• Asian Pacific Journal of Cancer Prevention
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• 제15권4호
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• pp.1703-1706
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• 2014

Background: The current standard treatment for patients with newly diagnosed diffuse large B cell lymphoma (DLBCL) is rituximab combined with cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP). A significant number of patients were not treated with recommended dose of rituximab due to limited financial resources in Malaysia. This study evaluates the efficacy of R-CHOP like chemotherapy in Malaysian patients with DLBCL. Materials and Methods: The study comprised a retrospective analysis of patients with DLBCL treated at a single centre. The outcome was compared with patients who were treated with R-CHOP like and CHOP like chemotherapy. Patients who were treated with lower dose of rituximab was subanalysed for outcome. Results: A total of 86 patients who had CHOP-like chemotherapy were included. Only 39 (45%) patients had rituximab and only 12 (29%) patients had the recommended dose. The overall response (OR) and complete response (CR) rates were 88% and 81% respectively. There was no significant difference in OR and CR in patients who had rituximab and those without rituxmab. Those with International Prognostic Index (IPI) score of ${\leq}2$ had significant higher CR rate, progression free survival (PFS) and overall survival (p<0.001). Conclusions: The lack of significant improvement in CR and DFS in our patients may be due to an inadequate dose of rituximab.

• Radiation Oncology Journal
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• 제35권4호
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• pp.317-324
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• 2017

Purpose: This study evaluated outcomes of radiotherapy (RT) after chemotherapy in limited-stage head-and-neck diffuse large B-cell lymphoma (DLBCL). Materials and Methods: Eighty patients who were treated for limited-stage head-and-neck DLBCL with CHOP (n = 43) or R-CHOP (n = 37), were analyzed. After chemotherapy, RT was administered to the extended field (n = 60) or the involved field (n = 16), or the involved site (n = 4). The median dose of RT ranged from 36 Gy in case of those with a complete response, to 45-60 Gy in those with a partial response. Results: In all patients, the 5-year overall survival (OS) and disease-free survival (DFS) rates were 83.9% and 80.1%, respectively. In comparison with the CHOP regimen, the R-CHOP regimen showed a better 5-year DFS (86.5% vs. 73.9%, p = 0.027) and a lower rate of treatment failures (25.6% vs. 8.1%, p = 0.040). The volume (p = 0.047) and dose of RT (p < 0.001) were significantly reduced in patients treated with R-CHOP compared to that in those treated with CHOP. Conclusion: The outcomes of RT after chemotherapy with R-CHOP were better than those of CHOP regimen for limited-stage head-and-neck DLBCL. In patients treated with R-CHOP, a reduced RT dose and volume might be feasible without increasing treatment failures.

• 대한영상의학회지
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• 제81권3호
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• pp.707-713
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• 2020

간문맥 종양혈전이 있으면서 간 실질에 이상 소견이 없는 것은 매우 드문 일이다. 간에서 종양 혈전이 있는 경우 간세포암이 가장 발생률이 높으며 림프종은 감별질환으로 잘 생각되지 않는다. 림프종의 종양혈전이 간문맥을 침범한 것은 이제까지 총 네 가지 경우에서만 보고되어 있고, 모든 경우에서 종양이 혈관으로 직접 전파되거나 또는 그 외의 림프종을 시사하는 다른 병변들이 있었다. 혈관 내 대세포 림프종이 간문맥을 함께 침범한 경우, 본 케이스와 영상학적으로 비슷하게 보일 수 있으나 본 증례 보고는 혈관 내 대세포 림프종이 아니므로 제외하여 생각하였다. 미만성 거대 B세포 림프종이 간문맥에서만 발견된 무증상의 면역력이 정상인 67세 여자 환자에 대한 증례를 소개한다. 이전에 발표된 증례에서 이와 비슷한 경우는 보고된 바가 없다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.929-934
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• 2013

