scholarly journals Liver tumor concurrent with chronic myelocytic leukemia and extreme thrombocytosis: A rare case report

2020 ◽  
Author(s):  
Ping Han ◽  
Zhiqiang Han ◽  
Xia Mao ◽  
Jin Wang ◽  
Qinglu Li ◽  
...  
Keyword(s):  
Liver Cancer ◽  
Solid Tumors ◽  
Rare Case ◽  
In Situ Hybridisation ◽  
Large Mass ◽  
Pathological Examination ◽  
Fluorescence In Situ Hybridisation ◽  
Chronic Myelocytic Leukemia ◽  
Myelocytic Leukemia

Abstract Background Chronic myelocytic leukemia (CML) may occasionally occur after organ transplantation or long-term chemotherapy for solid tumors; Solid tumors secondary to long-term chemotherapy and biotherapy in CML have also been reported. However, the concurrence of solid tumor with CML and extreme thrombocytosis in an untreated patient is seldom reported. Case presentation We describe a 61-year-old woman transferred to liver surgery department for the discovery of a large mass in the liver and an elevated plasmic AFP. She was initially diagnosed with liver cancer. Blood tests indicated a marked increase of platelets(2464x10 9 /L). The chromosome examination of bone marrow biopsy indicated the existence of t(9;22) translocation, fluorescence in situ hybridisation (FISH) and PCR were both positive for the Bcr-Abl rearrangement. The diagnosis of CML was made. She received hydroxyurea and imatinib to treat CML, and platelet-lowering therapy, and then underwent a liver biopsy, which suggestted a moderately-poorly differentiated adenocarcinoma, or might be a hepatic metastatic carcinoma. However, the patient refused further pathological examination and primary site screening for the tumor. She died six and a half months after discharge. Conclusion: Here, we describe a rare case of liver cancer concurrent with CML and extreme thrombocytosis in an old patient. However, the exact relationship between the two tumors is still unclear, and more cases are desired.

scholarly journals Cyclosporine v methotrexate for graft-v-host disease prevention in patients given marrow grafts for leukemia: long-term follow-up of three controlled trials

Blood ◽  
1988 ◽  
Vol 71 (2) ◽  
pp. 293-298
Author(s):  
R Storb ◽  
HJ Deeg ◽  
L Fisher ◽  
F Appelbaum ◽  
CD Buckner ◽  
...  
Keyword(s):  
Interstitial Pneumonia ◽  
Chronic Gvhd ◽  
Study Groups ◽  
Chronic Myelocytic Leukemia ◽  
Term Survival ◽  
Host Disease ◽  
Myelocytic Leukemia ◽  
Leukemic Relapse ◽  
Acute Nonlymphoblastic Leukemia

One hundred seventy-nine patients with acute nonlymphoblastic leukemia in first remission (n = 75), chronic myelocytic leukemia in chronic or accelerated phase (n = 48) or leukemia in advanced stage (n = 56) were given HLA-identical marrow grafts and randomized to receive methotrexate or cyclosporine for prevention of graft-v-host disease (GVHD). The current report updates the three prospective trials with follow-ups ranging from 3.2 to 6.2 years after marrow grafting. Results were analyzed separately for each individual study and for all three studies combined. Overall, 40% of patients given cyclosporine and 55% of those given methotrexate developed acute GVHD (P = .13); the incidence of chronic GVHD was 42% and 48%, respectively (P = .67). Twenty-two percent of cyclosporine-treated patients and 30% of methotrexate-treated patients developed interstitial pneumonia of any etiology (P = .25), and the figures for cytomegalovirus pneumonia were 18% and 20%, respectively (P = .41). The overall incidence of leukemic relapse was 31% in cyclosporine-treated patients and 36% in methotrexate-treated patients (P = .75). The probabilities of survival for cyclosporine-v methotrexate-treated patients were comparable for all three study groups: 52% v 48% in patients with acute nonlymphoblastic leukemia (P = .42), 55% v 60% for those with chronic myelocytic leukemia (P = .61), 12% and 12% for those with advanced leukemia (P = .93), and 39% v 38% overall (P = .72). We conclude that cyclosporine and methotrexate are comparable regarding the likelihood of acute/chronic GVHD, interstitial pneumonia, leukemic relapse, and long-term survival.

