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Zhu LJ, Zhu J, Lu SY, Wang J, Sun FF, Huang JT, Que Y, Huang H, Huang HQ, Zhen ZZ, Sun XF, Zhang YZ. [Clinical characteristics and prognosis of pediatric relapsed/refractory anaplastic large cell lymphoma]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2023; 44:854-856. [PMID: 38049339 PMCID: PMC10694085 DOI: 10.3760/cma.j.issn.0253-2727.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Indexed: 12/06/2023]
Affiliation(s)
- L J Zhu
- Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, National Key Laboratory of Malignant Tumor Prevention and Treatment in South China, Guangzhou 510060, China Department of Oncology, the First People's Hospital of Yu Lin, Yulin 537000, China
| | - J Zhu
- Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, National Key Laboratory of Malignant Tumor Prevention and Treatment in South China, Guangzhou 510060, China
| | - S Y Lu
- Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, National Key Laboratory of Malignant Tumor Prevention and Treatment in South China, Guangzhou 510060, China
| | - J Wang
- Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, National Key Laboratory of Malignant Tumor Prevention and Treatment in South China, Guangzhou 510060, China
| | - F F Sun
- Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, National Key Laboratory of Malignant Tumor Prevention and Treatment in South China, Guangzhou 510060, China
| | - J T Huang
- Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, National Key Laboratory of Malignant Tumor Prevention and Treatment in South China, Guangzhou 510060, China
| | - Y Que
- Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, National Key Laboratory of Malignant Tumor Prevention and Treatment in South China, Guangzhou 510060, China
| | - H Huang
- Department of Internal Medicine, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China
| | - H Q Huang
- Department of Internal Medicine, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China
| | - Z Z Zhen
- Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, National Key Laboratory of Malignant Tumor Prevention and Treatment in South China, Guangzhou 510060, China
| | - X F Sun
- Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, National Key Laboratory of Malignant Tumor Prevention and Treatment in South China, Guangzhou 510060, China
| | - Y Z Zhang
- Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, National Key Laboratory of Malignant Tumor Prevention and Treatment in South China, Guangzhou 510060, China
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Eshghi P, Abolghasemi H, Akhlaghi AA, Ashrafi F, Bordbar M, Hajifathali A, Hosseini H, Mirbehbahani N, Abedini A, Shahsavarani N, Faranoush M. Patient and Physician Perspectives in the Management of Immune Thrombocytopenia in Iran: Responses from the ITP World Impact Survey (I-WISh). Clin Appl Thromb Hemost 2023; 29:10760296221130335. [PMID: 36630731 PMCID: PMC9841860 DOI: 10.1177/10760296221130335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Data describing physicians' and patients' perspectives towards immune thrombocytopenia (ITP) management and impact of disease in Iran are limited. This ITP World Impact Survey was conducted between October 2019 and October 2020. Of the 114 patients included in the survey, 17 were aged ≤18 years. Forty-seven physicians, including 22 pediatric hematologists, participated in the survey. Fatigue and anxiety around stable platelet counts were frequent patient-reported symptoms at diagnosis and at survey completion. According to physicians, "watch-and-wait" was the preferred treatment option for mean (standard deviation) proportion of 50.1 (24.1) and 48.6 (21.8) of their adult and pediatric patients, respectively, following first diagnosis. Per adult and pediatric hematologists, the most prescribed treatments for newly diagnosed patients based on available answers were steroids (100%, n = 20/20; 89%, n = 16/18), respectively. Forty percent of adult (n = 10/25) and 38% of pediatric hematologists (n = 8/21) reported that ITP reduced patients' quality of life. Energy levels (46%, n = 52/112) and ability to concentrate on everyday activities (42%, n = 47/113) were the most affected aspects of patients' lives. This I-WISh study in Iran underlined the negative impact of ITP on patients.
