Search

Hepatocellular carcinoma (HCC) is regarded as a high-mortality cancer, but the effectiveness of surgical strategies for young patients with early-stage HCC remains controversial. We aimed to analyze the survival in young patients with stage I-II HCC who underwent different kinds of surgical treatments.Overall survival (OS) and cancer-specific survival (CSS) were compared among patients aged 18-45 years with stage I-II HCC from the Surveillance, Epidemiology, and End Results (SEER) database (2004-2013) who underwent local tumor destruction (LTD), wedge or segmental resection (WSR), lobectomy resection (LR), liver transplantation (LT), or non-surgery. Univariate and multivariate analyses and Kaplan-Meier method were used to examine the OS and CSS of the patients. A stratification analysis of CSS was also conducted among the subgroups.Data from 664 patients were extracted. The median survival time was 46 months. In the multivariate analysis of OS, compared with non-surgery, LTD [hazard ratio (HR), 0.37; 95% confidence interval (CI): 0.25-0.54; P0.0001], LR (HR, 0.29; 95% CI: 0.19-0.45; P0.0001), and WSR (HR, 0.26; 95% CI: 0.17-0.39; P0.0001) had better outcomes, and LT had the best survival benefit (HR, 0.24; 95% CI: 0.16-0.36; P0.0001), which was similar to CSS. In the stratification analysis, compared with the non-surgery group, among patients with chemotherapy, LT reduced the risk of CSS by 64% (HR, 0.36; 95% CI: 0.19-0.66; P interaction=0.0004).Surgery offers a survival benefit compared with non-surgery for young patients with stage I-II HCC. LT is associated with better survival than WSR, LR, and LTD.

Evidence regarding the need for surgery for primary intestinal non-Hodgkin lymphoma (PINHL) patients with chemotherapy is limited and controversial. We aimed to investigate the specific impact of surgery on survival of PINHL patients. Data from PINHL patients (aged > 18 years) with chemotherapy between 1983 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. We concerned about overall survival (OS) and improved cancer-specific survival (CSS). Propensity score matching (PSM) analysis was also used to explore the reliability of the results to further control for confounding factors. Finally, we screened 3537 patients. Multivariate regression analysis showed that patients with surgery and chemotherapy had better OS (hazard ratio [HR] 0.83; 95% confidence interval [CI] 0.75–0.93; p = 0.0009) and CSS (HR 0.87; 95% CI 0.77–0.99; p = 0.0404) compared with the non-operation group after adjusting for confounding factors. After PSM analysis, compared with non-surgery, surgery remained associated with improved OS (HR 0.77; 95% CI 0.68–0.87; p

Background The anti-tumor properties of curcumin have been demonstrated for many types of cancer. However, a systematic functional and biological analysis of its target proteins has yet to be fully documented. The aim of this study was to explore the underlying mechanisms of curcumin and broaden the perspective of targeted therapies. Methods Direct protein targets (DPTs) of curcumin were searched in the DrugBank database. Using the STRING database, the interactions between curcumin and DPTs and indirect protein targets (IPTs) weres documented. The protein–protein interaction (PPI) network of curcumin-mediated proteins was visualized using Cytoscape. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis was performed for all curcumin-mediated proteins. Furthermore, the cancer targets were searched in the Comparative Toxicogenomics Database (CTD). The overlapping targets were studied using Kaplan–Meier analysis to evaluate cancer survival. Further genomic analysis of overlapping genes was conducted using the cBioPortal database. Lastly, MTT, quantitative polymerase chain reaction (qPCR), and western blot (WB) analysis were used to validate the predicted results on hepatocellular carcinoma (HCC) cells. Results A total of five DPTs and 199 IPTs were found. These protein targets were found in 121 molecular pathways analyzed via KEGG enrichment. Based on the anti-tumor properties of curcumin, two pathways were selected, including pathways in cancer (36 genes) and HCC (22 genes). Overlapping with 505 HCC-related gene sets identified in CTD, five genes (TP53, RB1, TGFB1, GSTP1, and GSTM1) were finally identified. High mRNA levels of TP53, RB1, and GSTM1 indicated a prolonged overall survival (OS) in HCC, whereas elevated mRNA levels of TGFB1 were correlated with poor prognosis. The viability of both HepG2 cells and Hep3B cells was significantly reduced by curcumin at concentrations of 20 or 30 μM after 48 or 72 h of culture. At a concentration of 20 μM curcumin cultured for 48 h, the expression of TGFB1 and GSTP1 in Hep3B cells was reduced significantly in qPCR analysis, and reduced TGFB1 protein expression was also found in Hep3B cells.

