Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 32.239
Filtrar
1.
Cancer Treat Rev ; 88: 102042, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32521386

RESUMO

Since the clinical introduction of anti-CD20 monoclonal antibodies into lymphoma treatment, immunologic approaches in lymphoma have made substantial progress. Advances in our understanding of tumor immunology have led to the development of strategies to overcome immunologic barriers responsible for an ineffective immune response. Specifically, therapeutic agents have been developed and tested against molecules that are responsible for T-cell exhaustion. The use of monoclonal antibodies against immune checkpoints in the adaptive immune system, such as programmed cell death-1 and cytotoxic T-lymphocyte-associated protein 4, has changed the landscape of cancer therapy including the treatment of lymphoma. This achievement has recently been accompanied by the development of novel immune checkpoint inhibitors targeting the innate immune system, including the CD47-SIRPα signaling pathway, and this approach has yielded promising results. To overcome impaired antigen presentation, antibody-based cytotoxic strategies, namely antibody-drug conjugates (polatuzumab vedotin and brentuximab vedotin) and bispecific T-cell or NK-cell engagers (blinatumomab, REGN1979, RG6206, and AFM13), have rapidly evolved with promising clinical activity. As additional tools become available for lymphoma treatment, formulation of safe, rational combination strategies to combine them with standard therapy will be of paramount importance. A successful approach to the treatment of lymphoma may require both an optimized anti-tumor immune response as well as effective depletion of malignant lymphoid cells.


Assuntos
Doença de Hodgkin/imunologia , Doença de Hodgkin/terapia , Imunoterapia/métodos , Linfoma não Hodgkin/imunologia , Linfoma não Hodgkin/terapia , Imunidade Adaptativa , Anticorpos Biespecíficos/imunologia , Anticorpos Biespecíficos/uso terapêutico , Antineoplásicos Imunológicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Humanos , Imunidade Inata , Ensaios Clínicos Controlados Aleatórios como Assunto , Linfócitos T/imunologia
2.
J Comput Assist Tomogr ; 44(4): 619-626, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32558769

RESUMO

OBJECTIVE: The aim of the study was to study clinical, imaging findings, response patterns, and immune-related adverse events in classical Hodgkin lymphoma (cHL) and non-Hodgkin lymphoma (NHL) patients treated with immune checkpoint inhibitors (ICIs). METHODS: A retrospective search was performed to identify patients with relapsed/refractory cHL and NHL treated with ICIs from 2015 to 2019. Clinical and laboratory data were collected. Imaging studies were reviewed for treatment response and immune-related adverse events. RESULTS: Ten patients with relapsed/refractory cHL (median age, 41 years) and 14 patients with relapsed/refractory NHL (median age, 61 years) were identified. Overall response rate was 70% for cHL patients. None of the NHL patients demonstrated complete or partial response. One case of hyperprogression and one case with atypical response were radiologically detected in cHL patients. Hypothyroidism requiring treatment occurred in 2 (20%) of 10 cHL patients, one of which had imaging correlate. Of 14 NHL patients, 1 (7%) had radiologic evidence of pneumonitis and 1 (7%) had colitis. CONCLUSIONS: This single-institution observational study demonstrated that overall response rate was higher in patients with cHL undergoing ICI. Immune checkpoint inhibitor therapy has unique response patterns and toxicities in both cHL and NHL patients that radiologists should keep in mind.


Assuntos
Antineoplásicos Imunológicos/uso terapêutico , Colite/epidemiologia , Doença de Hodgkin/tratamento farmacológico , Hipotireoidismo/epidemiologia , Linfoma não Hodgkin/tratamento farmacológico , Pneumonia/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Monoclonais Humanizados/efeitos adversos , Anticorpos Monoclonais Humanizados/uso terapêutico , Antineoplásicos Imunológicos/efeitos adversos , Colite/induzido quimicamente , Feminino , Doença de Hodgkin/diagnóstico por imagem , Humanos , Hipotireoidismo/induzido quimicamente , Linfoma não Hodgkin/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Nivolumabe/efeitos adversos , Nivolumabe/uso terapêutico , Pneumonia/induzido quimicamente , Interpretação de Imagem Radiográfica Assistida por Computador , Estudos Retrospectivos , Análise de Sobrevida , Centros de Atenção Terciária , Resultado do Tratamento , Adulto Jovem
3.
Medicine (Baltimore) ; 99(26): e20861, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32590786

