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ABSTRAKLimfoma komposit merupakan penyakit yang jarang terjadi. Limfoma komposit merupakan dua atau lebih tipe limfoma berbeda yang terjadi pada satu lokasi anatomi, baik secara bersamaan maupun sekuensial. Proses diagnostik limfoma komposit memiliki tantangan tersendiri dan sampai saat ini belum ada panduan khusus mengenai tata laksana limfoma komposit. Tulisan ini melaporkan sebuah kasus, pasien wanita 36 tahun dengan limfoma komposit yang terdiri dari limfoma Hodgkin dan limfoma non-Hodgkin yang terjadi sekuensial. ABSTRACTComposite lymphoma (CL) is a rare disease. Composite lymphoma is two or more different type of lymphoma that sequentially or simultaneously occur in one anatomical site. Making a diagnosis of CL is a challenge and there is still no guidelines about the treatment. This case report is about a 36 y.o female with CL, sequentially consisted of Hodgkin and non-Hodgkin lymphoma.

BACKGROUND In Indonesia, lung cancer is one of the most prevalent solid cancer with the highest mortality rate. However, studies to identify prognostic factors associated with mortality are lacking. Thus, this study was aimed to determine the association of histological subtypes and prognosis of advanced stage non-small-cell lung cancer (NSCLC) patients receiving chemotherapy. METHODS This study focused on a retrospective cohort consisting of 60 patients with advanced stage NSCLC and treated with chemotherapy. Patients with NSCLC stage IIIB or stage IV, age ≥18 years, and good performance status were recruited. The outcomes were one-year mortality and treatment response. Gender, age, body mass index, staging, and performance status were evaluated. Chi-square and Fisher’s exact tests were used. RESULTS Two common histological subtypes, adenocarcinoma (68.3%) and squamous cell carcinoma (31.7%), were observed among all subjects. Four patients (6.7%) died during one-year observation period. Mortality rate was higher in squamous cell carcinoma (10.5%) patients than in adenocarcinoma (4.9%). Underweight patients had higher risk of death (relative risk [RR] = 1.09, 95% confidence interval [CI] = 1.00–1.19) and disease progression (RR = 1.30, 95% CI = 1.12–1.51). In adenocarcinoma, metastasis was a risk for progressive disease (RR = 1.35, 95% CI = 1.09–1.66). In squamous cell carcinoma, men had a lower risk of disease progression (RR = 0.11, 95% CI = 0.03–0.41). CONCLUSIONS Squamous cell carcinoma had comparable one-year mortality and disease progression rate with adenocarcinoma type in advanced stage NSCLC. However, underweight patients had a higher risk of mortality and disease progression.

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The background characteristics of the patients were as follows: median age, 65 (range: 36-81); male/female ratio, 40:36; and performance status, 0-1/2-4:56/20. The clinical stages were as follows:, 49; recurrence, 20; and other, 7. The pathological diagnosis was adenocarcinoma, 62 (81.6%); squamous cell carcinoma, 8 (10.5%); and other, 6 (0.8%). A total of 29 (46.8%) patients with adenocarcinoma were positive for EGFR mutation. The median D-dimer level was 5.63 (0.2-63.3) lg/ml. A total of 48 (77.4%) patients had an onset of TE while receiving chemotherapy. Patients who received chemotherapy followed the regimens mentioned below: CDDP (11), EGFR-TKI (18), DTX (6), PD-1 antibody (5), CBDCA (4), ALK-TKI (3), and other (2). About 63.2% of patients presented with symptoms at the diagnosis of TE. Among 28 (36.8%) of the asymptomatic patients, TE was diagnosed by routine computed tomography in 11, whereas the coagulation test increased in 16. The recurrence rate of TE in the DOAC group was not different from the warfarin group (13% vs 26.4%, p ¼ 0.199), and there was no significant difference in the incidence of major bleeding events (0% vs 1.9%, p ¼ 0.507). Conclusions: The efficacy and safety of DOAC and warfarin in lung cancer patients with TE were not significantly different in both groups.Legal entity responsible for the study: The Cancer Institute Hospital of JFCR. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.