干扰素、白细胞介素2联合沙利度胺治疗成年人复发难治朗格汉斯细胞组织细胞增生症一例并文献复习

目的:探讨干扰素、白细胞介素2（IL-2）联合沙利度胺治疗朗格汉斯细胞组织细胞增生症（LCH）的效果及相关机制。方法:回顾性分析广西医科大学第一附属医院2012年6月收治的1例应用干扰素、IL-2联合沙利度胺治疗的复发难治LCH患者的临床资料，并复习相关文献。结果:应用干扰素、IL-2联合沙利度胺治疗后，患者临床症状好转，获得完全缓解，无明显药物不良反应。结论:干扰素、IL-2联合沙利度胺治疗复发难治LCH患者有效且不良反应小，可作为治疗复发难治LCH的一种新选择。     

沙利度胺联合干扰素治疗复发难治T细胞淋巴瘤二例并文献复习

目的 探讨沙利度胺联合干扰素治疗复发难治T细胞淋巴瘤(TCL)的效果及患者不良反应.方法 观察使用沙利度胺联合干扰素治疗2例复发难治TCL患者的效果及不良反应,并复习相关文献.结果 2例患者均达部分缓解(PR),无明显不良反应.结论 沙利度胺联合干扰素治疗复发难治TCL有一定的疗效,可作为治疗复发难治TCL的一种新的选择.     

干扰素、白细胞介素2联合来那度胺治疗微小残留病阳性老年急性髓系白血病1例并文献复习

目的探讨干扰素、白细胞介素2(IL-2)联合来那度胺治疗微小残留病(MRD)阳性老年人急性髓系白血病(AML)的效果。方法回顾性分析郑州大学附属肿瘤医院2019年12月收治的1例应用干扰素、IL-2联合来那度胺治疗的持续MRD阳性老年AML患者的临床资料, 并复习相关文献。结果患者为72岁男性, 经实验室相关检查、流式细胞术、基因检测等确诊为AML-M2b(伴c-kit突变, 低危组)。行标准VA(维奈克拉、阿扎胞苷)方案治疗1个周期未缓解, IA(伊达比星、阿糖胞苷)方案再诱导1个周期后达完全缓解(CR);后应用中剂量阿糖胞苷、D-CAG(地西他滨、阿糖胞苷、阿柔比星、粒细胞集落刺激因子)方案巩固治疗, 其间AML1-ETO融合基因进行性升高;给予程序性死亡受体1(PD-1)抑制剂为基础的联合治疗, AML1-ETO融合基因维持阴性达1个月余, 后再次升高;给予患者沙利度胺联合干扰素、IL-2方案治疗, AML1-ETO融合基因维持阴性达7个月余, 后再次升高, 将沙利度胺调整为来那度胺继续治疗。截至2023年5月, AML1-ETO融合基因再次维持阴性2年。结论干扰素、IL-2联合...     

沙利度胺联合干扰素在复发难治及体能、经济状况欠佳多发性骨髓瘤患者中的应用

目的 初步观察沙利度胺联合干扰素治疗多发性骨髓瘤(MM)的有效性及安全性,为复发难治及体能、经济状况欠佳的MM患者探索出一种经济、有效、安全、易耐受的治疗方案.方法 回顾性分析2011年10月至2015年10月在河南省肿瘤医院采用沙利度胺联合重组人干扰素α-1b方案治疗的9例MM患者的临床资料,9例患者体能、经济状况均欠佳,其中7例(77.8％)为复发、难治,2例为初诊.分析该治疗方案的有效性及安全性.结果 9例患者均可评价疗效.治疗后2例达完全缓解(CR),2例达部分缓解(PR),3例疾病稳定(SD),2例疾病进展(PD),总有效(CR+PR)率为44.4％(4/9).9例患者均可耐受该方案,主要不良反应为发热、周围神经毒性、便秘等,未出现严重心、肾、肝等重要脏器损伤.结论 沙利度胺联合干扰素方案对部分复发难治及体能、经济状况欠佳的MM患者安全、有效且治疗费用低,或可为该患者群体提供一种新的治疗选择.     

