• 文章类型: Case Reports
    预防中枢神经系统(CNS)复发是治疗弥漫性大B细胞淋巴瘤(DLBCL)的主要挑战。然而,以前没有研究检测含有polatuzumabvedotin(PV)的方案在预防DLBCL患者CNS复发方面的疗效.这里,我们报告了2例接受含PV的DLBCL化疗后CNS复发的病例.与PV联合治疗期间出现CNS复发,苯达莫司汀,和利妥昔单抗(PV-BR)在一个患者和6个月后PV-BR在另一个患者。含PV的化疗可能对预防CNS复发无效;因此,在DLBCL患者中,还需要采用其他预防CNS复发的策略.
    Preventing central nervous system (CNS) relapse is a major challenge in the treatment of diffuse large B-cell lymphoma (DLBCL). However, no previous studies have examined the efficacy of polatuzumab vedotin (PV)-containing regimens in preventing CNS relapse in patients with DLBCL. Here, we report two cases of CNS relapse after PV-containing chemotherapy for DLBCL. CNS relapse developed during combination therapy with PV, bendamustine, and rituximab (PV-BR) in one patient and six months after PV-BR in the other patient. PV-containing chemotherapy may be ineffective as a prophylaxis against CNS relapse; therefore, additional strategies for preventing CNS relapse in DLBCL patients are required.
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  • 文章类型: Case Reports
    原发性中枢神经系统(CNS)淋巴瘤是一种罕见且侵袭性的结外非霍奇金淋巴瘤,仅限于大脑,眼睛,脊髓,或软脑膜没有全身参与。这组恶性肿瘤的特点是有特殊的诊断,治疗性的,与其他类型的非霍奇金淋巴瘤相比,以及进化概况。我们报告了一例在我们大学医院原发性脑淋巴瘤中心接受治疗的年轻患者,该患者受益于初级化疗,然后巩固放疗,疾病控制良好,耐受性良好。
    Primary central nervous system (CNS) lymphoma is a rare and aggressive form of extranodal non-Hodgkin\'s lymphoma, limited to the brain, eyes, spinal cord, or leptomeninges without systemic involvement. This group of malignant tumors is characterized by a particular diagnostic, therapeutic, and evolutionary profile compared to other types of non-Hodgkin\'s lymphomas. We report a case of a young patient treated in our university hospital center for primary cerebral lymphoma who benefited from primary chemotherapy and then consolidation radiotherapy with good disease control and good tolerance.
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  • 文章类型: Journal Article
    控制营养状况评分(CONUT)已广泛用于确定各种癌症的预后。然而,其在恶性血液病患者中的应用尚不清楚.这篇综述研究了CONUT作为血液系统恶性肿瘤患者预后标志物的有效性的证据。
    所有研究COUT与血液系统恶性肿瘤结局之间的关联的队列研究都发表在Embase的数据库上,Scopus,中部,WebofScience,和PubMed从数据库开始到2024年1月30日进行了搜索。主要结果是总生存期(OS),次要结局是无进展生存期(PFS).
    共有23项研究可供审查。对22项研究的荟萃分析表明,高CONUT与血液系统恶性肿瘤患者的不良OS显着相关(HR:1.9595%CI:1.62,2.35I2=89%)。基于研究地点的敏感性和亚组分析结果保持不变,样本量,诊断,CONUT截止,和纽卡斯尔-渥太华量表得分。只有六项研究报告了PFS的数据,汇总分析发现,高CONUT是恶性血液病患者PFS不良的重要标志[风险比(HR):1.6495%CI:1.21,2.20I2=70%].这些结果,也是,在敏感性分析中保持显著性。
    CONUT是恶性血液病患者OS差的独立预测因子。结果似乎对不同的癌症类型和不同的CONUT截止值有效。稀缺的数据还表明,CONUT可以预测PFS。
    UNASSIGNED: The controlling nutritional status score (CONUT) has been widely used for ascertaining the prognosis of various cancers. However, its use in patients with hematological malignancies remains unclear. This review examined evidence on the utility of CONUT as a prognostic marker for patients with hematological malignancies.
    UNASSIGNED: All cohort studies that examined the association between CONUT and outcomes of hematological malignancies and were published on the databases of Embase, Scopus, CENTRAL, Web of Science, and PubMed were searched from the inception of the databases to 30 January 2024. The primary outcome was overall survival (OS), and the secondary outcome was progression-free survival (PFS).
