Primary Non-Hodgkin’s Malignant Lymphoma of the Uterus at the Reference Hospital of Maradi/Niger: A Case Report

Malignant non-Hodgkins lymphoma (MHNL) of the uterus is uncommon. We report a case diagnosed on the basis of histologic and immunohistochemical studies of a hysterectomy specimen induced by a very painful pelvic mass in a 50-year-old patient with no previous history of the disease. It was classified as Ann Arbor IV Bb after imaging, given the medullary infiltration and signs of clinical and biological evolutivity: the patient had received two courses of chemotherapy, CHOP protocol. She died 23 days after the second treatment due to a hypertensive crisis.

PD-1在外周血Treg细胞中的表达与不同病理、分期、治疗方式非霍奇金淋巴瘤患者预后相关性分析

目的 探讨PD-1在外周血Treg细胞中的表达与不同病理、分期、治疗方式非霍奇金淋巴瘤患者预后的相关性。方法 选择2020年1月至2021年4月于我院接受治疗的非霍奇金淋巴瘤(NHL)患者共计74例,所有患者均经病理学组织检查确诊。统计所有患者淋巴瘤病理类型、临床分期以及治疗方式,测定患者程序性细胞死亡受体(PD-1)在患者外周血调节性T细胞(Treg)中的表达水平,并根据PD-1测定结果进行COX回归,分析患者预后情况。结果 (1)本研究74例患者分为:15例前驱淋巴性肿瘤(20.27%),21例惰性NHL(28.38%),19例侵袭性NHL(25.68%),19例成熟T细胞和NK细胞淋巴瘤(25.68%)。临床分期:Ⅰ期4例(5.41%),Ⅱ期23例(31.08%),Ⅲ期36例(48.65%),Ⅳ期11例(14.86%)。治疗方式:放疗16例(21.62%),联合化疗29例(39.19%),靶向药物治疗11例(14.86%),手术切除18例(24.32%)。(2)将侵袭性NHL作为对比因素,惰性NHL(P=0.000,HR=0.205)、前驱淋巴性肿瘤(P=0.013,HR=0.331)、成熟T细胞和NK细胞淋巴瘤(P=0.037,HR=0.329)的患者生存情况更好;将临床Ⅳ期作为对比因素,临床Ⅱ期(P=0.013,HR=0.252)、临床Ⅰ期(P=0.007,HR=0.104)的患者生存情况更好;将手术切除作为对比因素,靶向药物治疗(P=0.031,HR=1.279)的患者生存情况与手术切除类似。(3)测定患者外周血Treg细胞中的PD-1水平,结果显示:在患者不同病理分类、临床分期、治疗方式的分类下,PD-1水平均表现出了差异性(P <0.05),其中,侵袭性NHL、Ⅳ期以及联合化疗的情况下患者PD-1水平最高。结论 PD-1在不同病理类型、临床分期、治疗方式的NHL患者中表达存在差异;PD-1高水平表达的NHL患者预后较差。

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.

Positron emission tomography/computerized tomography in the evaluation of primary non-Hodgkin's lymphoma of prostate

Primary malignant lymphoma of the prostate is exceedingly rare.Here we report a case of a 65-year-old man who presented with increased urinary frequency,urinary urgency,and urinary incontinence for two years.Benign prostatic hypertrophy was suspected at primary impression.Ultrasound revealed a hypoechoic lesion of the prostate.The total serum prostate-specific antigen was within normal range.Positron emission tomography/computerized tomography(PET/CT)showed a hypermetabolic prostatic lesion.Prostate biopsy was consistent with a non-germinal center diffuse large B cell lymphoma.There was complete remission of the prostatic lesion following six cycles of chemotherapy as shown on the second PET/CT imaging.18F-fluoro-deoxy glucose PET/CT is not only a complement to conventional imaging,but also plays a significant role in the diagnosis and evaluation of treatment response of prostatic lymphoma.

