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Autologous peripheral blood stem cell transplantation(auto-PBSCT)combined with high-dose chemotherapy has been considered as the standard therapy for relapsed or induction therapy-refractory aggressive lymphomas sensitive to chemotherapy. While various regimens have been applied as the conditioning,none has yet been established as the standard. We have begun to employ high-dose ranimustine,cytarabine,etoposide and cyclophosphamide(MCVAC)regimen. The present study was undertaken to review the efficacy and safety of MCVAC. Regimen: We carried out a retrospective analysis of 20 patients diagnosed as diffuse large B-cell lymphoma. The median follow-up duration of 20 patients was 13.05 months(range, 0.57-49.5 months). The 4-year OS and PFS were 57.8% and 30.2%,respectively. Relapse was the most frequent cause of treatment failure(n=7). The major toxicities were anorexia/nausea(95%),diarrhea (75%),hypokalemia (70%). One patient died of hepatic veno-occlusive disease(VOD). The serious adverse events included hypokalemia,arrhythmia,cerebral hemorrhage,and heart failure(1 case[5%]each). There was 1 case of a late-onset adverse event: therapy-related myelo- dysplastic syndrome/acute myeloblastic leukemia(MDS/AML). MCVAC regimen was concluded as effective and well-toler- ated. However,we should carefully monitored for the possible development of VOD and MDS/AML. Further follow-up is needed to evaluate the long-term efficacy and safety.

Objective: To examine involvement of oxidative stress in the pathogenesis and vascular complications of diabetes., Methods: This cross sectional study was conducted at the Joint Laboratory Office (JLO), Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan from April 2010 to December 2011. Fasting glucose, glycosylated hemoglobin (HbA1c), serum lipids, urinary albumin excretion (UAE), ankle brachial index and pulse wave velocity were measured in 51 patients with type 2 diabetes and 20 healthy controls. The fundus oculi and Achilles` tendon reflex were also examined in the patients. Oxidative stress was measured by a reactive oxygen metabolites (ROM) test and antioxidant potency was evaluated by a biological antioxidant potential (BAP) test in the Free Radical Analytical System (FRAS)-4. Superoxide dismutase (SOD) activity was assayed using electron spin resonance (ESR)., Results: Diabetic patients tended to have increased ROM compared with healthy subjects, and ROM showed a marked increase with progression of diabetic retinopathy. A significant reduction of BAP was found in patients who were smokers, and BAP was significantly negatively correlated with UAE (p=0.029). Serum SOD activity significantly decreased with progression of diabetic retinopathy (p=0.017)., Conclusion: The FRAS-4 measurements showed that increased oxidative stress and decreased antioxidative potency are linked to deteriorated blood glucose control, heavy smoking, and progression of retinopathy and nephropathy in patients with type 2 diabetes.

Twenty patients with relapsing myeloma were treated with combination chemotherapy of ranimustine, doxorubicine, and dexamethasone (RAD) between July 1996 and March 2000. Of the 19 evaluable patients, 5 (26.3%) achieved partial response after the first round of RAD therapy and 10 (52.6%) achieved partial response after the second round of RAD therapy. Of 10 evaluable patients who had previously received high-dose dexamethasone therapy including VAD therapy, 2 (20%) achieved partial response after the first round of RAD therapy and 3 (30%) achieved partial response after the second round of RAD therapy. The median survival was 10.5 months and the progression-free survival was 9.3 months. Patients who responded to RAD therapy had a survival rate at 43 months of 59.3%. Toxicity and adverse events during RAD therapy were tolerable. This pilot study demonstrated that RAD therapy is useful for the treatment o frefractory myeloma.