NHL骨髓受累诊断中骨髓涂片形态学检查价值研究

目的探讨非霍奇金淋巴瘤(NHL)骨髓受累诊断中骨髓涂片形态学检查的临床价值。方法回顾性分析选取2013年1月至2020年1月于我院诊治NHL患者共318例临床资料,均行骨髓活检和骨髓涂片形态学检查,评价骨髓涂片形态学检查用于NHL骨髓受累诊断临床效能。结果318例患者中骨髓涂片形态学检查和骨髓活检同时诊断骨髓侵犯56例,均未见骨髓侵犯210例;两种检测方法的检出一致率为83.65%(266/318),两种检测方法的Kappa指数为0.583,95%CI为0.487~0.679(P<0.05)。骨髓涂片形态学检查针对全部患者的NHL骨髓受累诊断灵敏度、特异性、阳性预测值及阴性预测值分别为53.85%(56/104)、98.13%(210/214)、93.33%(56/60)、81.40%(210/258);其中检出不一致即骨髓活检阳性但骨髓涂片形态学检查阴性,包括PTCL-NOS 8例、FL 12例、DLBCL 20例、AITL 4例、MCL 2例、黏膜相关淋巴瘤2例。骨髓涂片形态学检查针对惰性NHL骨髓受累患者的诊断灵敏度、特异性、阳性预测值及阴性预测值分别为73.68%(28/38)、92.00%(46/50)、87.50%(28/32)、82.14%(46/56)。骨髓涂片形态学检查针对侵袭性NHL骨髓受累患者的诊断灵敏度、特异性、阳性预测值及阴性预测值分别为42.42%(28/66)、100.00%(164/164)、100.00%(28/28)、81.19%(164/202)。结论骨髓涂片形态学检查用于NHL骨髓受累诊断具有一定价值,可在一定程度上作为骨髓活检的参考和补充。

Preclinical evaluation of cyclophosphamide and fludarabine combined with CD19 CAR-T in the treatment of B-cell hematologic malignancies in vivo

Background:Chimeric antigen receptor T(CAR-T)cell therapy has achieved marked therapeutic success in ameliorating hematological malignancies.However,there is an extant void in the clinical guidelines concerning the most effective chemotherapy regimen prior to chimeric antigen receptor T(CAR-T)cell therapy,as well as the optimal timing for CAR-T cell infusion post-chemotherapy.Materials and Methods:We employed cell-derived tumor xenograft(CDX)murine models to delineate the optimal pre-conditioning chemotherapy regimen and timing for CAR-T cell treatment.Furthermore,transcriptome sequencing was implemented to identify the therapeutic targets and elucidate the underlying mechanisms governing the treatment regimen.Results:Our preclinical in vivo evaluation determined that a combination of cyclophosphamide and fludarabine,followed by the infusion of CD19 CAR-T cells five days subsequent to the chemotherapy,exerts the most efficacious therapeutic effect in B-cell hematological malignancies.Concurrently,RNA-seq data indicated that the therapeutic efficacy predominantly perturbs tumor cell metabolism,primarily through the inhibition of key mitochondrial targets,such as C-Jun Kinase enzyme(C-JUN).Conclusion:In summary,the present study offers critical clinical guidance and serves as an authoritative reference for the deployment of CD19 CAR-T cell therapy in the treatment of B-cell hematological malignancies.

RPRD1B/CREPT facilitates the progression of diffuse large B-cell lymphoma by inhibiting apoptosis through the NF-κB signaling pathway

Objective:To investigate the role of RPRD1B in the progression of diffuse large B-cell lymphoma(DLBCL)and its potential as a therapeutic target.Methods:This study analyzed RPRD1B expression in DLBCL and normal tissues using public databases and assessed its prognostic impact through survival analysis.In vitro and in vivo experiments were conducted to explore the mechanisms by which RPRD1B influences tumor growth and apoptosis.Results:RPRD1B expression was significantly elevated in DLBCL compared to normal tissues and was associated with poor prognosis.In vitro and in vivo experiments demonstrated that RPRD1B promoted lymphoma cell proliferation and inhibited apoptosis through the NF-κB signaling pathway.Conclusions:RPRD1B plays a critical role in the progression of DLBCL by modulating apoptosis and cellular proliferation.Targeting RPRD1B may offer a novel therapeutic strategy for DLBCL,suggesting its potential as a prognostic marker and therapeutic target in hematological malignancies.

