OBJECTIVES: To study the characteristics of vincristine-induced peripheral neuropathy (VIPN) in children with acute lymphoblastic leukemia (ALL) and the factors influencing the development of VIPN. METHODS: The children with ALL, aged 1-18 years, who were treated with CCCG-ALL2015 or CCCG-ALL2020 regimen in the Affiliated Hospital of Guizhou Medical University from January 2018 to February 2022 were enrolled as subjects. According to the influence of age on risk, the children were divided into 1-10 years group with 91 children and >10 years group with 29 children. VIPN was graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (5th edition), and the incidence rate, severity, and type of VIPN were compared between different groups. RESULTS: A total of 120 children were enrolled in this study, among whom 56 (46.7%) developed VIPN. The >10 years group had a significantly higher incidence rate of VIPN than the 1-10 years group (69% vs 40%, P<0.05). Among the 56 children with VIPN, 12 (21%) had grade 3 VIPN or above, and 44 (79%) had grade 2 VIPN. There were 77 cases of autonomic nerve symptoms (59.7%), 42 cases of peripheral nerve injury (32.5%), and 10 cases of cranial nerve injury (7.8%). There were no significant differences in the severity and type of VIPN between the groups with different ages, sexes, degrees of risk, or treatment regimens (P>0.05). The results of binary logistic regression analysis showed that age is the influencing factor for the occurrence of VIPN (P>0.05). CONCLUSIONS There is a relatively high incidence rate of VIPN in children with ALL, with the highest incidence rate of autonomic nervous symptoms. The incidence of VIP in children over 10 years old is relatively high.
Child ; Humans ; Antineoplastic Agents, Phytogenic/adverse effects* ; Cohort Studies ; Peripheral Nervous System Diseases/diagnosis* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy* ; Vincristine/adverse effects* ; Infant ; Child, Preschool ; Adolescent

A 69-year-old male was diagnosed in February 2004 with stage IV extranodal marginal zone B cell lymphoma involving the mediastinal nodes, lung parenchyma and bone marrow with high LDH. Shortness of breath developed following the 5th course of Rituximab-CHOP chemotherapy (cyclophosphamide, Vincristine, Doxorubicin, Prednisolone). Bronchoscopy guided transbronchial lung biopsy revealed interstitial thickening and type II pneumocyte activation, compatible with interstitial pneumonitis. After treatment with prednisolone a complete resolution of the dyspnea was observed. The patient was well on routine follow-up at the outpatient clinic, with no progression of lymphoma or interstitial pneumonitis.
Aged ; Antibodies, Monoclonal/*adverse effects/*therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/*adverse effects/*therapeutic use ; Biopsy ; Cyclophosphamide/adverse effects/therapeutic use ; Doxorubicin/adverse effects/therapeutic use ; Humans ; Lung Diseases, Interstitial/*chemically induced/*pathology/radiography/surgery ; Lymphoma, B-Cell, Marginal Zone/*drug therapy ; Male ; Prednisone/adverse effects/therapeutic use ; Tomography, X-Ray Computed ; Vincristine/adverse effects/therapeutic use

OBJECTIVETo evaluate the effects and the toxicity of the protocol of CDV combined with CiE as pre-operative chemotherapy in childhood stage IV neuroblastoma.

METHODSThe clinical data of 27 children aged from 1.2 to 8 years with neuroblastoma in stage IV was retrospectively studied. The primary sites of the diseases were abdomen (n = 21), posterior mediastinum (n = 4) and pelvic cavity (n = 2). Twenty three patients had bone marrow metastasis. Twelve patients had bone metastasis. All patients were treated with the CDV protocol (cyclophosphamide + doxorubicin + vincristine) for 3 cycles and the CiE protocol (cisplatin + etoposide) for 2 cycles. Neuroblastoma therapeutic response evaluation criterion and common terminology criteria for adverse events of National Cancer Institute were used to evaluate effects and chemotherapy related toxicity.

RESULTSAll patients received the pre-operative chemotherapy. The overall response rate was 82%. After chemotherapy, 24 patients received operations. Total resection of primary tumor was found in 14 patients (58%) and part resection in 10 patients (42%). The most common chemotherapy related toxicity was bone marrow suppression: grade IV suppression of neutrophils (n = 27), reduction in hemoglobin (III grade, n = 7; IV grade, n = 20) and reduction in platelet (III grade, n = 2; IV grade, n = 25). Infection was found in all patients and was controlled with antibiotics. I or II grade lesions of digestive, liver and kidney were found and could be recovered after therapy. Grade I neurotoxicity occurred in 2 patients (7%). The heart function damage was not found in any of patients.

CONCLUSIONSThe protocol of CDV combined with CiE as pre-operative chemotherapy might be effective in children with stage IV neuroblastoma.

Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; adverse effects ; therapeutic use ; Child ; Child, Preschool ; Cisplatin ; administration & dosage ; adverse effects ; Cyclophosphamide ; administration & dosage ; adverse effects ; Dacarbazine ; administration & dosage ; adverse effects ; Etoposide ; administration & dosage ; adverse effects ; Female ; Humans ; Infant ; Male ; Neuroblastoma ; drug therapy ; Retrospective Studies ; Vincristine ; administration & dosage ; adverse effects

The aim of this study was to compare the efficacy of rituximab plus CHOP regimen and CHOP regimen on newly diagnosed patients with diffuse large B-cell lymphoma (DLBCL), and analyze their toxicities. A total of 69 patients were enrolled from July 2003 to Dec 2006. The patients were non-randomly were divided into 2 groups: 36 received CHOP alone (CHOP group) and 33 received rituximab plus CHOP (R-CHOP group). The complete response (CR) rates, overall survival (OS) and side events of the 2 groups were compared. The results showed that the CR rate in R-CHOP group was higher than that in CHOP group (69.7% vs 47.2%, p = 0.049); especially in patients of male, Ann Arbor III - IV and IPI 3 - 5 (p = 0.017, p = 0.005 and p = 0.000). The estimated mean OS in R-CHOP group was longer than that in CHOP group (45.7 months vs 35.2 months, p = 0.145), and also in the estimated mean progression free survival (PFS) (38.5 months vs. 24.6 months, p = 0.017). The major adverse events in combination group were infusion-related responses which could be well tolerated in patients, and hematological toxicities which were similar to those in CHOP group. In conclusions, Rituximab increases the therapeutic efficacy of CHOP regimen on newly diagnosed patients with DLBCL, without a clinically significant increase in toxicity.
Adolescent ; Adult ; Aged ; Antibodies, Monoclonal ; administration & dosage ; adverse effects ; Antibodies, Monoclonal, Murine-Derived ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Cyclophosphamide ; adverse effects ; therapeutic use ; Doxorubicin ; adverse effects ; therapeutic use ; Female ; Humans ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; Male ; Middle Aged ; Prednisone ; adverse effects ; therapeutic use ; Prospective Studies ; Rituximab ; Safety ; Vincristine ; adverse effects ; therapeutic use ; Young Adult

OBJECTIVETo investigate the feasibility and efficacy of rituximab combined with high-dose chemotherapy supported by autologous peripheral blood stem cell transplantation (ASCT) in patients with aggressive B-cell non-Hodgkin lymphoma (NHL).

METHODSTwenty-eight patients with aggressive B-cell NHL (22 newly diagnosed, 6 relapsed) were enrolled in this study. The high-dose chemotherapy included CHOP regimen (CTX + ADM + VCR + PDN) for the newly diagnosed patients and DICE (DEX + IFO + DDP + VP-16) or EPOCH (VP-16 + PDN + VCR + CTX + ADM) for the relapsed patients. Each patient received infusion of rituximab at a dose of 375 mg/m(2) for four times, on D1 before and on D7 of peripheral blood stem cell mobilization, and on D1 before and D8 after stem cell reinfusion.

RESULTSComplete remission was achieved in all patients after high dose chemotherapy and ASCT. At a median follow-up of 37 months, the estimated overall 4-year survival and progression-free survival rate for all patients were 75.0% and 70.3%, respectively, while both were 72.7% for the previously untreated patients. The therapy was generally well tolerated with few side-effects attributable to rituximab.

CONCLUSIONThese results suggest that adding rituximab to high-dose chemotherapy with peripheral blood stem cell transplantation is feasible and may be beneficial for patients with aggressive B-cell non-Hodgkin lymphoma.

Adolescent ; Adult ; Antibodies, Monoclonal, Murine-Derived ; adverse effects ; therapeutic use ; Antineoplastic Agents ; adverse effects ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Cisplatin ; adverse effects ; therapeutic use ; Combined Modality Therapy ; Cyclophosphamide ; adverse effects ; therapeutic use ; Dexamethasone ; adverse effects ; therapeutic use ; Disease-Free Survival ; Doxorubicin ; adverse effects ; therapeutic use ; Etoposide ; adverse effects ; therapeutic use ; Female ; Fever ; chemically induced ; etiology ; Humans ; Ifosfamide ; adverse effects ; therapeutic use ; Lymphoma, Large B-Cell, Diffuse ; therapy ; Male ; Middle Aged ; Peripheral Blood Stem Cell Transplantation ; Prednisolone ; adverse effects ; therapeutic use ; Prednisone ; adverse effects ; therapeutic use ; Prospective Studies ; Remission Induction ; Rituximab ; Survival Rate ; Vincristine ; adverse effects ; therapeutic use ; Vomiting ; chemically induced ; Young Adult

Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Child, Preschool ; Cyclophosphamide ; administration & dosage ; Female ; Humans ; Male ; Neuroblastoma ; drug therapy ; Topotecan ; administration & dosage ; Vincristine ; administration & dosage