Background: Evidence regarding the need for surgery for primary intestinal non-Hodgkin lymphoma (PINHL) patients with chemotherapy is limited and controversial. However, there is a lack of large-scale multicenter studies for the specific analysis of this population. We aimed to investigate the specific impact of surgery on survival in a large cohort of PINHL patients (aged >18 years) with chemotherapy. Methods: For this retrospective cohort study, data from PINHL patients (aged >18 years) with chemotherapy between 1983 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database through strict acceptance and discharge standards. The primary and secondary objectives were to access improved overall survival (OS) and improved cancer-specific survival (CSS) with surgery, respectively. In addition to multiple regression analysis and stratification analysis adjusted for confounding factors, propensity score matching (PSM) analysis was used to explore the reliability of the results to further control for confounding factors. Findings: Data were collected from the SEER database for 8398 patients; 3537 met inclusion criteria. The median survival was 53 months. Multivariate regression analysis showed that patients with surgery and chemotherapy had significantly better OS (hazard ratio [HR] 0·83, 95% confidence interval [CI] 0·75–0·93; P=0·0009) and CSS (HR 0·87, 95% CI 0·77–0·99; P=0·0404) compared with the non-operation group after adjusting for age, gender, race, marital status, year of diagnosis, Ann Arbor stage, histology, tumor size, and radiation. In particular, histological subgroup analyses showed that patients with primary intestinal diffuse large B-cell lymphoma had a better prognosis with chemotherapy plus surgery compared with the non-operation group (HR 0·71, 95% CI 0·60–0·84; P for interaction=0·0067). After PSM analysis, compared with non-surgery, surgery remained associated with improved OS (HR 0·77, 95% CI 0·68–0·87; P

The adverse events of immune checkpoint inhibitors (ICIs) are mostly immune mediated reactions. In this study, we presented a patient who developed coexisting of myasthenia gravis, myocarditis and anemia after treatment with nivolumab only 1 cycle for ureteral epithelial cancer. A 66-year-old woman was admitted to our department with the complaint of recurrent hematuria and backache for 2 months. This patient was diagnosed with stage IV, T4N3M1, urothelial carcinoma of the right kidney. She received immune checkpoint therapy consisting of nivolumab. Then, the physical and neurological examination found the ptosis of eyes especially the right eye and weakness of proximal limb muscles. Patient presented with sub-sternal chest discomfort, shortness of breath, electrocardiograms suggested atrial fibrillation and possible acute myocardial ischemic. One week later, this patient died of ventricular arrhythmia. This patient has increased clinical awareness by indicating that the immune-related adverse events (irAEs) could simultaneously involve multiple systems and progress quickly. Early recognition of aberrant immune activation and complete evaluation upon the occurrence of irAEs are critical.

