The purpose of this essay is to describe the way in which the substantial circulation of men and ideas between France and Scotland ultimately turned against Marie de Guise and the kingdom of France ...in the years 1559 and 1560. In order to build a Franco-Scottish kingdom, an initial step towards a Franco-British Empire, the King of France, Henri II, helped increase this trans-Channel circulation of men and ideas. Henri II’s goal was to forge an alliance with both Scottish and English opponents of the Catholic Mary Tudor, particularly by supporting and employing notable Scottish Protestant figures. This policy failed after the Scots’ growing concerns about the “Frenchification” of their government encountered a new English political context in which a Protestant queen, Elizabeth Tudor, took the throne. The open conduit backfired against French ambitions and against the Regent of Scotland, Marie de Guise. The rebellion in Scotland that began in 1559 proved successful by 1560. It was a swift victory by the Protestant Lords that was partly due to the fact that they allied themselves with England after long benefiting from a highly tolerant French attitude. The English takeover of cross-Channel communications led to the isolation of the French army in Scotland and, with the Amboise conspiracy in 1560, to the opening of a second front in France. Significantly, a number of Protestant Scots officially serving the King of France were also double agents for the benefit of England.
A staging system was developed a decade ago for patients with Waldenström's macroglobulinemia (WM), however, since then WM treatments have changed. A revised staging system could better capture ...prognosis of WM patients in the chemoimmunotherapy era. We developed a revised system based on data from 492 symptomatic patients with at least 3 years and a median of 7 years of follow up while an independent validation cohort included 229 symptomatic patients. We identified age (≤65 vs 66-75 vs ≥76 years), b2-microglobulin ≥ 4 mg/L, serum albumin <3.5 gr/dl, and LDH ≥ 250 IU/L (ULN < 225) to stratify patients in five different prognostic groups and identify a very-low risk as well as a very-high risk group with a 3-year WM-related death rate of 0, 10, 14, 38, and 48% (p < 0.001) and 10-year survival rate of 84, 59, 37, 19, and 9% (p < 0.001). We evaluated this staging system separately in patients >65 years and <65 years, according to the reason for initiation of treatment, among patients receiving frontline rituximab or in patients treated primarily without rituximab. With further validation before clinical use, this revised IPSSWM could improve WM patient risk stratification, is easily available and may be used in the everyday practice to provide prognostic information.
Objective
18F-FDG PET/CT provides valuable informations regarding the prognosis of DLBCL. The aim of this study is to test a novel index based on cerebellar uptake to predict progression free ...survival in DLBCL patients.
Methods
Data from patients with de novo DLBCL between January 2011 and December 2018 were retrospectively collected and PFS was determined. The conventional PET parameters (SUV
max
and total metabolic tumor volume) and the CLIP, corresponding to the ratio of the cerebellum SUV
max
over the liver SUV
mean
, were extracted from baseline 18F-FDG PET.
Results
Ninety-five patients were included. When using a threshold of 3.24, CLIP was a significant predictor of PFS on univariate analysis (HR 3.4,
p
< 0.001) with different 5-year survival rates: 68% (CLIP ≥ 3.24) versus 32% (CLIP < 3.24). Multivariate analysis confirmed the prognostic value of CLIP, as it is one of the two factors remaining significant with β2-microglobulin (HR 2.1 and 2.5 respectively,
p
= 0.04 and
p
= 0.03). A score associating β2-microglobulin and CLIP allowed to separate the population into three groups of different outcome in terms of 5-year PFS: low risk (80%), intermediate risk (42%) and high risk (17%).
Conclusions
The CLIP derived from pre-therapeutic 18F-FDG PET seems to be an interesting predictive marker of PFS in DLBCL treated by immunochemotherapy.
The purpose of this study was to determine whether texture analysis features present on pretreatment unenhanced computed tomography (CT) images, derived from 18F-fluorodeoxyglucose positron ...emission/computed tomography (18-FDG PET/CT), can predict progression-free survival (PFS), progression-free survival at 24 months (PFS 24), time to next treatment (TTNT), and overall survival in patients with high-tumor-burden follicular lymphoma treated with immunochemotherapy and rituximab maintenance. Seventy-two patients with follicular lymphoma were retrospectively included. Texture analysis was performed on unenhanced CT images extracted from 18-FDG PET/CT examinations that were obtained within one month before treatment. Skewness at a fine texture scale (SSF = 2) was an independent predictor of PFS (hazard ratio = 3.72 (95% CI: 1.15, 12.11),
= 0.028), PFS 24 (hazard ratio = 13.38; 95% CI: 1.29, 138.13;
= 0.029), and TTNT (hazard ratio = 5.11; 95% CI: 1.18, 22.13;
= 0.029). Skewness values above -0.015 at SSF = 2 were significantly associated with lower PFS, PFS 24, and TTNT. Kurtosis without filtration was an independent predictor of PFS (SSF = 0; HR = 1.22 (95% CI: 1.04, 1.44),
= 0.013), and TTNT (SSF = 0; hazard ratio = 1.23; 95% CI: 1.04, 1.46;
= 0.013). This study shows that pretreatment unenhanced CT texture analysis-derived tumor skewness and kurtosis may be used as predictive biomarkers of PFS and TTNT in patients with high-tumor-burden follicular lymphoma treated with immunochemotherapy and rituximab maintenance.