Identifying relevant factors influencing cancer-related fatigue in patients with diffuse large B-cell lymphoma during chemotherapy

BACKGROUND Diffuse large B-cell lymphoma(DLBCL)is a rapidly growing malignant tumor,and chemotherapy is one of the treatments used to combat it.Although advancements of science and technology have resulted in more and more patients being able to receive effective treatment,they still face side effects such as fatigue and weakness.It is important to thoroughly investigate the factors that contribute to cancer-related fatigue(CRF)during chemotherapy.AIM To explore the factors related to CRF,anxiety,depression,and mindfulness levels in patients with DLBCL during chemotherapy.METHODS General information was collected from the electronic medical records of eligible patients.Sleep quality and mindfulness level scores in patients with DLBCL during chemotherapy were evaluated by the Pittsburgh Sleep Quality Index and Five Facet Mindfulness Questionnaire-Short Form.The Piper Fatigue Scale was used to evaluate the CRF status.The Self-Rating Anxiety Scale and Self-Rating Depression Scale were used to evaluate anxiety and depression status.Univariate analysis and multivariate regression analysis were used to investigate the factors related to CRF.RESULTS The overall average CRF level in 62 patients with DLBCL during chemotherapy was 5.74±2.51.In 25 patients,the highest rate of mild fatigue was in the cognitive dimension(40.32%),and in 35 patients the highest moderate fatigue rate in the behavioral dimension(56.45%).In the emotional dimension,severe fatigue had the highest rate of occurrence,34 cases or 29.03%.The CRF score was positively correlated with cancer experience(all P<0.01)and negatively correlated with cancer treatment efficacy(all P<0.01).Tumor staging,chemotherapy cycle,self-efficacy level,and anxiety and depression level were related to CRF in patients with DLBCL during chemotherapy.CONCLUSION There was a significant correlation between CRF and perceptual control level in patients.Tumor staging,chemotherapy cycle,self-efficacy level,and anxiety and depression level influenced CRF in patients with DLBCL during chemotherapy.

Primary anaplastic lymphoma kinase-positive large B-cell lymphoma of the left bulbar conjunctiva: A case report

BACKGROUND Anaplastic lymphoma kinase(ALK)-positive large B-cell lymphoma(LBCL)is an aggressive and rare variant of diffuse LBCL.Herein,we report an uncommon case of stage IE extranodal ALK-positive LBCL initially originating in the bulbar con-junctiva.CASE SUMMARY A 63-year-old woman presented with a mass in the left bulbar conjunctiva that had persisted for six months,accompanied by swelling and pain that had per-sisted for 3 d.Eye examination revealed an 8 mm slightly elevated pink mass in the lower conjunctival sac of the left eye.Microscopically,the tumor was com-posed of large immunoblastic and plasmablastic large lymphoid cells with scattered anaplastic or multinucleated large cells.Immunophenotypically,the neoplastic cells were positive for ALK,CD10,CD138,Kappa,MUM1,BOB.1,OCT-2,CD4,CD45,EMA,CD79a,CD38,and AE1/AE3,and negative for CD20,PAX5,Lambda,BCL6,CD30 and all other T-cell antigens.The results of gene rearrangement tests showed monoclonal IGH/IGK/IGL and TCRD rearran-gements.Fluorescence in situ hybridization studies did not reveal any BCL2,BCL6 or MYC rearrangements.Furthermore,Epstein-Barr virus was not detected by in situ hybridization in the lesions.Based on the histopathological and imaging examinations,the neoplasm was classified as stage IE ALK-positive LBCL.No further treatments were administered.At the 6,15,and 21 mo postoperative follow-up visits,the patient was in good condition,without obvious discomfort.This case represents the first example of primary extranodal ALK-positive LBCL presenting as a bulbar conjunctival mass,which is extremely rare and shares morphological and immunohistochemical features with a variety of other neo-plasms that can result in misdiagnosis.CONCLUSION Awareness of the condition presented in this case report is necessary for early and accurate diagnosis and appropriate treatment.