Background The anti-tumor properties of curcumin have been elucidated in many cancer types. However, a systematic functional and biological analysis related to its target proteins has yet to be documented fully. The aim of this study was to explore the underlying mechanisms of curcumin and broaden the perspective of targeted therapies. Methods Direct protein targets (DPTs) of curcumin were searched in the DrugBank database. Using the STRING database, the interaction between curcumin and DPTs and indirect protein targets (IPTs) was documented. The protein–protein interaction (PPI) network of curcumin-mediated proteins was visualized using Cytoscape. The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis was performed for all curcumin-mediated proteins. Furthermore, the cancer targets were searched in the Comparative Toxicogenomics Database (CTD). The overlapping targets were studied using Kaplan–Meier analysis to evaluate cancer survival. Further genomic analysis of overlapping genes was conducted using the cBioPortal database. Lastly, CKK-8, qPCR, and WB analysis were used to validate the predicted results on HCC cells. Results A total of 5 DPTs and 199 IPTs were found. These protein targets were found in 121 molecular pathways analyzed via KEGG enrichment. Based on the anti-tumor properties of curcumin, two pathways were selected, including pathways in cancer (36 genes) and hepatocellular carcinoma (HCC) pathway (22 genes). Overlapping with 505 HCC-related gene sets identified in CTD, five genes (TP53、 RB1、 TGFB1、 GSTP1、 and GSTM1) were finally identified. High mRNA levels of TP53, RB1, and GSTM1 indicated a prolonged OS in HCC, while elevated mRNA levels of TGFB1 were correlated with poor prognosis. The viability of HepG2 cells and Hep3B cells can both be significantly reduced by curcumin at concentrations of 20 or 30 µM after 48 or 72 h of culture. At a concentration of 20 µM curcumin, the expression of TGFB1 and GSTP1 in Hep3B cells was reduced significantly in qPCR analysis, and reduced TGFB1 protein expression was also found in Hep3B cells. Conclusions The current results provided evidence that curcumin has the potential to become an alternative chemotherapy or chemoprevention for HCC.

Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of adult non-Hodgkin's lymphoma (NHL). While DLBCL is sensitive to chemotherapy, a certain percentage of patients with DLBCL experience relapse. Previous studies have indicated that Yiqichutan treatment, which was developed to treat NHL, can inhibit DLBCL cell growth, but the mechanism is not fully understood. The present study identified 991 differentially expressed mRNAs, with 498 upregulated and 493 downregulated (P

There are limited data on serum total light chain (sTLC) in lymphoma and its relative role on the outcome of diffuse large B cell lymphoma (DLBCL) patients. Blood samples from 46 cases newly diagnosed with DLBCL were collected consecutively during chemotherapy to detect sTLC, IgG, IgA, and IgM levels. Clinical data and survival outcomes were analyzed according to the results of sTLC measurements. In summary, 22 patients (47.8 %) had abnormal k or λ light chain, respectively, and 6 patients (13.0 %) had both abnormal k and λ light chains before chemotherapy. Patients with elevated k light chain more frequently displayed multiple extra-nodal organ involvement (P = 0.01) and had an inferior overall survival (OS) (P = 0.041) and progression-free survival (PFS) (P = 0.044) compared to patients with normal level of k light chain. Furthermore, patients with elevated level of both k and λ also exhibited significant association with shorter OS (P = 0.002) and PFS (P = 0.009). Both elevated k alone and concurrent elevated k and λ had independent adverse effects on PFS (P = 0.031 and P = 0.019, respectively). sTLC level was reduced gradually by treatment in this study and reached the lowest point after the fourth cycle of chemotherapy, which was consistent with the disease behavior during chemotherapy. Considering the small sample size of this study, these results should be confirmed in a larger prospective study.

Non-Hodgkin's lymphoma (NHL) involving the ileocecal region is a rare occurrence. Optimal management and treatment outcomes of ileocecal NHL have not been well defined.In this study, clinical characteristics, treatment outcomes, and prognostic factors of 46 Chinese patients with ileocecal NHL were retrospectively analyzed.Among 46 patients, the median age of these patients was 46 years and 84.8% of them were male. Twenty-four cases (52.2%) had early-stage disease (stage I/II1/II2) and 35 (76.1%) cases were of B-cell origin. Higher incidence of fever (P=0.001) and intestinal perforation (P=0.038) at onset was observed in T-cell lymphomas. Surgical emergencies occurred in 13 patients, including 8 patients who were receiving chemotherapy. Patients with T-cell advanced ileocecal NHL (stage IIE/IV) suffered more surgical emergencies during chemotherapy than others (P=0.005). The 5-year overall survival and progression-free survival rates for these 46 patients were 64.2% and 49.3%, respectively. Early-stage cases undergoing radical resection before chemotherapy had a prolonged 5-year progression-free survival rate (P=0.01). In multivariate analysis, both advanced stage and T-cell phenotype were identified as independent prognostic factors for poor survival.Radical resection before chemotherapy should be considered in early-stage ileocecal NHL to achieve a better survival. Palliative resection of the primary lesion before chemotherapy may be necessary in T-cell advanced cases to avoid surgical emergencies during chemotherapy. Owing to the small sample number in this study, a prospective analysis with larger sample number is highly necessary.

