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Moreno-Torres V, Martínez-Urbistondo M, Vázquez-Comendador J, Mateos Seirul-Lo M, Castejón R, Huerta A, Durán-Del Campo P, Tutor P, Mellor-Pita S. Higher mortality risk from gynaecological neoplasms and non-Hodgkin's lymphoma in patients with systemic lupus erythematosus: an observational study from the Spanish National Registry. Lupus Sci Med 2024; 11:e001153. [PMID: 38631847 PMCID: PMC11029302 DOI: 10.1136/lupus-2024-001153] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 04/04/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVE To evaluate the impact of the different types of neoplasms and lineages on mortality of patients with SLE. METHODS Retrospective and observational comparison of the neoplasm-related deaths in patients with SLE and the general Spanish population reported in the Spanish Hospital Discharge Database. To determine the impact of SLE on the risk of dying from each neoplasm lineage, a binary logistic regression considering age, female sex, tobacco and alcohol consumption, was performed. RESULTS During 2016-2019, 139 531 in-hospital deaths from neoplasms were certified in Spain (91 in patients with SLE). Patients with SLE presented a lower mortality rate from solid organ neoplasms, (80.2% vs 91.1%, OR 0.393), linked to their lower risk of colorectal carcinoma (1.1% vs 10.8%, OR 0.110). By contrast, gynaecological neoplasms presented a higher risk (8.8% vs 3%, OR 3.039) in the deceased patients with SLE, associated with the higher frequency of vulvar neoplasms (2% vs 0.2%, OR 14.767) and cervical carcinomas (3.3% vs 0.5%, OR 3.809). Haematological neoplasm-related deaths were also more prevalent in patients with SLE (19.8% vs 8.9%, OR 2.546), mostly attributable to the higher proportion of deaths due to non-Hodgkin's lymphoma (11% vs 2.9%, OR 4.060) of B cell lineage (9.9% vs 2.5%, OR 4.133). CONCLUSIONS Patients with SLE present a higher risk of death from vulvar neoplasms, cervical carcinomas and B-cell non-Hodgkin's lymphoma in comparison with the general Spanish population. In addition to developing strategies that might help to attenuate their occurrence and impact, such as decreasing the immunosuppressive burden, specific early detection programmes for these conditions should be investigated and considered carefully.
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Affiliation(s)
- Víctor Moreno-Torres
- Puerta de Hierro University Hospital of Majadahonda, Majadahonda, Spain
- Health Sciences School and Medical Center, UNIR, Logrono, La Rioja, Spain
| | | | | | | | - Raquel Castejón
- Puerta de Hierro University Hospital of Majadahonda, Majadahonda, Spain
| | - Ana Huerta
- Puerta de Hierro University Hospital of Majadahonda, Majadahonda, Spain
| | | | - Pablo Tutor
- Puerta de Hierro University Hospital of Majadahonda, Majadahonda, Spain
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2
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Klaus M, Sitter T, Hoppe JM. Acute kidney failure reveals primary renal non-Hodgkin lymphoma. BMJ Case Rep 2024; 17:e259137. [PMID: 38569735 PMCID: PMC10989095 DOI: 10.1136/bcr-2023-259137] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
A male patient in his 60s was admitted to our hospital with symptoms of dyspnoea, asthenia, diaphoresis and acute kidney failure. No tumour or infection was detected in initial screening. However, laboratory examination suggested that the acute kidney failure was due to an intrarenal cause, exhibiting a tubular injury pattern and indications of tumour lysis syndrome. Initial hydration therapy, paired with intravenous rasburicase, rapidly improved the kidney function. Unfortunately, the kidney function deteriorated once again, prompting a kidney biopsy that revealed an aggressive diffuse large B-cell non-Hodgkin lymphoma of the kidney. The chemotherapy, comprised of R-CHOP scheme, led to a full recovery of the kidney function and complete remission of the lymphoma. Primary renal non-Hodgkin lymphoma without nodal manifestation is rare, and its pathophysiology is poorly understood. Therapy schemes can vary significantly between cases, relying primarily on non-renal-specific haemato-oncological guidelines. Therefore, further studies are needed to develop the best therapeutic approaches.
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Affiliation(s)
- Martin Klaus
- Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany
| | - Thomas Sitter
- Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany
| | - John Michael Hoppe
- Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany
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3
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Śluzar P, Reekhaye A, MacAskill F, Ong M, Rose V, Yap T. A rare case of an extra-oral plasmablastic lymphoma presenting through a scrotal abscess in a 42-year-old man. Ann R Coll Surg Engl 2024; 106:391-394. [PMID: 37051763 PMCID: PMC10981984 DOI: 10.1308/rcsann.2022.0166] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2022] [Indexed: 04/14/2023] Open
Abstract
Plasmablastic lymphoma (PBL) is a rare lymphoid neoplasm frequently presenting in the oral cavity. It is an aggressive type of non-Hodgkin's lymphoma that shares pathological features with plasma cell myeloma. In addition to human immunodeficiency virus (HIV), it is also associated with Epstein-Bar virus (EBV) and immunosuppression in HIV-negative patients, for example, post transplantation. Extra-oral PBL is rare and only a few case reports involving the testis have been described. Here we describe the first reported case of PBL presenting with a scrotal abscess (not involving the testes) in a patient newly diagnosed with HIV. This case highlights the rare presentation of a rare disease, the difficulties in establishing a diagnosis and the importance of a timely multidisciplinary approach to its management.
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Affiliation(s)
| | - A Reekhaye
- Guy’s and St Thomas’ NHS Foundation Trust, UK
| | | | - M Ong
- Guy’s and St Thomas’ NHS Foundation Trust, UK
| | - V Rose
- Guy’s and St Thomas’ NHS Foundation Trust, UK
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Rubiño JBG, Witt S, Martín-Valero R, Viñolo-Gil MJ, Dieterle T. Bilateral axillary web syndrome in a patient with primary lymphoedema of upper limbs and non-Hodgkin lymphoma. Br J Community Nurs 2024; 29:S32-S35. [PMID: 38578924 DOI: 10.12968/bjcn.2024.29.sup4.s32] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Abstract
Primary lymphoedema, axillary web syndrome (AWS) and yellow nail syndrome may be related. Mr B is a 66-year-old gentleman with genital lymphoedema and lymphoedema of all four extremities. In 2023, he was diagnosed with non-Hodgkin lymphoma and also underwent cardiac surgery. In November 2023, he completed an inpatient rehabilitation at the Földi clinic in Germany, where he received intensive treatment for his lymphoedema and was also diagnosed with bilateral AWS. The presence of AWS in a patient with primary lymphoedema and no history of axillary surgery is unique. Although AWS typically presents after axillary surgery, this case highlights that it can also occur in patients without lymph node surgery. While the precise cause of this presentation of AWS is not known, it may be connected to yellow nail syndrome or potentially the recent chemotherapy treatment. This article will describe the clinical case, highlighting the need for further research on AWS present in primary lymphoedema.
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Affiliation(s)
- Jesús Baltasar González Rubiño
- Földiklinik GmbH & Co. KG, Hinterzarten, Germany
- Department of Physiotherapy, Faculty of Health Sciences, University of Malaga, CTS-1071 Research Group, Malaga, Spain
- Rehabilitation Clinical Management Unit, Interlevels-Intercenters Hospital Punta Europa, Algeciras, A.G.S. Campo de Gibraltar Oeste, 11201 Algeciras, Cadiz, Spain
| | - Susan Witt
- Földiklinik GmbH & Co. KG, Hinterzarten, Germany
| | - Rocío Martín-Valero
- Department of Physiotherapy, Faculty of Health Sciences, University of Malaga, CTS-1071 Research Group, Malaga, Spain
| | - María Jesús Viñolo-Gil
- Department of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain
- Rehabilitation Clinical Management Unit, Interlevels-Intercenters Hospital Puerta del Mar, Hospital Puerto Real, Cadiz Bay-La Janda Health District, 11006 Cadiz, Spain
- Research Unit, Department Biomedical Research and Innovation Institute of Cadiz (INiBICA), Puerta del Mar University Hospital, University of Cadiz, 11009 Cadiz, Spain
| | - Thomas Dieterle
- Földiklinik GmbH & Co. KG, Hinterzarten, Germany
- Department of Clinical Research, University Hospital Basel, Switzerland
- Faculty of Medicine, University of Basel, Switzerland
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Okubo S, Shinmura K, Kadota S, Nakayasu M, Kurosawa S, Nakayama H, Sakurai A, Ito C, Aisa Y, Nakazato T. Evaluation of the cachexia index using a bioelectrical impedance analysis in elderly patients with non-Hodgkin's lymphoma: A single-center prospective study. Ann Hematol 2024; 103:823-831. [PMID: 38010408 DOI: 10.1007/s00277-023-05548-0] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 11/11/2023] [Indexed: 11/29/2023]
Abstract
Cancer cachexia is a disorder that affects patient outcomes. The present study prospectively evaluated the prognostic value of the cachexia index (CXI) in elderly patients with non-Hodgkin's lymphoma (NHL). We prospectively analyzed 51 elderly patients who were diagnosed with NHL at our institution. CXI was calculated as follows: CXI = SMI × Alb/NLR (SMI: skeletal muscle index, Alb: serum albumin, NLR: neutrophil-to-lymphocyte ratio). SMI was measured by a bioelectrical impedance analysis (BIA) using the InBody 720. We determined the sex-specific cutoff values of the CXI by a receiver operating characteristic curve analysis and divided all patients into low- and high-CXI groups. The median age at the diagnosis was 78 years (60-93 years), and 28 (55%) were male. The histologic subtypes were B-cell lymphoma in 49 patients and T-cell lymphoma in 2. Twenty-eight (55%) patients were categorized into the high-CXI group, and 23 (45%) were categorized into the low-CXI group. The overall survival (OS) in the low-CXI group was significantly shorter than that in the high-CXI group (3-year OS, 70.4% vs. 95.7%, p = 0.007). Among 23 patients with DLBCL, patients with low-CXI had shorter OS than those with high-CXI (3-year OS, 55.6% vs. 92.9%, p = 0.008). On the other hand, sarcopenia had less impact on the clinical outcome of DLBCL patients. Low-CXI was associated with poor outcomes in elderly NHL and the CXI may be a clinical useful index for predicting prognosis. Further large prospective studies are needed to verify this conclusion.
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Affiliation(s)
- So Okubo
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishi-Cho, Kanagawa-Ku, Yokohama, 221-0855, Japan
| | - Kohei Shinmura
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishi-Cho, Kanagawa-Ku, Yokohama, 221-0855, Japan
| | - Saori Kadota
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishi-Cho, Kanagawa-Ku, Yokohama, 221-0855, Japan
| | - Misa Nakayasu
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishi-Cho, Kanagawa-Ku, Yokohama, 221-0855, Japan
| | - Shuhei Kurosawa
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishi-Cho, Kanagawa-Ku, Yokohama, 221-0855, Japan
| | - Hitomi Nakayama
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishi-Cho, Kanagawa-Ku, Yokohama, 221-0855, Japan
| | - Aki Sakurai
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishi-Cho, Kanagawa-Ku, Yokohama, 221-0855, Japan
| | - Chisako Ito
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishi-Cho, Kanagawa-Ku, Yokohama, 221-0855, Japan
| | - Yoshinobu Aisa
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishi-Cho, Kanagawa-Ku, Yokohama, 221-0855, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishi-Cho, Kanagawa-Ku, Yokohama, 221-0855, Japan.
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Teixeira Ferreira R, Cardoso Ferreira I, Carmona S, Montalvão A, Santos AI. Spontaneous Remission of High-Grade Non-Hodgkin Lymphoma After SARS-CoV-2 Infection: A Case Report. Clin Nucl Med 2024; 49:e77-e79. [PMID: 38048523 DOI: 10.1097/rlu.0000000000004973] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
ABSTRACT Despite extensive research into COVID-19 since its emergence in late 2019, there is still much not fully understood about its long-term effects. When infected with SARS-CoV-2, cancer patients have been reported to be at higher risk for unfavorable outcomes. Nevertheless, evidence suggests that viruses may exhibit an antitumor effect in some cases, which has recently been anecdotally reported with SARS-CoV-2. We present the case of a patient with a recent high-grade non-Hodgkin lymphoma diagnosis and without any cancer-specific therapy, in whom a complete metabolic response on 2-[ 18 F]FDG PET/CT was observed after COVID-19.
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Affiliation(s)
| | - Inês Cardoso Ferreira
- From the Nuclear Medicine Department, Hospital Garcia de Orta E.P.E., Almada, Portugal
| | - Susana Carmona
- From the Nuclear Medicine Department, Hospital Garcia de Orta E.P.E., Almada, Portugal
| | - Ana Montalvão
- Oncology - Hematology Department, Unidade Local de Saúde do Baixo Alentejo E.P.E., Beja, Portugal
| | - Ana Isabel Santos
- From the Nuclear Medicine Department, Hospital Garcia de Orta E.P.E., Almada, Portugal
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7
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Bozkurt S, Genc DB, Vural S. Laboratory and clinical features of tumor lysis syndrome in children with non-Hodgkin lymphoma and evaluation of long-term renal functions in survivors. BMC Pediatr 2024; 24:85. [PMID: 38297237 PMCID: PMC10829167 DOI: 10.1186/s12887-024-04549-w] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 01/10/2024] [Indexed: 02/02/2024] Open
Abstract
OBJECTIVE The purpose of our study is to investigate the laboratory and clinical features of tumor lysis syndrome (TLS) and acute kidney injury (AKI) in childhood non-Hodgkin lymphomas (NHL) and to reveal their impact on long term kidney function in survivors. METHODS Our single-center retrospective study included 107 patients (0-18 years old) with NHL who were admitted and treated at our hospital between 1998 and 2020. The relationship between TLS and age, gender, histopathological subgroup, tumor stage, lactate dehydrogenase (LDH) level at presentation, bone marrow and kidney involvement were assessed. The long-term renal functions of the patients were investigated. RESULTS 80.3% of the patients were male with a median age of 9.8 years. The most common detected histopathological subgroup was Burkitt lymphoma. Hyperhydration with or without alkalinisation, and allopurinol were used in first-line treatment and prophylaxis of TLS. Laboratory TLS and clinical TLS was observed in 30.8% and 12.1% of patients, respectively. A significant correlation was found between young age, advanced stage, high LDH level at presentation, and TLS. AKI was observed in 12.1% of the patients. When the glomerular filtration rate values of the patients at the first and last admissions were compared after an average of 6.9 years, a mean decrease of 10 mL/min/1.73 m2 was found. It was not, however, found to be statistically significant. CONCLUSION Lower age, advanced stage, and high LDH level at presentation were found to be risk factors for TLS in our study. Long-term renal function loss was not observed in the survivors who received early and careful prophylaxis/treatment for TLS. The survivors are still being followed up.
