Hepatitis C virus and non-Hodgkin's lymphomas:Metaanalysisof epidemiology data and therapy options

Hepatitis C virus(HCV) is a global health problem affecting a large fraction of the world's population: This virus is able to determine both hepatic and extrahepatic diseases. Mixed cryoglobulinemia, a B-cell "benign" lymphoproliferative disorders, represents the most closely related as well as the most investigated HCVrelated extrahepatic disorder. Since this virus is able to determine extrahepatic [non-Hodgkin's lymphoma(NHL)] as well as hepatic malignancies(hepatocellular carcinoma), HCV has been included among human cancer viruses. The most common histological types of HCV-associated NHL are the marginal zone, the lymphoplasmacytic and diffuse large cell lymphomas. The role of the HCV in the pathogenesis of the B-cell lymphoproliferative disorders is confirmed also by the responsiveness of the NHL to antiviral therapy. The purpose of this review is to provide an overview of the recent literature and a meta analysis of the epidemiology data, to explain the role of HCV in the development of NHL's lymphoma. Furthermore, the possibility to treat these HCV-related NHL with the antiviral therapy or with other therapeutic options, like chemotherapy, is also discussed.

Autologous peripheral blood stem cell mobilization following dose-adjusted cyclophosphamide, doxorubicin, vincristine and prednisolone chemotherapy alone or in combination with rituximab in treating high-risk non-Hodgkin's lymphoma

Background: The regimen of cyclophosphamide, doxorubicin, vincristine, and prednisolone(CHOP) is an eicient treatment of non-Hodgkin's lymphoma(NHL). This study aimed to assess the eicacy and toxicity of dose-adjusted CHOP alone or in combination with rituximab(R-CHOP) by examining the stem cell mobilization in NHL patients. Factors afecting the collection of CD34+ cells were also explored.Methods: Our retrospective study included 39 patients eligible for autologous stem cell transplantation: 14 patients who expressed CD20 and were inancially eligible received R-CHOP for autologous peripheral blood stem cell(APBSC) mobilization; the remaining 25 patients received CHOP.Results: The median CD34+ cell yield was 7.01 × 106 cells/kg body weight(range 1.49–28.39 × 106 cells/kg body weight), with only two patients failing to meet the target CD34+ cell harvest of ber of apheresis procedures per patient was 1(range 1–3). The≥2.0 APBS× 106 cells/kg body weight. The median numC mobilization yield of the CHOP group appeared to be higher than that of the R-CHOP group(P response(CR) rate in = 0.005), whereas the success rate was similar between groups. R-CHOP elevated the completeB cell lymphoma patients as compared with CHOP(P = 0.01). No signiicant diferences in toxicity or engraftment were observed between the two groups.Conclusion: The present study demonstrated that dose-adjusted CHOP chemotherapy efectively mobilized APBSCs in NHL patients and that the addition of rituximab to dose-adjusted CHOP chemotherapy elevated the CR rate for patients with B-cell lymphoma.

STUDIES OF THE CHARACTERISTIC FEATURES OF KI-1 POSITIVE NON-HODGKIN'S LYMPHOMA

The clinical histopathological and immuno-phenotypic features in 5 patients with Ki-1 positive non-Hodgkin's lymphoma (NHL) were studied. When firstseen, 4 patients presented enlargement of superficiallymph nodes, with skin lesions in 2 patients. Two patientsin stage Ⅳ with fever, hepato-splenomegaly and bonemarrow invasion, died. Histologically, the tumor cellsshowed diffused or patchy hyperplasia. The cells wererelatively large in size, rich in basophilic or slightlyeosinophilic cytoplasm with irregular-shaped nuclei,prominent nucleoli, and distinct anaplasia andpleomorphism. Some of the cells looked very much likethe Reed-Sternberg cells. Multinucleated giant cells wereseen. Immunophenotypically, all the cells were CD30 (Ki-1) and CD25 (IL-2 receptor) positive but CD15 (Leu M1)negative. Thus, the 5 patients with Ki-1 positive NHLwere all of T cell type.