Registries constitute an interesting source of real‐world data and bring complementary information to randomised controlled trials. They are of particular importance in rare diseases such as ...Waldenström macroglobulinaemia (WM), which can present with various clinical and biological features. In their paper Uppal and colleagues describe the development of the Rory Morrison Registry, the UK registry for WM and IgM‐related disorders and highlight the profound changes in therapies both at first‐line and relapsed settings in the recent years.
Commentary on: Uppal E. et al. The WMUK Rory Morrison Registry for Waldenström Macroglobulinaemia: the growth of a national registry for a rare disorder. Br J Haematol. 2023;201:905‐912.
ABSTRACTAn 86-year-old woman was referred for a rare but aggressive subtype of primary cutaneous lymphoma of the right lower limbdiffuse large B-cell lymphoma leg type. Initial evaluation by ...whole-body F-FDG PET/CT showed intense hypermetabolic activity of multiple cutaneous and subcutaneous nodules of the distal third of the right leg. Follow-up evaluations by F-FDG PET/CT showed complete response after 4 and 8 cycles of appropriate rituximab combination with polychemotherapy. Although no specific recommendations are available, our case stresses the major role of F-FDG PET/CT for initial extension and treatment response evaluation in clinical practice of primary cutaneous diffuse large B-cell lymphoma leg type.
Histological transformation into diffuse large B-cell lymphoma is a rare complication in patients with Waldenström macroglobulinemia (WM) and is usually associated with a poor prognosis. The ...objective of this study was to develop and validate a prognostic index for survival of patients with transformed WM. Through this multicenter, international collaborative effort, we developed a scoring system based on data from 133 patients with transformed WM who were evaluated between 1995 and 2016 (training cohort). Univariate and multivariate analyses were used to propose a prognostic index with 2-year survival after transformation as an endpoint. For external validation, a dataset of 67 patients was used to evaluate the performance of the model (validation cohort). By multivariate analysis, three adverse covariates were identified as independent predictors of 2-year survival after transformation: elevated serum lactate dehydrogenase (2 points), platelet count <100x109/L (1 point) and any previous treatment for WM (1 point). Three risk groups were defined: low-risk (0-1 point, 24% of patients), intermediate-risk (2-3 points, 59%; hazard ratio = 3.4) and high-risk (4 points, 17%; hazard ratio = 7.5). Two-year survival rates were 81%, 47%, and 21%, respectively (P<0.0001). This model appeared to be a better discriminant than either the International Prognostic Index or the revised International Prognostic Index. We validated this model in an independent cohort. This easy-to-compute scoring index is a robust tool that may allow identification of groups of transformed WM patients with different outcomes and could be used for improving the development of risk-adapted treatment strategies.
Cutaneous involvement in Waldenström’s macroglobulinaemia (WM) has been poorly characterized. To describe this involvement, a retrospective study of 19 patients with WM and cutaneous involvement of ...tumour B cells was performed. Twelve patients (group 1) had lymphoplasmacytic, non-transformed cutaneous proliferation, while in 7 cases (group 2) cutaneous involvement corresponded to histological transformation. In group 1, skin involvement was inaugural in 6 cases. The lesions were infiltrated plaques (83%), papules (25%) and tumours (42%). Four patients had a similar clinical picture (purplish, bilateral and symmetrical infiltration on the face).
MYD88
L265P mutation was detected in the skin biopsy in all 6 cases tested. The 3-year specific survival rate was 88%. In group 2, cutaneous transformation occurred during the followup of the WM (71%). Lesions presented as ulcerated tumours (86%) of the trunk (57%) and lower limbs (57%). The 3-year specific survival rate was 22%. Skin involvement in WM has distinctive characteristics (e.g. clinical, histological, immunohistochemical,
MYD88
L265P mutation).
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
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