沙利度胺联合干扰素和硼替佐米治疗复发、难治性套细胞淋巴瘤一例并文献复习

目的：初步观察沙利度胺联合干扰素（IFN）和硼替佐米治疗复发、难治性套细胞淋巴瘤（MCL）的临床疗效。方法报道1例先后应用沙利度胺联合IFN和硼替佐米治疗的复发、难治性MCL患者临床资料,并进行文献复习。结果该患者对化疗原发耐药,应用沙利度胺联合IFN治疗后达完全缓解,疾病无进展生存期41.7个月;复发后给予二线方案化疗无效,应用硼替佐米治疗后达部分缓解,目前总生存为56.7个月。结论沙利度胺联合IFN和硼替佐米治疗复发、难治性MCL有效。     

沙利度胺联合CAG方案治疗老年人急性髓系白血病效果观察

目的 评价沙利度胺联合CAG方案治疗老年急性髓系白血病（AML）患者的临床疗效及安全性.方法 对51例初治的老年AML患者进行前瞻性研究,采用简单随机分组法分为沙利度胺联合CAG方案治疗组26例、CAG方案单用对照组25例,评估临床疗效及患者不良反应.结果 诱导缓解治疗2个周期后,治疗组完全缓解（CR）率为61.5％（16/26）,对照组为48.0％（12/25）,两组差异无统计学意义（P=0.404）.治疗组1年CR率为53.8％（14/26）,对照组为24.0％（6/25）（P=0.045）;治疗组2年CR率为42.3％（11/26）,对照组为12.0％（3/25） （P=0.027）;治疗组1年及2年生存率分别为73.1％和46.1％,对照组分别为52.0％和24.0％;随访2年,治疗组中位生存时间为22个月,对照组为13个月,差异有统计学意义（P=0.018）.两组患者诱导死亡率及血液学不良反应发生率差异无统计学意义;但治疗组恶心、呕吐明显减轻,与对照组相比差异有统计学意义（P=0.025）.结论 沙利度胺联合CAG方案治疗老年AML患者,疗效理想,患者不良反应轻,值得进一步研究及临床应用.     

小剂量沙利度胺联合COMP方案治疗多发性骨髓瘤的疗效分析

目的观察小剂量沙利度胺联合COMP方案治疗多发性骨髓瘤（MM）的疗效及不良反应,对比其与单纯COMP方案疗效的差异。方法分析42例初治和27例难治复发性MM应用小剂量沙利度胺联合COMP方案的总有效率和不良反应;分析应用两种治疗方案对患者M蛋白、骨髓浆细胞比例和血红蛋白改善情况。结果42例初治MM,单用COMP22例,联合应用小剂量沙利度胺20例,总有效率分别为40．91％和70．00％,两者差异有统计学意义;27例难治复发MM,单用COMP组13例,联合应用14例,总有效率分别为42．86％和84．62％,两者相比差异有统计学意义。应用沙利度胺不良反应轻,患者可以耐受。联合治疗组可以明显提高患者血红蛋白含量、降低血浆M蛋白浓度和骨髓浆细胞比例。结论小剂量沙利度胺联合COMP方案可以提高初治和难治复发MM的总有效率,不良反应轻。     

