressed in lymphoma cells so is a potential biomarker of epithelial toxicity in this setting. Tumour response was assessed before and after completion of chemotherapy by 2D and 3D computed tomography radiological response.Results:
Baseline nDNA level was significantly higher in all lymphoma subtypes compared with 61 healthy controls and was prognostic for progression-free survival in diffuse large B-cell lymphoma (DLBCL). Decreases in nDNA levels were observed in the first week after chemotherapy; in FL, early falls in nDNA predicted for long remission following therapy. In DLBCL, elevations in nDNA occurred in cases with progressive disease. Circulating CK18 increased within 48 h of chemotherapy and was significantly higher in patients experiencing epithelial toxicity graded >3 by Common Terminology for Classification of Adverse Events criteria. FLT3 ligand was elevated within 3–8 days of chemotherapy initiation and predicted those patients who subsequently developed neutropenic sepsis.Conclusion:
These data suggest circulating biomarkers contribute useful information regarding tumour response and toxicity in patients receiving standard chemotherapy and have potential utility in the development of individualised treatment approaches in lymphoma. These biomarkers are now being tested within multicentre phase III trials to progress their qualification. 相似文献14.
L Costas C Infante-Rivard J-P Zock M Van Tongeren P Boffetta A Cusson C Robles D Casabonne Y Benavente N Becker P Brennan L Foretova M Maynadié A Staines A Nieters P Cocco S de Sanjosé 《British journal of cancer》2015,112(7):1251-1256
Background:
Incidence rates of lymphoma are usually higher in men than in women, and oestrogens may protect against lymphoma.Methods:
We evaluated occupational exposure to endocrine disrupting chemicals (EDCs) among 2457 controls and 2178 incident lymphoma cases and subtypes from the European Epilymph study.Results:
Over 30 years of exposure to EDCs compared to no exposure was associated with a 24% increased risk of mature B-cell neoplasms (P-trend=0.02). Associations were observed among men, but not women.Conclusions:
Prolonged occupational exposure to endocrine disruptors seems to be moderately associated with some lymphoma subtypes. 相似文献15.
Lydie Dubanet Hafidha Bentayeb Barbara Petit Agnès Olivrie Sofiane Saada Miguel A de la Cruz-Morcillo Fabrice Lalloué Marie-Pierre Gourin Dominique Bordessoule Nathalie Faumont Manuela Delage-Corre Anne-Laure Fauchais Marie-Odile Jauberteau Danielle Troutaud 《British journal of cancer》2015,113(6):934-944
Background:
Diffuse large B-cell lymphoma (DLBCL) is a fatal malignancy that needs to identify new targets for additional therapeutic options. This study aimed to clarify the clinical and biological significance of endogenous neurotrophin (nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF)) in DLBCL biopsy samples and cell lines.Methods:
We analysed expression of NGF, BDNF, and their receptors (Trk, p75NTR) in 51 biopsies and cell lines by immunohistochemistry, immunofluorescence, and western blotting. To investigate the biological role of BDNF/TrkB/p75NTR axis, effects of neurotrophin signalling inhibition were determined on tumour cell survival and vascular endothelial growth factor (VEGF) secretion. The pharmacological pan-Trk inhibitor K252a was used for in vitro and in vivo studies.Results:
A BDNF/TrkB axis was expressed in all biopsies, which was independent of the germinal centre B-cell (GCB)/non-GCB profile. p75NTR, TrkB, and BDNF tumour scores were significantly correlated and high NGF expression was significantly associated with MUM1/IRF4, and the non-GCB subtype. Diffuse large B-cell lymphoma cell lines co-expressed neurotrophins and their receptors. The full-length TrkB receptor was found in all cell lines, which was also phosphorylated at Tyr-817. p75NTR was associated to Trk and not to its cell death co-receptor sortilin. In vitro, inhibition of neurotrophin signalling induced cell apoptosis. K252a caused cell apoptosis, decreased VEGF secretion, and potentiated rituximab effect, notably in less rituximab-sensitive cells. In vivo, K252a significantly reduced tumour growth and potentiated the effects of rituximab in a GCB-DLBCL xenograft model.Conclusions:
This work argues for a pro-survival role of endogenous neurotrophins in DLBCLs and inhibition of Trk signalling might be a potential treatment strategy for rituximab resistant subgroups. 相似文献16.
Background:
To evaluate the impact of treatment on health states that affect patients'' quality of life in advanced follicular lymphoma.Methods:
A quality-adjusted time without symptoms of disease or toxicity of treatment (Q-TwiST) analysis was performed on data from a phase III clinical trial (Marcus et al, 2008).Results:
Cyclophosphamide, vincristine, and prednisone plus rituximab (R-CVP)-treated patients gained a mean of 15.17 months in TWiST, 8.33 months in Q-TwiST, and 11.30 months less in disease relapse, without increase in toxicity compared with cyclophosphamide, vincristine, and prednisone (CVP)-treated patients.Conclusion
Rituximab plus CVP-treated patients reached a significant and clinically meaningful improvement within 12 months in quality-adjusted survival compared with CVP. 相似文献17.
Marta Bruno Ventre Andrés J.M. Ferreri Mary Gospodarowicz Silvia Govi Carlo Messina David Porter John Radford Dae Seog Heo Yeon Park Giovanni Martinelli Emma Taylor Helen Lucraft Angela Hong Lydia Scarfò Emanuele Zucca David Christie 《The oncologist》2014,19(3):291-298
Introduction.
