Feline cutaneous lymphoma: an evaluation of disease presentation and factors affecting response to treatment

2021 ◽  
pp. 1098612X2110288
Author(s):  
Jacob Siewert ◽  
MacKenzie A Pellin ◽  
Brian D Husbands ◽  
Kaitlin M Curran ◽  
Diane Scavelli ◽  
...  
Keyword(s):  
Physical Examination ◽  
Cell Size ◽  
Single Agent ◽  
Clinical Signs ◽  
Specific Treatment ◽  
Response To Therapy ◽  
Cutaneous Lymphoma ◽  
Response To Treatment ◽  
Treatment Modalities ◽  
Teaching Hospitals

Objectives The primary goal of this study was to characterize the clinical presentation of feline cutaneous lymphoma. The secondary aims included determining if treatment or initial response to treatment affected the overall survival of patients, and understanding if disease characteristics such as immunophenotype, cell size or the presence of epitheliotropism influenced response to treatment. Methods Veterinary medical oncologists at four academic veterinary teaching hospitals submitted cases of feline patients with cutaneous lymphoma diagnosed by histopathology or cytology. Signalment, feline leukemia virus (FeLV)/feline immunodeficiency virus (FIV) status, physical examination findings, clinical signs, diagnostic tests, therapy, response and outcome, and necropsy findings, when available, were recorded. Results Forty-one patients were identified and described. The majority of patients were domestic shorthair cats (n = 29). The median age at diagnosis was 12.3 years. Males were over-represented in the population (n = 30). In the majority of patients (n = 33), the FIV/FeLV status was unknown. Twenty patients were fully staged. Thirty-four patients were treated with a variety of modalities, including surgery, radiation, single-agent or combination chemotherapy, or prednisolone only. In multiple patients, surgery or radiation was combined with a systemic therapy. Of 34 patients treated with some form of therapy, 20 responded (achieving either a partial response or complete remission). Conclusions and relevance Clinical signs and physical examination findings varied among patients. Response to therapy appeared to be associated with survival (P = 0.0025); however, this population was highly censored. Immunophenotype, cell size and the presence of epitheliotropism did not influence treatment response. Results were limited by small numbers of patients, heterogeneous disease manifestations and treatment protocols. Further studies are necessary to evaluate the effect of specific treatment modalities and disease subtype on prognosis.

scholarly journals Managing sarcoma: where have we come from and where are we going?

2017 ◽  
Vol 9 (10) ◽  
pp. 637-659 ◽  
Author(s):  
Jenna S. Bleloch ◽  
Reyna D. Ballim ◽  
Serah Kimani ◽  
Jeannette Parkes ◽  
Eugenio Panieri ◽  
...  
Keyword(s):  
Molecular Mechanisms ◽  
Single Agent ◽  
Treatment Strategies ◽  
Specific Treatment ◽  
Primary Treatment ◽  
Response To Treatment ◽  
Molecular Characteristics ◽  
Mortality And Morbidity ◽  
Children And Young Adults ◽  
Robust Response

Sarcomas are a heterogeneous group of neoplasms of mesenchymal origin. Approximately 80% arise from soft tissue and 20% originate from bone. To date more than 100 sarcoma subtypes have been identified and they vary in molecular characteristics, pathology, clinical presentation and response to treatment. While sarcomas represent <1% of adult cancers, they account for approximately 21% of paediatric malignancies and thus pose some of the greatest risks of mortality and morbidity in children and young adults. Metastases occur in one-third of all patients and approximately 10–20% of sarcomas recur locally. Surgery in combination with preoperative and postoperative therapies is the primary treatment for localized sarcoma tumours and is the most promising curative possibility. Metastasized sarcomas, on the other hand, are treated primarily with single-agent or combination chemotherapy, but this rarely leads to a complete and robust response and often becomes a palliative form of treatment. The heterogeneity of sarcomas results in variable responses to current generalized treatment strategies. In light of this and the lack of curative strategies for metastatic and unresectable sarcomas, there is a need for novel subtype-specific treatment strategies. With the more recent understanding of the molecular mechanisms underlying the pathogenesis of some of these tumours, the treatment of sarcoma subtypes with targeted therapies is a rapidly evolving field. This review discusses the current management of sarcomas as well as promising new therapies that are currently underway in clinical trials.