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Affiliation(s)
- Peyman Eshghi
- Pediatric Congenital Hematologic Disorders Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Abolghasemi
- Pediatric Congenital Hematologic Disorders Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali A. Akhlaghi
- Clinical Trial Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Ashrafi
- Internal Medicine Department, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Abbas Hajifathali
- Hematopoietic Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Hosseini
- Clinical Trial Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ayat Abedini
- Medical Department, Novartis Pharma Services AG, Tehran, Iran
| | | | - Mohammad Faranoush
- Pediatric Growth and Development Research Center, Iran University of Medical Sciences, Tehran, Iran,Mohammad Faranoush, Pediatric Growth and Development Research Center, Iran University of Medical Sciences, Tehran, Iran.
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Tomiyama Y, Cheze S, Grant L, Bonner N, Affinito S, Nagano M, Rajput T, Viana R. Japanese and French translation and linguistic validation of a patient-reported outcome tool to assess quality of life in patients with Immune Thrombocytopenia (ITP): the ITP Life Quality Index (ILQI). Int J Hematol 2022; 116:500-527. [PMID: 35675024 PMCID: PMC9515020 DOI: 10.1007/s12185-022-03382-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 04/14/2022] [Accepted: 05/01/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The Immune Thrombocytopenia (ITP) Life Quality Index (ILQI) is a 10-item patient-reported outcome (PRO) measure developed in US-English to assess health-related quality of life (HRQoL) of adults with ITP. Analysis of ILQI responses indicated differences between Western and non-Western countries. The objective of this study was to translate and linguistically validate the ILQI for Japan and France. METHODS The ILQI underwent dual forwards/backwards translation with reconciliation and resolution. The translations were reviewed prior to conducting cognitive interviews with ITP patients (n = 5 Japan, n = 5 France). Analysis of interview transcripts highlighted required modifications to the ILQI translations. Japanese and French ITP experts reviewed the final translations for cultural relevance and appropriateness. RESULTS Most of the Japanese and French forward/backwards translations were reconciled with no revision. The ILQI instructions and items were well understood by Japanese and French participants. Wording in one item of the Japanese version of the ILQI was revised to better align with the source instrument. Three terms/phrases in the French translation were revised due to misunderstanding, being deemed inaccurate or culturally inappropriate. Following review by ITP experts from Japan and France, minor modifications were made. CONCLUSION Findings confirm the linguistic validity of the ILQI in Japanese and French.
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Affiliation(s)
| | - Stèphane Cheze
- Institut d'Hematologie de Basse-Normandie, CHU Caen Hopital, Caen, France
| | - Laura Grant
- Adelphi Values Ltd, Adelphi Mill, Grimshaw Lane, Bollington, SK10 5JB, Cheshire, UK
| | - Nicola Bonner
- Adelphi Values Ltd, Adelphi Mill, Grimshaw Lane, Bollington, SK10 5JB, Cheshire, UK.