Extranodal Imaging Manifestations of Non-Hodgkin's Lymphoma

A series of imaging features of extranodal, multi-systemic involvements in Non-Hodgkin's lymphoma (NHL) were investigated The clinical data and imaging findings of 16 patients with pathologically proved NHL were retrospectively analyzed The related literatures were reviewed Of the 16 cases of NHL, skeletal involvement was found in 4, nasal cavity and nasal sinuses were involved in 4, too Lesion in the thorax was seen in 3 patients, hepatic involvement occurred in one case, cerebral ventricle was affected in 3 cases, mesentery was involved in one case Even though extranodal involvement of NHL exhibited extremely variable patterns, there were some relatively typical imaging findings Emphasized in this report were the relatively specific imaging manifestations of different systems, which may mimic infectious or other neoplasms of different sites The importance of imaging studies lies in the availability for diagnosis, staging and follow-up of NHL Combined with the clinical and other related information, the diagnostic accuracy can be further improved, thus, providing reliable evidence in guiding clinical management

Therapeutic Efficacy of L-asparaginase in the Treatment of Refractory Midfacial Peripheral T-Cell Non-Hodgkin’s Lymphoma

Objective: To improve the efficacy of refractory midfacial peripheral T-cell non-Hodgkin’s lymphoma (MPTC-NHL) with L-asparaginase (L-ASP) based salvage chemotherapy. Methods: 21 patients with refractory MPTC-NHL were analyzed. 11patients (L-ASP group) received L-asparaginase based salvage chemotherapy consisting of L-asparaginase, vincristine and dexame-thosone. 10 patients (control group) received salvage combination chemotherapy without L-asparaginase. Results: Complete remission rates were 45.6% for L-ASP group and 0.0% for control group (p<0.05). Overall response rates (CR+PR) were 63.6% for L-ASP group and 10.0% for control group, respectively (p<0.05). 2-year survival rates were 45.5% for L-ASP group and 0.0% for control group (p<0.05). The major adverse effects of L-ASP were leukopenia, elevation of serum bilirubin and hyperglycemia. Conclusion: The preliminary clinical study shows that the L-ASP based salvage chemotherapy may improve the response rate and 2-year survival rate of the patients with refractory MPTC-NHL. It is necessary to continue the study further.

Hepatitis B Reactivation with Novel Agents in Non-Hodgkin's Lymphoma and Prevention Strategies

Hepatitis B virus (HBV) infection remains an endemic disease in most parts of the world despite available prophylactic vaccines.Non-Hodgkin's lymphoma is the most common hematological malignancy,and certain patients undergoing therapy are at increased risk of HBV reactivation.Rituximab,a monoclonal antibody,is well studied in HBV reactivation,but newer agents have been implicated as well.Here,we review novel agents suspected in HBV reactivation and effective strategies to prevent HBV reactivation.Fifteen years of literature were reviewed in order to better understand the reactivation rates of hepatitis B in patients with non-Hodgkin's lymphoma.Anti-CD20 antibodies continue to be the main medications that can lead to HBV reactivation,and HBV reactivation rates have decreased with increased awareness.HBV reactivation is uncommon when using other novel agents.Entecavir and lamivudine remain the agents of choice to prevent HBV reactivation in high risk patients.In conclusion,the immunosuppressive effect of NHL and its therapy provide a pathway for HBV reactivation,especially in patients treated with anti-CD20 antibody.Since many HBV positive patients are often excluded from clinical trials of novel agents in NHL,more aggressive post-market surveillance of new agents,welldesigned best practice advisories,and timely case reports are needed to reduce the incidence of HBV reactivation.Lastly,large prospective investigations coupled with well-utilized best practice advisories need to be conducted to understand the impact of more potent novel NHL therapy on HBV reactivation.(C) 2016 The Second Affiliated Hospital of Chongqing Medical University.Published by XIA & HE Publishing Inc.All rights reserved.

中线导管在淋巴瘤患者中的应用效果评价

探究中线导管在淋巴瘤患者中的应用效果。选取西安交通大学第一附属医院2022年3月—2023年2月收治的60例淋巴瘤患者为研究对象,按照不同输液途径,将2022年3月—2022年8月置入经外周中心静脉导管(peripherally in-serted central venous catheters,PICC)的30例患者纳入对照组;将2022年8月—2023年2月置入经中线导管的30例患者纳入试验组,比较两组患者导管留置时间、并发症发生情况和生活质量。结果显示,试验组患者导管留置时间长于对照组(P<0.05),并发症发生率低于对照组(P<0.05),生活质量评分高于对照组(P<0.05)。研究发现,在对淋巴瘤患者进行治疗的过程中,中线导管的应用效果较为明显,其具有创伤小、置管成功率高、费用相对较低等优势,有利于降低患者并发症发生率,提高患者生活质量,可有效满足部分肿瘤患者对静脉输液治疗的需求,为患者在住院期间提供一条安全的静脉通道,值得临床借鉴。

