The Korean Journal of Hematology最新文献

{"title":"The role of B cells in acute graft-versus-host disease.","authors":"Byung-Sik Cho, Nak-Gyun Chung","doi":"10.5045/kjh.2011.46.4.287","DOIUrl":"https://doi.org/10.5045/kjh.2011.46.4.287","url":null,"abstract":"TO THE EDITOR: \u0000 \u0000Mounting evidences implicates B cells in the pathogenesis of chronic graft-versus-host disease (GVHD). The body of evidence includes findings such as correlation between chronic GVHD and antibody production against Y chromosome-encoded minor histocompatabilty antigens (mHA) generated after sex-mismatched allogeneic stem cell transplantation (SCT), the clinical response of steroid-refractory chronic GVHD to rituximab, and association between high serum B cell-activating factor (BAFF) levels and chronic GVHD [1]. However, the role of B cells in acute GVHD remains controversial. Some studies that showed the association of high B cell count in the grafts in SCT patients with acute GVHD and beneficial effects of rituximab (used for B cell lymphoma treatment before transplantation) in acute GVHD patients, have suggested the possible role of B cells in the development of acute GVHD. \u0000 \u0000Kim et al. reported that the BAFF level/absolute lymphocyte count (ALC) ratio or that of APRIL (a proliferation-inducing ligand) level/ALC at the time of acute GVHD diagnosis was associated with disease severity [2]. In their study, patients with grade III-IV acute GVHD (6) had higher BAFF level/ALC or APRIL level/ALC ratio than the corresponding ratio observed in patients with grade II acute GVHD (9). These findings suggest that BAFF level/ALC or APRIL level/ALC ratio can help determine the severity of acute GVHD and need to be confirmed in large prospective studies. However, it would be somewhat unreasonable to conclude that B cells may play an important role in the development of acute GVHD on the basis of these findings alone. First, counting the number of B cells should be performed along with measurement of the BAFF or APRIL levels because higher serum BAFF levels may reflect relative B lymphopenia depending on the period after transplantation. Furthermore, comparison of the findings for patients with and without acute GVHD for the same period after allogeneic SCT is essential for investigating the relationship between B cells and acute GVHD. \u0000 \u0000BAFF has a complex, dichotomous role in immunity, which is mediated by the differential regulation of T cell- and B cell-dependent immune responses [3]. BAFF, a critical regulator of normal B cell homeostasis in mice and humans, also promotes T cell activation and survival [4]; these T cells play a pivotal role in acute GVHD pathogenesis. However, recent studies have also demonstrated the negative regulatory role of BAFF in T cell function [3, 5]. Walters et al. found that BAFF-transgenic mice accepted islet allografts and showed delayed rejection of skin allografts. On the basis of these results, they proposed that BAFF plays an anti-inflammatory role in T cell biology by promoting the expansion of regulatory T cells [3]. We studied the potential protective effect of BAFF against acute GVHD during the peritransplantation period in the setting of allogeneic SCT in humans [5]. Thus, further experimental and ","PeriodicalId":23001,"journal":{"name":"The Korean Journal of Hematology","volume":"46 4","pages":"287-8"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5045/kjh.2011.46.4.287","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30398600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human diversity of killer cell immunoglobulin-like receptors and disease.","authors":"Raja Rajalingam","doi":"10.5045/kjh.2011.46.4.216","DOIUrl":"https://doi.org/10.5045/kjh.2011.46.4.216","url":null,"abstract":"<p><p>Natural Killer (NK) cells are the third population of lymphocyte in the mononuclear cell compartment that triggers first-line of defense against viral infection and tumor transformation. Historically, NK cells were thought of as components of innate immunity based on their intrinsic ability to spontaneously kill target cells independent of HLA antigen restriction. However, it is now clear that NK cells are quite sophisticated and use a highly specific and complex target cell recognition receptor system arbitrated via a multitude of inhibitory and activating receptors. Killer cell immunoglobulin-like receptors (KIR) are the key receptors of human NK cells development and function. To date, fourteen distinct KIRs have been identified: eight are inhibitory types, and six are activating types. The number and type of KIR genes present varies substantially between individuals. Inhibitory KIRs recognize distinct motifs of polymorphic HLA class I molecules. Upon engagement of their specific HLA class I ligands, inhibitory KIR dampen NK cell reactivity. In contrast, activating KIRs are believed to stimulate NK cell reactivity when they sense their ligands (unknown). KIR and HLA gene families map to different human chromosomes (19 and 6, respectively), and their independent segregation produces a wide diversity in the number and type of inherited KIR-HLA combinations, likely contributing to overall immune competency. Consistent with this hypothesis, certain combinations of KIR-HLA variants have been correlated with susceptibility to diseases as diverse as autoimmunity, viral infections, and cancer. This review summarizes our emerging understanding of KIR-HLA diversity in human health and disease.