• 文章类型: Journal Article
    背景:尽管在高收入国家(HIC)治疗小儿伯基特淋巴瘤(BL)取得了良好的效果,低收入和中等收入国家(LMICs)的结果仍然很差。坦桑尼亚改善BL结果的努力包括在2016年制定了《国民待遇指南》。然而,迄今为止,坦桑尼亚在制定这些指南后的疾病结局尚未报告.
    方法:2016年至2021年在Bugando医学中心(BMC)看到的0-18岁诊断为BL的患者的历史记录,在姆万扎,坦桑尼亚,被编入电子数据库并进行描述性分析。该队列中的患者根据坦桑尼亚国家治疗指南接受治疗,其中包括六个环磷酰胺周期,长春新碱,甲氨蝶呤(COM)鞘内注射甲氨蝶呤和阿糖胞苷化疗。
    结果:总计,92例BL患者记录符合分析条件。该队列中的患者最常见的是MurphyII期(28%)或III期(34%)。几乎所有,91%,在演示时符合国际癌症治疗和研究网络(INCTR)高风险标准。42%的患者未接受活检,仅接受了BL的假定诊断。观察到1年无事件生存率为29.6%(95%置信区间[CI]:20.3%-39.5%),1年总生存率为38.5%(95%CI:28%-48.9%)。还观察到高的治疗放弃率(34%)。
    结论:在根据2016年坦桑尼亚国家治疗指南治疗的BL儿科患者的历史队列中,我们观察到不良结局和高放弃率.这些结果似乎不如在INCTR临床试验中获得的结果,该临床试验告知了指南的创建,并强调了“现实世界”结果数据在低收入国家中的重要性。这些数据强化了这样一种观点,即持续的临床研究和能力建设努力对于改善LMIC的BL结果是必要的。
    BACKGROUND: Despite the excellent outcomes achieved in the treatment of pediatric Burkitt lymphoma (BL) in high-income countries (HICs), outcomes remain poor in low- and middle-income countries (LMICs). Efforts to improve BL outcomes in Tanzania included the creation of National Treatment Guidelines in 2016. However, disease outcomes in Tanzania following the creation of these guidelines have not been reported to date.
    METHODS: Historical records from 2016 to 2021 for patients 0-18 years of age with a diagnosis of BL and seen at Bugando Medical Centre (BMC), in Mwanza, Tanzania, were curated into an electronic database and analyzed descriptively. Patients in this cohort were treated per the Tanzanian National Treatment Guidelines, which include six cycles of cyclophosphamide, vincristine, and methotrexate (COM) chemotherapy with intrathecal methotrexate and cytarabine.
    RESULTS: In total, 92 BL patients\' records were eligible for analysis. Patients in this cohort were most commonly Murphy stage II (28%) or stage III (34%). Nearly all, 91%, met International Network for Cancer Treatment and Research (INCTR) high-risk criteria at presentation. Forty-two percent of patients did not receive a biopsy and were treated with a presumed diagnosis of BL alone. A 1-year event-free survival of 29.6% (95% confidence interval [CI]: 20.3%-39.5%) and a 1-year overall survival of 38.5% (95% CI: 28%-48.9%) were observed. A high rate of treatment abandonment (34%) was also observed.
    CONCLUSIONS: In a historical cohort of pediatric patients with BL treated per the 2016 Tanzanian National Treatment Guidelines, we observed poor outcomes and a high rate of abandonment. These outcomes appear inferior to those achieved in the INCTR clinical trial that informed the guidelines\' creation, and highlights the importance of \"real-world\" outcomes data in LMICs. These data reinforce the idea that continued clinical research and capacity building efforts are necessary to improve BL outcomes in LMICs.
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  • 文章类型: Journal Article
    边缘区淋巴瘤(MZL)是一种罕见的,惰性组非霍奇金淋巴瘤具有不同的诊断,遗传和临床特征以及治疗意义。最常见的是粘膜相关淋巴组织的结外MZL,其次是脾MZL和淋巴结MZL。MZL患者通常具有良好的预后,具有长生存率,但经常具有复发/缓解过程,需要多种治疗方案。异质性表现和复发过程给临床医生带来了一些诊断和治疗挑战。该立场声明在澳大利亚和新西兰的背景下提出了基于证据的建议。
    Marginal zone lymphomas (MZLs) are a rare, indolent group of non-Hodgkin lymphomas with different diagnostic, genetic and clinical features and therapeutic implications. The most common is extranodal MZL of mucosa-associated lymphoid tissue, followed by splenic MZL and nodal MZL. Patients with MZL generally have good outcomes with long survival rates but frequently have a relapsing/remitting course requiring several lines of therapy. The heterogeneous presentation and relapsing course present the clinician with several diagnostic and therapeutic challenges. This position statement presents evidence-based recommendations in the setting of Australia and New Zealand.
