Purpose To investigate serum vitamin D levels in patients newly diagnosed with non-Hodgkin lymphoma/diffuse large B-cell lymphoma (NHL-DLBCL), multiple myeloma (MM) and chronic lymphocytic leukemia (CLL). Patients and methods We measured serum levels of vitamin D by ELISA in 103 patients prior to initiation of treatment, of whom 37 were diagnosed with MM, 32 with CLL and 34 with NHL-DLBCL. Results Suboptimal serum vitamin D levels (<30 ng/mL) were observed in all 103 patients. In 14 patients, serum vitamin D levels were between 20 and 30 ng/mL, while all other patients had vitamin D deficiency (<20 ng/mL). Severe vitamin D deficiency (<10 ng/mL) was observed in 32.3% of NHL-DLBCL patients, 28.1% of CLL patients and 81% of MM patients. Conclusion We observed low serum vitamin D levels in the majority of patients newly diagnosed with NHL-DLBCL, CLL and MM.

Aim: &#1058;&#1086; investigate the serum levels of vitamin D in newly diagnosed patients with multiple myeloma. Patients and methods: In this study we measured the serum levels of vitamin D in 37 patients (19 women, 18 men) at a median age of 68 years and a diagnosis of MM according to the International Myeloma Working Group (IMWG) criteria. The immunoassay tests used for the quantification of 25 (OH) &ndash; Vitamin D were original ELISA kits Immundiagnostic and the measurement was done before starting the treatment. Results: Serum levels below the optimum (<30 ng/ml) were recorded in all 37 patients. The median value of vitamin D was 4.3&plusmn;6.5 mg/ml, the maximum value measured was 24.7 mg/ml, which is below the lower limit of the reference value for deficiency. Conclusions: In this study, we found extremely low serum vitamin D levels in most of the newly diagnosed MM patients.

Lung cancer is the most common neoplasia and the most common cause of cancer mortality. The condition is usually diagnosed at a locally advanced or metastatic stage, which is a bad prognostic factor. Around 40% of all oncology patients with brain metastases have lung cancer. Modern linear accelerators allow clinicians to perform radiosurgery and deliver a high radiation dose to low volume with a high dose gradient. Herein we present a 55-year-old male patient who received radiosurgery four times over three years &ndash; two times with Gamma Knife and two times with CyberKnife. Re-irradiation gives the opportunity to treat a local progression of a metastasis, which already has been irradiated. A series of control brain magnetic resonance imaging confirmed a good local control of treated lesions with no necrosis in surrounding healthy tissue or significant oedema. The neurological symptoms were completely controlled and the quality of life of the patient improved considerably. Radiosurgery is a prevalent, non-invasive, painless method of treatment with proven clinical results. It may be reused as long as it has clinical benefits to the patient.

According to statistics, the 5-year overall survival in metastatic prostate cancer is about 21 months. We present a case of a patient with castration-resistant prostate cancer with proven bone lesions 2 years after the onset of the disease and the current survival of over 9 years.

Based on observations of the link between hemostatic system and malignancy it is plausible to consider that plasma coagulation factors could serve as easily accessible markers for detection of malignant state and monitoring of cancer patients. Therefore, we hypothesized that tissue factor (TF), angiopoietin-2 (Ang-2) and soluble urokinase plasminogen activator receptor (suPAR) might perform as diagnostic and predictive biomarkers for the presence of malignancy as well as for the development of cancer-related events: metastatic progression and death. To analyze their performance TF-associated microparticle activity (MPTF), tissue factor antigen (TFAg), Ang-2 and suPAR were determined in 128 cancer patients with various cancer types receiving chemotherapy by sequential measurements (up to four times) at prespecified time points incorporated into interim and end-of-treatment analysis. MPTF activity was measured with Zymuphen MPTF kit, TFAg, suPAR and ANG-2 were quantitated by ELISA. Patients were followed up for progression free survival (PFS) from therapy initiation until occurrence of a combined event defined as either metastatic progression or death. In order to determine the predictive ability of hemostatic biomarkers for a PFS event Log-rank (Mantel-Cox) test was applied. ROC analysis was used to determine the cut off values for detection of an event, cut off values were transformed into binary variables and Kaplan-Meier curves were constructed. Cox regression analysis was applied to explore quantitatively the effect on the risk of progression. Results: Cut off values for the occurrence of an event were MPTF < 0.5 pg/ml (AUC 0.591), TFAg (√ pg/ml) > 8.28 (AUC 0.603), Ang-2 > 302.3 pg/ml (AUC 0.615) and suPAR (√ pg/ml) > 2.83. Shortened PFS was associated with decreased MPTF procoagulant activity and elevated plasma levels of TFAg, Ang-2, suPAR. As significant predictors for PFS were determined only TFAg (RR 4.57, p=0.038), Ang-2 (RR 2.138, p=0.031) and suPAR (RR 2.238, p=0.049). Conclusion: TFAg, Ang-2 and suPAR might be identified as significant adverse predictors of metastatic progression or death in cancer patients and risk is increased with elevated plasma levels. Disclosures No relevant conflicts of interest to declare.