Non-Hodgkin's lymphoma of mucosa-associated lymphoid tissue (MALT) type arises from a wide variety of extranodal sites, most frequently from the gastrointestinal tract. Recently, it has been demonstrated that karyotypic alterations involving the PIK3CA and FOXP1 genes of chromosome 3 occur in MALT lymphoma. However, their associated protein expression has not been extensively studied. Tumor tissues from 27 gastric and 23 intestinal MALT lymphomas were analyzed for PIK3CA and FOXP1 protein expression using immunohistochemistry and correlated with histological features and treatment outcomes. Expression of PIK3CA, a novel indicator, was found in 40% of gastrointestinal cases and indicated an inferior progression-free survival in both gastric and intestinal MALT lymphomas (P = 0.001 and P = 0.015). Tumor staining of nuclear FOXP1 (46.0%) was more common in gastric than intestinal MALT lymphomas (P = 0.042) and was significantly associated with polymorphic histology (P = 0.007). FOXP1 expression was identified as an adverse prognostic factor for overall survival in gastric MALT lymphomas (P = 0.035). We further combined these two markers and observed that patients that are positive for both PIK3CA and FOXP1 had a worse overall and progression-free survival. Considering the small sample size of this study, these results should be confirmed in a large prospective study.

During chemotherapy for lymphoma, the administration of cytotoxic agents and rituximab often results in hepatitis B reactivation (incidence, 14-72%). This study was designed to compare the efficacy of entecavir and lamivudine in preventing hepatitis B reactivation in lymphoma patients. Between January 2007 and February 2009, patients treated in four hospitals in China were screened to identify those most appropriate for analysis. These patients received either entecavir or lamivudine during chemotherapy and for 6 months after completion of chemotherapy. A total of 34 patients received entecavir and 89 patients received lamivudine. Compared with the lamivudine group, the entecavir group had significantly lower rates of hepatitis (5.9 vs 27.0%, P = 0.007), hepatitis B reactivation (0 vs 12.4%, P = 0.024) and disruption of chemotherapy (5.9 vs 20.2%, P = 0.042). All patients with hepatitis B reactivation had B-cell non-Hodgkin's lymphoma (stage III-IV). In lymphoma patients under chemotherapy treatment, entecavir is more effective than lamivudine in preventing hepatitis B reactivation. For patients with advanced stage disease, entecavir should be considered the primary preventive therapy.

RATIONALE Metastases of breast carcinoma to the main bronchus and choroid are rare, but have been reported in relevant literature. Late distant recurrence of breast carcinoma after more than 20 years is extremely rare. Herein, we report a 57-year-old woman with late distant recurrence and metastasis to the main bronchus and choroid almost 28 years after surgery. PATIENT CONCERNS At the age of 29, the patient underwent chemotherapy and endocrine treatment after a right side mastectomy to remove breast carcinoma. The patient was hospitalized for a cough with blood-tinged sputum, dysphagia, and blurred vision in the left eye at the age of 57. DIAGNOSES On evaluation, laboratory findings detected the elevated serum tumor markers of CA12-5, CA15-3, NSE, and Cyfra21-1. The imaging showed left lung metastase, multiple lymph node metastases, and small suspected metastases in the both sides of parietal lobes. Fundus fluorescein angiography showed choroidal occupying lesion of the left side which indicates secondary metastasis and retinal detachment. Combined with the pathological finding via fiberoptic bronchoscopic biopsy, the patient was clinically diagnosed with a late distant recurrence of breast carcinoma. INTERVENTIONS The patient received oral endocrine therapy of letrozole, but she refused chemotherapy, radiotherapy and other topical treatments. OUTCOMES At the 3-month follow-up visit, the multiple lesions of the left lung and lymph nodes had partially regressed, and the lesion of right parietal lobe had disappeared. The patient's clinical symptoms, such as blood-tinged sputum and dysphagia, had significantly improved. LESSONS We have described this case and reviewed the relevant literature concerning late distant recurrence of breast carcinoma. Importantly, this case indicates that patients with HR positive breast carcinoma are more likely to develop late distant recurrence and clinicians should not ignore the follow-up examinations even more than 20 years after the surgery.

