Clinical characteristics for 112 cases with non-Hodgkin’s lymphoma

Objective： To study clinical characteristics of non-Hodgkin＇s lymphoma （NHL） in order to diagnose and treat early and improve prognosis. Methods： 112 cases with NHL were pathologically diagnosed and treated in 1992-2005. Results： Among all cases, 30 were not treated previously, 79 were involved in peripheral lymph nodes, 55 deep lymph nodes, 18 Waldeyer＇s ring, 25 respiratory system, 26 digestive system, 26 spleen, 13 bone, 13 skin and subcutaneous, 4 urinogenital system, 13 other sites. Among 30 previously untreated patients, there were 4 staged 1, 3 IE1 5 Ⅱ, 1 ⅡE, 9 Ⅲ, 1 Ⅲs and 7 IV. Among 82 patients with prior treatment, 29 were involved in lymph nodes only, 53 involved in different organs and tissues. In our series, there were 38 cases and 74 cases belonged to subtype A and subtype B respectively. Conclusion： The enlargement of peripheral lymph nodes is main clinical characteristic in NHL, but lesions also involve different organs and tissues. The diagnosis of NHL depends upon pathological examination.

The expressions of CD147 and MMP-9 in non-Hodgkin's lymphoma cells and the relation to prognosis

Objective： The aim of this study was to investigate the expression of CD147 and matrix metalioprpteinsae 9 （MMP-9） in children with non-Hodgkin＇s lymphoma （NHL） and the relations between expressions of CD147 ＆ MMP-9 and the clinical indexes. Methods： Specimens excised from NHL patients were prepared. Expression of CD147 and MMP-9 were tested by SABC immunohistochemistry and its correlation to clinical results were analyzed in this report. Results： The positive rate of CD147 expression was 73% （45/62）, and that of MMP-9 expression was 81% （50/62）. There was a positive correlation between CD147 and MMP-9 expressions. CD147 expression intensity was linked to clinical myelo-infiltration, tumor size, LDH value, and clinical staging （P 〈 0.05）, rather than children age, gender, or immune typing （P 〉 0.05）; MMP-9 expression intensity was linked to myelo-infiltration, and clinical staging （P 〈 0.05）, rather than age, gender, immune typing, tumor size, or LDH value （P 〉 0.05）. Five-year survival rates were 78% （22/28） and 45% （15/34） in CD147 （-）-（＋） and （＋＋）-（＋＋＋） cases respectively, and those were 84% （21/25） and 43% （16/37） in MMP-9 （-）-（＋） and （＋＋）-（＋＋＋） cases respectively, the difference was significant. Conclusion： The elevated expression of CD147 and/or MMP-9 correlates with a poor clinical outcome in patients with NHL.

Biodistribution and Anti-tumor Activities of the ^(131)I-labeled Rituximab in Nude Mice Bearing Human Burkitt's lymphoma

OBJECTIVE To explore the biodistribution and anti-tumoractivity of ^(131)I labeled rituximab injected intratumorally orintraperitoneally in vivo in nude mice bearing Raji human Burkitt's lymphoma xenografts.METHODS The rituximab and the mouse IgG were labeled withNa^(131)I using the IODO-GEN method.BALB/C nude mice werexenografted with ^(131)I-Rituximab or ^(131)I-IgG and killed on the 1st,3rd,7th,and 15th day after injection.The tumor/non-tumor ratio(T/NT)and the dose injected in each gram of the tissue(%ID/g)from12 organs or tissues of interest,e.g.tumor,blood,were calculated.The long and short axes of each tumor were measured by calipersat 2-3-day intervals after treatment,and the growth inhibition ofthe tumor was calculated using the MIRD formula.RESULTS When comparing intraperitoneal injection(IP)andintratumoral injection(IT)of ^(131)I-IgG,intratumoral injection of^(131)I-rituximab produced a significantly higher tumor/non-tumorratio in all tissues and organs of interest on the 1st,3rd,and 7thday,respectively(P<0.05).The %ID/g of tumor was 1.4-1.7-foldand 1.5-3.7-fold in the IP and IgG IT groups,respectively,but the%ID/g of non-tumors was significantly lower in the IP group andIgG IT group.Similarly,the tumor growth was greatly inhibitedby intratumoral injection of the ^(131)I-rituximab,whereas it wasless inhibited by other forms of the treatment(P<0.05).However^(131)I-rituximab injected intratumorally inhibited tumor growth ina dose-dependent manner.The inhibition rate was less with alow dose(75μCi)and greater with a high dose(150μCi),yet thedifference was not significant(P>0.05).CONCLUSION Tumors can absorb the highest amount of theradiolabelled antibodies,and the tumor/non-tumor ratios in thegroup with intratumoral injection of the ^(131)I-rituximab resulted inthe optimal anti-tumor activity.

