The blastic variant (BV) form of mantle cell lymphoma (MCL) is considered to be a very aggressive subtype of non-Hodgkin's lymphoma (NHL). In order to determine its clinico-biological features and response to therapy we studied 33 patients (17%) out of 187 suffering from MCL who were diagnosed with a BV of MCL. Blastic variant was diagnosed according to histopathological patterns, immunophenotyping, and bcl1 gene rearrangement and/or cyclin D1 overexpression. Three patients initially diagnosed with large cell NHL were classified as BV. Patients received front-line therapy including CHOP-like regimen or CVP (n = 29), or chlorambucil (n = 4) and CHOP or ESAP as second-line therapy. High-dose intensification with stem cell transplantation (SCT) was performed in 11 cases (autoSCT, n = 8; alloSCT, n = 3). All but two patients were in complete remission (CR) at the time of transplant (CR1, n = 5; CR2, n = 4). Clinical and biological characteristics did not differ from those of the common form of MCL. The median age was 62 years (29-80), with a sex ratio (M/F) of 2.6:1. Of the 33 patients, 66% had extranodal site involvement, 85% had an Ann Arbor stage IV, and 82% had peripheral lymphadenopathy. Circulating lymphomatous cells were seen in 48% of cases. Twelve patients (36%) entered a CR1 with a median duration of 11 months. Fifteen patients (46%) failed to respond and rapidly died of progressive disease. Second-line therapy led to a 26% (6/23) CR2 rate. Nine patients relapsed after high-dose therapy. Twenty-two of the 33 patients (66%) died of refractory or progressive disease. Median overall survival (OS) time was 14.5 months for the 33 BV patients as compared to 53 months for the 154 patients with a common form of MCL, P Ͻ0.0001. In the univariate analysis, OS was influenced by age, extranodal site involvement, circulating lymphomatous cells, and international prognosis index (IPI). In the multivariate analysis, only IPI affected OS: patients with IPI у2 had 8 months median OS as compared to 36 months median OS for patients with IPI Ͻ2, P = 0.003. Blastic variant is one of the worst forms of NHL. An improved recognition of BV of MCL is required, particularly in high-grade CD5 + NHL using immunophenotyping and bcl1 molecular study. Standard therapy using anthracycline or even high-dose intensification produce poor results and an alternative treatment should be proposed to such patients. Leukemia (2001) 15, 1785-1791.

Correspondence 1889 with cyclin D1. The cells were negative for anti-CD 10, 23, LMP1 and in situ hybridisation for Epstein-Barr virus RNA (EBERs) was also negative. A diagnosis of blastic variant of mantle cell lymphoma was made.CT scanning showed evidence of lymphomatous nodules in the lungs and a 4 cm mass at the bifurcation of the aorta, but there was no disease in the bone marrow. Her LDH was within normal limits.The patient was given one course of chemotherapy with ifosphamide, etoposide and epirubicin (IVE), but developed ifosphamideinduced encephalopathy requiring treatment with methylene blue. Her second course of chemotherapy was with mitozantrone and cytarabine. Following this, a repeat CT scan showed residual thickening of the stomach, but resolution of the lung and para-aortic disease. She received further chemotherapy with carmustine, etoposide, cytarabine and melphalan (mini-BEAM), but failed to mobilise stem cells. She relapsed aggressively 2 months after finishing chemotherapy and died.Immunosuppression has long been associated with an increased risk of lymphoma. This is thought to be due to increased susceptibility to transformation of B cells by latent infections such as EBV and human herpes 8, with defective immunosurveillance by cytotoxic lymphocytes against malignant cells.The majority of non-Hodgkin's lymphomas (both systemic and CNS) occurring in HIV-infected patients are diffuse large B cell lymphomas, although Burkitt's lymphoma and T cell lymphomas are also reported. 2 To our knowledge, the blastic variant of mantle cell lymphoma has not been previously described in the setting of HIV. As is common with HIV-related lymphoma, our first case was positive for LMP1, whereas the second case which was not related to HIV, was negative for LMP1 and EBERs.The second patient was significantly immunosuppressed over a 20-year period for treatment of autoimmune disease. There is known to be an increased incidence of non-Hodgkin's lymphoma in autoimmune diseases, including Sjogren's syndrome, rheumatoid arthrits and systemic lupus erythematosis, but again the blastic variant of mantle cell lymphoma has not been reported. [3][4][5] Both of our cases were females less than 60 years old, whereas the majority of cases

Oral ferrous sulfate supplementation is not an effective method to increase preoperative Hb in patients scheduled for hip or knee arthroplasty, and its use is associated with adverse effects.