沙利度胺联合地塞米松治疗复发和(或)难治及平台期多发性骨髓瘤疗效分析

目的观察沙利度胺联合地塞米松（TD方案）治疗多发性骨髓瘤（MM）的疗效。方法62例MM患者,其中复发和（或）难治组25例,平台期组37例。复发和（或）难治组治疗方案为：TD方案3个疗程后无效或进展者更换方案;有效者,继续使用TD方案,3个疗程后停用地塞米松,单独使用沙利度胺直到复发。平台期组的患者仅使用3个疗程的TD方案,再单独使用沙利度胺维持治疗。结果25例复发和（或）难治的患者,前3个疗程TD方案的25例中20例总有效[非常好的部分缓解（VGPR）＋部分缓解（PR）＋进步（MR）]率为80％,但无完全缓解（CR）或接近完全缓解（nCR）。有效者,经后3个疗程TD治疗后,1例获得nCR,而2例PR患者回到MR,无患者发展到NR或进展;对13例VGPR＋PR＋nCR患者,单独使用沙利度胺4～12个月（中位时间6．8个月）后复发。37例平台期的患者经上述方案治疗8～26个月（中位时间17．5个月）后复发。明显优于难治和（或）复发组的治疗效果（P〈0．001）。结论沙利度胺联合地塞米松是难治和（或）复发MM有效治疗方案,也可作为平台期患者的维持治疗。     

沙利度胺治疗多发性骨髓瘤17例分析

目的观察沙利度胺联合VAD方案治疗多发性骨髓瘤的临床疗效和不良反应.方法17例多发性骨髓瘤均采用沙利度胺联合VAD方案治疗.治疗2个疗程4个周期后,根据血象、血清M蛋白、血清肌酐、骨髓瘤细胞等指标来判断疗效,分为完全缓解、部分缓解、稳定和进展.结果初治组9例,完全缓解1例,部分缓解5例,稳定2例,进展1例.难治复发组8例,完全缓解1例,部分缓解3例,稳定2例,进展2例,总有效率为58.82%.主要不良反应有嗜睡(70.6%),便秘(53%),骨髓抑制(41%),头晕(17.6%),腹胀(17.6%),皮疹(5%),深静脉血栓(5%),均能耐受.结论沙利度胺联合VAD方案治疗多发性骨髓瘤具有疗效高和耐受性好的优点,是治疗初发性和难治性多发性骨髓瘤的一个较为安全的治疗方案,尤其是对难治性复发组,值得临床推广.     

三氧化二砷、沙利度胺、M2方案联合治疗复发、难治性多发性骨髓瘤疗效观察

 目的　观察三氧化二砷（ATO）、沙利度胺、M2方案联合治疗复发、难治性多发性骨髓瘤（MM）的临床疗效及不良反应。方法　选取复发、难治性MM患者33例,其中男23例,女10例,中位年龄65岁。将患者随机分成两组,A组16例,B组17 例,分别给予ATO+沙利度胺+M2方案及沙利度胺+ M2方案治疗,观察其有效率及不良反应。结果　总有效率（显效+进步）：A组93.75 %,B组76.47 %（P＜0.05）;6个月无进展生存率（PFS）：A组87.50 %,B组64.71 %。不良反应：胃肠道反应、肝功能损害、皮疹、骨髓抑制。结论　ATO+沙利度胺+M2方案联合治疗MM安全有效,疗效优于沙利度胺+M2方案。     

Excretion of nitrates with saliva and urine and nitrite excretion with saliva in patients with chronic gastritis and duodenal ulcer

The study assessed excretion of nitrates in urine and saliva and that of nitrites with saliva of patients suffering gastric and duodenal ulcer. In both study groups, a positive correlation was established between nitrate concentration in saliva, on the one hand, and that in urine, and nitrite level in urine, on the other. The groups failed to show a difference in nitrate concentrations in either urine or saliva. Since retention of nitrates in the body of chronic gastritis patients held as precancer of the stomach proved no higher than that in patients with duodenal ulcer, the authors cast doubt on endogenous nitroso compounds as a cause of gastric cancer in cases of chronic gastritis.     

Pathologic states associated with activation of eosinophils and with eosinophilia

Eosinophils are involved in cytotoxicity against helminths and tumor cells and effect both tissue damage and tissue protection in hypersensitivity reactions. Their migratory patterns and oxidative mechanisms are most similar to those of neutrophils, but their tissue longevity and functional variation are more similar to those of monocytes and macrophages. Their enzyme components and behaviors are only now beginning to be defined, and their biologic functions in pathologic states remain a topic of considerable discussion.     

