Asunto(s)
Neoplasias del Ojo/tratamiento farmacológico , Linfoma/tratamiento farmacológico , Neoplasias de la Retina/tratamiento farmacológico , Temozolomida/uso terapéutico , Adulto , Anciano , Anciano de 80 o más Años , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Neoplasias del Ojo/epidemiología , Neoplasias del Ojo/patología , Femenino , Humanos , Linfoma/epidemiología , Linfoma/patología , Masculino , Persona de Mediana Edad , Neoplasias de la Retina/epidemiología , Neoplasias de la Retina/patología , Estudios Retrospectivos , Resultado del Tratamiento , Cuerpo Vítreo/patologíaAsunto(s)
Leucemia Linfocítica Crónica de Células B/patología , Neoplasias Cutáneas/patología , Piel/patología , Adulto , Anciano , Anciano de 80 o más Años , Linfocitos B/patología , Femenino , Francia/epidemiología , Humanos , Leucemia Linfocítica Crónica de Células B/epidemiología , Leucemia Linfocítica Crónica de Células B/genética , Masculino , Persona de Mediana Edad , Mutación , Neoplasias Cutáneas/epidemiología , Neoplasias Cutáneas/genética , Resultado del TratamientoRESUMEN
Hydroxyurea-derived clinical and biological benefits and safety were retrospectively studied for 123 adult patients from 2 sickle cell disease referral centers during a total follow-up of 654 patient-years and total hydroxyurea exposure of 549 patient-years. Fifty-six adverse events occurred (incidence: 12%/patient-year), with leg ulcers being the most frequent. Adverse events could arise at any time and were usually reversible. No malignancy was observed. Clinical and biological benefits of our cohort were similar to those previously reported. Based on this relatively long retrospective study, the risk/benefit ratio for moderate hydroxyurea doses was satisfactory.
Asunto(s)
Anemia de Células Falciformes/tratamiento farmacológico , Hidroxiurea/uso terapéutico , Adolescente , Adulto , Anemia de Células Falciformes/complicaciones , Antidrepanocíticos , Niño , Evaluación de Medicamentos , Femenino , Estudios de Seguimiento , Humanos , Hidroxiurea/efectos adversos , Úlcera de la Pierna/inducido químicamente , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Medición de Riesgo , Resultado del Tratamiento , Adulto JovenRESUMEN
We report the case of a man with a primary diagnosis of Waldenström macroglobulinemia. He secondarily presented a diffuse large B cell lymphoma (DLBCL) located in the nasal fossae, which relapsed later in the eye. The diagnosis of these two malignancies is based on a multidisciplinary biological approach using new sensitive and specific techniques. These techniques revealed that the two diseases harbor different B cell clones, indicating a distinct origin. This observation highlights the importance of targeted biological techniques for the diagnosis of these two rare hemopathies. It also shows that it is possible to prove the independent nature of the two tumor clones, thus allowing optimized therapeutic management.
Asunto(s)
Carcinoma de Células Transicionales/diagnóstico , Neoplasias del Ojo/secundario , Linfoma de Células B Grandes Difuso/diagnóstico , Linfoma de Células B Grandes Difuso/patología , Gammopatía Monoclonal de Relevancia Indeterminada/diagnóstico , Neoplasias de la Vejiga Urinaria/diagnóstico , Macroglobulinemia de Waldenström/diagnóstico , Anciano , Carcinoma de Células Transicionales/sangre , Carcinoma de Células Transicionales/complicaciones , Diagnóstico Diferencial , Neoplasias del Ojo/sangre , Neoplasias del Ojo/diagnóstico , Pruebas Hematológicas , Humanos , Inmunoglobulina M/análisis , Inmunoglobulina M/sangre , Inmunofenotipificación , Hallazgos Incidentales , Linfoma de Células B Grandes Difuso/sangre , Linfoma de Células B Grandes Difuso/complicaciones , Masculino , Gammopatía Monoclonal de Relevancia Indeterminada/sangre , Gammopatía Monoclonal de Relevancia Indeterminada/complicaciones , Gammopatía Monoclonal de Relevancia Indeterminada/patología , Neoplasias de la Vejiga Urinaria/sangre , Neoplasias de la Vejiga Urinaria/complicaciones , Urotelio/patología , Baja Visión/diagnóstico , Baja Visión/etiología , Macroglobulinemia de Waldenström/sangre , Macroglobulinemia de Waldenström/complicaciones , Macroglobulinemia de Waldenström/patologíaRESUMEN
The different types of drug resistance encountered in chronic lymphocytic leukemia (CLL) cannot be fully accounted for by the 17p deletion (and/or TP53 mutation), a complex karyotype (CK), immunoglobulin heavy-chain variable region genes (IGHV) status and gene mutations. Hence, we sought to assess the associations between recurrent genomic abnormalities in CLL and the disease's development and outcome. To this end, we analyzed 64 samples from patients with CLL and gain of the short arm of chromosome 2 (2p+), which is frequent in late-stage and relapsed/refractory CLL. We found that fludarabine/cyclophosphamide/rituximab (a common first-line treatment in CLL) is not effective in removing the 2p+ clone - even in samples lacking a CK, the 17p deletion or unmutated IGHV. Our results suggest strongly that patients with CLL should be screened for 2p+ (using karyotyping and fluorescence in situ hybridization) before a treatment option is chosen. Longer follow-up is now required to evaluate bendamustine-rituximab, ibrutinib, and idelalisib-rituximab treatments.