The incidence rate is high in Asia country, accounting for 15 %-20 % of Non-Hodgkin lymphoma. Every phynotype has different heterogeneity, therapeutic effect and prognosis are also different. There is no standard rigemen for T cell lymphoma at present. CHOP like regimen is commonly used. But therapeutic effect is not as good as we expected. Clinical research shows that dose and intensity regimen, such as m-BACOD,ProMACE-CytaBOM, MACOP-B, do not exhibit survival advantage compared with CHOP regimen. New treatment includes cytotoxic drug, such as gemcitabine. As first line therapy for T cell lymphoma or as salvage therapy for refractory or relapsed T cell lymphoma, the therapeutic effect is good. Gemcitabine based regimen is new for PTCL. Alemtuzumab is a humanized CD52 mono-clonal antibody and is expected as good effect on PTCL therapy. Zanolimumab is a humanized mono-clonal antibody which targets CD4 antigen on T cell. Phase Ⅱclinical research has also got good effect. Denileukin difiitox and Pralatrexate also have good effect on PTCL therapy in clinical researches. Autologous stem cell transplantation(ASCT) is also used in PTCL therapy.

Objective: To determine the role of interleukin-10 (IL-10) secreted by peripheral blood mononuclear cells (PBMC) in the maintenance of hemodialysis in patients with immune deficiency and to evaluate thot if IL-10 can bea biocompatibility index of dialyzer. Methods: Twenty patients with end-stage renal disease were divided into maintenance hemodialysis group (MHD group) and non-hemodialysis group (NHD group). Patients in MHD group were dialyzed with cellulose (CA group) and polysulfone (PS group) dialyzers respectively. Ten healthy persons were as controls (CON group). The levels of IL-10 in supernatants of PBMC cultured with or without lipopolysaccharide (LPS) were measured by using ELISA method in all groups. Results: There was no spontanous IL-10 secretion in all groups. The level of IL-10 in all supernatants secreted by PBMC cultured with LPS increased significantly, and the increased levels of IL-10 in MHD and NHD patients were lower than that in controls. The PBMC stimulated by LPS secreted more IL-10 in patients dialyzed by PS with better biocompatibility than those of CA dialyzers with poor biocompatibility. Conclusion: Patients immune deficiency could be improved by using better biocompatible dialyzers more than poor ones, particularly in humoral immunity induced by urimia. The IL-10 could be a parameter in evaluating the biocompatibility of dialyzer.

Objectives To investigate the clinical features,diagnosis,treatment and prognosis of primary hepatic lymphoma (PHL).Methods A retrospective study was carried out on the clinical records of 6 patients with primary hepatic lymphoma (PHL) treated at the Tianjin Medical University Cancer Hospital from April 2005 to September 2010.The domestic and foreign medical literatures were reviewed.Results For the 6 patients with PHL,the median age was 57 years (range 31-78 years).The male-to-female ratio was 2: 1.The most common initial symptoms were abdominal pain and fever.Serum transaminase,lactate dehydrogenase and β2-microglobulin levels were elevated in 4 of 6 patients.For the 3 patients who were tested for alpha-fetoprotein and carcinoembryonic antigen levels,the results were normal.None of the patients had a history of hepatitis or cirrhosis.The diagnosis was non-Hodgkin's lymphoma.A R0 resection was carried out in 1 patient who was lost to follow-up soon after surgery.A R2 resection was carried out in another patient.The remaining 4 patients received liver biopsy.Five patients were treated by CHOP or CHOP-like chemotherapy.A patient died of brain metastases after 8 cycles of chemotherapy,and another patient was lost to follow-up after 1 cycle of chemotherapy.Chemotherapy combined with rituximab were given to the other 3 patients.There was a complete remission in 2 patients after chemotherapy and biotherapy,and these patients were still alive at the last follow-up.Partial remission was achieved in the remaining patient after chemotherapy.The patient was given radiotherapy,but he died finally of tumor progression.Conclusions PHL is an extremely rare lymphoma.Its clinical presentations and imaging manifestations are non-specific.PHL should be considered when the patient has abdominal pain or fever,with a mass in the liver.The ultimate diagnosis depends on histopathologic examination.The pathological type is mainly non Hodgkin's lymphoma,with diffuse large B cell lymphoma.There is still no standard treatment.Surgery,chemotherapy,radiotherapy,targeted therapy and biotherapy can be used.

