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Satoh T, Kayano H, Kohri M, Tanae K, Asou C, Takahashi N, Tsukasaki K, Yasuda M. Coincidence of de novo T-lymphoblastic lymphoma and cutaneous gamma/delta peripheral T-cell lymphoma. J Clin Exp Hematop 2023; 63:257-261. [PMID: 38148016 PMCID: PMC10861366 DOI: 10.3960/jslrt.23042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/22/2023] [Accepted: 10/23/2023] [Indexed: 12/28/2023] Open
Abstract
The coincidence of acute T-lymphoblastic leukemia/lymphoma, NOS (T-ALL/LBL), and peripheral T-cell lymphoma (PTCL) is unusual, and there have only been a few cases of their metachronous occurrence. In these cases, PTCLs emerged as recurrence after primary therapy for primary T-ALL, were the rare gamma/delta type, and uncommonly involved skin for T-ALL/LBL. We herein report the first case of de novo T-LBL that coincided with cutaneous gamma/delta PTCL before primary therapy. A 70-year-old man presented with systemic lymphadenopathy. Lymph node biopsy revealed a massive proliferation of lymphoblastoid cells; immunohistochemically, they were positive for TdT/CD1a/CD99, and cytoplasmic CD3ε, CD4, and CD8 and were negative for T-cell receptor (TCR) βf-1. A few TCRδ-positive cells were intermingled. Atypically, TIA was focally positive, whereas granzyme/perforin was negative. Multiple papules and plaques emerged on the trunk before the initiation of treatment for T-LBL. Skin biopsy revealed a massive proliferation of medium-to-large atypical lymphoid cells that were TdT/CD1a-negative mature T-cells; they were negative for TCRβf1 and CD4, and positive for TCRδ, CD5, CD8, CD56, TIA, granzyme B, and perforin. A conventional PCR analysis of TCRG showed no identical clonal band between the two tumors. The skin lesion was diagnosed as cutaneous gamma/delta T-cell lymphoma. Whether the lesion was primary or a transformation of T-LBL was unclear. After treating with reduced hyper-CVAD/MA targeting T-LBL, molecular complete remission was achieved. When an uncommon cutaneous lesion emerges in the course of T-ALL/LBL, both need to be evaluated pathologically and genetically, whether de novo or recurrent, assuming the possibility of coincident gamma/delta PTCL.
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Takahashi N, Tsukasaki K, Tanae K, Kohri M, Asou C, Okamura D, Ishikawa M, Maeda T, Kawai N, Matsuda A, Sato T, Kayano H, Arai E, Asou N. Bendamustine-induced rash is associated with a favorable prognosis in patients with indolent B-cell lymphoma. J Clin Exp Hematop 2021; 62:18-24. [PMID: 34980789 PMCID: PMC9010495 DOI: 10.3960/jslrt.21018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Bendamustine is now recognized as a key drug for indolent B-cell lymphoma (iBCL), mantle cell lymphoma (MCL) and chronic lymphocytic leukemia (CLL). Skin toxicity associated with bendamustine is one of the characteristic adverse effects. We retrospectively examined the relationship between bendamustine-associated drug rashes and disease prognosis of iBCL and MCL at our institution. Between January 2011 and August 2019, 65 patients (39 men and 26 women, median age 68, range 41-84 years) were treated with bendamustine alone (n=11, 120 mg/m2 on days 1 and 2) or a combination of rituximab and bendamustine (n=54, 90 mg/m2 on days 1 and 2). Of these patients, 47 had follicular lymphoma (FL), 10 had MCL and 8 had other iBCLs. Drug rash occurred in 27 (41.5%). Eight cases (29.6%) were grade 1, 5 (18.5%) were grade 2 and 14 (51.9%) were grade 3. The onset was in the first course in 17 (63.0%), 2nd course in 5 (18.5%), 3rd course in 2 (7.4%), 4th course in 1 (3.7%) and 5th course in 2 (7.4%). No treatment was administered in 1 case (3.7%), topical steroid was applied in 10 (37.0%), antiallergic drug was administered in 2 (7.4%), topical steroid and antiallergic drug were administered in 5 (18.5%), and oral and topical steroid and antiallergic drug were administered in 9 (33.3%). The 3-year progression-free survival (PFS) and overall survival (OS) in patients with rash development were 80.0% and 85.5%, respectively, and those in patients without development were 36.4% and 54.0%, respectively (p=0.009 and 0.02, respectively). By multivariate analysis, the development of rash was associated with a better PFS and a diagnosis of iBCL was associated with a better OS. This study revealed that bendamustine-induced rash is associated with a favorable prognosis among patients with iBCL.
