Lymphomas

MicroRNA-383-5p predicts favorable prognosis and inhibits the progression of diffuse large B-cell lymphoma

The roles of microRNA (miRNA/miR)-383-5p have been reported in several malignancies, including breast cancer, gastric cancer, ovarian cancer and lung adenocarcinoma. However, its function in diffuse large B-cell lymphoma (DLBCL) remains unclear. Thus, the present study aimed to investigate the role of miR-383-5p in DLCBL. Reverse transcription-quantitative PCR analysis was performed to detect miR-383-5p expression in 80 paired tissue samples from patients with DLBCL and control subjects, as well as related cancer cell lines. Kaplan-Meier survival analysis was performed, and the prognostic value of miR-383-5p was determined via Cox regression analysis. Furthermore, the association between miR-383-5p expression and the clinicopathological characteristics of patients with DLBCL was investigated. The Cell Counting Kit-8, crystal violet staining and Transwell assays were performed to assess the effects of miR-383-5p on cell proliferation and invasion, respectively. The results demonstrated that miR-383-5p expression was upregulated in human DLBCL tissues and cell lines. In addition, miR-383-5p expression was closely associated with clinical stage and extranodal invasion in patients with DLBCL. Notably, high miR-383-5p expression was able to predict a favorable clinical prognosis in patients with DLBCL. Furthermore, overexpression of miR-383-5p significantly inhibited the proliferation and invasion of DLBCL cells, the effects of which were reversed following miR-383-5p knockdown. Taken together, the results of the present study suggest that miR-383-5p may predict favorable prognosis, and thus may be used as a prognostic biomarker for patients with DLBCL. In addition, miR-383-5p appears to play critical roles in inhibiting the proliferation and invasion of DLBCL cells, and thus may be used as a potential therapeutic target in patients with DLBCL.

On the importance of multidimensional evaluation of elderly oncologic patients

The role of comorbidity and the psycho-affective attitudes have been studied in 108 elderly oncological patients, in comparison with 25 elderly subjects without tumor pathologies. The results have revealed positive correlations between the activity of daily living (ADL), as well as the instrumental activity of daily living (IADL) scales and the comorbidity both in the oncological subjects and the controls. The performance status defined by the eastern cooperative oncology group (ECOG-PS) positively correlated with the parameters of ADL and IADL scales, demonstrating an increased vulnerability and fragility of the oncological patients in their everyday activities. An increased psychological fragility of the oncological patients has also been revealed by the scores of the geriatric depression scale (GDS), which might be cause and consequence at the same time of the disease itself. In addition, the polypathologies are not associated with an increased gravity of the tumor stage, although there have been 2.5 accompanying pathologies, mainly diseases of osteoarticular and cardial character. The correction of functional damages of various organs due to aging or concomitant or previous diseases is a period of fundamental importance for an adequate oncological therapy. The principal goal of any intervention in the elderly oncological patient should certainly be an improvement of the quality of life, including an alleviation of the impact of the diagnostic and therapeutic procedures on it.

The comorbidities of elderly oncologic patients

The scope of this study was to evaluate the prevalence of comorbidity in elderly subjects with neoplastic diseases, and to compare it to those without tumor pathologies. Three groups of patients have been considered: (A)35 elderly oncological patients; (B)38 young/adult oncological patients; (C)25 elderly patients without oncological pathology. After clinical evaluation and pathohistological diagnostic analysis, the concomitant pathologies have been estimated by means of two methods: (i)the Satariano's score; and (ii)the Charlson Comorbidity Index (CCI). Statistical analyses performed by using the Chi-square and the Student's t-test gave coherent results, and revealed that the prevalence of comorbidities was the highest in Group C, and displayed significantly reduced prevalences in the sequence Group B, Group A.

Elderly patients with non-Hodgkin's lymphoma: population-based results in The Netherlands

BACKGROUND

To compare characteristics, treatment and outcome of patients > or = 70 years with patients < 70 years in a population-based non-Hodgkin's lymphoma (NHL) registry.

PATIENTS AND METHODS

All new patients with NHL (n = 1168) in a geographically defined region in the western part of The Netherlands were registered during a nearly 10-year period. Patient, tumour and treatment characteristics, response to therapy and survival were analysed for both age groups. An age-adjusted prognostic index was determined for elderly patients with aggressive lymphoma.

RESULTS

The elderly comprised 41% of the registered patients. There were significantly more females, a preponderance of intermediate-grade histology (diffuse large B-cell lymphoma) and a lower performance status. Incomplete staging in the elderly was mostly due to the omission of a bone marrow biopsy. With respect to WF grading the complete remission rate (except for patients with low-grade/stage I NHL, patients with extranodal NHL and for patients with intermediate grade/extensive NHL) and overall survival at five years (except for patients with low-grade/stage I NHL and for patients with intermediate-grade/extensive NHL) were significantly inferior in the elderly. With respect to the R.E.A.L. Classification the exceptions were in patients with high grade MALT lymphomas (elderly good) and patients with mantle-cell and peripheral T-cell lymphomas (younger group bad too). However, once complete remission was reached, the disease-free survival did not differ significantly between the two age groups, emphasising the importance of achieving complete remission. Although 65% of the classified elderly patients presented with intermediate-grade NHL, only 26% of the elderly patients treated with chemotherapy received anthracycline-based chemotherapy. In the elderly, lymphoma (treatment-related toxicity included) contributed to death in 70% and concomitant disease (other malignancy included) in 30%, versus 78% and 22%, respectively, for the younger group (P = 0.04). The age-adjusted prognostic index, made up of the factors serum LDH, stage and Karnofsky index, showed a clear distinction between the four risk categories low, low/intermediate, intermediate/high and high, with a median survival time of 43, 20, seven and four months, respectively. For the younger group the respective numbers were 144, 45, 19 and 11 months.

CONCLUSIONS

In a population-based NHL registry the elderly, predominately female patients, formed a larger proportion of the patient group than the one usually reported in the literature. In this population-based cohort inferior remission and overall survival rates were seen in the elderly. However, obtaining complete remission was beneficial for the prognosis of this disease in the elderly. By the application of the R.E.A.L. Classification important subgroups emerge.