原发于淋巴结外恶性淋巴瘤44例临床分析

淋巴组织遍布全身的器官组织，故淋巴结外恶性淋巴瘤可发生于任何器官组织。本病的发病率较低，其临床表现无特征性，常被误诊为受侵部位的常见病。现将我们所见的44例淋巴结外恶性淋巴瘤分析报告如下。II＄床资料1．l一般资料1986年1月一1998年5月在我院住院的经病理确诊...

鼻NK/T细胞淋巴瘤——15年研究报道

目的 :探讨鼻NK/T细胞淋巴瘤 (原诊断为“中线恶性网织细胞增生症”)的临床病理及免疫表型特征、病变性质及其与EB病毒感染的关系。方法 :过去 15年中对近 2 0 0例“中线恶网”病例做了一系列研究 ,包括临床病理分析、LSAB法免疫组化染色作免疫表型分析、用PCR技术作T细胞受体β和γ链基因重排及EBV DNA检测、EBER原位杂交和原位末端标记DNA片段技术检测细胞凋亡。结果 :①鼻NK/T细胞淋巴瘤有特征性临床及病理形态学表现 ;②瘤细胞表达CD3ε:89 8% ;CD45RO :81 2 % ;CD5 6 :81 2 % ;TIA 1:10 0 %。不表达B淋巴细胞和组织细胞分化抗原 ;③TCR β链基因重排检出率为85 7% ,TCR γ链基因重排检出率为 94 45 % ;④EBV DNA检出率为 6 7 86 % ;EBER原位杂交阳性率为 90 6 3% ;⑤肿瘤组织中的凋亡细胞与Ki 6 7+呈明显正相关 (P <0 0 0 6 3) ,Ki 6 7+细胞数量变化与患者的平均生存期有明显关系 (P <0 0 2 )。结论 :“中线恶网”实为EB病毒相关、细胞毒性NK/T细胞淋巴瘤。

鼻T/NK细胞淋巴瘤14例探讨

目的 探讨鼻T/NK细胞淋巴瘤的临床特点、病理诊断标准和生物学行为 ,为诊断和治疗提供经验。方法 选择既往诊断为“恶性肉芽肿”及相关疾病 2 3例 :①复习病理切片、进行免疫组化及EB病毒原位杂交染色 ,选用的抗体有 :TIA 1、CD4 3 、CD2 0 、CD3ε、CD56,原位杂交选用FITC标记 ,针对EB病毒编码的小分子RNA的寡核苷酸探针 (EBvirusencodedsmallnuclearRNA ,EBER原位杂交 ) ;②复习病历 ,总结临床病理特点。结果 ① 2 3例中 14例符合鼻T/NK细胞淋巴瘤形态学改变 ,免疫组化显示肿瘤细胞不表达CD2 0 ,表达TIA 1、CD56、CD3ε或CD4 3 ,EBER原位杂交阳性 ;② 14例患者中 8例侵犯鼻部中线 ,其余分别原发于鼻咽、咽、喉。其中 2例累及消化道 ,1例合并嗜血综合征。结论 ①鼻T/NK细胞淋巴瘤肿瘤细胞表达TIA 1,CD56,CD3ε,CD4 3,提示来源于T或自然杀伤细胞 (naturalkillercell,NK细胞 ) ,EBER原位杂交 10 0 %阳性 ,提示与EB病毒感染相关 ;②半数患者符合鼻腔恶性肉芽肿典型临床过程 ,少数病变累及消化道、骨髓及血液系统并出现嗜血综合征这一致死性并发症。