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Kandemir Alibakan Ö, Keskin G, Yılmaz U, Arman Y, Doğan EE, Apaydın Arıkan E. Granulomatous Inflammation in a Patient With Alk-Negative Anaplastic Large Cell Lymphoma. Turk J Haematol 2021; 39:82-83. [PMID: 34753277 PMCID: PMC8886270 DOI: 10.4274/tjh.galenos.2021.2021.0367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Özlem Kandemir Alibakan
- University of Health Sciences Turkey Prof. Dr. Cemil Taşçıoğlu City Hospital, Clinic of Internal Medicine, İstanbul,Turkey
| | - Gülşah Keskin
- University of Health Sciences Turkey Prof. Dr. Cemil Taşçıoğlu City Hospital, Clinic of Internal Medicine, İstanbul,Turkey
| | - Uğur Yılmaz
- University of Health Sciences Turkey Prof. Dr. Cemil Taşçıoğlu City Hospital, Clinic of Internal Medicine, İstanbul,Turkey
| | - Yücel Arman
- University of Health Sciences Turkey Prof. Dr. Cemil Taşçıoğlu City Hospital, Clinic of Internal Medicine, İstanbul,Turkey
| | - Esma Evrim Doğan
- University of Health Sciences Turkey Prof. Dr. Cemil Taşçıoğlu City Hospital, Clinic of Hematology, İstanbul,Turkey
| | - Evşen Apaydın Arıkan
- İstanbul University İstanbul Faculty of Medicine, Department of Pathology, İstanbul, Turkey
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Jiang JH, Zhang CL, Wu QL, Liu YH, Wang XQ, Wang XL, Fang BM. Rapidly progressing primary pulmonary lymphoma masquerading as lung infectious disease: A case report and review of the literature. World J Clin Cases 2021; 9:4016-4023. [PMID: 34141761 PMCID: PMC8180211 DOI: 10.12998/wjcc.v9.i16.4016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 02/22/2021] [Accepted: 03/24/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Primary anaplastic large cell lymphoma of the lung represents a diagnostic challenge due to diverse manifestations and non-specific radiological findings, particularly in cases that lack extra-pulmonary manifestations and lung biopsy. CASE SUMMARY A 40-year-old woman presented with a 6-d history of fever, dry coughing, and dyspnea. Her white blood cell count was 20100/mm3 with 90% neutrophils. PaO2 was 60 mmHg and SaO2 was 90% when breathing ambient air. Chest computed tomography (CT) identified a solid nodule, 15 mm in diameter, with a poorly defined boundary in the upper right lung, and several smaller solid nodules throughout both lungs. Pulmonary artery CT and subsequent bedside X-ray showed diffuse patchy shadows throughout both lungs. Repeated cultures of blood samples and alveolar lavage failed to identify any pathogen. Due to the mismatch between clinical and imaging features, we conducted a bone marrow biopsy, and the results showed proliferation along all three lineages but no atypical or malignant cells. The patient received empirical antibacterial, antiviral, and antifungal treatments, as well as corticosteroids. The patient's condition deteriorated rapidly despite treatment. The patient died 6 d after hospitalization due to respiratory failure. Post-mortem lung biopsy failed to show inflammation but identified widespread infiltration of alveolar septum by anaplastic lymphoma kinase (ALK)-positive anaplastic cells. CONCLUSION ALK-positive anaplastic large cell lymphoma could present as a primary pulmonary disease without extra-pulmonary manifestations.
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Affiliation(s)
- Jin-Hong Jiang
- Department of Hematology, Lishui City People's Hospital, Lishui 323000, Zhejiang Province, China
| | - Chun-Lai Zhang
- Department of Ultrasonography, Lishui City People's Hospital, Lishui 323000, Zhejiang Province, China
| | - Qin-Li Wu
- Department of Pathology, Lishui City People's Hospital, Lishui 323000, Zhejiang Province, China
| | - Yong-Hua Liu
- Department of Hematology, Lishui City People's Hospital, Lishui 323000, Zhejiang Province, China
| | - Xiao-Qiu Wang
- Department of Hematology, Lishui City People's Hospital, Lishui 323000, Zhejiang Province, China
| | - Xiao-Li Wang
- Department of Hematology, Lishui City People's Hospital, Lishui 323000, Zhejiang Province, China
| | - Bing-Mu Fang
- Department of Hematology, Lishui City People's Hospital, Lishui 323000, Zhejiang Province, China
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Auerbach A, Schmieg JJ, Aguilera NS. Pediatric Lymphoid and Histiocytic Lesions in the Head and Neck. Head Neck Pathol 2021; 15:41-58. [PMID: 33723759 PMCID: PMC7959275 DOI: 10.1007/s12105-020-01257-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/19/2020] [Indexed: 12/31/2022]
Abstract
Lymphoid and histiocytic lesions of the head and neck in pediatric patients is a fascinating topic as most of these lesions are benign, but that the neoplastic cases are essential to diagnose accurately for appropriate treatment. It is thought that 90% of children will have palpable lymph nodes between the ages of 4 to 8; most, but not all, are non-malignant and some resolve spontaneously without treatment. This paper will look at many of the benign and malignant lesions of both lymphocytic and histiocytic origin that present in the head and neck of children focusing on their diagnostic criteria. There is a very pertinent discussion of nonmalignant lymphoid proliferations, as infections and other reactive conditions dominate the pathology of pediatric lymphohistiocytic head and neck lesions. Discussion of those lymphomas which arise more frequently in the head and neck focuses on those seen in children and young adults such as classic Hodgkin lymphoma and Burkitt lymphoma, as well as new more controversial entities such as pediatric-type follicular lymphoma. Histiocytic lesions, both benign and malignant, are described and may be challenging to diagnose.