Novel PIKfyve/Tubulin Dual-target Inhibitor as a Promising Therapeutic Strategy for B-cell Acute Lymphoblastic Leukemia

Objective:In B-cell acute lymphoblastic leukemia(B-ALL),current intensive chemotherapies for adult patients fail to achieve durable responses in more than 50%of cases,underscoring the urgent need for new therapeutic regimens for this patient population.The present study aimed to determine whether HZX-02-059,a novel dual-target inhibitor targeting both phosphatidylinositol-3-phosphate 5-kinase(PIKfyve)and tubulin,is lethal to B-ALL cells and is a potential therapeutic for B-ALL patients.Methods:Cell proliferation,vacuolization,apoptosis,cell cycle,and in-vivo tumor growth were evaluated.In addition,Genome-wide RNA-sequencing studies were conducted to elucidate the mechanisms of action underlying the anti-leukemia activity of HZX-02-059 in B-ALL.Results:HZX-02-059 was found to inhibit cell proliferation,induce vacuolization,promote apoptosis,block the cell cycle,and reduce in-vivo tumor growth.Downregulation of the p53 pathway and suppression of the phosphoinositide 3-kinase(PI3K)/AKT pathway and the downstream transcription factors c-Myc and NF-κB were responsible for these observations.Conclusion:Overall,these findings suggest that HZX-02-059 is a promising agent for the treatment of B-ALL patients resistant to conventional therapies.

SENEX-mediated CDK4/6 inhibition promotes senescence and confers apoptosis resistance in B-cell non-Hodgkin lymphoma

Background:The primary cause of treatment failure in patients with refractory or relapsed B-cell non-Hodgkin lymphoma(r/r B-NHL)is resistance to current therapies,and therapy-induced senescence(TIS)stands out as a crucial mechanism contributing to tumor drug resistance.Here,we analyzed SENEX/Rho GTPase Activating Protein 18(ARHGAP18)expression and prognostic significance in doxorubicin-induced B-NHL-TIS model and r/r B-NHL patients,investigating its target in B-NHL cell senescence and the effect of combining specific inhibitors on apoptosis resistance in B-NHL-TIS cells.Methods:Raji cells were transfected with the human SENEX shRNA recombinant lentiviral vector(Sh-SENEX)and the empty vector negative(NC)to construct a stable transfection cell line with knockdown of SENEX.Effect of SENEX-silencing on B-NHL-TIS formation,cell function and cell cycle-related pathways was analyzed.Using doxorubicin(DOX)-inducible senescent B-NHL cells combined with the specific cyclin dependent kinase 4/6(CDK4/6)inhibitor Palbociclib to observe that blocking CDK4/6 effects on TIS formation.SENEX expression of 21 B-NHL patients and 8 healthy controls were analyzed by qRT-PCR,and the correlation between its expression and clinical indicators were evaluated.Results:The downregulation of SENEX expression promotes G1-S phase transition and apoptosis while inhibiting cell proliferation,collectively suppressing the formation of TIS in B-NHL.Blockade of CDK4/6 promotes the DOX-induced G1 phase arrest to enhance TIS formation in B-NHL cells which can reverse the regulatory effect of silencing SENEX on B-NHL cell cycle regulation and senescence.The expression levels of SENEX were notably elevated in B-NHL patients compared to healthy controls,and Elevated expression levels of SENEX were associated with poor prognosis of B-NHL patients.Conclusions:SENEX enhances apoptosis resistance in B-NHL by inhibiting CDK4/6,thereby preventing G1-S phase transition and promoting TIS formation.

Transformation of marginal zone lymphoma into high-grade B-cell lymphoma expressing terminal deoxynucleotidyl transferase:A case report

BACKGROUND High-grade B-cell lymphoma(HGBL)is an unusual malignancy that includes myelocytomatosis viral oncogene(MYC),B-cell lymphoma-2(BCL-2),and/or BCL-6 rearrangements,termed double-hit or triple-hit lymphomas,and HGBL-not otherwise specific(HGBL-NOS),which are morphologically characteristic of HGBL but lack MYC,BCL-2,or BCL-6 rearrangements.HGBL is partially transformed by follicular lymphoma and other indolent lymphoma,with few cases of marginal zone lymphoma(MZL)transformation.HGBL often has a poor prognosis and intensive therapy is currently mainly advocated,but there is no good treatment for these patients who cannot tolerate chemotherapy.CASE SUMMARY We reported a case of MZL transformed into HGBL-NOS with TP53 mutation and terminal deoxynucleotidyl transferase expression.Gene analysis revealed the gene expression profile was identical in the pre-and post-transformed tissues,suggesting that the two diseases are homologous,not secondary tumors.The chemotherapy was ineffective and the side effect was severe,so we tried combination therapy including venetoclax and obinutuzumab.The patient tolerated treatment well,and reached partial response.The patient had recurrence of hepatocellular carcinoma and died of multifunctional organ failure.He survived for 12 months after diagnosis.CONCLUSION Venetoclax combined with obinutuzumab might improve the survival in some HGBL patients,who are unsuitable for chemotherapy.

