VR-CAP was more effective than R-CHOP in patients with newly diagnosed mantle-cell lymphoma but at the cost of increased hematologic toxicity. (Funded by Janssen Research and Development and Millennium Pharmaceuticals; LYM-3002 ClinicalTrials.gov number, NCT00722137.).

Monthly monitoring of HBV DNA is useful for preventing HBV reactivation-related hepatitis among B-NHL patients with resolved HBV infection following R-steroid-chemo (UMIN000001299).

Central nervous system (CNS) events, including CNS relapse and progression to CNS, are known to be serious complications in the clinical course of patients with lymphoma. This study aimed to evaluate the risk of CNS events in patients with diffuse large B-cell lymphoma in the rituximab era. We performed a retrospective survey of Japanese patients diagnosed with diffuse large B-cell lymphoma who underwent primary therapy with R-CHOP chemoimmunotherapy between September 2003 and December 2006. Patients who had received any prophylactic CNS treatment were excluded. Clinical data from 1221 patients were collected from 47 institutions. The median age of patients was 64 years (range, 15-91 years). We noted 82 CNS events (6.7%) and the cumulative 5-year probability of CNS events was 8.4%. Patients with a CNS event demonstrated significantly worse overall survival (P < 0.001). The 2-year overall survival rate after a CNS event was 27.1%. In a multivariate analysis, involvement of breast (relative risk [RR] 10.5), adrenal gland (RR 4.6) and bone (RR 2.0) were identified as independent risk factors for CNS events. We conclude that patients with these risk factors, in addition to patients with testicular involvement in whom CNS prophylaxis has been already justified, are at high risk for CNS events in the rituximab era. The efficacy and manner of CNS prophylaxis in patients for each involvement site should be evaluated further. (Cancer Sci 2012; 103: 245-251) T he central nervous system (CNS) is thought to be a sanctuary for lymphoma cells from systemic chemoimmunotherapy, such as rituximab (R) plus CHOP (cyclophosphamide [CPA], doxorubicin [adriamycin, ADR], vincristine [VCR] and prednisolone [PSL]), because standard doses of these drugs do not adequately penetrate the CNS. Occurrence of a CNS event, defined as CNS relapse during systemic complete remission or CNS progression during concurrent systemic active lymphoma, is associated with extremely poor prognosis, with median survival of <6 months.(1-6) Many studies concerning CNS prophylaxis have been conducted; however, the efficacy of such prophylaxis in preventing CNS events is controversial. (5,(7)(8)(9)(10)(11)(12) The discrepancies between reports might be due to the differences in the various subtypes of lymphoma histology and the variability of treatment of CNS prophylaxis. (13)(14)(15)(16) In addition, R has had a substantial impact on outcomes in patients with diffuse large B-cell lymphoma (DLBCL).(17) It is thus necessary to re-evaluate the risk of CNS events in the R era.The present study comprises a multicenter retrospective analysis of patients with uniform DLBCL histology who have undergone uniform treatment with R-CHOP, widely accepted as the standard therapy in the R era. Patients who received any CNS prophylactic treatment, such as intrathecal chemotherapy, intraveneous high-dose methotrexate or whole brain irradiation, were excluded to evaluate the natural risk of CNS events in R-CHOP therapy. This study also took particular note of the evaluation ...

No abstract

Summary:therefore determined the incidence of VOD using the McDonald's criteria and analyzed the clinical characteristics of patients with VOD and those without it. One hundred and thirty-seven consecutive patients who received bone marrow or peripheral blood stem cell transplantation were studied retrospectively to identify the risk factors for hepatic veno-occlusive disease Materials and methods (VOD). Of the 137 recipients, twenty (14.6%) patients were diagnosed with VOD using the McDonald's criPatients teria. In these 20 patients with VOD, we analyzed various clinical parameters, including age, sex, HLA status, One hundred and thirty-seven consecutive patients (52 conditioning regimen, irradiation, immunosuppressive males and 85 females) underwent bone marrow transplanagents, mode of transplantation, history of hepatic dystation (including peripheral blood transplantation) for function, pre-transplant hepatic and renal function, hematological malignancies and severe aplastic anemia at infectious episodes, antibiotics use, and serum viral titour institution between September 1989 and October 1995. ers. A history of hepatic dysfunction and low levels ofThe average age of patients was 29.9 (6-51) years old. pseudocholinesterase before transplantation were found to be statistically significant (P = 0.04 and 0.04). LowConditioning regimens and graft-versus-host disease levels of pseudocholinesterase were significant by multi-(GVHD) prophylaxis variate analysis using the logistic regression model (P = 0.02). These results suggest that pseudocholinester-The primary disease for which transplantation was carried ase levels before transplant are important markers of out, transplantation procedures and immunosuppressive VOD in patients receiving BMT.agents used are summarized in Table 1.