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Affiliation(s)
- Naoki Takahashi
- Department of Hematology, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Kunihiro Tsukasaki
- Department of Hematology, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Ken Tanae
- Department of Hematology, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Mika Kohri
- Department of Hematology, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Chie Asou
- Department of Hematology, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Daisuke Okamura
- Department of Hematology, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Maho Ishikawa
- Department of Hematology, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Tomoya Maeda
- Department of Hematology, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Nobutaka Kawai
- Department of Hematology, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Akira Matsuda
- Department of Hematology, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Tsugumi Sato
- Department of Pathology, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Hidekazu Kayano
- Department of Pathology, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Eiichi Arai
- Department of Pathology, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Norio Asou
- Department of Hematology, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
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Maeda T, Matsuda A, Asou C, Okamura D, Tanae K, Kohri M, Ishikawa M, Takahashi N, Tsukasaki K, Kawai N, Asou N, Bessho M. Prognostic impact of peripheral blood Wilms' tumour 1 mRNA expression levels in response to azacytidine in MDS: A single-centre analysis. Leuk Res Rep 2020; 15:100231. [PMID: 33354513 PMCID: PMC7744716 DOI: 10.1016/j.lrr.2020.100231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 11/22/2020] [Accepted: 12/06/2020] [Indexed: 10/25/2022] Open
Abstract
To determine the impact of peripheral blood (PB) Wilms' tumour 1 (WT-1) mRNA levels in patients with primary myelodysplastic syndromes (MDS), we analysed the relationships between several clinical variables at the time of diagnosis and the haematological response of patients treated with azacytidine. We observed overall responses in 20 (63%) patients; there were no significant differences in clinical variables, including bone marrow blast counts, IPSS scores and IPSS-R risk scores, between responders and non-responders. The responders' PB WT-1 mRNA levels were significantly lower than those of non-responders (P = 0.03). PB WT-1 mRNA expression could be a marker for predicting the response to azacytidine in patients with de novo MDS.
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Affiliation(s)
- Tomoya Maeda
- Department of Haemato-Oncology, Saitama International Medical Centre, Saitama Medical University, Hidaka, Saitama, Japan
| | - Akira Matsuda
- Department of Haemato-Oncology, Saitama International Medical Centre, Saitama Medical University, Hidaka, Saitama, Japan
| | - Chie Asou
- Department of Haemato-Oncology, Saitama International Medical Centre, Saitama Medical University, Hidaka, Saitama, Japan
| | - Daisuke Okamura
- Department of Haemato-Oncology, Saitama International Medical Centre, Saitama Medical University, Hidaka, Saitama, Japan
| | - Ken Tanae
- Department of Haemato-Oncology, Saitama International Medical Centre, Saitama Medical University, Hidaka, Saitama, Japan
| | - Mika Kohri
- Department of Haemato-Oncology, Saitama International Medical Centre, Saitama Medical University, Hidaka, Saitama, Japan
| | - Maho Ishikawa
- Department of Haemato-Oncology, Saitama International Medical Centre, Saitama Medical University, Hidaka, Saitama, Japan
| | - Naoki Takahashi
- Department of Haemato-Oncology, Saitama International Medical Centre, Saitama Medical University, Hidaka, Saitama, Japan
| | - Kunihiro Tsukasaki
- Department of Haemato-Oncology, Saitama International Medical Centre, Saitama Medical University, Hidaka, Saitama, Japan
| | - Nobutaka Kawai
- Department of Haemato-Oncology, Saitama International Medical Centre, Saitama Medical University, Hidaka, Saitama, Japan
| | - Norio Asou
- Department of Haemato-Oncology, Saitama International Medical Centre, Saitama Medical University, Hidaka, Saitama, Japan
| | - Masami Bessho
- Department of Haemato-Oncology, Saitama International Medical Centre, Saitama Medical University, Hidaka, Saitama, Japan.,Department of Haematology, Saitama Medical University Hospital, Saitama Medical University, Iruma-gun, Saitama, Japan
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Sakai J, Tanae K, Takahashi N, Nagata K, Yoshino T, Tamaru JI, Niitsu N. Lymphocyte-Rich Classical Hodgkin Lymphoma. A Case with Difficulty in Distinguishing from Nodular Lymphocyte-Predominant Hodgkin Lymphoma. J Clin Exp Hematop 2015; 55:23-8. [PMID: 26106003 DOI: 10.3960/jslrt.55.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
A 35-year-old man was referred to our hospital because of left supraclavicular and cervical lymphadenopathies. Histopathological examination of the lymph nodes revealed reactive lymphadenopathy. He visited our hospital three years after the initial diagnosis because of enlarged left cervical lymph nodes. Histopathologically, both Hodgkin/Reed-Sternberg (H/RS) and lymphocyte-predominant (LP) cells were found in the lymph node. We first suspected nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), because these cells were CD15(-) and CD30(-). However, the diagnosis of lymphocyte-rich classical Hodgkin lymphoma (LRCHL) was finally confirmed, because these cells were found to be CD20(-), Bob.1(+), Oct.2(-), and BCL6(-) by additional immunostaining. The patient was treated with six cycles of ABVD chemotherapy, and a complete response was achieved. However, he underwent autologous stem-cell transplantation after high-dose chemotherapy owing to a relapse 10 months after primary treatment. Distingushing LRCHL from NLPHL was difficult in this patient, because histopathological examination showed both H/RS and LP cells, and immunostaining revealed these cells to be triple negative (CD15(-), CD30(-) and CD20(-)). Accumulation of such cases are necessary to establish better criteria for the differential diagnosis and assessment of clinical behavior.
