To further explore the role of rituximab when added to the CHOP-like regimen in the treatment of immunohistochemically defined non-germinal center B-cell subtype (non-GCB) diffuse large B-celllymphoma (DLBCL), 159 new...To further explore the role of rituximab when added to the CHOP-like regimen in the treatment of immunohistochemically defined non-germinal center B-cell subtype (non-GCB) diffuse large B-celllymphoma (DLBCL), 159 newly diagnosed DLBCL patients were studied retrospectively based on the immunohistochemical evaluation of CD10, Bcl-6, MUM-1, and Bcl-2. Altogether, 110 patients underwent the CHOP-like regimen, and rituximab was added for the other 49 patients. Cox regression analysis showed that compared with the CHOP-like regimen, the rituximab-based regimen (R-CHOP regimen)significantly decreased the risk of disease relapse and progression in CD10-negative patients (P=0.001),Bcl-6-negative patients (P=0.01), and MUM-1-positive patients (P=0.003). The risk of disease relapse in patients with non-GCB subtype (P=0.002) also decreased. In contrast, patients with the opposite immunohistochemical marker expression profile and GCB subtype did not benefit from treatment with the R-CHOP regimen. In addition, non-GCB subtype patients had a significantly higher expression rate of Bcl-2 than GCB subtype patients (P=0.042). Although univariate analysis found that both Bcl-2-positive and-negative patients had significantly higher event-free survival rates with the R-CHOP regimen, only Bcl-2 positivity (P=0.004) maintained significance in the Cox regression analysis. We conclude that the addition of rituximab can significantly improve the prognosis of patients with non-GCB subtype DLBCL, which is closely related to the expression of CD10, Bcl-6, MUM-1, and Bcl-2.展开更多
Objective: To observe the efficacy and safety of albumin-bound paclitaxel (ABP) monotherapy in treating recurrent advanced non-small-cell lung cancer (NSCLC). Methods: We retrospectively analyzed the short-term effica...Objective: To observe the efficacy and safety of albumin-bound paclitaxel (ABP) monotherapy in treating recurrent advanced non-small-cell lung cancer (NSCLC). Methods: We retrospectively analyzed the short-term efficacy and toxicities of ABP monotherapy in treating 21 patients who had previously undergone multiple cycles of therapy for their advanced NSCLC in our hospital since 2010. The treatment-related survival was also analyzed. Results: Of these 21 patients, the best overall response was partial response (PR) in 6 patients (28.6%), stable disease (SD) in 10 patients (47.6%), and progressive disease (PD) in 5 patients (23.8%). The overall response rate (ORR) was 28.6% and the disease control rate (DCR) (PR + SD) was 76.2%. The median progression-free survival (PFS) was 4.0 months (95% CI, 5.0-7.0 months). The main grade 3/4 toxicities included neutropenia (11.1%), peripheral nerve toxicity (5.6%), muscle and joint aches (5.6%), and fatigue (5.6%). Conclusions: The ABP monotherapy can achieve good objective response in advanced NSCLC patients who have previously received multiple cycles of treatment and be well tolerated.展开更多
Anaplastic large-cell lymphoma(ALCL) is characterized by frequently presenting adverse factors at diagnosis.Many groups believed aggressive treatment strategies such as autologous stem cell transplantation brought sur...Anaplastic large-cell lymphoma(ALCL) is characterized by frequently presenting adverse factors at diagnosis.Many groups believed aggressive treatment strategies such as autologous stem cell transplantation brought survival benefit for ALCL patients.However,few compared these approaches with conventional chemotherapy to validate their superiority.Here,we report a study comparing the efficacy of peripheral blood stem cell transplantation(PBSCT) and conventional chemotherapy on ALCL.A total of 64 patients with primary systemic ALCL were studied retrospectively.The median follow-up period was 51 months(range,1-167 months).For 48 patients undergoing conventional chemotherapy only,the 4-year event-free survival(EFS) and overall survival(OS) rates