Assessment of guilt and shame in patients with non-small-cell lung cancer compared with patients with breast and prostate cancer

PURPOSE: Patients with lung cancer might feel more guilt and shame resulting from previous smoking. This study was designed to determine the levels of guilt and shame among patients with non-small-cell lung cancer (NSCLC) compared with breast and prostate cancer. PATIENTS AND METHODS: Surveys were sent to participants 3 times (at enrollment, 2 months, and 6 months). Patients were eligible if they had stage IV NSCLC, breast cancer, or prostate cancer. The survey included tests of generalized guilt, shame, depression, and anxiety as well as guilt, shame, and embarrassment related to one's cancer. RESULTS: One hundred seventy-two participants completed >or= 1 questionnaire: 96 patients with NSCLC, 30 patients with breast cancer, and 46 patients with prostate cancer. Of the patients with NSCLC, 91.7% were current or former smokers versus 67.1% of the comparison patients. A composite score of embarrassment related to one's cancer (perceived cancer-related stigma; PCRS) was higher in patients with NSCLC (P < .01). Mean baseline generalized guilt and shame scores were not different among groups and did not change over time. A history of smoking correlated with increased levels of guilt and shame, regardless of tumor type. A personal identification of past behaviors as contributing to cancer correlated with higher levels of guilt, shame, anxiety, and depression. Of the patients with NSCLC, 29.5% felt that their behaviors contributed to their cancer compared with 10.5% of the comparison patients. CONCLUSION: Patients with NSCLC had higher levels of PCRS than patients with prostate cancer or breast cancer but not higher baseline levels of shame and guilt. Smoking is correlated with higher levels of guilt and shame. A belief that one caused one's own cancer is correlated with higher levels of guilt, shame, anxiety, and depression. These findings could be translated into an increased need for open communication among patients and their providers surrounding issues of cancer causation, guilt, shame, depression, and anxiety.     

Characteristics and survival of patients with non-Hodgkin's lymphoma with and without acquired immunodeficiency syndrome

Our objective was to determine the characteristics and survival of patients with non-Hodgkin's lymphoma (NHL) with and without acquired immunodeficiency syndrome (AIDS). A cancer registry and AIDS registry linkage for San Diego County was performed in October 1998 as part of a national multicentre study. We performed Kaplan-Meier analysis to compare survival in NHL patients with and without AIDS, after matching for age, sex, and race/ethnicity. We performed logistic regression to determine which patient and tumour characteristics were significantly associated with 1-year survival. Of the 4361 cases of NHL, 324 (7%) had AIDS and 4037 (93%) were not known to have AIDS. Patients with AIDS were more likely to have extranodal, high-grade, and disseminated NHL diagnosed by non-histologic means and were less likely to have received chemotherapy. Patients with AIDS and NHL who survived at least 1 year had less advanced disease stage and received chemotherapy. The median survival in patients with AIDS was 4 months (95% confidence interval (CI): 4-5) and 95 months (95% CI: 58-157) in patients without AIDS (P<0.001). Although these patients with AIDS-related NHL were unlikely to survive, the highly active antiretroviral agents currently used may improve outcomes in future patients.     

Outcomes of patients with stage III nonsmall cell lung cancer treated with chemotherapy and radiation with and without surgery

BACKGROUND:

The objective of this study was to identify the factors associated with improved outcome after treatment for stage III nonsmall cell lung cancer (NSCLC).

METHODS:

A retrospective review of stage III NSCLC patients treated at who were treated at the Dana‐Farber Cancer Institute/Brigham and Women's Cancer Center was done with institutional review board approval. Patients were followed for toxicity, local and distant failure, and overall survival. Multivariate Cox logistic regression analysis was used to determine the factors associated with treatment outcome.