Survival outcomes for various treatment modalities in early-stage grade 3 follicular lymphoma (FL3): a National Cancer Database (NCDB) study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 7551-7551
Author(s):  
Upama Giri ◽  
Eric Vick ◽  
Sophia SeoHyeon Lee ◽  
Alaa Altahan ◽  
Noam Avraham VanderWalde ◽  
...  
Keyword(s):  
Cox Regression ◽  
Early Stage ◽  
Single Agent ◽  
Treatment Strategies ◽  
Small Sample ◽  
Response To Therapy ◽  
Stage I ◽  
Treatment Modalities ◽  
Rank Test ◽  
Multi Agent

7551 Background: The prognosis, response to therapy and curability of FL3 is controversial. 5-year Overall Survival (OS) in the literature ranges from 35-72% (Ganti 2006). The aim of this study was to compare the OS for patients with early-stage FL3 managed with single- and multi-agent chemotherapy (CT) with and without radiotherapy (RT). Methods: We identified patients (pts) diagnosed with stage I & II FL3 between 2004 – 2012 from the NCDB and categorized into 3 groups based on therapy – pts given single agent CT with or without RT were combined due to small sample sizes (SA±RT), multi-agent CT without RT (MA-RT), and multi-agent CT with RT (MA+RT). We calculated OS for each group using Kaplan-Meier method and compared the results using Log Rank test. Cox regression model was used to identify factors which had significant impact on OS. Results: 1,563 pts were identified – 827 (53%) with stage I and 736 (47%) with stage II FL3. Median age was 61 yrs (range 18-90yrs); 750 (48%) males, 813 (52%) females; 1423 (91%) whites, 76 (5%) blacks. 112 (7%) received SA±RT, 886 (57%) MA-RT and 565 (37%) MA+RT. 5-year OS for MA+RT (95%) was significantly more than MA-RT (87%; HR 0.33, P<0.001) or SA±RT (88%; HR 0.38, P=0.007). Cox regression indicated that age (HR 1.05, P<0.001), sex (HR 0.66 for females, P=0.02), comorbidities (HR 1.60 for Charlson Deyo Score 1, P=0.04; HR 3.07 for Score 2, P=0.001), stage (HR 1.79, P=0.001), insurance status (HR 0.22 for insured, P<0.001) and increasing year of diagnosis (HR 0.92, P=0.03) also had significant impact on OS. Median radiation dose for the MA+RT was 36Gy (interquartile range 30.6 – 36Gy), and the proportion of patients who received greater than 36Gy decreased from 55% in 2004 to 38% in 2012 and at the same time, the proportion of patients who received intensity modulated RT increased from 5% in 2004 to 15% in 2012. Use of MA CT declined (2004 95% v 2012 89%, P=0.02) but there was no significant trend in use of RT (2004 39% v 2012 34%) during the periods studied. Conclusions: For pts with early-stage FL3, there was an association of improved survival with the use of MA+RT over other treatment strategies and appear to have outcomes superior to what has been previously reported.

Disparate histopathology of sebaceous adenitis in a rabbit

2020 ◽  
Vol 8 (3) ◽  
pp. e001128
Author(s):  
Nicole A Heinrich ◽  
Douglas Chamroeun ◽  
Erin Locke
Keyword(s):  
Physical Examination ◽  
Skin Biopsy ◽  
Clinical Signs ◽  
Response To Therapy ◽  
Cutaneous Lesions ◽  
One Year ◽  
Rex Rabbit ◽  
Sebaceous Adenitis ◽  
Over Time

A 13-month-old, spayed, female rex rabbit presented with mildly pruritic, progressive patches of alopecia, erythema and scaling of the head, trunk and legs of five months’ duration. Initial skin biopsy was consistent with cutaneous epitheliotropic lymphoma, but a follow-up skin biopsy and response to therapy revealed that the rabbit actually had sebaceous adenitis. Nearly one year after presentation, the rabbit’s clinical signs remained well controlled. This case demonstrates the importance of interpreting histopathology in light of history, physical examination, supportive tests and response to therapy. It also demonstrates how cutaneous lesions may evolve over time and that serial biopsies may be required to achieve a diagnosis. Finally, this case suggests that there may be histopathological overlap between cutaneous epitheliotropic lymphoma and sebaceous adenitis in rabbits.