Association of the Asp312Asn and Lys751 Gln polymorphisms in the XPD gene with the risk of non-Hodgkin's lymphoma:evidence from a meta-analysis

Polymorphisms in DNA repair genes may alter DNA repair capacity and,consequently,lead to genetic instability and carcinogenesis.Several studies have investigated the association of the Asp312 Asn and Lys751 Gln polymorphisms in the xeroderma pigmentosum complementation group D {XPD) gene with the risk of non-Hodgkin's lymphoma(NHL),but the conclusions have been inconsistent.Therefore,we performed this meta-analysis to more precisely estimate these relationships.A systematic literature search was performed using the PubMed,Embase,and Chinese Biomedical(CBM) databases.Ultimately,6 studies of Asp312 Asn,comprising 3,095 cases and 3,306 controls,and 7studies of Lys751 Gln,consisting of 3,249 cases and 3,676 controls,were included.Pooled odds ratios(ORs) and 95%confidence intervals(CIs) were calculated to assess the strength of each association.Overall,no association was observed between the Asp312 Asn polymorphism and NHL risk(homozygous:OR = 1.11,95%CI = 0.94-1.32;heterozygous:OR = 1.00,95%CI = 0.89-1.11;recessive:OR = 1.12,95%CI = 0.95-1.31;dominant:OR = 1.02,95%CI = 0.92-1.13;and allele comparison:OR = 1.04,95%CI = 0.96-1.12) or between the Lys751 Gln polymorphism and NHL risk(homozygous:OR = 0.97,95%CI = 0.83-1.15;heterozygous:OR = 0.96,95%CI = 0.86-1.06;recessive:OR = 1.00,95%CI = 0.86-1.16;dominant:OR = 0.96,95%CI = 0.87-1.06;and allele comparison:OR = 0.98,95%CI = 0.91-1.05).Furthermore,subgroup analyses did not reveal any association between these polymorphisms and ethnicity,the source of the controls,or the NHL subtype.These results indicated that neither the Asp312 Asn nor Lys751 Gln XPD polymorphism was related to NHL risk.Large and well-designed prospective studies are required to confirm this finding.

Correlation between Increased Circulating Endothelial Progenitor Cells and Stage of non-Hodgkin Lymphoma

This study aims to examine the levels of circulating endothelial progenitor cells （cEPCs） in the peripheral blood of patients with non-Hodgkin lymphoma （NHL） and their correlation with the tumor stage. Forty-one patients with biopsy-proven NHL and 16 healthy individuals were recruited. Pe- ripheral blood mononuclear cells （PBMCs） were isolated by density gradient centrifugation, and cEPCs were characterized by triple staining using antibodies against CD133, CD34 and vascular endothelial growth factor receptor-2 （VEGFR-2, CD309） and quantified by flow cytometry. In NHL patients, the number of cEPCs was significantly greater than in control group （P=-0.000）. The cEPCs counts in patients with NHL of stage III-1V were significantly greater than in stage I -II （P=-0.010）. FACS analysis revealed that the number of cEPCs in NHL patients had no correlation with the gender （P=0.401） or the pathological category （P=0.852）. It was suggested that the over-expression of cEPCs in NHL patients may serve as a novel biomarker for disease progression in NHL.

Simultaneous occurrence of a hepatocellular carcinoma and a hepatic non-Hodgkin's lymphoma infi ltration

To investigate the simultaneous occurrence of hepatocellular carcinoma and non-Hodgkin's lymphoma, we report the case of a 70 year old patient with a primary diagnosis of non-Hodgkin's lymphoma in 2002. In a routine follow up investigation of his chronic lymphocytic leukemia a newly detected mass in the Couinaud's segments 2 and 3 was found. No hepatitis C virus or hepatitis B virus infection or cirrhosis was evident. After laparoscopic segmentectomy the histological examination revealed a hepatocellular carcinoma. While the relation between liver parenchyma damages and hepatocellular carcinoma or non-Hodgkin's lymphoma is well known, only a few publications have focused on the coexistence of hepatocellular carcinoma and non-Hodgkin's lymphoma. With this case we demonstrate the coexistence of these diseases without having a pre- damaged liver parenchyma.