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Affiliation(s)
- Jun Sakai
- Department of Hematology, International Medical Center, Saitama Medical University
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Okamura D, Matsuda A, Ishikawa M, Maeda T, Tanae K, Kohri M, Takahashi N, Kawai N, Asou N, Bessho M. Hematologic improvements in a myelodysplastic syndromes with myelofibrosis (MDS-F) patient treated with azacitidine. Leuk Res Rep 2014; 3:24-7. [PMID: 24809010 DOI: 10.1016/j.lrr.2014.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Revised: 03/19/2014] [Accepted: 03/27/2014] [Indexed: 11/19/2022] Open
Abstract
Myelodysplastic syndromes with myelofibrosis (MDS-F) is a poor prognostic hematopoietic disorder. Azacitidine was shown to prolong survival of high-risk MDS patients. However, the effects of azacitidine on MDS-F have yet to be elucidated. Azacitidine was administered to a 74-year-old man with MDS-F at a dose of 75 mg/m(2)/daily subcutaneously for 7 days every 28 days. Hematologic improvements were observed according to the International Working Group 2006 criteria after 8 cycles of the azacitidine treatment, and complete remission was achieved after 14 cycles. The grade of myelofibrosis was also improved. The therapeutic activity of azacitidine was confirmed in our MDS-F patient.
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Affiliation(s)
- Daisuke Okamura
- Department of Hemato-Oncology, Comprehensive Cancer Center, Saitama International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Akira Matsuda
- Department of Hemato-Oncology, Comprehensive Cancer Center, Saitama International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Maho Ishikawa
- Department of Hemato-Oncology, Comprehensive Cancer Center, Saitama International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Tomoya Maeda
- Department of Hemato-Oncology, Comprehensive Cancer Center, Saitama International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Ken Tanae
- Department of Hemato-Oncology, Comprehensive Cancer Center, Saitama International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Mika Kohri
- Department of Hemato-Oncology, Comprehensive Cancer Center, Saitama International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Naoki Takahashi
- Department of Hemato-Oncology, Comprehensive Cancer Center, Saitama International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Nobutaka Kawai
- Department of Hemato-Oncology, Comprehensive Cancer Center, Saitama International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Norio Asou
- Department of Hemato-Oncology, Comprehensive Cancer Center, Saitama International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Masami Bessho
- Department of Hemato-Oncology, Comprehensive Cancer Center, Saitama International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
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Niitsu N, Hagiwara Y, Tanae K, Kohri M, Takahashi N. Prospective analysis of hepatitis B virus reactivation in patients with diffuse large B-cell lymphoma after rituximab combination chemotherapy. J Clin Oncol 2010; 28:5097-100. [PMID: 20837949 DOI: 10.1200/jco.2010.29.7531] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Recently, there have been reports of hepatitis B virus (HBV) reactivation after rituximab combination chemotherapy in hepatitis B surface antigen (HBsAg) -negative patients with B-cell lymphoma. In this prospective study, the frequency of and risk factors for HBV reactivation in patients who were receiving rituximab chemotherapy were examined. PATIENTS AND METHODS A total of 314 HBsAg-negative patients with diffuse large B-cell lymphoma were treated with rituximab chemotherapy. Antibody to hepatitis B surface antigen (anti-HBs) and antibody to hepatitis B core antigen (anti-HBc) tests were performed in all patients. In patients who were positive for anti-HBs and/or anti-HBc, serum HBV-DNA was measured. RESULTS Of the 314 patients, 51 (16.2%) were HBV carriers. HBV reactivation occurred during or after rituximab chemotherapy in six patients (12%). All six patients who developed HBV reactivation were anti-HBc positive, and three of them were also anti-HBs positive. In these six patients, the pretreatment anti-HBs titer was low. Entecavir administration was started when serum HBV DNA became positive, and serum HBV-DNA became negative within 1 to 3 weeks. Rituximab chemotherapy was then continued. Risk factors for HBV reactivation were being male and having a low anti-HBs titer. CONCLUSION HBV reactivation occurred in some patients who had been anti-HBs negative or had a low anti-HBs level. In addition, HBV reactivation occurred at an early stage of rituximab chemotherapy, but rituximab chemotherapy could be continued after entecavir administration reduced the serum HBV-DNA level. Entecavir (BMS 200495) prophylaxis was not performed when rituximab chemotherapy was started, and it was thought that entecavir could be started when serum HBV-DNA increased.