Association of overall survival benefit of radiotherapy with progression-free survival after chemotherapy for diffuse large B-cell lymphoma:A systematic review and meta-analysis

Objective:To evaluate whether improved progression-free survival(PFS)from radiotherapy(RT)translates into an overall survival(OS)benefit for diffuse large B-cell lymphoma(DLBCL).Methods:A systematic literature search identified randomized controlled trials(RCTs)and retrospective studies that compared combined-modality therapy(CMT)with chemotherapy(CT)alone.Weighted regression analyses were used to estimate the correlation between OS and PFS benefits.Cohen’s kappa statistic assessed the consis-tency between DLBCL risk-models and PFS patterns.Furthermore,the benefit trend of RT was analyzed by fitting a linear regression model to the pooled hazard ratio(HR)according to the PFS patterns.Results:For both 7 RCTs and 52 retrospective studies,correlations were found between PFS HR(HRPFS)and OS HR(HROS)at trial level(r=0.639-0.876),and between PFS and OS rates at treatment-arm level,regardless of CT regimens(r=0.882-0.964).Incorporating RT into CT increased about 18%of PFS,and revealed a different OS benefit profile.Patients were stratified into four CT-generated PFS patterns(>80%,>60-80%,>40-60%,and≤40%),which was consistent with risk-stratified subgroups(kappa>0.6).Absolute gain in OS from RT ranged from≤5%at PFS>80%to about 21%at PFS≤40%,with pooled HROS from 0.70(95%CI,0.51-0.97)to 0.48(95%CI,0.36-0.63)after rituximab-based CT.The OS benefit of RT was predominant in intermediate-and high-risk patients with PFS≤80%.Conclusion:We demonstrated a varied OS benefit profile of RT to inform treatment decisions and clinical trial design.

PCR检测NHL患者骨髓重排基因及临床意义

目的：为研究非霍奇金氏恶性淋巴瘤（ＮＨＬ）的骨髓微小病灶及其临床意义。方法：采用ＰＣＲ技术联合检测４２例ＮＨＬ患者骨髓标本免疫球蛋白重链（ＩｇＨ）、Ｔ细胞受体（ＴＣＲ）ＶγＩ－Ｊｒ及ＴＣＲＶδ２－Ｄδ３重排基因。结果：３０．９％（１３／４２）存在ＩｇＨ重排，２３．８％（１０／４２）存在ＴＣＲＶγＩ－Ｊγ重排，１９．０％（８／４２）存在ＴＣＲＶδ２－Ｄδ３重排；联合检测三个重排基因，总阳性率为４２．９％（１８／４２）。而骨髓形态学检查的阳性率仅为１９．０％（８／４２）。ＰＣＲ检测ＮＨＬ骨髓浸润的阳性率显著高于形态学检查（Ｐ＜０．０１）。对其中６例ＰＣＲ检测阳性而形态学检查阴性病例追踪观察发现，３～８月后病人形态学检查均发现骨髓浸润，ＰＣＲ检测阳性较形态学检查平均提前４．８３月。结论：ＰＣＲ检测ＮＨＬ患者骨髓重排基因能早期发现微小病灶且阳性率高，有助于预后判断。

增强剂量CTOP方案治疗NHL临床观察

目的:观察增强剂量CTOP方案治疗NHL(非霍奇金淋巴瘤)的疗效及不良反应,进而探讨提高THP(吡柔比星)在联合化疗方案中的剂量强度的安全性。方法:39例初治NHL随机分为两组分别接受常规剂量CTOP(THP40mg/m2)和增强剂量CTOP(THP60mg/m2)方案化疗至少2疗程,观察疗效及不良反应。结果:增强剂量CTOP与常规剂量CTOP方案相比完全缓解率有所提高(47.4%:21.1%),达到完全缓解的时间也缩短(P<0.01);而且提高THP剂量强度后并未增加心脏毒性、脱发及骨髓抑制等不良反应的发生,两组的不良反应发生率及严重程度相仿,无显著性差异。结论:增强剂量CTOP方案治疗NHL可提高疗效而不加重不良反应,增强剂量吡柔比星可安全使用。

NHL患者外周血淋巴细胞基因重排检测及意义

目的探索非何态金氏淋巴瘤（NHL）患者外周血淋巴细胞克隆性基因重排及其意义。方法应用多聚酶链反应（PCR）技术检测9例NHL患者外周血淋巴细胞IgH－TCRβ克隆性基因重排。结果9例中有7例出现克隆性阳性单带，其中包括化疗前2例，化疗过程中5例。阴性2例为放、化疗后与肠道淋巴瘤切除术后各1例。结论结果表明，NHL患者外周血的淋巴细胞基因检测可作为辅助诊断和治疗效果，复发的有效客观指标。