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  • 文章类型: Journal Article
    目前,在大多数急性淋巴细胞白血病(ALL)患者的治疗方案中,使用重排的免疫球蛋白和T细胞受体基因重排的实时定量PCR分析进行了最小/可测量的残留疾病(MRD)诊断。在欧洲MRD联盟内,我们的目标是提供可比的,高质量的MRD诊断,允许对患者进行适当的风险组分类和方案间比较。为此,我们建立了一个质量评估计划,在过去的20年里逐渐优化和更新,现在包括来自全球约70个实验室的参与者。我们在这里描述我们的质量评估方案的设计和分析。此外,我们在这里报告修订后的数据解释指南,基于我们新生成的数据和专家之间的广泛讨论。主要的新颖性是由两个新类别对“正低于定量范围”类别进行了部分重新定义,“MRD低阳性,低于定量范围“和”不确定意义的MRD“。质量评估计划和修订后的指南将确保ALL患者的MRD数据可重复且准确。在财团内,针对其他淋巴疾病引入了类似的计划和指南(例如,B细胞淋巴瘤),对于新的技术平台(例如,数字液滴PCR或下一代测序),以及其他基于患者特异性MRDPCR的靶标(例如,融合基因)。
    Minimal/measurable residual disease (MRD) diagnostics using real-time quantitative PCR analysis of rearranged immunoglobulin and T-cell receptor gene rearrangements are nowadays implemented in most treatment protocols for patients with acute lymphoblastic leukemia (ALL). Within the EuroMRD Consortium, we aim to provide comparable, high-quality MRD diagnostics, allowing appropriate risk-group classification for patients and inter-protocol comparisons. To this end, we set up a quality assessment scheme, that was gradually optimized and updated over the last 20 years, and that now includes participants from around 70 laboratories worldwide. We here describe the design and analysis of our quality assessment scheme. In addition, we here report revised data interpretation guidelines, based on our newly generated data and extensive discussions between experts. The main novelty is the partial re-definition of the \"positive below quantitative range\" category by two new categories, \"MRD low positive, below quantitative range\" and \"MRD of uncertain significance\". The quality assessment program and revised guidelines will ensure reproducible and accurate MRD data for ALL patients. Within the Consortium, similar programs and guidelines have been introduced for other lymphoid diseases (e.g., B-cell lymphoma), for new technological platforms (e.g., digital droplet PCR or Next-Generation Sequencing), and for other patient-specific MRD PCR-based targets (e.g., fusion genes).
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  • 文章类型: English Abstract
    Primary mediastinal large B-cell lymphoma (PMBL) is an aggressive B-cell lymphoma that is thought to arise from thymic (medullary) B cells and has unique clinicopathologic and molecular features. In recent years, the understanding of the pathogenesis and treatment of PMBL has been updated to varying degrees, particularly in the area of new drug therapy. In order to improve the diagnosis and treatment of PMBL in China, the Lymphocyte Disease Group of the Chinese Medical Association (CMA) and the Anti-Lymphoma Alliance of the Chinese Society of Clinical Oncology (CSCO) commissioned a group of experts to formulate this consensus.
    原发纵隔大B细胞淋巴瘤(primary mediastinal large B-cell lymphoma, PMBL)是一种起源于纵隔的成熟侵袭性大B细胞淋巴瘤,具有独特的临床、病理及分子学特征。近年来,对PMBL发病机制的认识及治疗均有不同程度的更新,特别是新药治疗领域取得了较大进展。为提高我国临床医师对PMBL的诊断及治疗水平,中华医学会血液学分会淋巴细胞疾病学组和中国临床肿瘤学会(CSCO)淋巴瘤专家委员会组织相关专家组,制订了本共识。.
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  • 文章类型: Journal Article
    脾虚患者存在严重感染或血栓性并发症的高风险,特别是当他们没有充分了解风险并且没有密切关注时。Ladhanietal.代表英国血液学会提出更新的治疗这些患者的指南.医疗保健专业人员需要通过使用已建立的国家登记处进行更好的鉴定和免疫接种来改善功能低下或缺乏脾脏的患者的感染预防。评论:Ladhani等人。脾脏缺失或功能减退患者感染的预防和治疗:英国血液学协会指南。BrJHaematol2024(在线印刷)。doi:10.1111/bjh.19361。
    Asplenic patients are at high risk of serious infectious or thrombotic complications, especially when they are not adequately informed of the risk and not closely followed. Ladhani et al. on behalf of the British Society for Haematology propose updated guidelines for managing these patients. Healthcare professionals need to improve infection prevention in patients with hypofunctional or absent spleen through better identification and immunisation using established national registries. Commentary on: Ladhani et al. Prevention and treatment of infection in patients with absent or hypofunctional spleen: A British Society for Haematology guideline. Br J Haematol 2024;204:1672-1686.