Hepatitis viruses and non-Hodgkin's lymphoma: A review

Non-Hodgkin's lymphoma(NHL) is among the haematological malignancies with high prevalence worldwide, causing estimated 355 900 new cases and 191 400 deaths in 2008. High prevalence of NHL is documented in economically more developed areas while low prevalence is observed in less developed areas of the globe. A wide array of environmental factors have been reported to be either directly involved or in modifying the risk of NHL development. In addition to these factors, a number of infectious agents, chiefly viruses have also been implicated in the development of NHL. This article reviews the available literature to discuss the role of hepatitis viruses in NHL development, possible mechanisms of lymphomagenesis and also identify the areas in which further research is required to better understand this disease. A brief discussion on the clinical aspects such as classification, staging, treatment approaches have also been included in this article.

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.

Prognostic value of pre-and post-transplantation 18F-fluorodeoxyglucose positron emission tomography results in non-Hodgkin lymphoma patients receiving autologous stem cell transplantation

Objective： High-dose chemotherapy （HDC） followed by autologous stem cell transplantation （ASCT） is the standard of care in the upfront or relapsed/refractory setting in some patients with non-Hodgkin lymphoma （NHL）. However, a proportion of patients do not respond to ASCT. lSF-fluorodeoxyglueose （FDG） positron emission tomography （PET）/computed tomography （CT） has been widely used for staging, response evaluation, and prognosis prediction. Here, we investigated the prognostic role of PET/CT in NHL patients before and after ASCT. Methods： A retrospective study was conducted at Peking University Cancer Hospital. All NHL patients who underwent ASCT between March 2010 and July 2016 were identified. Patients who had PET/CT scan before and after ASCT were included. Deauville criteria （5-point scale） were used to interpret PET scans. Univariate and multivariate survival analyses were performed using Cox regression. The predictive value of PET scanning was estimated by comparing the area under the receiver operating characteristic （ROC） curve. Results： In total, 79 patients were enrolled in this study. In univariate analysis, pre- and post-ASCT PET result was identified as prognostic factors for 3-year progression-free survival （PFS） and overall survival （OS）. Patients with negative pre-ASCT PET result demonstrated significantly better PFS （84.2% vs. 54.2%） and OS （89.2% vs. 63.6%） than patients with positive pre-ASCT PET result. PFS （91.6% vs. 25.3%） and OS （96.5% vs. 36.8%） were also significantly different between patients with negative and positive post-ASCT PET result. Multivariate analysis also showed a significant association between survival and post-ASCT PET result. ROC analysis revealed that the predictive value of post-ASCT PET result was superior to that of pre-ASCT PET result alone. Combined pre- and post-ASCT PET result is better for predicting outcomes in patients with NHL receiving transplantation. Deauville criteria score 〉3 was identified as the best cutoffvalue for post-ASCT PET. Conclusions： Post-ASCT PET result was more important than pre-ASCT PET result in predicting outcomes for NHL patients who underwent ASCT. The prognostic significance can be improved when combining pre- ASCT PET result with post-ASCT PET result. Deauville criteria can be used for interpreting PET scans in this scenario.

Expression of survivin in Human Non-Hodgkin Lymphoma and Its Correlation with Proliferation and Angiogenesis

In order to investigate the expression change of survivin in non-Hodgkin lymphoma （NHL） and its possible effects on NHL development, the expression of survivin, Ki-67, caspase3 and FⅧRAg in reactive lymphoid hyperplasia （RH） and NHL was detected by immunohistochemical assay, and apoptosis index （AI） in RH and NHL by TUNEL analysis. The results showed that the expression of survivin is significantly higher in aggressive NHL than in indolent NHL （P〈0.01）, while there was no statistically significant difference between RH and indolent NHL （P〉0.05）. The expres- sion of survivin had a significantly positive correlation with the expression of Ki-67 and FVSRAg （r=0.6495, 0.6635, respectively, both P〈0.01）, and a negative correlation with the expression of caspase3 and AI （r=-0.5820, -0.6013, respectively, P〈0.01）. It was suggested that survivin may contribute to the progression of NHL by playing an important role in promoting cell proliferation, inhibiting cell apoptosis and enlisting angiogenesis. Survivin expression is closely related to malignant grade and therefore may be considered an important prognostic factor of NHL.

