11:57,28,Jun,2005 | (10813/0/0) | Original

treatment for non hodgkin's lymphoma

[Abstract] Objective: To investigate the EMCOP in the treatment of non-Hodgkin's lymphoma patients. Methods: EMCOP combined with chemotherapy (VP-16, MTN, CTX, VCR, Pred) treatment of non-Hodgkin's lymphoma 30 cases. Among them, the initial treatment in 24 cases, 6 cases of retreatment. And impact of drug toxicity and efficacy factors were analyzed. Results: 30 patients with non-Hodgkin's lymphoma complete remission rate was 66.7%, partial response rate of 23.3%, 90.0% total efficiency, 2-year survival rate of 53.3%. Conclusion: EMCOP program for the treatment of non-Hodgkin's lymphoma chemotherapy better, whether this group of cases in the initial treatment or retreatment are more effective than CHOP program.
[Key words] non-Hodgkin's lymphoma; podophyllotoxin ethylidene glucoside; mitoxantrone
[CLC] R733.4 [Document code] C [Article ID] 1673-7210 (2008) 09 (a) -036-02
Non-Hodgkin's lymphoma (non-Hodgkin's lymphoma, NHL) is a highly heterogeneous group of lymphoid malignancies. Clinically, mostly CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) as first-line combination chemotherapy programs, domestic and international coverage of its 45% complete remission rate was 55%, total effective rate was 70% 90%, 2 to 3 year survival rate was 40% [1]. To further improve the response rate and prolong survival or response time, we EMCOP program combined with chemotherapy NHL 30 patients achieved good effect, are reported as follows:
1 Materials and Methods
1.1 General Information
Our hospital in January 2002 ~ December 2007 to EMCOP in the treatment of NHL 30 patients, all patients were diagnosed by lymph node biopsy NHL.
treatment for non hodgkin s lymphoma

Introduction in English: Non-Hodgkin's Lymphoma and continue to reflect the heterogeneity of the disease and the biological basis of cell origin of new insights. Course of varying lengths, from no obvious symptoms are resistant to the rapid and early death. In some types of NHL, 50% of the children and about 20% of adult patients with leukemia-like changes. epidemiology in the United States each year, about 50,000 cases of NHL incidence in the 4% of all cancers and all cancers each year in the proportion of deaths caused by NHL accounts for 4%. In the past few decades the incidence of NHL increased stability was sustained growth of 3% each year than most
Non-Hodgkin's lymphoma cancer growth in sub-fast, partly due to the AIDS epidemic, and the other may also be other unknown causes. Italian study on 1388 cases of NHL were analyzed showed immune suppression and HIV prevalence can not explain the NHL's growth trend, while the delayed infection (delayed infection) Th1/Th2 lymphocytes by increasing the damage risk of NHL can be explained by continued growth in the current NHL . NHL patients with bacterial or viral infection for the first time the
age was significantly higher. And the first occurrence of infectious disease incidence of older age can increase the risk of NHL small, family only people of high social status was not found when the HL and the first age-related infection. NHL NHL men more common than women, whites are more common than the other races, unknown or the reasons for this may be due to genetic factors in some ethnic differences in certain NHL subtypes, such as the reticular tissue lymphoma is very obvious it a large proportion of Western countries are rare in developing countries. Singapore in 1996 and 1968 to 1992 of 1988 cases of NHL patients were analyzed: the Chinese and Malaysians, the incidence of NHL were tested growth trends, and the women (1968 to 1972 the incidence was 1.8/10 million to 1988 ~ 1992 4.5/10 million) grew faster than men (at the same time period increased to 5.9/10 3.2/10 million million) in the lymphatic system to other diseases, genetic factors may also play an important role, such as chronic lymphocytic lymphoma (chronic lymphocytic lympahoma, CLL) and multiple myeloma, CLL in Asian populations is very low and the incidence of multiple myeloma in African Americans (African Americans) in the incidence rate increased. On the other hand, some countries, especially common in certain lymphomas and viral infections such as EBV (as in South America and Asia, more common in the NK-cell lymphoma or Burkitt lymphoma-prone Africa) HTLV-â…  (as in the Caribbean and Asia common adult T cell leukemia / lymphoma), or hepatitis virus C (more common in northern Italy, and Japan B-cell lymphoma, particularly immunoblastic lymphoma). In most cases disseminated disease, NHL non-specific risk factors. However, epidemiological studies reveal the NHL major risk factors for the environment, diet, immune status and infection. Environmental and occupational factors in the agricultural workers, NHL incidence in the general population. Numerous studies show that exposure to pesticides