Vincristine

长春新碱
  • 文章类型: Journal Article
    在肯尼亚儿童中,长春新碱引起的周围神经病变(VIPN)的低发生率可能是由于长春新碱的低暴露所致。我们研究了肯尼亚儿童的长春新碱暴露,并在低长春新碱暴露的情况下增加了剂量(NCT05844670)。长春新碱平均暴露量高。用先前开发的列线图评估个体长春新碱暴露。对于低暴露和无VIPN的参与者,建议增加20%的剂量。高胆红素血症,或营养不良。15名参与者均未开发VIPN。在一名参与者中观察到低长春新碱暴露:实施剂量增加而无副作用。总之,尽管有较高的长春新碱暴露,但参与者没有发展为VIPN.
    The low incidence of vincristine-induced peripheral neuropathy (VIPN) in Kenyan children may result from low vincristine exposure. We studied vincristine exposure in Kenyan children and dose-escalated in case of low vincristine exposure (NCT05844670). Average vincristine exposure was high. Individual vincristine exposure was assessed with a previously developed nomogram. A 20% dose increase was recommended for participants with low exposure and no VIPN, hyperbilirubinemia, or malnutrition. None of the 15 participants developed VIPN. Low vincristine exposure was seen in one participant: a dose increase was implemented without side effects. In conclusion, the participants did not develop VIPN despite having high vincristine exposure.
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    文章类型: Case Reports
    A 5-year-old spayed female mixed-breed dog was referred to the Atlantic Veterinary College (Charlottetown, Prince Edward Island) because of a 7-month history of intermittent pink, mucoid, vulvar discharge. The dog was imported from the Bahamas at 3.5 y of age and had a history of transmissible venereal tumor (TVT) of the vulva that was successfully treated with a course of vincristine chemotherapy. Complete remission was achieved with a disease-free interval of 6 mo before clinical signs recurred. Abdominal ultrasound and CT scan identified a large caudal abdominal mass thought to arise from the uterine stump. An exploratory laparotomy was performed and the mass grossly excised. Histopathology was consistent with a poorly differentiated round cell tumor, and immunohistochemical analysis confirmed TVT as the most likely diagnosis. No further treatment was carried out. Repeat abdominal ultrasound at 4 mo after surgery showed no evidence of mass recurrence. At 8 mo after surgery, the dog was reported to be doing well clinically. Key clinical message: Transmissible venereal tumor should be considered as a differential diagnosis for masses arising from the deep genital tissues of dogs in cases where there is a history of previous TVT. Transmissible venereal tumor should be considered even in dogs that have had complete resolution of a primary mass after chemotherapy.
    Tumeur vénérienne transmissible du moignon utérin à la suite d’une chimiothérapie réussie chez un chien croisé de 5 ans.Une chienne de race mixte de 5 ans, stérilisée, a été référée au Atlantic Veterinary College (Charlottetown, Île-du-Prince-Édouard) en raison d’antécédents de pertes vulvaires roses, mucoïdes et intermittentes depuis 7 mois. Le chien a été importé des Bahamas à l’âge de 3,5 ans et avait des antécédents de tumeur vénérienne transmissible (TVT) de la vulve qui a été traitée avec succès par une chimiothérapie à la vincristine. Une rémission complète a été obtenue avec un intervalle sans maladie de 6 mois avant la réapparition des signes cliniques. L’échographie abdominale et la tomodensitométrie ont identifié une grosse masse abdominale caudale qui proviendrait du moignon utérin. Une laparotomie exploratoire a été réalisée et la masse excisée. L’histopathologie était compatible avec une tumeur à cellules rondes peu différenciée et l’analyse immunohistochimique a confirmé la TVT comme le diagnostic le plus probable. Aucun autre traitement n’a été effectué. Une échographie abdominale répétée 4 mois après la chirurgie n’a montré aucun signe de récidive massive. Huit mois après l’opération, la chienne se portait bien cliniquement.Message clinique clé:Les tumeurs vénériennes transmissibles doivent être considérées comme un diagnostic différentiel pour les masses provenant des tissus génitaux profonds des chiens dans les cas où il existe des antécédents de TVT. Une tumeur vénérienne transmissible doit être envisagée même chez les chiens dont la masse primaire a complètement disparu après chimiothérapie.(Traduit par Dr Serge Messier).
