Influenza Vaccination in Patients with Hematologic Malignancies: Analysis of Practices in 200 Patients in a Single Center

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4693-4693
Author(s):  
Florence Lachenal ◽  
Catherine Sebban ◽  
Mickael Duruisseaux ◽  
Irène Philip ◽  
Pierre Biron ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Cell Lymphoma ◽  
Hematologic Malignancy ◽  
B Cell Lymphoma ◽  
Hematologic Malignancies ◽  
Epidemic Season ◽  
Lymphoid Malignancies ◽  
Mantle Cell ◽  
History Of ◽  
Tract Infections

Abstract Vaccination against influenza in patients with hematologic malignancies has long been a matter of clinical uncertainty. Recent studies demonstrated the immunogenicity and the tolerance of the vaccine in this population and the absence of exacerbation of the hematologic disease after vaccination. However practices are still heterogeneous and there are no established routines in France regarding the influenza vaccination of these patients. The aim of this study was to analyse vaccinal practices in a single centre and to determine clinical efficiency of the vaccination. A standardized questionnaire about influenza vaccination was filled out by 200 patients with hematologic malignancies in January, 2008 and the patients were then observed prospectively during the epidemic season to May, 2008. The median age was 58.3 (range 18–87) ; 40% of patients were older than 65 y and could benefit from a free influenza vaccine after information by social security. Most patients suffered from lymphoid malignancies (diffuse large B-cell lymphoma: 30%; follicular, marginal, lymphoplasmacytic or mantle cell lymphoma: 31.5%; multiple myeloma: 13.5%; Hodgkin’s disease:13%). The treatment was ongoing in 53.5% of cases, using aplasia-inducing chemotherapy regimens in 27.5%, rituximab in 27.5% and/or steroids in 33.5%. One quarter of patients disclosed one or several comorbidities and 14.5% had a a past medical history of autologous stem cell transplantation. Lymphopenia was present in 34.9% of cases and hypogammaglobulinemia in 21.7%. Global vaccinal rate was 25.5%; it was 16.6% among patients younger than 65 y and 38.75% among those older than 65 y. The most frequent reasons for not being vaccinated were: the vaccination was not suggested to the patients (53.7%), vaccination was contraindicated by doctors (24.2%), the patient refused the vaccine (21.5%). The main reasons for physicians for contraindicating the vaccine were: hematologic malignancy could be worsened by vaccination (33.3%), the vaccination could generate illness or asthenia (27.8%), the vaccination could not be efficient under chemotherapy (16.7%), unknown (22.2%). Half of patients who refused the vaccine were afraid of having fever; 15.5% refused because they thought that the vaccine was uselessness. Thirteen patients (6.7%) developed influenza during follow-up and 38 (19.5%) presented a significant pulmonary infection. We did not establish a significant link between the vaccination and a protection against influenza, even in specific subgroups of patients, nor between vaccination and prevention of lower respiratory tract infections. Additionnal prospective studies are thus requested. In conclusion our study revealed that the vaccination coverage could be improved in patients with hematologic malignancies. Even if we failed to demonstrate the clinical usefullness of influenza vaccination, we believe that a better knowledge by physicians of studies demonstrating its tolerance and efficiency in this population could enhance the rate of vaccination.

scholarly journals Flow Cytometry in the Diagnosis of Canine B-Cell Lymphoma

2021 ◽  
Vol 8 ◽  
Author(s):  
Fulvio Riondato ◽  
Stefano Comazzi
Keyword(s):  
Flow Cytometry ◽  
B Cell ◽  
Prognostic Markers ◽  
Residual Disease ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Lymphoid Malignancies ◽  
Large B Cell Lymphoma ◽  
Mantle Cell ◽  
Lymphoma Subtype

B cell lymphoma (BCL) is a heterogeneous group of lymphoid malignancies which comprise the majority of canine lymphomas. Diffuse large B cell lymphoma is the most common lymphoma subtype in dogs but other subtypes (e.g., marginal zone lymphoma, follicular lymphoma, mantle cell lymphoma, and others) have been described. This review aims to explore the use of flow cytometry to refine the diagnosis of canine BCL. Particular emphasis will be given to the possible identification of peculiar immunotypes, putative prognostic markers, staging and minimal residual disease.