Survivin在中线T细胞淋巴瘤中的表达及其与EB病毒感染的关系

为了探讨凋亡抑制基因存活蛋白(survivin)在中线T细胞淋巴瘤(midlineTcelllymphoma,MTL)中的表达及其与EB病毒(EpstinBarrvirus,EBV)感染的关系,应用免疫组织化学方法检测石蜡切片中存活蛋白和EBV潜伏膜蛋白(latentmembraneprotein,LMP1)的表达,采用原位分子杂交技术检测EBV编码的RNA(EBVencodedRNA,EBER1/2)。结果表明:41例MTL中26例存活蛋白阳性表达(63.42%),而在10例反应性增生淋巴组织中均未检测出存活蛋白表达;存活蛋白在低度恶性MTL中的阳性表达率为12.50%,在中高度恶性MTL中的阳性表达率为75.76%,两组之间的差异具有显著性的意义(χ2=8.55,P<0.01);EBER1/2阳性率为70.73%,LMP1阳性率为41.46%,EBV阳性组与EBV阴性组之间存活蛋白的表达差异无显著性意义(P>0.05)。结论:MTL组织中存活蛋白表达上调,存活蛋白表达阳性率与MTL的恶性程度有关,存活蛋白基因可能通过肿瘤细胞凋亡的抑制参与MTL的发生发展,但未发现存活蛋白表达与EBV感染之间有明显相关性。

中线T淋巴瘤诊断的探讨

目的：探讨中线恶网的诊断及其临床病理意义，与其他一些疾病的鉴别诊断。方法：对中线恶网进行临床病理分析和免疫表型标记。结果：５０例中线恶网中，Ｔ细胞淋巴瘤４３例，Ｂ细胞淋巴瘤２例，余５例尚不能分类。结论：结果表明本病多数是Ｔ细胞淋巴瘤（即所谓的中线Ｔ淋巴瘤）。认为本病的临床、病理特点结合免疫标记技术有助于中线Ｔ淋巴瘤的确诊。

肠型恶性组织细胞增生症的再探讨——兼论肠型中线外周T细胞淋巴瘤

报道7例肠型恶性组织细胞增生症(简称IMH),其中4例为中小多形T细胞淋巴瘤,1例为Tr-ML,2例为组织细胞性淋巴瘤。4例中小多形T细胞淋巴瘤临床表现为腹痛、腹泻、反复便血伴发热,肠壁出血坏死形成溃疡甚至穿孔。病理形态:溃疡表面坏死形成肉芽样血管增生,异形淋巴细胞浸润而无明确肿块。经免疫组化证实LCA、UCHL_1呈阳性,电镜显示异形淋巴细胞多形性。作者建议将此特殊类型T细胞淋巴瘤称肠型中线外周T细胞淋巴瘤,以区别子肠道形成明确肿块的T、B和组织细胞恶性淋巴瘤,有助于治疗和预后的判断。

中线T细胞淋巴瘤与EB病毒关系的研究

为了解ＥＢ病毒在中线Ｔ细胞淋巴瘤中的感染情况，作者对遵义地区４６例中线Ｔ细胞淋巴瘤进行ＥＢＶ检测，用聚合酶链反应检测ＥＢＶ特征性的ＤＮＡ序列（ＥＢＶＤＮＡ），用ＲＮＡ原位杂交法检测ＥＢＶ编码的ＲＮＡ（ＥＢＥＲ１／２）。结果：ＥＢＶＤＮＡ阳性率为７６．１％（３５／４６）；ＥＢＥＲ１／２阳性率为６７．４％（３１／４６）。鼻腔、鼻咽、口咽Ｔ淋巴瘤ＥＢＥＲ１／２阳性率分别为８８．９％（１６／１８）、７１．４％（５／７）、４７．６％（１０／２１）。在多形细胞性淋巴瘤中，中多形和大多形细胞性ＥＢＥＲ１／２阳性率为８０．０％（１６／２０），小多形细胞性为７３．３％（１１／１５）。结果表明ＥＢＶ感染与中线Ｔ淋巴瘤关系密切，它在该肿瘤的发病中可能起重要作用，中线Ｔ淋巴瘤的ＥＢＶ感染率与解剖学部位有关，多形细胞性淋巴瘤ＥＢＶ感染率较高。

中线外周T细胞淋巴瘤

目的 总结 13例中线外周T细胞淋巴瘤 (MPTL)探讨其特征、治疗及预后。方法 用病理、免疫酶标方法对 13例MPTL进行确诊 ,采用CHOP方案化疗并观察其预后。结果 8例CR ,2例PR ,其中 2例CR后复发 ,另 3例NR死亡。结论CHOP方案对MPTL有效。血和尿 β2 MG升高和血清LDH升高应视为预后不良因素。

