Liver disease induced by radioembolization of liver tumors

Abstract

Primary plasma cell leukemia (pPCL) is a rare, yet aggressive form of de novo plasma cell tumor, distinct from secondary PCL (sPCL) which represents a leukemic transformation of pre‐existing multiple myeloma (MM). Herein, we performed a comprehensive molecular analysis of a prospective series of pPCLs by means of FISH, single nucleotide polymorphism (SNP) array and gene expression profiling (GEP). IGH@ translocations were identified in 87% of pPCL cases, with prevalence of t(11;14) (40%) and t(14;16) (30.5%), whereas the most frequent numerical alterations involved 1p (38%), 1q (48%), 6q (29%), 8p (42%), 13q (74%), 14q (71%), 16q (53%), and 17p (35%). We identified a minimal biallelic deletion (1.5 Mb) in 8p21.2 encompassing the PPP2R2A gene, belonging to a family of putative tumor suppressors and found to be significantly down‐regulated in deleted cases. Mutations of TP53 were identified in four cases, all but one associated with a monoallelic deletion of the gene, whereas activating mutations of the BRAF oncogene occurred in one case and were absent in N‐ and K‐RAS. To evaluate the influence of allelic imbalances in transcriptional expression we performed an integrated genomic analysis with GEP data, showing a significant dosage effect of genes involved in transcription, translation, methyltransferase activity, apoptosis as well as Wnt and NF‐kB signaling pathways. Overall, we provide a compendium of genomic alterations in a prospective series of pPCLs which may contribute to improve our understanding of the pathogenesis of this aggressive form of plasma cell dyscrasia and the mechanisms of tumor progression in MM. Am. J. Hematol. 2013. © 2012 Wiley Periodicals, Inc.

A review of 3D image-based dosimetry, technical considerations and emerging perspectives in 90Y microsphere therapy

“…Their results provide reasoning to the D NL threshold noted in other clinical studies of 70 Gy using GMS [44] and approximately 40-50 Gy using RMS [13,45]. It should be noted that although no toxicity was noted with absorbed doses of up to 100 Gy [46], the manufacturer of RMS recommends a D NL of 80 Gy, and a recent summary suggests a preferable D NL of 50 Gy [29].…”

Yttrium-90 radioembolization for the treatment of chemorefractory colorectal liver metastases: Technical results, clinical outcome and factors potentially influencing survival

“…This index takes values between 0.5 (discriminator no better than random) and 1 (perfect discrimination). Interpretation is similar to the area under the curve (AUC) or C-index for binary responses, indicating the probability that the predictions for a random pair of subjects are concordant with their outcomes [17].…”

The dosimetric importance of the number of 90Y microspheres in liver transarterial radioembolization (TARE)

“…Crudely speaking, the lower number of glass spheres gives a less uniform irradiation, which is associated with reduced toxicity, which makes tolerable a three times higher mean parenchyma absorbed dose. This argument and calculation explains why clinical studies have shown that higher mean absorbed doses can be tolerated with glass microspheres than with resin microspheres (70 Gy averaged over the whole non tumoral liver in Child A HCC patients for glass microspheres [19], versus about 40 Gy for resin microspheres [20][21][22][23]). …”