Pattern of Mir-155 and PU.1 Expression in CLL/SLL and Aggressive Lymphomas

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4600-4600
Author(s):  
Tomas Stopka ◽  
Karin Vargova ◽  
Hana Huskova ◽  
Pavel Burda ◽  
Nikola Curik ◽  
...  
Keyword(s):  
B Cell ◽  
Conflicts Of Interest ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Lymphocytic Leukemia ◽  
Peripheral T Cell Lymphoma ◽  
Lymphoid Malignancies ◽  
Mantle Cell ◽  
Prognostic Groups ◽  
Nfkb Pathway

Abstract Abstract 4600 MicroRNA miR-155 represents a candidate pathogenic factor in chronic lymphocytic leukemia (CLL) and lymphomas (Eis PS, et al. 2005, Fulci V, et al. 2007, Calin GA, et al. 2005, Kluiver J, et al. 2005, Metzler M, et al. 2004, van den Berg A, et al. 2003., Vargova K. et al 2011). In diffuse large B-cell lymphoma (DLBCL) expression of miR-155 was associated with NFkB pathway (Rai et al., 2008). In addition, increased miR-155 levels were associated with more aggressive (Activated B-cell like) DLBCL (Eis et al. 2005). The targets of up-regulated miR-155 apparently include a key hematopoietic transcription factor PU.1. Down-regulation of PU.1 represents an important and critical step for both myeloid as well as lymphoid tumorigenesis. We herein found the increased levels of miR-155 coupled with downregulation of its target PU.1 are frequent events in B cells of a vast majority of CLL patients (N=169). To advance understanding of miR-155 and PU.1 in lymphoid malignancies we studied lymph node biopsies derived from patients with lymphomas. We show that increased miR-155 levels are also found in DLBCL (N=31, P < 0.0001), Hodgkin lymphoma (HL, N=22, P < 0.0001), follicular lymphoma (FL, N=23, P < 0.001), small lymphocytic lymphoma (SLL, N=12, P < 0.01), and marginal zone lymphoma (MZL, N=11, P < 0.01). The miR-155-overexpressing tumors display downregulation of PU.1. In contrast, peripheral T cell lymphoma (T-NHL, N=6) and mantle cell lymphoma (MCL, N=7) expressed miR-155 and PU.1 comparably as control lymph nodes. Our data indicate that expression pattern of miR-155 and its target PU.1 represents a hallmark of some but not all lymphoid malignancies. Interestingly, the miR-155/PU1 levels vary substantially within each diagnosis, therefore, our aim is to further analyze the occurrence of this relationship in different prognostic groups and analyze the clinical outcome as well. (Grants: NT10310-3/2009 & NT11218-6/2010, MPO FR-TI2/509, GAUK251135 82210 & 251070 45410, SVV-2011-262507) Disclosures: No relevant conflicts of interest to declare.

Clinical Experience With Intravenous and Oral Formulations of the Novel Histone Deacetylase Inhibitor Suberoylanilide Hydroxamic Acid in Patients With Advanced Hematologic Malignancies

2006 ◽  
Vol 24 (1) ◽  
pp. 166-173 ◽  
Author(s):  
Owen A. O'Connor ◽  
Mark L. Heaney ◽  
Lawrence Schwartz ◽  
Stacie Richardson ◽  
Robert Willim ◽  
...  
Keyword(s):  
Histone Deacetylase ◽  
Histone Deacetylase Inhibitor ◽  
Hydroxamic Acid ◽  
Cell Lymphoma ◽  
Hematologic Malignancy ◽  
B Cell Lymphoma ◽  
Hematologic Malignancies ◽  
Suberoylanilide Hydroxamic Acid ◽  
Small Lymphocytic Lymphoma ◽  
Deacetylase Inhibitor