Clinical Outcomes of Advanced-Stage Cutaneous Lymphoma under Low-Dose Gemcitabine Treatment: Real-Life Data from the German Cutaneous Lymphoma Network

Dermatology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Christoph Blazejak ◽  
Rene Stranzenbach ◽  
Janika Gosman ◽  
Thilo Gambichler ◽  
Ulrike Wehkamp ◽  
...  
Keyword(s):  
Side Effects ◽  
Median Time ◽  
Low Dose ◽  
Plasmacytoid Dendritic Cell ◽  
Single Agent ◽  
Response To Therapy ◽  
Cutaneous Lymphoma ◽  
Advanced Stage ◽  
Standard Dosage ◽  
Increased Risk

<b><i>Background:</i></b> Gemcitabine is an effective single-agent chemotherapy used in advanced stages of cutaneous T-cell lymphoma (CTCL). However, gemcitabine used in the current standard regimen is frequently associated with adverse events (AE), such as an increased risk for myelosuppression and severe infections. <b><i>Objectives:</i></b> We investigated in this retrospective study the effect of low-dose gemcitabine in pretreated advanced-stage CTCL and in blastic plasmacytoid dendritic cell neoplasia (BPDCN) regarding overall response (OR), progression-free survival (PFS), and AE. <b><i>Material and Methods:</i></b> A retrospective, multicenter study was conducted on 64 CTCL and BPDCN patients treated with gemcitabine in average absolute dosage of 1,800 mg/m<sup>2</sup> per cycle, which is 50% lower compared to standard dosage of 3,600 mg/m<sup>2</sup> per cycle (1,200 mg/m<sup>2</sup> day 1, 8, 15). Evaluation of response to therapy and AE was done 4–6 weeks after the sixth cycle. <b><i>Results:</i></b> OR was 62% with 11% demonstrating a complete response. The median time of PFS was 12 months and median time to next treatment was 7 months. Only 3/63 patients showed serious side effects, e.g., port infection or acute renal failure. Almost 73% of the patients experienced minor to moderate side effects (CTCAE grade 0–2). Fatigue (27.2%), fever (22.7%), and mild blood count alteration (18.2%) were the most common AE. <b><i>Conclusions:</i></b> This retrospective analysis supports the use of low-dose gemcitabine therapy in CTCL, demonstrating with 62% OR and PFS of 12 months an almost identical response rate and survival as compared to the standard dose therapy reported in previous studies but with a significantly improved safety profile and tolerability.

scholarly journals Linfoma cutâneo em equino Quarto de Milha

2017 ◽  
Vol 45 ◽  
pp. 5
Author(s):  
Fernanda Carlini Dos Santos ◽  
Lays Wouters Ugolini ◽  
Henrique Ramos Oliveira ◽  
Tanise Policarpo Machado ◽  
Leonardo Porto Alves
Keyword(s):  
Histopathological Examination ◽  
Systemic Disease ◽  
Clinical Signs ◽  
Specific Treatment ◽  
The Body ◽  
Cutaneous Lymphoma ◽  
Differential Diagnoses ◽  
Cytological Examination ◽  
Clinical Exam ◽  
Histopathological Evaluation