Aim: To analyze the significance of different clinical factors for prognostic prediction in diffuse large B-cell lymphoma (DLBCL) patients. Methods: Two hundred and twenty-seven DLBCL patients were retrospectively reviewed. Patients were managed with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) regimen or rituximab plus the CHOP (RCHOP) regimen. Results: Lactate dehydrogenase (LDH), ${\beta}2$-microglobulin (${\beta}2$-M), B symptoms, Ann Arbor stage and genetic subtypes were statistically relevant in predicting the prognosis of the overall survival (OS). In the CHOP group, the OS in patients with germinal center B-cell-like (GCB)(76.2%) was significantly higher than that of the non-GCB group (51.9%, P=0.032). With RCHOP management, there was no statistical difference in OS between the GCB (88.4%) and non-GCB groups (81.9%, P=0.288). Conclusion: Elevated LDH and ${\beta}2$-M levels, positive B symptoms, Ann Arbor stage III/IV, and primary nodal lymphoma indicate an unfavorable prognosis of DLBCL patients. Patients with GCB-like DLBCL have a better prognosis than those with non-GCB when treated with the CHOP regimen. The RCHOP treatment with the addition of rituximab can improve the prognosis of patients with DLBCL.

• 생명과학회지
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• 제30권4호
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• pp.379-385
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• 2020

Phlojodicarpus sibiricus와 Artemisia kruhsiana Besser는 러시아 극한 지방에서 자생하며, 민간요법으로 널리 쓰여 왔다. 최근 연구에 따르면, 두 식물 추출액(PSE와 AKBE)은 항비만효과, 혈관신생 억제 효과 등 다양한 의학적 효과를 가진 것으로 나타났다. 본 연구논문에서는 PSE와 AKBE의 항림프종 효과와 기작을 분석하였다. PSE와 AKBE를 다양한 유전적 변이를 가진 DLBCL 세포주에 처리하였을 때, 농도 의존적으로 세포 생존율이 감소하였다. 하지만, 마우스의 골수나 비장으로부터 분리한 정상 세포에는 거의 영향을 미치지 않는 것으로 보아, 두 식물 추출액의 세포사멸 효과는 종양세포 특이적인 것으로 예상되며, 환자에 적용할 경우 부작용이 최소한만 나타날 것으로 예상된다. PSE와 AKBE의 세포사멸 효과는 Bcl-2, Bcl-xL, 그리고 Mcl-1 등의 anti-apoptotic Bcl-2 family member 유전자의 감소로 인한 미토콘드리아의 막 전위 붕괴에 기인함을 증명하였다. 흥미롭게도, 두 식물 추출액에 의한 세포사멸 효과는 Myc 종양유전자와는 독립적으로 일어났다. 이 결과를 종합하면, PSE와 AKBE는 항림프종 효과를 보유하고 있으며, 추후 연구를 통하여 세포사멸에 관여하는 단일 물질을 분리할 경우, 기존의 항암제를 대체할 수 있는 새로운 방법을 제시할 수 있을 것으로 기대된다.

• 대한의생명과학회지
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• 제21권4호
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• pp.227-232
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• 2015

Epstein-Barr virus (EBV) has a pathogenic role in several lymphomas including diffuse large B-cell lymphoma (DLBCL). In this study, we detected EBV from formalin-fixed paraffin embedded (FFPE) tissues of DLBCL patients by RT-PCR and compared the sensitivity of the RT-PCR method to in situ hybridization (ISH) method. The RNA was extracted from 91 FFPE samples with DLBCL and amplified with primers targeting EBV-encoded small RNA (EBER) by RT-PCR. When using the RT-PCR method, 13 of 91 patients (14.3%) were positive and among these 13 cases, 7 cases (7.7%) were from > 50-year-old patients that is classified as EBV positive DLBCL of the elderly. In previous results using ISH method, 3 of 91 patients (3.3%) were positive and 2 case (2.4%) were older than 50-year-old. These results indicate that RT-PCR method used in this study shows a higher sensitivity than ISH method. The ratio of male versus female among the EBV positive samples was 1.2:1 with the ratio of male higher. If RT-PCR method having high sensitivity is used simultaneously as well as the ISH method providing the information of the EBV positive cellular location, it is expected that EBV will be more accurately detected.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5825-5828
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• 2014