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  • 文章类型: Journal Article
    长春新碱(VCR)是治疗儿科癌症最广泛使用的化疗药物之一。尽管如此,已知它会引起剂量依赖性神经毒性,几乎可以影响每个器官系统。尽管它广泛使用,VCR对下尿路(LUT)的确切影响仍未充分阐明。我们的初步临床和转化研究表明,儿童VCR暴露对LUT功能的性别特异性影响。因此,本研究旨在探讨全身VCR暴露对LUT生理的后期影响及其潜在机制,关注剂量和男性,采用幼年CD-1小鼠作为模型。接受VCR的雄性小鼠在清醒膀胱测压期间表现出功能性膀胱容量增强,并伴有频繁的非空隙收缩,伴随着肥大细胞在膀胱内的积累,与盐水处理的对照组相比。在VCR组的膀胱条带中观察到值得注意的功能变化,包括神经介导的收缩减少,对胆碱能和嘌呤能激动剂的收缩反应增强,增强对组胺的反应性-主要通过组胺受体1(Hrh1)-和化合物48/80(肥大细胞脱粒剂)增强的松弛作用,相对于对照组。在VCR组的膀胱和腰s背根神经节(Ls-DRG)中均观察到与神经炎症和伤害感受相关的基因表达水平的显着变化。这些发现表明,儿童时期的VCR暴露,尤其是男性,触发膀胱和Ls-DRG的神经免疫反应,增强对膀胱神经递质的反应,从而导致以混合膀胱表型为特征的LUT功能障碍,这是存活期间的后期效应。
    Vincristine (VCR) is one of the most widely used chemotherapy agents in treating pediatric cancer. Nonetheless, it is known to cause dose-dependent neurotoxicity which can impact virtually every organ system. Despite its widespread use, the precise impact of VCR on the lower urinary tract (LUT) remains inadequately elucidated. Our initial clinical and translational investigations suggest a sex-specific influence of childhood VCR exposure on LUT function. Thus, the current study aimed to investigate the late effects of systemic VCR exposure on LUT physiology and the underlying mechanisms, focusing on dosage and male-sex, employing juvenile CD-1 mice as a model. Male mice subjected to VCR exhibited augmented functional bladder capacity accompanied by frequent non-void contractions during awake cystometry, alongside mast cell accumulation within the bladder, compared to the saline-treated control group. Noteworthy functional changes were observed in bladder strips from the VCR group, including decreased nerve-mediated contraction, heightened contractile responses to cholinergic and purinergic agonists, enhanced responsiveness to histamine-primarily via histamine receptor 1 (Hrh1)-and an augmented relaxation effect with compound 48/80 (a mast cell degranulator), relative to the control group. Significant changes in gene expression levels associated with neuroinflammation and nociception were observed in both the bladder and lumbosacral dorsal root ganglia (Ls-DRG) of the VCR group. These findings suggest that VCR exposure during childhood, particularly in males, triggers neuroimmune responses in the bladder and Ls-DRG, amplifying responsiveness to neurotransmitters in the bladder, thereby contributing to LUT dysfunction characterized by a mixed bladder phenotype as a late effect during survivorship.
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  • 文章类型: Case Reports
    背景:绒毛膜癌是一种高度恶性的妊娠相关滋养细胞肿瘤,以早期转移到肺部为特征。因此,由于远处转移,患者可能会出现非神经系统症状。足月妊娠后绒毛膜癌的发生率非常罕见(1/160,000妊娠)。
    方法:我们报告一例20岁的伊朗妇女,gravida2para1活1流产1,她在分娩后第二天因突然发作的呼吸困难和左半胸疼痛而被转诊到我们的妇科。指数妊娠无任何并发症。在最初的检查之后,β-人绒毛膜促性腺激素(HCG)水平的升高(>1,000,000)以及远处转移的临床(阴道病变)和放射学证据(双侧肺结节)的鉴定指导我们对肺转移性绒毛膜癌的诊断。肿瘤学会诊后,依托泊苷,甲氨蝶呤,放线菌素D,环磷酰胺,并对患者开始长春新碱化疗方案。她对治疗反应良好,目前正在继续她的化疗过程。
    结论:如果按时开始治疗,绒毛膜癌的预后非常好。我们建议临床医生在产后并发症的鉴别诊断中应考虑妊娠滋养细胞瘤。尤其是在足月和非磨牙妊娠后。
    BACKGROUND: Choriocarcinoma is a highly malignant pregnancy-related trophoblastic neoplasm, characterized by early metastasis to the lungs. Therefore, patients may manifest nongynecological symptoms owing to distant metastases. The incidence of choriocarcinoma after a term pregnancy is really rare (1/160,000 pregnancies).