单克隆IgH基因重排检测在B-NHL诊断和随访中的意义

目的 评价单克隆IgH基因重排检测在恶性淋巴瘤 (B NHL)临床中的应用价值。方法 用半巢式PCR检测单克隆IgH基因重排。病例组为B NHL ,包括 6 9例石蜡包埋组织切片、治疗前 16例骨髓和 2 9例外周血、阳性者治疗后复查骨髓和外周血 ;对照组为 10例慢性淋巴结炎、3例T NHL和 2例HD。结果 对照组均阴性。病例组 :切片中单克隆IgH基因重排阳性率为 6 3.8% (44 / 6 9) ;骨髓和外周血阳性率分别为 43 .8%(7/ 16 )和 41.4% (12 / 2 9) ,细胞形态学检查未见异常细胞者阳性率分别为 33 .3% (3/ 9)和 31.3% (5 / 16 )。 16例同时采集骨髓和外周血者 ,阳性率分别为 43 .8% (7/ 16 )和 37.5 % (6 / 16 ) ,两者无统计学差异。治疗前单克隆IgH重排阳性者 ,6例完全缓解 (CR)后转阴 ,处于持续缓解状态 ,1例临床缓解后 13个月仍阳性 ,现在继续随访中 ,另 1例CR后持续阳性者 ,6个月后复发。结论 切片、骨髓和外周血中检测单克隆IgH基因重排可以作为B

改良B-NHL-BFM-90方案治疗儿童青少年伯基特淋巴瘤的疗效分析

背景与目的:伯基特淋巴瘤是高度恶性非霍奇金淋巴瘤,进展快,常伴骨髓和中枢侵犯,死亡率高。CHOP方案疗效差,生存率低。伯基特淋巴瘤的最佳化疗方案仍需要积极探讨。本研究总结中山大学肿瘤防治中心近年来采用改良B-NHL-BFM-90方案治疗儿童青少年伯基特淋巴瘤的疗效和生存率。方法:从1999年10月至2006年11月,31例20岁以下经病理确诊的伯基特淋巴瘤患者入组。年龄1.5～20岁,中位年龄5岁;男性20例(64.5%),女性11例(35.5%)。临床分期(StJude分期):Ⅰ期1例(3.2%),Ⅱ期6例(19.4%),Ⅲ期8例(25.8%),Ⅳ期16例(51.6%),Ⅲ/Ⅳ期患者占77.4%。根据临床分期、治疗反应和LDH水平,将患者分为低危组、中危组和高危组。采用改良B-NHL-BFM-90方案治疗,药物包括cyclophosphamide、vincristine、ifosfamide、etoposide、adriamycin、HD-methotrexate、vindesine、dexamethasone、cytarabine/HD-cytarabine和鞘内注射。结果:31例患者中1例于诱导前期死于肿瘤溶解综合征。30例可评价疗效。30例中25例(83.3%)完全缓解,3例(10.0%)部分缓解,2例(6.7%)进展。1例复发。治疗期间大部分患者发生Ⅲ/Ⅳ度骨髓抑制,经积极对症支持治疗可恢复,不影响下一疗程治疗。中位随访33个月(3～98个月),全组3年无事件生存率86.0%;Ⅰ/Ⅱ期100%,Ⅲ/Ⅳ期82.1%;低危组100%,中危组92.0%,高危组70.0%。结论:改良B-NHL-BFM-90方案可明显改善儿童青少年伯基特淋巴瘤的疗效和生存率,毒性可耐受,但需要在有经验的肿瘤中心和血液科中应用。

CHOPE方案治疗侵袭性非霍奇金淋巴瘤(NHL)40例

目的:观察CHOPE方案治疗侵袭性NHL的近期疗效。方法:80例侵袭性NHL患者,分成对照组与治疗组,每组各40例。对照组为CHOP方案:CTX 750mg/m^2静脉注射,d1;VCR 1.4mg/m^2,静脉注射,d1;ADM 40mg/m^2,静脉注射,d1;强的松100mg/d,d1～5。治疗组为CHOPE方案:CHOP(同对照组)+VP-16 100mg/d,静脉滴注,d1～3。21天为1个周期,完成2个周期以上者做疗效评价。结果:治疗组40例患者中,CR 21例,PR 12例,NC 4例,PD 3例,总有效率(CR+PR)为82.5%。结论:CHOPE方案治疗侵袭性NHL的近期疗效满意,不良反应可耐受。