scholarly journals Cyclosporine v methotrexate for graft-v-host disease prevention in patients given marrow grafts for leukemia: long-term follow-up of three controlled trials

Blood ◽  
1988 ◽  
Vol 71 (2) ◽  
pp. 293-298 ◽  
Author(s):  
R Storb ◽  
HJ Deeg ◽  
L Fisher ◽  
F Appelbaum ◽  
CD Buckner ◽  
...  
Keyword(s):  
Interstitial Pneumonia ◽  
Chronic Gvhd ◽  
Study Groups ◽  
Chronic Myelocytic Leukemia ◽  
Term Survival ◽  
Host Disease ◽  
Myelocytic Leukemia ◽  
Leukemic Relapse ◽  
Acute Nonlymphoblastic Leukemia

Abstract One hundred seventy-nine patients with acute nonlymphoblastic leukemia in first remission (n = 75), chronic myelocytic leukemia in chronic or accelerated phase (n = 48) or leukemia in advanced stage (n = 56) were given HLA-identical marrow grafts and randomized to receive methotrexate or cyclosporine for prevention of graft-v-host disease (GVHD). The current report updates the three prospective trials with follow-ups ranging from 3.2 to 6.2 years after marrow grafting. Results were analyzed separately for each individual study and for all three studies combined. Overall, 40% of patients given cyclosporine and 55% of those given methotrexate developed acute GVHD (P = .13); the incidence of chronic GVHD was 42% and 48%, respectively (P = .67). Twenty-two percent of cyclosporine-treated patients and 30% of methotrexate-treated patients developed interstitial pneumonia of any etiology (P = .25), and the figures for cytomegalovirus pneumonia were 18% and 20%, respectively (P = .41). The overall incidence of leukemic relapse was 31% in cyclosporine-treated patients and 36% in methotrexate-treated patients (P = .75). The probabilities of survival for cyclosporine-v methotrexate-treated patients were comparable for all three study groups: 52% v 48% in patients with acute nonlymphoblastic leukemia (P = .42), 55% v 60% for those with chronic myelocytic leukemia (P = .61), 12% and 12% for those with advanced leukemia (P = .93), and 39% v 38% overall (P = .72). We conclude that cyclosporine and methotrexate are comparable regarding the likelihood of acute/chronic GVHD, interstitial pneumonia, leukemic relapse, and long-term survival.

scholarly journals Gastrointestinal clear cell sarcoma-like tumour of the ascending colon

2016 ◽  
Vol 98 (03) ◽  
pp. e37-e39 ◽  
Author(s):  
A Gahanbani Ardakani ◽  
DJ Boyle ◽  
C Elton
Keyword(s):  
Gastrointestinal Tract ◽  
Clear Cell ◽  
S100 Protein ◽  
In Situ Hybridisation ◽  
Clear Cell Sarcoma ◽  
Pathological Examination ◽  
Fluorescence In Situ Hybridisation ◽  
Ascending Colon ◽  
Cell Sarcoma ◽  
Hmb 45

Introduction A clear cell sarcoma-like gastrointestinal tumour (CCSLGT) is a rare malignant soft tissue sarcoma. In the literature, they are sometimes referred to as malignant gastrointestinal neuroectodermal tumours, clear cell sarcomas or osteoclast rich tumours of the gastrointestinal tract. Case history We present a case of a CCSLGT arising from the ascending colon of a previously well 22-year-old man presenting with abdominal pain and anaemia. Computed tomography of the abdomen and pelvis showed a 7cm irregular mass in the right flank that seemed to emerge from the proximal transverse colon. A laparoscopic right hemicolectomy was undertaken to remove the mass. Microscopic pathological examination of the specimen revealed sections of spindle to oval cells with monomorphic nuclei and scant cytoplasm. The cells were arranged in a striking perivascular growth pattern with microcytic breakdown and pseudopapillary formation. Immunohistochemistry analysis showed that the tumour cells removed expressed S100 protein, and were negative for smooth muscle actin, desmin, CD34, CD117, DOG1, HMB-45 and MNF116. Additionally, cytogenetic testing identified EWSR1 gene rearrangement, which was observed by interphase fluorescence in situ hybridisation. Conclusions A complex tumour, a CCSLGT can be thought of in simple terms as a gastrointestinal tract tumour that is S100 protein positive, osteoclast rich, HMB-45 negative and compromises a t(12;22)(q13;q12) gene translocation. These simplified CCSLGT characteristics seem to be described and classified under different aliases in the literature, which makes it difficult to accurately predict the appropriate diagnostic and therapeutic modality required to provide the best clinical care. Given that this case report describes the fourth CCSLGT of primary colonic origins, it may aid future targeted therapies as well as offering epidemiological evidence on prevalence and prognosis.

