Epidemiological, clinical and therapeutic profiles of mantle cell lymphoma cared for in a Moroccan center: a review of 14 cases.

Mantle cell lymphoma (MCL) accounts for 3-10% of non-Hodgkin's lymphomas (NHL). We identified 14 patients with mantle cell lymphoma, with an average number of 3.5 new cases/year. A male predominance was observed with a sex ratio equal to 6. The average age of our patients was 64.4±14.1 years, with an average diagnostic delay of 6.57 months. Regarding the clinical presentation, adenopathy was the most reported physical sign (78.6%) followed by B symptoms (57.1%). Disseminated stages were the most frequent in our series: stages IV (78.5%) and III (7.1%) versus stages I (0%) and II (7.1%). The extra-ganglionic localizations observed were hepatic 5 cases (31.1%), pulmonary 04 cases (25%), medullary 4 cases (25%), pleural 2 cases (12.5%) and prostate 1 case (6.2%). All diagnosed cases are mantle cell lymphomas, of which 12 cases (85.7%) are classical and 2 cases (14.3%) indolent. The high-risk group is, according to international prognostic index (MIPI) MCL prognostic score, the most represented in our series: 0-3 = 6 cases (42.9%), 6-11 = 8 cases (57.1%). The therapeutic protocol chosen 1st line: 9 patients treated with R-DHAP, three with R-CHOP, one with DHAOX and one with R-CVP. Second line: two patients treated with R-DHAP, one after R-CHOP and the other after R-CVP. Two patients received autologous hematopoietic stem cell transplant at the end of the treatment. The evolution was marked by the death of 7 patients, 3 lost to follow-up and 4 still followed. Additionally, the study highlights characteristics and treatment patterns of mantle cell lymphoma, emphasizing its predominance in males, delayed diagnosis, frequent dissemination, and high-risk classification, with chemotherapy as the primary treatment modality and a challenging prognosis contributing to a comprehensive understanding of mantle cell lymphoma presentation and management.

[Evaluation of training in transfusion safety offered to medical students in Morocco]. / Evaluation d´une formation en sécurité transfusionnelle auprès des étudiants en médecine au Maroc.

Introduction: students worldwide receive little training on blood transfusion therapies during their time at medical schools and hospitals, then reformulation of academic programs is mandatory. Indications for blood transfusions are more frequent than recommended, which helps to increase the risks associated with this procedure. To overcome this, structured objective training on nursing care and procedures was organised with the topic of transfusion safety. The purpose of our study was to assess medical students´ appreciation of this training and the degree to which this population had mastered it. Methods: we conducted a cross-sectional, descriptive, single-centre study. We conducted a survey among the 3rd-year medical students. A self-administered assessment questionnaire, as well as an evaluation grid for acquired skills, filled in by the training doctors during the session, were used. Data analysis was based on descriptive statistics using Excel software. Results: three hundred and eighty-four (n=384) students were invited to attend this training course, 275 (71.6%) of whom were enrolled in the study. The overall satisfaction rate was 93.8%. The objectives and organisation were 95.6% successful. The quality of the training was 90.3% satisfactory. The choice of topic for the station was satisfactory for 80% of participants, the flow of the session for 86.3%, the quality of the organisation and debriefing for 89%, the interaction between trainers and learners for 90.2%, the motivation of trainers and the reflection stimulated in the learners for 92%. We noted that 93% of students had never participated in training in transfusion safety. Mastery of global skills was total for 67%, partial for 26% and absent for 7%. The students mastered the procedures for checking the identity and grouping of the product to be transfused at 97%, the principle of interpreting the ultimate pre-transfusion test (96%), the purpose of ultimate test at the patient´s bedside 93% with mastery of its technical implementation 83%. Conclusion: training in transfusion safety was well received, with a satisfactory level of proficiency. This experience can easily be extended to other topics.

An unusual presentation of subcutaneous panniculitis-like T-cell lymphoma: Extensive necrosis and hemophagocytic lymphohistiocytosis: A case report.

Key Clinical message: Subcutaneous panniculitis-like T-cell lymphoma, a primary cutaneous lymphoma, which is described as following a slow course, could claim life. The occurrence of facial and breast nodules, the association with hemophagocytic lymphohistiocytosis, and the extent of necrosis and ulceration are signs of its aggressive nature needing early diagnosis and prompt treatment. Abstract: Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare skin disease that accounts for <1% of all peripheral T-cell lymphomas. It is described as following a slow and gradual process. However, it can be associated with a variety of clinical symptoms ranging from mild to severe. Hemophagocytic lymphohistiocytosis (HLH), a rare and potentially fatal hematologic factor that complicates SPTCL in 20% of cases, is an important prognostic factor. We report here an aggressive case of disseminated SPTCL with HLH involving a young woman who presented with extensive necrosis and ulceration at diagnosis. The report highlights the aggressive course of the disease, the occurrence of facial and breast nodules, the association with HLH, and the extent of necrosis and ulceration. The report highlights the poor prognosis despite polychemotherapy regimen use.

Intravascular Large B-Cell Lymphoma.