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Affiliation(s)
- Selcen Bozkurt
- Department of Pediatric Allergy-Immunology, Marmara University School of Medicine, Istanbul, Turkey.
| | - Dildar Bahar Genc
- Department of Pediatric Oncology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Sema Vural
- Department of Pediatric Oncology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
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8
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Wang L, Zheng Y, Luo R, Kang K, Niedermann G, Zhao A, Wu Y. Lifetime risks of second primary malignancies after pediatric Hodgkin lymphoma and non-Hodgkin lymphoma. J Cancer Res Clin Oncol 2024; 150:41. [PMID: 38280006 PMCID: PMC10821973 DOI: 10.1007/s00432-023-05583-4] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 12/07/2023] [Indexed: 01/29/2024]
Abstract
OBJECTIVES Survivors after pediatric Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) are with lifetime risk for second primary malignancy (SPM). This necessitates a thorough analysis to better understand the potential long-term health implications for these individuals. METHODS We used a US-wide population-based cancer registry data to quantify the SPM risk and identify its incidence patterns among pediatric lymphoma patients. RESULTS We observed 4.74-fold (95% CI 4.27-5.25) and 3.40-fold (95% CI 2.78-4.10) increased risks of SPM in survivors after pediatric HL and NHL, respectively. Through over 40 years' follow-up, the cumulative incidence of SPM for pediatric lymphoma was persistently increasing, and here we firstly report the high 40-year cumulative incidence rates of SPM, 22.2% for HL and 12.6% for NHL, suggesting that SPM accounts for a great proportion of deaths among survivors. Of 6805 pediatric lymphomas, 462 (6.36%) developed a SPM, especially second breast and thyroid cancer, followed by hematologic neoplasms including leukemia and NHL. The competing risk analysis demonstrated gender, lymphoma subtype and radiotherapy were significantly associated with SPM. Different risk patterns of SPM were identified between pediatric HL and NHL. Chemotherapy accelerated SPM development but did not increase its incidence risk. CONCLUSION Overall, patients after pediatric lymphoma can be with high lifetime risk of SPM, and more attention should be paid to SPM-related signs for early detection and intervention.
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Affiliation(s)
- Laduona Wang
- Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yue Zheng
- Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Ren Luo
- Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Kai Kang
- Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Gabriele Niedermann
- Department of Radiation Oncology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ailin Zhao
- Department of Hematology, West China Hospital, Sichuan University, Chengdu, China.
| | - Yijun Wu
- Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
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Nath K, Peterson K, Brown S, Devlin S, Rodriguez N, Barker J, Giralt S, Gyurkocza B, Jakubowski A, Papadopoulos E, Ponce D, Scordo M, Shah G, Perales MA, Sauter C, Lin A, Dahi PB. Reduced-Intensity Compared to Nonmyeloablative Conditioning in Patients with Non-Hodgkin Lymphoma Undergoing Allogeneic Hematopoietic Stem Cell Transplantation. Transplant Cell Ther 2024; 30:81-92. [PMID: 37788792 PMCID: PMC10842498 DOI: 10.1016/j.jtct.2023.09.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/20/2023] [Accepted: 09/23/2023] [Indexed: 10/05/2023]
Abstract
Reduced-intensity conditioning (RIC) and nonmyeloablative (NMA) conditioning are preferred for patients with non-Hodgkin lymphoma (NHL) undergoing allogeneic hematopoietic stem cell transplantation (allo-HCT). Although prior studies have suggested that higher-intensity regimens in RIC-NMA conditioning are associated with inferior outcomes in patients with NHL, the optimal conditioning regimen remains unknown. We performed a retrospective single-center analysis to determine outcomes of adult patients with B cell and T cell NHL who underwent allo-HCT and received either RIC or NMA conditioning between March 2008 and December 2019. RIC regimens included fludarabine-cyclophosphamide-thiotepa-4 Gy-total body irradiation (Flu-Cy-TT-4Gy-TBI), fludarabine-melphalan (Flu-Mel), fludarabine-cyclophosphamide-4 Gy-total body irradiation (Flu-Cy-4Gy-TBI), and fludarabine-busulfan-4 (Flu-Bu-4). The NMA regimen comprised fludarabine-cyclophosphamide-2 Gy-total body irradiation (Flu-Cy-2Gy-TBI). The primary outcome was overall survival (OS); secondary outcomes included progression-free survival (PFS), nonrelapse mortality (NRM), and the incidence of acute and chronic graft-versus-host-disease (GVHD). Of 279 transplants recipients (median age, 58 years), 110 received RIC (55% Flu-Mel, 38% Flu-Cy-TT-4Gy-TBI, 6% Flu-Bu-4, 1% Flu-Cy-4Gy-TBI) and 169 received NMA conditioning with Flu-Cy-2Gy-TBI. With a median of 64 months of follow-up post-allo-HCT, there was no significant difference in OS between the NMA and RIC groups (median, not reached [NR] versus 103 months; P = .1), and this was maintained on multivariable analysis. Similarly, after adjustment for all independently significant covariates (age, Karnofsky Performance Status [KPS], Hematopoietic Cell Transplantation Comorbidity Index [HCT-CI], and disease histology), the regression analysis showed no significant difference in PFS with RIC compared to NMA conditioning (hazard ratio [HR] 1.38; 95% confidence interval [CI], .92 to 2.09; P = .24). On univariable analysis, there was no significant difference in NRM between the RIC and NMA arms (100-day estimate, 10.0% versus 1.8%; P = .5). After adjustment for age, ethnicity, KPS, HCT-CI, GVHD prophylaxis, and donor source, RIC conditioning was associated with a significantly higher incidence of NRM compared to NMA conditioning (HR, 2.61; 95% CI, 1.04 to 6.52; P = .039). On multivariable analysis, compared with the NMA arm, the RIC arm had higher rates of grade II-IV (HR, 2.25; 95% CI, 1.31 to 3.86; P = .002) and grade III-IV acute GVHD (HR, 5.62; 95% CI, 2.03 to 15.6; P < .001). The findings of this study suggest that NMA conditioning with Flu-Cy-TBI-2Gy may be considered over more intensive RIC regimens for patients with NHL undergoing allo-HCT.
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Affiliation(s)
- Karthik Nath
- Cellular Therapy Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Samantha Brown
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sean Devlin
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Natasia Rodriguez
- Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Juliet Barker
- Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Sergio Giralt
- Cellular Therapy Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Boglarka Gyurkocza
- Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Ann Jakubowski
- Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Esperanza Papadopoulos
- Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Doris Ponce
- Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Michael Scordo
- Cellular Therapy Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Gunjan Shah
- Cellular Therapy Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Miguel-Angel Perales
- Cellular Therapy Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Craig Sauter
- Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio
| | - Andrew Lin
- Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Parastoo B Dahi
- Cellular Therapy Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York.
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10
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Roccuzzo G, Avallone G, Cavallo F, Mastorino L, Conti L, Fava P, Tomasini C, Ribero S, Quaglino P. Synchronous occurrence of primary cutaneous B-cell lymphoma and cutaneous Rosai-Dorfman disease in distinct lesions: A unique association. J Cutan Pathol 2024; 51:7-10. [PMID: 36636954 DOI: 10.1111/cup.14391] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 12/01/2022] [Accepted: 01/09/2023] [Indexed: 01/14/2023]
Abstract
Rosai-Dorfman disease, also known as sinus histiocytosis with massive lymphadenopathy (SHML), is a rare subtype of reactive histiocytosis which is seldom associated with Hodgkin's and non-Hodgkin's lymphomas. To date, the coexistence in the same patient of extra nodal SHML and primary cutaneous B-cell lymphoma (PCBCL) has been reported in the literature, as metachronous diagnosis in the anatomical area of the original PCBCL or synchronous occurrence in the same lesions. However, no data have been published as for synchronous occurrence of the two pathological entities in distinct anatomical sites. Herein, we report the first ever described synchronous occurrence of PCBCL and SHML, detected in distinct lesions, affecting the same patient. The complete resolution of the patient's PCBCL after rituximab treatment and the concomitant regression of SHML suggest that this clinically benign reactive histiocytic proliferation, potentially triggered by the lymphoma microenvironment itself, may take place not only in the site of the PCBCL lesion, but also in other distant areas not directly affected by the primary cutaneous lymphoma.
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Affiliation(s)
- Gabriele Roccuzzo
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Gianluca Avallone
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Francesco Cavallo
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Luca Mastorino
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Luca Conti
- Department of Medical Sciences, Section of Surgical Pathology, University of Turin, Turin, Italy
| | - Paolo Fava
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Carlo Tomasini
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Simone Ribero
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Pietro Quaglino
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
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11
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Rajagopal A, Thompson CA, Chorzempa AK, Ryu AJ. Advanced enteropathy-associated T cell lymphoma (EATL) presenting with severe malabsorption and concomitantly diagnosed coeliac disease (CD). BMJ Case Rep 2023; 16:e258265. [PMID: 38142052 DOI: 10.1136/bcr-2023-258265] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2023] Open
Abstract
Enteropathy-associated T cell lymphoma (EATL) is an aggressive subtype of non-Hodgkin's lymphoma often associated with coeliac disease (CD). We describe a previously healthy man in his 50 s who presented with a history of abdominal pain, failure to thrive and significant weight loss over a 3-month period. Investigations revealed a positive coeliac serology, diffuse duodenal atrophy with multiple duodenal and jejunal ulcers on endoscopy and mesenteric lymphadenopathy on CT imaging. Duodenal tissue biopsy confirmed a diagnosis of EATL Stage IVB. Chemotherapy with cyclophosphamide, doxorubicin, vincristine and prednisone regimen was initiated. This case highlights the need for greater awareness and consideration of EATL in individuals with worsening malabsorption and abdominal pain, irrespective of coeliac history.
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Affiliation(s)
- Anjali Rajagopal
- Department of Medicine, AI & Innovation, Mayo Clinic, Rochester, Minnesota, USA
| | - Carrie A Thompson
- Division of Hematology, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Allison K Chorzempa
- Division of Hospital Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Alexander J Ryu
- Division of Hospital Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Bai Y, Zheng Y, Zhang Q, Jiang Q, Diao Z, Guo W, Liu S, Liu W. Renomegaly and acute kidney injury as primary manifestations of non-Hodgkin's lymphoma: a report of three cases. Diagn Pathol 2023; 18:133. [PMID: 38066507 PMCID: PMC10704622 DOI: 10.1186/s13000-023-01408-7] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 10/24/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND In adults with non-Hodgkin's lymphoma, renal enlargement and acute kidney injury occur infrequently at first presentation, especially in T lymphocytic lymphomas. CASE PRESENTATION We report three cases of non-Hodgkin's lymphoma with acute renal injury and bilateral renal enlargement. At diagnosis, one patient presented with an adrenal mass, one patient's lymph node biopsy was consistent with a renal biopsy, and one patient had primary renal lymphoma with no extrarenal disease. Assessment of renal pathology in Case 2 and Case 3 showed interstitial lymphocyte infiltration; the pathological types were non-Hodgkin's diffuse large B lymphoma originating from activated B cells outside germinal centers and non-Hodgkin's T-lymphoblastic lymphoma/leukemia, respectively. Case 1 did not receive anti-lymphoma therapy and died from infection and multiple organ failure within 1 month of hospitalization. Case 2 received eight courses of R-CHOP; her lymphoma recurred 2 years after diagnosis and she died from severe pulmonary infection 3 years after diagnosis. Case 3 received hyper-CVAD regularly and achieved stable renal function; this patient remains under follow-up. CONCLUSIONS Renal lymphoma may have diverse manifestations, especially primary renal lymphoma without extrarenal involvement. Nephrologists should pay careful attention to these manifestations to ensure accurate diagnosis.
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Affiliation(s)
- Yu Bai
- Department of Nephrology, Faculty of Kidney Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yuanyuan Zheng
- Department of Pathology, Faculty of Kidney Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Qidong Zhang
- Department of Nephrology, Faculty of Kidney Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Qun Jiang
- Department of Nephrology, Faculty of Kidney Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zongli Diao
- Department of Nephrology, Faculty of Kidney Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Wang Guo
- Department of Nephrology, Faculty of Kidney Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Sha Liu
- Department of Nephrology, Faculty of Kidney Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
| | - Wenhu Liu
- Department of Nephrology, Faculty of Kidney Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
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13
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Ou J, Huang Y. Nasal Maggot Infection in a Patient With Nasal Non-Hodgkin's Lymphoma. Ear Nose Throat J 2023; 102:NP591-NP595. [PMID: 34233486 DOI: 10.1177/01455613211031024] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We describe a case of nasal non-Hodgkin's lymphoma in a 79-year-old Chinese patient accompany with nasal myiasis. The first 2 biopsies in this case were false negative. Subsequently, nasal maggots developed in this patient. After removing all maggots under nasal endoscopy, the patient continued to have recurrent fever and was transferred to a higher hospital for further treatment, in which he received a third biopsy. Unfortunately, several hours after the biopsy, the patient died for severe nasal bleeding. The final biopsy result indicated the neoplasm of the left nasal cavity was non-Hodgkin's lymphoma. This case illustrates the importance of repeated biopsies for nasal non-Hodgkin's lymphoma if necessary. Nasal myiasis is a secondary disease of nasal non-Hodgkin's lymphoma in this case.
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Affiliation(s)
- Jing Ou
- Department of Otorhinolaryngology, Luoding People's Hospital, Luoding, China
| | - Yan Huang
- Department of Otorhinolaryngology-Head and Neck Surgery, Guangdong Provincial People's Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China
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Mishra R, Dima D, Kumar SA, Mian A, Taneja A, Karna R, Caimi PF, Hill BT, Dean R, Jagadeesh D. A population level analysis of second hematological malignancies in chronic lymphocytic leukemia/small lymphocytic lymphoma survivors in the era of targeted therapies. Hematol Oncol 2023; 41:884-893. [PMID: 37309225 DOI: 10.1002/hon.3192] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/12/2023] [Accepted: 05/19/2023] [Indexed: 06/14/2023]
Abstract
With improvement in survival after chronic lymphocytic leukemia (CLL) diagnosis, the real-world burden of second hematological malignancies (SHM) has not been comprehensively assessed in recent era. We analyzed risk, incidence, and outcomes of SHM in CLL patients between 2000 and 2019 using SEER database. CLL patients had greater risk for hematological malignancies than general population [SIR, standardized incidence ratio (95% CI):2.58 (2.46-2.70); p < 0.05]. The risk for subsequent lymphoma increased by 1.75 folds in 2015-2019 compared to 2000-2004. The duration, after CLL diagnosis, of maximum risk for SHM decreased as 60-119 months for time-period 2000-2004, 6-11 months for 2005-2009 to 2-5 months for 2010-2014 and 2015-2019. Incidence of SHM was 2.5% in CLL survivors (1736/70,346) with lymphoid SHM being more common than myeloid SHM, and DLBCL being the most common pathology (n = 610, 35% of all SHM). Male sex, age ≤65 years at CLL diagnosis, and chemotherapy treatment were associated with higher risk for SHM. The median gap between CLL and SHM diagnoses was 46 months. The median survival for de-novo-AML, t-MN, CML, and aggressive NHL was 63, 86, 95, and 96 months respectively. Although SHM remains rare, there is increased risk in recent era, likely due to improved survival in CLL patients, necessitating active surveillance strategies.
