0.21), stage III/ IV (17% vs 12%), any extranodal involvement (27% vs 43%, p = 0.11), any serositis (49% vs 46%), bulky disease (71% vs 75%), LDH levels >twice normal (>2x; 41% vs 39%), anemia (48% vs 42%), leukocytosis ≥10x10 9 /L (31% vs 27%), ESR ≥30 mm/h (78% vs 79%), albumin <4 g/ dL (49% vs 45%), age-adjusted IPI (aaIPI) ≥2 (39% vs 38%) (all p-values >0.40, unless otherwise stated). Among R-CHOP-treated patients 10/43 had treatment failure compared to 5/52 for R-da-EPOCH. One R-da-EPOCH patient developed early-onset acute leukemia with t(9;11) and was counted as event in event-free survival (EFS) analysis. The 2-year freedom from progression (FFP) was 89% vs 77% (p = 0.22), while the 2-year EFS was 86% vs 77% (p = 0.35). With 5 deaths recorded (4 in R-CHOP vs 1 in R-da-EPOCH; all disease related), the 3-year overall survival (OS) was 96% vs 90% (p = 0.27). Among R-CHOP-treated patients, 5 did not receive RT due to chemorefractory disease; 29/38 potentially eligible patients (76%) received RT. Among 46 R-da-EP-OCH-treated patients who had completed final resonse assessment, 5 did not receive RT due to chemorefractory disease; only 6/41 potentially eligible patients (15%) received RT (p < 0.001).
Patient: Female, 35-year-old Final Diagnosis: Succesful pregnancy Symptoms: Pain • pregnancy Medication: — Clinical Procedure: — Specialty: Hematology • Obstetrics and Gynecology Objective: Unknown etiology Background: Persistent polyclonal B cell lymphocytosis (PPBL) is a benign clinical condition, which is characterized by persistent absolute polyclonal B lymphocytosis (>4.0 K/μL), with the presence of circulating binucleated lymphocytes on the peripheral blood smear and an extra 3 chromosome long arm i(3q) in most cases. Immunophenotype reveals the polyclonal population of B cell lymphocytes with expression of CD19, CD20, and CD22 antigens, and κ and λ immunoglobulin light chains. Patients are mostly asymptomatic. Although PPBL has a benign clinical course and does not affect the survival expectancy of most patients, pregnancy seems to be extremely rare in these patients, as only 1 case reported so far. Although the real role of immunologic disorders, possibly PPBL, in recurrent pregnancy losses remains unclear, the rarity of successful pregnancy in PPBL patients could be attributed to the possible association of PPBL with infertility or recurrent miscarriages. Case Report: In the present study we present the second published case of a woman with a typical PPBL and recurrent pregnancy loss with a successful pregnancy outcome. Close clinical and laboratory monitoring in combination with the administration of thromboprophylaxis and the induction of mild immunosuppression with low-dose prednisolone may have contributed to the successful outcome of the pregnancy. Conclusions: In conclusion and taking all these findings into consideration, pregnancy in patients with PPBL seems to be extremely rare and the contribution of PPBL to the 2 previous miscarriages in our case could not be excluded.
Background: PET-scan has been evaluated in PMLBCL regarding its prognostic significance under R-CHOP and R-MACOP-B chemotherapy. Patients with clearly positive scans, and especially those with SU-Vmax ≥5 and Deauville 5-point scale (D5PS) score 5, have inferior outcomes even after consolidative radiotherapy (RT) [1,2]. However, after more intensive chemotherapy, as R-da-EPOCH, the prognostic significance of PET/CT can be modulated, since most patients with positive scans achieve durable remissions without consolidative RT, pointing out to the possibility of false-positive results [3]. Aims: To assess the clinical and prognostic significance of end-of-treatment PET (EOT-PET) in patients with PMLBCL and to evaluate the outcome of patients without subsequent RT Methods: Among 54 patients with PMLBCL treated with R-da-EPOCH in 11 Greek Centers, 45 were evaluated with EOT-PET-scan after 6 cycles. PET evaluation was pending in 5 patients, whereas no data were available in 4 patients at the time of the analysis. Results: The median follow-up from treatment initiation was 17 months. Among 45 evaluable patients, 6 had an EOT-PET D5PS of 1 (13%), 9 had D5PS 2 (20%), 13 had D5PS 3 (29%), 12 had D5PS 4 (27%) and 5 had D5PS 5 (11%). Among the 12 patients with D5PS 4, when evaluated according to the "1,4'' criterion: 8 were reviewed as D5PS score 4 (SUVmax of residual lesion >1.4xSUVmax liver ) and 4 were reclassified as D5PS score 3 (SUVmax of residual lesion <1.4xSU-Vmax liver ). Thus the frequency of D5PS score 4 was reduced from 27% to 14% (6/43) with that of D5PS score 3 increasing from 29% to 40% (17/43). Only one of the patients with D5PS scores 1-3 (28 or 62% of total) actually received RT (a patient with D5PS score 2). Among the 12 patients with D5PS score 4, 5 were irradiated (42%). The SUVmax for these 5 patients was 2.9, 3.8, 4.3, 4.5, and 6.0 (4/5 were D5PS score 4 according to the "1.4'' criterion). Two of them achieved complete metabolic remission (D5PS 1 and 2), the 3 rd continued to have D5PS score 4 after RT and 2 had no available follow-up scans post-RT. Overall, none of the 40 patients with D5PS score 1-4 developed disease progression despite the omission of consolidative RT in 34/40 (85%). In contrast, all 5 patients with D5PS score 5 either progressed or received salvage chemotherapy. Data on follow-up scans will be presented at the Meeting. Summary/Conclusion: PET/CT is a valuable tool for response assessment in PMBCL after R-da-EPOCH, greatly facilitating clinical decision making regarding further consolidative RT. In a real-life setting, RT was safely omitted in the vast majority of patients with EOT-PET D5PS scores 1-4 without even a single case of treatment failure. Patients with D5PS score 5 are rare and their handling requires further study.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.