were 70.7% and 88.3%,respectively.Altogether,16 patients underwent PBSCT,including 11 at first remission(CR1/PR1),3 at second remission,and 2 with disease progression during first-line chemotherapy.The 4-year EFS and OS rates for patients underwent PBSCT at first remission were 81.8% and 90.9%,respectively.Compared with conventional chemotherapy,PBSCT did not show superiority either in EFS(P = 0.240) or in OS(P = 0.580) when applied at first remission.Univariate analysis showed that patients with B symptoms(P = 0.001),stage III/IV disease(P = 0.008),bulky disease(P = 0.075),negative anaplastic lymphoma kinase(ALK) expression(P = 0.059),and age ≤ 60 years(P = 0.054) had lower EFS.Furthermore,PBSCT significantly improved EFS in patients with B symptoms(100% vs.50.8%,P = 0.027) or bulky disease(100% vs.52.8%,P = 0.045) when applied as an up-front strategy.Based on these results,we conclude that,for patients with specific adverse factors such as B symptoms and bulky disease,PBSCT was superior to conventional chemotherapy in terms of EFS.展开更多
Patients with lymphocytic malignancies like Non-Hodgkin's lymphoma (NHL), multiple myeloma (MM), and chronic lymphocytic leukemia (CLL) are often complicated with anemia. In this prospective study, we devised a ca...Patients with lymphocytic malignancies like Non-Hodgkin's lymphoma (NHL), multiple myeloma (MM), and chronic lymphocytic leukemia (CLL) are often complicated with anemia. In this prospective study, we devised a carefully controlled erythropoietin (Epo) level measurement in anemic or non-anemic patients with lymphocytic malignancies, in order to determine whether the response of Epo was decreased in anemic patients.展开更多
Objective Due to the rarity of angioimmunoblastic T-cell lymphoma(AITL),very limited data concerning its incidence patterns and prognostic factors are available.This study aimed to explore the incidence,characteristic...Objective Due to the rarity of angioimmunoblastic T-cell lymphoma(AITL),very limited data concerning its incidence patterns and prognostic factors are available.This study aimed to explore the incidence,characteristics,survival outcomes,and prognostic factors of AITL.Methods Age-adjusted incidence and temporal trends were calculated based on 1247 AITL patients from the National Cancer Institute’s Surveillance,Epidemiology,and End Results(SEER)-13 database.A total of 1525 AITL patients from the SEER-18 database and 43 patients from our single center were included for survival analysis and nomogram construction.Results The age-adjusted incidence for overall cohort was 0.123[95%confidence interval(CI),0.117–0.131)per 100000 during 1992–2017.The overall incidence increased steeply at the rate of 15.3%(95%CI 11.0%–19.8%,P<0.001)per year during 1992–2004,but remained stable during 2004–2017(P=0.200).Similar incidence trends were observed in age,sex,and stage subgroups.The final nomograms consisted of four variables:age at diagnosis,sex,Ann Arbor stage,and primary site.The concordance index(C-index)of the nomogram for 5-year overall survival prediction was 0.717,0.690 and 0.820 in the training cohort,validation cohort-1 and cohort-2,respectively.Regarding the disease-specific survival(DSS),the nomogram also demonstrated a good discrimination level,with the C-index for predicting the probability of DSS at 5 years of 0.716,0.682 and 0.813 for the three cohorts,respectively.The calibration displayed good concordance between the nomogram-predicted and actual observed outcomes.Conclusion The age-adjusted incidence for AITL was low during 1992–2017.The incidence continuously increased during 1992–2004,but remained stable during 2004–2017.The nomograms as proposed may provide a favorable and accurate prognostic survival prediction in AITL.展开更多