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Affiliation(s)
- Rahul Mishra
- Department of Hematology and Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, USA
| | - Danai Dima
- Department of Hematology and Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, USA
| | - Sumukh A Kumar
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts, USA
| | - Agrima Mian
- Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Alankrita Taneja
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Rahul Karna
- Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA
| | - Paolo F Caimi
- Department of Hematology and Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, USA
| | - Brian T Hill
- Department of Hematology and Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, USA
| | - Robert Dean
- Department of Hematology and Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, USA
| | - Deepa Jagadeesh
- Department of Hematology and Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, USA
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Gil-García CA, Cueto-Robledo G, Gonzalez-Hermosillo LM, Alfaro-Cruz A, Roldan-Valadez E. Nonthrombotic Pulmonary Embolism Associated With Non-Hodgkin Lymphoma. Curr Probl Cardiol 2023; 48:102001. [PMID: 37506958 DOI: 10.1016/j.cpcardiol.2023.102001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 07/30/2023]
Abstract
Nonthrombotic pulmonary embolism (NTPE) challenges the medical community with its diverse etiologies and potential life-threatening implications. The classification section delves into the multifaceted nature of NTPE, which includes various embolic agents that traverse the vascular system. From air and fat emboli to tumor and amniotic fluid emboli, this exploration of diverse etiologies sheds light on the complexity of NTPE. Diagnostic methods play a crucial role in the effective management of NTPE. This article describes a range of traditional and cutting-edge diagnostic techniques, from computed tomography angiography to novel biomarkers, enabling the accurate and timely identification of NTPE. NTPE treatment options are diverse and patient-specific, requiring customized approaches to address varying embolic sources. Anticoagulation, embolus removal, and emerging interventions under study are discussed, providing clinicians with a comprehensive understanding of management strategies. This article uncovers the rare but captivating association between NTPE and non-Hodgkin lymphoma. Although rare, documented cases have sparked curiosity among researchers and medical practitioners. We explore potential pathophysiological connections, discussing challenges and considerations when encountering this unique scenario. In conclusion, this captivating review encapsulates the multifaceted realm of NTPE, covering its classification, diagnostics, and treatment modalities. Moreover, it presents a fascinating connection with non-Hodgkin lymphoma. This article offers a comprehensive and concise review of NTPE, guiding readers through its intricate classification, diagnostic approaches, and therapeutic interventions.
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Affiliation(s)
- Cesar-Alejandro Gil-García
- Faculty of Medicine, Autonomous University of Sinaloa, Los Mochis, Sinaloa, México; Directorate of Research, General Hospital of Mexico "Dr. Eduardo Liceaga," Mexico City, Mexico
| | - Guillermo Cueto-Robledo
- Cardiorespiratory Emergencies, General Hospital of Mexico "Dr. Eduardo Liceaga", Mexico City, Mexico; Pulmonary Circulation Clinic, General Hospital of Mexico "Dr. Eduardo Liceaga", Mexico City, Mexico; Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico.
| | | | - Ana Alfaro-Cruz
- Department of Surgical Pathology, General Hospital of Mexico, "Dr. Eduardo Liceaga," Mexico City, Mexico
| | - Ernesto Roldan-Valadez
- Directorate of Research, General Hospital of Mexico "Dr. Eduardo Liceaga," Mexico City, Mexico; Department of Radiology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
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Arima F. [A Case of Non-Hodgkin Lymphoma with Liver Involvement and Severe Jaundice That Benefited from Therapy with Gemcitabine, Carboplatin, Dexamethasone(GCD)Therapy with Rituximab]. Gan To Kagaku Ryoho 2023; 50:1227-1229. [PMID: 38056881] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
An 84-year-old man visited a hospital owing to general malaise. Blood tests revealed hyperbilirubinemia and liver dysfunction. The patient was hospitalized and underwent various examinations. Bone marrow puncture revealed diffuse large B- cell lymphoma, and the patient was transferred to our hospital. At the time of transfer, the patient presented a total bilirubin of 8.4 mg/dL, indicating a marked elevation. His advanced age made disease treatment risky. A decision to treat the patient with gemcitabine, carboplatin, dexamethasone(GCD), and rituximab was reached, which was not standard treatment at the initial presentation. Hyperbilirubinemia and liver dysfunction improved rapidly. After 2 courses of treatment, the patient was switched to pirarubicin, cyclophosphamide, vincristine, and prednisolone(THP-COP), the standard therapy in elderly patients, combined with rituximab. The patient exhibited remittance after 6 treatment courses. Thus, during hyperbilirubinemia and hepatic dysfunction, gemcitabine-based therapy may improve prognosis when compared with low-dose standard therapy.
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Olén O, Smedby KE, Erichsen R, Pedersen L, Halfvarson J, Hallqvist-Everhov Å, Bryder N, Askling J, Ekbom A, Sachs MC, Sørensen HT, Ludvigsson JF. Increasing Risk of Lymphoma Over Time in Crohn's Disease but Not in Ulcerative Colitis: A Scandinavian Cohort Study. Clin Gastroenterol Hepatol 2023; 21:3132-3142. [PMID: 37061104 DOI: 10.1016/j.cgh.2023.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 02/20/2023] [Accepted: 04/03/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND & AIMS Earlier studies have provided varying risk estimates for lymphoma in patients with inflammatory bowel disease (IBD), but often have been limited by detection biases (especially during the first year of follow-up evaluation), misclassification, and small sample size; and rarely reflect modern-day management of IBD. METHODS We performed a binational register-based cohort study (Sweden and Denmark) from 1969 to 2019. We compared 164,716 patients with IBD with 1,639,027 matched general population reference individuals. Cox regression estimated hazard ratios (HRs) for incident lymphoma by lymphoma subtype, excluding the first year of follow-up evaluation. RESULTS From 1969 to 2019, 258 patients with Crohn's disease (CD), 479 patients with ulcerative colitis (UC), and 6675 matched reference individuals developed lymphoma. This corresponded to incidence rates of 35 (CD) and 34 (UC) per 100,000 person-years in IBD patients, compared with 28 and 33 per 100,000 person-years in their matched reference individuals. Although both CD (HR, 1.32; 95% CI, 1.16-1.50) and UC (HR, 1.09; 95% CI, 1.00-1.20) were associated with an increase in lymphoma, the 10-year cumulative incidence difference was low even in CD patients (0.08%; 95% CI, 0.02-0.13). HRs have increased in the past 2 decades, corresponding to increasing use of immunomodulators and biologics during the same time period. HRs were increased for aggressive B-cell non-Hodgkin lymphoma in CD and UC patients, and for T-cell non-Hodgkin lymphoma in CD patients. Although the highest HRs were observed in patients exposed to combination therapy (immunomodulators and biologics) or second-line biologics, we also found increased HRs in patients naïve to such drugs. CONCLUSIONS During the past 20 years, the risk of lymphomas have increased in CD, but not in UC, and were driven mainly by T-cell lymphomas and aggressive B-cell lymphomas.
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Affiliation(s)
- Ola Olén
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Sachs' Children and Youth Hospital, Stockholm South General Hospital, Stockholm, Sweden; Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
| | - Karin E Smedby
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Hematology, Karolinska University Hospital, Stockholm, Sweden
| | - Rune Erichsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Department of Surgery, Randers Regional Hospital, Randers, Denmark
| | - Lars Pedersen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Jonas Halfvarson
- Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Åsa Hallqvist-Everhov
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Nicklas Bryder
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Johan Askling
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Anders Ekbom
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Michael C Sachs
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Jonas F Ludvigsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Pediatrics, Orebro University Hospital, Orebro, Sweden; Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York
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Mayer M, Martinic M, Reihl-Crnogaj M, Anic B. The risk of developing non-Hodgkin lymphoma and the mortality rate in primary Sjögren's syndrome: a single-centre, retrospective cohort study. Rheumatol Int 2023; 43:2031-2036. [PMID: 37491526 DOI: 10.1007/s00296-023-05386-3] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 06/27/2023] [Indexed: 07/27/2023]
Abstract
Primary Sjögren's syndrome (pSS) is a systemic autoimmune disease that is manifested by the sensation of dry eyes and dry mouth. The higher incidence of non-Hodgkin lymphoma (NHL) among pSS has already been extensively researched. However, there are uncertanties whether the mortality risk in pSS patients and in pSS patients with NHL is increased. The purpose of this study was to describe the prevalence of NHL among pSS patients and to calculate their mortality risk. We retrospectively analysed data on 1367 patients treated in our rheumatology department under the ICD-10 code M35.0. The study finally recruited 155 patients who met the 2016 ACR/EULAR criteria for the diagnosis of pSS. Descriptive statistics was used in data analysis. We applied the indirect standardization by age to compare the incidence rate of NHL in our cohort to general population. Additionally, we compared the mortality in our study to the general population by calculating the standardized mortality ratio (SMR). The overall incidence rate of NHL was 440 per 100,000 patient-years. The SIR compared to the general population was 30.13 (95% CI 12.87-54.63). The overall mortality rate of pSS patients in our cohort was nearly identical to that of the general population (SMR = 0.98 [95% CI (0.47-1.69)]). This study confirms that there are significant differences in lymphoma prevalence, histology, and prognosis across the studied populations. Furthermore, this study found that patients with pSS have similar mortality risk as the general population, and no patient in our cohort died from NHL.
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Affiliation(s)
- Miroslav Mayer
- Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University Hospital Center Zagreb, 10000, Zagreb, Croatia
- School of Medicine, University of Zagreb, 10000, Zagreb, Croatia
| | - Matea Martinic
- Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University Hospital Center Zagreb, 10000, Zagreb, Croatia.
| | - Mirna Reihl-Crnogaj
- Department of Physichal Medicine and Rheumatology, National Memorial Hospital Vukovar, 32000, Vukovar, Croatia
| | - Branimir Anic
- Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University Hospital Center Zagreb, 10000, Zagreb, Croatia
- School of Medicine, University of Zagreb, 10000, Zagreb, Croatia
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Tawfiq E, Pylypchuk R, Elwood JM, McKeage M, Wells S, Selak V. Risk of cardiovascular disease in cancer survivors: A cohort study of 446,384 New Zealand primary care patients. Cancer Med 2023; 12:20081-20093. [PMID: 37746882 PMCID: PMC10587917 DOI: 10.1002/cam4.6580] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/11/2023] [Accepted: 09/12/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND Given advances in the management of cancer, it is increasingly important for clinicians to appropriately manage the risk of cardiovascular disease (CVD) among cancer survivors. It is unclear whether CVD risk is increased among cancer survivors overall, and there is inconsistency in evidence to date about CVD incidence and mortality by cancer type. METHODS Patients aged 30-74 years entered an open cohort study at the time of first CVD risk assessment, between 2004 and 2018, in primary care in New Zealand. Patients with established CVD or cancer within 2 years prior to study entry were excluded. Cancer diagnosis (1995-2016) was determined from a national cancer registry. Cause-specific hazard models were used to examine the association between history of cancer and two outcomes: (1) CVD-related hospitalization and/or death and (2) CVD death. RESULTS The study included 446,384 patients, of whom 14,263 (3.2%) were cancer survivors. Risk of CVD hospitalization and/or death was increased among cancer survivors compared with patients without cancer at cohort entry (multivariable-adjusted hazard ratio, mHR, 1.11, 95% CI 1.05-1.18), more so for CVD death (1.31, 1.14-1.52). Risk of CVD hospitalization and/or death was increased in patients with myeloma (2.66, 1.60-4.42), lung cancer (2.19, 1.48-3.24) and non-Hodgkin lymphoma (1.90, 1.42-2.54), but not for some cancers (e.g., colorectal, 0.87, 0.71-1.06). Risk of CVD death was increased in several cancer types including melanoma (1.73, 1.25-2.38) and breast cancer (1.56, 1.16-2.11). CONCLUSION CVD risk management needs to be prioritized among cancer survivors overall, and particularly in those with myeloma, lung cancer and non-Hodgkin lymphoma given consistent evidence of increased risk.
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Affiliation(s)
- Essa Tawfiq
- School of Population HealthUniversity of AucklandAucklandNew Zealand
| | - Romana Pylypchuk
- School of Population HealthUniversity of AucklandAucklandNew Zealand
| | - J. Mark Elwood
- School of Population HealthUniversity of AucklandAucklandNew Zealand
| | - Mark McKeage
- School of Medical SciencesUniversity of AucklandAucklandNew Zealand
| | - Sue Wells
- School of Population HealthUniversity of AucklandAucklandNew Zealand
| | - Vanessa Selak
- School of Population HealthUniversity of AucklandAucklandNew Zealand
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Martínez LE, Magpantay LI, Guo Y, Hegde P, Detels R, Hussain SK, Epeldegui M. Extracellular vesicles as biomarkers for AIDS-associated non-Hodgkin lymphoma risk. Front Immunol 2023; 14:1259007. [PMID: 37809067 PMCID: PMC10556683 DOI: 10.3389/fimmu.2023.1259007] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/08/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Extracellular vesicles are membrane-bound structures secreted into the extracellular milieu by cells and can carry bioactive molecules. There is emerging evidence suggesting that EVs play a role in the diagnosis, treatment, and prognosis of certain cancers. In this study, we investigate the association of EVs bearing PD-L1 and molecules important in B-cell activation and differentiation with AIDS-NHL risk. Methods EVs were isolated from archived serum collected prior to the diagnosis of AIDS-NHL in cases (N = 51) and matched HIV+ controls (N = 52) who were men enrolled in the Los Angeles site of the MACS/WIHS Combined Cohort Study (MWCCS). Serum specimens of AIDS-NHL cases were collected at a mean time of 1.25 years (range of 2 to 36 months) prior to an AIDS-NHL diagnosis. The expression of PD-L1 and other molecules on EVs (CD40, CD40L, TNF-RII, IL-6Rα, B7-H3, ICAM-1, and FasL) were quantified by Luminex multiplex assay. Results and discussion We observed significantly higher levels of EVs bearing PD-L1, CD40, TNF-RII and/or IL-6Rα in AIDS-NHL cases compared with controls. Using multivariate conditional logistic regression models adjusted for age and CD4+ T-cell count, we found that EVs bearing PD-L1 (OR = 1.93; 95% CI: 1.10 - 3.38), CD40 (OR = 1.97, 95% CI: 1.09 - 3.58), TNF-RII (OR = 5.06; 95% CI: 1.99 - 12.85) and/or IL-6Rα (OR = 4.67; 95% CI: 1.40 - 15.53) were significantly and positively associated with AIDS-NHL risk. In addition, EVs bearing these molecules were significantly and positively associated with non-CNS lymphoma: PD-L1 (OR = 1.94; 95% CI: 1.01 - 3.72); CD40 (OR = 2.66; 95% CI: 1.12 - 6.35); TNF-RII (OR = 9.64; 95% CI: 2.52 - 36.86); IL-6Rα (OR = 8.34; 95% CI: 1.73 - 40.15). These findings suggest that EVs bearing PD-L1, CD40, TNF-RII and/or IL-6Rα could serve as biomarkers for the early detection of NHL in PLWH.
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Affiliation(s)
- Laura E Martínez
- UCLA AIDS Institute and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Larry I Magpantay
- UCLA AIDS Institute and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Yu Guo
- UCLA AIDS Institute and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Priya Hegde
- UCLA AIDS Institute and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Roger Detels
- Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
| | - Shehnaz K Hussain
- Department of Public Health Sciences, School of Medicine and Comprehensive Cancer Center, University of California, Davis, Davis, CA, United States
| | - Marta Epeldegui
- UCLA AIDS Institute and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, United States
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Medina-Marroquín R, González-Godínez I, Maldonado-López CDJ, Calzada-Rascón AC. [Upper digestive tract bleeding as a clinical presentation of non-Hodgkin's lymphoma]. Rev Med Inst Mex Seguro Soc 2023; 61:685-690. [PMID: 37773174 PMCID: PMC10599780 DOI: 10.5281/zenodo.8316481] [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] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/21/2023] [Indexed: 10/01/2023]
Abstract
Background Non-Hodgkin's lymphoma (NHL) is a group of malignant tumors of the nodal and extranodal lymphoid tissues, and it is associated with autoimmune diseases, mainly rheumatoid arthritis (RA). Extra nodal presentation is observed in 40%, mainly affecting the gastrointestinal tract in 3% of cases, with bleeding in the digestive tract being a rare cause of clinical presentation that requires a detailed diagnostic approach. Clinical case 55-year-old female with a history of RA, admitted to an internal medicine service due to bleeding in the digestive tract; patient presented clinical data of deep vein thrombosis in the left pelvic limb and consumptive syndrome under study. During her approach she was identified with splenic and liver infarctions, as well as multiple lymph node conglomerates, due to which it was performed an axillary lymph node biopsy reporting neoplastic proliferation of lymphoid cells, and bone marrow aspirate with presence of lymphoplasmacytic infiltration, with which a diagnosis of stage IV non-Hodgkin lymphoma was made. Patient was sent to a third-level hospital to start treatment. Conclusions This case shows us what has already been described in literature, which is why it is of fundamental importance to carry out a comprehensive approach of clinical findings in patients with previously identified risk factors, with the aim of achieving an etiological diagnosis that allows early therapy to improve their survival.