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  • 文章类型: Journal Article
    暂无摘要。
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  • 文章类型: Journal Article
    本准则的目标,由BSBMTCT(英国血液和骨髓移植学会)高级细胞治疗小组委员会的ALL小组编写,从转诊到接受CAR-T细胞治疗的角度,为医疗保健专业人员提供有关B急性淋巴细胞白血病儿童和年轻人准备的实用指导。建议评估的分级,使用开发和评估(GRADE)命名法评估证据水平并评估建议的强度。等级标准可在http://www上找到。gradeworkinggroup.org.
    The objective of this guideline, prepared by the ALL subgroup of the Advanced Cell Therapy Sub-Committee of BSBMTCT (British Society of Blood and Marrow Transplantation), is to provide healthcare professionals with practical guidance on the preparation of children and young adults with B-acute lymphoblastic leukaemia from the point of referral to that of admission for CAR T-cell treatment. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) nomenclature was used to evaluate the levels of evidence and to assess the strength of recommendations. The GRADE criteria can be found at http://www.gradeworkinggroup.org.
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  • 文章类型: Journal Article
    转移性肱骨病的治疗是基于对已发表的关于转移性疾病治疗的研究的系统评价。多发性骨髓瘤,淋巴瘤仅限于肱骨。该指南包含七个行动声明,以协助整形外科医生,骨科肿瘤学家,医师,以及任何其他参与肱骨转移性疾病手术管理的合格医疗保健专业人员。它还旨在作为决策者的信息资源,研究人员,和临床实践指南的开发者。除了提供务实的实践建议外,该指南还突出了文献中的差距,并为未来的研究和质量测量开发提供了信息。该指南已得到美国骨科医师学会的认可。
    Management of Metastatic Humeral Disease is based on a systematic review of published studies surrounding the management of metastatic disease, multiple myeloma, and lymphoma limited to the humerus. This guideline contains seven action statements to assist orthopaedic surgeons, orthopaedic oncologists, physicians, and any other qualified healthcare professionals involved in the surgical management of metastatic disease of the humerus. It is also intended to serve as an information resource for decision makers, researchers, and developers of clinical practice guidelines. In addition to providing pragmatic practice recommendations, this guideline also highlights gaps in the literature and informs areas for future research and quality measure development. This guideline has been endorsed by the American Academy of Orthopaedic Surgeons.
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  • 文章类型: English Abstract
    Ocular adnexal extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (OAML) is a common malignant tumor that affects the ocular adnexal region. The incidence of OAML is increasing due to the aging population. The tumor invades the ocular adnexal region, which can result in abnormal ocular appearance and function, thereby reducing the quality of life. Currently, there is no standardized diagnosis and management guideline for OAML. To enhance the standardization of diagnosis and management in OAML, a collaborative effort was undertaken by esteemed organizations in China. The Cellular Immune Therapy Committee of China Association for Promotion of Health Science and Technology, the Ocular Tumor Committee of Chinese Medical Doctor Association for Ophthalmologist Branch, the Imaging Medicine Branch of Chinese International Exchange and Promotion Association for Medical and Healthcare, the Tumor and Microecology Professional Committee of China Anti-cancer Association, and the Lymphoma Immunotherapy Committee of Beijing Cancer Prevention Society jointly convened a panel of experts to develop the inaugural \"Chinese Expert Consensus on the Diagnosis and Management of ocular adnexal extranodal marginal zone mucosa-associated lymphoid tissue lymphoma (2023 edition)\"..
    眼附属器黏膜相关淋巴组织结外边缘区(MALT)淋巴瘤是发生在眼附属器常见的恶性肿瘤,随着人口老龄化,眼附属器MALT淋巴瘤的发生率呈上升趋势。肿瘤组织侵犯眼附属器局部,容易导致眼部外观和功能的异常,影响患者的生活质量。目前眼附属器MALT淋巴瘤尚无统一的规范化诊疗指南,为了进一步提高眼附属器MALT淋巴瘤的规范化诊断和治疗水平,中国人体健康科技促进会细胞免疫治疗专业委员会、中国医师协会眼科医师分会眼肿瘤专业委员会、中国医疗保健国际交流促进会影像医学分会、中国抗癌协会肿瘤与微生态专业委员会学会和北京癌症防治学会淋巴瘤免疫治疗专业委员会专家联合编写了首个眼附属器MALT淋巴瘤诊治中国专家共识(2023版),以期为临床提供指导。.
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  • 文章类型: Journal Article
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