Kidney involvement is an under-recognized complication of non-Hodgkin lymphomas. They occur in a variety of mechanisms and differ widely in their clinical presentation. We take this opportunity to report a case of a 65 year-old man who developed a rapidly progressive glomerulonephritis within days after completing his first cycle of R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, Prednisolone) chemotherapy for newly diagnosed mantle cell lymphoma. He was odematous, hypertensive, oliguric with nephrotic range proteinuria and an active urine sediment. A renal biopsy showed a crescentic C3 glomerulonephritis (C3GN) with no evidence endocapillary or mesangial hypercellularity. He was promptly treated with immunosuppression and dialysis, with resumption of his chemotherapy. Genetic testing on complement proteins revealed a homozygous deletion spanning the CFHR1 and CFHR3 genes. Crescentic C3GN is a rare form of kidney injury, and this is the first known case of lymphoma-associated kidney involvement manifesting as C3GN. This article explores the possible mechanism of disease and reviews the literature of lymphoma-related kidney disease.

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Introduction: Thromboembolism (TE) is common and one of major causes of morbidity and mortality in patients with malignancy. The neutrophil to lymphocyte ratio (NLR) and the platelet to lymphocyte ratio (PLR) are biomarkers for systemic inflammation. Principal advantage of NLR and PLR is their modest computability from complete blood count (CBC). Several publications showed predictive strength of high NRL for development of venous thromboembolism (VTE) in cancer patients receiving chemotherapy. However, the prognostic values of the NLR and PLR in patients with lymphoma have not been elucidated. We aimed to investigate the association between NLR, PLR and future risk of TE, in a prospective cohort of lymphoma patients receiving chemotherapy.Methods: A total of 484 patients who were diagnosed with lymphoma (including non-Hodgkin and Hodgkin lymphoma; excluding chronic lymphocytic leukemia/small lymphocytic lymphoma) at the Clinic for Hematology, Clinical Centre of Serbia, were prospectively included in the study. Data for newly diagnosed and relapsed patients who had completed a minimum of one chemotherapy cycle were collected for all venous and arterial TE events from time of diagnosis to 3 months after the last cycle of therapy. NLR and PLR were calculated according to the CBC. TE was diagnosed objectively based on radiographic studies, clinical examination, and laboratory evaluation. Logistic regression analysis and ROC curve were performed to assess the association of NLR and PLR with TE. Results: The mean patients' age was 53 years (range, 18-89 years); 52.3% were males. Most patients were newly diagnosed and had advanced stage disease: Ann Arbor stage III 21.1% and stage IV, 42.5%. A total of 242 patients (50.0%) had high-grade NHL; 137 (28.3%) had low-grade NHL; 84 (17.4%) had HL; 21 (4.3%) had Background: B-cell non-Hodgkin lymphomas (B-NHL) are frequently characterised by deregulation of the B-cell leukaemia/lymphoma-2 (BCL2) family of anti-apoptotic proteins. Venetoclax is a BCL2-specific inhibitor approved for chronic lymphocytic leukemia (CLL), with activity in other B-cell malignancies in small cohorts. Venetoclax has been available for patients (pts) with relapsed/refractory B-NHL via the Abbvie compassionate access scheme or as off label treatment, however data regarding effectiveness in this setting are scarce. Methods: We performed a multicentre, international, retrospective study of the clinical outcomes and safety of pts with B-NHL (excluding CLL) who received venetoclax either as monotherapy or as combination treatment in Australia or Denmark between 7/2016 and 12/2018. Results: The baseline characteristics of the 24 eligible pts are summarised in the table (Figure 1a). Target daily dose varied from 400-1200mg and was reached in 77%. Among all pts, the objective response rate (ORR) was 35%, clinical benefit rate (SD/PR/CR) 65% and CR rate 8%; one patient each with MCL and transformed follicular lymphoma. The Waldenstrom macroglobulinaemia patient ABSTRACT 535 achieved a MR with monotherapy, impr...

Objective: This study was conducted to investigate the microbial spectrum, outcome and catheter management in febrile neutropenic acute leukemia patients with long-term central venous access, at a single center in Kuwait. Methods: One hundred and thirty-three febrile neutropenic episodes in 64 adult acute leukemia patients with long-term central venous access encountered at the Kuwait Cancer Control Centre were studied. The frequency of clinically documented infections, microbiologically documented infections, fevers of unknown origin and catheter-related infection was determined. Response to treatment and the need for catheter removal were studied. Results: In the 133 febrile neutropenic episodes, clinically documented infections, microbiologically documented infections and fever of unknown origin occurred in 12.8, 30.8 and 56.4%, respectively. Thirty-two episodes of catheter-related infections were encountered. Gram-positive and gram-negative infections occurred in equal frequency. Escherichia coli and methicillin-resistant Staphylococcus aureus were the most frequent organisms. Of all episodes, 87.2% responded to antibiotics and 11 episodes required removal of the catheter. Of the clinically documented infections, 76.5% of the episodes responded to treatment without catheter removal. Of the microbiologically documented episodes, 68.3% were treated successfully without removal of the catheter. One hundred percent of the episodes of fever of unknown origin responded to a broad spectrum of antibiotics, without catheter removal. Conclusion: Gram-negative and gram-positive infections occur in equal frequency in febrile neutropenic acute leukemia patients with long-term central venous catheters. E. coli and methicillin-resistant S. aureus are the most frequent organisms and the majority of the episodes are curable by antimicrobial therapy without the removal of the catheter.