Objective:This study aimed to investigate the inhibitory effect of zoledronic acid (ZOL) alone or the combined treat-ment of ZOL and paclitaxel (PTX) on the cell growth of lung cancer cell line in vitro. Methods:The effects of different concentrations of ZOL alone, 2 nM PTX, and combined treatment of ZOL and PTX on the growth of A-549 cell line were determined using methyl thi-azolyl tetrazolium (MTT) method. The mechanism of the curative effect was analyzed by flow cytometry on the basis of apoptotic rate. AKT, phospho-AKT, ERK, phospho-ERK, and Bcl-2 expressions were determined by western blot analysis. AKT and ERK gene ex-pressions were determined by RT-PCR. Results:MTT results showed that ZOL alone could inhibit the growth of lung cancer cell line A-549 in a dose-dependent manner. The combined therapy of ZOL and PTX could inhibit cell growth. This combined treatment is more effective than the single treatment with either ZOL or PTX alone. The synergistic inhibition rate is dependent on drug sequencing. Fur-thermore, maximum inhibition was induced by sequence order, i.e., initial treatment with PTX and then with ZOL. RT-PCR results dem-onstrated that the mRNA of ERK and AKT of the group treated with PTX and then ZOL were lower than that in other treatment groups. Western blot analysis results demonstrated that the ERK and AKT levels of the treated groups were parallel in the cell line. However, the lowest phospho-ERK, phospho-AKT, and Bcl-2 levels were observed in the PTX then ZOL group. The cell lines treated with PTX alone and ZOL alone ranked second and third among the lowest results, respectively. The highest level was observed in the control group. Conclusion: The combined ZOL and PTX treatment induced the downregulation of phospho-ERK, phospho-AKT, and Bcl-2 protein expressions in RAF/MEK/ERK and PI3K/AKT signaling pathway. This pathway could be one of the synergistic antitumor mechanisms of the two drugs.

Objective To evaluate the expression of bcl-2, p53, Ki-67 in malignant lymphoma (ML)and the relationship between the expression of bcl-2, Ki-67, p53 and prognosis for the patients who were given autologous hematopoietic stem cell transplantation (AHSCT). Methods The expression of bcl-2,Ki-67, p53 were measured by immunohistochemistry (IHC) on paraffin-embedded slices in 33 cases of ML who received AHSCT. Survival analysis was done by the Kaplan-Meier method and Log-Rank test.Multivariate analysis was carried out using COX proportional hazard model. Results For patients with ML who received AHSCT, the 3-year disease free survival (DFS) of bcl-2(+) group was 35.71%, while that bcl-2(-) group was 88.89 %. There was significant difference of DFS between the two groups. Meanwhile, for these patients, the 3-year DFS of Ki-67(+) and Ki-67(-) were 43.75 % and 85.71%, respectively (P ＜0.05).Multivariate analysis showed that the expression of bcl-2 and Ki-67 were the independent prognostic factors.Conclusion The expression of bcl-2 and Ki-67 were closely related with relapse after AHSCT in patients with ML. They were useful molecular makers for predicting the prognosis of patients with ML after AHSCT.

Objective:To evaluate the efficacy and safety of pegaspargase plus GEMOX (pegaspargase, gemcitabine, oxaliplatin) regimen in the initial treatment of nasal NK/T-cell lymphoma. Methods: Twelve preliminarily diagnosed nasal NK/T-cell lymphoma patients in Tianjin Medical University Cancer Institute and Hospital from June 2011 to March 2012 were analyzed. All patients took the pegaspargase plus GEMOX regimen (gemcitabine 800-1 000 mg/m2 on days 1 and 8, oxaliplatin 130 mg/m2 on day 1, and pegaspargase 2 500 IU/m2 on day 2), every three weeks for one cycle. The efficacy and toxicity of the regimen were evaluated in the follow-up treat-ment. Results:After two cycle treatments, 1 patient dropped out of treatment because of acute pancreatitis;the remaining 11 patients had response, in which 1 achieved complete response , 7 had partial response, 2 had stable disease, and 1 had progressive disease. The objective response rate was 72.7%, and the disease control rate was 90.9%. The 2-year overall survival rate was 90.9%. With median 6-cycle P-GEMOX regimen treatment, 81.8% of 11 patients presented side effects, primarily myelosuppression and hepatic dysfunc-tion. Conclusion:Pegaspargase plus GEMOX regimen showed high efficacy on the initial treatment of nasal NK/T-cell lymphoma pa-tients, but the incidence of adverse effect was still high.