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Affiliation(s)
- René Medina-Marroquín
- Instituto Mexicano del Seguro Social, Hospital General de Zona No. 47 “Vicente Guerrero”, Servicio de Medicina Interna. Ciudad de México, México Instituto Mexicano del Seguro SocialMéxico
| | - Iván González-Godínez
- Instituto Mexicano del Seguro Social, Hospital General de Zona No. 47 “Vicente Guerrero”, Servicio de Medicina Interna. Ciudad de México, México Instituto Mexicano del Seguro SocialMéxico
| | - Carlos de Jesús Maldonado-López
- Instituto Mexicano del Seguro Social, Hospital General de Zona No. 47 “Vicente Guerrero”, Servicio de Medicina Interna. Ciudad de México, México Instituto Mexicano del Seguro SocialMéxico
| | - Ana Cristina Calzada-Rascón
- Instituto Mexicano del Seguro Social, Hospital General de Zona No. 47 “Vicente Guerrero”, Servicio de Medicina Interna. Ciudad de México, México Instituto Mexicano del Seguro SocialMéxico
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22
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Ruiz M, Rubens M, Ramamoorthy V, Chavez CB, Saxena A. Comparison of Inpatient Outcomes Between HIV Positive and Negative Hospitalizations for Autologous Stem Cell Transplant Treatment among Lymphoid Malignancies. Clin Lymphoma Myeloma Leuk 2023; 23:e307-e313. [PMID: 37244799 DOI: 10.1016/j.clml.2023.05.006] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/01/2023] [Accepted: 05/07/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Comorbidity burden is higher among people living with HIV (PLWH). In addition, they experience adverse effects associated with antiretrovirals. In this study we looked for differences in adverse hospital outcomes between those with and without HIV among hospitalizations for autologous stem cell transplantations (ASCTs) for lymphoid malignancies. MATERIALS AND METHODS The current study was a retrospective analysis using the National Inpatient Sample (NIS) database, for the years 2005 to 2014. Adult hospitalizations ≥18 years of age, for ASCTs were included for the analysis, and were stratified into those with and without HIV. The primary outcome variables were in-hospital mortality, prolonged length of stay, and adverse dispositions. RESULTS We included a total of 117,686 ASCT hospitalizations, of which, 468 (0.4%) were HIV positive. Among HIV-positive hospitalizations, there were 251 (53.4%), non-Hodgkin lymphoma, 128 (27.4%), Hodgkin lymphoma, and 89 (19.2%) multiple myeloma cases. Only half of the PLWH among Black population received ASCT, compared to Whites (26.8% vs. 54.8%). Regression analyses showed that the odds of in-hospital mortality (OR, 0.77; 95% CI, 0.13-4.44), prolonged length of stay (OR, 1.18; 95% CI, 0.67-2.11), and dispositions other than home (OR, 1.26; 95% CI, 0.61-2.59) did not differ significantly between 2 groups. DISCUSSION We found that adverse hospital outcomes did not differ between those with and without HIV among hospitalized autologous stem cell transplant recipients. However, the rates of ASCT were substantially lower among Black PLWH. New interventions and approaches should be developed to improve ASCT rates among HIV positive racial minorities.
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Affiliation(s)
- Marco Ruiz
- Hematology Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA.
| | - Muni Rubens
- Hematology Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA; Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA; Department of Health Science, Universidad Espíritu Santo, Samborondón, Guayas, Ecuador
| | | | | | - Anshul Saxena
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA; Center for Advanced Analytics, Baptist Health South Florida, Miami, FL, USA
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Núñez-García B, Clemente MB, Sánchez JC, Royuela A, Ibargüen BCSD, Méndez M, López-Ibor JV, Martínez M, Traseira C, Garitaonaindia Y, Aguado R, Calvo V, Torrente M, Parejo C, Provencio Z, Provencio M. Long-term outcomes in Hodgkin lymphoma survivors. Temporary trends and comparison with general population. Hematol Oncol 2023; 41:407-414. [PMID: 36934306 DOI: 10.1002/hon.3131] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/08/2023] [Indexed: 03/20/2023]
Abstract
The high cure rates of Hodgkin lymphoma (HL) make this oncological disease among those with the greatest number of long-term survivors. This single-institution study including 383 HL patients with up to 45 years of follow-up, analyses the morbidity and mortality of this population after treatments in comparison with the overall Spanish population, and investigates whether it has changed over time stratifying by periods of time, as a consequence of therapeutic optimization. The median age was 34.8 years (range 15-87) with median overall survival of 30 years, significantly higher in women (HR 0.58, 95% CI 0.42-0.79) (p = 0.0002). 185 late-stage diseases were noted (35% patients), cardiovascular disease (CVD) being the most frequent (23.2%). 30% of patients developed at least one second malignant neoplasm (SMN) to give a total of 174 SMNs. 20.9% of the patients died from HL and 67.0% died from non-HL causes (32.2% from SMN, 17% from CVD). The overall standardized mortality ratio (SMR) was 3.57 (95% CI: 3.0-4.2), with striking values of 7.73 (95% CI: 5.02-8.69) and of 14.75 (95% CI: 11.38-19.12) for women and patients <30 years at diagnosis, respectively. Excluding HL as the cause of death, the SMRs of those diagnosed before 2000 and from 2000 were proved to be similar (3.88 vs 2.73), maintaining in this last period an unacceptable excess of mortality due to secondary toxicity in patients cured of HL. Our study confirm that HL treatment substantially reduces the life expectancy of patients cured of HL. In recent periods, despite therapeutic optimization, deaths from toxicity continue to occur, mainly from CVD and SMN. Risk-factor monitoring should be intensified, prevention programs developed, and therapeutic optimization of LH investigated, especially in two vulnerable groups: those aged <30 years at diagnosis, and women.
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Affiliation(s)
- Beatriz Núñez-García
- Department of Medical Oncology, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
| | | | | | - Ana Royuela
- Biostatistics Unit, Hospital Universitario Puerta de Hierro Majadahonda, IDIPHISA. CIBERESP, ISCIII, Madrid, Spain
| | | | - Miriam Méndez
- Department of Medical Oncology, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
| | | | - Marta Martínez
- Department of Medical Oncology, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Cristina Traseira
- Department of Medical Oncology, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Yago Garitaonaindia
- Department of Medical Oncology, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Ramón Aguado
- Department of Medical Oncology, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Virginia Calvo
- Department of Medical Oncology, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
| | - María Torrente
- Department of Medical Oncology, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Consuelo Parejo
- Department of Medical Oncology, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Zaida Provencio
- Department of Medical Oncology, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Mariano Provencio
- Department of Medical Oncology, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
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Zou Y, Xu H, Lyu Q, Weng M, Cui J, Shi H, Song C. Malnutrition diagnosed by GLIM criteria better predicts long-term outcomes for patients with non-Hodgkin's lymphoma: A prospective multicenter cohort study. Hematol Oncol 2023; 41:371-379. [PMID: 36416610 DOI: 10.1002/hon.3107] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/17/2022] [Accepted: 11/19/2022] [Indexed: 11/25/2022]
Abstract
Since Global Leadership Initiative on Malnutrition (GLIM) method was proposed, few studies have applied these new criteria to hematological tumors. In this study, we explored the prevalence of malnutrition according to the GLIM criteria and scored Patient-Generated Subjective Global Assessment (sPG-SGA) and their association with 1-year, 3-year and 5-year mortality among patients with non-Hodgkin's lymphoma (NHL). Malnutrition of all patients were assessed by GLIM criteria and sPG-SGA. Relationship between the malnutrition based on GLIM criteria or sPG-SGA and mortality was investigated by Cox regression analyses. The performance of GLIM criteria was evaluated by assessing the sensitivity, specificity, k-value, receiver operating characteristic (ROC) curve and time-dependent ROC. Of 963 patients with NHL, the prevalence of malnutrition was 38.8% with GLIM criteria, 65.3% with GLIM-omitted NRS-2002 and 53.2% with sPG-SGA. In comparison with sPG-SGA, the sensitivity of GLIM criteria was 61.7%, the specificity was 84.8%, and the agreement was moderate (k = 0.48, p < 0.001). Malnutrition based on GLIM criteria could also predict 3-year and 5-year mortality after adjusting for confounders, except for sPG-SGA (HR = 1.816, 95%CI = 1.274-2.589, p = 0.001 for 3-year mortality; HR = 1.707, 95%CI = 1.223-2.382, p = 0.002 for 5-year mortality). For patients with NHL, GLIM criteria could be applied as an effective replacement to sPG-SGA for nutrition assessment and mortality prediction, especially for predicting long-term prognostic outcomes.
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Affiliation(s)
- Yuanlin Zou
- Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, Zhengzhou, Henan, China
| | - Hongxia Xu
- Department of Clinical Nutrition, Daping Hospital, Army Medical University Third Military Medical University, Chongqing, China
| | - Quanjun Lyu
- Department of Clinical Nutrition, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Min Weng
- Department of Gastrointestinal Surgery, Institute of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Jiuwei Cui
- Cancer Center of the First Hospital of Jilin University, Changchun, Jilin, China
| | - Hanping Shi
- Department of Gastrointestinal Surgery and Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Chunhua Song
- Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, Zhengzhou, Henan, China
- State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, Zhengzhou, Henan, China
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Vargas-Garcia EK, Fernandez-Aristi AR, Cornejo-Venegas G, Montenegro-Idrogo JJ, Chirinos-Vega J, Chiappe-Gonzalez A. Unmasked immune reconstitution inflammatory syndrome towards B-cell non-Hodgkin lymphoma during treatment of esophageal actinomycosis in a patient with advanced HIV: a case report. AIDS Res Ther 2023; 20:48. [PMID: 37452343 PMCID: PMC10347741 DOI: 10.1186/s12981-023-00526-y] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 05/13/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Actinomycosis is an unusual chronic bacterial infection, even rarer in people living with HIV. It is not considered an AIDS-defining disease. However, the role in co-presentation or overlap with other opportunistic conditions of advanced HIV is unknown. CASE PRESENTATION A 49-year-old Peruvian male presented with a 4-month history of dysphagia, odynophagia, hyporexia and wasting. He underwent an upper digestive endoscopy, in which ulcers with a necrotic center were observed, therefore, the initial diagnostic assumption was esophageal cancer. Subsequent pathology report excluded neoplasms and confirmed the diagnosis of actinomycosis. Serology for human immunodeficiency virus was requested, yielding a positive result. Antimicrobial treatment with amoxicillin and antiretroviral therapy were indicated, with slow clinical improvement. After 4 months, epigastric discomfort presented, for which a new upper digestive endoscopy was performed, revealing a deep gastric ulcer, which was compatible with diffuse large B-cell non-Hodgkin lymphoma. CONCLUSION Esophageal actinomycosis in people living with HIV is very rare. We suggest HIV-associated immunosuppression is not enough to allow for actinomycosis to develop, and masked underlying entities should be sought. The existence of such entities in people living with HIV should raise awareness of the possibility of unmasked immune reconstitution inflammatory syndrome once treatment has started.
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Affiliation(s)
- Elsa K. Vargas-Garcia
- Universidad Peruana de Ciencias Aplicadas, Avenida Alameda San Marcos cuadra 2 S/N, Chorrillos, Lima, 15023 Peru
| | - Augusto R. Fernandez-Aristi
- Universidad Peruana de Ciencias Aplicadas, Avenida Alameda San Marcos cuadra 2 S/N, Chorrillos, Lima, 15023 Peru
| | - Gonzalo Cornejo-Venegas
- Universidad Peruana de Ciencias Aplicadas, Avenida Alameda San Marcos cuadra 2 S/N, Chorrillos, Lima, 15023 Peru
| | - Juan José Montenegro-Idrogo
- Hospital Nacional Dos de Mayo. Parque “Historia de la Medicina Peruana” S/N, Lima, 15003 Peru
- Facultad de Ciencias de la Salud, Universidad Científica del Sur. Carretera Panamericana, Sur km19, Villa El Salvador, Lima, 15067 Peru
- Centro de Investigaciones Tecnológicas, Biomédicas y Medioambientales, Universidad Nacional Mayor de San Marcos, Lima, 070102 Peru
| | - Juan Chirinos-Vega
- Clínica Angloamericana, Calle Alfredo Salazar 350, Lima, San Isidro 15073 Peru
| | - Alfredo Chiappe-Gonzalez
- Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Peru
- Clínica Angloamericana, Calle Alfredo Salazar 350, Lima, San Isidro 15073 Peru
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Buege MJ, Drill E, Horwitz SM, LeVoir A, Pak T, Peterson TJ, Dao PH, Matasar MJ. Low incidence of cardiotoxicity in patients with non-Hodgkin lymphoma receiving EPOCH after prior anthracycline exposure. Eur J Haematol 2023; 111:96-102. [PMID: 36971022 PMCID: PMC10634315 DOI: 10.1111/ejh.13971] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVE To describe the incidence of cardiotoxicity in patients with anthracycline exposure who subsequently receive EPOCH for non-Hodgkin lymphoma (NHL). METHODS We conducted a retrospective cohort study of adults with anthracycline exposure who subsequently received EPOCH for NHL at Memorial Sloan Kettering Cancer Center. The primary outcome was cumulative incidence of arrhythmia, heart failure (HF), left ventricular (LV) dysfunction, or cardiac death. RESULTS Among 140 patients, most had diffuse large B-cell lymphoma. Inclusive of EPOCH, median cumulative doxorubicin-equivalent dose was 364 mg/m2 ; exposure was 400 mg/m2 or higher in 41%. With median 36-month follow-up, 23 cardiac events were noted in 20 patients. Cumulative incidence of cardiac events at 60 months was 15% (95% confidence interval [CI]: 9%-21%). When limited to LV dysfunction/HF, cumulative incidence at 60 months was 7% (95% CI: 3%-13%), with most events occurring after the first year. Univariate analysis indicated only history of cardiac disease and dyslipidemia to be associated with cardiotoxicity; no other risk factors, including cumulative anthracycline dose, were identified. CONCLUSIONS In this retrospective cohort, representing the largest experience in this setting with extended follow-up, cumulative incidence of cardiac events was low. Rates of LV dysfunction or HF were particularly low, suggesting infusional administration may mitigate risk despite prior exposure.