Purpose To document the toxicity and activity of the histone deacetylase inhibitor suberoylanilide hydroxamic acid (SAHA) in patients with pretreated hematologic malignancies. Patients and Methods Two formulations of SAHA (intravenous [IV] and oral) have been assessed in two consecutive phase I trials. In both trials, dose escalation was performed in parallel and independently in patients with solid tumors and hematologic malignancies. Eligible patients were required to have adequate hepatic and renal function, an absolute neutrophil count ≥ 500/μL and a platelet count more than 25,000/mL. All patients provided informed consent for study inclusion. Results A total of 39 patients with hematologic malignancy were enrolled (14 on IV SAHA and 25 on oral SAHA), of whom 35 were treated. The spectrum of diseases included patients with diffuse large B-cell lymphoma (n = 12), Hodgkin's disease (HD; n = 12), multiple myeloma (n = 2), T-cell lymphoma (n = 3), mantle cell lymphoma (n = 2), small lymphocytic lymphoma (n = 2), and myeloid leukemia (n = 2). Major adverse events with the oral formulation included fatigue, diarrhea, anorexia, and dehydration, whereas myelosuppression and thrombocytopenia were more prominent with the IV formulation. Typically, the hematologic toxicities resolved shortly after SAHA was stopped. There was no neutropenic fever or neutropenic sepsis. Reduction in measurable tumor was observed in five patients. One patient with transformed small lymphocytic lymphoma met criteria for complete response, whereas another met the criteria for partial response (PR). One patient with refractory HD had a PR, whereas three patients had stable disease for up to 9 months. Conclusion These results suggest that SAHA has activity in hematologic malignancies including HD and select subtypes of non-Hodgkin's lymphoma.

scholarly journals Prevalence of Multiple Primary Hematologic Malignancies Seen at a Tertiary Care Center

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5017-5017
Author(s):  
Kathrine A Cooper ◽  
Jonathan Lattell ◽  
Beverly Gonzalez ◽  
Stephanie Kliethermes ◽  
Sucha Nand
Keyword(s):  
Hepatitis B ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
Solid Tumors ◽  
Myeloid Leukemia ◽  
Cell Lymphoma ◽  
Hematologic Malignancy ◽  
B Cell Lymphoma ◽  
Hematologic Malignancies ◽  
Large B Cell Lymphoma

Abstract Background: There is a paucity of data regarding patients who develop multiple unrelated hematologic malignancies. This study aims to determine the prevalence of two or more hematologic malignancies in the same patient at Loyola University Medical Center (LUMC) over a period of 7 years and to explore associations with certain clinical risk factors. Methods: After obtaining IRB approval, the electronic medical record was queried for various hematologic malignancies according to ICD-9 codes from 2007-2014. Chemotherapy-associated and transformed malignancies were excluded. In addition, the following data were collected: age at first and second diagnoses, gender, ethnicity, HIV, EBV, CMV, hepatitis B or C, JAK2 mutation, or autoimmune disorders. Survival outcomes and presence of coexisting solid tumors were assessed. Results: Of 5902 patients diagnosed with any hematologic malignancy, 27 were found to have more than one. Two patients had three hematologic malignancies (Hodgkin lymphoma, cutaneous t-cell lymphoma, diffuse large B-cell lymphoma; chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), MALT lymphoma, diffuse large B-cell lymphoma). The most common first hematologic malignancy was CLL/SLL (10) followed by chronic myeloid leukemia (CML) (5) and Hodgkin lymphoma (4). The most common second primary hematologic malignancy was Hodgkin lymphoma (5), followed by multiple myeloma or plasmacytoma (4), acute myeloid leukemia (3) and CLL or monoclonal B-cell lymphocytosis (3). Thirty-seven of all malignancies were lymphoid, 16 myeloid and one Kaposi's sarcoma. Fifteen had both a myeloid and lymphoid malignancy; the remaining 12 patients had either two myeloid or two lymphoid malignancies. Seven cases were diagnosed synchronously and 20 metachronously. The median interval between the first and second diagnosis was 3 years (range: 0.19 - 6.26). The average age at diagnosis of the first and second disease was 62.4 and 67.2 years. Although not tested for statistical differences, the median survival after first and second diagnosis was 4.9 and 0.8 years, respectively. Seven patients also had at least one solid tumor malignancy; three had two different solid tumors. One patient had rheumatoid arthritis and hypothyroidism (SLL followed by Hodgkin lymphoma). Two patients had hypothyroidism, and four had type two diabetes. One patient had hepatitis B, and another had hepatitis B and C. Males were five times more likely to die after the first malignancy diagnosis compared to females, irrespective of the type of malignancy (p=0.04). No association was seen between survival and type of first malignancy or whether the second diagnosis was of lymphoid or myeloid lineage. Conclusion: These data show that in patients presenting with a hematologic malignancy, the risk of developing a second hematologic malignancy over a 7 year period was low at 0.005% (27 out of 5902). In about half (15 out of 27) the second hematologic malignancy belonged to a separate lineage and about a quarter (7/27) developed solid tumors. About one fourth of the patients (7/27) had an autoimmune disorder. Males in this cohort had a five-fold increased risk of death compared to females. The second hematologic malignancy was an ominous development and was associated with a median survival of 0.8 years. These observations should be confirmed in a prospective study. Disclosures No relevant conflicts of interest to declare.