</p>","PeriodicalId":23001,"journal":{"name":"The Korean Journal of Hematology","volume":"46 4","pages":"216-28"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5045/kjh.2011.46.4.216","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30398086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical implications of chimerism after allogeneic hematopoietic stem cell transplantation in children with non-malignant diseases.","authors":"Meerim Park,&nbsp;Kyung Nam Koh,&nbsp;Jong Jin Seo,&nbsp;Ho Joon Im","doi":"10.5045/kjh.2011.46.4.258","DOIUrl":"https://doi.org/10.5045/kjh.2011.46.4.258","url":null,"abstract":"<p><strong>Background: </strong>The effects of chimerism on outcomes following allogeneic hematopoietic stem cell transplantation (HSCT) are unclear and may differ between diseases. We retrospectively evaluated the association between chimerism and transplant outcomes in children with nonmalignant diseases.</p><p><strong>Methods: </strong>Chimerism was evaluated using short-tandem repeat polymerase chain reaction (STR-PCR) in 48 patients, with mixed chimerism (MC) defined as greater than 1% recipient cells.</p><p><strong>Results: </strong>The only variable exerting a significant influence on patients' chimerism status was the number of infused CD34+ cells. MC was detected in 23 transplants (9 showing transient MC; 10 with sustained low levels [≤30%] of autologous cells; and 4 with high-level MC [>30%]). The degree of STR-PCR at 28 days after HSCT was significantly higher in patients with high-level MC than those with transient or low-level MC. All patients with transient or low-level MC successfully maintained engraftment and showed a clinical response to HSCT, whereas 2 of the 4 patients with high-level MC experienced graft failure. The incidences of grades II-IV acute and chronic graft-versus-host disease (GVHD) were significantly higher in patients with complete donor chimerism (CC) than MC. We observed no significant survival differences between CC and MC groups. However, the survival rate was lower in patients with high MC than those with low-level or transient MC (P=0.03).</p><p><strong>Conclusion: </strong>In non-malignant diseases, MC may indicate a tolerant state with a decreased incidence of GVHD. However, high-level MC may signify an increased risk of graft failure and a lower survival rate.</p>","PeriodicalId":23001,"journal":{"name":"The Korean Journal of Hematology","volume":"46 4","pages":"258-64"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5045/kjh.2011.46.4.258","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30398595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CXCR4 antagonists in hematologic malignancies: more than just mobilizers?","authors":"Deog-Yeon Jo","doi":"10.5045/kjh.2011.46.4.209","DOIUrl":"https://doi.org/10.5045/kjh.2011.46.4.209","url":null,"abstract":"Stromal cell-derived factor-1 (SDF-1) is a chemokine constitutively expressed and produced in bone marrow (BM) stromal cells. It plays a central role in the migration and homing of hematopoietic stem cells (HSCs) and hematopoietic progenitor cells (HPCs) through signaling via its receptor CXCR4. AMD3100 is a small bicyclam molecule, which was originally developed as a CXCR4 antagonist that could block the entry of the HIV into T cells. It inhibits the binding of SDF-1 to CXCR4 and induces peripheral mobilization of HSCs and HPCs [1]. AMD3100 safely and rapidly mobilizes stem cells in healthy donors and in patients with lymphoma and myeloma, and it does so in synergy with the granulocyte-colony stimulating factor (G-CSF) [2]. A recent phase III clinical study on autologous stem cell transplantation showed that a combination of AMD3100 and G-CSF allowed for the collection of a large number of stem cells in fewer apheresis sessions and can help the patients in whom mobilization with G-CSF alone was ineffective [3]. On the basis of these findings, the FDA has recently approved the use of AMD3100 in combination with G-CSF for stem cell mobilization in patients with non-Hodgkin's lymphoma and multiple myeloma. \u0000 \u0000Leukemia and myeloma cells also express different