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Affiliation(s)
- Nozomi Niitsu
- Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Hidaka, Saitama, Japan.
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Niitsu N, Kohri M, Hagiwara Y, Tanae K, Takahashi N, Bessho M, Okamoto M. Multicentre phase II study of CyclOBEAP plus rituximab in patients with diffuse large B-cell lymphoma. Hematol Oncol 2010; 28:68-74. [PMID: 20235332 DOI: 10.1002/hon.940] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The R-CHOP regimen has been found to improve the outcome of diffuse large B-cell lymphoma (DLBCL). However, it does not provide a satisfactory treatment outcome in the high-risk group. We previously administered the CyclOBEAP regimen to patients with DLBCL, and reported its safety and efficacy. The R-CyclOBEAP regimen was administered over a total period of 12 weeks, and rituximab 375 mg/m(2) was given every 2 weeks. There were 101 eligible patients. CR was achieved in 96 patients (95%). The 5-year overall survival (OS) rate was 85% and progression-free survival (PFS) rate was 76%. When the patients were divided according to the IPI, the 5-year OS and PFS rates did not significantly differ among the risk groups. The 5-year PFS of the germinal centre B-cell group was 80% and that of the non-GCB group was 74% (NS). Univariate analysis showed that the presence of B symptoms, extranodal lesions >or=2, and sIL-2R were significant poor prognostic factors. Grade 4 neutropenia was observed in 91 patients and thrombocytopenia in 9 patients. The addition of rituximab to CyclOBEAP therapy may enhance the effect of CyclOBEAP therapy for DLBCL.
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Affiliation(s)
- Nozomi Niitsu
- Department of Hematology, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Hidaka, Saitama, Japan.
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Yoshitake K, Hagiwara Y, Tanae K, Takahashi N, Kohri M, Tamaru JI, Bessho M, Niitsu N. [Marfan syndrome complicated with CD5+ CD10+ diffuse large B-cell lymphoma]. Rinsho Ketsueki 2010; 51:196-200. [PMID: 20379114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Marfan syndrome (MFS) is caused by mutations in the gene encoding fibrillin. A 35-year-old man with MFS visited a local physician because of a sore throat. His left tonsil gradually became swollen and he was referred to our department. Histopathological examination of tonsil biopsy specimens showed diffuse proliferation of lymphoma cells with large nuclei. The tumor cells showed CD5+, CD10+, CD20+, BCL-6+, and MUM-1-. Based on these findings, the patient was diagnosed with CD5+ CD10+ diffuse large B-cell lymphoma (DLBCL). Chemotherapy combined with rituximab was administered and complete response was achieved. CD5+ DLBCL comprises approximately 5 approximately 10% of DLBCLs. In addition, CD5+ CD10+ DLBCL comprises about 5% of CD5+ DLBCLs. There may be a relationship between MFS and B-cell lymphoma because mutations in the gene encoding the receptor of transforming growth factor-beta (TGF-beta) have been implicated in the pathogenesis of MFS and downregulation of TGF-beta receptor expression has been described in the pathology of B-cell lymphoma.
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MESH Headings
- Adult
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal, Murine-Derived
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- CD5 Antigens
- Down-Regulation
- Fibrillins
- Gene Expression
- Humans
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Marfan Syndrome/complications
- Marfan Syndrome/genetics
- Microfilament Proteins/genetics
- Mutation
- Neprilysin
- Palatine Tonsil/pathology
- Receptors, Transforming Growth Factor beta/genetics
- Rituximab
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Affiliation(s)
- Kumiko Yoshitake
- Department of Hematology, International Medical Center, Saitama Medical University
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Shimizu Y, Tanae K, Takahashi N, Kohri M, Arai E, Bessho M, Niitsu N. Primary cutaneous anaplastic large-cell lymphoma presenting with hemophagocytic syndrome: A case report and review of the literature. Leuk Res 2010; 34:263-6. [DOI: 10.1016/j.leukres.2009.07.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2009] [Revised: 06/30/2009] [Accepted: 07/02/2009] [Indexed: 10/20/2022]
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Niitsu N, Nakamine H, Hagiwara Y, Tanae K, Miura I. The t(1;3)(p34;q27)translocation: a nonrandom BCL6 rearrangement in diffuse large B cell lymphoma. Ann Hematol 2007; 87:151-3. [PMID: 17653714 DOI: 10.1007/s00277-007-0345-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2007] [Accepted: 07/02/2007] [Indexed: 10/23/2022]
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