    UNASSIGNED: A total of 23 studies were available for review. A meta-analysis of 22 studies showed that high CONUT was significantly associated with poor OS in patients with hematological malignancies (HR: 1.95 95% CI: 1.62, 2.35 I 2 = 89%). The results remained unchanged on sensitivity and subgroup analyses based on study location, sample size, diagnosis, CONUT cutoff, and the Newcastle-Ottawa Scale score. Only six studies reported data on PFS, and the pooled analysis found that high CONUT was a significant marker for poor PFS in patients with hematological malignancies [hazards ratio (HR): 1.64 95% CI: 1.21, 2.20 I 2 = 70%]. These results, too, maintained significance in the sensitivity analysis.
    UNASSIGNED: CONUT is an independent predictor of poor OS in patients with hematological malignancies. The results appear to be valid across different cancer types and with different CONUT cutoffs. Scarce data also suggest that CONUT could predict PFS.
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  • 文章类型: Case Reports
    虽然比较少见,淋巴瘤是马最常见的造血肿瘤,多中心淋巴瘤仍然是该疾病最常见的表现。马淋巴瘤的发病机制仍然知之甚少,诊断通常在疾病的晚期得到证实,影响预后。这项研究调查了临床,病态,1例马多中心淋巴瘤的分子特征。
    在Vairão动物繁殖中心住院的5岁杂交母马,葡萄牙,突然出现眶上水肿和下颌淋巴结肿大的临床症状,发展中的发烧,面部水肿,和全身淋巴结病。由于多系统器官衰竭,在第一个临床症状出现24天后,母马最终死亡。血液和生化分析,尸检,并对受影响的组织进行显微镜和分子评估。尸检时,主要发现是多发性多结节性病变,沿口咽浆液表面分布,气管,心包,胃肠道,和肠系膜.微观上,这些包括对CD3(T细胞)表现出免疫阳性的肿瘤圆形细胞的实体增殖.基于这些发现,诊断为中度多中心T细胞淋巴瘤.
    关于马淋巴瘤的分子表征的研究仍然很少。作为一个实体本身是相当异构的,重要的是要描述物种间的特殊性,以了解其发展和行为。
    UNASSIGNED: Although relatively uncommon, lymphoma is the most prevalent haematopoietic neoplasia in horses, and multicentric lymphoma remains the most common presentation of the disease. The pathogenesis of equine lymphoma is still poorly understood and the diagnosis is usually confirmed at an advanced stage of the disease, compromising the prognosis. This study investigated the clinical, pathological, and molecular features of a case of equine multicentric lymphoma.
    UNASSIGNED: An apparently healthy 5-year-old crossbreed mare hospitalized at the Centre of Animal Reproduction of Vairão, Portugal, suddenly presented clinical signs of supraorbital oedema and mandibular lymph node enlargement, developing fever, facial oedema, and generalized lymphadenopathy. The mare ended up dying twenty-four days after the first clinical signs due to multisystem organ failure. Haematological and biochemical analyses, necropsy, and microscopic and molecular evaluation of affected tissues were performed. At necropsy, the main findings were multiple multinodular lesions, distributed along the serous surface of oropharynx, trachea, pericardium, gastrointestinal tract, and mesentery. Microscopically, these consisted of solid proliferations of neoplastic round cells that exhibited immunopositivity for CD3 (T cells). Based on these findings, a medium-grade multicentric T-cell lymphoma was diagnosed.
    UNASSIGNED: There is still very little research regarding the molecular characterization of lymphoma in horses. As an entity itself is quite heterogeneous, it is important to describe the interspecies particularities to understand its development and behaviour.
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  • 文章类型: Journal Article
    尽管肿瘤患者的治疗取得了进展,治疗相关的副作用可能导致过早发病.与心血管疾病相关的炎症激活对于霍奇金(HL)和非霍奇金淋巴瘤(NHL)的发病机理至关重要。
    本研究的目的是通过18-氟脱氧葡萄糖(18-FDGPET/CT)的正电子发射断层扫描/计算机断层扫描评估HL和NHL患者化疗的血管效应,并通过循环炎症标记物评估与全身炎症的相互作用。
    在2015年7月至2019年7月之间,对65例确诊为HL(n=33)或NHL(n=32)的连续患者(平均年龄56±17.78岁)进行了前瞻性研究。在基线时进行PET/CT成像,在过渡阶段,经过一线治疗。通过测量整体主动脉靶-背景比(GLA-TBR)评估主动脉FDG摄取。在每个阶段测量血清生物标志物白细胞介素(IL)-6和IL-1b。
    接受一线治疗后,HL患者的主动脉TBR显着降低(GLA-TBR基线中位数:1.98,GLA-TBR第三次扫描中位数:1.75,中位数差异=-0.20,95%CI:-0.07至-0.33,P=0.006),在对混杂因素进行调整后仍然很重要(调整。模型的R2=0.53)。相比之下,NHL患者未出现明显的主动脉炎症反应(P=0.306).此外,HL患者IL-6(P=0.048)和IL-1b(P=0.045)显著降低,而NHL患者的IL-6(P=0.085)和IL-1b水平(P=0.476)没有显着降低。
    主动脉炎,通过18-FDGPET/CT评估,一线治疗后HL患者减少,但NHL患者没有减少。这些发现表明,不同的病理生理途径和不同的治疗方法可能以不同的方式影响淋巴瘤患者的动脉床。
    UNASSIGNED: Despite advances in the treatment of oncology patients, therapy-related side effects may lead to premature morbidity. Inflammatory activation that has been linked to cardiovascular disease is crucial for the pathogenesis of both Hodgkin (HL) and non-Hodgkin lymphoma (NHL).