levels of CXCR4 and respond to SDF-1, resulting in the migration and stable localization of these cells in the BM [4]. AMD3100 induces the segregation of leukemia and myeloma cells in the BM microenvironment, thereby mobilizing these cells to the peripheral blood and sensitizing them to chemotherapy [5]. Studies are underway for testing the use of AMD3100 as an adjunct to chemotherapy in patients with refractory acute myeloid leukemia (AML) and other hematologic malignancies; if successful, this strategy may be used to sensitize leukemic cells to chemotherapy and improve clinical outcomes. \u0000 \u0000SDF-1 alone has a minimal or negligible effects on the survival and growth of normal and malignant hematopoietic cells in vitro, but the SDF-1/CXCR4 axis is involved in the progression and dissemination of a variety of hematologic malignancies and solid tumors [6]. Patients with multiple myeloma and extramedullary plasmacytoma, which is a manifestation of an advanced stage of multiple myeloma, show elevated levels of serum SDF-1 and CXCR4 expression, respectively. Moreover, BM endothelial cells in multiple myeloma patients secrete CXC chemokines, including SDF-1, that mediate interactions with the myeloma cells. Similar findings have been reported in leukemia patients. For example, AML patients with high levels of CXCR4 in CD34+ cells had a significantly lower survival rate and higher probability of relapse than those with low levels of CXCR4. A polymorphism in the SDF-1 gene correlated with the risk of distant tissue being infiltrated by AML cells. Compared to the Philadelphia chromosome (Ph)-negative CD34+CXCR4+ cells, the Ph-positive CD34+CXCR4+ cells from chronic myelogenous leukemia patients showed li","PeriodicalId":23001,"journal":{"name":"The Korean Journal of Hematology","volume":"46 4","pages":"209-10"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5045/kjh.2011.46.4.209","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30398082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV-associated plasmablastic lymphoma diagnosed by fine-needle aspiration cytology.","authors":"Michele Bibas,&nbsp;Andrea Baiocchini","doi":"10.5045/kjh.2011.46.4.214","DOIUrl":"https://doi.org/10.5045/kjh.2011.46.4.214","url":null,"abstract":"which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. A 25-year-old man without any relevant medical history was admitted to our hospital for progressive weakness, fever, night sweats, and weight loss. Physical examination showed several round skin nodules and multiple painless lymph nodes in the axillary and inguinal regions (A). A CT scan revealed diffuse lymphadenopathy and hepatosplenomegaly with multiple liver nodules (B). Percutaneous fine-needle aspiration cytology (FNAC) of a skin nodule revealed large atypical cells with plasmacytoid and anaplastic features, which indicated a lymphoma (C). The diagnosis of plasmablastic lymphoma was confirmed by traditional biopsy of another cutaneous lesion (D). Neoplastic cells were strongly positive (＞95%) for CD138, CD43, and Ki-67, and were negative for CD3, CD20, CD45, MUM-1, EBV, and HHV8. Because this type of lymphoma is mainly associated with HIV, blood samples were tested for HIV antibodies. The HIV RNA load was 389.98 cp/mL, and CD4 ＋ cell count was 76/mm 3. The patient was diagnosed with HIV-associated disseminated extraoral plasmablastic lymphoma. Cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy was initiated for the lymphoma and highly active antiretroviral therapy (HAART) for HIV infection.","PeriodicalId":23001,"journal":{"name":"The Korean Journal of Hematology","volume":"46 4","pages":"214"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5045/kjh.2011.46.4.214","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30398084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential effects of CXCR4 antagonists on the survival and proliferation of myeloid leukemia cells in vitro.","authors":"Ha-Yon Kim,&nbsp;Ji-Young Hwang,&nbsp;Yoon-Suk Oh,&nbsp;Seong-Woo Kim,&nbsp;Hyo-Jin Lee,&nbsp;Hwan-Jung Yun,&nbsp;Samyong Kim,&nbsp;Young-Jun Yang,&nbsp;Deog-Yeon Jo","doi":"10.5045/kjh.2011.46.4.244","DOIUrl":"https://doi.org/10.5045/kjh.2011.46.4.244","url":null,"abstract":"<p><strong>Background: </strong>Antagonists of CXC chemokine receptor 4 (CXCR4), including AMD3100, induce peripheral mobilization of hematopoietic stem cells and have been approved for clinical use. We explored whether the CXCR4 antagonists affected the survival and proliferation of myeloid leukemia cells in vitro.</p><p><strong>Methods: </strong>The effects of CXCR4 antagonists AMD3100 and T140 on the survival and proliferation of myeloid leukemia cell lines (U937, HL-60, MO7e, KG1a, and K562) as well as CD34(+) cells obtained from patients with AML and CML were analyzed by flow cytometry by using annexin V and a colorimetric cell proliferation assay.