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.
One of the Kurdish scholars who have research on the doctrinal issues of the author of this brief message that we are about to achieve; to bring it out better and in order to preserve the Islamic heritage, and revive what can be revived after being close to death by staying in libraries here and there, out of reach of hands, carrying dust Years of forgetting and marginalization, and this letter is the papers in the door of the divorce entitled his author "Iqdar al-dream for those who did not sign divorce commoner," and the name is evident the name, and the intention of the author through writing, where he wrote it to answer some of the knowledgeable among the public at the time So they decreed that there was no divorce from commoners D w
... Show MoreThe present work focuses on examining the strategy of cognitive trips and the Arabic language teachers’ training needs of such a strategy when teaching Arabic language courses in the Saudi Arabia Kingdom. To achieve the objective of the study, and check whether this strategy is used in lesson planning, lesson teaching, or lesson assessment, a descriptive approach and a questionnaire have been adopted. The researchers used a number of statistical tools, and chose a purposive sample, which consists of (58) Arabic language teachers from Saudi Arabia Kingdom. Results have shown that the training needs of Arabic language teachers for implemining the strategy of cognitive journeys while teaching Arabic language courses came in the following
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به نظر میآید که عالم هستی ، بر مسألهی « حرکت» استوار دارد ، و روح ، همیشه دنبال دگرگونی و تکامل و برتری میگردد. حرکت ، همهی چیزها در عالم إمکان را در بر میگیرد. حرکت در بنیادهای فکر مولانا جای مهمی دارد .اشعار مولانا مقدار زیادی از پویایی و حرکت برخوردارست، و از آنجایی که فعل ، عنصر تکانبخش جمله ، و کانون دلالت است ، ترجیح دادیم - علاوه بر دیگر عنا
... Show MoreThe Islamic architectural heritage constitutes a civilized fortune that has to be preserved and protected and work should be done to maintain its development to be more convenient for the circumstances of the age and the civilization transformations. Due to the fact that architecture represents the civilization pot and cultural identity, its originality has to be preserved and work has to be done to prevent the strange architectural invasion that changes its character and make it lose the identity and the character and detached from its roots and environment.
Decoration, in the interior design, as a concept is connected to ornamentation process of interior spaces, which is a process of adding certain items
... Show MoreBackground: Breast cancer is the most frequently diagnosed cancer in women worldwide and organized national mammographic screening has been adopted as gold standard for breast cancer early detection in most developed countries in the world.
Objectives: to evaluate and emphasize the performance of the initiative opportunistic breast cancer screening program in Iraq and to determine the incident malignancy rate of breast cancer among asymptomatic self-referring women aged 40 years or older via digital mammography by mean of the breast imaging reporting and data system (BI-RADS©).
Patients and methods: this retrospective study included a total of 809 asymptomatic self-referring women over age 40 years, mostly consisted of employees o
In this paper we introduce new class of open sets called weak N-open sets and we study the relation between N-open sets , weak N-open sets and some other open sets. We prove several results about them.
The study has tackled three important variables on the strategic and organizational level, that are : (Administrative skill, strategic Entrepreneurship and organizational flexibility). Through the statistical analysis is, the research hers have sought to identify the relation among them. The study has been applied on a sample of (44) private banks in Iraq. A questionnaire, which has been designed according to a number of international standards, has been used. It's made of (29) items that cover the three variables to test their hypotheses. A number of statistical tools have been used A number of conclusion have been reached and recommendations have also been suggested.
The health care provided by health institutions and all kinds suffers from many problems, and since the health services provided are related to human life, it is necessary to shed light on this activity and identify the causes of these problems. This research aims to Definition of health institutions (hospitals) Performance audit of these institutions according to the latest indicators, which are the standards of health accreditation for hospitals, specifically the basic standards issued by the Health Care Accreditation Council (HCAC) to reach the level of performance and Knowledge of Constraints that lead to in an acceptable manner consistent with the approved standards. In theoretical and practical study, a number of conclusions were r
... Show MoreOur study comes up to clarify the role of television in spreading the culture of violence with a child. This study represents one of the important studies that have tried to highlight the impact of these programmes, particularly cartoons, on the child's behaviors, actions and acquired habits.Violence considers a common phenomenon among the people, as the role of the media, particularly TV has a vital role due to its properties, characteristics and its significant impact on different segments and groups in society and in children particularly through exposure to programmes of films.The results of the study have been affected by the rising proportion of females to males, and that the contribution of real life has a big role in the child ac
... Show MoreEnvironmental Tax is deemed as one of the most important tools that can be used to eliminate the problem of oil –based environment pollution resulted out of oil products processes and this has been significantly approved by the experience in those leading countries in the field of protecting the environment against pollution whereas oil-producing countries which are rather awkward in maintaining the environment such as Iraq , suffer from notorious environmental effects pertaining to oil product processes.
The problem of the research is represented the increased and constant rise in the volume of the environmental pollutants resulted from the processes managed by the intern
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