Background: Lymphoma, although rare, is the most common hematopoietic neoplasia in horses. The overall incidence of lymphoma is between 1.3-2.8% of all equine neoplasia and it has a prevalence of 0.002-0.5% in the equine population. Lymphoma can be classified as multicentric, alimentary, mediastinal, cutaneous and solitary. The cutaneous is the rarest form and it usually presents with multifocal skin lesions, with no other clinical signs. The diagnoses is accomplished by histopathological examination of a biopsy or cytological examination of a fine needle aspirate. The aim of the current study is to report a case of the rarest form of equine lymphoma, the cutaneous.Case: An 8-year-old equine female, Quarter Mile, was evaluated due to volume’s increase and subcutaneous nodules disseminated along the body. These lesions developed gradually during 2 years. The mare was used for ridding, it was kept in the field with 10 other equines and was the only one affected. The mare was vaccinated for influenza and was negative for glanders and equine infectious anemia. During clinical exam, all vital parameters were within limits and body condition score was classified as 6 (Henneke Chart). It was observed bilateral nasal secretion and depigmentation in ocular and vulvar mucous. It was observed multiple delimited areas with size ranging from few cm up to 7 cm, hard, mobile, painless, located in the subcutaneous and disseminated in the body (including head, neck, thorax, limbs and perineum). Red blood cell, leucocytes, fibrinogen, total plasmatic protein were within normal limits. Due to clinical signs and the potential risk of a zoonosis, the glanders test was repeated (complement fixation test) and the result was negative. Differential diagnoses also included insect hypersensitive, which was discarded since the female did not presented pruritus nor alopecia, lesions gradually increased in size and no seasonality was observed. It was performed excisional biopsy for tissue culture, which revealed no growth of aerobic mesophile bacteria. Histopathological evaluation revealed rounded cell proliferation similar to lymphocytes situated in the deep derma and subcutaneous. After evaluation of history, clinical exam and complementary exams the mare was diagnosed with cutaneous lymphoma. The owner was instructed that there was no available specific treatment with good efficacy and viable for equines at this stage. Besides, it is important to evaluated the mare constantly due the possibility of future lesions in organs or intern lymph nodes.Discussion: Cutaneous lymphoma is an uncommon disease, especially in horses, that can present with variable clinical signs, immunosuppression, rapid systemic disease progression or none at all. In the present case report, during clinical examination lesions were observed in areas of lymphatic drainage. Identification of neoplastic lymphocytes during cytological examination or histopathological evaluation of biopsy tissue can confirm the presence of lymphoma, as performed in the present case. Treatment is palliative and occasionally results in complete cure, mainly in equine with single lesions. The mare had cutaneous lymphoma disseminated all long the body and no clinical signs that could suggest gastrointestinal neoplastic lesions, even though the owner was advised that this animal should be monitored regularly in the future, specially due the possibility of metastatic lesions in any other organ. In equine, lymphoma has low incidence and the cutaneous form is the rarest one. Clinical signs are typically non specific and develop insidiously, so it is important to perform complementary exams for accurate diagnoses and for differential diagnoses of tegumental and infectious diseases.

scholarly journals Perspectives in Melanoma: meeting report from the Melanoma Bridge (December 3rd–5th, 2020, Italy)

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Paolo A. Ascierto ◽  
Christian Blank ◽  
Reinhard Dummer ◽  
Marc S. Ernstoff ◽  
Soldano Ferrone ◽  
...  
Keyword(s):  
Overall Survival ◽  
Targeted Therapy ◽  
Clinical Decision Making ◽  
Predictive Accuracy ◽  
Single Agent ◽  
Specific Treatment ◽  
Advanced Melanoma ◽  
Response To Therapy ◽  
Meeting Report ◽  
Selection Of

AbstractAdvances in immune checkpoint therapy and targeted therapy have led to improvement in overall survival for patients with advanced melanoma. Single agent checkpoint PD-1 blockade and combination with BRAF/MEK targeted therapy demonstrated benefit in overall survival (OS). Superior response rates have been demonstrated with combined PD-1/CTLA-4 blockade, with a significant OS benefit compared with single-agent PD-1 blockade. Despite the progress in diagnosis of melanocytic lesions, correct classification of patients, selection of appropriate adjuvant and systemic therapies, and prediction of response to therapy remain real challenges in melanoma. Improved understanding of the tumor microenvironment, tumor immunity and response to therapy has prompted extensive translational and clinical research in melanoma. Development of novel biomarker platforms may help to improve diagnostics and predictive accuracy for selection of patients for specific treatment. There is a growing evidence that genomic and immune features of pre-treatment tumor biopsies may correlate with response in patients with melanoma and other cancers but they have yet to be fully characterized and implemented clinically. Overall, the progress in melanoma therapeutics and translational research will help to optimize treatment regimens to overcome resistance and develop robust biomarkers to guide clinical decision-making. During the Melanoma Bridge meeting (December 3rd–5th, 2020, Italy) we reviewed the currently approved systemic and local therapies for advanced melanoma and discussed novel biomarker strategies and advances in precision medicine.