Context. The current conventional realization of the ICRS (International Celestial Reference System) is, in the radio wavelength, the International Celestial Reference Frame 2 (ICRF2). The individual positions of the defining sources have been found to have accuracies better than 1 milliarcsecond (mas). In 2012, the European astrometric satellite Gaia will be launched. This mission will provide an astrometric catalog of an estimated number of 500 000 QSOs. The uncertainty in the coordinates is anticipated to be 200 microarcsecond (μas) for the magnitude = 20. If this were achieved, the ICRF and the Gaia related reference frame could be related with a μas accuracy. Aims. The goal of this work is both to measure the photometric variability of a set of quasars in a given field, and search wether this variability can be related to an astrometric instability characterized by a motion of the quasar photocenter. If this correlation existed for some given QSO, then it would be inadequate to materialize the Gaia extragalactic reference frame at the level of confidence required, i.e. the sub-milliarcsecond one. This should be an important result in the scope of the Gaia mission. Methods. We use QSO CCD images obtained over 4.5 years with the Canada France Hawaï Telescope (CFHT) in the framework of the CFHT-Legacy Survey (CFHT-LS). The pictures were analysed with both the SExtractor software and customised codes to perform a photometric calibration together with an astrometric one. A total of 41 QSOs in the Deep 2 field were analysed. Magnitude variations during more than 50 months are given at three different bandwiths G, R, and I. Among the set above, 5 quasars were chosen to test the ties between the postion of their centroid and their magnitude variations. For one of these 5 QSOs, the proximity of a neighbouring star allows the comparison between the PSFs. Results. We clearly show significant photometric variations reaching sometimes more than one magnitude, for a good proportion of the 41 quasars in our sample. We show that these variations often occur within a few months, and that the correlation between the photometric curves in the three bands, G, R and I is obvious. As a second important result, we show that with a reasonably high probability, photometric variations for one quasar in our sample are accompagnied by substantial modification of its PSF.

The outcome of adult patients with Philadelphia chromosome-negative acute lymphoblastic leukemia (Ph− ALL) relapsing after pediatric-inspired front-line therapy is ill known. Here 229 relapsing Ph− ALL younger adults (18–63 years) treated within the Group for Research on Adult Acute Lymphoblastic Leukemia (GRAALL)-2003/-2005 trials were considered. Salvage regimens consisted of potentially curative therapies in 194 cases, low-intensity therapies in 21, allogeneic stem cell transplant (allo-SCT) in 6 and best supportive care in 8. Overall, 77 patients received allo-SCT after relapse. The median follow-up was 3.1 years. A second complete remission (CR2) was achieved in 121 patients (53%). In multivariate analysis, only younger age <45 years (P=0.008) and CR1 duration ⩾18 months (P=0.009) predicted CR2. Overall survival (OS) at 2 and 5 years was 19.3% (14–24%) and 13.3% (8–18%), respectively. In CR2 patients, disease-free survival (DFS) at 2 and 5 years was 29.0% (21–38%) and 25% (17–33%). In multivariate analysis, CR1 duration ⩾18 months and allo-SCT after relapse were associated with longer DFS (P<0.009 and P=0.004, respectively) and longer OS (P=0.004 and P<0.0001, respectively). In conclusion, although younger adults relapsing after pediatric-inspired ALL therapies retain a poor outcome, some of them may be cured if CR1 duration ⩾18 months and if allo-SCT can be performed in CR2. New therapies are definitely needed for these patients.