Long Term Survival of Patients with Chronic Myelocytic Leukemia after Allogeneic Stem Cell Transplant Using a Reduced Intensity Regimen of Melphanlan, Lomustine and Cyclophosphamide.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5308-5308
Author(s):  
Yongqian Jia ◽  
Ting Liu ◽  
Ting Niu ◽  
Caigang Xu ◽  
Wentong Meng ◽  
...  
Keyword(s):  
Disease Free Survival ◽  
Mixed Chimerism ◽  
Cell Transplant ◽  
Chronic Myelocytic Leukemia ◽  
Free Survival ◽  
Myelocytic Leukemia ◽  
Disease Free ◽  
Reduced Intensity

Abstract Introduction: Non-ablative regimens have been shown to be effective and less toxic than traditional ablative regimens, but they usually need close monitoring and skillful manipulates e.g. donor lymphocyte infusions. In the present study, we used a novel reduced intensity regimen with melphanlan, lomustine and cyclophosphamide to treat patients with chronic myelocytic leukemia and made a long term follow-up. Methods: 14 patients with median age of 35(23~52) were treated with MCC regimen(Melphanlan 170 mg/m2/d×1, Lomustine 400 mg/m2/d×1, Cyclophosphamide 60 mg/kg/d×2) and the median follow-up time is 6 years; another 16 patients with median age of 33(16~44) were treated with BuCy regimen(Busulfan 4 mg/kg/d×4, Cyclophosphamide 60 mg/kg/d×2) and the median follow-up time is 4 years. Results: All the patients were engrafted successfully and the platelet recovery to 20×109/L was earlier at median 3 days in patients with MCC regimen. 4 of 10 patients examined in MCC group showed mixed chimerism at day 100 post transplant, whereas only 1 of 12 patients examined in BuCy group showed mixed chimerism. All the patients became complete donor sources later without any DLI. The regimen related toxicity was relatively lower in MCC group, especially the incidence and severity of mucositis and liver dysfunction were decreased significantly. The median duration of hospitalization was 39 days (25~55)for patients with MCC regimen, and 55 days (39~90) for BuCy regimen. The 5 year disease-free survival was 71.4% for MCC group and 62.5% for BuCy group, respectively. The transplant related mortality and relapse rate were 21% and 7% for MCC regimen, whereas 25% and 12% for BuCy regimen. Conclusions: MCC regimen is an effective and less toxic conditioning regimen and the long term disease-free survival is as the same as that of BuCy regimen. Considering the cost-effect efficacy, MCC regimen may have some prominent advantages over BuCy regimen. Figure Figure

Relevance of a medicosurgical strategy combining cetuximab and chronomodulated (Chrono) chemotherapy (chemo) with metastases resection as 3rd line treatment for patients (pts) with metastatic colorectal cancer (MCRC)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 14505-14505
Author(s):  
A. Karaboue ◽  
M. Bouchahda ◽  
R. Adam ◽  
P. Innominato ◽  
M. P. Bralet ◽  
...  
Keyword(s):  
Objective Response ◽  
In Situ Hybridisation ◽  
Progression Free Survival ◽  
Fluorescence In Situ Hybridisation ◽  
Term Survival ◽  
Survival Estimate ◽  
Gene Copies ◽  
Acneiform Rash