    UNASSIGNED: The purpose of this study was to assess the vascular effects of chemotherapy in patients with HL and NHL by positron emission tomography/computed tomography with 18-fluorodeoxyglucose (18-FDG PET/CT) and to investigate interactions with systemic inflammation as assessed by circulating inflammatory markers.
    UNASSIGNED: Between July 2015 and July 2019, 65 consecutive patients (mean age 56 ± 17.78 years) with confirmed diagnosis of either HL (n = 33) or NHL (n = 32) were prospectively studied. PET/CT imaging was performed at baseline, at an interim phase, and after first-line treatment. Aortic FDG uptake was assessed by measuring global aortic target-to-background ratio (GLA-TBR). Serum biomarkers interleukin (IL)-6 and IL-1b were measured at each phase.
    UNASSIGNED: Patients with HL demonstrated significant reduction in aortic TBR after first-line treatment (median GLA-TBR baseline: 1.98, median GLA-TBR third scan: 1.75, median difference = -0.20, 95% CI: -0.07 to -0.33, P = 0.006), which remained significant after adjustment for confounders (adj. R2 of model = 0.53). In contrast, patients with NHL did not demonstrate a significant aortic inflammation response (P = 0.306). Furthermore, patients with HL demonstrated a significant reduction in IL-6 (P = 0.048) and IL-1b (P = 0.045), whereas patients with NHL did not demonstrate significant reduction in IL-6 (P = 0.085) and IL-1b levels (P = 0.476).
    UNASSIGNED: Aortic inflammation, as assessed by 18-FDG PET/CT, is reduced in HL patients after first-line treatment but not in NHL patients. These findings imply that different pathophysiological pathways and different therapies might affect the arterial bed in different ways for patients with lymphoma.
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  • 文章类型: Case Reports
    结外弥漫性大B细胞淋巴瘤(DLBCL)是一种异质性疾病过程,是一种侵袭性形式的非霍奇金淋巴瘤。我们介绍了一个有记录的危险因素的患者的DLBCL多器官受累的病例。包括[18F]氟脱氧葡萄糖正电子发射断层扫描/磁共振成像发现,突出显示了双侧三叉神经的颅内和颅外段的显着神经周围扩散。
    Extranodal diffuse large B-cell lymphoma (DLBCL) is a heterogeneous disease process and an aggressive form of non-Hodgkin\'s lymphoma. We present a case of multiorgan involvement of DLBCL in a patient with documented risk factors, including [ 18 F] fluorodeoxyglucose positron emission tomography/magnetic resonance imaging findings highlighting striking perineural spread involving intracranial and extracranial segments of the bilateral trigeminal nerves.
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  • 文章类型: Journal Article
    体外光去除术(ECP)是一种用于T细胞介导的疾病的治疗方式。这种方法涉及将分离的白细胞暴露于可光活化的8-甲氧基补骨脂素(8-MOP)和UVA光,旨在诱导T细胞凋亡,从而调节免疫反应。然而,传统的8-MOP-ECP缺乏细胞选择性,杀死健康和患病细胞,并显示出有限的治疗效果。正在研究的另一种方法涉及使用5-氨基乙酰丙酸(ALA)与光结合,称为基于ALA的光动力疗法。我们先前的离体研究表明,与用8-MOP-ECP治疗的患者相比,ALA-ECP在杀死源自T细胞介导的疾病的患者的T细胞方面表现出更高的选择性和效率。我们进行了一项I-(II)临床研究,评估了ALA-ECP在皮肤T细胞淋巴瘤(CTCL)中的安全性和耐受性。这里,对一名CTCL患者进行了20种ALA-ECP治疗,生命体征无明显变化。报告了两个不良事件;两个均由内部安全性审查委员会评估为非严重事件。此外,发生了5起可能的事件,主要是轻微症状.在学习期间,观察到皮肤受累减少53%,瘙痒减少50%.总之,结果表明ALA-ECP治疗是安全且耐受性良好的.