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Affiliation(s)
- A Auerbach
- The Joint Pathology Center, Silver Spring, MD, USA.
| | - J J Schmieg
- The Joint Pathology Center, Silver Spring, MD, USA
| | - N S Aguilera
- University of Virginia Health System, Charlottesville, VA, USA
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Lu N, Li XF, Dong YJ, Wang YN, Fu XR, Wu YM, Li YH, Wang MH, Li NN, Ren HY, Wang Z, Zhang MZ, Wu XX, Hu LD, Liu Y, Huang WR. [Outcomes of 33 patients with anaplastic large cell lymphoma treated after hematopoietic stem cell transplantation]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2020; 41:117-122. [PMID: 32135627 PMCID: PMC7357945 DOI: 10.3760/cma.j.issn.0253-2727.2020.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Indexed: 11/23/2022]
Abstract
Objective: To explore the efficacy and prognostic factors of hematopoietic stem cell transplantation (HSCT) for the treatment of patients with anaplastic large cell lymphoma (ALCL) . Methods: The clinical records of 33 ALCL patients after HSCT were collected and analyzed retrospectively to evaluate the rates of overall survival (OS) and recurrence after autologous (auto-HSCT) and allogeneic HSCT (allo-HSCT) and the factors influencing prognosis. Results: The median-age of this cohort of 33 ALCL cases at diagnosis was 31 (12-57) years old with a male/female ratio of 23/10, 24 cases (72.7%) were ALK(+) and 9 ones (27.3%) ALK(-). Of them, 25 patients (19 ALK(+) and 6 ALK(-)) underwent auto-HSCT and 8 cases (5 ALK(+) and 3ALK(-)) allo-HSCT with a median follow-up of 18.7 (4.0-150.0) months. Disease states before HSCT were as follows: only 6 patients achieved CR status and received auto-HSCT, 16 patients achieved PR (14 cases by auto-HSCT and 2 ones allo-HSCT) , the rest 11 cases were refractory/relapse (5 cases by auto-HSCT and 6 ones allo-HSCT) . There were 7 cases died of disease progression (5 after auto-HSCT and 2 allo-HSCT) and 5 cases treatment-related mortality (TRM) (2 after auto-HSCT and 3 allo-HSCT) , TRM of two groups were 8.0% and 37.5%, respectively. Both the median progression-free survival (PFS) and OS were 15 months after auto-HSCT, the median PFS and OS after allo-HSCT were 3.7 (1.0-90.0) and 4.6 (1.0-90.0) months, respectively. There was no statistically significant difference in terms of survival curves between the two groups (OS and PFS, P=0.247 and P=0.317) . The 2-year OS rates in auto-HSCT and allo-HSCT groups were 72% and 50%, respectively. The 5-year OS rates in auto-HSCT and allo-HSCT groups were 36% and 25%, respectively. Conclusion: ALCL treated by chemotherapy produced high rates of overall and complete responses. Chemotherapy followed by auto-HSCT remained to be good choice for patients with poor prognostic factors. High-risk patients should be considered more beneficial from allo-HSCT.