    METHODS: We report a case of a 20-year-old Iranian woman, gravida 2 para 1 live 1 abortion 1, who was referred to our gynecology department with sudden onset dyspnea and pain in the left hemithorax the day after her labor. The index pregnancy was without any complications. After the initial workup, the elevation of β-human chorionic gonadotropin (HCG) levels (> 1,000,000) along with the identification of clinical (vaginal lesions) and radiological evidence of distant metastases (bilateral pulmonary nodes) directed us toward pulmonary metastatic choriocarcinoma diagnosis. After the oncology consult, the etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine chemotherapy regimen was started for the patient. She responded well to the treatment and is currently continuing her chemotherapy process.
    CONCLUSIONS: The prognosis of choriocarcinoma is very good if the treatment is started on time. We suggest that clinicians should consider gestational trophoblastic neoplasia in their differential diagnosis of the post-natal period complications, especially after a term and nonmolar pregnancy.
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  • 文章类型: Journal Article
    背景:儿童肿瘤学小组将中危横纹肌肉瘤定义为出现在不利部位的未切除FOXO1融合阴性疾病或非转移性FOXO1融合阳性疾病。坦西罗莫司联合化疗在复发性或难治性横纹肌肉瘤患者中显示出有希望的活性。我们旨在比较接受长春新碱治疗的中危横纹肌肉瘤患者的无事件生存率。放线菌素,环磷酰胺与长春新碱和伊立替康(VAC/VI)交替联合替西罗莫司,然后进行维持治疗,而VAC/VI单独进行维持治疗。
    方法:ARST1431是随机的,开放标签,在澳大利亚的210个机构中进行的第三阶段试验,加拿大,新西兰,和美国。符合条件的患者是年龄在40岁或以下,患有非转移性FOXO1阳性横纹肌肉瘤或来自不利部位的未切除FOXO1阴性横纹肌肉瘤疾病的患者。另外两组患者也符合资格:在未切除的有利部位(不包括眼眶)患有FOXO1阴性疾病的患者;以及年龄小于10岁的IV期FOXO1阴性疾病伴远处转移的患者。如果16岁或以下,符合条件的患者必须具有50或更高的Lansky表现状态评分,如果16岁以上,则Karnofsky表现状态评分必须为50或更高;所有患者先前均未接受治疗。患者被随机(1:1)分为4个组,并按组织学分层,舞台,和团体。患者接受静脉VAC/VI化疗,每个周期的环磷酰胺剂量为1·2g/m2,有或没有减少剂量的每周静脉坦西罗莫司,从15mg/m2或0·5mg/kg开始体重小于10kg。所有患者的治疗总持续时间为42周,然后口服环磷酰胺加静脉注射长春瑞滨维持治疗6个月。在放疗期间和任何重大外科手术前2周内,坦西罗莫司被停用。主要终点是3年无事件生存期。采用修订后的意向治疗方法分析数据。该研究已在ClinicalTrials.gov(NCT02567435)注册,并且已完成。
    结果:2016年5月23日至2022年1月1日,共纳入325例患者。在297名可评估患者中(148名仅接受VAC/VI治疗,149名接受替西罗莫司治疗的VAC/VI治疗),中位年龄为6·3岁(IQR3·0-11·3);33例(11%)患者年龄在18岁或以上;297人中有179例(60%)为男性.在VAC/VI组中,148例患者中有113例(77%)FOXO1阴性,在替罗莫司组的VAC/VI中,149例中的108例(73%)为FOXO1阴性。中位随访时间为3·6年(IQR2·8-4·5),两组之间的3年无事件生存率没有显着差异(VAC/VI组的64·8%[95%CI55·5-74·1]与66·8%[57·5-76·2]在VAC/VI加替西罗莫司组(风险比0·86[95%CI0·58-1·26];log-rankp=0·44)。最常见的3-4级不良事件是贫血(VAC/VI组148例患者中有62例发生[41%],VAC/VI组149例患者中有89例发生[58%],淋巴细胞减少(65例[44%]中的83例事件与71例[48%]中的99例事件),中性粒细胞减少症(99例[67%]中的160例事件与105例[70%]中的164例事件),和白细胞减少症(86例[58%]中121例,93例[62%]中132例)。VAC/VI与替西罗莫司组发生1例治疗相关死亡,归类为未指定。
    结论:在VAC/VI中添加替西罗莫司并不能改善由FOXO1易位状态和临床因素定义的中危横纹肌肉瘤患者的无事件生存率。需要新的基于生物学的策略来改善该人群的结果。
    背景:儿童肿瘤学小组(由美国国家癌症研究所支持,美国国立卫生研究院)。
    BACKGROUND: The Children\'s Oncology Group defines intermediate-risk rhabdomyosarcoma as unresected FOXO1 fusion-negative disease arising at an unfavourable site or non-metastatic FOXO1 fusion-positive disease. Temsirolimus in combination with chemotherapy has shown promising activity in patients with relapsed or refractory rhabdomyosarcoma. We aimed to compare event-free survival in patients with intermediate-risk rhabdomyosarcoma treated with vincristine, actinomycin, and cyclophosphamide alternating with vincristine and irinotecan (VAC/VI) combined with temsirolimus followed by maintenance therapy versus VAC/VI alone with maintenance therapy.