    Extracorporeal photopheresis (ECP) is a therapeutic modality used for T-cell-mediated disorders. This approach involves exposing isolated white blood cells to photoactivatable 8-methoxypsoralen (8-MOP) and UVA light, aiming to induce apoptosis in T-cells and thereby modulate immune responses. However, conventional 8-MOP-ECP lacks cell selectivity, killing both healthy and diseased cells, and has shown limited treatment efficacy. An alternative approach under investigation involves the use of 5-aminolevulinic acid (ALA) in conjunction with light, referred to as ALA-based photodynamic therapy. Our previous ex vivo studies suggest that ALA-ECP exhibits greater selectivity and efficiency in killing T-cells derived from patients with T-cell-mediated disorders compared to those treated with 8-MOP-ECP. We have conducted a clinical phase I-(II) study evaluating ALA-ECP safety and tolerability in cutaneous T-cell lymphoma (CTCL). Here, 20 ALA-ECP treatments were administered to one CTCL patient, revealing no significant changes in vital signs. Two adverse events were reported; both evaluated by the Internal Safety Review Committee as non-serious. In addition, five conceivable events with mainly mild symptoms took place. During the study period, a 53% reduction in skin involvement and a 50% reduction in pruritus was observed. In conclusion, the results indicate that ALA-ECP treatment is safe and well tolerated.
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  • 文章类型: Journal Article
    背景和目的:成人T细胞白血病/淋巴瘤(ATLL)是一种与人类I型T细胞淋巴细胞病毒(HTLV-1)相关的高度侵袭性T细胞淋巴增殖性疾病。ATLL是一种罕见的疾病,在HTLV-1流行区更常见,罗马尼亚就是其中之一。尽管治疗进展,预后仍然令人沮丧。我们的目的是描述临床,生物,罗马尼亚侵袭型ATLL患者的生存结局特征。材料和方法:我们报告了前瞻性的数据,观察,以及过去12年在我们中心诊断为淋巴瘤和急性类型ATLL的所有20例患者的单中心研究。数据来自患者的医疗记录。结果:淋巴瘤型ATLL(60%)比急性型ATLL(40%)更常见。诊断时的中位年龄为40.5岁,大多数患者是女性。实验室数据显示,急性和淋巴瘤型ATLL之间存在显着差异,即,急性型ATLL患者白细胞(p=0.02)和淋巴细胞计数(p=0.02)和校正钙水平(p=0.001)较高。所有患者均接受化疗,只有两个人接受了同种异体干细胞移植。只有六名患者对化疗有完全或部分反应,主要是淋巴瘤型的.所有患者的中位生存期为6.37个月,淋巴瘤型ATLL(8.16个月)的生存率高于急性型(3.60个月)。正常钙水平(p=0.011),尿酸(p=0.005),BUN评分(p=0.000),JCOG-PI中度风险(p=0.038),获得完全或部分缓解(p=0.037)与更高的生存率相关。结论:罗马尼亚患者的侵袭型ATLL表现出明显的特征,包括诊断时年龄较小,女性占主导地位,与目前报道的数据相比,淋巴瘤型ATLL的发病率更高。存活率仍然很低,所有亚型的中位生存期不到一年。
    Background and Objectives: Adult T-cell leukemia/lymphoma (ATLL) is a highly aggressive T-cell lymphoproliferative disease associated with the human T-cell lymphotropic virus type I (HTLV-1). ATLL is a rare disease, found more frequently in HTLV-1-endemic areas, Romania being one of them. Despite treatment advances, the prognosis remains dismal. We aimed to describe the clinical, biological, and survival outcome features of Romanian patients with aggressive-type ATLL. Materials and Methods: We report the data of a prospective, observational, and unicentric study of all 20 patients diagnosed with lymphoma and acute types of ATLL at our center over the past 12 years. Data were collected from the patients\' medical records. Results: Lymphoma-type ATLL (60%) was more common than acute-type ATLL (40%). Median age at diagnosis was 40.5 years, and most patients were female. Laboratory data revealed significant differences between acute and lymphoma-type ATLL, namely, higher leukocyte (p = 0.02) and lymphocyte counts (p = 0.02) and higher levels of corrected calcium (p = 0.001) in acute-type ATLL. All patients received chemotherapy, and only two underwent allogeneic stem cell transplantation. Only six patients obtained a complete or partial response to chemotherapy, mostly the lymphoma-type ones. The median survival for all patients was 6.37 months, with higher survival in the lymphoma-type ATLL (8.16 months) than in the acute-type (3.60 months). Normal calcium levels (p = 0.011), uric acid (p = 0.005), BUN score (p = 0.000), JCOG-PI moderate risk (p = 0.038), and obtaining complete or partial response (p = 0.037) were associated with higher survival. Conclusion: Aggressive-type ATLL among Romanian patients presents distinct characteristics, including younger age at diagnosis, female predominance, and higher incidence of lymphoma-type ATLL compared to currently reported data. Survival remains very low, with all subtypes experiencing a median survival of less than one year.