HCV infection, B-cell non-Hodgkin's lymphoma and immunochemotherapy: Evidence and open questions

There is plenty of data confirming that hepatitis C virus (HCV) infection is a predisposing factor for a B-cell non-Hodgkin's lymphoma (B-NHL) outbreak, while relatively few reports have addressed the role of HCV in affecting B-NHL patients' outcome. HCV infection may influence the short-term outcome of B-NHL because of the emergence of severe hepatic toxicity (HT) during immunochemotherapy. Furthermore, the long term outcome of HCV-related liver disease and patients' quality of life will possibly be affected by Rituximab maintenance, multiple-lines of toxicity during chemotherapy and hematopoietic stem cell transplantation. In this review, data dealing with aggressive and low-grade B-NHL were separately analyzed. The few retrospective papers reporting on aggressive B-NHL patients showed that HCV infection is a risk factor for the outbreak of severe HT during treatment. This adverse event not infrequently leads to the reduction of treatment density and intensity. Existing papers report that low-grade B-NHL patients with HCV infection may have a more widespread disease, more frequent relapses or a lower ORR compared to HCV-negative patients. Notwithstanding, there is no statistical evidence that the prognosis of HCV-positive patients is inferior to that of HCV-negative subjects. HCV-positive prospective studies and longer follow-up are necessary to ascertain if HCV-positive B-NHL patients have inferior outcomes and if there are long term sequels of immunochemotherapies on the progression of liver disease.

Relationship between Eukaryotic Translation Initiation Factor 4E and Malignant Angiogenesis in Non-Hodgkin Lymphoma

The relationship between angiogenesis and eukaryotic translation initiation factor 4E （EIF4E） expression level in non Hodgkin lymphoma （NHL） was studied. Mean microvessel density （MVD） and EIF4E were detected in 52 lymph node samples paraffin sections of patients with newly diagnosed NHL by the way of immunohistochemistry. Antisense EIF4E cDNA was cloned into plasmid pcDNA3.1 （＋） and transfected into Raji cells. A series of angiogenesis related factors,including vascular endothelial growth factor （VEGF）, matrix metalloproteinases 9 （MMP-9） and tissue inhibitor of metalloproteinases-2 （TIMP-2） proteins were detected by Western blot. The results showed that： （1） The Expression of EIF4E and MVD was higher in aggressive lymphomas than in indolent lymphomas（P〈0.05）and the expression of EIF4E was positively correlated with MVD in lymph node of NHL（r=0. 695, P〈0.01）. （2） Antisense EIF4E eukaryocytic expression vector （pcDNA3. 1-EIF4Eas） was constructed successfully. （3） EIF4E, VEGF and MMP-9 were expressed at high levels in Raji cells as compared to normal human peripheral blood monocular cells （NHPMC）, and blockage of EIF4E expression brought down the expression of VEGF and MMP-9. However, TIMP-2 was undetectable in Rail cells, although a moderate level of TIMP-2 was detected in NHPMC. It was concluded that the increased EIF4E expression was associated with aggressive property of NHL.

Pediatric Non-Hodgkin Lymphoma: A Retrospective 7-Year Experience in Children &Adolescents with Non-Hodgkin Lymphoma Treated in King Fahad Medical City (KFMC)