Background:Elderly patents with diffuse large B-cell lymphoma (DLBCL) have a worse prognosis than younger patients,and the optimal treatment strategy for this group remains controversial.We conducted a retrospective a...Background:Elderly patents with diffuse large B-cell lymphoma (DLBCL) have a worse prognosis than younger patients,and the optimal treatment strategy for this group remains controversial.We conducted a retrospective analysis to investigate the clinical features and outcomes of elderly patients (>60 years) and to assess the impact of clinical and molecular factors on outcome in this age group.Methods:From April 2006 to December 2012,a total of 349 elderly patients with DLBCL from the National Cancer Center/Cancer Hospital,Chinese Academy of Medical Sciences,and Peking Union Medical College were included in this analysis.Patients were further divided into two age groups (61-69 years and ≥70 years).We compared clinical characteristics and outcomes between groups.Results:Of 349 total patients,204 (58.5%) were aged 61 to 69 years,and 145 (41.5%) patients were aged 70 years or older.Except for the Eastern Cooperative Oncology Group performance status,clinical characteristics were comparable between the two groups.With a median follow-up of 82 (range,1-129) months,the 5-year overall survival (OS) and progression-free survival (PFS) rates were 51.9% and 45.8%,respectively.The 5-year OS rates for patients aged 61 to 69 years and those over 70 years were 58.3% and 42.8%(P =0.007),respectively,and the 5-year PFS rates were 51.0% and 38.6%(P =0.034).Treatment regimens including rituximab provided a higher 5-year OS rate (63.1% vs.37.1%,P < 0.001) and PFS rate (56.6% vs.31.8%,P < 0.001) than chemotherapy alone.For patients aged 61 to 69 years,chemotherapy plus rituximab resulted in a higher 5-year OS rate (66.7% vs.46.4%,P =0.002) and PFS rate (60.0% vs.38.1%,P =0.002) than chemotherapy alone.For patients aged ≥70 years,there was a marked survival advantage in patients who received chemotherapy plus rituximab (5-year OS rate:57.7% vs.25.4%,P < 0.001;5-year PFS rate:51.3% vs.23.9%,P < 0.001) compared with that seen in those who received chemotherapy alone.Multivariate analysis established that stage Ⅲ/Ⅳ disease,elevated lactate dehydrogenase (LDH),initial treatment,and chemotherapy with rituximab were independent risk factors for 5-year OS,and stage Ⅲ/Ⅳ disease,elevated LDH,and chemotherapy with rituximab were independent risk factors for 5-year PFS for elderly patients with DLBCL.Conclusions:In comparison to patients aged 61 to 69 years,those aged ≥70 years have poorer survival.Prolonged survival is obtainable with rituximab,cyclophosphamide,doxorubicin,vincristine,and prednisone (R-CHOP)-like in elderly Chinese patients in all age groups,indicating that the R-CHOP-like regimen should be considered for this population,even for those aged 70 years or older.展开更多
To the Editor:Recently,the advantages of peri-operative chemotherapy in downstaging tumor and improving patient survival have been reported. Herein, we report a case of gastric cancer patient receiving neoadjuvant che...To the Editor:Recently,the advantages of peri-operative chemotherapy in downstaging tumor and improving patient survival have been reported. Herein, we report a case of gastric cancer patient receiving neoadjuvant chemotherapy along with trastuzumab and nivolumab.展开更多
Background:Bendamustine was approved in China on May 26th,2019 by the National Medical Product Administration for the treatment of indolent B-cell non-Hodgkin lymphoma(NHL).The current study was the registration trial...Background:Bendamustine was approved in China on May 26th,2019 by the National Medical Product Administration for the treatment of indolent B-cell non-Hodgkin lymphoma(NHL).The current study was the registration trial and the first reported evaluation of the efficacy,safety,and pharmacokinetics of bendamustine in Chinese adult patients with indolent B-cell NHL following relapse after chemotherapy and rituximab treatment.Methods:This was a prospective,multicenter,open-label,single-arm,phase 3 study(NCT01596621;C18083/3076)with a 2-year follow-up period.Eligible patients received bendamustine hydrochloride 120 mg/m2 infused intravenously on days 1 and 2 of each 21-day treatment cycle for at least six planned cycles(and up to eight cycles).The primary endpoint was the overall response rate(ORR);and secondary endpoints were duration of