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1.
J Clin Exp Hematop ; 60(1): 7-10, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32224564

RESUMEN

Successful treatment of indolent T-cell lymphoproliferative disorder of the gastrointestinal tract (ITLPDGI) by chemotherapy is rare and watchful waiting is often performed for asymptomatic patients. We report a case of ITLPDGI successfully treated by involved field radiotherapy (IFRT). The patient presented with slow ITLPDGI localised to the stomach with mild symptoms. IFRT (30 Gy/20f) was administered, after which endoscopy revealed resolution of lesions and blood vessel appearance, and absence of proliferating abnormal lymphocytes was confirmed by biopsy. The patient remains lymphoma-free 1 year post-treatment. Although long-term follow-up and additional cases are essential for the evaluation of IFRT as a treatment option for localised ITLPDGL, complete remission after relatively low-dose IFRT is promising, particularly as this has been rarely achieved by chemotherapy.


Asunto(s)
Trastornos Linfoproliferativos/radioterapia , Neoplasias Gástricas/radioterapia , Anciano , Femenino , Humanos , Trastornos Linfoproliferativos/patología , Estómago/patología , Estómago/efectos de la radiación , Neoplasias Gástricas/patología , Linfocitos T/patología , Linfocitos T/efectos de la radiación , Resultado del Tratamiento
2.
Leuk Res ; 91: 106336, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32151888

RESUMEN

The 2017 WHO classification includes a new provisional entity of indolent T-lymphoproliferative disorders of the gastrointestinal tract (ITLPD-GIT). We investigated GI involvement of peripheral T-cell lymphoma (PTCL). Eighty-two patients were diagnosed with PTCL during 2007-2017. Eleven patients (13 %) had histologically-confirmed GI tract involvement {3 monomorphic epitheliotropic intestinal lymphoma (MEITL), 3 extranodal NK-/T-cell lymphoma nasal type (ENKL), 2 PTCL, not otherwise specified, 1 adult T-cell leukemia-lymphoma, 2 ITLPD-GIT}. Three patients each had lesions in the small intestine and multiple lesions, two each in the stomach and colon, and one in the duodenum. Six of the 11 patients remained alive. No perforation/stenosis was observed after chemo-radiotherapy, although one patient with ENKL developed gastric bleeding during chemotherapy. One patient with ITLPD-GIT (CD4-/CD8+/Ki67Low) with a colonic lesion showing diffuse edema and multiple aphtha by endoscope and diarrhea, initially diagnosed with MEITL, had active but stable disease after various chemotherapies for 1 year and no therapy for the next 5 years. Another patient with ITLPD-GIT (CD4+/CD8+/Ki67Low) with a localized gastric lesion and slight epigastralgia was in remission for 1 year after radiation. In conclusion, about 10 % of PTCLs were complicated by GI tract lesions and most had a poor prognosis. ITLPD-GIT should be considered as a differential diagnosis based on histology and clinical course. Local complications after chemo/radiotherapy in PTCL with GI involvement were not frequent.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Rayos gamma/uso terapéutico , Enfermedades Gastrointestinales/terapia , Linfoma Extranodal de Células NK-T/terapia , Linfoma de Células T Periférico/terapia , Adulto , Anciano , Bleomicina/uso terapéutico , Ciclofosfamida/uso terapéutico , Diagnóstico Diferencial , Doxorrubicina/uso terapéutico , Etopósido/uso terapéutico , Femenino , Enfermedades Gastrointestinales/diagnóstico , Enfermedades Gastrointestinales/mortalidad , Enfermedades Gastrointestinales/patología , Tracto Gastrointestinal/efectos de los fármacos , Tracto Gastrointestinal/patología , Tracto Gastrointestinal/efectos de la radiación , Humanos , Linfoma Extranodal de Células NK-T/diagnóstico , Linfoma Extranodal de Células NK-T/mortalidad , Linfoma Extranodal de Células NK-T/patología , Linfoma de Células T Periférico/diagnóstico , Linfoma de Células T Periférico/mortalidad , Linfoma de Células T Periférico/patología , Masculino , Persona de Mediana Edad , Prednisolona/uso terapéutico , Prednisona/uso terapéutico , Estudios Retrospectivos , Análisis de Supervivencia , Resultado del Tratamiento , Vincristina/uso terapéutico
3.
Transpl Infect Dis ; 22(2): e13246, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31943573

RESUMEN

We reported the case of a patient with leukemia who developed febrile neutropenia after hematopoietic stem cell transplantation. Blood culture results revealed the presence of Streptococcus oralis, while antimicrobial susceptibility testing showed the resistance to penicillin and cephem. Furthermore, isolates were not susceptible to either meropenem or daptomycin but not to vancomycin. S oralis is known to belong to Streptococcus mitis group and be a causative agent of bacteremia in the neutropenic patients, but multidrug resistance of S oralis is rare. Our findings suggest that we might pay attention to the emergence of the microorganisms acquiring multidrug resistance in neutropenic patients.


Asunto(s)
Antibacterianos/uso terapéutico , Bacteriemia/diagnóstico , Farmacorresistencia Bacteriana Múltiple , Neutropenia Febril/complicaciones , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Infecciones Estreptocócicas/diagnóstico , Adulto , Bacteriemia/tratamiento farmacológico , Neutropenia Febril/microbiología , Femenino , Humanos , Leucemia/terapia , Pruebas de Sensibilidad Microbiana , Infecciones Estreptocócicas/tratamiento farmacológico , Streptococcus oralis/efectos de los fármacos , Resultado del Tratamiento
4.
J Clin Exp Hematop ; 59(3): 108-111, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31564712

RESUMEN

We examined 13 patients with adult T-cell leukemia-lymphoma (ATL) diagnosed between 2007 and 2018 at a single center in a metropolitan area non-endemic for human T-cell leukemia virus type I (HTLV-1). The median age of the patients (eight male, five female) was 65 years (range, 48-83). The time from onset of symptoms to referral to our center was relatively short (median, 2 months; range, 1-9 months). Upon referral, all patients were suspected to have lymphoma, five were examined for soluble IL-2 receptor and two were examined for anti-HTLV-1 antibody. In ten of the 13 (77%), the patient themselves or their relatives were born in Kyushu. The birth places of the remaining three patients were unknown. Three patients (23%) had family histories of lymphoma. They all exhibited aggressive ATL (five acute, eight lymphoma type); however, the disease status was generally stable, with relatively stable performance status and low scores for prognostic indices. After combination chemotherapy, eight (62%) achieved remission. However, long-term remission was achieved in only one patient with localized lymphoma-type ATL and one young patient after allogeneic hematopoietic stem cell transplantation. In conclusion, at a center in a metropolitan and HTLV-1 non-endemic area in Japan, patients with ATL were relatively young and mainly presented with aggressive subtypes. At initial referral to our center, all 13 patients were suspected of having lymphoma but only two of having ATL. For centers in similar areas of Japan, prompt diagnosis and appropriate treatment of ATL patients will become increasingly necessary following the recent migration of HTLV-1 carriers to non-endemic areas.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Trasplante de Células Madre Hematopoyéticas , Virus Linfotrópico T Tipo 1 Humano , Leucemia-Linfoma de Células T del Adulto , Anciano , Anciano de 80 o más Años , Aloinjertos , Supervivencia sin Enfermedad , Femenino , Humanos , Leucemia-Linfoma de Células T del Adulto/sangre , Leucemia-Linfoma de Células T del Adulto/mortalidad , Leucemia-Linfoma de Células T del Adulto/terapia , Masculino , Persona de Mediana Edad , Tasa de Supervivencia
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