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Abstract Objectives Standard treatment with a thiotepa-based regimen in countries with a limited resource is less feasible. Aims of the study were to evaluate the treatment outcome, and identify the prognostic factors in patients with primary central nervous system lymphoma (PCNSL). Methods We conducted a retrospective study of 43 patients diagnosed with PCNSL, DLBCL subtype, who were treated with either HDMTX-based regimen, whole brain radiotherapy (WBRT), or both between 2010 and 2017. Results There were 43 patients with a median age of 65 years (range 34–89 years). Protein expression of CD10, Bcl6, MUM1, Bcl2 and MYC were found in 19, 86, 91, 91 and 23%, respectively. Both germinal center B cell (GCB) and double-expressor (MYC+/Bcl2+) lymphomas were found in 21%. Multiple brain lesions and maximum tumor diameter (MTD) ≥5 cm were seen in 27 and 10 patients, respectively. Chemotherapy combined with WBRT, chemotherapy and WBRT were given to 20, 14 and 9 patients, respectively. Overall complete remission (CR) rate was 55.8%. Those receiving a combined-modality therapy had a higher CR rate than those treated with either chemotherapy (75% versus 36%, p = 0.036) or WBRT (75% versus 44%, p = 0.109). Median follow-up time was 17 months, and a 7-year overall survival (OS) was 40%. Features associated with a prolonged OS were an ECOG score ≤ 2 (p = 0.001), multiple brain lesions (p = 0.010), multiple area of brain involvement (p = 0.023), MTD

The effect of splenectomy on pulmonary function test (PFT) and pulmonary hypertension (PH) in thalassemia remains unclear. We aimed to investigate PFT and their association with PH in patients with hemoglobin E/β-thalassemia stratified by their splenic status. Thirteen splenectomized patients (SP) and 12 non-splenectomized patients (NSP) were compared regarding to the PFT abnormalities and PH (mean pulmonary artery pressure from right-heart catheterization ≥25 mmHg or estimated systolic pulmonary artery pressure from echocardiography ≥40 mmHg). Eleven (84%) SP and 9 (75%) NSP had restrictive impairment (RI). Of these, more patients having severe RI in SP than in NSP (8 vs 2, P=0.035). FVC and PaO2 were lower in SP than in NSP (66±15% vs 77±12%, P=0.043, and 79.38±1.6 mmHg vs 98.83±6.2 mmHg, Pvs 64±15%, P=0.036). Seven (54%) SP who developed PH had a longer time interval between splenectomy and the onset of PH than those who did not (17±4.9 years vs 9.8±6.1 years, P=0.04). In conclusion, greater severity of extrapulmonary restrictive impairment and hypoxemia were more common in SP. These patients developed PH as a late complication unrelated to hypoxemia and PFT parameters. 因脾脏切除而对肺功能测试(PFT)以及地中海贫血症中肺动脉高压 (PH)情况造成的影响，尚不明确。我们旨在通过对血红蛋白E/β-地中海贫血症的患者进行脾脏位置的分级来探查肺功能测试(PFT)和肺动脉高压 (PH)之间的相关性。十三位脾切除患者(SP)和十二位未切除脾脏的患者(NSP)参与了有关肺功能测试(PFT)和肺动脉高压 (PH)(肺动脉高压是指从右心房导管术测量的肺动脉平均压力≥25 mmHg或者由超声心动图所估计的收缩期的肺动脉平均压力≥40 mmHg)的对比检查。十一位脾切除患者(SP)(84%)和九位未切除脾脏的患者(NSP)(75%)显现出了限制性的障碍 (RI)。毫无疑问，脾切除患者(SP)对于未切除脾脏的患者(NSP)表现出了更严重的限制性障碍(RI)(8 比2, P=0.035)。脾切除患者(SP)比未切除脾脏的患者(NSP)表现出更低的肺活量最大值及动脉氧分压值(相对应地，66±15% 比77±12%, P=0.043, 79.38±1.6 mmHg 比98.83±6.2 mmHg, P