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  • 文章类型: Case Reports
    原发性肺淋巴瘤是一种罕见的肿瘤,其特征是影响肺的淋巴组织增殖。最常见的亚型是粘膜相关淋巴组织边缘区淋巴瘤(MALT)。很少,MALT淋巴瘤转变为弥漫性大B细胞淋巴瘤(DLBCL)。治疗方案包括化疗,放射治疗,免疫疗法,和手术。这里,我们描述了一名原发性肺MALT淋巴瘤转化为DLBCL的患者。本病例报告的目的是提高对相关临床和影像学特征的认识,并强调需要采用多学科方法来优化管理。此外,我们在PubMed和Embase数据库中筛选了类似的报告,证实肺部存在转化性淋巴瘤.
    Primary pulmonary lymphoma is a rare neoplasm characterized by the proliferation of lymphoid tissue affecting the lungs. The most common subtype is marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT). Rarely, a MALT lymphoma transforms into a diffuse large B-cell lymphoma (DLBCL). Treatment options include chemotherapy, radiotherapy, immunotherapy, and surgery. Here, we describe a patient with a primary pulmonary MALT lymphoma transforming into DLBCL. The purpose of this case report is to raise awareness of the relevant clinical and imaging features and to emphasize the need for a multidisciplinary approach to optimal management. In addition, we screened the PubMed and Embase databases for similar reports with a confirmed presence of transforming lymphoma within the lungs.
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  • 文章类型: Case Reports
    脾破裂和血肿是非霍奇金淋巴瘤(NHL)患者可能发生的重要并发症。了解这些相关并发症对于优化患者管理和提高患者预后至关重要。组织病理学和免疫组织化学分析对于诊断NHL和评估脾受累至关重要。在这项研究中,检察官办公室要求进行司法尸检,要求因医院摔倒而提出医疗事故索赔。在急诊室,一名72岁男子从轮床上摔下来,报告额头受伤。未报告其他症状。面部和脑部CT扫描未显示异常。出院后9天,患者出现腹痛。腹部CT显示脾破裂和腹膜积血。患者接受了开放性脾切除术,但出现了血液动力学休克的迹象,随后死亡。尸检的证据使我们能够诊断出脾受累的套细胞非霍奇金淋巴瘤,以前未知。进行组织病理学和免疫组织化学分析以评估脾破裂的诊断并估计其时机。结果强烈提示脾破裂与患者跌倒和先前存在的恶性肿瘤有关。此病例强调了在研究延迟性脾破裂时考虑潜在血液恶性肿瘤的重要性。脾脏样本的免疫组织化学研究允许评估脾血肿和破裂的时间。导致与创伤建立因果关系。
    Splenic rupture and hematoma are significant complications that can occur in patients with non-Hodgkin lymphoma (NHL). Understanding these associated complications is essential for optimal patient management and enhanced patient outcomes. Histopathological and immunohistochemical analyses are crucial in diagnosing NHL and assessing splenic involvement. In this study, a judicial autopsy had been requested by the Prosecutor\'s Office for a malpractice claim due to a fall in the hospital. In the Emergency Department, a 72-year-old man fell from a gurney and reported sustaining a wound to his forehead. No other symptoms were reported. A face and brain CT scan showed no abnormalities. Nine days after discharge, the patient presented with abdominal pain. An abdominal CT revealed splenic rupture and hemoperitoneum. The patient underwent open splenectomy but showed signs of hemodynamic shock and subsequently died. The evidence from the autopsy allowed us to diagnose mantle cell non-Hodgkin lymphoma with spleen involvement, previously unknown. Histopathological and immunohistochemical analyses were performed to assess the diagnosis of splenic rupture and estimate its timing. The findings strongly suggest that the splenic rupture was associated with the patient\'s fall and the pre-existing malignancy. This case highlights the importance of considering an underlying hematological malignancy when investigating delayed splenic rupture. An immunohistochemical study of spleen samples allowed the timing of splenic hematoma and rupture to be assessed, leading to the establishment of a causal relationship with trauma.
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