Cancer Research and Treatment

Original Article

Clinical Significance of Non-neutropenic Fever in the Management of Diffuse Large B-Cell Lymphoma Patients Treated with Rituximab-CHOP: Comparison with Febrile Neutropenia and Risk Factor Analysis: Silvia Park, Cheol-In Kang, Doo Ryeon Chung, Kyong Ran Peck, Won Seog Kim, Seok Jin Kim; Cancer Res Treat. 2015;47(3):448-457. Published online November 3, 2014; DOI: https://doi.org/10.4143/crt.2014.034

Purpose
Rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is the standard chemotherapy in diffuse large B-cell lymphoma (DLBCL) patients. Although febrile neutropenia (FN) is the major toxicity of this regimen, non-neutropenic fever (NNF) becomes an emerging issue. Materials and Methods We analyzed clinical features and outcomes of febrile complications from 397 patients with newly diagnosed DLBCL who were registered in the prospective cohort study. They had completed R-CHOP between September 2008 and January 2013. Results Thirty-nine patients (9.8%) had NNF whereas 160 patients (40.3%) had FN. Among them, 24 patients (6.0%) had both during their treatment. Compared to frequent occurrence of initial FN after the first cycle (> 50% of total events), more than 80% of NNF cases occurred after the third cycle. Interstitial pneumonitis comprised the highest proportion of NNF cases (54.8%), although the causative organism was not identified in the majority of cases. Thus, pathogen was identified in a limited number of patients (n=9), and Pneumocystis jiroveci pneumonia (PJP) was the most common. Considering that interstitial pneumonitis without documented pathogen could be clinically diagnosed with PJP, the overall rate of PJP including probable cases was 4.5% (18 cases from 397 patients). The NNF-related mortality rate was 10.3% (four deaths from 39 patients with NNF) while the FN-related mortality rate was only 1.3%. Conclusion NNF was observed with incidence of 10% during R-CHOP treatment, and showed different clinical manifestations with respect to the time of initial episode and causes.

Citations

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Incidence and risk factors of severe infections in diffuse large B-cell lymphoma patients undergoing immunochemotherapy
Haiqiu Zhao, Rong Su, Jie Luo, Lin Liu
Annals of Hematology.2025; 104(5): 2869. CrossRef
Interstitial lung disease presents with varying characteristics in patients with non-Hodgkin lymphoma undergoing rituximab-containing therapies
Wailong Zou, Jia Zhang, Yulin Li, Zhe Zhang, Rui Yang, Yaxin Yan, Weihua Zhu, Feng Ma, Piping Jiang, Yumin Wang, Xinjun Zhang, Jichao Chen
Annals of Hematology.2024;[Epub] CrossRef
The effect of ciprofloxacin prophylaxis during haematopoietic cell transplantation on infection episodes, exposure to treatment antimicrobials and antimicrobial resistance: a single-centre retrospective cohort study
Ioannis Baltas, Konstantinos Kavallieros, Giannis Konstantinou, Eirini Koutoumanou, Malick M Gibani, Mark Gilchrist, Frances Davies, Jiri Pavlu
JAC-Antimicrobial Resistance.2023;[Epub] CrossRef
Infection profiles of different chemotherapy regimens and the clinical feasibility of antimicrobial prophylaxis in patients with DLBCL
Akihiro Ohmoto, Shigeo Fuji
Blood Reviews.2021; 46: 100738. CrossRef
Infectious complications during immunochemotherapy of post-transplantation lymphoproliferative disease–can we decrease the risk? Two case reports and review of literature
Aleksandra Gładyś, Sylwia Kozak, Kamil Wdowiak, Mateusz Winder, Jerzy Chudek
World Journal of Clinical Cases.2021; 9(3): 748. CrossRef
Incidence of Pneumocystis jirovecii pneumonia utilizing a polymerase chain reaction‐based diagnosis in patients receiving bendamustine
Mikhaila L. Rice, Jason N. Barreto, Carrie A. Thompson, Kristin C. Mara, Pritish K. Tosh, Andrew H. Limper
Cancer Medicine.2021; 10(15): 5120. CrossRef
Not all bad: Drug-induced interstitial pneumonia in DLBCL patients is potentially fatal but could be linked to better survival
Wen Wei, Yajie Zhu, Jianning Tang, Chuan Xu, Jiman Li, Shuya He, Zhihui Zhang, Ping Wu, Lei Luo, Qin Guo, Fang Li, Yuanrong Ren, Sisi Yu, Renqin Li, Li Li
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A phase II study of ibrutinib in combination with rituximab-cyclophosphamide-doxorubicin hydrochloride-vincristine sulfate-prednisone therapy in Epstein-Barr virus-positive, diffuse large B cell lymphoma (54179060LYM2003: IVORY study): results of the fina
Sang Eun Yoon, Seok Jin Kim, Dok Hyun Yoon, Youngil Koh, Yeung-Chul Mun, Young Rok Do, Yoon Seok Choi, Deok Hwan Yang, Min Kyoung Kim, Gyeong-Won Lee, Cheolwon Suh, Young Hyeh Ko, Won Seog Kim
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Prognostic significance of infectious episodes occurring during first‐line therapy for diffuse large B‐cell lymphoma ‐ A nationwide cohort study
Michael R. Clausen, Sinna P. Ulrichsen, Maja B. Juul, Christian B. Poulsen, Brian Iversen, Per T. Pedersen, Jakob Madsen, Robert S. Pedersen, Pär L. Josefsson, Jette S. Gørløv, Mette Nørgaard, Francesco d'Amore
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Patterns of growth factor usage and febrile neutropenia among older patients with diffuse large B-cell non-Hodgkin lymphoma treated with CHOP or R-CHOP: the Intergroup experience (CALGB 9793; ECOG-SWOG 4494)
Vicki A. Morrison, Edie A. Weller, Thomas M. Habermann, Shuli Li, Richard I. Fisher, Bruce D. Cheson, Bruce A. Peterson
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Pneumocystispneumonia versus rituximab-induced interstitial lung disease in lymphoma patients receiving rituximab-containing chemotherapy
Se Yoon Park, Mi Young Kim, Won Jin Choi, Dok Hyun Yoon, Sang-Oh Lee, Sang-Ho Choi, Yang Soo Kim, Cheolwon Suh, Jun Hee Woo, Sung-Han Kim
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Case Report