A Phase I Study of Vorinostat (V) in Combination with Rituximab (R), Ifosphamide, Carboplatin, and Etoposide (ICE) for Patients with Relapsed or Refractory Lymphoid Malignancies or Untreated T- or Mantle Cell Lymphoma.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3696-3696 ◽  
Author(s):  
Lihua E. Budde ◽  
Michelle M. Zhang ◽  
Andrei R. Shustov ◽  
John M. Pagel ◽  
Thomas A. Warr ◽  
...  
Keyword(s):  
Stem Cell ◽  
T Cell ◽  
Phase I ◽  
Mantle Cell Lymphoma ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
T Cell Lymphoma ◽  
Lymphoid Malignancies ◽  
Mantle Cell ◽  
Grade 3

Abstract Abstract 3696 Poster Board III-632 Platinum based regimens such as ICE with or without Rituximab (RICE) have been widely used to treat relapsed or refractory lymphoid malignancies prior to transplantation. However, a significant portion of patients do not respond to treatment, and improved therapies are needed. Vorinostat (V) is an oral HDAC inhibitor with moderate toxicity and has clinical activity against a variety of tumors including cutaneous T cell lymphoma. Preclinical data demonstrated marked anti-tumor synergism between V and platinum analogues as well as etoposide. We present data from a phase I, open-label, multicenter, dose escalation study estimating the maximally tolerated dose of V that can be combined with RICE or ICE (V-RICE or VICE) in patients with relapsed or refractory lymphoid malignancies or untreated T- or Mantle Cell Lymphoma. Other endpoints include tolerability, exploratory anti-tumor activity and impact of above regimen on stem cell reserve. Patients (aged ≥18 years, an ECOG performance status of 0-2, measurable disease, no active central nervous system involvement, adequate bone marrow, hepatic and renal function, no active arrhythmias on EKG) were sequentially enrolled on escalating doses of V combination therapy using the “two stage” design introduced by Storer with single patient cohorts until a dose limiting toxicity (DLT) is observed, followed by cohorts of 4 patients. A DLT was defined as any gastrointestinal grade 3 NCI-CTCAE adverse event (AE) lasting longer than 7 days, or any related non-hematologic grade 4 or 5 AE; any event that prevents the completion of one full cycle of therapy (5 days of V) due to toxicity from V; or any AE at the discretion of the principal investigator. Therapy consisted of V ranging from 400 mg daily to 700 mg BID days 1 to 5 in combination with standard RICE or ICE on days 3 to 5 every 21 days. A total of 18 patients have been enrolled on this study thus far (9 in stage 1, 9 in stage 2) and 14are fully evaluable to date, including: Hodgkin lymphoma (4), T-cell lymphoma (3); mantle cell lymphoma (2); diffuse large B cell lymphoma (2); follicular lymphoma (2), and chronic lymphocytic leukemia (1). Baseline characteristics (n=14) included: median age 55 (range: 33-67), male 10 (71%), stage III/IV 14 (100%), median number of prior therapies 2 (range: 0-6), elevated LDH 5 (35%), prior anthracycline 13 (93%), prior platinum 2 (14%), refractory diseases 5 (36%), relapsed diseases 8 (57%), untreated disease 1 (7%). A maximum V dose of 700 mg BID was attained in stage I (Table). The dose adjustment schema of stage II has ranged from 600 mg BID to 400 mg BID currently. Among the 14 evaluable patients, six received only1 cycle of treatment (3/5 patients declined the second cycle; 2/5 patients developed DLT), 8 completed 2 cycles. Eight of 14 (57%) patients experienced non-hematologic AEs≥ grade 3 with most common being nausea, vomiting, or diarrhea seen in 6 and grade 4 hypokalemia in 2. Twelve patients (86%) responded including 1 with complete remission (CR), 2 with unconfirmed CR, and 9 with partial responses. One patient had stable disease and one had disease progression. Nine of 12 patients (75%) who attempted peripheral blood stem cell collection following VICE/V-RICE were successful (>5×106 CD34+/kg) Collectively, these findings indicate that the combination of vorinostat with RICE or ICE, is feasible and active in patients with lymphoid malignancies. Special attention should be given to the management of the frequent gastrointestinal AEs. Pending identification of the MTD, phase II evaluation of VICE or V-RICE regimen will be designed to formally define its efficacy. Table Summary of DLTs and responses at various dose levels Stage Dose level Dose n DLTs responses I 1 400 mg QD 2 0 PR(1); SD (1) 2 300 mg BID 1 0 PR (1) 3 400 mg BID 1 0 PD (1) 4 500 mg BID 2 0 PR (1); CR (1) 5 600 mg BID 1 0 PR (1) 6 700 mg BID 2 1 PR (2) II 5 600 mg BID 4 3 PR (1); CRu (3) 4 500 mg BID 1 1 PR (1) Total - - 14 5 12 (86%) Disclosures: No relevant conflicts of interest to declare.

A Highly Selective AKT 1/2 Inhibitor Abrogates AKT Signaling and Is Cytotoxic to Primary Chronic Lymphocytic Leukemia and Mantle Cell Lymphoma Cells

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 3594-3594
Author(s):  
Luke B Fletcher ◽  
Stephen Spurgeon ◽  
Jeffrey W Tyner ◽  
Brian J Druker ◽  
Marc M Loriaux
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Cell Lymphoma ◽  
Specific Inhibitor ◽  
Cell Receptor ◽  
Hematologic Malignancies ◽  
Akt Signaling ◽  
B Cell Receptor ◽  
Lymphocytic Leukemia ◽  
Lymphoid Malignancies ◽  
Mantle Cell