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Affiliation(s)
- N Lu
- Department of Hematology, Chinese PLA General Hospital, Beijing 100853, China
| | - X F Li
- Department of Hematology, Union Hospital of Fujian Medical University, Fuzhou 350001, China
| | - Y J Dong
- Department of Hematology, Peking University First Hospital, Beijing 100034, China
| | - Y N Wang
- Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - X R Fu
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - Y M Wu
- Department of Hematology, No. 304 Hospital of Chinese PLA, Beijing 100037, China
| | - Y H Li
- Department of Hematopoietic Stem Cell Transplantation, No. 307 Hospital of Chinese PLA, Beijing 100071, China
| | - M H Wang
- Department of Hematology, Xinqiao Hospital, Army Medical University, Chongqing 400037, China
| | - N N Li
- Department of Hematology, Union Hospital of Fujian Medical University, Fuzhou 350001, China
| | - H Y Ren
- Department of Hematology, Peking University First Hospital, Beijing 100034, China
| | - Z Wang
- Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - M Z Zhang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - X X Wu
- Department of Hematology, No. 304 Hospital of Chinese PLA, Beijing 100037, China
| | - L D Hu
- Department of Hematopoietic Stem Cell Transplantation, No. 307 Hospital of Chinese PLA, Beijing 100071, China
| | - Y Liu
- Department of Hematology, Xinqiao Hospital, Army Medical University, Chongqing 400037, China
| | - W R Huang
- Department of Hematology, Chinese PLA General Hospital, Beijing 100853, China
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Jiang Y, Wang L, Zhou W, Gu J, Tian Y, Dong Y, Fu L, Wu HB. 18F-FDG PET/CT imaging findings in anaplastic large cell lymphoma, a rare subtype of lymphoma. Cancer Imaging 2020; 20:4. [PMID: 31924270 PMCID: PMC6954597 DOI: 10.1186/s40644-019-0278-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 12/09/2019] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To investigate the 18F-FDG PET/CT imaging manifestations for anaplastic large cell lymphoma (ALCL), a rare subtype of T/NK cell lymphoma. METHODS Fifty patients with ALCL, including 32 anaplastic lymphoma kinase (ALK)-positive patients and 18 ALK-negative patients, were enrolled. The positive detection, maximal standardized uptake value (SUVmax), and distribution of nodal and extranodal involvement were recorded and analysed. Fifty patients with diffuse large B cell lymphoma (DLBCL) were collected as a control group. RESULTS ALCL lesions were demonstrated to be 18F-FDG-avid tumours with a mean SUVmax of 19.4 ± 12.6. Most (76%) ALCL patients presented with stage III-IV disease, and nodal and extranodal involvement occurred in 74.0 and 72.0% of the patients, respectively. ALCL and DLBCL showed many similarities in tumour stage, 18F-FDG uptake and tumour involvement (P > 0.05), although the preferred extranodal organs of involvement (bone and the gastrointestinal tract, respectively) were different (P < 0.05). Compared to ALK-negative lesions, a higher uptake of 18F-FDG was found in the ALK-positive lesions (SUVmax: 22.1 ± 14.3 vs. 15.1 ± 6.6, t = 2.354, P = 0.023). ALK-positive ALCL was more likely to involve the lymph nodes than ALK-negative ALCL (84.3% vs. 55.5%, χ2 = 4.973, P = 0.043), while ALK-negative ALCL was more prone to involve the extranodal organs compared to ALK-positive ALCL (88.9% vs. 62.5%, χ2 = 3.979, P = 0.046). CONCLUSION The present study demonstrated that ALCL is a systemic 18F-FDG-avid lymphoma with many imaging manifestations similar to DLBCL on PET/CT. The present study also showed that ALK expression actually influenced tumour 18F-FDG uptake and lesion distribution. These findings may be useful to improve the understanding of the biological characteristics of ALCL.
