Treatment of splenic marginal zone lymphoma of the CNS with high-dose therapy and allogeneic stem cell transplantation

Abstract

Therapy of indolent lymphomas with involvement of the central nervous system (CNS) has not been standardized so far. A 42-year old male patient presented with neurological signs because of leukemic splenic marginal zone lymphoma (SMZL) manifested in bone marrow, lymph nodes and CNS. Due to the aggressiveness of the disease and the young age of the patient, an intensive immunochemotherapy followed by high-dose therapy with busulfan, thiotepa and fludarabine and subsequent unrelated allogeneic stem cell transplantation (alloSCT) was performed. The haemopoietic stem cells engrafted in time and the patient is doing well (ECOG 0) without evidence for active lymphoma three years after transplantation. Highly sensitive tests by specific quantitative real-time polymerase chain reaction for presence of lymphoma cells in blood and bone marrow indicated also a molecular remission. The reported case shows the feasibility of high-dose therapy and allogeneic stem cell transplantation in high-risk patients with CNS-involvement of indolent non-Hodgkin’s lymphoma. In addition, the case supports the hypothesis that the graft-versus lymphoma effect after alloSCT is also active within the CNS.

Computational fluid dynamics simulation of airflow in the trachea and main bronchi for the subjects with left pulmonary artery sling

“…CFD results have shown to be consistent with the PFTs for the study of the alternation of the airflow before and after trachea-bronchial stent placements [15]. It is suggested that CFD may offer an important approach to assess the pulmonary function for the patients unsuitable for PFTs.…”

“…The pressure drop is only 0.68 Pa for the healthy infant, which is close to the 0.70 ± 0.41 Pa for the healthy adult [15]. Even for the airway 17 generations deep in a healthy adult, the pressure drop is only 50.0 Pa while the flow rate is 28.3 L/min [26].…”

Central nervous system involvement in primary bone marrow or splenic marginal zone lymphoma: Report of two cases and review of the literature

“…Regarding SMZL, there are only 5 cases with secondary CNS disease in the literature up‐to‐date, rising the number of such cases to seven, including ours, as shown on Table . In all instances, CNS symptoms were the trigger for diagnosis of systemic disease.…”

Quantification of tissue‐engineered trachea performance with computational fluid dynamics

“…Historically, CFD has been used to describe airflow in upper airway reconstructive surgery, as well as for modeling fluid flow through blood vessels 4,22–24 . Previous work has shown that CFD has the potential for use in evaluating treatment planning for airway interventions 4,25–27 . CFD allows for advanced diagnostic capabilities and is especially useful in cases involving multi-level or complex pathology.…”