14505 Background: Metastases surgery offers long tem survival for pts with chemo-downstaged MCRC (Adam et al. Ann Surg 2004). The relevance of this medicosurgical strategy was investigated in pts given cetuximab (Cetux) and Chrono after chemo failure. Methods: 56 pts with progressive MCRC on prior chemo received Cetux (400 mg/m2 on 1st dose then 250 mg/m2/week) and q2w Chrono based on irinotecan (34 pts), oxaliplatin (14 pts) or both (8 pts). Toxicity grades (G) and response were assessed q2w and q8w, respectively. Tumour EGFR was determined by immunohistochemistry (all pts) and gene copies by fluorescence in situ hybridisation (27 pts). Metastases surgery was attempted whenever complete resection was foreseen. Results: Median of 3 prior chemo (1 to 8); median age: 61 years (35 to 79); M/F: 34/22; WHO PS 0/1/2/3: 37/14/4/1; colon/rectum: 32/24; M sites 1/2/=3: 15/22/19; liver/lung: 45/40. EGFR was detected in the tumor of 39 pts (69.6%). 3 pts had G4 allergy. 53 evaluable pts received a median of 5 courses of Cetux-Chrono (1–22). G2–3 acneiform rash occurred in 36 pts (67.8%; G3: 30.4%). Main G3–4 toxicities were diarrhea (26.5%), neutropenia (23.1%) and neuropathy (22.6%). The objective response rate (ORR) was 32% [95% CI, 19.4 to 44.6] (13 PR and 3 CR). ORR was correlated positively with acneiform rash (p= 0.019) but negatively with the detection of EGFR+ tumor cells (0%, ORR=54.5%; 1–10%, 33%; >10%, 16.7%; p = 0.044). No EGFR amplification was documented including 8 OR. Median progression-free survival (PFS) and overall survival were 5.1 [3.2–6.9] and 13.9 months [6.5–21.3] respectively. Metastases surgery was performed in 10 pts (8 R0, 2 R1) after 3–15 courses of Cetux-Chrono as 2nd-5th line. Median PFS in resected pts was 11.7 months [5.8–17.6], with a survival estimate of 80% at 21 months. Conclusions: Cetux-Chrono safely reverted MCRC resistance and allowed successful metastases resection in 17.8% of these pts, like 1st line chemo. This medicosurgical strategy impacted favourably on long term survival, despite its application as 3rd treatment line. Supported by ARTBC, Hôpital Paul Brousse, Villejuif, France No significant financial relationships to disclose.

scholarly journals Serial horizontal transfer of vitamin-biosynthetic genes enables the establishment of new nutritional symbionts in aphids’ di-symbiotic systems

2019 ◽  
Vol 14 (1) ◽  
pp. 259-273 ◽  
Author(s):  
Alejandro Manzano-Marı́n ◽  
Armelle Coeur d’acier ◽  
Anne-Laure Clamens ◽  
Céline Orvain ◽  
Corinne Cruaud ◽  
...  
Keyword(s):  
In Situ Hybridisation ◽  
Essential Amino Acids ◽  
Aphid Species ◽  
Fluorescence In Situ Hybridisation ◽  
The Novel ◽  
Buchnera Aphidicola ◽  
Biosynthetic Genes ◽  
Obligate Symbiont

Abstract Many insects depend on obligate mutualistic bacteria to provide essential nutrients lacking from their diet. Most aphids, whose diet consists of phloem, rely on the bacterial endosymbiont Buchnera aphidicola to supply essential amino acids and B vitamins. However, in some aphid species, provision of these nutrients is partitioned between Buchnera and a younger bacterial partner, whose identity varies across aphid lineages. Little is known about the origin and the evolutionary stability of these di-symbiotic systems. It is also unclear whether the novel symbionts merely compensate for losses in Buchnera or carry new nutritional functions. Using whole-genome endosymbiont sequences of nine Cinara aphids that harbour an Erwinia-related symbiont to complement Buchnera, we show that the Erwinia association arose from a single event of symbiont lifestyle shift, from a free-living to an obligate intracellular one. This event resulted in drastic genome reduction, long-term genome stasis, and co-divergence with aphids. Fluorescence in situ hybridisation reveals that Erwinia inhabits its own bacteriocytes near Buchnera’s. Altogether these results depict a scenario for the establishment of Erwinia as an obligate symbiont that mirrors Buchnera’s. Additionally, we found that the Erwinia vitamin-biosynthetic genes not only compensate for Buchnera’s deficiencies, but also provide a new nutritional function; whose genes have been horizontally acquired from a Sodalis-related bacterium. A subset of these genes have been subsequently transferred to a new Hamiltonella co-obligate symbiont in one specific Cinara lineage. These results show that the establishment and dynamics of multi-partner endosymbioses can be mediated by lateral gene transfers between co-ocurring symbionts.

