Subject(s)
Eye Neoplasms/drug therapy , Lymphoma/drug therapy , Retinal Neoplasms/drug therapy , Temozolomide/therapeutic use , Adult , Aged , Aged, 80 and over , Drug-Related Side Effects and Adverse Reactions/epidemiology , Eye Neoplasms/epidemiology , Eye Neoplasms/pathology , Female , Humans , Lymphoma/epidemiology , Lymphoma/pathology , Male , Middle Aged , Retinal Neoplasms/epidemiology , Retinal Neoplasms/pathology , Retrospective Studies , Treatment Outcome , Vitreous Body/pathologySubject(s)
Leukemia, Lymphocytic, Chronic, B-Cell/pathology , Skin Neoplasms/pathology , Skin/pathology , Adult , Aged , Aged, 80 and over , B-Lymphocytes/pathology , Female , France/epidemiology , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/epidemiology , Leukemia, Lymphocytic, Chronic, B-Cell/genetics , Male , Middle Aged , Mutation , Skin Neoplasms/epidemiology , Skin Neoplasms/genetics , Treatment OutcomeABSTRACT
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.
Subject(s)
Anemia, Sickle Cell/drug therapy , Hydroxyurea/therapeutic use , Adolescent , Adult , Anemia, Sickle Cell/complications , Antisickling Agents , Child , Drug Evaluation , Female , Follow-Up Studies , Humans , Hydroxyurea/adverse effects , Leg Ulcer/chemically induced , Male , Middle Aged , Retrospective Studies , Risk Assessment , Treatment Outcome , Young AdultABSTRACT
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.
Subject(s)
Carcinoma, Transitional Cell/diagnosis , Eye Neoplasms/secondary , Lymphoma, Large B-Cell, Diffuse/diagnosis , Lymphoma, Large B-Cell, Diffuse/pathology , Monoclonal Gammopathy of Undetermined Significance/diagnosis , Urinary Bladder Neoplasms/diagnosis , Waldenstrom Macroglobulinemia/diagnosis , Aged , Carcinoma, Transitional Cell/blood , Carcinoma, Transitional Cell/complications , Diagnosis, Differential , Eye Neoplasms/blood , Eye Neoplasms/diagnosis , Hematologic Tests , Humans , Immunoglobulin M/analysis , Immunoglobulin M/blood , Immunophenotyping , Incidental Findings , Lymphoma, Large B-Cell, Diffuse/blood , Lymphoma, Large B-Cell, Diffuse/complications , Male , Monoclonal Gammopathy of Undetermined Significance/blood , Monoclonal Gammopathy of Undetermined Significance/complications , Monoclonal Gammopathy of Undetermined Significance/pathology , Urinary Bladder Neoplasms/blood , Urinary Bladder Neoplasms/complications , Urothelium/pathology , Vision, Low/diagnosis , Vision, Low/etiology , Waldenstrom Macroglobulinemia/blood , Waldenstrom Macroglobulinemia/complications , Waldenstrom Macroglobulinemia/pathologyABSTRACT
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.