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Affiliation(s)
- Michael J. Buege
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10018, USA
| | - Esther Drill
- Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10018, USA
| | - Steven M. Horwitz
- Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10018, USA
| | - Andréa LeVoir
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10018, USA
| | - Terry Pak
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10018, USA
| | - Tim J. Peterson
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10018, USA
| | - Phuong H. Dao
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10018, USA
| | - Matthew J. Matasar
- Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10018, USA
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Parra-Lara LG, Arango-Ibañez JP, Martínez-Arboleda JJ, Bravo JC, Zambrano ÁR, Collazos P, Andino F, Badillo A, Estrada S, Rosso F. Survival of patients living with HIV and cancer in Cali, Colombia. Colomb Med (Cali) 2023; 54:e2015558. [PMID: 38098512 PMCID: PMC10719985 DOI: 10.25100/cm.v54i3.5588] [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] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/22/2023] [Accepted: 09/21/2023] [Indexed: 12/17/2023] Open
Abstract
Background People living with HIV have an increased risk of cancer compared to the general population. However, with the increase in life expectancy and advances in antiretroviral therapy, the survival of patients with cancer and HIV has changed. Objective To determine the survival of patients living with HIV and cancer in Cali, Colombia. Methods A retrospective cohort study was conducted at the Fundación Valle del Lili, Cali, Colombia. Data from the HIV database was crossed with data from the hospital and population-based cancer registries between 2011-2019. Patients <18 years, limited available clinical information on the diagnosis and treatment of HIV and cancer, and non-oncological tumor diagnosis were excluded. Results A total of 173 patients were included. The frequencies of AIDS-defining neoplasms were: Non-Hodgkin lymphoma (42.8%), Kaposi sarcoma (27.8%), and cervical cancer (4.6%). Overall survival was 76.4% (95% CI 68.9-82.3) at five years. Poorer survival was found in patients with AIDS-defining infections (56.9% vs. 77.8%, p=0.027) and non-AIDS-defining infections (57.8% vs. 84.2%, p=0.013), while there was better survival in patients who received antiretroviral therapy (65.9% vs. 17.9%, p=0.021) and oncological treatment (66.7% vs. 35.4%, p<0.001). The presence of non-AIDS-defining infections increases the risk of dying (HR = 2.39, 95% CI 1.05-5.46, p=0.038), while oncological treatment decreases it (HR = 0.33, 95% CI 0.14-0.80, p=0.014). Conclusions In people living with HIV, Non-Hodgkin lymphoma and Kaposi sarcoma are the most common neoplasms. Factors such as AIDS-associated and non-AIDS-associated infections have been identified as determinants of survival. Cancer treatment seems to improve survival.
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Affiliation(s)
- Luis Gabriel Parra-Lara
- Universidad Icesi, Facultad de Ciencias de la Salud, Cali, Colombia
- Fundación Valle del Lili, Centro de Investigaciones Clínicas (CIC), Cali, Colombia
| | | | | | - Juan C. Bravo
- Fundación Valle del Lili, Departamento de Patología y Laboratorio Clínico, Cali, Colombia
| | - Ángela R. Zambrano
- Fundación Valle del Lili, Departamento de Medicina Interna, Servicio de Hematología & Oncología Clínica, Cali, Colombia
| | - Paola Collazos
- Universidad del Valle, Facultad de Salud, Registro Poblacional de Cáncer de Cali (RPCC), Cali, Colombia
| | - Francisco Andino
- Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Angélica Badillo
- Fundación Valle del Lili, Centro de Investigaciones Clínicas (CIC), Cali, Colombia
| | - Sebastián Estrada
- Fundación Valle del Lili, Centro de Investigaciones Clínicas (CIC), Cali, Colombia
| | - Fernando Rosso
- Universidad Icesi, Facultad de Ciencias de la Salud, Cali, Colombia
- Fundación Valle del Lili, Centro de Investigaciones Clínicas (CIC), Cali, Colombia
- Fundación Valle del Lili, Departamento de Medicina Interna, Servicio de Infectología, Cali, Colombia
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Peralta-Amaro AL, Domínguez Valdez LF, Hernández-Jiménez CA, Chávez Sánchez IN, Montoya-Fuentes IM, Mondragón Morfin JM. A fatal case of hyper-warburgism associated with non-Hodgkin's lymphoma. QJM 2023; 116:244-246. [PMID: 36250896 DOI: 10.1093/qjmed/hcac237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 10/10/2022] [Indexed: 03/29/2023] Open
Affiliation(s)
- Ana Lilia Peralta-Amaro
- From the Department of Internal Medicine, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Centro Médico Nacional La Raza del Instituto Mexicano del Seguro Social, Calle Seris y Zaachila, La Raza, Azcapotzalco, 02990 Mexico City, Mexico
| | - Luis Fernando Domínguez Valdez
- From the Department of Internal Medicine, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Centro Médico Nacional La Raza del Instituto Mexicano del Seguro Social, Calle Seris y Zaachila, La Raza, Azcapotzalco, 02990 Mexico City, Mexico
| | - Carlos Alberto Hernández-Jiménez
- From the Department of Internal Medicine, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Centro Médico Nacional La Raza del Instituto Mexicano del Seguro Social, Calle Seris y Zaachila, La Raza, Azcapotzalco, 02990 Mexico City, Mexico
| | - Iliana Nelly Chávez Sánchez
- From the Department of Internal Medicine, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Centro Médico Nacional La Raza del Instituto Mexicano del Seguro Social, Calle Seris y Zaachila, La Raza, Azcapotzalco, 02990 Mexico City, Mexico
| | - Itzel María Montoya-Fuentes
- From the Department of Internal Medicine, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Centro Médico Nacional La Raza del Instituto Mexicano del Seguro Social, Calle Seris y Zaachila, La Raza, Azcapotzalco, 02990 Mexico City, Mexico
| | - José Manuel Mondragón Morfin
- From the Department of Internal Medicine, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Centro Médico Nacional La Raza del Instituto Mexicano del Seguro Social, Calle Seris y Zaachila, La Raza, Azcapotzalco, 02990 Mexico City, Mexico
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29
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Popovych MY. MANIFASTATIONS OF COMPLICATION IN THE ANEMIC SYNDROME IN NON-HODGKIN LYMPHOMAS OF TRANSCARPATIA. Wiad Lek 2023; 76:2469-2473. [PMID: 38112366 DOI: 10.36740/wlek202311120] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
OBJECTIVE The aim: To investigate the main indicators characterising clinical and haematological manifestations in patients with NHL complicated by anaemia at the stages of the disease development for optimisation of diagnostics and prognosis of the disease. PATIENTS AND METHODS Materials and methods: Data from 40 patients were analysed, 40 (100%) of whom were diagnosed with NHL complicated by anaemia. The severity of anaemia was divided into: mild anaemia - haemoglobin 10 - 12 g/dl; moderate anaemia - 8 - 10 g/dl; severe anaemia - 6.5 - 8 g/dl; life-threatening anaemia - below 6.5 g/dl. Patients were divided into 2 groups: the first group included 27 patients with haemoglobin levels of 100-120 g/l; the second group consisted of 13 patients with haemoglobin levels of 80 to 99 g/l. All patients were examined using clinical, laboratory, instrumental and special research methods. Statistical processing of the results was performed using the methods of variation statistics using the Microsoft Excel XP. RESULTS Results: The course of lymphoproliferative diseases in which the proliferation of a malignant clone is often complicated by anaemia. The prognostically unfavourable factors were identified. The article discusses possible pathophysiological mechanisms of the identified changes. CONCLUSION Conclusions: The results of the study demonstrate that as the disease progresses and the tumour mass increases, NHL patients tend to develop more severe anaemia. The leading cause of anaemia in patients is the infiltration of the bone marrow by tumour cells and their negative impact on erythropoiesis.
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Pereira V, Boudjemaa S, Besson C, Leblanc T, Rigaud C, Leruste A, Garnier N, Lambilliotte A, Simonin M, Curtillet C, Bonneau-Lagacherie J, Coulomb A, Landman-Parker J. Epstein-Barr Virus in Childhood and Adolescent Classic Hodgkin Lymphoma in a French Cohort of 301 Patients. J Pediatr Hematol Oncol 2022; 44:e1033-e1038. [PMID: 35091521 DOI: 10.1097/mph.0000000000002403] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 12/06/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim was to analyze the role of Epstein-Barr virus (EBV) in the bioclinical characteristics of patients treated for classic Hodgkin lymphoma (cHL) in France. METHODS Biopathologic data of 301 patients treated for a cHL in/or according to the EuroNet PHL-C1 trial between November 2008 and February 2013 were centrally reviewed. RESULTS Median age at diagnosis was 14 (3 to 18) years and the F/M ratio 0.86, 0.47 before 10 years and 0.9 from 11 to 18. CHL subtypes were nodular sclerosis for 266/301 (88%) patients, mixed cellularity for 22/301 (7%), lymphocyte rich for 2/301 (1%), and 11/301 were unclassified. EBV positivity by in situ hybridization was observed for 68/301 (23%) patients, significantly associated with mixed cellularity subtype and male sex, particularly overrepresented in boys below 10 years: 15/23 (65%) versus 28/139 among other male patients (20%). EBV viral load was detectable in 22 of 108 (22%) tested cases and was overrepresented in EBV cHL (13/28) versus non-EBV cHL (9/80) patients. Detailed semiquantitative histologic analysis showed a high number of B-cell residual follicles in EBV cHL relative to EBV-negative HL. CONCLUSION Distribution of EBV cHL in children and adolescents is associated with young age and male sex, suggesting a specific physiopathology and may require a differential therapeutic approach.
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Affiliation(s)
- Victor Pereira
- Department of Pediatric Hematology and Oncology, Besançon University Hospital, Besançon
| | | | - Caroline Besson
- Department of Hematology Versailles University Hospital, Versailles
| | - Thierry Leblanc
- Department of Pediatric Hematology and Immunology, APHP, Robert Debré Hospital
- Paris Diderot University
| | - Charlotte Rigaud
- Department of Pediatric Oncology, Gustave Roussy Cancer Campus, Villejuif
| | - Amaury Leruste
- SIREDO, Pediatric Cancer Center, Institut Curie, PSL Research University, Paris
| | - Nathalie Garnier
- Department of Pediatric Hematology and Oncology, Pediatric Hematology and Oncology Institute, Hospices Civils de Lyon, Lyon
| | - Anne Lambilliotte
- Department of Pediatric Hematology and Oncology, Lille University Hospital, Lille
| | | | - Catherine Curtillet
- Department of Pediatric Hematology and Oncology, APHM, La Timone Hospital, Marseille
| | | | | | - Judith Landman-Parker
- Department of Pediatric Hematology and Oncology, Armand Trousseau Hospital, APHP, Sorbonne University, UMRs938
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Cabañero-Navalon MD, Garcia-Bustos V, Nuñez-Beltran M, Císcar Fernández P, Mateu L, Solanich X, Carrillo-Linares JL, Robles-Marhuenda Á, Puchades-Gimeno F, Pelaez Ballesta A, López-Osle N, Torralba-Cabeza MÁ, Bielsa Masdeu AM, Diego Gil J, Tornador Gaya N, Pascual Castellanos G, Sánchez-Martínez R, Barragán-Casas JM, González-García A, Patier de la Peña JL, López-Wolf D, Mora Rufete A, Canovas Mora A, Forner Giner MJ, Moral Moral P. Current clinical spectrum of common variable immunodeficiency in Spain: The multicentric nationwide GTEM-SEMI-CVID registry. Front Immunol 2022; 13:1033666. [PMID: 36389743 PMCID: PMC9650514 DOI: 10.3389/fimmu.2022.1033666] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/11/2022] [Indexed: 08/22/2023] Open
Abstract
Common variable immunodeficiency (CVID) constitutes a heterogenic group of primary immunodeficiency disorders with a wide-ranging clinical spectrum. CVID-associated non-infectious morbidity constitutes a major challenge requiring a full understanding of its pathophysiology and its clinical importance and global variability, especially considering the broad clinical, genetic, and regional heterogeneity of CVID disorders. This work aimed to develop a nationwide, multicenter, retrospective study over a 3-year period describing epidemiological, clinical, laboratory, therapeutic, and prognostic features of 250 CVID patients in Spain. The mean diagnostic delay was around 10 years and most patients initially presented with infectious complications followed by non-infectious immune disorders. However, infectious diseases were not the main cause of morbimortality. Non-infectious lung disease was extraordinarily frequent in our registry affecting approximately 60% of the patients. More than one-third of the patients in our cohort showed lymphadenopathies and splenomegaly in their follow-up, and more than 33% presented immune cytopenias, especially Evans' syndrome. Gastrointestinal disease was observed in more than 40% of the patients. Among biopsied organs in our cohort, benign lymphoproliferation was the principal histopathological alteration. Reaching 15.26%, the global prevalence of cancer in our registry was one of the highest reported to date, with non-Hodgkin B lymphoma being the most frequent. These data emphasize the importance of basic and translational research delving into the pathophysiological pathways involved in immune dysregulation and diffuse lymphocytic infiltration. This would reveal new tailored strategies to reduce immune complications, and the associated healthcare burden, and ensure a better quality of life for CVID patients.
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Affiliation(s)
| | - Victor Garcia-Bustos
- Department of Internal Medicine, University and Polytechnic Hospital LaFe, Valencia, Spain
| | - Maria Nuñez-Beltran
- Department of Internal Medicine, University and Polytechnic Hospital LaFe, Valencia, Spain
| | | | - Lourdes Mateu
- Department of Internal Medicine, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Xavier Solanich
- Department of Internal Medicine, Bellvitge University Hospital, Barcelona, Spain
| | | | | | | | - Ana Pelaez Ballesta
- Department of Internal Medicine, Rafael Méndez University Hospital, Murcia, Spain
| | - Nuria López-Osle
- Department of Internal Medicine, Cruces University Hospital, Bizkaia, Spain
| | | | | | - Jorge Diego Gil
- Department of Internal Medicine, University Hospital October 12, Madrid, Spain
| | - Nuria Tornador Gaya
- Department of Internal Medicine, University General Hospital of Castellón, Castellón, Spain
| | | | | | | | - Andrés González-García
- Department of Internal Medicine, Santiago Ramón y Cajal University Hospital, Madrid, Spain
| | | | - Daniel López-Wolf
- Department of Internal Medicine, University Hospital Alcorcón Foundation, Madrid, Spain
| | - Antonia Mora Rufete
- Department of Internal Medicine, General University Hospital of Elche, Alicante, Spain
| | - Alba Canovas Mora
- Department of Internal Medicine, General University Hospital of Elche, Alicante, Spain
| | | | - Pedro Moral Moral
- Department of Internal Medicine, University and Polytechnic Hospital LaFe, Valencia, Spain
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Thomsen BJ, Ulfelder EH. A case of colonic-colonic intussusception in a dog secondary to lymphoma treated with colonic resection and anastomosis. Can Vet J 2022; 63:957-961. [PMID: 36060480 PMCID: PMC9377197] [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: 06/15/2023]
Abstract
A 2-year-old castrated male Great Dane crossbreed dog was presented with a history of diarrhea and suspected intussusception. Abdominal ultrasound revealed a colonic-colonic intussusception. The gastrointestinal tract was explored, and an approximately 5-cm intussusception was discovered mid-colon. All other gastrointestinal structures were normal in appearance. The intussusception could not be reduced manually. A colonic resection and anastomosis were performed together with a left-sided incisional colopexy. The dog recovered from surgery and histopathology revealed the intussusception to be secondary to large cell transmural lymphoma. Sections from the surgical margins revealed proliferation of fibrovascular tissue along the serosal surface segmentally, but no neoplastic cells were identified. The dog was subsequently treated with chemotherapy consisting of doxorubicin and prednisone. No evidence of disease recurrence was noted on ultrasound 9 months after surgery. Approximately 2 years after surgery, the dog is noted to be clinically normal at home with no abnormal findings on physical examination. A complete blood (cell) count and chemistry obtained at this time revealed no significant abnormalities besides mild azotemia. Additional restaging was declined by the owner.