    METHODS: ARST1431 was a randomised, open-label, phase 3 trial conducted across 210 institutions in Australia, Canada, New Zealand, and the USA. Eligible patients were those aged 40 years or younger with non-metastatic FOXO1-positive rhabdomyosarcoma or unresected FOXO1-negative rhabdomyosarcoma disease from unfavourable sites. Two other groups of patients were also eligible: those who had FOXO1-negative disease at a favourable site (excluding orbit) that was unresected; and those who were aged younger than 10 years with stage IV FOXO1-negative disease with distant metastases. Eligible patients had to have a Lansky performance status score of 50 or higher if 16 years or younger and a Karnofsky performance status score of 50 or higher if older than 16 years; all patients were previously untreated. Patients were randomised (1:1) in blocks of four and stratified by histology, stage, and group. Patients received intravenous VAC/VI chemotherapy with a cyclophosphamide dose of 1·2 g/m2 per dose per cycle with or without a reducing dose of intravenous weekly temsirolimus starting at 15 mg/m2 or 0·5 mg/kg per dose for those who weighed less than 10 kg. The total duration of therapy was 42 weeks followed by 6 months of maintenance therapy with oral cyclophosphamide plus intravenous vinorelbine for all patients. Temsirolimus was withheld during radiotherapy and for 2 weeks before any major surgical procedure. The primary endpoint was 3-year event-free survival. Data were analysed with a revised intention-to-treat approach. The study is registered with ClinicalTrials.gov (NCT02567435) and is complete.
    RESULTS: Between May 23, 2016, and Jan 1, 2022, 325 patients were enrolled. In 297 evaluable patients (148 assigned to VAC/VI alone and 149 assigned to VAC/VI with temsirolimus), the median age was 6·3 years (IQR 3·0-11·3); 33 (11%) patients were aged 18 years or older; 179 (60%) of 297 were male. 113 (77%) of 148 patients were FOXO1 negative in the VAC/VI group, and 108 (73%) of 149 were FOXO1 negative in the VAC/VI with temsirolimus group. With a median follow-up of 3·6 years (IQR 2·8-4·5), 3-year event-free survival did not differ significantly between the two groups (64·8% [95% CI 55·5-74·1] in the VAC/VI group vs 66·8% [57·5-76·2] in the VAC/VI plus temsirolimus group (hazard ratio 0·86 [95% CI 0·58-1·26]; log-rank p=0·44). The most common grade 3-4 adverse events were anaemia (62 events in 60 [41%] of 148 patients in the VAC/VI group vs 89 events in 87 [58%] of 149 patients in the VAC/VI with temsirolimus group), lymphopenia (83 events in 65 [44%] vs 99 events in 71 [48%]), neutropenia (160 events in 99 [67%] vs 164 events in 105 [70%]), and leukopenia (121 events in 86 [58%] vs 132 events in 93 [62%]). There was one treatment-related death in the VAC/VI with temsirolimus group, categorised as not otherwise specified.
    CONCLUSIONS: Addition of temsirolimus to VAC/VI did not improve event-free survival in patients with intermediate-risk rhabdomyosarcoma defined by their FOXO1 translocation status and clinical factors. Novel biology-based strategies are needed to improve outcomes in this population.
    BACKGROUND: The Children\'s Oncology Group (supported by the US National Cancer Institute, US National Institutes of Health).