response(DoR),progression-free survival(PFS),safety,and pharmacokinetics.Patients were classified according to their best overall response after initiation of therapy.Proportions of patients in each response category(complete response[CR],partial response[PR],stable disease,or progressive disease)were summarized along with a twosided binomial exact 95%confidence intervals(CIs)for the ORR.Results:A total of 102 patients were enrolled from 20 centers between August 6th,2012,and June 18th,2015.At the time of the primary analysis,the ORR was 73%(95%CI:63%–81%)per Independent Review Committee(IRC)including 19%CR and 54%PR.With the follow-up period,the median DoR was 16.2 months by IRC and 13.4 months by investigator assessment;the median PFS was 18.6 months and 15.3 months,respectively.The most common non-hematologic adverse events(AEs)were gastrointestinal toxicity,pyrexia,and rash.Grade 3/4 neutropenia was reported in 76%of patients.Serious AEs were reported in 29 patients and five patients died during the study.Pharmacokinetic analysis indicated that the characteristics of bendamustine and its metabolites M3 and M4 were generally consistent with those reported for other ethnicities.Conclusion:Bendamustine is an active and effective therapy in Chinese patients with relapsed,indolent B-cell NHL,with a comparable risk/benefit relationship to that reported in North American patients.展开更多
文摘To further explore the role of rituximab when added to the CHOP-like regimen in the treatment of immunohistochemically defined non-germinal center B-cell subtype (non-GCB) diffuse large B-celllymphoma (DLBCL), 159 newly diagnosed DLBCL patients were studied retrospectively based on the immunohistochemical evaluation of CD10, Bcl-6, MUM-1, and Bcl-2. Altogether, 110 patients underwent the CHOP-like regimen, and rituximab was added for the other 49 patients. Cox regression analysis showed that compared with the CHOP-like regimen, the rituximab-based regimen (R-CHOP regimen)significantly decreased the risk of disease relapse and progression in CD10-negative patients (P=0.001),Bcl-6-negative patients (P=0.01), and MUM-1-positive patients (P=0.003). The risk of disease relapse in patients with non-GCB subtype (P=0.002) also decreased. In contrast, patients with the opposite immunohistochemical marker expression profile and GCB subtype did not benefit from treatment with the R-CHOP regimen. In addition, non-GCB subtype patients had a significantly higher expression rate of Bcl-2 than GCB subtype patients (P=0.042). Although univariate analysis found that both Bcl-2-positive and-negative patients had significantly higher event-free survival rates with the R-CHOP regimen, only Bcl-2 positivity (P=0.004) maintained significance in the Cox regression analysis. We conclude that the addition of rituximab can significantly improve the prognosis of patients with non-GCB subtype DLBCL, which is closely related to the expression of CD10, Bcl-6, MUM-1, and Bcl-2.
文摘Objective: To observe the efficacy and safety of albumin-bound paclitaxel (ABP) monotherapy in treating recurrent advanced non-small-cell lung cancer (NSCLC). Methods: We retrospectively analyzed the short-term efficacy and toxicities of ABP monotherapy in treating 21 patients who had previously undergone multiple cycles of therapy for their advanced NSCLC in our hospital since 2010. The treatment-related survival was also analyzed. Results: Of these 21 patients, the best overall response was partial response (PR) in 6 patients (28.6%), stable disease (SD) in 10 patients (47.6%), and progressive disease (PD) in 5 patients (23.8%). The overall response rate (ORR) was 28.6% and the disease control rate (DCR) (PR + SD) was 76.2%. The median progression-free survival (PFS) was 4.0 months (95% CI, 5.0-7.0 months). The main grade 3/4 toxicities included neutropenia (11.1%), peripheral nerve toxicity (5.6%), muscle and joint aches (5.6%), and fatigue (5.6%). Conclusions: The ABP monotherapy can achieve good objective response in advanced NSCLC patients who have previously received multiple cycles of treatment and be well tolerated.
