简介：Autoimmunehepatitis(AIH)hasrarelybeendescribedasanautoimmuneparaneoplasticsyndromeofthymoma.ThiscaseistheseventhcaseofAIHrevealedbycholestasisfewyearsafterthediagnosisofthymomaandthefirstcasetreatedwithchemotherapyalone.Wereportinthispaperanewapproachtothisrareseverecondition.A29year-oldmanpresentedwithchestpainanddyspneawithahistoryofthymomasurgicallyremoved4yearsago.CTscanshowedtherecurrenceofananteriormediastinalmass.Biologyshowedelevatedliverenzymesandprofoundcholestasis.Nosignofviralortoxichepatitisorbileductabnormalitieswereobserved.Autoimmuneantibodies,exceptfortheanti-nuclearantibody,werenegative.LiverbiopsyshowedactivechronicAIH.ThepatientwasdiagnosedwithrecurrentthymomawithAIHandunderwent6cyclesofchemotherapy.Acompleteresponseonthymomaandcholestasiswasobtainedafter10monthsoffollow-up.SteroidsandimmunosuppressorsarethestandardtreatmentforAIH.Theeffectofchemotherapyasaspecifictreatmentofthisparaneoplasticsyndromeneedstobeconsidered.

简介：Objective:Chemotherapyisthestandardtreatmentforsmall-celllungcancer(SCLC),andleukopeniaisacommonsideeffect.Thisstudyassesseswhetherchemotherapy-inducedleukopeniaisapredictorofefficacyandwhetheritisassociatedwiththesurvivalofSCLCpatients.Methods:Aretrospectiveanalysiswasconductedondatafrom445patientswithSCLCwhoreceivedstandardchemotherapyfor4to10cycles.TheWorldHealthOrganizationgradingsystemclassifiesleukopeniaduringchemotherapyasfollows:absent(grade0),mild(grades1and2),orsevere(grades3and4).Theprimaryendpointisoverallsurvival(OS).Results:Theassociationbetweenchemotherapy-inducedleukopeniaandOSwasassessed.AccordingtoamultivariateCoxmodelwithtime-varyingcovariates,thehazardratioofdeathwassignificantlyloweramongpatientswithmildleukopeniathanamongpatientswithsevereleukopeniaat0.687(0.506to0.943)and1.414(1.147to1.744),respectively.Themediansurvivalwas13months(95%CI:11to15months)forpatientswhodidnotexperienceleukopenia,17months(95%CI:14to18months)forthosewithmildleukopenia,and14months(95%CI:13to16months)forthosewithsevereleukopenia(absentvs.mildvs.severeleukopenia,P=0.047).Conclusion:LeukopeniaduringchemotherapyisassociatedwiththesurvivalofSCLCpatients.Mildleukopeniaisstronglyassociatedwithlongersurvivaltime.

简介：A60-year-oldwomanwithsquamouscellcarcinomaintherightlungwassuccessfullytreatedwithfourcyclesofcombinationchemotherapyaftersurgery,andcompleteremissionwasachieved.However,thepatientdevelopedmyelodysplasticsyndrome(MDS)RAEB-2withmyelofibrosisafterremission,possiblybecauseofchemotherapyorDNAmethylation.Thepatientrespondedwelltodacitabine(Dacogen),suggestingthatDNAhypomethylationagentscanbeapromisingtherapytoretardtheprogressionofasecondtumororcarcinoma.