</p><p><strong>Results: </strong>AMD3100, but not T140, stimulated the proliferation of leukemia cells in vitro in a dose-dependent manner for up to 5 days (~2-fold increase at a concentration of 10(-5) M), which was not abrogated by pretreatment of the cells with pertussis toxin, but was attenuated by RNAi knockdown of CXCR7 transcripts. In contrast, AMD3100 induced a marked decrease in the cell numbers after 5-7 days. AMD3100, but not T140, induced phosphorylation of MAPK p44/p42. AMD3100 increased the number and size of leukemia cell colonies and reduced cell apoptosis during the first 5-7 days of incubation, but the phenomena were reversed during the later period of incubation.</p><p><strong>Conclusion: </strong>The effects of CXCR4 antagonists on the proliferation of myeloid leukemia cells are not uniform. AMD3100, but not T140, exerts dual effects, initially enhancing and subsequently inhibiting the survival and proliferation of the cells in vitro.</p>","PeriodicalId":23001,"journal":{"name":"The Korean Journal of Hematology","volume":"46 4","pages":"244-52"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5045/kjh.2011.46.4.244","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30398593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adenovirus as a new agent for multiple myeloma therapies: Opportunities and restrictions.","authors":"Svjetlana Raus,&nbsp;Silvia Coin,&nbsp;Vladia Monsurrò","doi":"10.5045/kjh.2011.46.4.229","DOIUrl":"https://doi.org/10.5045/kjh.2011.46.4.229","url":null,"abstract":"<p><p>Multiple myeloma is a malignancy of B-cells that is characterized by the clonal expansion and accumulation of malignant plasma cells in the bone marrow. This disease remains incurable, and a median survival of 3-5 years has been reported with the use of current treatments. Viral-based therapies offer promising alternatives or possible integration with current therapeutic regimens. Among several gene therapy vectors and oncolytic agents, adenovirus has emerged as a promising agent, and it is already being used for the treatment of solid tumors in humans. The main concern with the clinical use of this vector has been its high immunogenicity; adenovirus is often able to induce a strong immune response in the host. Furthermore, new limitations in the efficacy of this therapy, intrinsic to the nature of tumor cells, have been recently observed. For example, our group showed a strong antiviral phenotype in vitro and in vivo in a subset of tumors, shedding new insights that may explain the partial failure of clinical trials based on this promising new therapy. In this review, we describe novel therapeutic approaches that implement viral-based treatments in hematological malignancies and address the novelty as well as the possible limitations of these new therapies, especially in the context of the use of adenoviral vectors for treating multiple myeloma.</p>","PeriodicalId":23001,"journal":{"name":"The Korean Journal of Hematology","volume":"46 4","pages":"229-38"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5045/kjh.2011.46.4.229","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30398087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indeterminate lupus anticoagulant results: Prevalence and clinical significance.","authors":"Khaldoun Alkayed,&nbsp;Kandice Kottke-Marchant","doi":"10.5045/kjh.2011.46.4.239","DOIUrl":"https://doi.org/10.5045/kjh.2011.46.4.239","url":null,"abstract":"<p><strong>Background: </strong>Reports of indeterminate lupus anticoagulant (LAC) results are common; however, no published data on their prevalence or clinical significance are available. We investigated the prevalence and clinical characteristics of patients with indeterminate LAC.</p><p><strong>Methods: </strong>We retrospectively reviewed the clinical and serologic characteristics of 256 unselected patients with LAC results.</p><p><strong>Results: </strong>Indeterminate results were observed in 32.7% of LAC profiles that were least frequent (25.4%) when activated partial thromboplastin time (aPTT) was normal, most frequent (39.8%) when aPTT was elevated, and were observed in 35% of patients taking warfarin. The final indeterminate LAC cohort included 65 patients with a mean follow-up of 18 months. Malignancy and autoimmune disease were present in 29% and 25% of patients, respectively. The most common thrombotic events were deep vein thrombosis (DVT) (28%), cerebral ischemic stroke (14%) and pulmonary embolism (14%). Patients with indeterminate results were more likely to be men, older, and with a history of DVT, superficial thrombosis, or myocardial infarction than patients with negative tests (N=106). Concurrent warfarin therapy was more prevalent in the indeterminate group, but was not statistically significant. In the multivariate analysis, none of the variables showed statistical significance. During follow-up, 10 of 16 patients with indeterminate results showed change in classification upon retesting.