Melanoma: Prognostic Factors and Factors Predictive of Response to Therapy

2020 ◽  
Vol 27 (17) ◽  
pp. 2792-2813
Author(s):  
Martina Strudel ◽  
Lucia Festino ◽  
Vito Vanella ◽  
Massimiliano Beretta ◽  
Francesco M. Marincola ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Lactate Dehydrogenase ◽  
Checkpoint Inhibitors ◽  
Survival Rates ◽  
Elevated Serum ◽  
Predictive Biomarkers ◽  
Response To Therapy ◽  
Response To Treatment ◽  
Prognostic Features ◽  
Programmed Death

Background: A better understanding of prognostic factors and biomarkers that predict response to treatment is required in order to further improve survival rates in patients with melanoma. Predictive Biomarkers: The most important histopathological factors prognostic of worse outcomes in melanoma are sentinel lymph node involvement, increased tumor thickness, ulceration and higher mitotic rate. Poorer survival may also be related to several clinical factors, including male gender, older age, axial location of the melanoma, elevated serum levels of lactate dehydrogenase and S100B. Predictive Biomarkers: Several biomarkers have been investigated as being predictive of response to melanoma therapies. For anti-Programmed Death-1(PD-1)/Programmed Death-Ligand 1 (PD-L1) checkpoint inhibitors, PD-L1 tumor expression was initially proposed to have a predictive role in response to anti-PD-1/PD-L1 treatment. However, patients without PD-L1 expression also have a survival benefit with anti-PD-1/PD-L1 therapy, meaning it cannot be used alone to select patients for treatment, in order to affirm that it could be considered a correlative, but not a predictive marker. A range of other factors have shown an association with treatment outcomes and offer potential as predictive biomarkers for immunotherapy, including immune infiltration, chemokine signatures, and tumor mutational load. However, none of these have been clinically validated as a factor for patient selection. For combined targeted therapy (BRAF and MEK inhibition), lactate dehydrogenase level and tumor burden seem to have a role in patient outcomes. Conclusions: With increasing knowledge, the understanding of melanoma stage-specific prognostic features should further improve. Moreover, ongoing trials should provide increasing evidence on the best use of biomarkers to help select the most appropriate patients for tailored treatment with immunotherapies and targeted therapies.

Management of Optic Neuritis in Ayurveda - A Special Case Report

2018 ◽  
Vol 3 (5) ◽  
Author(s):  
Dr. Harsha S. ◽  
Dr. Mamatha KV.
Keyword(s):  
Optic Nerve ◽  
Optic Neuritis ◽  
Visual Information ◽  
Vision Loss ◽  
Specific Treatment ◽  
Interesting Case ◽  
Treatment Modalities ◽  
Further Development ◽  
Special Case

The optic nerve carries visual information from your eye to your brain. Optic neuritis is when your optic nerve becomes inflamed. Optic neuritis can flare up suddenly from an infection or nerve disease. The inflammation usually causes temporary vision loss that typically happens in only one eye. Those with Optic neuritis sometimes experience pain. As you recover and the inflammation goes away, your vision will likely return. There are no direct references in our classics regarding optic neuritis but can be contemplated as a condition by name Parimlayi Timira. The specific management as such is not cited but a transcendence approach can be done with adopting the treatment which has the ability to pacify the already occurred pathology and prevent the further development of the disease. One such interesting case study on Optic neuritis is elaborated here where in specific treatment modalities (Shodana, Shamana and Kriyakalpas) played role in pacifying the condition.

scholarly journals Molecular Subtypes and Precision Oncology in Intrahepatic Cholangiocarcinoma

2021 ◽  
Vol 10 (13) ◽  
pp. 2803
Author(s):  
Carolin Czauderna ◽  
Martha M. Kirstein ◽  
Hauke C. Tews ◽  
Arndt Vogel ◽  
Jens U. Marquardt
Keyword(s):  
Clinical Care ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Specific Treatment ◽  
Growth Factor Receptor ◽  
Treatment Modalities ◽  
Precision Oncology ◽  
Recurrence Rates ◽  
Isocitrate Dehydrogenase 1 ◽  
Liver Cancers