Background: Lymphomas represent the fifth most frequent cancer in Lebanon. However, little is known concerning epidemiologic characteristics and distribution of lymphoid neoplasms according to the 2008 WHO classification. Materials and Methods: We conducted a retrospective study of lymphoma cases diagnosed from 2008 till 2012 at $H\hat{o}tel$-Dieu de France University Hospital. Results: A total of 502 new cases of lymphoma were diagnosed at our institution during a five year period: 119 cases (24%) were Hodgkin lymphomas (HL) and 383 cases (76%) were non-Hodgkin lymphomas (NHL). HLs were equally distributed in both sexes with a mean age at diagnosis of 30 years. Among NHL, 87% (332 cases) were B cell lymphomas, 9% (34 cases) were T cell lymphomas and 4%(17 cases) were classified as precursor lymphoid neoplasms. Among B cell lymphomas, 44% (147 cases) were diffuse large B cell lymphomas (DLBCL), 20% (65 cases) follicular lymphomas and 8% (27 cases) mantle cell lymphomas. DLBCL were equally distributed in both sexes with a mean age of 58 years. Follicular lymphomas were characterized by a male predominance (57%) and a mean age of 60 years. Mantle cell lymphomas showed a pronounced male predominance (85%) with a mean age of 60 years in men and 70 years in women. Some 72% of patients having T cell lymphomas were men, with a mean age of 57 years in men and 45 years in women, while 65% of patients having precursor lymphoid neoplasms were women with a mean age of 22 years in women and 30 years in men. Conclusions: The lymphoma subtype distribution in Lebanon is unique when compared to other countries from around the world. In fact, Hodgkin and follicular lymphomas are more frequent than in most Far Eastern, European and American countries, while T-cell lymphomas and DLBCL are less frequent.

• 생명과학회지
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• 제27권2호
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• pp.149-154
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• 2017

미만성 거대 B 세포 림프종(DLBCL)은 비호지킨 림프종에서 가장 흔한 형태이다. DLBCL에서 약물치료에 대한 연구가 많은 진전을 보였지만, 아직 많은 환자의 경우 DLBCL로 인한 사망률이 상당하다. 따라서 DLBCL에 대한 이해와 새로운 표적 치료제의 개발이 필요하다. PDE (인산이에스테르 가수분해효소)4B는 최근 시행된 유전자 발현 프로파일링에서 약제내성을 가지는 DLBCL에서 과발현 되는 유전자로 밝혀졌다. PDE4B의 주된 역할은 이차전달자인 고리형 AMP (cylclic AMP, cAMP)를 5'AMP로의 가수분해를 촉진시켜 cAMP를 비활성화 시키는 것이다. cAMP는 B 세포에서 세포증식 저해와 세포사멸을 유도하고 PDE4B는 B 세포에서 이러한 cAMP의 기능을 소멸시키는 것으로 알려져 있다. 그러나 PDE4B의 과발현이 어떤 기작에 의한 것인지는 연구가 미비하다. 본 논문에서는 비정상적으로 발현된 마이크로 RNA (microRNA, miRNA)가 PDE4B의 과발현에 관련되어 있을 것이라는 가정하에 실험을 진행하였다. PDE4B 3'-UTR에는 세 개의 miR-23b 예상 결합부위가 존재하고, 이는 luciferase reporter assay를 통해서 확인하였다. 흥미롭게도, miR-23b 결합 부위들은 인간에서부터 도마뱀에 이르기까지 진화적으로 보존되어 있었고, 이는 세포 생리학적 측면에서 PDE4B-miR-23b 사이의 상호작용이 중요한 역할을 수행함을 암시하고 있다. miR-23b의 과발현은 PDE4B의 mRNA 발현을 감소시키고 세포내의 cAMP의 농도를 증가시켰다. 뿐만 아니라, miR-23b의 발현은 아데닐산고리화효소(adenylyl cyclase)의 활성약제인 forskolin이 처리된 경우에만 DLBCL 세포들의 증식과 생존을 억제하였다. 이는 miR-23b는 PDE4B 발현을 감소시킴으로써 세포증식과 생존을 조절함을 보여주는 것이다. 이를 통해 생각해 볼 때, miR-23b는 PDE4B를 억제함으로써 DLBCL에서 나타나는 항암제 내성을 극복할 수 있고, 따라서 miR-23b는 잠재적 종양 억제자로서 효과적인 치료적 타겟으로 예상된다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권5호
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• pp.2513-2518
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• 2016

