Diffuse large B-cell lymphoma (DLBCL) is the most common lymphoid malignancy and a heterogeneous entity comprised of several biologically distinct subtypes. Recently, novel genetic classifications of ...DLBCL have been resolved based on common mutational patterns indicative of distinct pathways of transformation. However, the complicated and costly nature of the novel classifiers has precluded their inclusion into routine practice. In view of this, the status of the TP53 gene, which is mutated or deleted in 20–30% of the cases, has emerged as an important prognostic factor for DLBCL patients, setting itself apart from other predictors. TP53 genetic lesions are particularly enriched in a genetic subtype of DLBCL that shares genomic features with Richter Syndrome, highlighting the possibility of a subset of DLBCL arising from the transformation of an occult chronic lymphocytic leukemia-like malignancy, such as monoclonal B-cell lymphocytosis. Patients with TP53-mutated DLBCL, including those with Richter Syndrome, have a particularly poor prognosis and display inferior responses to standard chemoimmunotherapy regimens. The data presented in this manuscript argue for the need for improved and more practical risk-stratification models for patients with DLBCL and show the potential for the use of TP53 mutational status for prognostication and, in prospect, treatment stratification in DLBCL.
Next generation sequencing (NGS) is a technology that broadens the horizon of knowledge of several somatic pathologies, especially in oncological and oncohematological pathology. In the case of NHL, ...the understanding of the mechanisms of tumorigenesis, tumor proliferation and the identification of genetic markers specific to different lymphoma subtypes led to more accurate classification and diagnosis. Similarly, the data obtained through NGS allowed the identification of recurrent somatic mutations that can serve as therapeutic targets that can be inhibited and thus reducing the rate of resistant cases. The article’s purpose is to offer a comprehensive overview of the best ways of integrating of next-generation sequencing technologies for diagnosis, prognosis, classification, and selection of optimal therapy from the perspective of tailor-made medicine.
Background: Chronic lymphocytic leukemia (CLL) is a malignant lymphoproliferative, monoclonal, indolent hemopathy characterized by pathologically increased synthesis of mature but immunologically ...dysfunctional B lymphocytes. CLL is considered the pathology of the adult with comorbidities, whose average age is 55 years, who is integrated into the work field. Despite advances in the field of medicine, CLL remains an incurable disease, but the use of targeted, personalized therapy with new agents’ conditions not only increases the life span, but also improves the of quality life of these patients, ensuring social, family and professional integration. This fact presents a favourable socioeconomic impact, a valuable indicator especially in countries with a low and medium socio-demographic index. The identification of biomarkers and the advent of personalized therapies have transformed the way the disease is treated and changed the lives and quality of life of CLL patients. Conclusions: CLL remains a current medical and socioeconomic problem, and the behaviour of patients with CLL remains a challenge for the health system in the Republic of Moldova. The implementation of cyto-genetic and molecular-biological diagnosis is important for the stratification of patients, the selection of optimal targeted therapy. CLL comorbidity is an independent indicator of treatment response, predisposes to adverse drug effects and reduces the quality of life of CLL patients. The individual approach to the patient with CLL, the administration of therapy according to international guidelines will give patients better chances of survival and a longer plateau of stabilization.
Key Clinical Message
Identifying myeloid sarcoma in rare locations is a diagnostic challenge and requires careful evaluation. The optimal management of extramedullary disease requires further ...investigation, but tissue biopsy and a personalized approach are crucial.
Herein, we describe an unusual case of acute myeloid leukemia presenting with an isolated involvement of the temporal bone after a complete remission of systemic disease for more than a year. The clinical, radiological, and pathological features are discussed, highlighting the importance of considering differential diagnoses and appropriate management.
A computed tomography scan reveals a complete homogenous left‐sided and partial right‐sided opacification of the mastoid cells and the middle ear with a relatively intact bony structure and no distinct masses.
Non-Hodgkin's lymphomas (NHL) are malignant tumors that develop from lymphoid tissue. They are one of the most common malignancies and they represent one of the most complicated problems of ...oncohematology. The age group that is mostly affected by NHL in the Republic of Moldova is the patients over 60 years, and the disorder in most cases starts in lymph nodes. This study aims to determine the particularities of elderly patients with NHL with primary involvement of peripheral lymph nodes(l/n).
A retrospective study of a group of 78 NHL patients with primary lymph node involvement was performed. The average age of study participants ranged from 60 to 84 years.