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Affiliation(s)
- Brian J Thomsen
- Gulf Coast Veterinary Specialists, 8042 Katy Freeway, Houston, Texas, 77024 USA (Thomsen); Angell Animal Medical Center, 350 S Huntington Avenue, Boston, Massachusetts, 02130 USA (Ulfelder)
| | - Emily H Ulfelder
- Gulf Coast Veterinary Specialists, 8042 Katy Freeway, Houston, Texas, 77024 USA (Thomsen); Angell Animal Medical Center, 350 S Huntington Avenue, Boston, Massachusetts, 02130 USA (Ulfelder)
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Farooqui N, Sy-Go JPT, Miao J, Mehta R, Vaughan LE, Bennani NN, Wang Y, Bansal R, Hathcock MA, Hayman SR, Johnston PB, Villasboas JC, Paludo J, Ansell SM, Leung N, Lin Y, Herrmann SM. Incidence and Risk Factors for Acute Kidney Injury After Chimeric Antigen Receptor T-Cell Therapy. Mayo Clin Proc 2022; 97:1294-1304. [PMID: 35787856 PMCID: PMC9703303 DOI: 10.1016/j.mayocp.2022.05.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 05/17/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the association of baseline and postinfusion patient characteristics with acute kidney injury (AKI) in the month after chimeric antigen receptor T-cell (CAR-T) therapy. METHODS We retrospectively reviewed records of 83 patients with non-Hodgkin lymphoma undergoing CAR-T therapy (axicabtagene ciloleucel) between June 2016 and November 2020. Patients were followed up to 1 month after treatment. Post-CAR-T AKI was defined as a more than 1.5-fold increase in serum creatinine concentration from baseline (on the day of CAR-T infusion) at any time up to 1 month after CAR-T therapy. RESULTS Of 83 patients, 14 (17%) developed AKI during follow-up. At 1 month after CAR-T infusion, 10 of 14 (71%) AKI events had resolved. Lower baseline estimated glomerular filtration rate, use of intravenous contrast material, tumor lysis prophylaxis, higher peak uric acid and creatine kinase levels during follow-up, and change in lactate dehydrogenase from baseline to peak level within 1 month after initiation of CAR-T therapy were significantly associated with AKI incidence during follow-up. Incidence of AKI was also higher in patients who received higher doses of corticosteroids and tocilizumab. CONCLUSION Acute kidney injury occurred in approximately 1 in 6 patients who received axicabtagene ciloleucel for non-Hodgkin lymphoma. Patients with high tumor burden receiving higher total doses of corticosteroids or tocilizumab should be closely monitored for development of AKI. Lower baseline kidney function at CAR-T initiation, exposure to contrast material, and progressive increase in levels of tumor lysis markers (uric acid, lactate dehydrogenase, creatine kinase) after CAR-T infusion may predict risk of AKI during the 1 month after infusion.
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Affiliation(s)
- Naba Farooqui
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN
| | | | - Jing Miao
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN
| | - Ramila Mehta
- Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Lisa E Vaughan
- Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | | | - Yucai Wang
- Division of Hematology, Mayo Clinic, Rochester, MN
| | - Radhika Bansal
- Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | | | | | | | | | - Jonas Paludo
- Division of Hematology, Mayo Clinic, Rochester, MN
| | | | - Nelson Leung
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN
| | - Yi Lin
- Division of Hematology, Mayo Clinic, Rochester, MN
| | - Sandra M Herrmann
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN.
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Hoogland AI, Barata A, Logue J, Kommalapati A, Hyland KA, Nelson AM, Eisel SL, Small BJ, James BW, Christy SM, Bulls HW, Booth-Jones M, Jayani RV, Jain MD, Mokhtari S, Chavez JC, Lazaryan A, Shah BD, Locke FL, Jim HS. Change in Neurocognitive Performance Among Patients with Non-Hodgkin Lymphoma in the First Year after Chimeric Antigen Receptor T Cell Therapy. Transplant Cell Ther 2022; 28:305.e1-305.e9. [PMID: 35378330 PMCID: PMC9197947 DOI: 10.1016/j.jtct.2022.03.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/11/2022] [Accepted: 03/28/2022] [Indexed: 01/31/2023]
Abstract
The success of chimeric antigen receptor (CAR) T cell therapy in treating patients with relapsed/refractory hematologic malignancies is leading to a growing number of survivors treated with this regimen. To our knowledge, no previous studies have examined neurocognitive performance in adult CAR T cell therapy recipients, despite high rates of neurotoxicity and cytokine release syndrome (CRS) in the acute treatment period. This study examined changes in neurocognitive performance in the first year after CAR T cell therapy for non-Hodgkin lymphoma (NHL). Putative risk factors for worsening neurocognitive performance (eg, neurotoxicity, CRS) were explored as well. Neurocognition was assessed before initiation of CAR T cell therapy and at 30, 90, and 360 days post-treatment. Clinical variables were abstracted from medical records. Mixed models were used to examine change in total neurocognitive performance (TNP) and cognitive domains (ie, attention, executive function, verbal ability, immediate and delayed memory, and visuospatial abilities). Among 117 participants (mean age, 61 years; 62% male), TNP and executive function declined slightly on average from baseline to day 90 and then improved from day 90 to day 360 (P < .04). Small but significant linear declines in visuospatial ability on average were also observed over time (P = .03). Patients who had 4 or more lines of previous therapy and those with worse neurotoxicity (but not CRS) demonstrated worse TNP. CAR T cell therapy recipients reported transient or persistent deterioration in several cognitive domains, although changes were slight. These findings may be useful when educating future patients on what to expect when receiving CAR T cell therapy.
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Affiliation(s)
- Aasha I. Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Anna Barata
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Jennifer Logue
- Department of Blood and Marrow Transplantation and Cellular Therapy, Moffitt Cancer Center, Tampa, FL
| | - Anuhya Kommalapati
- Department of Blood and Marrow Transplantation and Cellular Therapy, Moffitt Cancer Center, Tampa, FL
| | - Kelly A. Hyland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Ashley M. Nelson
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Sarah L. Eisel
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Brent J. Small
- School of Aging Studies, University of South Florida, Tampa, FL
| | - Brian W. James
- Morsani College of Medicine, University of South Florida, Tampa, FL
| | - Shannon M. Christy
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Hailey W. Bulls
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | | | - Reena V. Jayani
- Department of Blood and Marrow Transplantation and Cellular Therapy, Moffitt Cancer Center, Tampa, FL
| | - Michael D. Jain
- Department of Blood and Marrow Transplantation and Cellular Therapy, Moffitt Cancer Center, Tampa, FL
| | | | - Julio C. Chavez
- Department of Blood and Marrow Transplantation and Cellular Therapy, Moffitt Cancer Center, Tampa, FL
| | - Aleksandr Lazaryan
- Department of Blood and Marrow Transplantation and Cellular Therapy, Moffitt Cancer Center, Tampa, FL
| | - Bijal D. Shah
- Department of Blood and Marrow Transplantation and Cellular Therapy, Moffitt Cancer Center, Tampa, FL
| | - Frederick L. Locke
- Department of Blood and Marrow Transplantation and Cellular Therapy, Moffitt Cancer Center, Tampa, FL
| | - Heather S.L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
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王 竹, 谢 亚, 李 雅, 杨 锦, 谢 艳. [Analysis and Treatment Experience of 25 Cases of Primary Gastric Lymphoma with Acute Upper Gastrointestinal Bleeding as the Primary Manifestation]. Sichuan Da Xue Xue Bao Yi Xue Ban 2022; 53:404-408. [PMID: 35642146 PMCID: PMC10409412 DOI: 10.12182/20220560204] [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] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Indexed: 06/15/2023]
Abstract
Objective To summarize the clinical characteristics and treatment experience of gastric primary lymphoma with acute upper gastrointestinal bleeding as the primary manifestation, and to provide support for clinical treatment. Methods Information on gastric primary lymphoma patients admitted to the Department of Gastroenterology, West China Hospital of Sichuan University between January 2010 and March 2021 for acute upper gastrointestinal bleeding was retrospectively collected. Data on endoscopic morphology, tumor staging, pathology typing, severity of bleeding, risks of rebleeding, treatment and inhospital prognosis were documented and analyzed. Results A total of 25 patients with a mean age of 57.2 years were included in the study, all of whom presented clinically with melena (100%), 9 (36%) had hematemesis, and 6 (24%) was accompanied with abdominal pain. Twenty, or 80%, of the gastric lymphoma patients with bleeding as the primary manifestation showed endoscopically a tumor-forming phenotype (Yao Classification), mostly involving the middle and lower parts of the gastric body (44% and 32%, respectively). After conservative treatment with medication, rebleeding occurred in 4 patients during hospitalization. One of them required endoscopic hemostasis, two required surgical resection to stop the bleeding, and one decided not to undergo any further treatment. Only one patient died from infection and no death resulted directly from severe bleeding. Conclusion Gastric primary lymphoma presenting acute upper gastrointestinal bleeding as the sole clinical manifestation rarely occurs, but when the condition does occur, it shows a wide range of endoscopic involvement. It has a higher risk of rebleeding, and endoscopic or surgical treatment may be attempted when conservative medication treatment for acute upper gastrointestinal bleeding fails.
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Affiliation(s)
- 竹 王
- 四川大学华西医院 消化内科 (成都 610041)Department of Gastroenterology, West China Hospital, Sichuan Univeristy, Chengdu 610041, China
| | - 亚文 谢
- 四川大学华西医院 消化内科 (成都 610041)Department of Gastroenterology, West China Hospital, Sichuan Univeristy, Chengdu 610041, China
| | - 雅茹 李
- 四川大学华西医院 消化内科 (成都 610041)Department of Gastroenterology, West China Hospital, Sichuan Univeristy, Chengdu 610041, China
| | - 锦林 杨
- 四川大学华西医院 消化内科 (成都 610041)Department of Gastroenterology, West China Hospital, Sichuan Univeristy, Chengdu 610041, China
| | - 艳 谢
- 四川大学华西医院 消化内科 (成都 610041)Department of Gastroenterology, West China Hospital, Sichuan Univeristy, Chengdu 610041, China
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Zhang L, Zhang J, He H, Ling X, Li F, Yang Z, Zhao J, Li H, Yang T, Zhao S, Shi K, Guan X, Zhao R, Li Z. Increased Cytokine Levels Assist in the Diagnosis of Respiratory Bacterial Infections or Concurrent Bacteremia in Patients With Non-Hodgkin’s Lymphoma. Front Cell Infect Microbiol 2022; 12:860526. [PMID: 35463642 PMCID: PMC9024136 DOI: 10.3389/fcimb.2022.860526] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 03/11/2022] [Indexed: 11/13/2022] Open
Abstract
Non-Hodgkin’s lymphoma (NHL) is a form of tumor that originates in the lymphoid tissues. Bacterial infections are very common in NHL patients. Because most of the patients do not experience apparent symptoms during the initial stage of infection, it is difficult to detect the underlying condition before it progresses to a more critical level. The activation of the cytokines is a hallmark of inflammation. Due to the advantages of short detection time and high sensitivity of cytokines, many studies have focused on relationship between cytokines and infection. However, few studies have been conducted on NHL patients with infection. Therefore, we reviewed the cytokine profiles of 229 newly diagnosed NHL patients and 40 healthy adults to predict respiratory bacterial infection and bacteremia. Our findings revealed that IL-6(41.67 vs 9.50 pg/mL), IL-8(15.55 vs 6.61 pg/mL), IL-10(8.02 vs 4.52 pg/mL),TNF-β(3.82 vs 2.96 pg/mL), IFN- γ(4.76 vs 2.96 pg/mL), body temperature(37.6 vs 36.5°C), CRP(20.80 vs 4.37 mg/L), and PCT(0.10 vs 0.04 ng/mL) levels were considerably greater in NHL cases with respiratory bacterial infections relative to NHL cases without infection (P<0.05). Furthermore, IL-6(145.00 vs 41.67 pg/mL), IL-8(34.60 vs 15.55 pg/mL),temperature(38.4 vs 37.6°C), PCT(0.79 vs 0.10 ng/mL), and CRP(93.70 vs 20.80 mg/L) levels in respiratory infectious NHL patients with more severe bacteremia were considerably elevated than in patients with respiratory bacterial infections only (P<0.05). Remarkably, increased levels of IL-6 and IL-8 are effective in determining whether or not pulmonary bacterial infectious NHL patients have bacteremia. Temperature, PCT, and CRP all have lower sensitivity and specificity than IL-6. IL-6 ≥18.79pg/mL indicates the presence of pulmonary bacterial infection in newly diagnosed NHL patients, and IL-6 ≥102.6pg/mL may suggest pulmonary bacterial infection with bacteremia. In short, this study shows that cytokines can be advantageous in the diagnosis and differentiation of pulmonary bacterial infection and bacteremia in newly diagnosed NHL patients and may also guide for the use of clinical antibiotics.