RESULTS:

Between August 2000 and November 2006, 144 patients received concurrent chemoradiation (CRT) for stage III NSCLC. Eighty of 144 patients were men (56%), and the median age was 61 years (range, 33‐81 years). Sixty‐two patients (43%) had stage IIIA NSCLC, and 82 patients (57%) had stage IIIB NSCLC. Radiotherapy (RT) was given concurrently with chemotherapy to all patients; 100 patients (69%) received CRT without surgery, and 44 patients (31%) received with neoadjuvant CRT followed by surgical resection. The median RT dose was 60 grays (Gy) (range, 46‐70 Gy). The median follow‐up was 15 months (range, 3‐64 months), the median potential follow‐up was 37 months (range, 12‐84 months), and the median overall survival was 22 months (95% confidence interval, 15‐28 months). The 1‐year and 2‐year survival rates were 68% and 47%, respectively. Among the 44 patients who underwent resection, the median survival was 61 months, and the 2‐year survival rate was 73%. On multivariate analysis, stage at the time of treatment (stage IIIA vs stage IIIB) and use of surgery were the only factors associated with improved outcome (P = .01 and P = .001, respectively).

CONCLUSIONS:

In this retrospective series, those patients who were able to undergo resection appeared to have improved outcome after induction CRT. Cancer 2009. © 2009 American Cancer Society.     

VEGF and EMMPRIN expression correlates with survival of patients with osteosarcoma

Aim

To investigate the clinicopathologic characteristics of Vascular Endothelial Growth Factor (VEGF) and Extracellular Matrix Metalloproteinase Inducer (EMMPRIN) expression in osteosarcoma, and to evaluate the clinical significance of these two markers in the survival of osteosarcoma.

Methods

VEGF and EMMPRIN expression in paraffin-embedded specimens gathered from 65 patients with primary osteosarcoma were detected by the method of immunohistochemistry using antibodies against VEGF and EMMPRIN. The correlation of VEGF and EMMPRIN expression with the clinicopathologic features and with the survival of osteosarcoma was subsequently assessed.

Results

The expression of VEGF and EMMPRIN was detected in 47/65 (72.31%) and 45/65 (69.23%) of patients with osteosarcoma, respectively. Positive expression of VEGF and EMMPRIN was significantly correlated with surgical stage and percentage of dead cells of osteosarcoma. A significant correlation was found between the expression of VEGF and EMMPRIN in osteosarcoma (r = 0.89, p = 0.01). Additionally, surgical stage, percentage of dead cells, VEGF and EMMPRIN expression showed significant influence on overall survival (OS) and disease-free survival (DFS) in univariate analysis. In multivariate analysis, surgical stage (IIA versus IIB/III) and percentage of dead cells (≤90% versus >90%) were significant for DFS and OS. Those patients with VEGF+/EMMPRIN+ co-expression showed significantly shorter OS and DFS compared with VEGF−/EMMPRIN− expression.

Conclusion

According to our study, the overexpression of VEGF or EMMPRIN may be an important feature of osteosarcoma. A combined detection of VEGF/EMMPRIN co-expression may benefit us in prediction of a poor survival of osteosarcoma.     

肽胺哌啶酮联合MP化疗方案治疗多发性骨髓瘤的疗效观察

目的：观察肽胺哌啶酮联合MP方案，即马法兰＋泼尼松（强的松）治疗多发性骨须瘤的疗效及其毒副作用。方法：确诊的多发性骨髓瘤病人12例，肽胺哌啶酮－MP方案；肽胺哌啶酮自MP方案开始持续给药，每晚睡前口服，剂量从每天100mg开始，每周日剂量递增50mg，至病人不能耐受或最高至每日400mg;MP方案每月一个疗程。结果：部分缓解6例（50％），进步3例（25％）。总有效率为9／12（75．0），有效的病人中7例在4周内起效，肽胺哌啶酮每天100－400mg不等，中位剂量每天225mg，常见的副反应为皮疹，便秘，嗜睡、乏力、头昏，水肿等，结论：肽胺哌啶酮＋MP方案治疗多发性骨髓瘤副反应少，耐受性好，且反应率可能提高。