Ionizing radiation in radiotherapy can disrupt cellular functions based on radiation type, energy, and dose. However, investigations on the effects of accelerated electrons, particularly on serotonin mediation, are limited. This study aimed to investigate changes in serotonin signal transduction (targeting 5-HT2A and 5-HT2B receptors) in gastric smooth muscle (SM) samples isolated from rats irradiated with accelerated electrons (linear accelerator Siemens Primus S/N 3561) and their effects on serotonin-induced reactions. The radiation effects were examined in samples prepared five days after the procedure. The contractile activity of smooth muscle samples was measured using an isometric method. The expression of 5-HT2A and 5-HT2B receptors was determined by immunohistochemical assay. Increased contractile reactivity to exogenous serotonin (1.10−8–1.10−4 mol/L) was observed in irradiated samples compared to controls. The expression of 5-HT2A and 5-HT2B receptors was significantly increased in the irradiated tissue. By selecting appropriate time intervals between equimolar (1.10−6 mol/L) sequential serotonin exposures, a process of desensitization associated with agonist-induced internalization was established in control samples, which was absent in irradiated samples. In conclusion, irradiation with accelerated electrons affects the agonist-induced receptor internalization of 5-HT2A and 5-HT2B receptors and increases their expression in rat gastric SM, which alters their contractile reactivity to exogenous serotonin.

We present a case of a 47-year-old woman with type 1 multiple endocrine neoplasia, primary hyperparathyroidism, insulinoma, and nonfunctioning pituitary adenoma. In July 2017, the patient was referred to the Department of Nuclear Medicine of St George University Hospital in Plovdiv for a PET/CT scan because of persistent hypoglycemic episodes and high serum insulin levels. A whole-body PET/CT examination was performed 65 min after intravenous application of 188 MBq 18F-FDG on a hybrid PET/CT scanner (Biograph mCT 64, Siemens). We detected a low metabolically active lesion 10 mm in diameter (SUVmax - 2.00), located below the left thyroid lobe suspicious for parathyroid adenoma. In the remaining scanned areas there were no PET/CT data for other areas with increased glucose metabolism with malignant characteristics that could be associated with the underlying disease.&nbsp; For further characterisation of the lesion, two months later we performed a single-isotope dual-phase 99mTc-tetrofosmin scintigraphy combined with an early SPECT technique on a SPECT gamma camera (SYMBIA E DUAL). The examination visualized a zone of hyperfixation located dorsally to the caudal portion of the left thyroid lobe associated with a hyperfunctioning parathyroid adenoma. This case allowed us to compare two nuclear medicine modalities with different equipment and radiopharmaceuticals &ndash; PET/CT with 18F-FDG and single-isotope dual-phase 99mTc-tetrofosmin scintigraphy combined with an early SPECT in one and the same patient. Different factors can explain the acquired different diagnostic information.

Since the late 1990s, when the first tyrosine kinase inhibitor (TKI) imatinib was introduced as a front-line treatment for chronic myeloid leukaemia, the disease’s course and prognosis has dramatically changed. The development of second-line and further-line more potent generations of TKI has further improved disease control and patients’ quality of life; however, during this time, many questions such as the duration of treatment, the depth of response, fertility, pregnancy, and family planning, have been raised. Recent prospective and retrospective discontinuation trials for TKI have shown encouraging results regarding the cessation of TKI treatment and maintaining complete molecular response. The authors report three cases of female patients diagnosed with chronic phase chronic myeloid leukaemia who achieved a long-term deep molecular response; had planned management during pregnancy, including regular molecular monitoring with or without INF-α; and all delivered healthy babies.