Objective To study the clinical features, effects of therapeutic regimen and prognosis of patents with mantle cell lymphoma (MCL). Methods Clinical data of 27 MCL patients admitted in Tianjin Medical University Cancer Institute&Hospital from January 2008 to December 2014 were retrospectively analyzed. Cox regression analysis was used to analyze influencing factors of prognosis of MCL. Results The median age was 68 years old for 27 patients, and the male-to-female ratio was 4.4∶1. Ann Arbor staging showed that 25 cases were stageⅢ-Ⅳ(92.6%), 8 cases were heptosplenomegaly (29.6%), 7 cases showed extranodal involvement (25.9%). ECOG scoring showed that 4 cases with scores of 2-4 (14.8%), 8 cases were 0-3 (29.6%), 14 cases were 4-5 (51.9%) and 5 cases were 6-11 (18.5%). The Ki-67 index≤30%was found in 9 cases (33.3%), and>30%was found in 18 cases (67.7%). Patients with B symptom was found in 10 (37.0%). The elevated lactate dehydrogenase (LDH) was found in 17 cases (63.0%). The increased Beta 2- microglobulin was found in 8 cases (29.6%). Seven patients were found with bone marrow involvement. The total effective rate (ORR) was 81.8%in group with R-CHOP method, and the ORR was 68.8%in group with CHOP method. Multivariate analysis showed that age, LDH and Ki-67 were independent factors influencing the prognosis of MCL (P<0.05). Conclusion Most patients with MCL are found in advanced stage. Patients with age>60 years, elevated LDH and Ki-67 index>30%are with poor prognosis.

Objective: To study the relationship between the expressions of Bel -2, Ki -67, C -myc and prognosis in patients given chemotherapy for malignant lymphoma (ML). Methods: The expressions of Bel-2, Ki-67 and C-myc were measured by immunohistochemistry (IHC) in paraffin-embedded samples of 65 ML cases who received chemotherapy. The survival analysis was done by the Kaplan -Meier method and Log -rank test. Results: For patients with non -Hodgkin lymphoma (NHL) who received chemotherapy, the 3-year disease free survival (DFS) was 22.22% in Bcl-2(+) group compared with that of 55.56% in Bcl-2 (-) group. The difference of DFS was significant between the two groups. Meanwhile, for ML patients, the 3-year DFS was 37.50% in Ki-67(+) group, and 61.54% in Ki-67(-) group respectively(P < 0.05). Conclusion: The expressions of Bcl-2 and Ki-67 were closely related with relapse after chemotherapy in patients with ML. They were useful molecular makers for predicting the prognosis in patients with ML after chemotherapy.

Objective To discuss the clinical features and prognostic factors of primary testicular lymphoma (PTL). Methods A retrospective review was performed based on the clinical records of 33 PTL cases treated at Tianjin Medical University Cancer Hospital from June 1977 to May 2009.Drawing survival curves by Kaplan-Meier method, using Log-rank test to the univariate analysis, and multivariate analysis by COX regression model to evaluate independent prognostic factors. Results The median age of patients was 62 years at presentation(range 33-81 years). Painless testicular swelling was the initial symptom. The majority of histological subtype was B cell lymphoma, 48% of which was diffuse large B-cell non-Hodgkin's lymphoma. By postoperative chemotherapy and/or radiotherapy, 23 patients achieved complete remission and 7 achieved partial remission, with a median follow-up of 23 months (4-231 months). The 5 years and 10 years of overall survival was 39.1% and 19.5%. The effect of patients who received chemotherapy≥4 cycles and B cell lymphoma patients combination with Rituximab were better. In multivariate analysis, Ann Arbor stage, B symptoms, age of patient and number of extranode site were independent prognostic factors of survival. Conclusions Primary non-Hodgkin lymphoma should be treated with multi-modality strategies. Treatment with doxorubicin-based chemotherapy after orchiectomy should be recommended. Ann Arbor stage, B symptoms, age of patient and number of extranode site were independent prognostic factors of survival in PTL.

Objective:This study was conducted to evaluate and discuss the curative effect and toxicity of gemcitabine, navel-bine, and therarubicin (GNT) regimen for patients with refractory or relapsed T-cell lymphoma (TCL). Methods:A total of 69 patients with refractory or relapsed TCL treated with GNT were enrolled. The treatment protocol was set as follows:800 mg/m2 gemcitabine ad-ministered at 1 and 8 d;25 mg/m2 navelbine administered at 1 d;and 20 mg/m2 therarubicin administered at 1 d. This protocol was re-peated every three weeks. The median cycle was 4 (range:2 to 6). Results:The overall response rate was 65.2%and the achieved com-plete remission was 29.0%. Hematology toxicities were the main adverse reactions observed in all of the patients. The incidence rates of grades 1 and 2 toxicity in leukopenia or neutropenia, anemia, and thrombocytopenia were 50.7%, 33.3%, and 26.1%, respectively. Grades 3 and 4 treatment-associated toxicities were detected in 23.1%of the responding patients. One-, three-, and five-year estimated overall survival (OS) of the whole cohort were 71.7%, 47.3%, and 32.4%, respectively. The median OS was 36 months. Conclusion:GNT was effective and suitable for patients with refractory or relapsed TCL.