NHL more often developed primarily in the peripheral l/n (84.7%), less frequently in the mediastinal l/n (6.4%) and abdominal l/n(8.9%). Aggressive NHL predominated (59.0%), but indolent NHL also developed quite frequently (41.0%), which were more frequent in cases of primary affection to the cervical l/n (47.4%), inguinal l/n(41.7%), and abdominal l/n(42.9%). The 5-year survival of NHL patients with primary lymph node involvement aged over 60 years was low and amounted to 31.2%;
NHL occurred more often in the peripheral lymph nodes (84.7%), less frequently in the mediastinum (6.4%), and abdominal lymph nodes (8.9%). The frequency of aggressive NHL was 59.0%. Indolent NHL was diagnosed in 41% of cases. The 5-year survival rate in the study group constitutes 31,2%, lower compared with younger patients treated in the same center.
ANTICARDIOLIPINIC ANTIBODIES IN NON-HODGKIN LYMPHOMA Buruiana, Sanda; Mazur, Minodora; Robu, Maria ...
Hematology, Transfusion and Cell Therapy,
November 2021, 2021-11-00, 2021-11-01, Letnik:
43
Journal Article
Recenzirano
Odprti dostop
Identification of hemostasis changes in patients with non-Hodgkin's lymphoma (NHL) and anticardiolipin antibodies (aCL).
The study included 83 patients (men-34, women-49) with a mean age of 63.2 ...years, with NHL, investigated complex, by research of lupus anticoagulant (LA) by Turbidimetry; antiβ2glycoprotein I IgG, IgM and aCL antibodies, by ELISA method. Hemostasis disorders were evaluated according to the type of NHL, stage, tumor size.
aCL were detected in 10 (12%) patients: 6 patients with aggressive type lymphoma and 4 patients with indolent type lymphoma, with advanced stage B cell NHL in 60%, mean age 52.8 years. LA was present in 80% of cases, unlike aCL IgG antibodies (10%) and antiβ2glycoprotein I IgG (10%). Hemostasis disorders were found in 6 (60%) patients: thrombotic events-at 4 (40%) patients with Mantle cell lymphoma (1 patient), Small lymphocytic lymphoma (1 patient), lymphoblastic lymphoma (2 patients). Local stage (I and II) of the lymphoma was in 75%, but with a large size of the tumor (> 11 cm), and hemorrhage at 2 (20%) patients with stage IV Small lymphocytic lymphoma, in which immune thrombocytopenia developed.
The presence of antiphospholipid antibodies, in particular of lupus anticoagulant, advanced age, generalized stage, and large tumor size are risk factors for the development of hemostasis diseases in NHL patients, especially thrombosis.
Background: Non-Hodgkin’s lymphomas (NHL) are malignant tumors that develop from lymphoid tissue. Primary lymph node (LN) involvement is the most common localization (52-70%). The integration of ...Rituximab (R) in the NHL treatment represented a turning point. The aim of this study was to evaluate the therapeutic impact of the use of R in combination with conventional polychemotherapeutic (PChT) in the treatment of nodal onset NHL. Material and methods: A descriptive cohort study was performed on 80 patients diagnosed with NHL. Results: In the study participated: men – 39(48.8%), women – 41(51.2%). The mean age of the patients was 56.09 ± 13.6 years. The onset of NHL occurred in peripheral l/n in 85.0% of cases, in mediastinal LN – 7.5%, and abdominals in 7.5%. Stages I-II were identified in 21(26.2%) patients, stages III-IV in 59(73.8%) cases. Aggressive NHLs were diagnosed in 54(67.5%) patients, indolent NHLs in 26(32.5%) cases. In 61(76.3%) patients, first-line R+PChT treatment was applied – group 1(G1), and in 19(23.8%) cases conventional PChT was applied – group 2(G2). The overall response rate (ORR) in G1 was 86.8%, in G2 – 63.1%. Complete remissions (CR) were obtained in G1 in 63.9% of patients, in G2 – 47.3% of cases. Progression-free survival (PFS) in G1 had a median of 20 months, and in G2 the median was 12 months (p <0.05). Conclusions: The use of Rituximab increased the ORR rate (86.8% vs 63.1%), the frequency of CR (63.9% vs 47.3%) and PFS (20 months vs 12 months (p <0.05).
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