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Affiliation(s)
- Lihua Zhang
- Department of Hematology, The First People’s Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Yunnan Blood Disease Clinical Medical Center, The First People’s Hospital of Yunnan Province, Kunming, China
- Yunnan Blood Disease Hospital, The First People’s Hospital of Yunnan Province, Kunming, China
- National Key Clinical Specialty of Hematology, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Jinping Zhang
- Department of Hematology, The First People’s Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Yunnan Blood Disease Clinical Medical Center, The First People’s Hospital of Yunnan Province, Kunming, China
- Yunnan Blood Disease Hospital, The First People’s Hospital of Yunnan Province, Kunming, China
- National Key Clinical Specialty of Hematology, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Haiping He
- Department of Hematology, The First People’s Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Yunnan Blood Disease Clinical Medical Center, The First People’s Hospital of Yunnan Province, Kunming, China
- Yunnan Blood Disease Hospital, The First People’s Hospital of Yunnan Province, Kunming, China
- National Key Clinical Specialty of Hematology, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Xiaosui Ling
- Department of Hematology, The First People’s Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Yunnan Blood Disease Clinical Medical Center, The First People’s Hospital of Yunnan Province, Kunming, China
- Yunnan Blood Disease Hospital, The First People’s Hospital of Yunnan Province, Kunming, China
- National Key Clinical Specialty of Hematology, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Fan Li
- Department of Hematology, The First People’s Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Yunnan Blood Disease Clinical Medical Center, The First People’s Hospital of Yunnan Province, Kunming, China
- Yunnan Blood Disease Hospital, The First People’s Hospital of Yunnan Province, Kunming, China
- National Key Clinical Specialty of Hematology, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Zefeng Yang
- Department of Hematology, The First People’s Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Yunnan Blood Disease Clinical Medical Center, The First People’s Hospital of Yunnan Province, Kunming, China
- Yunnan Blood Disease Hospital, The First People’s Hospital of Yunnan Province, Kunming, China
- National Key Clinical Specialty of Hematology, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Jinlian Zhao
- Department of Hematology, The First People’s Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Yunnan Blood Disease Clinical Medical Center, The First People’s Hospital of Yunnan Province, Kunming, China
- Yunnan Blood Disease Hospital, The First People’s Hospital of Yunnan Province, Kunming, China
- National Key Clinical Specialty of Hematology, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Huiyuan Li
- Department of Hematology, The First People’s Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Yunnan Blood Disease Clinical Medical Center, The First People’s Hospital of Yunnan Province, Kunming, China
- Yunnan Blood Disease Hospital, The First People’s Hospital of Yunnan Province, Kunming, China
- National Key Clinical Specialty of Hematology, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Tonghua Yang
- Department of Hematology, The First People’s Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Yunnan Blood Disease Clinical Medical Center, The First People’s Hospital of Yunnan Province, Kunming, China
- Yunnan Blood Disease Hospital, The First People’s Hospital of Yunnan Province, Kunming, China
- National Key Clinical Specialty of Hematology, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Shixiang Zhao
- Department of Hematology, The First People’s Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Yunnan Blood Disease Clinical Medical Center, The First People’s Hospital of Yunnan Province, Kunming, China
- Yunnan Blood Disease Hospital, The First People’s Hospital of Yunnan Province, Kunming, China
- National Key Clinical Specialty of Hematology, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Keqian Shi
- Department of Hematology, The First People’s Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Yunnan Blood Disease Clinical Medical Center, The First People’s Hospital of Yunnan Province, Kunming, China
- Yunnan Blood Disease Hospital, The First People’s Hospital of Yunnan Province, Kunming, China
- National Key Clinical Specialty of Hematology, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Xin Guan
- Department of Hematology, The First People’s Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Yunnan Blood Disease Clinical Medical Center, The First People’s Hospital of Yunnan Province, Kunming, China
- Yunnan Blood Disease Hospital, The First People’s Hospital of Yunnan Province, Kunming, China
- National Key Clinical Specialty of Hematology, The First People’s Hospital of Yunnan Province, Kunming, China
- *Correspondence: Xin Guan, ; Renbin Zhao, ; Zengzheng Li,
| | - Renbin Zhao
- Department of Hematology, The First People’s Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Yunnan Blood Disease Clinical Medical Center, The First People’s Hospital of Yunnan Province, Kunming, China
- Yunnan Blood Disease Hospital, The First People’s Hospital of Yunnan Province, Kunming, China
- National Key Clinical Specialty of Hematology, The First People’s Hospital of Yunnan Province, Kunming, China
- *Correspondence: Xin Guan, ; Renbin Zhao, ; Zengzheng Li,
| | - Zengzheng Li
- Department of Hematology, The First People’s Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Yunnan Blood Disease Clinical Medical Center, The First People’s Hospital of Yunnan Province, Kunming, China
- Yunnan Blood Disease Hospital, The First People’s Hospital of Yunnan Province, Kunming, China
- National Key Clinical Specialty of Hematology, The First People’s Hospital of Yunnan Province, Kunming, China
- *Correspondence: Xin Guan, ; Renbin Zhao, ; Zengzheng Li,
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Bruns L, Panagiota V, von Hardenberg S, Schmidt G, Adriawan IR, Sogka E, Hirsch S, Ahrenstorf G, Witte T, Schmidt RE, Atschekzei F, Sogkas G. Common Variable Immunodeficiency-Associated Cancers: The Role of Clinical Phenotypes, Immunological and Genetic Factors. Front Immunol 2022; 13:742530. [PMID: 35250968 PMCID: PMC8893227 DOI: 10.3389/fimmu.2022.742530] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 01/19/2022] [Indexed: 12/02/2022] Open
Abstract
Objective The aim of this study was to investigate the prevalence of cancer and associating clinical, immunological, and genetic factors in a German cohort of patients with common variable immunodeficiency (CVID). Methods In this retrospective monocenter cohort study, we estimated the standardized incidence ratio (SIR) for different forms of cancer diagnosed in CVID patients. Furthermore, we evaluated the likely association of infectious and non-infectious CVID-related phenotypes with the diagnosis of cancer by calculation of the odds ratio. The genetic background of CVID in patients with cancer was evaluated with sequential targeted next-generation sequencing (tNGS) and whole-exome sequencing (WES). Patients’ family history and WES data were evaluated for genetic predisposition to cancer. Results A total of 27/219 patients (12.3%) were diagnosed with at least one type of cancer. Most common types of cancer were gastric cancer (SIR: 16.5), non-melanoma skin cancer (NMSC) (SIR: 12.7), and non-Hodgkin lymphoma (NHL) (SIR: 12.2). Immune dysregulation manifesting as arthritis, atrophic gastritis, or interstitial lung disease (ILD) was associated with the diagnosis of cancer. Furthermore, diagnosis of NMSC associated with the diagnosis of an alternative type of cancer. Studied immunological parameters did not display any significant difference between patients with cancer and those without. tNGS and/or WES yielded a definite or likely genetic diagnosis in 11.1% of CVID patients with cancer. Based on identified variants in cancer-associated genes, the types of diagnosed cancers, and family history data, 14.3% of studied patients may have a likely genetic susceptibility to cancer, falling under a known hereditary cancer syndrome. Conclusions Gastric cancer, NMSC, and NHL are the most frequent CVID-associated types of cancer. Manifestations of immune dysregulation, such as arthritis and ILD, were identified as risk factors of malignancy in CVID, whereas studied immunological parameters or the identification of a monogenic form of CVID appears to have a limited role in the evaluation of cancer risk in CVID.
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Affiliation(s)
- Luzia Bruns
- Department of Rheumatology and Immunology, Hannover Medical School, Hanover, Germany
| | - Victoria Panagiota
- Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | | | - Gunnar Schmidt
- Department of Human Genetics, Hannover Medical School, Hanover, Germany
| | | | - Eleni Sogka
- Department of Medical Oncology, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stefanie Hirsch
- Department of Rheumatology and Immunology, Hannover Medical School, Hanover, Germany
| | - Gerrit Ahrenstorf
- Department of Rheumatology and Immunology, Hannover Medical School, Hanover, Germany
| | - Torsten Witte
- Department of Rheumatology and Immunology, Hannover Medical School, Hanover, Germany
- Hannover Medical School, Cluster of Excellence RESIST (EXC 2155), Hanover, Germany
| | - Reinhold Ernst Schmidt
- Department of Rheumatology and Immunology, Hannover Medical School, Hanover, Germany
- Hannover Medical School, Cluster of Excellence RESIST (EXC 2155), Hanover, Germany
| | - Faranaz Atschekzei
- Department of Rheumatology and Immunology, Hannover Medical School, Hanover, Germany
- Hannover Medical School, Cluster of Excellence RESIST (EXC 2155), Hanover, Germany
| | - Georgios Sogkas
- Department of Rheumatology and Immunology, Hannover Medical School, Hanover, Germany
- Hannover Medical School, Cluster of Excellence RESIST (EXC 2155), Hanover, Germany
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38
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Yang CL, Xiang XR, Wu Y. Armor sign on PET-CT in a young male with non-Hodgkin's lymphoma. Int J Hematol 2021; 115:5-6. [PMID: 34766238 DOI: 10.1007/s12185-021-03258-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 11/01/2021] [Accepted: 11/01/2021] [Indexed: 02/05/2023]
Affiliation(s)
- Chen-Lu Yang
- Department of Hematology and Institute of Hematology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xin-Rong Xiang
- Department of Hematology and Institute of Hematology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yu Wu
- Department of Hematology and Institute of Hematology, West China Hospital, Sichuan University, Chengdu, 610041, China.
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39
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Silverstein J, Liu H, Shin D, Berler D. Plasmablastic Lymphoma Causing Adult Intussusception After Cardiac Transplantation. CRSLS 2021; 8:e2021.00069. [PMID: 36017063 PMCID: PMC9387386 DOI: 10.4293/crsls.2021.00069] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Intussusception in adults is a rare occurrence at approximately 5% and malignancy as the cause comprises half that number. The most common malignancies found are primary adenocarcinoma, metastatic carcinoma, lymphoma, and gastrointestinal stromal tumors. Lymphoma is the second most common. The management of adult intussusception is generally surgical, which is due to the higher likelihood of malignancy being the underlying cause. The patient's history helps to direct management and the most likely underlying diagnosis. This is especially important in patients who are immunosuppressed and with a history of lymphoproliferative disease. Early management and proper surgical intervention allow for the best survival rate. Here we present a case of adult intussusception caused by a rare and aggressive type of non-Hodgkin lymphoma.
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Affiliation(s)
| | - Helen Liu
- Surgery Department, NYU Langone - Long Island, Mineola, NY
| | - David Shin
- Surgery Department, NYU Langone - Long Island, Mineola, NY
| | - David Berler
- Staten Island University Hospital, Staten Island, NY
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40
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Ding Y, Ru Y, Song T, Guo L, Zhang X, Zhu J, Li C, Jin Z, Huang H, Tu Y, Xu M, Xu Y, Chen J, Wu D. Epstein-Barr virus and cytomegalovirus reactivation after allogeneic hematopoietic cell transplantation in patients with non-Hodgkin lymphoma: the prevalence and impacts on outcomes : EBV and CMV reactivation post allo-HCT in NHL. Ann Hematol 2021; 100:2773-2785. [PMID: 34480615 PMCID: PMC8510926 DOI: 10.1007/s00277-021-04642-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/18/2021] [Indexed: 12/22/2022]
Abstract
Epstein–Barr virus (EBV) and cytomegalovirus (CMV) reactivations are common complications after allogeneic hematopoietic cell transplantation (allo-HCT), but data focusing on non–Hodgkin lymphoma (NHL) are limited. We retrospectively analyzed the prevalence of EBV and CMV reactivation post-allo-HCT and the impacts on transplant outcomes in 160 NHL patients. The 1-year incidences of EBV and CMV reactivation were 22.58% and 25.55%, respectively. Independent impactors for EBV reactivation were more than 6 lines of chemotherapy (P = 0.030), use of rituximab (P = 0.004), and neutrophil recovery within 30 days post-HCT (P = 0.022). For T-cell lymphoblastic lymphoma patients, the International Prognostic Index (IPI) (P = 0.015) and chronic GVHD (P = 0.001) increased the risk of CMV reactivation. CMV reactivation was independently related to a lower risk of relapse (P = 0.027) but higher transplant-related mortality (TRM) (P = 0.038). Although viral reactivation had no significant impact on overall survival (OS) in the whole cohort, it led to an inferior 2-year OS (67.6% versus 92.5%, P = 0.005) and TRM (20.1% versus 4.7%, P = 0.020) in recipients surviving for more than 180 days. We concluded that EBV and CMV reactivation post-allotransplant still deserved concern particularly in NHL patients with high-risk factors, since it is generally related to a deteriorated prognosis. Large-scale studies are warranted to validate our findings.
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Affiliation(s)
- Yiyang Ding
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Shizi Street 188, Suzhou, 215006, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- Key Laboratory of Stem Cells and Biomedical, Materials of Jiangsu Province and Chinese Ministry of Science and Technology, Suzhou, China
| | - Yuhua Ru
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Shizi Street 188, Suzhou, 215006, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- Key Laboratory of Stem Cells and Biomedical, Materials of Jiangsu Province and Chinese Ministry of Science and Technology, Suzhou, China
| | - Tiemei Song
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Shizi Street 188, Suzhou, 215006, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- Key Laboratory of Stem Cells and Biomedical, Materials of Jiangsu Province and Chinese Ministry of Science and Technology, Suzhou, China
| | - Lingchuan Guo
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Shizi Street 188, Suzhou, 215006, China
- The pathology department of the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiang Zhang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Shizi Street 188, Suzhou, 215006, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- Key Laboratory of Stem Cells and Biomedical, Materials of Jiangsu Province and Chinese Ministry of Science and Technology, Suzhou, China
| | - Jinjin Zhu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Shizi Street 188, Suzhou, 215006, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- Key Laboratory of Stem Cells and Biomedical, Materials of Jiangsu Province and Chinese Ministry of Science and Technology, Suzhou, China
| | - Caixia Li
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Shizi Street 188, Suzhou, 215006, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- Key Laboratory of Stem Cells and Biomedical, Materials of Jiangsu Province and Chinese Ministry of Science and Technology, Suzhou, China
| | - Zhengming Jin
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Shizi Street 188, Suzhou, 215006, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- Key Laboratory of Stem Cells and Biomedical, Materials of Jiangsu Province and Chinese Ministry of Science and Technology, Suzhou, China
| | - Haiwen Huang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Shizi Street 188, Suzhou, 215006, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- Key Laboratory of Stem Cells and Biomedical, Materials of Jiangsu Province and Chinese Ministry of Science and Technology, Suzhou, China
| | - Yuqing Tu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Shizi Street 188, Suzhou, 215006, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- Key Laboratory of Stem Cells and Biomedical, Materials of Jiangsu Province and Chinese Ministry of Science and Technology, Suzhou, China
| | - Mimi Xu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Shizi Street 188, Suzhou, 215006, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- Key Laboratory of Stem Cells and Biomedical, Materials of Jiangsu Province and Chinese Ministry of Science and Technology, Suzhou, China
| | - Yang Xu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Shizi Street 188, Suzhou, 215006, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- Key Laboratory of Stem Cells and Biomedical, Materials of Jiangsu Province and Chinese Ministry of Science and Technology, Suzhou, China
| | - Jia Chen
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Shizi Street 188, Suzhou, 215006, China.
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China.
- Key Laboratory of Stem Cells and Biomedical, Materials of Jiangsu Province and Chinese Ministry of Science and Technology, Suzhou, China.
| | - Depei Wu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Shizi Street 188, Suzhou, 215006, China.
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China.
- Key Laboratory of Stem Cells and Biomedical, Materials of Jiangsu Province and Chinese Ministry of Science and Technology, Suzhou, China.
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Nelwan EJ, Tunjungputri RN, Wardani RS, Wahyuningsih R. Black Fungus Complicated with COVID-19 in a Man with Underlying Non-Hodgkin's Lymphoma. Acta Med Indones 2021; 53:349-351. [PMID: 34611076] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
COVID-19 is a disease reported to suppress cellular immunity. This may lead to the development of opportunistic infections, among others black fungus, or mucormycosis. On the other hand, pre-existing defect in immunity may render patients susceptible to both mucormycosis and COVID-19. Mucormycosis is a relatively rare fungal infection with rapid progression unless diagnosed promptly and treated adequately, and urgent surgical and medical intervention is lifesaving. The manifestation of mucormycosis largely depends on the presence of exposure to the pathogen and the existing risk factor of the host. As black fungus is locally invasive, the majority of cases will involve tissue damage with local destruction and contiguous spread to nearby structure. We here with present a case of black fungus complicated with COVID-19 in a man with underlying non-Hodgkin's lymphoma.
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Affiliation(s)
- Erni J Nelwan
- 1. Division of Tropical and Infectious Disease. Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia. 2. Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
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Saito M, Wages NA, Schiff D. Incidence, risk factors and management of venous thromboembolism in patients with primary CNS lymphoma. J Neurooncol 2021; 154:41-47. [PMID: 34164780 DOI: 10.1007/s11060-021-03791-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 06/18/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Venous thromboembolism (VTE) is a known complication of malignancy. While brain tumors in general predispose to VTE, the incidence in primary central nervous system lymphoma (PCNSL) is poorly characterized. We sought to characterize incidence, risk factors, management, and outcome of VTE in PCNSL METHOD: Retrospective study of 78 PCNSL patients from 2/1/2002 to 4/1/2020 at the University of Virginia RESULTS: 31% (24/78) of patients developed VTE. 12.8% (10/78) had deep venous thrombosis (DVT) alone, 11.5% (9/78) isolated pulmonary embolism (PE) and 6.4% (5/78) both. The median time from PCNSL diagnosis to VTE was 3 months. In a univariate competing risks analysis, previous VTE (p < 0.001), impaired ambulation (p = 0.035), baseline hemoglobin < 10 g/dL (p = 0.025) and history of diabetes mellitus (type 1 or 2) (p = 0.007) were associated with increased VTE risk. 34.8% were anticoagulated acutely with heparin (8/23) or 65.2% LMWH (15/23), and 25.0% (6/24) received warfarin, 41.7% (10/24) LMWH, and 33.3% (8/24) DOACs long-term. One adverse event was attributable to anticoagulation (arm hematoma with hemoglobin decrease). Five patients received IVC filters with concomitant oral anticoagulation; one experienced IVC thrombosis after anticoagulation discontinuation. Six of the 24 patients experienced recurrent VTE, four while anticoagulated. CONCLUSION Patients with PCNSL are at high risk of VTE, most of which accrues in the first few months. History of VTE, diabetes mellitus (type 1 or 2), impaired ambulatory status, or hemoglobin < 10 g/dL may predispose patients to this complication. While optimal management is uncertain, anticoagulation prevented recurrent VTE in most patients without intracranial bleeding.
