Diffuse large B-cell lymphoma with MYC gene rearrangements: Current perspective on treatment of diffuse large B-cell lymphoma with MYC gene rearrangements; case series and review of the literature.

In the past decade, patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) were treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) therapy. Standard treatment is now changing as a result of deeper understanding of underlying biologic differences of such lymphomas. One of the most powerful predictors of an adverse outcome on R-CHOP therapy is the presence of a MYC gene rearrangement (MYC+ lymphoma). Determination of MYC gene rearrangement by FISH (fluorescent in situ hybridisation) has recently become a standard diagnostic procedure. In this paper, an overview of current literature on MYC function and MYC+ lymphoma patient outcome is presented. Furthermore, we present 26 patients from our tertiary referral centre who were diagnosed with MYC+ lymphoma between 2009 and 2014. In our patient series, we confirm the dismal prognosis of MYC+ lymphoma patients. Intensification of classical chemotherapy does not lead to better overall survival, justifying new treatment modalities. First line therapy should be more specifically targeted against MYC and the genes and proteins that are deregulated by MYC. To this end, the first clinical trial in which MYC+ patients will be offered targeted treatment has recently been launched.

Chlorinated organic contaminants in breast milk of New Zealand women.

Breast milk samples from 38 women in New Zealand were analyzed for organochlorine pesticides, polychlorinated biphenyls (PCBs), polychlorinated dibenzo-p-dioxins (PCDDs), and polychlorinated dibenzofurans (PCDFs) as part of a World Health Organization collaborative study of breast-milk contaminants. The women were recruited from two urban areas (Auckland and Christchurch) and two rural areas (Northland and North Canterbury) in the North and South Islands of New Zealand. The best predictor of contaminant concentrations in breast milk was found to be the age of the mother. Regional differences were found for hexachlorobenzene, dieldrin, and pp-DDE, reflecting historical use patterns. Urban-rural differences were found for several PCBs, PCDDs, and PCDFs when contaminant concentrations were calculated on a whole-milk basis. However, these differences could be attributed to variation in breast-milk fat concentrations between urban and rural mothers. Urban mothers had about 50% more breast-milk fat than rural mothers. Evidence suggests that breast-milk consumption by babies is regulated by caloric intake. Almost all of the caloric content of milk is in the fat fraction. This suggests that breast-milk contaminant levels calculated on a whole-milk basis do not necessarily reflect the relative levels of exposure of infants to these contaminants. However, the factors that influence breast-milk fat concentration deserve further study.

Imported human trichinellosis: sequential IgG4 antibody response to Trichinella spiralis.

Two out of five members of one household presented with clinical signs of trichinellosis after their return to the Netherlands. The family had consumed Trichinella-infected pork in Montenegro, formerly Yugoslavia. Serological tests were performed at 1, 2, 6, and 18 months after ingestion of the infected meat. Trichinella-specific IgM, IgG, and IgA antibodies measured in sera from symptomatic and asymptomatic patients remained positive up to 18 months after ingestion. The measured IgG4 antibody response directed to a 45 kDa Trichinella spiralis antigen also persisted 18 months after ingestion for three of the family members.