Abstract Abstract 3594 Background: The AKT (PKB) family of serine-threonine kinases is an essential component of cell signaling and survival pathways that are important to cancer pathogenesis. Significant clinical activity has been observed with compounds that target key upstream kinases such as PI3K and downstream effectors such as mTOR. Many of these drugs have previously been applied towards patients diagnosed with solid tumors, however, only recently has their potential efficacy for patients with hematologic malignancies become apparent. Dysregulation of AKT has been observed in a number of lymphoid malignancies including chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL). In CLL this aberrant activity may be derived from signaling from the B-cell receptor (BCR). Early clinical data with inhibitors that target AKT and other kinases, including those activated via the BCR, have shown activity in lymphoid malignancies, justifying the evaluation of new inhibitors that target this pathway. An AKT 1/2 specific inhibitor (Merck) is a highly selective allosteric AKT inhibitor for AKT 1(IC50 = 16 nM) and AKT 2 (266 nM) with little AKT3 activity (IC50 = 1900 nM). Xenograft models in solid tumors have shown significant decreases in tumor growth and potent in vivo AKT1 and AKT2 inhibition of 95% and 59% respectively at average blood concentrations of 12.8 μ M. To date, no data have been reported for this inhibitor in hematologic malignancies. Given increasing data supporting the importance of AKT activity in lymphoid malignancies, we evaluated this drug as a possible therapeutic agent in CLL and MCL. Methods: Fresh primary CLL or MCL cells from 26 CLL patients and 2 leukemic MCL patients were purified using a ficoll gradient and cultured with graded concentrations of the AKT 1/2 specific inhibitor (50 nM to 50 μ M—concentrations that encompass the predicted IC50). After three days, cell viability was assessed using a tetrazolium-based MTS assay and absorbance values were normalized to wells in which cells were cultured in the absence of drug. Patient-specifc IC50 values were calculated, and the ability of the compound to inhibit AKT signaling was evaluated via immunoblot (pAKT Ser473). Result: Of the 28 primary samples tested, we saw significantly decreased cell viability at achievable IC50 drug concentrations(≤ 10uM) in 15 (58%) CLL samples and in 1 (50%) MCL sample. Responses were seen in samples from both treatment-naïve and relapsed patients as well as patients with high-risk features (i.e. advanced stage, poor risk cytogenetics, or unmutated IgVh). In addition, AKT phosphorylation was significantly decreased in all samples tested. Conclusion: These data demonstrate activity of the highly selective AKT 1/2 inhibitor in both CLL and MCL and support the ongoing clinical development of AKT inhibitors, alone or in combination with other agents. The data also highlight the need for ongoing development of therapeutic compounds that inhibit key signaling pathways, such as the B-cell receptor signaling complex, in lymphoid malignancies. Disclosures: Druker: Molecular MD: Equity Ownership.

scholarly journals Mantle cell lymphoma polarizes tumor-associated macrophages into M2-like macrophages, which in turn promote tumorigenesis

2021 ◽  
Vol 5 (14) ◽  
pp. 2863-2878
Author(s):  
Kang Le ◽  
Jing Sun ◽  
Hunain Khawaja ◽  
Maho Shibata ◽  
Sanjay B. Maggirwar ◽  
...  
Keyword(s):  
Tumor Growth ◽  
Mantle Cell Lymphoma ◽  
Cell Line ◽  
Cell Lymphoma ◽  
Flow Cytometric Analysis ◽  
B Cell Lymphoma ◽  
Tumor Associated Macrophages ◽  
Lymphoid Malignancies ◽  
Syngeneic Mouse Model ◽  
Mantle Cell

Abstract Tumor-associated macrophages (TAMs) are recognized as a hallmark of certain solid cancers and predictors of poor prognosis; however, the functional role of TAMs in lymphoid malignancies, including B-cell lymphoma, has not been well defined. We identified infiltration of F4/80+ TAMs in a syngeneic mouse model using the recently generated murine mantle cell lymphoma (MCL) cell line FC-muMCL1. Multicolor flow cytometric analysis of syngeneic lymphoma tumors showed distinct polarization of F4/80+ TAMs into CD206+ M2 and CD80+ M1 phenotypes. Using human MCL cell lines (Mino, Granta, and JVM2), we further showed that MCL cells polarized monocyte-derived macrophages toward an M2-like phenotype, as assessed by CD163+ expression and increased interleukin-10 (IL-10) level; however, levels of the M1 markers CD80 and IL-12 remained unaffected. To show that macrophages contribute to MCL tumorigenesis, we xenografted the human MCL cell line Mino along with CD14+ monocytes and compared tumor growth between these 2 groups. Results showed that xenografted Mino along with CD14+ monocytes significantly increased the tumor growth in vivo compared with MCL cells alone (P &lt; .001), whereas treatment with liposomal clodronate (to deplete the macrophages) reversed the effect of CD14+ monocytes on growth of MCL xenografts (P &lt; .001). Mechanistically, IL-10 secreted by MCL-polarized M2-like macrophages was found to be responsible for increasing MCL growth by activating STAT1 signaling, whereas IL-10 neutralizing antibody or STAT1 inhibition by fludarabine or STAT1 short hairpin RNA significantly abolished MCL growth (P &lt; .01). Collectively, our data show the existence of a tumor microenvironmental network of macrophages and MCL tumor and suggest the importance of macrophages in interventional therapeutic strategies against MCL and other lymphoid malignancies.