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Affiliation(s)
- Yanping Jiang
- Nanfang PET Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong Province, China
| | - Lijuan Wang
- Nanfang PET Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong Province, China
| | - Wenlan Zhou
- Nanfang PET Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong Province, China
| | - Jiamei Gu
- Nanfang PET Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong Province, China
| | - Ying Tian
- Nanfang PET Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong Province, China
| | - Ye Dong
- Nanfang PET Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong Province, China
| | - Lilan Fu
- Nanfang PET Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong Province, China
| | - Hu-Bing Wu
- Nanfang PET Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong Province, China.
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Lymphomas arising in immune-privileged sites: insights into biology, diagnosis, and pathogenesis. Virchows Arch 2019; 476:647-665. [PMID: 31863183 DOI: 10.1007/s00428-019-02698-3] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 09/24/2019] [Accepted: 10/16/2019] [Indexed: 02/07/2023]
Abstract
Session 2 of the 2018 European Association of Hematopathology/Society for Hematopathology Workshop focused on lymphomas arising in immune-privileged sites: both lymphomas arising in the traditionally described "immune sanctuary" sites of the central nervous system (CNS) and testes, as well as those arising at sites of local immune privilege. Primary CNS large B cell lymphoma and primary testicular large B cell lymphoma were discussed, and the biology of these unique tumors was highlighted by several cases showing the classic mutation profile including MYD88 L265P and CD79B. The tendency of these tumors to involve both the CNS and testis was also reinforced by several cases. Four cases of low-grade B cell lymphomas (LGBCL) of the CNS were discussed. Two were classic Bing-Neel syndrome associated with LPL, and two were LGBCL with plasmacytic differentiation and amyloid deposition without systemic disease. Rare examples of systemic T and NK cell lymphomas involving the CNS were also discussed. Several cases of breast implant-associated anaplastic large cell lymphoma (BI-ALCL) were submitted showing the typical clinicopathologic features. These cases were discussed along with a case with analogous features arising in a patient with a gastric band implant, as well as large B cell lymphomas arising alongside foreign materials. Finally, large B cell lymphomas arising in effusions or localized sites of chronic inflammation (fibrin-associated diffuse large B cell lymphoma [DLBCL] and DLBCL associated with chronic inflammation) were described. The pathogenesis of all of these lymphomas is believed to be related to decreased immune surveillance, either innate to the physiology of the organ or acquired at a local site.
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10
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Comparison of Mohs Surgery and Surgical Excision in the Treatment of Localized Sebaceous Carcinoma. Dermatol Surg 2019; 45:1125-1135. [DOI: 10.1097/dss.0000000000001780] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Hallab NJ, Samelko L, Hammond D. The Inflammatory Effects of Breast Implant Particulate Shedding: Comparison With Orthopedic Implants. Aesthet Surg J 2019; 39:S36-S48. [PMID: 30715176 PMCID: PMC6355107 DOI: 10.1093/asj/sjy335] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Currently, there is a dearth of information regarding the degree of particle shedding from breast implants (BIs) and what are the general biological consequences of BI debris. Thus, it is unclear to what degree BI debris compromises the long-term biological performance of BIs. For orthopedic implants, it is well established that the severity of biological reactivity to implant debris governs long-term clinical performance. Orthopedic implant particulate debris is generally in the range of 0.01 to 100 μm in diameter. Implant debris-induced bioreactivity/inflammation is mostly a peri-implant phenomenon caused by local innate immune cells (eg, macrophages) that produce proinflammatory cytokines such as tumor necrosis factor-α, interleukin-1β, interleukin-6, and prostaglandin 2 (PGE2). In orthopedics, there have been few systemic concerns associated with polymeric implant debris (like silicone) other than documented dissemination to remote organs (eg, liver, spleen, etc.) with no known associated pathogenicity. This is not true of metal implant debris where normal (well-functioning) implants can induce systemic reactions such as delayed type hypersensitivity. Diagnostic analysis of orthopedic tissues has focused on innate (macrophage mediated) and adaptive (lymphocyte-mediated hypersensitivity) immune responses. Orthopedic implant debris-associated lymphocyte cancers have not been reported in over 40 years of orthopedic literature. Adaptive immune responses such as hypersensitivity reactions to orthopedic implant debris have been dominated by certain implant types that produce specific kinds of debris (eg, metal-on-metal total joint prostheses). Orthopedic hypersensitivity responses and atypical BI bioreactivity such as BI-associated anaplastic large cell lymphoma share crossover markers for diagnosis. Differentiating normal innate immune reactivity to particles from anaplastic large cell lymphoma reactions from delayed type hypersensitivity reactions to BI-associated implant debris remains unclear but vital to patients and surgeons.