Non Hodgkin’s Lymphoma with Right Atrial Intra Cardiac Metastases

Background: Diffuse Large B-Cell Lymphoma (DLBCL) is the most variant of Non-Hodgkin’s Lymphoma (NHL) and also the most common variant with secondary intracardiac masses. Case summary: 7 years old child presented to emergency with acute decompensated cardiac failure, ascites and tender hepatomegaly. 2D echo evaluation was suggestive of large intracardiac mass in the right atrium almost completely obstructing Tricuspid valve orifice, gross pericardial effusion and dilated Inferior Vena Cava (IVC). Emergency tumor excision surgery was performed which revealed 4 × 4 cm pinkish firm mass arising from anterior Tricuspid annulus which was completely excised. Child was extubated on postoperative day (POD) 0 and was on minimal inotropic support. Ascites reduced significantly on POD1 allowing abdominal palpation which revealed a mass in the epigastric region. This prompted evaluation by pediatrician and oncology workup suggestive of increased 18-Flouro Deoxy Glucose (18-FDG) uptake in the mediastinum, abdomen, bilateral proximal thighs, all mediastinal lymph nodal stations, bilateral lung hilar stations 10R, 10L involving all encasing the heart and great vessels with pleural deposits, Celiac trunk, superior Mesenteric Artery (SMA), Portal vein, IVC and abdominal aorta. Histo pathology Examination (HPE) and Immuno Histo Chemistry (IHC) of intracardiac mass revealed DLBCL which is metastatic in nature. Chemotherapy was started as per (French American British Lymphomes Malins B) FAB LMB-96 protocol with the child currently in the Induction phase having poor prognosis and less survival interval. Conclusion: Surgery can be considered a treatment option for metastatic intracardiac masses during emergency scenarios like cardiogenic shock to relieve obstruction along the pathway of blood flow in the heart even though we may not be able to completely excise the tumor surgically.

QUANTITATIVE STUDY OF AgNOR IN DIFFERENTIAL DIAGNOSIS BETWEEN NON-HODGKIN'S LYMPHOMA AND REACTIVE HYPERPLASIA

The argyrophilic staining technique was used in differential diagnosis between non-odgkin's lymphoraa (NHL) and reactive hyperplasia (RH) of lymphatic tissues in 30 cases of RH and 71 cases of NHL which were classified as low (11 cases), moderate (49 cases) and high malignant (11 cases) groups. The mumber and the area of Ag nucleolar organizer region (AgNORs) in 100 cells of each case were examined by both IBAS-200 cytoimage analyser and microscope. The results showed that there was significant difference in the number, but not in area, of AgNOR granules between RH and low malignant group of NHL (P< 0.001). In NHL, the significant differences in the number and area of AgNORs were found between each groups (P<0.05 or P< 0.001). It was also observed that in NHL, the number of AgNOR was negatively correlated with the area of the granules, and the shapes and distribution patterns of AgNOR were significantly different between each groups. Our results suggest that the quantitative study of AgNOR combining with the histological characteristics is very helpful in the differential diagnosis of RH and NHL and in the classification of NHL.

重组融合蛋白抗CD20Fab-LDM的构建、表达及体外活性研究

目的构建和表达抗CD20Fab-LDP(力达霉素辅基蛋白)融合蛋白,制备强化融合蛋白抗CD20Fab-LDM(力达霉素),并测定该融合蛋白的生物学活性。方法采用PCR和overlapPCR方法构建抗CD20Fab-LDP融合蛋白,并用双脱氧终止法测定DNA序列;采用亲和层析法纯化该产物,并用Western blot鉴定纯化产物;采用FACS方法鉴定纯化产物与靶细胞的结合活性;采用冷乙二醇法制备强化融合蛋白抗CD20Fab-LDM;采用MTT法鉴定抗CD20Fab-LDM对CD20+Raji细胞特异性的细胞毒作用。结果DNA序列测定结果表明抗CD20Fab-LDP融合蛋白已构建成功,可溶性表达产物的产量可达4mg.L-1以上,具有与Raji细胞(CD20+)结合的活性,与抗CD20Fab的亲合常数相当,抗CD20Fab-LDM体外能特异性杀伤Raji细胞,IC50值为0.9×10-10mol.L-1。结论成功地构建了抗CD20Fab-LDP融合蛋白,并获得可溶性高效表达,表达产物具有与相应靶抗原结合的活性,并成功制备了抗CD20Fab-LDM强化融合蛋白,体外能特异性杀伤CD20+的Raji细胞。