RESUMEN
PURPOSE OF REVIEW: This review will discuss the most recent literature regarding frontline therapy, treatment of patients not eligible for intensive chemotherapy, and novel agents for relapsed/refractory patients with mantle cell lymphoma (MCL). RECENT FINDINGS: Longer follow-up of previously studied intensive regimens still demonstrates encouraging results, but late relapses are still evident. Consolidation and maintenance strategies continue to be attractive options to be explored in this disease that is characterized by frequent relapses and short remissions. The combination of bendamustine-rituximab was demonstrated to be noninferior and less toxic to R-CHOP and should be considered the new standard of care for elderly patients. Multiple novel agents directed towards different molecular targets like BTK, mTOR, PI3K, HDAC, and BCL-2, involved in the pathogenesis of MCL have shown promising results. SUMMARY: Management of MCL still represents a challenge due to heterogeneity of the disease. As we approach the molecular era of oncology, future strategies should focus on combination of newer agents with known effective regimens to improve outcome.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Linfoma de Células del Manto/tratamiento farmacológico , Terapia Molecular Dirigida/métodos , Recurrencia Local de Neoplasia/tratamiento farmacológico , Terapia Recuperativa , Adolescente , Adulto , Anciano , Inhibidores de la Angiogénesis/administración & dosificación , Anticuerpos Monoclonales de Origen Murino/administración & dosificación , Clorhidrato de Bendamustina , Niño , Femenino , Humanos , Lenalidomida , Linfoma de Células del Manto/mortalidad , Linfoma de Células del Manto/patología , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/mortalidad , Compuestos de Mostaza Nitrogenada/administración & dosificación , Selección de Paciente , Fosfatidilinositol 3-Quinasas/administración & dosificación , Pronóstico , Rituximab , Talidomida/administración & dosificación , Talidomida/análogos & derivados , Resultado del TratamientoRESUMEN
Patients with systemic lupus erythematosus (SLE) may develop thrombotic thrombocytopaenic purpura (TTP) or TTP-like illness manifested by microangiopathic haemolytic anaemia (MAHA) and thrombocytopaenia. The distinction between active SLE and TTP is difficult because these entities share similar clinical features. Drug-induced TTP caused by an immune-mediated reaction have been documented for several drugs. Herein, we report a middle-aged Hispanic woman with long-standing SLE, who developed a TTP-like illness characterised by MAHA and thrombocytopaenia after exposure to nitrofurantoin. The patient responded well to plasmapheresis and immunosuppressive therapy and has remained clinically stable after 18 months of follow-up. To our knowledge, this is the first case that reports the association between nitrofurantoin and a TTP-like presentation.