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Affiliation(s)
- Nadim James Hallab
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
| | - Lauryn Samelko
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
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12
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Tang R, Su C, Bai HX, Zeng Z, Karakousis G, Zhang PJ, Zhang G, Xiao R. Association of insurance status with survival in patients with cutaneous T-cell lymphoma. Leuk Lymphoma 2018; 60:1253-1260. [PMID: 30326769 DOI: 10.1080/10428194.2018.1520987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The effect of insurance status on overall survival (OS) of patients with cutaneous T-cell lymphoma (CTCL) is unclear. We identified 11,861 patients from the US National Cancer Data Base diagnosed with CTCL from 2004-2014, of which 6088 had private insurance, 756 had Medicaid, 4536 had Medicare, and 481 are uninsured. Privately insured patients were more likely to present at an early stage (p < .001). On multivariate Cox regression analysis, privately insured patients had significantly longer OS than patients with Medicaid (HR: 1.936, 95% CI: 1.680-2.230, p < .001), Medicare (HR: 1.342, 95% CI: 1.222-1.474, p < .001), or no insurance (HR 1.849, 95% CI: 1.539-2.222, p < .001). The survival advantage of privately insured patients persisted on relative survival and propensity score-matched analyses. In conclusion, privately insured patients were more likely to present at an early stage, and had longer OS than patients who were Medicaid-, Medicare-, or not insured.
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Affiliation(s)
- Rui Tang
- a Department of Dermatology , The Second Xiangya Hospital, Central South University , Changsha , China
| | - Chang Su
- a Department of Dermatology , The Second Xiangya Hospital, Central South University , Changsha , China.,b Department of Dermatology , Yale School of Medicine , New Haven , CT , USA
| | - Harrison X Bai
- c Department of Radiology , Hospital of the University of Pennsylvania , Philadelphia , PA , USA
| | - Zhuotong Zeng
- a Department of Dermatology , The Second Xiangya Hospital, Central South University , Changsha , China
| | - Giorgos Karakousis
- d Department of Surgery , Hospital of the University of Pennsylvania , Philadelphia , PA , USA
| | - Paul J Zhang
- e Department of Pathology and Laboratory Medicine , Hospital of the University of Pennsylvania , Philadelphia , PA , USA
| | - Guiying Zhang
- a Department of Dermatology , The Second Xiangya Hospital, Central South University , Changsha , China
| | - Rong Xiao
- a Department of Dermatology , The Second Xiangya Hospital, Central South University , Changsha , China
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Su C, Tang R, Bai HX, Girardi M, Karakousis G, Zhang PJ, Xiao R, Zhang G. Disease site as a prognostic factor for mycosis fungoides: an analysis of 2428 cases from the US National Cancer Database. Br J Haematol 2018; 185:592-595. [PMID: 30216417 DOI: 10.1111/bjh.15570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Chang Su
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, China.,Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - Rui Tang
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Harrison X Bai
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Michael Girardi
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - Giorgos Karakousis
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Paul J Zhang
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Rong Xiao
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Guiying Zhang
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, China
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