Pirarubicin is an analog of doxorubicin. Few studies have compared the long-term outcomes of patients receiving pirarubicin-based THP-COP and doxorubicin-based CHOP in the treatment of non-Hodgkin's lymphoma (NHL). We retrospectively compared the efficacy and safety of these two regimens in 459 previously untreated aggressive NHL patients admitted to Sun Yat-Sen University Cancer Center from 1987 to 2003. For initial treatment, 205 patients received the THP-COP regimen, and 254 patients received the CHOP regimen. The patients' characteristics were well balanced. The groups did not differ in the complete remission rate (THP-COP, 57.1% vs. CHOP, 57.0%; P = 0.998) or response rate (THP-COP, 82.9% vs. CHOP, 81.5%; P = 0.691). At a median follow-up of 95.7 months, the 8-year survival rates were also similar (overall survival: THP-COP, 55.8% vs. CHOP, 56.7%; progression-free survival: THP-COP, 47.3% vs. CHOP, 43.5%; lymphoma-specific survival: THP-COP, 51.2% vs. CHOP, 48.5%). The THP-COP group had fewer cases of alopecia (P < 0.001) and gastrointestinal toxicities (P = 0.015). A tendency toward decreased arrhythmia (P = 0.075), especially in elderly patients (P = 0.030), was found. In combination chemotherapy for aggressive NHL, pirarubicin has comparable efficacy to doxorubicin and has a lower incidence of alopecia, gastrointestinal toxicities, and arrhythmia. Further studies are warranted to confirm these results.

e17007 Background: Distant mNPC, commonly treated with platinum-based chemotherapy, is conventionally considered as an incurable disease. We explored the efficacy and survival of cetuximab plus pla...

e19532 Background: High-dose cytarabine treatment of non-Hodgkin lymphoma most likely cause severe thrombocytopenia which may be fatal. Thrombopoietin (TPO) specifically stimulates megakaryopoiesis...

Abstract 4148 Background extranodal NK/T cell lymphoma, nasal type (ENKL) has worse efficacy and prognosis than B-NHL. Circulating EBV DNA concentration can reflect the efficacy and prognosis in some EBV related malignance (nasopharyngeal carcinoma). But there are few studies about the relation between EBV infection and ENKL. This prospective study is to confirm predictive value of circulating EBV DNA concentration and EBV serology in ENKL patients. Methods In the prospective study, serum samples from 125 previously untreated ENKL patients were collected from Jan 2002 to Dec 2006. We detect VCA-IgA and EA-IgA level by immunoenzyme methods and circulating EBV DNA concentration by real-time PCR assay. All patients were received long-term efficacy and survival assessment. Results The median follow-up time is 4.53 years. The positive rates of VCA ƒüIgA and EA ƒüIgA are 30.6% and 1.6% respectively, both of which could not predict the efficacy and survivals. The positive rate of circulating EBV DNA is 69.4%, with a median concentration of 13400 copies/ml. Patients with extranodal involvement, B syndrome, upper respiratory involvement, neutropenia or anemia or thrombocytopenia, liver dysfunction, and increasing of β2MG, have significantly higher EBV DNA positive rate(45.1% A54.4% A62.3% A53.5% A90.0% A59.3%, respectively). Patients in higher EBV DNA concentration group is easier to have bone and/or skin involvement (≤13400 copies/ml group: 45.8%vs. >13400 copies: 16.0%, p=0.024). The positive circulating EBV DNA group has a lower complete remission (CR) rate (38.8%vs.59.2%, p=0.026), higher relapse rate (52.6%VS.26.7%, p=0.046) than negative one. The 5-year DFS and 5-year OS decreased with the dose of circulating EBV DNA group (DFS: negative group74.3% vs. ≤13400 copies/ml group 55.0% vs. >13400 copies/ml group 28.6%, p=0.003; OS: negative group 55.8% vs. ≤13400 copies/ml group 48.4% vs. >13400 copies/ml group 29.2%, p=0.004). Conclusions The positive rate of circulating EBV DNA is much higher in ENKL. Circulating EBV DNA concentration, as measured by real-time PCR, is a useful tumor marker for diagnosis and prognostication with ENKL patients. Patients with higher dose of circulating EBV DNA level (>13400 copies/ml) may undergo more aggressive biological behavior. Disclosures: No relevant conflicts of interest to declare.

