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In our experience, gemcitabine proved to be effective in pretreated MF and PTCLU patients, even in the long term.

This study assesses the usefulness of ultrasound in the diagnosis of portal hypertension due to hepatic cirrhosis. Seventy-nine patients with portal hypertension and 45 control subjects underwent ultrasonography. Two factors were measured: (a) the caliber of the portal vein and (b) the caliber variation of the splenic and superior mesenteric veins during respiration. A lack of normal caliber variation (an increase during inspiration and a decrease during expiration) in these vessels is put forward as an ultrasonographic sign of portal hypertension, and the pathophysiological and clinical significance of this finding are discussed. The sensitivity of ultrasound in detecting portal hypertension, based on the measurement of caliber variation, was 79.7%, and the specificity was 100%. In contrast, the sensitivity of the method, assessed on the basis of portal dilatation, was only 41.8%.

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BACKGROUND. Limited data exist about the role of second‐line chemotherapy response assessed by positron emission tomography (PET) as a prognostic factor in patients with aggressive non‐Hodgkin Lymphoma (NHL) who undergo autologous stem cell transplantation (ASCT). The objective of this analysis was to investigate the main determinants of prognosis in patients with aggressive B‐cell NHL who undergo ASCT, focusing on the impact of pretransplantation PET, secondary age‐adjusted International Prognostic Index (sAA‐IPI) score, histology, and previous response to first‐line chemotherapy. METHODS. Seventy‐five patients with diffuse, large B‐cell lymphoma or grade 3 follicular lymphoma who were treated at the author' institution with second‐line chemotherapy (combined ifosfamide, etoposide, and epirubicin [IEV]) followed by ASCT between September 2002 and September 2006 were included. All patients were evaluated by PET after 1 to 3 courses of IEV chemotherapy before ASCT, and all patients received a conditioning regimen of combined carmustine, etoposide, cytosine arabinoside, and melphalan. The prognostic impact of pretransplantation PET, sAA‐IPI score, histology, and previous response to first‐line chemotherapy was evaluated by univariate and multivariate analyses. RESULTS. Seventy‐two of 75 patients underwent ASCT. In a univariate analysis for progression‐free survival (PFS) and overall survival (OS), a significant association was observed with pretransplantation PET (PFS, P < .00001; OS, P < .01) and previous first‐line response (PFS, P = .02; OS, P = .04). In the multivariate framework, pretransplantation PET was identified as the only independent prognostic factor (PFS, P < .001; OS, P = .01). CONCLUSIONS. The current data indicated that pretransplantation PET is the main prognostic predictor in patients with aggressive B‐cell NHL who are scheduled for ASCT. Cancer 2008. © 2008 American Cancer Society.