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Affiliation(s)
- Miyabi Saito
- UVA School of Medicine, University of Virginia, Charlottesville, VA, 22903, USA
| | - Nolan A Wages
- Division of Translational Research & Applied Statistics, Department of Public Health Sciences, University of Virginia, P.O. Box 800717, Charlottesville, VA, 22903-0717, USA
| | - David Schiff
- Divison of Neuro-Oncology, Department of Neurology, University of Virginia, PO Box 800432, Charlottesville, VA, 22908-0432, USA.
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Díaz-Roldán J, Franch-Arcas G, Ruiz-Luque V. Hypercalcemia and bulky primary adrenal non-Hodgkin lymphoma: A case report. Med Clin (Barc) 2021; 157:595-596. [PMID: 34116849 DOI: 10.1016/j.medcli.2021.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Jorge Díaz-Roldán
- Department of General and Gastrointestinal Surgery. Hospital Universitario Virgen de Valme, Sevilla, Spain.
| | - Guzmán Franch-Arcas
- Department of General and Gastrointestinal Surgery. Complejo Asistencial Universitario de Salamanca, Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - Virgilio Ruiz-Luque
- Department of General and Digestive Surgery. Hospital Universitario Virgen de Valme, Sevilla, Spain
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Abstract
RATIONALE Primary biliary non-Hodgkin's lymphoma (PBNHL) is a rare disease with only 41 cases reported since 1982. The incidence of PBNHL in patients with malignant cholangiocarcinoma was 0.6%, and PBNHL accounted for 0.4% of extranodal non-Hodgkin's lymphoma, and only 0.016% of all non-Hodgkin's lymphoma cases. PATIENT CONCERNS We present a rare case of PBNHL in a 59-year-old female who had jaundice for 3 days with weight loss and Epstein-Barr virus infection. Initial computed tomography and magnetic resonance imaging showed diffuse thickening wall of bile ducts with corresponding lumen stenosis, blurred fat space around the portal vein, lymphadenopathy, and a normal spleen. These manifestations and images were similar to hilar cholangiocarcinoma. So, the diagnosis of hilar cholangiocarcinoma was initially considered. DIAGNOSES Postoperative pathology confirmed the final diagnosis was PBNHL. INTERVENTIONS The patient and her family requested to clarify the histologic diagnosis by laparotomy biopsy. Because the biopsy result could not be defined during operation, then right hemihepatectomy and choledochojejunostomy were performed. She did not receive any antitumor treatment. OUTCOMES One month after the patient's first examination, both computed tomography and magnetic resonance images showed diminished stenosis of common bile duct and left hepatic duct, but a new mass in segment IV of liver was observed. Unfortunately, the patient died due to disease progression. LESSONS This case reminds us that although PBNHL is rare, making accurate diagnosis difficult preoperatively, PBNHL should be considered when encountering a case with Epstein-Barr virus infection and those typical imaging findings.
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Affiliation(s)
| | | | - Qingshu Li
- Department of Pathology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Sica A, Spada A, Sagnelli C, Verolino P, Mazzocca A, Sagnelli E, Colella G, Guastafierro S, Marrone A. Elbasvir/Grazoprevir combination therapy in a B-NHL patient with HCV genotype 1 infection. Infez Med 2021; 29:277-279. [PMID: 34061795] [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: 06/12/2023]
Abstract
Patients with indolent non-Hodgkin lymphomas (NHL) may often be followed up only with observation, reserving chemotherapy in case of spread. Patients with chronic HCV infection and B cell NHL frequently undergo regression of lymphoproliferative disease once HCV infection is eradicated by treatment. Interferon (IFN)-based therapy has been the treatment of choice for years, remaining unclear whether it is effective in B cell NHL directly or through HCV eradication, since IFN is effective in both HCV infection and B cell NHL. IFN therapy for HCV infection became obsolete with the advent of the well tolerated direct-acting antiviral agents (DAAs), whose excellent efficacy in treating patients with chronic HCV infection and B cell NHL has been recently highlighted. We treated a 53-year-old woman with chronic HCV infection and marginal zone lymphoma (MZL) with elbasvir plus grazoprevir in 2018, with complete remission and persisting excellent results: sustained virological response 24 weeks after treatment (SVR24). The exclusive role of HCV eradication in B cell NHL regression is also underlined.
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Affiliation(s)
- Antonello Sica
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessandro Spada
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Pasquale Verolino
- Plastic Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Annalisa Mazzocca
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Evangelista Sagnelli
- Department of Mental Health and Public Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuseppe Colella
- Multidisciplinary Department of Medical Surgery and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Salvatore Guastafierro
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Aldo Marrone
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
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Abstract
Secondary immune thrombocytopenic purpura (ITP) with non-Hodgkin lymphoma (NHL) is a rare disease. Although some treatment regimens are available for primary ITP, the treatment strategy for secondary ITP remains unconfirmed. We herein report a 79-year-old man who was diagnosed with secondary ITP with mantle cell lymphoma. Although intravenous immunoglobulin (IVIG) has been considered an effective option for secondary ITP, similar to the treatment of primary ITP, our patient did not benefit from IVIG. A literature review including the current report revealed that IVIG was ineffective in all treated patients. Secondary ITP with NHL should be treated differently from primary ITP.
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Affiliation(s)
- Yuya Kurihara
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Kazuki Taoka
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Eri Takagi
- General Education Center, The University of Tokyo Hospital, Japan
| | - Kazuhiro Toyama
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Kumi Nakazaki
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Mineo Kurokawa
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Japan
- Department of Cell Therapy and Transplantation Medicine, The University of Tokyo Hospital, Japan
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Murthy NK, Amrami KK, Spinner RJ. Circumdural extension of perineural spread leading to bilateral disease in neurolymphomatosis. Acta Neurochir (Wien) 2020; 162:3197-3200. [PMID: 32468322 DOI: 10.1007/s00701-020-04417-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/15/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Patients with neurolymphomatosis (NL) often present with one primarily symptomatic limb but can be found to have bilateral upper or bilateral lower limb disease during workup. We sought to explain the finding of bilateral disease and understand if there was a connection to the initial, symptomatic side of disease. METHODS We reviewed imaging studies of patients with bilateral upper or bilateral lower limb disease from a previously published cohort from our institution, as well as more recent patients seen at our institution. We reviewed demographics (sex and age), clinical data (primary or secondary disease and biopsy-proven diagnosis), and imaging findings (primary involved nerve, contralateral nerve(s) affected, and location of circumdural extension). RESULTS We identified 8 cases with evidence of bilateral disease out of 22 cases of tumefactive NL. All eight cases were found to have circumdural extension of disease to the corresponding contralateral nerve. CONCLUSION We describe the pathomechanism of spread in our cases of bilateral upper or bilateral lower limb disease, where NL spreads along a dominant nerve toward the spinal canal and moves circumdurally to affect the corresponding contralateral nerve. We believe this information is useful to further understand the spread of NL, as well as offering important diagnostic and prognostic information for patients.
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MESH Headings
- Adult
- Aged
- Biopsy
- Female
- Humans
- Lower Extremity
- Lymphoma, B-Cell, Marginal Zone/complications
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Non-Hodgkin/complications
- Lymphoma, Non-Hodgkin/pathology
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Neurolymphomatosis/diagnostic imaging
- Neurolymphomatosis/etiology
- Positron Emission Tomography Computed Tomography
- Upper Extremity
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Affiliation(s)
- Nikhil K Murthy
- Department of Neurosurgery, Mayo Clinic, 200 First St. SW, Gonda 8-214, Rochester, MN, 55905, USA
| | | | - Robert J Spinner
- Department of Neurosurgery, Mayo Clinic, 200 First St. SW, Gonda 8-214, Rochester, MN, 55905, USA.
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Zafar T, Ahmad W, Bashir H. Targeting the neighbour: Primary gastric lymphoma with concealed splenic perforation. J PAK MED ASSOC 2020; 70:2488-2489. [PMID: 33475573] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Primary gastric lymphoma is a rare entity which manifests with vague abdominal symptoms and occasionally presents as complications including perforation and haemorrhage requiring urgent management. Chemotherapy has surpassed surgery with advancing medical era. We hereby present an unusual case of primary gastric lymphoma with splenic involvement complicated by localized perforation.
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Affiliation(s)
- Tehreem Zafar
- Department of Nuclear Medicine, Shaukat Khanum Memorial Cancer Hospital & Research Center, Lahore, Pakistan
| | - Waqas Ahmad
- Department of Nuclear Medicine, Shaukat Khanum Memorial Cancer Hospital & Research Center, Lahore, Pakistan
| | - Humayun Bashir
- Department of Nuclear Medicine, Shaukat Khanum Memorial Cancer Hospital & Research Center, Lahore, Pakistan
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49
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Santana Quintana A, Valga F, Vega Díaz N, Fernández JM, Quevedo Reina JC, Rincón Tirado M, Aladro Escribano S, Rodríguez Pérez JC. [Not all cytokin storms are due to COVID-19: Hemophagotic syndrome with renal involvement secondary to extranasal lymphoma and Epstein-Barr virus. A case report during the pandemic]. Nefrologia 2020; 41:347-349. [PMID: 33069494 PMCID: PMC7492003 DOI: 10.1016/j.nefro.2020.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 07/05/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- Adonay Santana Quintana
- Servicio de Nefrología. Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas, Canarias, España.
| | - Francisco Valga
- Servicio de Nefrología. Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas, Canarias, España
| | - Nicanor Vega Díaz
- Servicio de Nefrología. Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas, Canarias, España
| | - Juan Manuel Fernández
- Servicio de Nefrología. Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas, Canarias, España
| | - Juan Carlos Quevedo Reina
- Servicio de Nefrología. Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas, Canarias, España
| | - Marian Rincón Tirado
- Servicio de Nefrología. Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas, Canarias, España
| | - Sara Aladro Escribano
- Servicio de Nefrología. Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas, Canarias, España
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50
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Ramos JC, Sparano JA, Chadburn A, Reid EG, Ambinder RF, Siegel ER, Moore PC, Rubinstein PG, Durand CM, Cesarman E, Aboulafia D, Baiocchi R, Ratner L, Kaplan L, Capoferri AA, Lee JY, Mitsuyasu R, Noy A. Impact of Myc in HIV-associated non-Hodgkin lymphomas treated with EPOCH and outcomes with vorinostat (AMC-075 trial). Blood 2020; 136:1284-1297. [PMID: 32430507 PMCID: PMC7483436 DOI: 10.1182/blood.2019003959] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 04/14/2020] [Indexed: 12/11/2022] Open
Abstract
EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin) is a preferred regimen for HIV-non-Hodgkin lymphomas (HIV-NHLs), which are frequently Epstein-Barr virus (EBV) positive or human herpesvirus type-8 (HHV-8) positive. The histone deacetylase (HDAC) inhibitor vorinostat disrupts EBV/HHV-8 latency, enhances chemotherapy-induced cell death, and may clear HIV reservoirs. We performed a randomized phase 2 study in 90 patients (45 per study arm) with aggressive HIV-NHLs, using dose-adjusted EPOCH (plus rituximab if CD20+), alone or with 300 mg vorinostat, administered on days 1 to 5 of each cycle. Up to 1 prior cycle of systemic chemotherapy was allowed. The primary end point was complete response (CR). In 86 evaluable patients with diffuse large B-cell lymphoma (DLBCL; n = 61), plasmablastic lymphoma (n = 15), primary effusion lymphoma (n = 7), unclassifiable B-cell NHL (n = 2), and Burkitt lymphoma (n = 1), CR rates were 74% vs 68% for EPOCH vs EPOCH-vorinostat (P = .72). Patients with a CD4+ count <200 cells/mm3 had a lower CR rate. EPOCH-vorinostat did not eliminate HIV reservoirs, resulted in more frequent grade 4 neutropenia and thrombocytopenia, and did not affect survival. Overall, patients with Myc+ DLBCL had a significantly lower EFS. A low diagnosis-to-treatment interval (DTI) was also associated with inferior outcomes, whereas preprotocol therapy had no negative impact. In summary, EPOCH had broad efficacy against highly aggressive HIV-NHLs, whereas vorinostat had no benefit; patients with Myc-driven DLBCL, low CD4, and low DTI had less favorable outcomes. Permitting preprotocol therapy facilitated accruals without compromising outcomes. This trial was registered at www.clinicaltrials.gov as #NCT0119384.
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MESH Headings
- Adult
- Aged
- Anti-HIV Agents/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- CD4 Lymphocyte Count
- Cyclophosphamide/administration & dosage
- Cyclophosphamide/adverse effects
- DNA, Viral/blood
- Doxorubicin/administration & dosage
- Doxorubicin/adverse effects
- Drug Administration Schedule
- Etoposide/administration & dosage
- Etoposide/adverse effects
- Female
- Genes, myc
- HIV Infections/drug therapy
- HIV-1/drug effects
- Herpesviridae Infections/complications
- Herpesviridae Infections/virology
- Herpesvirus 4, Human/genetics
- Herpesvirus 4, Human/isolation & purification
- Herpesvirus 8, Human/genetics
- Herpesvirus 8, Human/isolation & purification
- Histone Deacetylase Inhibitors/administration & dosage
- Histone Deacetylase Inhibitors/adverse effects
- Humans
- Kaplan-Meier Estimate
- Lymphoma, AIDS-Related/complications
- Lymphoma, AIDS-Related/drug therapy
- Lymphoma, AIDS-Related/genetics
- Lymphoma, AIDS-Related/virology
- Lymphoma, Non-Hodgkin/complications
- Lymphoma, Non-Hodgkin/drug therapy
- Lymphoma, Non-Hodgkin/genetics
- Lymphoma, Non-Hodgkin/virology
- Male
- Middle Aged
- Neutropenia/chemically induced
- Prednisone/administration & dosage
- Prednisone/adverse effects
- Progression-Free Survival
- Prospective Studies
- Rituximab/administration & dosage
- Rituximab/adverse effects
- Thrombocytopenia/chemically induced
- Treatment Outcome
- Vincristine/administration & dosage
- Vincristine/adverse effects
- Viral Load/drug effects
- Vorinostat/administration & dosage
- Vorinostat/adverse effects
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Affiliation(s)
- Juan C Ramos
- Department of Medicine, University of Miami School of Medicine, Miami, FL
| | - Joseph A Sparano
- Department of Oncology, Albert Einstein Comprehensive Cancer Center, Bronx, NY
| | - Amy Chadburn
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, NY
| | - Erin G Reid
- Department of Medicine, University of California, San Diego, San Diego, CA
| | | | - Eric R Siegel
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Page C Moore
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Paul G Rubinstein
- Section of Hematology/Oncology, John H. Stroger Jr Hospital of Cook County, Chicago, IL
| | | | - Ethel Cesarman
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, NY
| | - David Aboulafia
- Division of Hematology and Oncology, Virginia Mason Medical Center, Seattle, WA
| | - Robert Baiocchi
- Department of Internal Medicine, Ohio State University, Columbus, OH
| | - Lee Ratner
- Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Lawrence Kaplan
- Department of Medicine, University of California, San Francisco, San Francisco, CA
| | | | - Jeannette Y Lee
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Ronald Mitsuyasu
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - Ariela Noy
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; and
- Department of Medicine, Weill Medical College of Cornell University, New York, NY
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