4042 Background: With the development of more effective regimens, the use of neoadjuvant (preoperative) chemotherapy (CT) was considered to down-stage tumor and improves resectability. However, most reports of neoadjuvant CT for gastric cancer were inconclusive and produced confusing results. The objective of this analysis is to assess the effect of neoadjuvant CT in gastric cancer. Methods: By searching electronic databases (PubMed, EMBASE, CENTRAL, J-STAGE and CNKI) and ASCO, AACR proceedings, all randomized controlled trails (RCTs) which compared the effect of neoadjuvant CT combined surgery versus surgery alone in gastric cancer would be included. The primary outcome was overall survival (OS). Secondary outcomes included R0-resection rates, postoperative stage and complications. Hazard Ratio (HR) and Odds Ratio (OR) with fixed effect model were used for meta-analysis and were expressed with 95% confidence intervals (CI). Results: 8 RCTs with a total of 1447 patients were included. All patients had loc...

8577 Background: Recent study showed that the most common gene abnomalities in gastrointestinal MALT lymphoma included 3q26.2 -27,11q23–24 amplifications and t(3;14) (p14.1;q32). MALT lymphoma shar...

8601 Background: Extranodal NK/T-cell lymphoma, nasal type (NKTL) is a rare disease originated from NK or toxic T cells. NKTL arising from the upper aerodigestive tract (UNKTL) is a newly recognize...

8556 Background: The level of circulating EBV DNA concentration is a prognostic marker in patients with some EBV-associated malignant diseases. To evaluate the prognostic impact of serum EBV DNA an...

18186 Background: Pulmonary lymphoepithelioma-like carcinoma (PLELC) belongs to large cell sub-type of non-small cell lung cancer (NSCLC) with just about 160 cases reported previously. Its epidemiology, prognosis and therapeutic approach is evidently different from other NSCLCs. EBV infection is seen in 100% of Asian PLELC patients whenever tested. The aim of this study was to analyze serum antibodies level against EBV in PLELC patients. Methods: Sera of all seven patients with re-confirmed PLELC from a single institute in Canton, China in the past 4 years were collected. Serum levels of 8 different antibodies against EBV (Epstein-Barr virus): EBNA1 (EBV nuclear antigen 1- IgA and IgG), Zta (Bam Z transactivator antigen-IgA and IgG), VCA-p18 (Viral capsid antigen-p18-IgA and IgG), VCA-antigen complex (VCA-IgA) and Early antigen complex (EA-IgA ) were measured in each of these patients using enzyme-linked immunosorbent assay and Immunoenzymatic assay respectively. Results: Out of 7 cases, 6 showed high EBNA-1 level, 4 showed high zta, 3 showed high VCA-p18, 3 showed high titer of VCA complex and 2 showed high EA complex titer ( Table 1 ) Conclusions: Though small sample size, this is the first study in this depth ever to conclude that sera of all Asian patients with pulmonary LELC have high antibody titers against EBV. The infection mainly is latency II type as seen in Nasopharyngeal carcinoma and Hodgkin’s disease as well. A small portion of PLELC express lytic products such as Zta, EA and VCA. The authors assume that pre-therapeutic measurement of serum levels of anti-EBV antibodies (at least 2 kinds) is highly warranted in suspected Asian NSCLC patients. Positive result strongly puts PLELC into differential diagnosis. [Table: see text] No significant financial relationships to disclose.