恶性淋巴瘤的肝脾侵犯──29例NHL尸体肝脾穿刺分析

本文介绍２９例ＮＨＬ尸体的肝脾穿刺研究。肝穿刺２９例，肝侵犯率７９．３％。脾穿刺２６例。脾侵犯率７６．９％。有肝脾肿大的病例肝或脾侵犯率分别为７１．４％和９０％，无肝脾肿大的病例，肝或脾侵犯率分别为８０．０％和６８．７５％。ＬＤＨ显著升高和高热多见于肝侵犯病例。脾累及的病人常同时有肝累及，肝累及病人几乎均同时有脾累及。由于肝侵犯的证实，３１％的病例分期上升。

NHL化疗患者NLR、PLR、RDW变化及对肺部感染的预测价值

目的探究非霍奇金淋巴瘤(NHL)化疗患者外周血中性粒细胞计数/淋巴细胞计数比率(NLR)、血小板计数/淋巴细胞计数比率(PLR)和红细胞体积分布宽度(RDW)变化情况,分析其对肺部感染的预测价值。方法选取2018年3月至2021年3月在湖南中医药大学第一附属医院接受化疗的110例NHL患者(观察组)的临床资料,根据是否存在肺部感染将观察组患者分为肺部感染组、非肺部感染组和未感染组,根据感染程度将肺部感染组患者分为轻中度感染和重度感染,另选取同期体检的105例健康人群(对照组),比较各组外周血NLR、PLR和RDW表达水平,Logistic回归分析NHL化疗患者肺部感染的危险因素;受试者工作特征(ROC)曲线分析NLR、PLR和RDW对NHL化疗患者发生肺部感染的预测价值。结果外周血NLR、PLR和RDW水平:对照组<观察组化疗后<和观察化疗前,肺部感染组>非肺部感染组>未感染组,重度感染>轻中度感染,差异均有统计学意义(P<0.05)。Logistic回归分析显示,化疗前NLR、PLR和RDW水平是化疗后肺部感染的危险因素(P>0.05)。ROC曲线分析显示,NLR、PLR和RDW对肺部感染预测的AUC值分别为0.848、0.758和0.713(P<0.05)。结论NHL患者外周血NLR、PLR、RDW水平偏高,化疗后三者水平均有所改善,其水平变化对肺部感染的预测具有一定参考价值。

EPOCH方案治疗复发耐药NHL临床疗效

目的:评价EPOCH方案作为挽救方案的疗效及耐受性。方法:2004年6月至2006年12月应用EP-OCH方案治疗我院收治的复发耐药中高度恶性非霍奇金淋巴瘤(NHL)31例,每例至少接受过2个化疗方案的治疗,采用VP-1650mg/m2/d、ADM或THP10mg/m2/d、VCR0.4mg/m2/d持续静脉滴注第1-4天,CTX750mg/m2/d静推第6天,强的松60mg/m2/d口服第1-5天,21天为1个疗程。结果:评价疗效者31例,评价不良反应疗程数为67,总有效率54.9%,其中完全缓解6例(19.4%),部分缓解11例(35.5%)。不良反应为骨髓抑制,其他系统不良反应少见。结论:EPOCH作为复发耐药中高度恶性NHL的挽救化疗方案经济有效,毒性可耐受。通过持续静脉滴注的给药途径可能减低肿瘤细胞的耐药率和化学毒性。

NHL患者血清TNF-α、LDH水平及与血沉的相关性研究

目的探讨非霍奇金淋巴瘤(NHL)患者血清TNF-αs、TNFRI、LDH、球蛋白、白蛋白水平及血沉的变化和意义。方法严格选取25例初诊NHL患者和26例正常人为研究对象,采用ELISA法测定血清TNF-α及sTNFRI水平,采用OLYMPUS 600血生化仪测定血清LDH、球蛋白及白蛋白水平,采用魏氏法测定血沉。结果NHL患者血清TNF-αs、TNFRI、LDH、球蛋白水平及血沉值均高于对照组,且血清TNF-αs、TNFRI、LDH、球蛋白水平与血沉值均具有相关性;两组血清白蛋白水平差异无显著性,NHL患者血清白蛋白水平血沉值成负相关。结论NHL患者TNF-α、sTN-FRI、LDH、球蛋白、白蛋白改变与血沉增快均有关系,其中TNF-α、白蛋白及LDH作用较大。