Background: CHOP regimen was the standard treatment for patients with diffuse large and mixed cells Non-Hodgkin's lymphoma (NHL) even in comparison with second and third generation regimen. Recently Rituximab –CHOP is considered the standard treatment for aggressive B-cell NHL while CHOP (alone) is so for aggressive T-cell NHL, yet more than one study investigates another regimen which is VACOP-B and some showed its superiority over CHOP. Prior to the introduction of Rituximab, we used VACOP-B in the treatment of high &intermediate grade NHL in adult Iraqi patients as an alternative to CHOP.
Patients and Methods:We performed a prospective analysis of 20 adult patients who, between April 2000 and October2005, received VACOP-B chemotherapy for high and intermediate grade NHL. The weekly regimen consisted of: doxorubicin50 mg/m2 i.v. weeks 1,3,5,7,9,11; cyclophosphamide350 mg/m2 i.v. weeks 1, 5, 9; etoposide 100mg/m2iv, weeks 3,7,11; vincristine1.4 mg/m2 i.v. (2 mg max.) weeks 2, 4, 6, 8, 10;bleomycin 10 mg/m2 i.v.(max. 15 mg) weeks 2,4, 6,8, 10; methotrexate12.5 mg intratheical was given in selected patients.; prednisolone 60mg p.o.daily for 2 weeks, reduced to 60 mg every other day for 10weeks.The patients treated were aged 25-50 years, 8(40%) had high grade (Working Formulation )NHL; 12 (60%) had intermediate grade NHL;seventeen patients(85%) had Stage III/IV disease; and 3 (15%) had stage II,bone marrow involvement seen in 3(15%)patients .patients distribution regarding age adjusted international prognostic index(aaIPI)was 8(40%)with aaIPI 0,1and 12(60%)with 2,3. Follow-up time from completion of VACOP-B chemotherapy ranged from 6 months to 40 months (median 22).
Results: VACOP-B induced a complete response (CR) and partial response (PR) in 70% and 15% respectively, whilst one patient had no response to treatment and died due to progression of the disease, 2 patients died due to treatment related toxicity. The three year disease free survival (DFS) was 78%, where 4 patients relapsed, one of them in the central nervous system. This study showed 3-year overall survival (OS) 100% for those with a IPI 0-1and 48% for those with aa IPI 2-3. Tolerance to treatment was measured by WHO toxicity scores. The hemoglobin (Hb) toxicity median score for all patients was grade 1 (Hb 9.5-10.9 g/dl), and the white cell count (WCC), toxicity score was grade 2(WCC 2.0-2.9 x 109/1). No platelet toxicity was observed. Ten per cent of patients suffered grade 3 severity infections requiring antibiotics and there was two treatment related death.
Conclusions: VACOP-B chemotherapy is an effective regimen for high and intermediate grade NHL, with an encouraging result in patients with aaIPI 0, 1. although chemotherapy was given weekly, the tolerance to treatment was acceptable. Studies comparing VACOP-B vs. CHOP chemotherapy to decide the exact role of the first in treating high grade &intermediate grade NHL, in the absence of Rituximab, are still needed.