8081 Background: THP-ADM (Pirarubicin) has potential to replace conventional ADM (Adriamycin) because of less severe toxicities. However, only a few studies have compared the long-term outcome between patients receiving the two drugs. A Japanese trial (JGTLE) shows the CR rate of THP-COP group was greater than CHOP group in elderly T-cell Non-Hodgkin's Lymphoma (NHL) patients. The current study was aimed at comparing the long-term outcome and toxicities between NHL patients receiving CHOP and THP-COP regimens within similar age-groups and pathological sub-types. Methods: 505 previously untreated NHL patients receiving either standard CHOP or THP-COP regimen (cyclophosphamide 750 mg/m2, doxorubicin or pirarubicin 50 mg/m2, vincristine 1.4 mg/m2and prednisone 40 mg/m2 for 5 days) were enrolled. Results: Patients’ characteristics between CHOP group(n=279) and THP-COP (n=228) group were well balanced. There were no differences in CR rate (54.8% vs. 54.0%, p=0.85) and response rate (82.1% vs. 84.1%, p=0.55). With a median follow-up of 59.7months, survival rate was similar (5-year OS: 56.7% vs. 55.8%, 5-year PFS: 43.5% vs. 47.3%, 5-year DFS: 54.0% vs. 54.7%). The incidence of cardiotoxicity(myocardial dysfunction and arrhythmia)was almost the same (10.0% vs10.2 %; P=0.958). Less Alopecia (39.1% vs. 28.8%, p= 0.015)and gastrointestinal toxicities(63.1% vs. 50.0%, p=0.003) were observed in THP-COP group. No differences between the two groups were observed within different pathological subtypes (B-cell subtype: CR rate 58.2% vs. 56.7%, 5-year OS 59.2% vs. 60.0%; T-cell subtype: CR rate 47.0% vs. 45.5%, 5-year OS 50.5% vs. 43.4%) and age-groups ( No significant financial relationships to disclose.

17557 Background: Natural Killer (NK) cell lymphoma is a group of increasingly recognized but poorly defined disease entities. This study investigated its clinical features and prognostic factors for southern China population. Methods: Patients with pathologically confirmed NK cell lymphoma in one center since 1999 to 2004 were included. Central histological and immunohistochemical review was undertaken to every case. The major study endpoint was overall survival. Survival curves were estimated by the Kaplan-Meier method. Detailed clinical, pathological and laboratory data were included in univariate analysis and statistically significant factors in univariate analysis were then included in multivariate analysis. Results: Totally 64 eligible patients were identified. Of these, 59 patients were extranodal NK cell lymphoma nasal type, 3 patients were aggressive NK cell lymphoma and 2 patients were blastic NK cell lymphoma. From the basic analysis, 47% of the patients had stage I disease, 42% were stage II, 11% were stage III or IV. B-symptoms were present in 39%. 73% of these patients had International Prognostic Index (IPI) 0 or 1. Before treatment, 25% complicated with anemia. As to the therapy, 38% received chemotherapy alone, 3% received radiotherapy alone and 59% received a multidisciplinary therapy. After initial therapy, 59% achieved CR, 22% achieved PR and 19% were refractory disease. With a median follow-up duration of 20 months, the median overall survival was 28 months (95% CI: 10, 45). Hb lower than 110 g/l before treatment was statistically significant in multivariate analysis (p = 0.031). Presenting B-symptoms and ECOG PS score higher than 1 were also independent prognostic factors (P = 0.001 and 0.006 respectively). Conclusions: The outcome of patients with NK cell lymphoma was poor even for Stage I or II cases. Our data suggested Hemoglobin < 110 g/l had more prognostic value than IPI and Ann Arbor staging system for NK cell lymphoma in southern China, but it needs further confirmation. No significant financial relationships to disclose.