Chronic Hepatitis B Viral Activity As A Prognostic Factor For Survival In Malignant Lymphoma

Background: Hepatitis B virus (HBV) infection carries a risk of liver cancer and extrahepatic malignancy. However, the incidence trend and clinical course of malignant lymphoma (ML) in HBV patients are not well known. Methods: Data about ML newly diagnosed in chronic hepatitis B (CHB) patients from 2003 to 2016 were collected from National Health Insurance Service claims. Results: A total of 13,942 CHB patients were newly diagnosed with ML from 2003 to 2016. The number of patients increased 3.8 times, from 442 in 2003 to 1,711 in 2016. The 2-year survival rate of all patients was 76.8%, and the 5-year survival rate was 69.8%. The survival rate of patients taking antivirals due to high viral activity before their diagnosis with ML was significantly lower than that of patients with lower viral activity (1 yr-77.3%, 3 yr-64.5%, and 5 yr-58.3% vs. 1 yr-84.0%, 3 yr-73.4%, and 5 yr-68.0%, respectively). The survival rate of patients with liver cirrhosis (LC) at baseline was significantly lower than that of those without LC. Cirrhotic patients taking antivirals before ML diagnosis had a worse prognosis than who did not. Conclusions: High viral activity in CHB patients with ML is useful in predicting the prognosis for survival.

ML-13 Primary central nervous system malignant lymphoma in a patient with rheumatoid arthritis receiving tocilizumab

Background: Although the risk of developing malignant lymphoma is higher in patients with rheumatoid arthritis (RA) than in the general population, the occurrence of primary central nervous system lymphoma (PCNSL) in patients with RA is extremely rare. In recent years, there has been concern that biological disease-modifying antirheumatic drugs (DMRADs), which are widely administered to patients with RA, may increase the risk of developing cancer. We report the first case of PCNSL in a patient with RA who was treated with the biological DMRADs, tocilizumab. Case description: A 70-year-old man, who was diagnosed with RA in 2010 was treated with low-dose methotrexate from 2010 to 2015. He was started on tocilizumab in 2012. In 2018, he suffered from gait disturbance and was diagnosed with lumbar spinal stenosis. He underwent L2/3 posterior fusion surgery, but his paraplegia gradually deteriorated. Two months after the surgery, a head Gd-MRI showed multiple contrast-enhanced lesions in the basal ganglia and brain stem. A stereotactic brain biopsy was performed and DLBCL was diagnosed, and finally PCNSL was diagnosed because of no neoplastic lesions in other organs. He was treated with 5 courses of MTX 3.5g/m2 with rituximab and has been in remission for 23 months. He has maintained an independent life with residual paraplegia, but his ADLs gradually worsened. He was restarted on tocilizumab with a diagnosis of worsening RA. Conclusion: Low-dose methotrexate and biological DMRADs including tocilizumab, have been concerned to increase the risk of cancer in patients with RA, but there is no solid evidence. Since it has been a short time since the use of biological DMRADs, further accumulation of cases and careful follow-up are necessary.

Survival analysis of 8785 malignant lymphoma cases in the oral and nasal cavities in the USA: a cohort study

ObjectiveTo identify the factors associated with the survival of malignant Hodgkin and non-Hodgkin lymphomas in oral and nasal cavities.Study design. Retrospective cohort survival analysis.MethodsThe Surveillance, Epidemiology and End Results 18 database was used to analyse the factors associated with the 5-year survival rate of malignant lymphomas diagnosed in the oral cavity and pharynx (OCP) and nasal cavity and sinus (NCS) regions from 1988 to 2011 for all patients in the USA. Multivariable Cox regression models were used to calculate the HR of malignant lymphoma death overall and by the site of cancer diagnosis.ResultsAmong the 8785 patients included in the analysis, 4103 (46.7%) were women, 6096 (69.4%) were non-Hispanic (NH) white, 635 (7.2%) were NH black and 1209 (13.8%) were Hispanic patients of all races. We found that a higher 5-year survival rate of malignant lymphoma is associated with: female gender; younger age at diagnosis; NH white race/ethnicity; diagnosis in the oral cavity; receiving surgery/radiation and surgery/radiation, surgery and chemotherapy as the treatment; diagnosis at a localised stage and diagnosis in later calendar years. No association with lymphoma subtype was observed.ConclusionWe have identified several demographics and prognosis factors associated with the 5-year survival rate of malignant lymphomas in the OCP and NCS regions. These findings warrant greater public health attention on the prognosis of malignant lymphomas in the OCP and NCS regions among the most vulnerable populations.

The Meta-Analysis About The Expression and Prognosis of Anti-Ro-52, Anti-CENP-B and AMA in Sjogren's Syndrome and Systemic Sclerosis