鼻腔及鼻咽部恶性淋巴瘤60例临床病理观察

报告鼻腔及鼻咽部恶性淋巴瘤６０例，其中属中线恶组（ＭＭＨ）４１例，其中２４例作免疫组化，证实为Ｔ细胞型淋巴瘤；中线非何杰金氏淋巴瘤（ＭＮＨＬ）１９例，其中１０例作免疫组化，证实为Ｔ细胞型４例，Ｂ细胞型６例。ＭＭＨ与ＭＮＨＬ对比观察，前组有肉芽组织结构，其中有异型细胞，并常见淋巴上皮病表现及容易侵犯血管壁等特点，后组形态与淋巴结内淋巴瘤无异；据临床分析，前组以局部破坏及发烧为主，后者以鼻塞、耳聋及局部肿块为主，因此我们认为：ＭＭＨ可看作一种特殊类型的淋巴瘤，有其独立的临床病理特点。

29例中线恶性网状细胞增多症的病理及免疫组化观察

本文报告29例中线恶性网状细胞增多症,着重对临床、病理形态及,免疫组化观察进行探讨.病理诊断依据是:1、有显著的坏死.2、炎性浸润及异形淋巴细胞(ALC)浸润,并浸润粘膜上皮及缸管壁.3、ALC 的形态分大、中、小3型,数量随临床分期而变化.免疫组化标记结果,病变组织中 ALC 呈 UCHL_1,LCA 膜阳性反应,而 K、λ、Mac_(387)、Lysozymc 均呈阴性反应,提示是 T 细胞来源的恶性淋巴瘤.

67例面中线非霍奇金淋巴瘤临床病理及其EBV感染关系

目的 探讨面中线非霍奇金淋巴瘤 (Non -Hodgkin’slymphma ,NHL)的临床病理特点及其与EBV感染的关系。 方法 应用免疫组化SP法检测多种抗体标记T淋巴细胞 (CD45RO、CD5 6、TIA -1)和B淋巴细胞 (CD2 0、CD45RA) ,同时进行EBV原位杂交检测。 结果 ⑴ 67例病例中 ,男女之比为 2 .7∶1,平均年龄 43岁 ,发病部位多位于鼻腔 ;⑵按照WHO新分类法 ,67例中B细胞淋巴瘤有 3 1例 ( 4 7.4% ) ,NK/T细胞淋巴瘤有 3 0例 ( 4 6.2 % ) ,外周T (非特殊类 )细胞淋巴瘤有 6例 ( 9.1% ) ;⑶ 67例中有 2 7例EBER1/ 2检测表达阳性 ( 4 0 .3 % ) ,其中 2 5例为NK/T细胞淋巴瘤 ,2例为外周T(非特殊类 )细胞淋巴瘤 ,3 1例B细胞淋巴瘤均表达阴性。 结论 面中线NHL以NK /T细胞淋巴瘤多发 ,EBV感染与淋巴瘤组织类型有关 ,与部位无关。

中线恶性淋巴瘤临床病理和免疫组化特征研究

目的 :探讨头面中线非何杰金淋巴瘤 (中线NHL)的临床病理特点及免疫表型。方法 :采用免疫组化LSAB法 ,选用单克隆抗体CK、LCA、UCHL1、L2 6检测 2 8例中线NHL ,4例鼻咽癌(NPC)和 2例坏死性鼻腔炎的组织表型抗原。结果 :2 8例中线NHL中 ,2 7例阳性表达LCA(白细胞共同抗原 ) ;2 0例 (71.4 % )UCHL1阳性 ,为T细胞淋巴瘤 ;8例 (2 8.6 % )L2 6阳性 ,为B细胞淋巴瘤。无 1例表达CK(Cytokeratin ,细胞角蛋白抗原 )。 4例NPC中的肿瘤细胞均表现较强的CK阳性而LCA呈阴性。 2例坏死性鼻腔炎及NPC的病灶中可见一些散在的细胞呈现LCA、UCHL1、L2 6阳性。结论 :中线NHL以T细胞淋巴瘤多见。

中线T细胞淋巴瘤的临床病理、免疫组织化学与形态定量分析

应用系列抗体对１２２例中线恶网作免疫组化染色，证实１１２例为Ｔ细胞源性，４例Ｂ细胞性，余６例尚不能分类，支持本病大多数是Ｔ细胞淋巴瘤的观点。本病可分为肉瘤样型和肉芽肿样型两种组织学类型，经形态定量发现前者光镜下可再分为大、中、小细胞亚型。对随访病例作临床病理分析表明，不同组织类型者其临床表现有所不同并与其预后密切相关。