Background Chemotherapy, radiation and autologous bone marrow transplant are conventional standard therapies in Non-Hodgkin's lymphoma (NHL). Nowadays the introduction of monoclonal antibodies has enhanced the specificity of treatment, reducing the toxicity and presenting synergism with conventional chemotherapy. Purpose To compare rituximab efficacy and safety in combination with CHOP chemotherapy (cyclophosphamide, adriamycin, vincristine and prednisone) in the treatment of NHL in our hospital, with that published in the literature. Materials and methods Retrospective observational study of 116 patients diagnosed with NHL who received chemotherapy with R-CHOP (rituximab-CHOP) between January 2005 and December 2010. The authors reviewed the medical history (100%) and the data were analysed using SPSS predictive analytics software. Were recorded: demographic data (age, sex); efficacy (complete response (CR), partial response (PR), overall response rate (ORR), progression and relapse, overall survival (OS) and event free survival (EFS)); toxicity (haematological and non-haematological). Results 53.5% of patients were male and mean age at diagnosis was 59 years. The authors obtained an ORR of 80.2% (71.3% CR and 8.9% PR). 14.8% of patients did not respond, and 5% had an unknown response. The progression and relapse rates were 18.8% and 17.8% respectively. Projected median OS for responding patients was over 30 months and EFS after one year was 70.3%. Neutropenia, anaemia and thrombocytopenia rates were reported as 15.8%, 12.4% and 2.3% respectively. Infusion-related reactions were reported in 1.95% of patients, 72.2% during the first session. The detected rate of infection was relatively low, and 3.5% of all infections were microbiologically documented. Conclusions The results obtained were comparable to those of published studies in the literature for the treatment arm with R-CHOP in randomised patients (GELA NHL-95.5 study group, U.S. Intergroup Study, Mabthera International Trial MINT study). Neutropenia rates were higher than those found in the study of McLaughlin et al, while the other cell lines the results were similar.
BackgroundThe chemokine C-X-C Motif Chemokine Ligand 10 (CXCL10) has been found to be elevated in those patients with psoriasis (PsO) who will develop psoriatic arthritis (PsA), thus being proposed as a predictor of joint involvement [1]. CXC10 progressively declines in these PsO patients until the diagnosis of PsA and further, in parallel with the duration of the disease [2]. In contrast, CXCL10 remains invariable on time in the rest of PsO patients. Subclinical ultrasound synovitis may be considered a pre-disease state of PsA [3]. CXCL10 serum levels in patients with preclinical PsA are still unknown.ObjectivesTo better characterize the preclinical phase of PsA and to assess the relationship of CXCL10 levels with subclinical joint involvement in PsO patients.Methods62 patients with PsO without PsA were included, all of them naïve to biological therapy. Ultrasonography (US) was performed on the wrist and metacarpophalangeal 1–5 joints (MCP), proximal interphalangeal 1–5 joints (PIP), and distal interphalangeal 2–5 joints (DIP) bilaterally, and grey scale (GS) synovitis were scored semiquantitatively (0–3) using the OMERACT scoring system. Serum CXCL10 levels were also determined by ELISA in all the patients.Results31 men and 31 women were recruited. GS synovitis ≥1 was present in 30 patients, 10 men and 20 women, while only 7 patients exhibited GS synovitis ≥2, 4 men and 3 women. The mean logCXCL10 was inferior in patients showing any grade of GS, both in the whole group and after stratifying by sex (Table 1), although the difference was only statistically significant for grade 1 of GS in men (p=0.02) and grade 2 of GS in women (p=0.02).ConclusionPsO patients with subclinical synovitis show lower serum levels of CXCL-10 than patients without it, as occurs in patients with established PsA. This finding confirms a close relationship between this biomarker and joint involvement in PsO and supports its potential use as a predictor marker in the preclinical phase of PsA.Reference[1]Arthritis Rheumatol. 2016 Dec;68(12):2911-2916. [2] Br J Dermatol. 2020 Nov;183(5):920-927. [3] Nat Rev Rheumatol. 2021 Apr;17(4):238-243.GroupVariableCategoryLogCXCL10 Mean ± SDpp*PsOPresence of GS synovitis ≥1 in handsYes(n=30)3.3 ± 1.10.070.13No(n=32)3.8 ± 1.1Presence of GS synovitis ≥2 in handsYes(n=7)2.9 ± 0.90.150.22No(n=55)3.6 ± 1.1Male PsOPresence of GS synovitis ≥1 in handsYes(n=10)2.9 ± 0.90.020.02No(n=21)3.9 ± 1.2Presence of GS synovitis ≥2 in handsYes(n=4)3.4 ± 0.51.000.96No(n=27)3.6 ± 1.3Female PsOPresence of GS synovitis ≥1 in handsYes(n=20)3.5 ± 1.10.760.98No(n=11)3.6 ± 1.0Presence of GS synovitis ≥2 in handsYes(n=3)2.2 ± 0.80.020.03No(n=28)3.7 ± 1.0*Adjusted by sex and age at the study in the PsO group and by age at the study in the male and female PsO groups.AcknowledgementsThis study was funded by Instituto de Salud Carlos III (ISCIII) through the project PI20/00059, co-funded by European Regional Development Fund (ERDF), and by NVAL19/22 (IDIVAL) awarded to JR-G. VP-C is supported by PI18/00042 (ISCIII), co-funded by ERDF. RL-M is recipient of the grant CPII21/00004 (ISCIII), co-funded by the European Social Fund. MSM-G is supported by TRANSVAL22/01 (IDIVAL). JR-G is beneficiary of a program of intensification funded by ‘Fundación Española de Reumatología (FER)´.Disclosure of InterestsVerónica Pulito-Cueto: None declared, Susana Armesto: None declared, Sara Remuzgo-Martínez: None declared, Raquel López-Mejías: None declared, María Sebastián Mora-Gil: None declared, J. Gonzalo Ocejo-Vinyals: None declared, Alfonso Corrales: None declared, Vanesa Calvo-Río: None declared, Ana María Salas Martínez: None declared, Marcos González López: None declared, Cristina López-Obregón: None declared, Elena Aurrecoechea: None declared, Luis Rodriguez Rodriguez: None declared, Carolina Aguirre Portilla: None declared, Miguel A González-Gay Speakers bureau: Abbvie, Pfizer, Roche, Sanofi, Lilly, Celgene, MSD and GSK, Grant/research support from: Abbvie, MSD, Jansen and Roche, Ricardo Blanco Speakers bureau: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen and MSD, Consultant of: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen and MSD, Grant/research support from: Abbvie, MSD and Roche, Fernanda Genre Romero: None declared, Javier Rueda-Gotor: None declared.
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