Background: Non-Hodgkin’s lymphoma is an aggressive malignant disease in children and adolescents. Although it is the fourth most common malignancy in Saudi children as reported in Saudi cancer registry, less information is available about pediatric Non-Hodgkin lymphoma and its outcome in Saudi Arabia. Study Objectives: To provide demographic data, disease characteristics, treatment protocol, toxicity and outcome of treatment in children & adolescents with Non-Hodgkin’s lymphoma treated at KFMC. This study will form base line for future studies about pediatric Non-Hodgkin’s lymphoma in KFMC, which may help to improve outcome for children with cancer in Saudi Arabia. Study Patients and Method: We retrospectively analyzed 28 children and adolescents diagnosed to have Non-Hodgkin’s lymphoma at KFMC between December 2006 and December 2013, followed-up through June 2014. Results: Of the 28 patients, 10 (35.7%) girls and 18 (64.3%) boys, the male-to-female ratio was 1.8;1. The median age at time of diagnosis was 6.4 years old (range 2.0 to 13.0 years old). The majority of patients (64.3%) were aged between 5 and 12 years old. Burkitt’s lymphoma BL/BLL was the most common pathological subtype (60.7%), and DLBCL was the second most common subtype (21.4%). Abdominal and Retroperitoneal involvement was the most common primary site (78.6%) including the ileocaecal region. Most of the children presented with advanced Stage III and IV (75%), Cytogenetic study which screens specifically for the t (8;14) (q24;q32) a characteristic genetic feature of Burkitt’s Lymphoma was obtained from 21 patients, variant rearrangement was observed in 3/21 samples and complex chromosomes karyotype in addition to IGH/MYC rearrangement was observed in 2/21 samples. Those patients presented with very aggressive lymphoma and combined BM and CNS involvement. We use the French-American-British Mature B-Cell Lymphoma 96 Protocol (FAB LMB 96) for treatment fornewly diagnosed Mature B-Cell type NHL and high risk ALL CCG 1961 Protocol for lymphoblastic lymphoma and international Anaplastic Large Cell Lymphoma 99 Study Protocol for ALCL. The median follow-up in patients not experiencing an adverse event was 53.1 months. The estimated 3-year EFE and OS rates in the entire cohort of patients with newly diagnosed NHL treated in the KFMC were 85.2% and 89.2% respectively;Overall survival (OS) rate of patients with mature B-cell-NHL was 88.9%. Conclusion: The outcomes and survival in our small series appeared to be excellent compared with those reported in other international trials even though most of our patients presented in advanced stage of the disease. We feel that the importance of the current study is to document the relative distribution of various types of pediatric non-Hodgkin’s lymphomas and age-specific distribution in different Histological subtypes.

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.

CAR-T细胞免疫疗法在B细胞非霍奇金淋巴瘤中的应用进展

嵌合抗原受体T(CAR-T)细胞疗法是近年来迅速发展的免疫治疗新方法。相对于其他疗法,CAR-T疗法在高危及复发/难治性B细胞非霍奇金淋巴瘤(B-NHL)患者中具有显著优势。目前多种抗CD-19 CAR-T细胞已被FDA批准用于B-NHL的治疗,如阿基仑赛、司利弗明、利基迈仑赛、贝林妥欧单抗。除此之外,许多研究正在积极探索和开发不同靶点的CAR-T细胞,它们在B-NHL的治疗中表现出巨大的潜力。本文就CAR-T在常见B-NHL中的最新应用研究进展作一综述。