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  • 文章类型: Journal Article
    OBJECTIVE: To compare the prognostic value of two predictive models based on C-reactive protein (CRP) and albumin (ALB), namely the CRP to ALB ratio (CAR) and the Glasgow prognostic score (GPS), in newly diagnosed patients with diffuse large B-cell lymphoma (DLBCL).
    METHODS: The data of newly diagnosed DLBCL patients admitted to our center from May 2014 to January 2022 were reviewed. A total of 111 patients who completed at least 4 cycles of R-CHOP or R-CHOP-like chemotherapy with detailed clinical, laboratory data and follow-up information were included. The receiver operating characteristic (ROC) curve was performed to evaluate the predictive value of pre-treatment CAR on disease progression and survival. Furthermore, the association between CAR and baseline clinical, laboratory characteristics of patients was evaluated, and progression-free survival (PFS) and overall survival (OS) were compared between different CAR and GPS subgroups. Finally, the univariate and multivariate COX propor-tional hazard regression models were used to analyze the factors affecting disease outcomes.
    RESULTS: ROC curve showed that the area under the curve (AUC) of CAR predicting PFS and OS in DLBCL patients was 0.687 (P =0.002) and 0.695 (P =0.005), respectively, with the optimal cut-off value of 0.11 for both predicting PFS and OS. Compared with the lower CAR (<0.11) group, the higher CAR (≥0.11) group had more clinical risk factors, including age >60 years (P =0.025), ECOG score ≥2 (P =0.004), Lugano stage III-IV (P < 0.001), non-germinal center B-cell-like (non-GCB) subtype (P =0.035), elevated lactate dehydrogenase (LDH) ( P < 0.001), extranodal involved site >1 (P =0.004) and IPI score >2 (P < 0.001). The interim response evaluation of patients showed that the overall response rate (ORR) and complete response rate (CRR) in the lower CAR group were both significantly better than those in the higher CAR group (ORR: 96.9% vs 80.0%, P =0.035; CRR: 63.6% vs 32.5%, P =0.008). With a median follow-up of 24 months, patients with lower CAR had significantly longer median PFS and OS than those with higher CAR (median PFS: not reached vs 67 months, P =0.0026; median OS: not reached vs 67 months, P =0.002), while there was no statistical difference in PFS (P =0.11) and OS (P =0.11) in patients with GPS of 0, 1, and 2. Multivariate Cox regression analysis indicated that only sex (male) and IPI score >2 were independent risk factors for both PFS and OS.
    CONCLUSIONS: CAR is significantly correlated with disease progression and survival in DLBCL patients; And compared with GPS, CAR has more advantages in predicting disease outcomes in DLBCL patients.
    UNASSIGNED: 比较C反应蛋白与白蛋白比值和格拉斯哥预后评分对弥漫大B细胞淋巴瘤患者预后判断的价值.
    UNASSIGNED: 探讨并比较基于C反应蛋白(CRP)和白蛋白(ALB)的两种预测模型——CRP与ALB比值(CAR)和格拉斯哥预后评分(GPS)——在新诊断弥漫大B细胞淋巴瘤(DLBCL)患者预后评估中的价值。.
    UNASSIGNED: 回顾性分析本院2014年5月至2022年1月收治的初诊DLBCL患者的资料,纳入至少完成4个周期R-CHOP或R-CHOP样方案化疗,且临床、实验室检查数据以及随访资料均完整的111例患者。根据患者治疗前CAR及随访截止时的生存状态绘制受试者工作特征曲线(ROC),初步判断CAR对疾病进展和生存结局的预测价值,进一步分析CAR与患者基线临床、实验室特征的关系,并比较不同CAR、GPS分组患者的无进展生存期(PFS)和总生存期(OS),采用单因素和多因素COX风险比例回归模型分析影响疾病预后的因素。.