Intravascular large B-cell lymphoma (IVBCL) is a very rare and aggressive subtype of extranodal diffuse large B-cell lymphoma (DLBCL) involving the growth of lymphoma cells within blood vessels of all organ types. We present the case of a 55-year-old North-African man with no prior history of neoplastic disease presenting with weight loss and an isolated splenomegaly. Investigations led to the diagnosis of this disease. To the best of our knowledge, this is the first case recorded in Africa. Through this article, we discuss this case and outline the common presentation, paraclinical investigations, and treatment options of IVBCL.

Prolonged SARS-CoV-2 infection during autologous hematopoietic stem cell transplantation from Hodgkin's lymphoma: a case report.

Autologous hematopoietic stem cell transplantation (HSCT) for relapsed Hodgkin's lymphoma increases the risk of infection by using intensive chemotherapy. This risk is obviously ongoing given the increased virulence of severe COVID-19. We report a case of a young man with Hodgkin's lymphoma who received conditioning chemotherapy followed by autologous HSCT and tested positive for SARS-CoV-2 by polymerase chain reaction (PCR) during the early phase of aplasia with persistence of COVID-19 beyond 30 days with favorable follow-up and clinical improvement on treatment. For this type of patient with hematologic malignancy, viral infection can be fatal and strict medical precautions with isolation rules must be maintained, especially for SARS-CoV-2.

[Cardiac tamponade as first manifestation of multiple myeloma : A case report with literature review]. / Tamponnade cardiaque : première manifestation du myélome multiple : à propos d'un cas et revue de la littérature.

Multiple myeloma is a hematologic malignancy characterized by clonal proliferation of plasma cells, mainly in bone marrow. Extramedullary disease is reported in many cases and may occur at diagnosis, at progression, or during relapse phase. Pericardial involvement is a rare condition that usually occurs with advanced-stage disease. We report a rare case of 76-year-old women with plasma cell-based pericardial effusion with cardiac tamponade as a form of presentation of multiple myeloma and discuss it in the light of literature. Diagnosis was established by pericardial fluid cytology. The patient received systemic chemotherapy, according to MPT protocol.

Esophageal Plasmacytoma Revealed by Persistent Hiccups: A Case Report and Literature Review.

INTRODUCTION: Solitary extramedullary plasmacytoma (SEP) is a rare neoplasm that is derived from monoclonal proliferation of plasma cells in the soft tissues or organs arising outside the bone marrow. It is present in about 3% of all plasma cell tumors and originates mainly from the upper respiratory tract and nasopharynx. Involvement of the esophagus is exceptionally seen in cases of SEP. Case Presentation. We report a novel case of a 74-year-old male patient attended with a 6-month history of hiccupping further associated with dysphasia and weight loss all caused by esophageal plasmacytoma. Histological and immunohistochemical examination of the tumor confirmed the diagnosis of plasmacytoma. Workup for the multiple myeloma came out to be negative, thus confirming the diagnosis of SEP. The patient was treated with radiotherapy alone, leading to complete remission (at 30 months of follow-up). CONCLUSION: Esophageal plasmacytoma, an exceptional presentation of extramedullary plasmacytoma, should be kept in mind while dealing with patients presenting with intractable hiccups.

[Activity report of the Bone Marrow Transplant Department of the Mohammed VI University Hospital, Marrakech, Morocco, over the period 2012- 2018]. / Bilan d'activité de l'unité de greffe de moelle osseuse du Centre Hospitalier Universitaire Mohamed VI de Marrakech, Maroc: 2012-2018.

INTRODUCTION: hematopoietic stem cell transplantation (HSCT) is part of the cellular immunotherapy arsenal. It is used in the treatment of several malignant and non-malignant hematological conditions as well as other extra-hematological diseases. HSCT has been described since 1950 and introduced in Morocco since the 2000s. GSCH is still little used in our context due to several legal, financial and organizational barriers. The purpose of this study is to report the experience of the Bone Marrow Transplant Department of the Marrakech's Mohammed VI University Hospital with hematopoietic stem cell transplantation, is one of the Hospital Departments in developing countries. METHODS: we carried out a descriptive retrospective study over a period of 6 years. RESULTS: during the study period, sixty-six HSCT were performed. Multiple myeloma was the main indication for HSCT in our case series (30 patients with autografts). In our case series, mortality rate was around 20%, relapse rate was 23% while complications rate was 38%. Despite the challenges, our results were encouraging during the long follow-up period. CONCLUSION: efforts still need to be made to improve therapy results.

Neutropenic Enterocolitis Disclosing an Underlying Cyclic Neutropenia.

Neutropenic enterocolitis is a syndrome characterized by fever and abdominal pain in a neutropenic patient. It is often reported in children treated for leukemia and rarely reported in patients with other diseases. Herein, we report the case of a 9-year-old patient with a medical history of recurrent fever and mouth ulcers since the age of 4, who presented with neutropenic enterocolitis complicated with intestinal perforation which all leaded to disclose cyclic neutropenia. The patient was successfully treated by aggressive supportive care combined with surgical intervention. Neutropenic enterocolitis with possible complications should be considered and promptly managed in every neutropenic patient and may reveal a rare cause of neutropenia as cyclic neutropenia.