Treatment results of Para-Testicular Rhabdomyosarcoma (PT-RMS) using radiation as an alternative to retro-peritoneal nodal dissection: A single Institution experience.

BACKGROUND: Para-testicular Rhabdomyosarcoma (PT-RMS) has a favorable treatment outcome adopting multidisciplinary management; resection, namely high inguinal orchiectomy ± retro-peritoneal lymph node dissection (RPLND) followed by standard or intensive chemotherapy ± adjuvant radiation therapy. PATIENTS AND METHODS: This is a retrospective study including all patients with pathologically proven PT-RMS, presented to the National Cancer Institute, Cairo University, during the period from 2005 to 2020. Endpoints included overall survival, disease free survival and patterns of failure of different treatment modalities. RESULTS: Forty one patients were identified. Median age in our cohort was 15 years (range: 2-54 years). After a median follow up of 26 months (range, 3-75 months) ,two and five years OS were 100% and 91.7% respectively and median survival was not reached. Patients who underwent retro-peritoneal nodal dissection had a 5-year DFS rate of 100% versus 73% for those who received radiation to para-aortic nodes (p = 0.185). Limitations include retrospective nature and deviation from COG protocol. CONCLUSIONS: This study shows promising results suggesting that less aggressive local treatment modalities including radiation to para-aortic chain could be an option in PT-RMS, given the excellent results of this subtype. However further validation in a prospective study is warranted.

Frequency of expression of RHAMM/CD168 in Egyptian patients with CML.

RHAMM/CD168 is a cell surface receptor for hyaluronan, a glycoaminoglycan that plays a fundamental role in cell growth, differentiation and motility. It is one of the leukemia-associated antigens (LAA) identified in patients with myeloid leukemias. WE AIMED: at studying the frequency of expression of RHAMM/CD168 in Egyptian patients with CML, both in chronic phase and accelerated/blastic phase, as a potential target structure for cellular immunotherapies, and to compare it with available western records. PATIENTS AND METHODS: RHAMM expression was tested by RT-PCR in peripheral blood mononuclear cells of 60 CML patients divided into 2 groups, group A: 44 chronic phase CML patients, group B: 16 accelerated/ blastic phase patients as well as 15 healthy volunteers. OUR RESULTS: Demonstrated that 14/44 (31.8%) of chronic CML patients showed positive RHAMM expression in contrast to 15/16 ( 93.7%) in the accelerated/blastic phase patients. Moreover within the chronic phase patients the RHAMM positive patients had a significantly higher level of bcr-abl/abl ratio. This highlighted the contribution of RHAMM expression with CML disease progression. CONCLUSION: Our work demonstrated a similar proportion of RHAMM expression in both Egyptian and western CML patients. This may pave the way for subsequent studies suggesting the concomitant use of RHAMM R3 peptide vaccination with conventional CML therapy especially in accelerated phase, in order to achieve complete molecular remission for our patient.