Background: In 2008, non-Hodgkin lymphoma ranked tenth among other malignancies worldwide with an incidence of around 5 cases per 100,000 in both genders. The latest available rates in Tunisia are from 2006. Materials and Methods: This study aimed to provide an update about NHL incidence for 2009 and its trend between 1998 and 2009 as well as a projection until 2024, using data from the Salah Azaiz Institute hospital registry and the Noth Tunisia cancer registry. Results: In 2009, the NHL incidence in the north of Tunisia was 4.03 cases per 100,000, 4.97 for men and 3.10 for women. Diffuse large B-cell lymphoma (DLBCL) accounted for 63.2% of all NHL subtypes. Between 1998 and 2009, the overall trend showed no significant change. When we compared the trend between two periods (1998-2005 and 2005-2009), joinpoint regression showed a significant decrease of NHL incidence in the first period with an annual percentage change (APC) of -6.7% (95% CI:[-11.2%;-2%]), then the incidence significantly increased from 2005 to 2009 with an APC of 30.5% (95% CI: [16.1%; 46.6%]. The analyses of the different subtype trends showed a significant decrease in DLBCL incidence between 1998 and 2000 (APC:-21.5; 95% CI: [-31.4%;-10.2%]) then the incidence significantly increased between 2004 and 2007 (APC: 18.5; 95% CI: [3,6%;35.5%]). Joint point analysis of the age-period-cohort model projection showed a significant increase between 2002 and 2024 with an APC of 4.5% (%95 CI: [1.5%; 7.5%]). The estimated ASR for 2024 was 4.55/100 000 (95% CI: [3.37; 6.15]). Conclusions: This study revealed an overall steady trend in the incidence of NHL in northern Tunisia between 1998 and 2009. Projection showed an increase in the incidence in NHL in both genders which draw the attention to the national and worldwide burden of this malignancy.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1135-1138
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• 2015

Background: The objective of this study was to investigate the MSCT characteristics of PTL in order to enhance the awareness of this uncommon entity among both clinicians and radiologists. Materials and Methods: The clinicopathological data and MSCT images of 27 patients with PTL were retrospectively reviewed. The MSCT appearances were classified into three types: type 1, solitary nodule surrounded by normal thyroid tissue; type 2, multiple nodules in the thyroid, and type 3, enlarged thyroid glands with a reduced attenuation with or without peripheral thin hyperattenuating thyroid tissue. Results: The patients were enrolled in the study with a mean age of 68 years (range, 51-86years) and compression symptoms or enlarged cervical lymph nodes at diagnosis. Hashimoto's thyroiditis was in 20 patients. All patients had non-Hodgkin lymphoma of B-cell in origin, including 22 cases of diffuse large B-cell lymphoma (DLBCL) and 5 of low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT). For MSCT appearance, type 1 pattern was observed in 2 patients, type 2 in 8, and seventeen type 3 in 17. The lesions occurred in more than one lobe with a mean maximal transverse diameter of 6.9 cm and an ill-defined margin. Most tumors showed a homogeneous attenuation equal to that of surrounding muscles before contrast and obvious enhancement after contrast. Cervical lymph node involvement and invasion of the trahea and (or) esophagus were mainly observed in patients with DLBCL. Conclusions: PTL should be clinically considered in elder patients presenting with a history of Hashimoto's thyroiditis and cervical lymphadenopathy. The MSCT characteristics of PTL includes a mass diffusely affecting more than one thyroid lobe, isointense to muscle and obvious enhancement before and after contrast. DLBCL, the most common histological subtype of PTL, is associated with a higher invasive tendency.