Primary diffuse large B cell lymphoma (DLBCL) of the prostate presenting with lower urinary tract symptoms (LUTS)

2020 ◽  
Vol 13 (12) ◽  
pp. e236280
Author(s):  
Ayesha Nusrat ◽  
Syed Muhammad Nazim
Keyword(s):  
Urinary Tract ◽  
B Cell ◽  
Lower Urinary Tract ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Large B Cell Lymphoma ◽  
Urinary Tract Symptoms ◽  
History Of ◽  
Large B Cell ◽  
Lower Urinary

Malignant lymphomas of the prostate are very rare tumours and are generally not considered in the clinical or pathological diagnosis of prostatic enlargement. We report a case of a 56-year-old man who presented with long-standing history of low back pain and a 2-month history of voiding lower urinary tract symptoms. He denied any history of urinary retention, trauma, catheterisation or any constitutional symptoms. Examination revealed no lymphadenopathy and hepatosplenomegaly. Digital rectal examination showed an irregular, moderately enlarged nodular prostate. His prostate-specific antigen was 1.54 ng/mL. MRI of the pelvis did not show any focal lesion apart from abnormal signal intensity in the central zone. Bone scan was negative. Transrectal ultrasound-guided prostate biopsy revealed diffuse large B cell lymphoma. Bone marrow biopsy and whole body positron emission tomography/CT were unremarkable. The patient achieved complete remission after receiving six cycles of R-CHOP chemotherapy.

scholarly journals Predicting Responses to Checkpoint Inhibitors in Lymphoma: Are We Up to the Standards of Solid Tumors?

2020 ◽  
Vol 14 ◽  
pp. 117955492097636
Author(s):  
Ah-Reum Jeong ◽  
Edward D Ball ◽  
Aaron Michael Goodman
Keyword(s):  
Cell Death ◽  
Programmed Cell Death ◽  
B Cell ◽  
Solid Tumors ◽  
Cell Lymphoma ◽  
Checkpoint Inhibitors ◽  
B Cell Lymphoma ◽  
Hematologic Malignancies ◽  
Checkpoint Blockade ◽  
Programmed Cell Death 1

Treatment of cancer has transformed with the introduction of checkpoint inhibitors. However, the majority of solid tumor patients do not respond to checkpoint blockade. In contrast, the response rate to programmed cell death 1 (PD-1) blockade in relapsed/refractory classical Hodgkin lymphoma (cHL) is 65% to 84% which is the highest among all cancers. Currently, checkpoint inhibitors are only approved for cHL and primary mediastinal B-cell lymphoma as the responses to single-agent checkpoint blockade in other hematologic malignancies is disappointingly low. Various established biomarkers such as programmed cell death 1 ligand 1 (PD-L1) protein surface expression, mismatch repair (MMR) status, and tumor mutational burden (TMB) are routinely used in clinical decision-making in solid tumors. In this review, we will explore these biomarkers in the context of hematologic malignancies. We review characteristic 9p24.1 structural alteration in cHL and primary mediastinal B-cell lymphoma (PMBCL) as a basis for response to PD-1 inhibition, as well as the role of antigen presentation pathways. We also explore the reported frequencies of MMR deficiency in various hematologic malignancies and investigate TMB as a predictive marker.

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