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Primary adrenal lymphoma (PAL) is a rare subtype of all non-Hodgkin lymphomas in several literature reviews [[1]]. The following definition of PAL as used: (1) histologically proven lymphoma that involves one or both adrenal glands; (2) no prior history of lymphoma elsewhere; and (3) lymph nodes or other organ involvement allowed, but the adrenal lesion should be unequivocally dominant [[3]]. One patient (14.3%) received adrenalectomy for diagnosis and therapeutic purposes and did not receive chemotherapy because of renal failure and the patient's choice. Although upfront ASCT is not routinely recommended for DLBCL in first CR, some studies reported the efficacy of upfront ASCT in limited patients as high-risk DLBCL and primary central nervous system lymphoma [[11]]. [Extracted from the article]

NS-398, a selective inhibitor of cyclooxygenase 2 (COX-2), has been reported to inhibit growth and induce apoptosis in several cancer cell lines that overexpress COX-2. However it has not been extensively studied in multiple myeloma (MM). Here, we studied the effects of COX-2 inhibitors on MM cell lines and primary myeloma patient cells. We investigated the effects of NS-398 on proliferation and apoptosis in three myeloma cell lines (PCM6, U266 and RPMI8226) and isolated CD138-positive cells from MM patients. Furthermore, the combined effects of NS-398 plus dexamethasone (Dex) or thalidomide (Thal) were investigated. All myeloma cell lines express COX-2. NS-398 inhibited growth and induced apoptosis in PCM6, RPMI8226 and CD138-positive MM cells in a time- and dose-dependent manner. At low concentrations (10 μM), NS-398 primarily induced growth arrest without affecting cell viability, but at higher concentrations (over 25 μM), apoptosis was induced. During the process of apoptosis, the number of Fas-positive cells increased. Downstream signals of Fas, such as caspase 8, 3 and 9, were also activated. On the other hand, protein levels of the Bcl-2 family did not change, although mitochondrial transmembrane potential (Δψm) was decreased. Combined incubation with Dex or Thal enhanced NS-398-induced growth inhibition and apoptosis in RPMI8226 cells. The combined effect of Dex was more potent than that of Thal. Our findings suggests that COX-2 plays an important role in regulation of apoptosis in myeloma cells, and COX-2 inhibitors might serve as an effective tool for future chemoprevention and/or treatment of myeloma. [ABSTRACT FROM AUTHOR]