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New risk factors and new tendency for central nervous system relapse in patients with diffuse large B-cell lymphoma:a retrospective study

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Chinese Journal of Cancer 2016年第12期35卷 713-724页

作者： Qing-Qing Cai Li-Yang Hu Qi-Rong Geng Jie Chen Zhen-Hai Lu Hui-Lan Rao Qing Liu Wen-Qi Jiang Hui-Qiang Huang Tong-Yu Lin Zhong-Jun Xia State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer MedicineSun Yat-sen University Cancer CenterGuang-zhou 510060GuangdongP.R.China. Department of Medical Oncology Sun Yat-sen University Cancer Center651 Dongfeng Road EastGuang-zhou 510060GuangdongP.R.China. Department of Hematology Oncology Sun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China. Guangdong Province Key Laboratory of Arrhythmia and Elec-trophysiology Guangzhou 510120GuangdongP.R.China. Department of Radiotherapy Sun Yat-sen Memorial Hospital of Sun Yat-sen UniversityGuangzhou 510120GuangdongP.R.China. Department of Colorectal Carci-noma Sun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China. Department of Pathology Sun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China. Department of Cancer Preven-tion Research Sun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China.

Background: In patients with difuse large B?cell lymphoma(DLBCL), central nervous system(CNS) relapse is uncom?mon but is nearly always fatal. This study aimed to determine the risk factors for CNS relapse in DLBCL patients and to evaluate the eicacy of rituximab and intrathecal chemotherapy prophylaxis for CNS relapse ***: A total of 511 patients with newly diagnosed DLBCL treated at the Sun Yat?sen University Cancer Center between January 2003 and December 2012 were included in the study. Among these patients, 376 received R?CHOP regimen(rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) as primary treatment, and 135 received CHOP regimen(cyclophosphamide, doxorubicin, vincristine, and prednisone) as primary treatment. Intrathe?cal chemotherapy prophylaxis(methotrexate plus cytarabine) was administered to those who were deemed at high risk for CNS relapse. In the entire cohort and in the R?CHOP set in particular, the Kaplan–Meier method coupled with the log?rank test was used for univariate analysis, and the Cox proportional hazards model was used for multivariate analysis. Diferences were evaluated using a two?tailed test, and P relapse. There was a trend of reduced occurrence of CNS relapse in patients treated with rituximab; the 3?year cumulative CNS relapse rates were 7.1% in CHOP group and 2.7% in R?CHOP group(P = 0.045). Intrathecal chemotherapy prophylaxis did not confer much beneit in terms of preventing CNS relapse. Bone involvement [hazard ratio(HR) = 4.21, 95% conidence interval(CI) 1.38–12.77], renal involvement(HR = 3.85, 95% CI 1.05–14.19), alkaline phosphatase(ALP) >110 U/L(HR = 3.59, 95% CI 1.25–10.34), serum albumin(ALB) <35 g/L(HR = 3.63, 95% CI 1.25–10.51), treatment with rituxi?mab(HR = 0.34, 95% CI 0.12–0.96), and a time to complete remission ≤ 108 days(HR = 0.22, 95% CI 0.06–0.78) were independent p

关键词： Diffuse large B?cell lymphoma central nervous system relapse Risk factor Rituximab Intrathecal chemotherapy prophylaxis

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Disseminated soft tissue diffuse large B-cell lymphoma involving multiple abdominal wall muscles:A case report

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World Journal of Clinical Cases 2021年第28期9卷 8557-8562页

作者： Chang-Hoon Lee So-Yeon Jeon Ho-Young Yhim Jae-Yong Kwak Department of Internal Medicine Jeonbuk National University Medical SchoolJeonju 54907South Korea

BACKGROUND Diffuse large B-cell lymphoma(DLBCL)is the most common subtype of non�Hodgkin lymphoma,and patients with DLBCL typically present rapidly growing *** involving muscle is rare and accounts for only 5%;furthermore,multiple muscles and soft tissue involvement of DLBCL is *** to unusual clinical manifestation,accurate diagnosis could be *** SUMMARY A 61-year-old man complained of swelling,pain and erythematous changes in the lower ***,soft tissue infection was suspected,however,skin lesion did not respond to antibiotics.18Fluoro-2-deoxy-D-glucose(18F-FDG)positron emission tomography-computed tomography demonstrated FDG uptake not only in the skin and subcutaneous tissue of the abdomen but also in the abdominal wall muscles,peritoneum,perineum,penis and *** was confirmed by biopsy of the abdominal wall muscle and subcutaneous *** intensive treatment including chemotherapy with rituximab,cyclophosphamide,doxorubicin,vincristine and prednisolone,central nervous system prophylaxis(intrathecal injection of methotrexate,cytarabine and hydrocortisone)and orchiectomy,he underwent peripheral blood stem cell mobilization for an autologous hematopoietic stem cell *** intensive treatment,the disease progressed rapidly and the patient showed poor outcome(overall survival,9 mo;disease free survival,3 mo).CONCLUSION The first clinical manifestation of soft tissue DLBCL involving multiple muscles was similar to the infection of the soft tissue.

关键词： Primary extranodal diffuse large B-cell lymphoma Soft tissue lymphoma Disseminated muscles and soft tissue invasion Atypical presentation of diffuse large B�cell lymphoma central nervous system relapse Case report

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central nervous system recurrence in a patient treated for acute promyelocytic leukemia,resulting in sideroblastic anemia:A case report

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World Journal of Hematology 2022年第1期9卷 1-5页

作者： Haroon Nawaz Ayesha Choudhry William Joseph Morse Department of Internal Medicine Westside Regional Medical CenterPlantationFL 33324United States MBBS Fatima Jinnah Medical UniversityMozang ChungiLahore 54000PunjabPakistan Clinical Medical Student Ross University School of MedicineMiramarFL 33027United States

BACKGROUND Previous cases that have been stated in this article have displayed that around 1%to 7%of patients that have been treated with chemotherapy for acute promyelocytic leukemia developed myelodysplastic syndrome or acute myeloid *** can see that’s why this case presentation of a 60-year-old man that had a good response to acute promyelocytic leukemia treatment,that later presented with a central nervous system recurrence of acute promyelocytic leukemia and acquired sideroblastic anemia(a form of myelodysplasia)from treatment is a unique case *** SUMMARY The presence of central nervous system relapse in acute promyelocytic leukemia patients is very unlikely compared to recurring mainly in the bone *** is also uncommon to be diagnosed with sideroblastic anemia(form of myelodysplastic syndrome)as a result from treatment for acute promyelocytic *** case report highlights the detection,treatment/maintenance with idarubicin,all-trans-retinoic-acid,arsenic trioxide,methotrexate,6-mercaptopurine,and ommaya reservoir intrathecal methotrexate administration in a patient that had central nervous system relapse of acute promyelocytic leukemia and acquired sideroblastic *** In essence,first time relapse concerning the central nervous system in treated acute promyelocytic leukemia patients who had a good response to therapy is very *** acquirement of a myelodysplastic syndrome such as ringed sideroblastic anemia is also rare regarding this patient *** such cases are infrequent,this case report represents a unique insight of the detection,treatment,and maintenance of a 60-year-old man diagnosed with acute promyelocytic leukemia,resulting in the acquirement of sideroblastic anemia and central nervous system relapse.

关键词： Acute promyelocytic leukemia central nervous system relapse Sideroblastic anemia All-transretinoic acid Myelodysplasia Case report

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