Cholangiocarcinomas (CCAs) are the second-most common primary liver cancers. CCAs represent a group of highly heterogeneous tumors classified based on anatomical localization into intra- (iCCA) and extrahepatic CCA (eCCA). In contrast to eCCA, the incidence of iCCA is increasing worldwide. Curative treatment strategies for all CCAs involve oncological resection followed by adjuvant chemotherapy in early stages, whereas chemotherapy is administered at advanced stages of disease. Due to late diagnosis, high recurrence rates, and limited treatment options, the prognosis of patients remains poor. Comprehensive molecular characterization has further revealed considerable heterogeneity and distinct prognostic and therapeutic traits for iCCA and eCCA, indicating that specific treatment modalities are required for different subclasses. Several druggable alterations and oncogenic drivers such as fibroblast growth factor receptor 2 gene fusions and hotspot mutations in isocitrate dehydrogenase 1 and 2 mutations have been identified. Specific inhibitors have demonstrated striking antitumor activity in affected subgroups of patients in phase II and III clinical trials. Thus, improved understanding of the molecular complexity has paved the way for precision oncological approaches. Here, we outline current advances in targeted treatments and immunotherapeutic approaches. In addition, we delineate future perspectives for different molecular subclasses that will improve the clinical care of iCCA patients.

scholarly journals Rituximab-Containing Risk-Adapted Treatment Strategy in Nodular Lymphocyte Predominant Hodgkin Lymphoma: 7-Years Follow-Up

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1760
Author(s):  
Novella Pugliese ◽  
Marco Picardi ◽  
Roberta Della Pepa ◽  
Claudia Giordano ◽  
Francesco Muriano ◽  
...  
Keyword(s):  
Side Effects ◽  
Hodgkin Lymphoma ◽  
Prognostic Score ◽  
Single Agent ◽  
Response To Therapy ◽  
Baseline Risk ◽  
Historical Cohort ◽  
Treatment Groups

Background: Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is a rare variant of HL that accounts for 5% of all HL cases. The expression of CD20 on neoplastic lymphocytes provides a suitable target for novel treatments based on Rituximab. Due to its rarity, consolidated and widely accepted treatment guidelines are still lacking for this disease. Methods: Between 1 December 2007 and 28 February 2018, sixteen consecutive newly diagnosed adult patients with NLPHL received Rituximab (induction ± maintenance)-based therapy, according to the baseline risk of German Hodgkin Study Group prognostic score system. The treatment efficacy and safety of the Rituximab-group were compared to those of a historical cohort of 12 patients with NLPHL who received Doxorubicin, Bleomycin, Vinblastine, Dacarbazine (ABVD) chemotherapy followed by radiotherapy (RT), if needed, according to a similar baseline risk. The primary outcome was progression-free survival (PFS) and secondary outcomes were overall survival (OS) and side-effects (according to the Common Terminology Criteria for Adverse Events, v4.03). Results: After a 7-year follow-up (range, 1–11 years), PFS was 100% for patients treated with the Rituximab-containing regimen versus 66% for patients of the historical cohort (p = 0.036). Four patients in the latter group showed insufficient response to therapy. The PFS for early favorable and early unfavorable NLPHLs was similar between treatment groups, while a better PFS was recorded for advanced-stages treated with the Rituximab-containing regimen. The OS was similar for the two treatment groups. Short- and long-term side-effects were more frequently observed in the historical cohort. Grade ≥3 neutropenia was more frequent in the historical cohort compared with the Rituximab-group (58.3% vs. 18.7%, respectively; p = 0.03). Long-term non-hematological toxicities were observed more frequently in the historical cohort. Conclusion: Our results confirm the value of Rituximab in NLPHL therapy and show that Rituximab (single-agent) induction and maintenance in a limited-stage, or Rituximab with ABVD only in the presence of risk factors, give excellent results while sparing cytotoxic agent- and/or RT-related damage. Furthermore, Rituximab inclusion in advanced-stage therapeutic strategy seems to improve PFS compared to conventional chemo-radiotherapy.

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