Bleeding, Obstruction, and Perforation in a Series of Patients With Aggressive Gastric Lymphoma Treated With Primary Chemotherapy

Spectre, Galia; Libster, Diana; Grisariu, Sigal; Da’as, Nael; Yehuda, Dina Ben; Gimmon, Zvi; Paltiel, Ora

doi:10.1245/s10434-006-9069-x

Cited by 30 publications

(20 citation statements)

References 27 publications

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“…The small intestine was the most common site of perforation [53, 54]. Perforation as a result of therapy can occur shortly after treatment, usually within a few weeks, as in our patient [53, 54]. The risk of perforation from the cytotoxic agent seems to be less than that of the tumor's presence itself, but clinicians should nonetheless be cautious in treating patients with lymphoma in the GI tract.…”

Section: Discussionmentioning

confidence: 66%

“…Perforation from lymphoma involvement in the GI tract was a well-known complication, with the majority occurring as the first sign of GI involvement and not as a result of antineoplastic treatment [46, 47, 48, 49, 50, 51, 52, 53, 54]. The small intestine was the most common site of perforation [53, 54]. Perforation as a result of therapy can occur shortly after treatment, usually within a few weeks, as in our patient [53, 54].…”

Section: Discussionmentioning

confidence: 99%

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A Rare Case of Mycosis Fungoides in the Oral Cavity and Small Intestine Complicated by Perforation

et al. 2016

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Extracutaneous involvement in mycosis fungoides (MF) carries a poor prognosis. Oral and gastrointestinal (GI) tract lesions are both rare locations of disease. We describe the clinical findings of one case with oral and GI MF complicated by perforation after systemic antineoplastic treatment, and review the relevant literature. The patient had a 1-year history of MF before development of tongue and palate tumors. He was treated with local electron beam radiation, but re-presented to the hospital after what was found to be small intestine perforation following systemic antineoplastic therapy. The case reveals key insights into the progression and complications of lymphomas with GI tract involvement.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

A Rare Case of Mycosis Fungoides in the Oral Cavity and Small Intestine Complicated by Perforation

et al. 2016

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“…There are a few reports describing the features of gastric complications occurring with chemotherapy, and gastric perforation and bleeding were considered as the result of rapid tumor necrosis by response to chemotherapy . Bleeding occurred relatively early, usually around 10‐14 days after the first chemotherapy course .…”

Section: Discussionmentioning

confidence: 99%

“…The current standard therapy for DLBCL with gastric lesions (DLBCL‐GL) is six to eight cycles of R‐CHOP or three cycles of R‐CHOP followed by involved‐field radiation therapy (IFRT) for early‐stage disease. Some reports showed the outcome of primary gastric DLBCL after R‐CHOP therapy while others reported that gastric complications such as bleeding, perforation, and stenosis, occurred under chemotherapy in 0%‐26% . However, the detailed features of these gastric complications were not well documented.…”

Section: Introductionmentioning

confidence: 99%

Complications and outcomes in diffuse large B‐cell lymphoma with gastric lesions treated with R‐CHOP

et al. 2019

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Standard therapy for gastric diffuse large B‐cell lymphoma (DLBCL) is considered to be chemotherapy with or without involved‐field radiation therapy. Although R‐CHOP therapy alone is widely used for DLBCL with gastric lesions (DLBCL‐GL), the outcome and incidence of treatment‐related gastric complications following R‐CHOP are not well known. This study aimed to evaluate the outcome after R‐CHOP therapy in patients with gastric DLBCL including gastric complications and to identify risk factors for the complications. Consecutive patients with newly diagnosed DLBCL‐GL treated with R‐CHOP between 2003 and 2014 were retrospectively evaluated. DLBCL‐GL was defined only when pathologically confirmed in the stomach. Of the 96 patients with DLBCL‐GL, 63 patients were diagnosed with gastric symptoms. Eighty‐eight patients (92%) completed six to eight cycles of R‐CHOP. The complete remission (CR) rate was 86%, and 3‐year and 5‐year overall survival rates were 80% and 73%, respectively. Patients were well stratified according to the Revised International Prognostic Index (R‐IPI). Complication rate was 8% (8/96); seven patients had bleeding and three had stenosis. No patients had gastric perforation. Bleeding occurred during the first cycle of R‐CHOP in five patients (5/7, 71%). Patients with gastric complications had a lower R‐CHOP completion rate (50%, P = 0.001) and a lower CR rate (25%, P < 0.001) than those without complications. A low serum albumin level at diagnosis was the only risk factor identified for gastric complications (P = 0.001) and six of the eight patients with complications were shown to be at stage IV. Further studies of DLBCL‐GL are warranted to identify patients at high risk for gastric complications and to provide better treatment strategies.

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“…Bleeding from tumor invasion is especially common in lymphomas involving the gastrointestinal tract [146][147][148]. Other endothelial injury can be caused by radiation, infection or amyloid deposition.…”

Section: Endothelial Injurymentioning

confidence: 99%

Thrombosis and bleeding in cancer patients

Kwaan

Vicuna

2007

Oncol Rev

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It is well recognized that thrombosis and bleeding are two major complications seen in cancer patients. Recent advances in both basic and clinical observations have enhanced our understanding of the pathogenesis of both phenomena. In this article, the significance of thrombotic complications is reviewed first. This is followed by a detailed discussion of the present day concept of thrombogenesis in cancer based on Virchow's original triad of aberrant blood flow, loss of vascular integrity and altered blood components. While most cancer patients experience bleeding at some time during the course of their illness, there are special situations that increase bleeding diathesis. These include thrombocytopenia, endothelial injury, acquired hemophilia and adverse effects of drugs. Recognition of these factors will assit in the adoption of appropriate preventive and therapeutic measures.

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Bleeding, Obstruction, and Perforation in a Series of Patients With Aggressive Gastric Lymphoma Treated With Primary Chemotherapy

Cited by 30 publications

References 27 publications

A Rare Case of Mycosis Fungoides in the Oral Cavity and Small Intestine Complicated by Perforation

A Rare Case of Mycosis Fungoides in the Oral Cavity and Small Intestine Complicated by Perforation

Complications and outcomes in diffuse large B‐cell lymphoma with gastric lesions treated with R‐CHOP

Thrombosis and bleeding in cancer patients

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