</p><p><strong>Conclusion: </strong>Patients with indeterminate LAC results were common, and their clinical characteristics differed from those with negative results. There is a need for a prospective study of the clinical history of patients with indeterminate LAC results.</p>","PeriodicalId":23001,"journal":{"name":"The Korean Journal of Hematology","volume":"46 4","pages":"239-43"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5045/kjh.2011.46.4.239","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30398592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary cutaneous B-cell lymphoblastic lymphoma in an elderly man.","authors":"Su-Yeon Cho,&nbsp;Seung-Sook Lee,&nbsp;Dae Hyun Back,&nbsp;Kyung Ah Lim,&nbsp;Ye Rim Lee,&nbsp;Hye Jin Kang","doi":"10.5045/kjh.2011.46.4.283","DOIUrl":"https://doi.org/10.5045/kjh.2011.46.4.283","url":null,"abstract":"<p><p>Precursor B-cell lymphoblastic lymphoma (B-LBL) is an uncommon high-grade neoplasm of immature B cells. It occurs predominantly in childhood with extranodal involvement such as skin and bone. Therefore, primary cutaneous involvement in elderly adults is a very rare manifestation of B-LBL. Here, we report a 78-year-old man with B-LBL presenting as a single cutaneous lesion which was immunohistochemically positive for leukocyte common antigen (LCA), CD79a, paired box 5 (PAX5), B cell lymphoma-2 (bcl-2), and terminal deoxynucleotidyl transferase (TdT) staining, but was without systemic involvement. The patient was treated using cyclophosphamide, adriamycin, vincristine, and prednisolone (CHOP), and achieved complete response (CR) at the first response assessment conducted after 3 CHOP cycles. After an additional cycle of CHOP treatment, radiotherapy was administered at a total dose of 3,600 cGy over 4 weeks. At the 21-month follow-up, he had maintained CR.</p>","PeriodicalId":23001,"journal":{"name":"The Korean Journal of Hematology","volume":"46 4","pages":"283-6"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5045/kjh.2011.46.4.283","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30398599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fludarabine-containing chemotherapy for patients with previously untreated low-grade non-Hodgkin's lymphoma.","authors":"Jae-Sook Ahn,&nbsp;Deok-Hwan Yang,&nbsp;Sung-Hoon Jung,&nbsp;Soo-Young Bae,&nbsp;Huong Thi Thanh Tran,&nbsp;Hyung Chul Park,&nbsp;Ha-Na Kim,&nbsp;Yeo-Kyeoung Kim,&nbsp;Hyeoung-Joon Kim,&nbsp;Je-Jung Lee","doi":"10.5045/kjh.2011.46.3.180","DOIUrl":"https://doi.org/10.5045/kjh.2011.46.3.180","url":null,"abstract":"<p><strong>Background: </strong>The clinical efficacy and safety of fludarabine combination chemotherapy was investigated for the treatment of previously untreated patients with low-grade (NHL).</p><p><strong>Methods: </strong>Twenty-five patients who were newly diagnosed as low-grade NHL were treated with fludarabine combination chemotherapy. Fludarabine combination regimens consisted of fludarabine, mitoxantrone and dexamethasone or fludarabine, cyclophosphamide and mitoxantrone with or without rituximab and repeated every 4 weeks.</p><p><strong>Results: </strong>The median age was 60 years (range, 35-77 years), with 13 of 25 patients (52%) ≥60 years of age. Seven of 25 patients (28%) with an intermediate risk follicular lymphoma international prognostic index (FLIPI) and 9 of 25 patients (36%) with a high risk FLIPI were enrolled in this study. The delivered median number of chemotherapy was six (range, 2-9 cycles). The overall response rate with fludarabine-based treatment was 88%, including 52% complete remission and 36% partial remission. During the median follow-up of 19 months, the estimated 2-year event-free survival was 63±10% (95% CI, 43-83) and the 2-year overall survival was 78±9% (95% CI, 60-96). Fludarabine combination chemotherapy was frequently associated with grade 3 or 4 neutropenia in 84% patients. However, neutropenic infection was observed in only one (4%) patient. Four patients (16%) showed grade 3 or more non-hematologic toxicities, such as acute coronary syndrome, intracranial hemorrhage, anaphylaxis and gastric cancer.</p><p><strong>Conclusion: </strong>Fludarabine-combination treatment was a highly active regimen with well toleration in untreated low-grade NHL.</p>","PeriodicalId":23001,"journal":{"name":"The Korean Journal of Hematology","volume":"46 3","pages":"180-5"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5045/kjh.2011.46.3.180","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40138108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}