The clinical features, management, and prognosis of stage I–II diffuse large B-cell lymphoma of the bone (PB-DLBCL) included in an international database of 499 lymphoma patients with skeletal involvement were reviewed.Methods.
HIV-negative patients (n = 161) with diffuse large B-cell lymphoma of the bone (PB-DLBCL) after complete staging workup were considered. The primary objective of this study was to identify the most effective treatment modality; the secondary objectives were to define the contribution of irradiation fields and doses and the pattern of relapse.Results.
Median age was 55 years (range, 18–99 years), with a male/female ratio of 1:2; 141 (87%) patients had stage I, 14 (9%) had B symptoms, 37 (23%) had bulky lesion, 54 (33%) showed elevated lactate dehydrogenase serum levels, and 25 (15%) had fracture. Thirteen (8%) patients received chemotherapy alone, 23 (14%) received radiotherapy alone, and 125 (78%) received both treatments. The response to the first-line treatment was complete in 131 of 152 assessed patients (complete response rate, 86%; 95% confidence interval [CI], 81%–91%) and partial in 7, with an overall response rate of 91% (95% CI, 87%–95%). At a median follow-up of 54 months (range, 3–218), 107 (67%) patients remained relapse-free, with a 5-year progression-free survival of 68% (SE: 4). Four (2.5%) patients had meningeal relapse; 119 patients were alive (113 disease-free), with a 5-year overall survival of 75% (SE: 4). Patients managed with primary chemotherapy, whether followed by radiotherapy or not, had a significantly better outcome than patients treated with primary radiotherapy, whether followed by chemotherapy or not. The addition of consolidative radiotherapy after primary chemotherapy was not associated with improved outcome; doses >36 Gy and the irradiation of the whole affected bone were not associated with better outcome.Conclusion.
Patients with PB-DLBCL exhibit a favorable prognosis when treated with primary anthracycline-based chemotherapy whether followed by radiotherapy or not. In patients treated with chemoradiotherapy, the use of larger radiation fields and doses is not associated with better outcome. Central nervous system dissemination is a rare event in PB-DLBCL patients. 相似文献18.
Background.
We conducted a systematic review and meta-analysis to better define the prognostic ability of fluorine-18-fluorodeoxyglucose positron emission tomography (18F-FDG PET) following salvage chemotherapy for relapsed or refractory Hodgkin''s lymphoma (HL) and aggressive non-Hodgkin''s lymphoma.Methods.
We searched PubMed (from inception to January 31, 2010), bibliographies, and review articles without language restriction. Two assessors independently assessed study characteristics, quality, and results. We performed a meta-analysis to determine prognostic accuracy.Results.
Twelve studies including 630 patients were eligible. The most commonly evaluated histologies were diffuse large B-cell lymphoma (n = 313) and HL (n = 187), which were typically treated with various salvage and high-dose chemotherapy regimens. Studies typically employed nonstandardized protocols and diagnostic criteria. The prognostic accuracy was heterogeneous across the included studies. 18F-FDG PET had a summary sensitivity of 0.69 (95% confidence interval [CI], 0.56–0.81) and specificity of 0.81 (95% CI, 0.73–0.87). The summary estimates were stable in sensitivity analyses. In four studies that performed direct comparisons between PET and conventional restaging modalities, PET had a superior accuracy for predicting treatment outcomes. Subgroup and metaregression analyses did not identify any particular factor to explain the observed heterogeneity.Conclusion.
18F-FDG PET performed after salvage therapy appears to be an appropriate test to predict treatment failure in patients with refractory or relapsed lymphoma who receive high-dose chemotherapy. Some evidence suggests PET is superior to conventional restaging for this purpose. Given the methodological limitations in the primary studies, prospective studies with standardized methodologies are needed to confirm and refine these promising results. 相似文献19.
Zhitao Ying Xuejuan Wang Yuqin Song Wen Zheng Xiaopei Wang Yan Xie Ningjing Lin Meifeng Tu Lingyan Ping Weiping Liu Lijuan Deng Chen Zhang Zhi Yang Jun Zhu 《中国癌症研究》2013,25(1):95-101
Objective: Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous disease. The prognostic factor currently used is not accurate enough to predict the outcomes of patients with DLBCL. The prognostic significance of interim PET/CT in DLBCL remains controversial. The aim of this study is to determine the predictive value of interim 18F-FDG PET/CT after first-line treatment in patients with DLBCL. Methods: Thirty-two patients with DLBCL underwent baseline, interim and post-treatment 18F-FDG PET/CT scans. Imaging results were analyzed for the survival of patients via software SPSS 13.0, retrospectively. Results: Thirty-one of the 32 patients were treated with R-CHOP regimen, and interim 18F-FDG PET/CT of 24 patients was performed after 2 cycles of treatment. After a median follow-up period of 16.7 months, the 2-year progression-free survival (PFS) rates were significantly different between the groups above and below SUV max cut-off value of 2.5 (P=0.039). No significant differences were found in the 2-year PFS rates if SUV max cut-off values were set as 2.0 and 3.0, respectively (P=0.360; P=0.113). Conclusions: Interim PET/CT could predict the prognosis of DLBCL patients with the SUV max cut-off value of 2.5, but more clinical data should be concluded to confirm this conclusion. 相似文献
20.