文摘Anaplastic large-cell lymphoma(ALCL) is characterized by frequently presenting adverse factors at diagnosis.Many groups believed aggressive treatment strategies such as autologous stem cell transplantation brought survival benefit for ALCL patients.However,few compared these approaches with conventional chemotherapy to validate their superiority.Here,we report a study comparing the efficacy of peripheral blood stem cell transplantation(PBSCT) and conventional chemotherapy on ALCL.A total of 64 patients with primary systemic ALCL were studied retrospectively.The median follow-up period was 51 months(range,1-167 months).For 48 patients undergoing conventional chemotherapy only,the 4-year event-free survival(EFS) and overall survival(OS) rates were 70.7% and 88.3%,respectively.Altogether,16 patients underwent PBSCT,including 11 at first remission(CR1/PR1),3 at second remission,and 2 with disease progression during first-line chemotherapy.The 4-year EFS and OS rates for patients underwent PBSCT at first remission were 81.8% and 90.9%,respectively.Compared with conventional chemotherapy,PBSCT did not show superiority either in EFS(P = 0.240) or in OS(P = 0.580) when applied at first remission.Univariate analysis showed that patients with B symptoms(P = 0.001),stage III/IV disease(P = 0.008),bulky disease(P = 0.075),negative anaplastic lymphoma kinase(ALK) expression(P = 0.059),and age ≤ 60 years(P = 0.054) had lower EFS.Furthermore,PBSCT significantly improved EFS in patients with B symptoms(100% vs.50.8%,P = 0.027) or bulky disease(100% vs.52.8%,P = 0.045) when applied as an up-front strategy.Based on these results,we conclude that,for patients with specific adverse factors such as B symptoms and bulky disease,PBSCT was superior to conventional chemotherapy in terms of EFS.
文摘Patients with lymphocytic malignancies like Non-Hodgkin's lymphoma (NHL), multiple myeloma (MM), and chronic lymphocytic leukemia (CLL) are often complicated with anemia. In this prospective study, we devised a carefully controlled erythropoietin (Epo) level measurement in anemic or non-anemic patients with lymphocytic malignancies, in order to determine whether the response of Epo was decreased in anemic patients.
基金supported by the China National Major Project for New Drug Innovation(No.2017ZX09304015)Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(CIFMS)(No.2016-I2M-1-001).
文摘Objective Due to the rarity of angioimmunoblastic T-cell lymphoma(AITL),very limited data concerning its incidence patterns and prognostic factors are available.This study aimed to explore the incidence,characteristics,survival outcomes,and prognostic factors of AITL.Methods Age-adjusted incidence and temporal trends were calculated based on 1247 AITL patients from the National Cancer Institute’s Surveillance,Epidemiology,and End Results(SEER)-13 database.A total of 1525 AITL patients from the SEER-18 database and 43 patients from our single center were included for survival analysis and nomogram construction.Results The age-adjusted incidence for overall cohort was 0.123[95%confidence interval(CI),0.117–0.131)per 100000 during 1992–2017.The overall incidence increased steeply at the rate of 15.3%(95%CI 11.0%–19.8%,P<0.001)per year during 1992–2004,but remained stable during 2004–2017(P=0.200).Similar incidence trends were observed in age,sex,and stage subgroups.The final nomograms consisted of four variables:age at diagnosis,sex,Ann Arbor stage,and primary site.The concordance index(C-index)of the nomogram for 5-year overall survival prediction was 0.717,0.690 and 0.820 in the training cohort,validation cohort-1 and cohort-2,respectively.Regarding the disease-specific survival(DSS),the nomogram also demonstrated a good discrimination level,with the C-index for predicting the probability of DSS at 5 years of 0.716,0.682 and 0.813 for the three cohorts,respectively.The calibration displayed good concordance between the nomogram-predicted and actual observed outcomes.Conclusion The age-adjusted incidence for AITL was low during 1992–2017.The incidence continuously increased during 1992–2004,but remained stable during 2004–2017.The nomograms as proposed may provide a favorable and accurate prognostic survival prediction in AITL.
