Expression of interleukin-32 in bone marrow of patients with myeloma and its prognostic significance

BACKGROUND The guiding effect of prognostic stratification in multiple myeloma(MM) for treatment has been increasingly emphasized in recent years. The stratification of risk factors based on the International Staging System(ISS), Durie-Salmon(DS)staging and related indicators is affected by the renal function of patients,resulting in poor performance. This study assesses the relationship between interleukin-32(IL-32) and related risk factors in 67 patients with MM and their clinical outcomes.AIM To investigate the feasibility of IL-32 in evaluating prognosis in patients with MM and the factors influencing prognosis.METHODS This was a pragmatic, prospective observational study of patients with MM at a single center. According to IL-32 level, patients were divided into two groups.The variables under consideration included age, blood β2-microglobulin,albumin, C-reactive protein, serum calcium, serum creatinine, lactate dehydrogenase, M protein type, ISS stage, DS stage, and IL-32 levels and minimal residual disease(MRD) after induction treatment. The main outcomes were progression-free survival(PFS) and overall survival(OS).RESULTS IL-32 was an important factor affecting PFS and OS in patients with MM.Compared with patients with IL-32 levels ≥ 856.4 pg/m L, patients with IL-32 levels < 856.4 pg/m L had longer PFS(P = 0.0387) and OS(P = 0.0379);Univariate analysis showed that IL-32 level and MRD were significantly associated with OS and PFS(P < 0.05). Multivariate analysis showed that IL-32 levels ≥ 856.4 pg/m L and MRD positive were still independent risk factors for OS and PFS(P < 0.05).CONCLUSION IL-32 is valuable for assessing the prognosis of MM patients. IL-32 level combined with MRD may be a useful routine evaluation index for MM patients after treatment.

Fractionated stereotactic radiotherapy with vagina carotica protection technique for local residual nasopharyngeal carcinoma after primary radiotherapy

Background Local failure of nasopharyngeal carcinoma （NPC） after radiotherapy （RT） remains one of the major treatment failures. This study aimed to evaluate the clinical efficacy and complications of fractionated stereotactic radiotherapy （FSRT） with vagina carotica protection technique for local residual of NPC patients after the primary RT. Methods From August 2006 to August 2010, FSRT with vagina carotica protection technique was applied to 36 patients in our department, the patients aged between 13 and 76 years with a median of 41.3 years, 25 of them were male and 11 were female. According to 2002 Union for International Cancer Control （UICC） Staging System, the stages before primary radiotherapy were： Ila 2, lib 5, III 18, IVa 7, IVb 4. In the first course of radiotherapy, 9 patients received conventional RT, 27 patients received intensity modulated radiotherapy （IMRT） and 20 out of the 36 patients received concurrent chemoradiotherapy. The total dose in the first course of RT was 69.96-76.90 Gy （median, 72.58 Gy）. The intervals between the primary RT and FSRT ranged from 12 to 147 days （median, 39.8 days）. Target volumes ranged from 1.46 to 32.98 cm3 （median, 14.94 cm3）. The total FSRT doses were 10.0-24.0 Gy （median, 16.5 Gy） with 2.0-5.0 Gy per fraction. The most common regimen was 15 Gy in 5 fractions of 3 Gy, the irradiation dose to vagina carotica was less than 2 Gy per fraction. Results The median follow-up time was 34 months （range, 12-59 months）. The 3-year local control rate was 100%; the 3-year overall survival rate was 94.4%; the 3-year disease-free survival rate was 77.8%. In this study, we had one case of cranial nerve injury, two cases of temporal lobe necrosis, and no nasopharyngeal massive hemorrhage was observed. Conclusion FSRT with vagina carotica protection technique is an effective and safe RT regimen for local residual of NPC with reduction of radiation-related neurovascular lesions.