Objective: To identify the risk factors and clinical features associated with the interstitial pneumonia in diffuse large B-cell lymphoma (DLBCL) patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (RCHOP) or rituximab, cyclophosphamide, liposomal doxorubicin, vincristine and prednisone (RCDOP) regimens. Methods: A retrospective study was conducted in 836 patients with DLBCL admitted to the Department of Hematology at Ruijin Hospital from 2013 to 2018. Among them, 114 patients were treated with RCDOP regimen. Using the method of propensity score matching according to age, gender, IPI score of patients, 114 patients treated with RCHOP regimen were selected as controls. Clinical data, including comorbidities, gender, age, B symptoms, international prognostic index (IPI) score, disease stage, serum lactic dehydrogenase (LDH) and β(2) microglobulin (β(2)-MG) level were collected and the risk factors of interstitial pneumonia were further analyzed. Results: The interstitial pneumonia developed more frequently in RCDOP group than RCHOP group (28.95% vs 2.60%, P<0.01) . As the dose of liposomal doxorubicin elevated from 25-30 mg/m(2) to 35-40 mg/m(2), the incidence of interstitial pneumonia accordingly increased from 17.30% to 38.71% (P<0.05) . By multivariate analysis, disease stage was an independent factor of interstitial pneumonitis. Conclusions: Front line regimens containing liposomal doxorubicin in DLBCL patients link to a higher incidence of dose-dependent interstitial pneumonia. Prevention and surveillance should be emphasized in future studies.
Antineoplastic Combined Chemotherapy Protocols/adverse effects* ; Cyclophosphamide ; Doxorubicin ; Humans ; Lung Diseases, Interstitial/chemically induced* ; Lymphoma, Large B-Cell, Diffuse/drug therapy* ; Prednisone ; Retrospective Studies ; Rituximab ; Vincristine

The objective of the current study was to investigate the treatment outcomes for the use of cyclophosphamide, adriamycin, vincristine, and prednisolone (CHOP) chemotherapy in adult patients with hemophagocytic lymphohistiocytosis (HLH). Seventeen HLH patients older than 18 yr of age were treated with CHOP chemotherapy. A response evaluation was conducted for every two cycles of chemotherapy. With CHOP chemotherapy, complete response was achieved for 7/17 patients (41.2%), a partial response for 3/17 patients (17.6%), and the overall response rate was 58.8%. The median response duration (RD) was not reached and the 2-yr RD rate was 68.6%, with a median follow-up of 100 weeks. Median overall survival (OS) was 18 weeks (95% CI, 6-30 weeks) and the 2-yr OS rate was 43.9%. Reported grade 3 or 4 non-hematological toxicities were increased serum liver enzyme levels and stomatitis. Grade 3 or 4 hematological toxicities were leukopenia (50.8%), anemia (20%), and thrombocytopenia (33.9%). Neutropenic fever was observed in 21.6% of patients (14/65 cycles), and most of the cases were resolved with supportive care including treatment with broad-spectrum antibiotics. CHOP chemotherapy seems to be effective in adult HLH patients and the toxicities are manageable.
Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/*administration & dosage/adverse ; Cyclophosphamide/administration & dosage/adverse effects ; Doxorubicin/administration & dosage/adverse effects ; Female ; Follow-Up Studies ; Humans ; L-Lactate Dehydrogenase/blood ; Lymphohistiocytosis, Hemophagocytic/*drug therapy ; Male ; Middle Aged ; Prednisone/administration & dosage/adverse effects ; Remission Induction ; Survival Rate ; Treatment Outcome ; Vincristine/administration & dosage/adverse effects

The radiologic findings of a single nodule from Pneumocystis jirovecii pneumonia (PJP) have been rarely reported. We described a case of granulomatous PJP manifesting as a solitary pulmonary nodule with a halo sign in a 69-year-old woman with diffuse large B cell lymphoma during chemotherapy. The radiologic appearance of the patient suggested an infectious lesion such as angioinvasive pulmonary aspergillosis or lymphoma involvement of the lung; however, clinical manifestations were not compatible with the diseases. The nodule was confirmed as granulomatous PJP by video-assisted thoracoscopic surgery biopsy.
Aged ; Antibodies, Monoclonal, Murine-Derived/adverse effects/therapeutic use ; Antineoplastic Agents/adverse effects/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/adverse effects/therapeutic use ; Biopsy/methods ; Cyclophosphamide/adverse effects/therapeutic use ; Doxorubicin/adverse effects/therapeutic use ; Female ; Humans ; Lymphoma, Large B-Cell, Diffuse/drug therapy/microbiology ; Pneumocystis jirovecii/pathogenicity ; Pneumonia, Pneumocystis/*diagnosis/*radiography ; Positron-Emission Tomography ; Prednisone/adverse effects/therapeutic use ; Solitary Pulmonary Nodule/*microbiology ; Thoracic Surgery, Video-Assisted ; Tomography, X-Ray Computed ; Vincristine/adverse effects/therapeutic use

Adolescent ; Adult ; Aged ; Agranulocytosis ; chemically induced ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Cisplatin ; administration & dosage ; adverse effects ; Cyclophosphamide ; administration & dosage ; adverse effects ; Doxorubicin ; administration & dosage ; adverse effects ; Etoposide ; administration & dosage ; adverse effects ; Female ; Follow-Up Studies ; Humans ; Lymphoma, T-Cell, Peripheral ; drug therapy ; Male ; Middle Aged ; Nausea ; chemically induced ; Prednisone ; administration & dosage ; adverse effects ; Remission Induction ; Vincristine ; administration & dosage ; adverse effects ; Young Adult