文摘Background:Elderly patents with diffuse large B-cell lymphoma (DLBCL) have a worse prognosis than younger patients,and the optimal treatment strategy for this group remains controversial.We conducted a retrospective analysis to investigate the clinical features and outcomes of elderly patients (>60 years) and to assess the impact of clinical and molecular factors on outcome in this age group.Methods:From April 2006 to December 2012,a total of 349 elderly patients with DLBCL from the National Cancer Center/Cancer Hospital,Chinese Academy of Medical Sciences,and Peking Union Medical College were included in this analysis.Patients were further divided into two age groups (61-69 years and ≥70 years).We compared clinical characteristics and outcomes between groups.Results:Of 349 total patients,204 (58.5%) were aged 61 to 69 years,and 145 (41.5%) patients were aged 70 years or older.Except for the Eastern Cooperative Oncology Group performance status,clinical characteristics were comparable between the two groups.With a median follow-up of 82 (range,1-129) months,the 5-year overall survival (OS) and progression-free survival (PFS) rates were 51.9% and 45.8%,respectively.The 5-year OS rates for patients aged 61 to 69 years and those over 70 years were 58.3% and 42.8%(P =0.007),respectively,and the 5-year PFS rates were 51.0% and 38.6%(P =0.034).Treatment regimens including rituximab provided a higher 5-year OS rate (63.1% vs.37.1%,P < 0.001) and PFS rate (56.6% vs.31.8%,P < 0.001) than chemotherapy alone.For patients aged 61 to 69 years,chemotherapy plus rituximab resulted in a higher 5-year OS rate (66.7% vs.46.4%,P =0.002) and PFS rate (60.0% vs.38.1%,P =0.002) than chemotherapy alone.For patients aged ≥70 years,there was a marked survival advantage in patients who received chemotherapy plus rituximab (5-year OS rate:57.7% vs.25.4%,P < 0.001;5-year PFS rate:51.3% vs.23.9%,P < 0.001) compared with that seen in those who received chemotherapy alone.Multivariate analysis established that stage Ⅲ/Ⅳ disease,elevated lactate dehydrogenase (LDH),initial treatment,and chemotherapy with rituximab were independent risk factors for 5-year OS,and stage Ⅲ/Ⅳ disease,elevated LDH,and chemotherapy with rituximab were independent risk factors for 5-year PFS for elderly patients with DLBCL.Conclusions:In comparison to patients aged 61 to 69 years,those aged ≥70 years have poorer survival.Prolonged survival is obtainable with rituximab,cyclophosphamide,doxorubicin,vincristine,and prednisone (R-CHOP)-like in elderly Chinese patients in all age groups,indicating that the R-CHOP-like regimen should be considered for this population,even for those aged 70 years or older.
文摘To the Editor:Recently,the advantages of peri-operative chemotherapy in downstaging tumor and improving patient survival have been reported. Herein, we report a case of gastric cancer patient receiving neoadjuvant chemotherapy along with trastuzumab and nivolumab.
基金by the Teva Branded Pharmaceutical Products R&D Inc.
文摘Background:Bendamustine was approved in China on May 26th,2019 by the National Medical Product Administration for the treatment of indolent B-cell non-Hodgkin lymphoma(NHL).The current study was the registration trial and the first reported evaluation of the efficacy,safety,and pharmacokinetics of bendamustine in Chinese adult patients with indolent B-cell NHL following relapse after chemotherapy and rituximab treatment.Methods:This was a prospective,multicenter,open-label,single-arm,phase 3 study(NCT01596621;C18083/3076)with a 2-year follow-up period.Eligible patients received bendamustine hydrochloride 120 mg/m2 infused intravenously on days 1 and 2 of each 21-day treatment cycle for at least six planned cycles(and up to eight cycles).The primary endpoint was the overall response rate(ORR);and secondary endpoints were duration of response(DoR),progression-free survival(PFS),safety,and pharmacokinetics.Patients were classified according to their best overall response after initiation of therapy.Proportions of patients in each response category(complete response[CR],partial response[PR],stable disease,or progressive disease)were summarized along with a twosided binomial exact 95%confidence intervals(CIs)for the ORR.Results:A total of 102 patients were enrolled from 20 centers between August 6th,2012,and June 18th,2015.At the time of the primary analysis,the ORR was 73%(95%CI:63%–81%)per Independent Review Committee(IRC)including 19%CR and 54%PR.With the follow-up period,the median DoR was 16.2 months by IRC and 13.4 months by investigator assessment;the median PFS was 18.6 months and 15.3 months,respectively.The most common non-hematologic adverse events(AEs)were gastrointestinal toxicity,pyrexia,and rash.Grade 3/4 neutropenia was reported in 76%of patients.Serious AEs were reported in 29 patients and five patients died during the study.Pharmacokinetic analysis indicated that the characteristics of bendamustine and its metabolites M3 and M4 were generally consistent with those reported for other ethnicities.Conclusion:Bendamustine is an active and effective therapy in Chinese patients with relapsed,indolent B-cell NHL,with a comparable risk/benefit relationship to that reported in North American patients.