血清IL-10、TGF-β_(1)、sCD30联检对非霍奇金淋巴瘤患者化疗相关间质性肺炎的预测价值

目的 探究血清白细胞介素-10 (IL-10)、转化生长因子-β_(1)(TGF-β_(1))、可溶性CD30 (sCD30)联检对非霍奇金淋巴瘤(NHL)患者化疗相关间质性肺炎(IP)的预测价值。方法 回顾性分析2019年1月至2022年12月南阳市第二人民医院收治的168例NHL患者的临床诊治资料,根据化疗期间是否出现IP分为IP组(n=37)和非IP组(n=131),比较两组患者的一般资料、入院时血清IL-10、TGF-β_(1)、sCD30水平,采用Logistic回归方程筛选IP发生影响因素,绘制受试者工作特征曲线(ROC)及曲线下面积(AUC)分析血清IL-10、TGF-β_(1)、sCD30预测IP效能,采用相对危险度(RR)分析不同血清IL-10、TGF-β_(1)、sCD30表达对IP发生的影响。结果 IP组患者的血清LDH水平为(288.84±86.41) U/L,利妥昔单抗应用所占比例为48.65%,明显高于非IP组的(199.95±59.66) U/L、22.90%,差异均有统计学意义(P<0.05),但两组患者的性别、年龄、BMI、IPI评分、临床分期、全身症状、肺实质侵犯、骨髓侵犯、以往基础肺疾病史、吸烟史比较差异均无统计学意义(P>0.05);IP组患者的血清IL-10、TGF-β_(1)、sCD30水平分别为(25.41±7.60) ng/L、(29.55±8.83) pg/mL、(142.21±42.67) k U/L、,明显高于非IP组的(18.00±5.41) ng/L、(20.65±6.20) pg/mL、(98.87±28.96) kU/L、,差异均有统计学意义(P<0.05);经Logistic回归方程显示,IL-10 (OR:18.046)、TGF-β_(1)(OR:16.755)、sCD30 (OR:17.126)、LDH (OR:15.561)、应用利妥昔单抗(OR:10.331)均是NHL患者化疗相关IP发生的影响因素(P<0.05);经ROC分析结果显示,血清IL-10、TGF-β_(1)、sCD30联合预测IP效能[AUC:0.947,95%CI:0.901~0.976]明显优于三者单一预测[AUC:0.740,95%CI:0.667~0.804]、[AUC:0.762,95%CI:0.691~0.824]、[AUC:0.745,95%CI:0.672~0.809];血清IL-10、TGF-β_(1)、sCD30高表达者IP发生率是低表达的2.914、5.287、3.142倍。结论 血清IL-10、TGF-β_(1)、sCD30是NHL患者化疗相关IP的高危因素,联合检测有助于提高预测效能,指导临床医生做出治疗决策,减少IP发生风险。

平消胶囊联合R-CHOP方案治疗老年B细胞非霍奇金淋巴瘤患者的疗效分析

目的:探讨平消胶囊联合常规化疗方案(R-CHOP)对老年B细胞非霍奇金淋巴瘤(B-cell non-Hodgkin lymphoma,B-NHL)患者的临床疗效。方法:选取2019年01月至2023年01月本院收治的80例B-NHL患者(>60岁),随机分为对照组和实验组,每组40例。对照组患者采用R-CHOP方案化疗,实验组患者采用平消胶囊联合R-CHOP方案治疗,对比分析两组患者的疗效差异。结果:实验组患者的ORR、CR率分别为90.00%、40.00%,高于对照组(P<0.05)。实验组患者CD3+、CD4+、CD4+/CD8+、CD56+细胞比例均高于对照组,CD8+细胞比例低于对照组(P<0.05)。实验组不良反应与对照组相比无明显统计学差异。结论:老年B-NHL患者的临床治疗中应用平消胶囊联合R-CHOP方案有助于提升疗效,改善免疫功能,不良反应较轻,安全性好。