Intra-tumoral Metastatic Double Primary Carcinoma: Synchronous Metastatic Tumor in Lung from Breast and Thyroid Carcinoma: Lee Chun Park, Ji Yun Jeong, Jun Ho Ji, Silvia Park, Jin Seok Ahn, Young-Hyuck Im, Yeon Hee Park; Cancer Res Treat. 2014;46(2):200-203. Published online April 15, 2014; DOI: https://doi.org/10.4143/crt.2014.46.2.200

Abstract PDF PubReader ePub

Cases of phenotypic heterogeneity of cells within tumors have recently been reported. Here, we report on a patient with characteristic intra-tumor double primary metastases in the lung. This patient was a 40-year-old Korean woman who had been diagnosed with breast cancer (T1N0M0, estrogen receptor/progesterone receptor/HER2 +/+/+) and papillary thyroid cancer three years prior and underwent a complete surgical resection followed by appropriate adjuvant treatment with radiation, hormone, and radioactive iodine. She was recently admitted for newly developed pulmonary nodules. Metastasectomy through video-assisted thoracoscopic surgery revealed recurrent double primary cancer with two different components (metastatic ductal carcinomas from the breast and metastatic papillary carcinomas from the thyroid gland) in each pulmonary nodule in the right upper lobe and right middle lobe. To the best of our knowledge, this is the first report of simultaneous recurrent double metastasis in one organ from different primary origins.

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Risk Factors and Prognostic Implications in Synchronous Breast-Thyroid Dual Primary Cancers: A Matched Case-Control Study
Tao Li, Bin Lu, Yantao Zhang, Peng Zhang, Jun Qi, Yong Sun
Cancer Management and Research.2025; Volume 17: 997. CrossRef

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Original Articles

Nomogram to Predict Treatment Outcome of Fluoropyrimidine/Platinum-Based Chemotherapy in Metastatic Esophageal Squamous Cell Carcinoma: Hyun Ae Jung, Antoine Adenis, Jeeyun Lee, Se Hoon Park, Chi Hoon Maeng, Silvia Park, Hee Kyung Ahn, Young Mog Shim, Nicolas Penel, Young-Hyuck Im; Cancer Res Treat. 2013;45(4):285-294. Published online December 31, 2013; DOI: https://doi.org/10.4143/crt.2013.45.4.285