Microfinance Institutions (MFIs) offers small loans with easy repayment system and till now these institutions have served millions of needy people around the globe. This study highlights the hurdles influence the smooth working and growth of Microfinance institution in Egypt. The structured interviews were conducted from the top and mid-level managers of MFI's. This study revealed that interest rate, political and economic conditions, corruption, customer outreach, competition and technology are the important elements for MFI's success. It is evident that lack of use of technology and less importance drawn on customer outreach programs are the main challenges of MFI's in Egypt. This study provides a roadmap for practitioners and strategic
... Show MoreThe imperative of achieving financial stability has transcended national boundaries, necessitating heightened attention from both researchers and policymakers. Consequently, this article delves into an examination of the impact of government debt and public debt on financial development within the context of Iraq. The study employs monetary policy, interest rate, inflation, and population growth as control variables to prognosticate financial development. Utilizing data extracted from the World Development Indicators (WDI) spanning the period from 1995 to 2022, the study employs the dynamic autoregressive distributed lag (DARDL) approach to scrutinize the associations under investigation. The findings underscore a negative association betwe
... Show MoreIn this research, the effect of the rotation variable on the peristaltic flow of Sutterby fluid in an asymmetric channel with heat transfer is investigated. The modeling of mathematics is created in the presence of the effect of rotation, using constitutive equations following the Sutterby fluid model. In flow analysis, assumptions such as long wave length approximation and low Reynolds number are utilized. The resulting nonlinear equation is numerically solved using the perturbation method. The effects of the Grashof number, the Hartmann number, the Hall parameter, the magnetic field, the Sutterby fluid parameter, and heat transfer analysis on the velocity and the pressure gradient are analyzed graphically. Utilizing MATHEMATIC
... Show MoreChalcopyrite thin films ternary Silver Indium Diselenide AgInSe2 (AIS) pure and Aluminum Al doped with ratio 0.03 was prepared using thermal evaporation with a vacuum of 7*10-6 torr on glass with (400) nm thickness for study the structural and optical properties. X-ray diffraction was used to show the inflance of Al ratio dopant on structural properties. X-ray diffraction show that thin films AIS pure, Al doped at RT and annealing at 573 K are polycrystalline with tetragonal structure with preferential orientation (112). raise the crystallinity degree. AFM used to study the effect of Al on surfaces roughness and Grain Size Optical properties such as the optical band gap, absorption coefficient, Extinction coefficient, refractive ind
... Show MoreThermonuclear reaction rates are calculated for three oxygen isotopes 14,15,16O in CNO cycles reactions occurring in red giant stars. These reactions are:, , , , and . Reaction rates have been calculated using Matlab codes, and related comparisons were made with NACRE II and Reaclib libraries, and the ratios of production to the destruction of 15,16O isotopes were found. Present reaction rate results were close to most of the selected reactions, and in some cases larger with a factor of 1-3. 15,16O production to destruction ratios indicated a special tendency to saturate at temperatures higher than ~ 2 GK, and these ratios were in general larger than 1 indicating an excess of producing such isotopes in re
... Show MoreObjective: The present study aimed to shed light on the role of narghileh and cigarette smoking on immunity status of oral cavity by assess (C3 complement component, Immunoglobulin A, Total protein, α-Amylase and EBV IgG antibody). Method: Saliva levels in two smokers groups the first include 28 narghileh smokers and the second include 32 narghileh and cigarette smokers as well as 30 non-smokers consider as control. Results: As compared control, the levels of C3, IgA and total protein were significantly decreased, and the highest decreased was observed in saliva of narghileh and cigarette smokers, the result was (C3= 0.400±0.194 µg vs. 9.728±3.561 µg; IgA= 2.460±0.492 mg/dl vs. 5.048±0.937 mg/dl; Total protein= 170.20±45.93 mg% vs.
... Show MoreAn experiment during the two seasons 2019, 2020. The experiment conducted according to Split Plot Design by two factors; the first was addition Nano NPK with five levels (control, addition 7.5 g.plant-1, addition 15 g.plant-1, spray 1 g.L-1, spray 2 g.L-1). The second factor was four levels of Mineral NPK which were (control, 50 g.plant-1, 100 g.plant-1, 50 g.plant-1+1.5 g.L-1) respectively. N3 (spray 1 g.L-1 ) increased plant height, stem diameter first season, branch number se
Aim: To evaluate the commercial pure titanium disks that structuring by laser in two design (dot and groove) each one with three different laser scan (5, 15 and 25) and comparing with titanium surface that not subjected to any surface structuring (control) through measuring the wettability test and surface roughness test. Materials and methods: Structuring on the surface of the commercial pure titanium (CP Ti) disks was performed via using fiber laser CNC machine in two design (dot and groove) in three different laser scans (5, 15 and 25), then the structuring disks analyzed with the control group by atomic force microscope and water contact angle test. Results: The results of this study showed that the surface roughness and the wettability
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