and herbicides 24 - dichlorophenoxyacetic acid (24-dichlorophenoxyacetic acid ,2,4-D) can increase the risk of NHL. The United States over the past 40 years, pesticide use was growing trend, through the family garden and lawn food and water directly through the extensive exposure to pesticides in addition to the field of pesticides in surface water nitrate pollution in some parts of the United States is also a serious The problem, to a certain extent with a high incidence of NHL in addition to agricultural work on other career but also have a higher risk of NHL. These occupations include work exposure to chemical agents, such as chemists Dry Cleaning workers, printing workers, carpenters, beauticians and other exposure to acetic acid (phenoxyacetic acid), especially benzene, chloroform and the solvent is also increased risk of NHL, especially the use of permanent hair dye increase the risk of preparation and the NHL. A study reveals that application of hair coloring agents in the NHL NHL caused about 20% of cases. Nutrition and diet studies have shown that increased intake of protein or vitamins and vegetable intake to reduce disease progression and the NHL two European studies found that milk intake increased incidence of NHL increased and correlated high intake of milk (> 2 cups / d) NHL 2-fold increase in the risk; Nebraska (Nebraska), a study reported that cancer risk is limited to men. In a study of the United States 88,410 cases and 47,336 cases of women, men, only the application of vitamin A, C and E or multivitamins is increased risk of NHL were studied. Studies show that women using a variety of vitamins can increase risk of NHL and men are not affected, only application of vitamin A, C and E and the incidence of NHL has nothing to do. For women, only the application of vitamins AC and E can increase the risk of NHL. But the risk of secondary applications in a variety of vitamins after. In addition, whether male or female long-term regular use of vitamin AC and E or multivitamins and fatal NHL has nothing to do. Smoking has been that smoking increases the risk of NHL, but the results of epidemiological studies do not fully support this Jielun epidemiological studies in Australia, five cohort studies 4 revealed the incidence of smoking and NHL but 3 of Wu Guan a preference not to smoke. 14 case-control study 8 revealed the current and (or) no previous relationship between smoking and NHL incidence, but five studies tend not to smoke another study found that serious risk of smoking can increase the incidence of NHL, especially the 45 years of age. Therefore, the current epidemiological study did not confirm that smoking increases the risk of NHL, but there is no evidence that the incidence of smoking has nothing to do with the NHL. Immune pathogenesis of immune suppression increases the risk of NHL. The best example is the increased incidence of AIDS NHL patients with other immune deficiency states such as rheumatoid arthritis, sjogren syndrome, and organ transplantation increases the risk of NHL. In many cases of immune deficiency in the NHL, the risk of infection with EBV. Infection of certain infectious factors can greatly increase the risk of NHL. Some infectious agents can cause different types of NHL, but some other infectious agent related to a particular subtype. (1) EBV: causes lymphoid malignancy is the most important pathogens of many EBV it with NHL and HL subtypes and EBV-related NHL related, including Burkitt lymphoma, lymphomatoid granulomatosis NK / T cell lymphoma in a These angioimmunoblastic lymphoma and intestinal T-cell lymphoma and other Chinese study reported a larger series, NHL 14% positive rate of EBV, but EBV is rare due to gastric lymphoma mycosis fungoides (MF) T cells in the skin lymphoma (CTCL), a clinical subtype of skin tumor cell invasion. The cause of CTCL has not been clear. Recently, a Japanese study detected by DNA in situ hybridization 7 cases of MF in all cases are detected EBV DNA, and detected by polymerase chain reaction in most cases have EBV DNA. Immunohistochemistry and RNA in situ hybridization also confirmed the existence of the above results show that EBV, EBV and the pathogenesis of CTCL. (2) HTLV-â…  (human T cell lymphoma / leukemia virus): 1980, U.S. and Japanese scholars isolated a virus and adult T-cell lymphoma / leukemia is closely related to the HTLV-â… ; Although most of the gastric mucosa-associated lymphoid tissue (MALT) lymphoma by the Helicobacter pylori (Hp) causes, but HTLV-â…  infection can also lead to MALT lymphoma. Virus infection is generally believed that tumors are two possible ways: direct viral induced lymphocyte transformation; have abnormal lymphocytes susceptible to virus infection, and on this basis for further transformation. (3) HCV: a recent study found that hepatitis virus C (HCV) infection increases the risk of NHL B cells, especially