Abstract PDF PubReader ePub

PURPOSE
The degree of benefit from palliative chemotherapy differs widely among patients with metastatic esophageal squamous cell carcinoma (MESCC). The purpose of this study was to develop and validate a prognostic nomogram to predict survival and aid physicians and patients in the decision-making process regarding treatment options.
MATERIALS AND METHODS
Clinicopathologic variables and treatment outcomes of 239 patients who were diagnosed with MESCC and received either fluorouracil/cisplatin (FP) or capecitabine/cisplatin (XP) as first-line chemotherapy were reviewed. A nomogram was developed as a prognostic scoring system incorporating significant clinical and laboratory variables based on a multivariate Cox proportional hazards regression model. An independent series of 61 MESCC patients treated with FP served as an independent data set for nomogram validation.
RESULTS
No difference in response rate was observed between the FP group (44.8%) and the XP group (54.2%). Similarly, no significant differences in median progression-free survival and median overall survival were observed between regimen groups. Multivariate analysis showed that poor performance status (Eastern Cooperative Oncology Group [ECOG] status> or =2), weight loss (10% of the weight loss for 3 months), low albumin level (< or =3.5 g/dL), and absence of previous esophagectomy at the time of chemotherapy were significantly associated with low OS in both groups (p<0.05). Based on these findings, patients were classified into favorable (score, 0 to 90), intermediate (91-134), and poor (>135) prognostic groups. The median survival for those with a favorable ECOG was 13.8 months (95% confidence interval [CI], 10.8 to 18.6 months), for intermediate 11.2 months (95% CI, 8.7 to 11.9 months), and for poor, 7.0 months (95% CI, 3.6 to 10.0 months). External validation of the nomogram in a different patient cohort yielded significantly similar findings.
CONCLUSION
The nomogram described here predicts survival in MESCC patients and could serve as a guide for the use of FP/XP chemotherapy in MESCC patients.

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Shubing Jia, Chunling Yin, Xingyu Li, Long Yang, Yina Liang, Jiajing Ma, Mingyu Gao, Yijia Xu, Mingyi Zhao, Rongwu Xiang, Jingyu Yang
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Nuria Kotecki, Sandrine Hiret, Pierre-Luc Etienne, Nicolas Penel, Emmanuelle Tresch, Eric François, Marie Pierre Galais, Meher Ben Abdelghani, Pierre Michel, Laetitia Dahan, François Ghiringelli, Laurent Bedenne, Emmanuelle Samalin, Guillaume Piessen, Jaf
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Michael W. Kattan, Cora N. Sternberg, Faisal Mehmud, Kamal Bhatt, Lauren McCann, Robert J. Motzer
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Nomogram to Predict Treatment Outcome of Fluoropyrimidine/Platinum-Based Chemotherapy in Metastatic Esophageal Squamous Cell Carcinoma
Hyun Ae Jung, Antoine Adenis, Jeeyun Lee, Se Hoon Park, Chi Hoon Maeng, Silvia Park, Hee Kyung Ahn, Young Mog Shim, Nicolas Penel, Young-Hyuck Im
Cancer Research and Treatment.2013; 45(4): 285. CrossRef

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Implications of Bone-Only Metastases in Breast Cancer: Favorable Preference with Excellent Outcomes of Hormone Receptor Positive Breast Cancer: Su Jin Lee, Silvia Park, Hee Kyung Ahn, Jun Ho Yi, Eun Yoon Cho, Jong Mu Sun, Jeong Eon Lee, Seok Jin Nam, Jung-Hyun Yang, Yeon Hee Park, Jin Seok Ahn, Young-Hyuck Im; Cancer Res Treat. 2011;43(2):89-95. Published online June 30, 2011; DOI: https://doi.org/10.4143/crt.2011.43.2.89

Abstract PDF PubReader ePub

PURPOSE
The aim of the current study was to determine the incidence, clinical presentation, and treatment outcomes of "bone-only metastases" in patients with breast cancer and to analyze the impact of hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status on prognosis.
MATERIALS AND METHODS
Between 1994 and 2007, of 968 patients with metastatic breast cancer who underwent palliative management at Samsung Medical Center, 565 (57%) relapsed with distant metastases. Of the 968, 146 (15%) had bone-only metastases during a median follow-up period of 75 months. Among the 146 patients with bone-only metastases, 122 (84%) were relapsed patients after curative surgery and 24 (26%) were initially metastatic cases.
RESULTS
The median time from primary surgery to bone-only metastases of the 122 patients was 37 months (95% confidence interval [CI], 27 to 46 months). Bone-only metastases were more common in the HR-positive group than in the other subtypes (85% for HR+; 8.2% for HER2+; 6.8% for triple negative. Among all 146 patients, 75 (51%) were treated with hormone therapy. The median post-relapse progression-free survival was 15 months (95%CI, 13 to 17 months). The median overall survival was much longer in the HR+ patients than the HER2+ and triple negative breast cancer patients with marginal statistical significance (65 vs. 40 vs. 40 months, p=0.077).
CONCLUSION
Breast cancer patients with "bone-only metastases" had excellent clinical outcomes. Further study is now warranted to reveal the underlying biology that regulates the behavior of this indolent tumor, as it should identify 'favorable tumor characteristics' in addition to 'favorable preferential metastatic site.'

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