The Effect of FcγRIIIA Gene Polymorphism on the Treatment of Diffuse Large B-cell Non-Hodgkin Lymphoma: A Multicenter Prospective Observational Study.

OBJECTIVE: The curative treatment approach for diffuse large B-cell lymphoma (DLBCL) is controversial even in the rituximab (R) era. The aim of this study was to examine the FcγRIIIA gene polymorphism distribution of DLBCL patients who had been treated with R-CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy. Furthermore, we investigated the impact of FcγRIIIA gene polymorphism on the overall response rate (ORR) and overall survival (OS). MATERIALS AND METHODS: Patients from 3 centers in the Aegean region of Turkey who had newly diagnosed CD20-positive DLBCL were enrolled in the study. The single nucleotide polymorphisms of the FcγRIIIA gene were analyzed by real time-PCR. The response to treatment was determined in the middle and at the end of the protocol. During 2 years of follow-up, the patients were clinically and radiologically evaluated for disease status every 3 months. RESULTS: Thirty-six patients were included in the study and the distributions of F/F, V/F, and V/V types of alleles of FcγRIIIA were 25%, 50%, and 25%, respectively. Twenty-seven patients were considered as evaluable according to ORR and OS. The patients' ORR was 87.5%, 100%, and 50% in the F/F, V/F, and V/V allele groups, respectively. We did not establish any statistically significant differences among the 3 alleles groups in respect to ORR (p=0.93). The OS within 2 years in the F/F, V/F, and V/V allele groups was 62.5%, 100%, and 100%, respectively. The OS in the F/F allele group was found to be lower than in the other 2 allele groups (p=0.01). CONCLUSION: The distribution of gene polymorphisms in our study group was similar to those of previous studies. While ORR was similar between the groups, our results highlight a lower OS in F/F patients compared to other allele groups of FcγRIIIA.

Successful management of imatinib despite alopecia and nail necrosis.

Imatinib mesylate selectively inhibits bcr/abl and other non-specific tyrosine kinases, such as c-kit and platelet derived growth factor (PDGF) receptor and successfully used to treat chronic myeloid leukaemia (CML). In most cases, the drug is well tolerated: however, side effects can be seen. Hair loss and paronychia inflammation were often reported with Imatinib, but total alopecia was rarely mentioned. We report a CML patient who was presented with alopecia and paronychia inflammation probably induced by imatinib therapy. We have successfully treated our patient by cessation and then re-applying therapy with lower doses after improvement of lesions and have not found a similar report in literature.

Use of cytarabine and idarubicin in a newly diagnosed AML patient with a severe wound.

Acute myeloid leukemia (AML) is malignant tumor of haemopoietic precursor cells of non-lymphoid lineage. AML can atypically present with non-spesific cutaneous lesions or wounds. There are rare acute leukemia cases which present with genital ulcerations or pyoderma gangrenosum in the literature. The effect of acute leukemia on wound healing is not known, but it is thought that cytopenias and chemotherapy can impair wound healing in patients with leukemia. The effects of chemotherapeutic agents on wound healing are arguable. Here we present wound care strategies and simultaneously applied chemotherapy in an AML patient.

Brucellosis: a rare cause of febrile neutropenia in acute myeloblastic leukemia.

Brucellosis is a zoonotic disease and endemically seen in the Middle East, Eastern Europe and continental America. Febrile neutropenia related to Brucellosis has been reported only in a few cases. Brucella was cultured from the bone marrow of a 42-year-old woman who was admitted to hospital with symptoms of fever and fatigue and later diagnosed as acute myeloblastic leukemia (AML). The patient was treated for both AML and Brucellosis without any problems and discharged from the hospital after scheduling her follow-up visits. Brucellosis might be considered in the etiology of febrile neutropenia in endemic regions and must be treated effectively to prevent possible morbidity and mortality during or after chemotherapy.

Factors influencing engraftment in autologous peripheral hematopoetic stem cell transplantation (PBSCT).

Autologous peripheral blood stem cells transplantation (PBSCT) is a therapeutic option which can be used in various hematological neoplastic disorders; and it can prolong disease free survival and total survival and at times it may be curative. In this study, we investigated variables influencing PBSCT in 91 patients who had undergone PBSCT between 1998 and 2002 in our center, retrospectively. PBSC collection was performed after mobilization with G-CSF or chemotherapy plus growth factor. Only high dose chemotherapy was used for conditioning regimes. The median number of CD34+ was 11.5 x 10(6)/kg. Posttransplant neutrophil engraftment (>500/microL) was requiring a median of 10 days, it was 13 days for platelet engraftment (>20,000/microL). For neutrophil and platelet engraftment, we investigated; sex, age, diagnosis and CD34+ cells, the time interval between diagnosis and transplantation, number of apheresis, conditioning regime, growth factor initiation day as independent variables. In univariate analysis CD34+ cell number (>10 x 10(6)/kg), time interval more than one year between diagnosis and transplantation and BEAM conditioning was found to be significant for neutrophil engraftment. But in multivariate analysis none of them was found to be significant. For platelet engraftment in univariate analysis CD34+ cell number (>7 x 10(6)/kg), primary diagnosis of multiple myeloma initiation day of growth factor (>2 day) was found to be significant. In multivariate analyses only CD34+ cell count was found to be significant (p=0.005). In conclusion, as in previous studies we found that the only predictor of engraftment kinetics was CD34+ cell count.

WITHDRAWN: Factors influencing engraftment in autologous peripheral hematopoetic stem cell transplantation (PBSCT).

The Publisher regrets that this article was an accidental duplication of an article that has already been published in Transfus Apher Sci, 36 (1) 23 - 29, doi:10.1016/j.transci.2006.08.009. The duplicate article has therefore been withdrawn.