Pituitary Apoplexy in Long-Term Cabergoline User During Thrombocytopenia Due to Chemotherapy for Chronic Myelocytic Leukemia

2018 ◽  
Vol 120 ◽  
pp. 290-295 ◽  
Author(s):  
Yoshinori Maki ◽  
Yoshitaka Kurosaki ◽  
Kaori Uchino ◽  
Ryota Ishibashi ◽  
Masaki Chin ◽  
...  
Keyword(s):  
Pituitary Apoplexy ◽  
Chronic Myelocytic Leukemia ◽  
Myelocytic Leukemia

scholarly journals Busulfan in the Treatment of Chronic Myelocytic Leukemia. The Effect of Long Term Intermittent Therapy

Blood ◽  
1961 ◽  
Vol 17 (1) ◽  
pp. 1-19 ◽  
Author(s):  
A. HAUT ◽  
W. S. ABBOTT ◽  
M. M. WINTROBE ◽  
G. E. CARTWRIGHT
Keyword(s):  
Acute Phase ◽  
Treated Patient ◽  
Intermittent Therapy ◽  
Chronic Myelocytic Leukemia ◽  
Radioactive Phosphorus ◽  
X Ray ◽  
Myelocytic Leukemia ◽  
Complete Resistance ◽  
Previously Treated

Abstract 1. The observations made during the administration of 114 courses of busulfan to 30 patients over a period of seven years are recorded. The responses to initial courses of therapy corresponded with those reported previously. With repeated courses of therapy, subjective improvement, the decline in the number of leukocytes, decrease of anemia and the subsidence of physical signs of the disease were as satisfactory as during the first course but tended to appear later. Patients were ambulatory and most were symptomatically and objectively improved during and after repeated courses as compared to their status beforehand. 2. Remissions were longest when the leukocyte values were 10,000 per cu. mm., or less, at the time busulfan was discontinued. Among such patients, remissions of six months or longer were seen in 85 per cent after the initial course of busulfan but in only 19 per cent after fifth or later courses. 3. Evidence of partial resistance to busulfan was seen in some cases after multiple courses of treatment. Complete resistance occurred in 15 patients upon development of the acute, myeloblastic phase of chronic myelocytic leukemia. When busulfan failed, 6-mercaptopurine and colcemide were temporarily of value; x-ray was not of benefit. After the onset of the acute phase. the median survival was three months. This mode of termination is probably no more frequent (50 per cent of cases) since the advent of busulfan therapy than before. 4. If anemia was not relieved, or a large spleen was not reduced 50 per cent in size following a course of therapy, the prognosis was poor and the acute phase imminent. 5. Thrombocytopenia in early, untreated cases was not necessarily a bad sign, nor was the use of busulfan precluded because of it. However, when thrombocytopenia appeared in a previously treated patient, without other evidence indicating busulfan toxicity, or when it occurred in a patient with three or more years of known disease, it usually presaged the development of the terminal acute phase. 6. Side effects of busulfan were significant in only one patient; this man received 8 milligrams daily, double the usual dose, for eight months and developed glossitis, anhydrosis and alopecia totalis. The major hazard in the use of the drug was the occurrence of pancytopenia. This could be related to excessive dosage. 7. Morbidity was clearly decreased. Longevity (median 42 months) was greater than in Minot’s untreated cases (median 31 months) and at least as great as that achieved by treatment with radioactive phosphorus and x-ray (median 32-41 months). Repeated courses of busulfan are considered to offer an effective and practical palliative form of therapy for chronic myclocytic leukemia, up to the time of appearance of the terminal acute myeloblastic phase.

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