利妥昔单抗注射与中药外敷联合CHOP化疗方案对非霍奇金淋巴瘤患者近期疗效白细胞介素-6白细胞介素-8及癌胚抗原的影响

目的探究利妥昔单抗注射与中药外敷联合CHOP化疗方案对非霍奇金淋巴瘤患者近期疗效、免疫功能和血清指标的影响。方法回顾性选取2020年6月至2023年3月浙江中医药大学附属江南医院收治的118例非霍奇金淋巴瘤为研究对象,按患者的治疗方案分为对照组和观察组,每组患者各59例,其中对照组采取CHOP(环磷酰胺+多柔比星+长春新碱+泼尼松)方案序贯化疗,观察组在对照组基础上联合使用中药外敷和利妥昔单抗进行治疗,比较2组生存率、近期疗效、至少完成4个化疗周期前后的血清白细胞介素(IL)-2、IL-6、IL-8水平、铁调素(HEPC)、癌胚抗原(CEA)、乳酸脱氢酶(LDH)水平、T细胞亚群分布情况及免疫球蛋白表达水平、化疗期间不良反应情况及生活质量。结果对照组客观缓解率(ORR)、疾病控制率(DCR)分别为51%(30/59)、64%(38/59),观察组为56%(33/59)、78%(46/59),2组ORR对比差异无统计学意义(P>0.05),但DCR观察组优于对照组(P<0.05);随访1年,观察组总生存率、无进展生存率均高于对照组(P<0.05);干预前2组患者各项血清指标对比差异无统计学意义(P>0.05),干预后对照组患者IL-2、IL-6、IL-8含量分别为(829±90)ng/L、(8.2±1.7)ng/L、(82±13)ng/L,观察组患者分别为(905±94)ng/L、(6.2±1.3)ng/L、(54±9)ng/L;干预后对照组HEPC、CEA、LDH分别为(38±4)ng/ml、(6.7±1.2)ng/ml、(255±64)U/L,观察组分别为(30±4)ng/ml、(4.3±1.0)ng/ml、(214±38)U/L;对照组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)分别为(58±4)、(26.6±3.0)、(1.24±0.32),观察组患者为(62±5)、(29.8±3.6)、(1.65±0.35);对照组患者IgA、IgG、IgM分别为(1.89±0.56)ng/L、(12.8±2.6)ng/L、(1.33±0.43)ng/L,观察组分别为(2.58±0.44)ng/L、(15.8±3.3)ng/L、(1.98±0.52)ng/L,差异均具有统计学意义(P<0.05);2组患者均未发生化疗相关死亡,主要不良表现为消化道症状、骨髓抑制和脱发等,其中对照组患者治疗期间不良反应发生率29%(17/59),观察组为34%(20/59),2组差异无统计学意义(P>0.05)。干预后,2组患者健康调查简表(SF-36)各项评分均高于本组干预前(P<0.05),且观察组均高于对照组(P<0.05)。结论利妥昔单抗注射与中药外敷联合CHOP化疗方案对非霍奇金淋巴瘤患者的近期临床疗效较好,能有效提升患者1年内生存率并提升免疫功能,改善患者血清指标情况,治疗不良反应可控。

基线^(18)F-FDG PET/CT代谢参数对侵袭性非霍奇金淋巴瘤的治疗反应和预后的作用

目的:探讨基线18氟氟代脱氧葡萄糖-正电子发射计算机断层显像(^(18)F-FDG PET/CT)代谢参数对侵袭性非霍金淋巴瘤(NHL)的治疗反应和预后的作用。方法:回顾性分析101例侵袭性NHL病人的临床资料,所有病人均接受CHOP样方案化疗及^(18)F-FDG PET/CT检查,根据治疗反应将病人分为完全反应组63例、部分反应组22例和无反应组16例,另根据预后将病人分为预后良好组66例、预后不良组35例,比较不同治疗反应、预后病人基线^(18)F-FDG PET/CT代谢参数[最大标准化摄取值(SUVmax)、肿瘤代谢体积(MTV)、总糖酵解量(TLG)],采用受试者工作特征曲线(ROC)分析基线^(18)F-FDG PET/CT代谢参数联合检测对侵袭性NHL治疗反应和预后的预测价值。结果:不同治疗反应侵袭性NHL病人基线SUVmax、MTV、TLG水平存在明显差异(F=37.38、22.20、17.16,P<0.05);其中,完全反应组、部分反应组基线SUVmax、MTV、TLG水平低于无反应组,且完全反应组水平低于部分反应组水平(P<0.05)。预后良好组基线SUVmax、MTV、TLG水平低于预后不良组(t=6.49、6.02、5.48,P<0.05)。ROC曲线显示,基线SUVmax、MTV、TLG对侵袭性NHL治疗反应和预后具有一定预测价值(AUC=0.791、0.792、0.797,0.792、0.790、0.791,P<0.01),且联合检测(AUC=0.853、0.846,P<0.01)预测价值较高。结论:联合检测基线SUVmax、MTV、TLG等^(18)F-FDG PET/CT代谢参数对侵袭性NHL治疗反应和预后具有较高预测价值。