    UNASSIGNED: ROC曲线分析结果显示,CAR预测DLBCL患者PFS、OS的曲线下面积(AUC)分别为0.687(P =0.002),0.695(P =0.005),最佳截断值均为0.11;相较于低CAR(<0.11)组,高CAR(≥0.11)组患者具有更多的临床高危因素,包括年龄>60岁(P =0.025)、ECOG评分≥2分(P =0.004)、Lugano分期III-IV期( P < 0.001)、non-GCB亚型(P =0.035)、乳酸脱氢酶升高( P < 0.001)、结外病变数>1处(P =0.004)及IPI评分>2分( P < 0.001)。对患者进行中期疗效评估,低CAR组患者的总有效率(ORR)及完全缓解率(CRR)均明显优于高CAR组(ORR: 96.9% vs 80.0%, P =0.035;CRR: 63.6% vs 32.5%, P =0.008)。中位随访24个月,低CAR组患者的中位PFS及OS均明显优于高CAR组(中位PFS:未达到 vs 67个月,P =0.0026;中位OS:未达到 vs 67个月,P =0.002),而GPS 0分、1分和2分3组患者的PFS(P =0.11)和OS(P =0.11)差异均不具有统计学意义。多因素分析显示,仅有性别为男性和IPI评分>2分是影响患者PFS和OS的独立危险因素。.
    UNASSIGNED: CAR与DLBCL患者的疾病进展和生存显著相关;与GPS相比,CAR对患者的预后判断价值更大。.
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  • 文章类型: English Abstract
    OBJECTIVE: To investigate the clinical efficacy and prognosis of Rituximab combined with DHAX and CHOP regimen in the first-line treatment of elderly patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL).
    METHODS: A total of 36 elderly patients with DLBCL who were admitted and treated with 3 of more courses of treatment from August 2011 to August 2021 were retrospectively analyzed, and they were divided into rituximab±DHAX (R±DHAX) regimen group (18 cases) and rituximab±CHOP (R-CHOP) regimen group (18 cases) according to the treatment plan, and clinical features, efficacy and survival of the patients were observed.
    RESULTS: Compared with R-CHOP group, patients of the R±DHAX group were older, and had worse performance status and higher IPI score, the differences between two groups in age, ECOG score and IPI score were statistically significant ( P =0.005 P =0.018, P =0.035), but there were no significant differences beween two groups in gender, whether there were B symptoms, whether LDH was elevated, whether there was extranodal involvement, cell origin, bone marrow infiltration, and whether rituximab was combined ( P =0.738, P =1, P =0.315, P =0.305, P =0.413, P =0.177, P =0.711, P =0.229). The efficacy could be evaluated in 36 cases, including CR 14 (38.9%), PR 17 (47.2%), PD 5 (13.9%), and ORR of 86.1% (31/36). There were no statistically significant differences in CR[(27.8%(5/18) vs 50.0%(9/18); P >0.05] and PR [44.4%(8/18) vs 50.0%(9/18); P >0.05] of R±DHAX group and R-CHOP group, there was statistically significant difference in ORR[72.2%(13/18) vs 100.0%(18/18); P =0.045] between two groups. The 1-year OS of R±DHAX group and R-CHOP group was (38.9±11.5%)% and (94.4±7.4%)%, respectively, 2-year OS was (16.7±8.8)% and (72.2±10.6)%, respectively, and the differences between two groups were statistically significant ( P =0.001, P =0.002). The median survival time in the R±DHAX group was 11 months(95%CI :8.9-13.1), and the median survival time in the R-CHOP group was not reached, and there was a statistically significant difference between the groups (P < 0.001).
    CONCLUSIONS: For elderly DLBCL patients, R±DHAX may not be superior to R-CHOP in OS, and ECOG score, IPI score and age may affect the survival of elderly DLBCL patients. However, R±DHAX regimen is safe, tolerable and has a certain efficacy, which can be used as one of the clinical treatment options for elderly DLBCL.
    UNASSIGNED: 利妥昔单抗联合DHAX方案与CHOP方案一线治疗老年初诊弥漫大B细胞淋巴瘤的回顾性研究.
    UNASSIGNED: 探讨R±DHAX方案与R-CHOP方案一线治疗老年初诊弥漫大B细胞淋巴瘤(DLBCL)患者的临床疗效及预后。.
    UNASSIGNED: 回顾性分析江苏大学附属医院血液科2011年8月—2021年8月收治并至少完成3疗程的36例老年DLBCL患者,根据治疗方案分为利妥昔单抗±DHAX(R±DHAX)方案组(18例)和利妥昔单抗联合CHOP(R-CHOP)方案组(18例),观察患者的临床特征、疗效及生存。.
