We conclude that HCV-positive patients with DLBCL treated with rituximab plus CHOP have high incidence in hepatic toxicity. Specific protocols evaluating antiviral therapy should be designed for these patients.
Background and objectivesMyeloid leukemias (MLs) are clonal stem cell disorders affecting myeloid lineage cells. Advances in cytogenetic and molecular studies partially disclosed the mystery about risk factors and pathophysiology of MLs. Regarding incidence, risk factors, response to treatment, and overall survival of patients, research showed differences among different countries. However, the Western registry data are the basis for the documented description of MLs in medical textbooks. This research aimed to study MLs in Middle Eastern health centers. Egypt has the highest population in the Middle East; furthermore, 96.6% of the population is native Egyptians; accordingly the study focused on Egypt.Patients and methodsData of 468 patients with MLs were collected from hospital records at two big tertiary health centers. They were grouped into group 1 (chronic myeloid leukemia, CML) and group 2 (acute myeloid leukemia, AML); the latter was subgrouped into 2a (primary AML) and 2b (secondary AML).Results and conclusionsThe median age of patients was 43 years; males predominate in group 2a and females in groups 1 and 2b. 37.2% of group 1 patients were treated with Gleevec. Hematopoietic stem cell transplantation was planned for only 5% of group 2 and 18% relapsed. Of groups 1 and 2 patients, 25% and 12%, respectively, stopped follow up, and 15% and 35% died. ORR and overall survival were 53%, 27% and 7%, 0.4% for groups 1 and 2, respectively. Conclusively, this study showed a young age of ML patients, with female predominance in CML, and poor outcome. This reflected racial, ethnic and risk factor differences in incidence of MLs.
Background: This study was performed to evaluate the efficacy and safety of switch maintenance therapy with oral vinorelbine in advanced non-small cell lung cancer (NSCLC) with adenocarcinoma limited to epidermal growth factor receptor (EGFR) wild type. Materials and Methods: In this single randomized trial, patients with advanced stage (IIIB and IV) NSCLC with adenocarcinoma EGFR wild-type status, treated with 6 cycles of platinum based chemotherapy. Patients did not show progression after first-line chemotherapy were randomly assigned to receive switch maintenance with vinorelbine (80 mg/m 2 , day 1, 8) (group I) or the best supportive care until disease progression (group II). Results: The median progression free survival (PFS) was 9.7 months for group I versus 5.7 months for group II with statistically significant difference between both groups [HR = 1.15; 95% CI 1.19 to 1.49; P value = 0.002], while the median overall survival (OS) was 13.2 months for group I versus 11.9 months for group II with no statistically significant differences between both groups [HR = 1.24; 95% CI 1.05 to 1.46; P value = 0. 3]. The patients who received oral vinorelbine had tolerable toxicity profile. Conclusion: Switch maintenance therapy with oral vinorelbine, though improve PFS, did not improve OS in patients with NSCLC with adenocarcinoma EGFR wild type.
Background and Aim: The treatment of choice for relapsed or refractory Non-Hodgkin Lymphoma (NHL) mainly, is High dose chemotherapy with autologous stem cell transplantation. However, its use is mostly restricted to patients responding to salvage chemotherapy. In this study, our aim was to evaluate outcome and toxicity of different treatment modalities of relapsed and refractory NHL. Patient and Methods: This retrospective study included 217 patients were diagnosed as refractory or relapsed NHL. Those patients received different treatment modalities as GDP (Gemcitabine, dexamethasone, cisplatin), DHAP (Dexamethasone, Cytarabine, and Cisplatin), MINE (Mitoxantrone, ifosfamide, etoposide and mesna), CHOP (Cyclophosphamide, Doxorubicin, Vincristine and Prednisone), and CVP (Cyclophosphamide, vincristine and prednisone). Results: The median age of patients in the study was 50 years. Patients who received DHAP showed ORR of 62%, which was the highest response. The most common adverse effects were hematological which were more noticed in patients, received CHOP. Sixty one patients (54.5%) had anemia, 54 patients (48.2%) had neutropenia and 55 patients (49.1%) had thrombocytopenia, but the difference between the different lines of treatment wasn't significant p value of 0.95. The median time to relapse is 10 months and the median survival time is 40 months. The 3-year PFS rates of all patients were 49.3%, while the 3 year OS rates were 54.8%. Conclusion: The overall and PFS didn't show any difference between different lines of treatment.
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