Objective This project aims to investigate the diagnostic value of anti-Ro-52, anti-CENP-B, and AMA in Sjogren's syndrome and systemic sclerosis. Methods We constructed the Meta-analysis to evaluate the existing experimental data and obtain the advantages of the three antinuclear antibodies compared with traditional test items using specific data processing methods and evaluated their value in the diagnosis as well as the differential diagnosis of Sjogren's syndrome and systemic sclerosis. During the process of paper collection, we strictly followed the principle of PICOS to screen the literature, trying to include the literature with a large sample size, controversial and influential results which would make the results of this Meta-analysis more valuable. In this study, Revman and Stata software was used for data processing, and the forest map was drawn to analyze the difference in antibody-positive rate, age, and gender distribution, and other factors. At the same time, a funnel plot was used to evaluate the bias of literature results.Results The positive rate of anti-Ro-52 in SS and SSC was higher than that of anti-SSB (P < 0.00001); The positive rate of anti-CENP-B in SSc patients was higher than that in anti-SSB patients (P < 0.00001), but there was no significant difference in SS patients (P = 0.77); The positive rate of AMA in SS and SSc was significantly lower than that in ANA (P < 0.00001), but the expression of AMA increased in SS patients with autoimmune hepatitis. In patients with anti-Ro-52 positive SS and SSc associated with EBV infection, the former had a significantly increased risk of developing malignant lymphoma, while the latter had more severe symptoms of tissue fibrosis. Conclusion The accuracy of anti-Ro-52 in the diagnosis of SS and SSC is higher. The positive rate of anti-CENP-B in the diagnosis of SSc is higher than that of anti-SSB and anti-Scl-70. SS patients with EBV infection are more likely to develop into malignant lymphoma, while SSc patients with EBV infection have increased skin fibrosis and inflammation.

Concordance Study of CD30 Expression Detected By Multiple Immunohistochemistry Assays and Ventana CD30 Assay in Chinese Lymphoma Patients

Background: CD30 is emerging as an important biomarker guiding the clinical diagnosis, treatment, and evaluating the efficacy and prognosis of lymphoma. However, there is no standard procedure for specification and interpretation of the pathological detection of CD30 in China. This study intends to evaluate the staining and interpretation concordance of CD30 expression detected by the VENTANA CD30 assay and other multiple immunohistochemistry (IHC) assay in Chinese malignant lymphoma patients. Design: This is a multi-center, observational study enrolling 1,000 adult patients with a diagnosis of histologically confirmed malignant lymphoma in China. Patients, aged 18 years or older at diagnosis and who provided available formalin-fixed paraffin-embedded (FFPE) samples stored within 2 years, with diagnosis of classical Hodgkin's lymphoma, anaplastic large-cell lymphoma, large cell transformation of mycosis fungoides, diffuse large B-cell lymphoma, primary mediastinal B-cell lymphoma, extranodal NK/T-cell lymphoma, peripheral T cell lymphoma not otherwise specified, angioimmunoblastic T-cell lymphoma, and pcCD30+ T-cell lymphoproliferative disease were eligible to participate. Exclusion criteria included sample insufficiency for CD30 testing, incomplete sample information, lack of written informed consent. Methods: Each eligible patient provides an available r FFPE sample. Tissue slides obtained from each eligible FFPE sample will be stained by the VENTANA CD30 assay and at least one of the following IHC assays [umAB256 (zhongshanjinqiao) + Ventana BenchMark; Ber-H2 (Maixin) + Ventana BenchMark；Ber-H2 (Maixin) + DAKO; Ber-H2 (DAKO) + DAKO; Ber-H2 (DAKO) + Ventana BenchMark;umAB256 (Zhongshanjinqiao) + Leica; JCM182 (Leica) + Ventana BenchMark;JCM182 (Leica) + Leica; Ber-H2 (DAKO) + Leica]. CD30 expression of all immunostained slides will be independently interpreted as a percentage of CD30 positive cells by trained pathologists. The primary endpoint will be the staining concordance of percentages of positive cells for CD30 expression detected by each of the nine IHC assays and VENTANA CD30 assay (interpreted by expert panel) Secondary endpoints will be the interpretation concordance of pathologists at sites and the expert panel by assessing CD30 expression detected by various IHC assays. Both primary and secondary endpoint will be evaluated by intraclass correlation coefficient ICC, Bland-Altman, and Pearson correlation method. Discussion: This planned study will explore more equivalent testing methods to detect the expression of CD30 in Chinese patients with lymphoma. Disclosures Shi: Takeda Pharmaceuticals: Current Employment. Li: Takeda Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees, Other: Receiving lecture fees.

Application Effect and Evaluation of Two-Dimensional Speckle Tracking Imaging on Myocardial Damage in Patients with Malignant Lymphoma Treated with Anthracyclines

Objective. The purpose was to study the monitoring effect and application value of two-dimensional speckle tracking imaging (2D-STI) on myocardial function in patients with malignant lymphoma after treatment with anthracyclines. Methods. 50 patients with malignant lymphoma treated in our hospital from June 2017 to December 2019 were randomly selected and were treated with anthracyclines to compare the cardiac global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), left ventricular twist (LVtw), GLS × LVtw, and changes of atrioventricular inner diameters before and after 3 cycles of treatment. According to the pathological examination results, the accuracy of 2D-STI in the detection of changes in myocardial function of patients was also clarified. Results. The absolute values of GLS, GRS and GCS after treatment were significantly lower than those before treatment, with statistical significance (P < 0.05). The LVtw and GLS × LVtw after 3 cycles of treatment were significantly lower than those before treatment, with statistical significance (P < 0.05). There was no significant difference in the atrioventricular inner diameters of patients before and after treatment, with no statistical significance (P > 0.05). There was no significant difference between the monitoring results of 2D-STI and the pathological examination results, with no statistical significance (P > 0.05). Conclusion. Anthracyclines can cause some myocardial damage in patients with malignant lymphoma. The application of 2D-STI to monitor the changes in myocardial function of patients can give more accurate monitoring results, facilitating the early implementation of appropriate treatment.