    UNASSIGNED: 与R-CHOP组比较,R±DHAX组患者更高龄、体能状态更差及IPI评分更高,在年龄、ECOG评分、IPI评分上两组间差异有统计学意义(P =0.005,P =0.018,P =0.035),而在性别、有无B症状、LDH是否升高、有无结外累及、细胞来源、有无骨髓浸润、是否联合使用利妥昔单抗上两组间差异均无统计学意义(P =0.738,P =1,P =0.315,P =0.305,P =0.413,P =0.177,P =0.711,P =0.229)。36例患者均可评价疗效,其中CR 14例(38.9%)、PR 17例(47.2%)、PD 5例(13.9%),ORR为86.1%(31/36)。R±DHAX组和R-CHOP组CR[(27.8%(5/18)对50.0%(9/18)]、PR[44.4%(8/18)对50.0%(9/18)]差异无统计学意义,但ORR[72.2%(13/18)对100.0%(18/18)]差异有统计学意义(P =0.045)。R±DHAX组和R-CHOP组1年OS率分别为(38.9±11.5)%和(94.4±7.4)%,2年OS率分别为(16.7±8.8)%和(72.2±10.6)%,组间比较差异有统计学意义(P =0.001,P =0.002)。R±DHAX组中位生存时间11个月(95%CI :8.9-13.1),R-CHOP组中位生存时间未达到,组间存在统计学差异(P <0.001)。.
    UNASSIGNED: 对于老年DLBCL患者,在OS方面R±DHAX方案可能不优于R-CHOP方案,且ECOG评分、IPI评分、年龄可能影响老年DLBCL患者生存。但R±DHAX方案安全、可耐受且具有一定疗效,可作为临床上老年DLBCL治疗选择之一。.
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  • 文章类型: English Abstract
    OBJECTIVE: To investigate the effectiveness, safety, and related prognostic factors of the treatment of follicular lymphoma (FL) with a regimen containing Bendamustine.
    METHODS: The clinical data of 129 FL patients who were treated with Bendamustine containing regimen were collected from January 1,2020 to October 30,2022 in the Hematology Department of Lianyungang Second People\'s Hospital and Jiangsu Provincial People\'s Hospital. The patients were divided into three groups: Bendamustine plus Rituximab (BR), Bendamustine plus Obinutuzumab (GB), Rituximab + Cyclophosphamide + Epirubicin / Doxorubicin + Vindesine + Prednisone (R-CHOP). The efficacy, safety and related prognostic factors of the treatment of FL with a regimen based on Bendamustine were retrospectively analyzed.
    RESULTS: The ORR was 98% for the BR group, 94% for the GB group, and 72.3% for the R-CHOP group, while the CR rate was 61.2%,70% and 40.4%, respectively. The ORR and CR rates of the R-CHOP group were statistically different from those of the BR group and GB group (P < 0.05). The 3-year PFS rate of the BR group, GB group, and R-CHOP group was 89.6%, 90.9%, 48.9%, respectively. There was a statistically significant difference in 3-year PFS between the R-CHOP group, BR group, and GB group (P < 0.05), while there was no statistically significant difference in 3-year OS(P >0.05). Hematological adverse reactions were mainly bone marrow suppression. Lymphocytes and CD4+T lymphocytes decreased to the lowest level about 6 months after treatment, and the incidence of lymphopenia in BR group and GB group was higher than that in R-CHOP group, with a statistical difference (P < 0.05). The higher incidence of non-Hematological adverse reactions were pulmonary infection, EB virus infection, hepatitis B virus reactivation, and gastrointestinal reactions without statistical difference in 3 groups (P >0.05), and were all controllable. The Receiver operating characteristic of CD4+T lymphocyte count showed that AUC of BR group was 0.802, and the critical value was 258/uL; AUC of GB group was 0.754 with a critical value of 322/uL.
    CONCLUSIONS: The treatment of FL with the Bendamustine containing regimen has good efficacy and controllable adverse reactions, but lymphocytopenia was significant after treatment, and the curative efficacy in combination with various CD20 monoclonal antibodies was different. The lowest CD4+T lymphocyte count can be used as a predictive factor for the occurrence of infection and efficacy of the Bendamustine containing regimen for FL.
    UNASSIGNED: 苯达莫司汀治疗滤泡性淋巴瘤后CD4+T淋巴细胞减少或可预测感染发生及疗效.
    UNASSIGNED: 探讨含苯达莫司汀方案治疗滤泡性淋巴瘤(FL)的有效性、安全性及相关预后因素。.