immune cells and growth of tumors in the liver and a large number of studies reported that the salivary gland lymphoma, HCV is the cause of B cell lymphoproliferative disease (LPD) of the pathogens. A Japanese study also revealed B cell NHL in patients with HCV infection was significantly higher than that of non-B cell NHL, and HCV-positive B-cell NHL patients, liver involvement and liver a number of cases of the more common cardiac death reported in the course of chronic hepatitis C virus infection lymphoma in the spleen can occur. (4) HIV: NHL to one of AIDS-related tumors, 1988 to 1998, reported AIDS cases in Western Europe the incidence of NHL and 3.9% from 3.8% in 1988 to 5.3% in 1998. In the HIV / AIDS in low-grade adult relative risk of NHL (RR) was 14, high grade NHL, RR, 300 or more. Developing countries compared with Western European countries such as Africa, A1DS related lower the incidence of NHL. Italian epidemiological study found that from 1985 to 1994, 15 AIDS, 49, 136 cases of NHL patients in the same age group accounted for 8% of all NHL in the AIDS 1 year before diagnosis and 3.5 years after diagnosis, AIDS patients with NHL overall standardized incidence rate (SIR) for the 302 in the diagnosis of AIDS within 3 months after the SIR is particularly high for the 394, then decreased to 170 women (428) than men (280) SIR slightly higher, intravenous drug injection (299) and other HIV infection (309) SIR fairly high degree of malignancy in AIDS patients with NHL, especially immunoblastic type and the incidence of Burkitt lymphoma, 2 times the non-AIDS patients; the contrary, the incidence of low-grade NHL than in AIDS patients AIDS patients with non-AIDS patients compared with non-AIDS, NHL involvement of the brain were more common in AIDS patients in the group of grade NHL had no effect on the survival, overall survival is very low (2-year survival rate was 10%). (5) HHV-8: human herpes virus -8 (HHV-8), also known as Kaposi's sarcoma-associated herpes virus (Kaposi's sarcoma associated herpesvirus) is a new DNA virus and the pro-lymphatic recently proposed NHI is a rare PEL (characteristic of the body cavity lymphoma / primary effusion lymphoma, primary effusion lymphoma) and most also have HIV related infection. In the course of the disease has been the growth of tumor cells in the body cavity in the liquid without the formation of lumps and other viruses of different HHV-8 virus-encoded protein homologous to several people, including cytokines (IL-6, MIPSIRFS) and regulatory proteins (cycle Su D, G protein receptor), affecting B cell growth thus play an important role in the pathogenesis of PEL. Another study found that, LANA2 overexpression of HHV-8 infection in B cells LANA2 caused by inhibiting the p53 tumor which needs to be further confirmed. (6) other infection factors: Bo burgdorferi (Borrella burgdorfferi) is caused by Lyme disease (Lyme's Disease) pathogens, some of it associated with cutaneous lymphoma of one of our studies have shown that human herpes virus -6 (human herpesvirus-6 , HHV-6) virus may be involved in lymphoma pathogenesis of radiation exposure to chemotherapeutic drugs is not generally considered the main factor in the pathogenesis of NHL, but exposure to certain chemicals is the NHL major risk factors. HL NHL after the cumulative incidence rate of 1% to 6% recently, the German Hodgkin Lymphoma Study Group (GHSG) large amounts of data indicate that 5406 cases occurred HL HL patients after chemotherapy in 42 cases of secondary NHL the rate was 0.9% . Slightly lower than previously reported. 7. Other blood transfusion can increase the risk of NHL 1.5 to 2.5 times the risk may be infected with the transfer of the relevant factors and immunosuppressive effects. NHL familial and genetic immune defects that have a family history of leukemia or lymphoma population, the occurrence of inertia 3.3 times increased risk of lymphoma. Cause of the cause of non-Hodgkin lymphoma involving viruses, bacteria, radiation, certain chemicals and herbicides agent multiple factors. Known high incidence of EB virus and Burkitt lymphoma and extranodal T / NK cell lymphoma nasal type on adult T-cell lymphoma / leukemia virus and human pro-T cells in type â…  (HTLV1) closely related infection. Gastric mucosa-associated lymphoid tissue lymphoma is a response to H. pylori infection caused by lesions of malignant transformation start radiation exposure, such as survivors of nuclear explosions and nuclear reactor accidents, radiotherapy and chemotherapy in patients with non-Hodgkin lymphoma cancer incidence increased risk. AIDS certain genetic diseases or acquired immune deficiency diseases such as autoimmune own ataxia - telangiectasia United Immune Deficiency Syndrome, rheumatoid arthritis, systemic lupus erythematosus, Sjogren's syndrome (Sjogren's syndrome, Sj
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