No abstract

Background: A high neutrophil to lymphocyte ratio (NLR) has been associated with adverse outcomes in non-small cell lung cancer (NSCLC). However, information on epidermal growth factor receptor (EGFR)-mutant advanced NSCLC is scarce, and most of the studies published have been conducted in Asian populations. We aimed to assess the influence of pretreatment NLR on progression-free survival (PFS) and overall survival (OS) in Western European patients treated with EGFR tyrosine kinase inhibitors (TKIs). Methods: A retrospective evaluation of 41 patients with EGFR-mutant advanced NSCLC treated with EGFR TKIs between June 2010 and May 2016 was carried out. The association between several prognostic factors including pretreatment NLR and survival was analyzed. Results: Median PFS and OS were 10.58 and 20.84 months, respectively. OS for patients with a high NLR was 7.4 months, compared to 24.6 months for patients with a low NLR (p = 0.0122). In multivariate analysis, poor performance status (ECOG PS ≥ 2) and presence of ≥ 3 metastatic locations were identified as significant independent prognostic factors for worse PFS. For OS, unfavorable prognostic factors were a high NLR and central nervous system metastasis at diagnosis. Conclusion: Pretreatment NLR is an independent prognostic factor for OS in Western European patients with EGFR-mutant NSCLC treated with EGFR TKIs.

The prognosis of follicular lymphoma (FL) has significantly improved over the last decade, particularly following the introduction of the anti-CD20 monoclonal antibody rituximab, which has challenged the old concept of FL as an incurable disease. However, the decision whether to start treatment in a patient with advanced FL or adopt a watch-and-wait policy remains a subject of controversy. Furthermore, the optimal first-line treatment for FL remains a clinical challenge owing to the numerous different therapeutic options available. In this review, the authors focus on the initial management of patients with newly diagnosed FL, consider the different treatment options for every stage, paying special consideration to the therapeutic approaches for each clinical scenario, and discuss future directions.

Artículo originalResumen Objetivo: determinar la calidad de vida y capacidad funcional de pacientes con artritis reumatoide. Métodos: se realizó una encuesta descriptiva prospectiva a pacientes portadores de artritis reumatoide en la unidad de medicina familiar (umf) no. 66 de Xalapa, Veracruz, México, de febrero a noviembre de 2015, aplicando las pruebas Qol-RA y haq para medir la calidad de vida y la capacidad funcional, respectivamente. Resultados: se incluyeron 217 pacientes, el género predominante fue femenino (92%), con una edad media de 55 años. El tiempo de evolución de la enfermedad fue de alrededor de siete años; 100% de la población tuvo tratamiento a base de fármacos modificadores de la enfermedad. La calidad de vida por Qol-RA fue buena para la mayoría (7.3), con el puntaje más alto en apoyo (8.4) y el menor en tensión nerviosa (6.6). En general se encontró discapacidad leve haq (0.77), con mayor afectación en alcanzar objetos (1.35) y menor en vestirse y asearse (0.34). Mediante el coeficiente de correlación de Pearson se observó que las actividades cotidianas se ven relacionadas negativa-mente con la presencia de dolor y artritis. Conclusión: los pacientes con artritis reumatoide adscritos a la umf no. 66 presentaron buena calidad de vida y discapacidad leve, con una correlación negativa entre ambas variables.

Abstract:Rituximab is an IgG1, chimeric monoclonal antibody specifically designed to recognize the CD20 antigen expressed on the surface of normal and malignant B-lymphocytes, from the B-cell precursor to the mature B-cells of the germinal center, and by most neoplasms derived from B-cells. After 2 decades of use, rituximab is firmly positioned in the treatment of follicular lymphoma (FL), both in the front line and in the relapsing disease, improving previous results by including it in classical chemotherapy regimens. However, the pharmacology of rituximab continues to generate controversial issues especially regarding the mechanisms of action in vivo. The contribution of rituximab as a maintenance treatment in FL has been significant progress in the management of this disease without an increase in side effects or a decrease in the quality of life of patients. With the widespread use of rituximab, there are new security alerts and side effects not previously detected in the pivotal trials that clinicians should learn to recognize and manage. In this article, we will review the pharmacokinetics and pharmacodynamics of rituximab, the management issues in the treatment of advanced FL focusing on maintenance rituximab, its long-term efficacy and safety profile, and its effect on the quality of life.