    UNASSIGNED: 收集2020年1月1日-2022年10月30日在连云港市第二人民医院与江苏省人民医院血液科应用含苯达莫司汀方案治疗的129例FL患者的临床资料。将患者分为苯达莫司汀联合利妥昔单抗(BR)组、苯达莫司汀联合奥妥珠单抗(GB)组、利妥昔单抗+环磷酰胺+表柔比星/多柔比星+长春地辛+泼尼松(R-CHOP)组,回顾性分析苯达莫司汀为基础的方案治疗FL的疗效、安全性及相关预后因素。.
    UNASSIGNED: BR组、GB组与R-CHOP组的ORR分别为98%、94%、72.3%,CR率分别为61.2%、70%、40.4%,R-CHOP组的ORR率、CR率与BR组、GB组均具有统计学差异(P < 0.05)。BR组、GB组与R-CHOP组的3年PFS率分别为89.6%、90.9%、48.9%,具有统计学差异(P < 0.05),但3年OS无统计学差异(P >0.05)。血液学不良反应主要为骨髓抑制,淋巴细胞及CD4+T淋巴细胞在用药后6个月降至最低,且BR组与GB组淋巴细胞减少的发生率高于R-CHOP组,具有统计学差异(P < 0.05);非血液学不良反应发生率较高的依次为肺部感染、EB病毒感染、乙肝病毒再激活、胃肠道反应,均可控,组间比较无统计学差异(P >0.05)。CD4+T淋巴细胞计数ROC曲线示,BR组判断感染的AUC为0.802,临界值为258/uL;GB组判断感染的AUC为0.754,临界值为322/uL。.
    UNASSIGNED: 含苯达莫司汀方案治疗FL疗效佳,且不良反应可控,但治疗后淋巴细胞减少明显且与不同CD20单抗联合使用时表现出差异性。CD4+T淋巴细胞计数最低值可以作为含苯达莫司汀方案治疗FL感染发生及疗效的预测因素。.
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  • 文章类型: Letter
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  • DOI:
    文章类型: Case Reports
    脂膜炎是一种发生在皮下脂肪组织中的炎症。脂膜炎包括物理性脂膜炎(例如,创伤性)和传染性脂膜炎(例如,细菌,真菌,皮下脂膜炎样T细胞淋巴瘤[SPCTL],等。).由于所有类型的脂膜炎的临床表现相似,因此准确的诊断至关重要。这里,我们报告了一例最初被诊断为创伤性脂膜炎的SPCTL病例。一名15岁的男性患者因腹部瘀伤后右侧腹和腹股沟肿块逐渐扩大而入院。他最初被诊断为创伤性脂膜炎,但是肿块在整个胸部和腹部扩张,并伴有超过11个月的发烧。计算机断层扫描(CT)显示胸前和腹壁有皮下肿块。使用FDG正电子发射断层扫描(PET)在那些病变处观察到了氟脱氧葡萄糖F18(FDG)的摄取。对肿块进行了活检,在此期间根据病理检查诊断SPCTL。他最初用泼尼松龙和环孢素A治疗两周。他退烧了,但胸部和腹壁皮下肿块持续存在。因此,他接受了环磷酰胺,阿霉素,长春新碱,和泼尼松(CHOP)方案。在CHOP的6个课程之后,CT显示无疾病证据。他在治疗30个月时仍处于完全缓解状态。
    Panniculitis is an inflammation that occurs in subcutaneous adipose tissue. Panniculitis includes physical panniculitis (e.g., traumatic) and infectious panniculitis (e.g., bacterial, fungal, subcutaneous panniculitis-like T cell lymphoma [SPCTL], etc.). Accurate diagnosis is crucial due to similar clinical presentation of all types of panniculitis. Here, we report a case of SPCTL which was initially diagnosed with traumatic panniculitis. A 15-year-old male patient was admitted to a previous hospital due to a progressively enlarged right flank and inguinal mass after an abdominal bruise. He was initially diagnosed with traumatic panniculitis, but the mass expanded throughout the chest and abdomen accompanied by a fever of over 11 months. Computed tomography (CT) revealed a subcutaneous mass in the anterior chest and abdominal wall. Fludeoxyglucose F18 (FDG) uptake was observed at those lesions using FDG-positron emission tomography (PET). A biopsy of the mass lesion was performed, during which SPCTL was diagnosed based on pathological examination. He was initially treated with prednisolone and cyclosporine A for two weeks. His fever went down, but subcutaneous mass in the chest and abdominal wall persisted. Therefore, he received a cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) regimen. After 6 courses of CHOP, CT revealed no disease evidence. He remained in complete remission at 30 months of therapy.
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