RESUMO

RATIONALE: Primary non-Hodgkin lymphoma (NHL) of the testes is rare, representing about 9% of testicular neoplasms and 1% to 2% of non-Hodgkin lymphomas. PATIENT CONCERNS: A previously healthy 47-month-old boy came to our institution for 3 months unilateral testicular swelling without tenderness. After preliminary examination, inguinal orchiectomy was performed to resect the right scrotal mass. The histopathological diagnosis of high-grade lymphoma was rendered and paraffin blocks were sent for immunophenotyping. DIAGNOSIS: The final diagnosis by histopathological combined with immunohistochemical staining revealed primary testicular T-cell lymphoblastic lymphoma (St Jude Children's Research Hospital Staging System, stage I). INTERVENTIONS: The patient was treated with right inguinal orchidectomy followed by chemotherapy (SMCC-2011 protocol modified based on the BFM-90/95 regimen from Germany) without prophylactic radiotherapy to the contralateral testis. OUTCOMES: After 36 months of follow-up, the patient is now disease-free without any complication. LESSONS: T-lymphoblastic lymphoma should be considered in the differential diagnosis of testicular masses in children. Intensive chemotherapy may improve the prognosis of such patients.


Assuntos
Linfoma não Hodgkin/diagnóstico , Neoplasias Testiculares/diagnóstico , Pré-Escolar , China , Humanos , Linfoma não Hodgkin/patologia , Masculino , Orquiectomia/métodos , Neoplasias Testiculares/patologia , Resultado do Tratamento
4.
Medicine (Baltimore) ; 99(18): e20030, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32358382

RESUMO

INTRODUCTION: Complications such as severe infection may occur during the chemotherapy of malignant lymphoma. Phlegmonous gastritis (PG) is a rare acute bacterial infection associated with high mortality, requiring early diagnosis, and prompt management. In addition, Guillain-Barré syndrome (GBS) occasionally requires early treatment and intensive care management due to the occurrence of severe neuropathy and respiratory failure. PATIENT CONCERNS: A 70-year-old male was diagnosed with primary gastric diffuse large B-cell lymphoma (DLBCL) after the detection of several polypoid tumors with ulcers. The patient underwent chemotherapy for DLBCL and exhibited adverse effects (i.e., fever, vomiting, epigastric pain, and neutropenia). Computed tomography indicated widespread thickening in the gastric wall. Furthermore, approximately 2 weeks later, the patient presented with gradual symmetric lower extremity weakness and respiratory failure due to paralysis of the respiratory muscle. DIAGNOSES: DLBCL was diagnosed through a gastric tumor biopsy. On the basis of the computed tomography findings, a culture of gastric juice, nerve conduction studies, and clinical symptoms, this case of gastric lymphoma was complicated with PG and GBS. INTERVENTIONS: The patient was treated with antimicrobial therapy and administration of granulocyte colony-stimulating factor for PG, and with intravenous immunoglobulin and intensive care management for GBS. OUTCOMES: Despite the aggressive progress of the condition, the patient improved without relapse of DLBCL. CONCLUSION: PG was regarded as a precedent infection of GBS. In this article, we present the first reported case of gastric lymphoma complicated with PG and GBS.


Assuntos
Gastrite/complicações , Síndrome de Guillain-Barré/complicações , Linfoma não Hodgkin/complicações , Infecções por Pseudomonas/complicações , Neoplasias Gástricas/complicações , Idoso , Antibacterianos/uso terapêutico , Antineoplásicos/uso terapêutico , Gastrite/tratamento farmacológico , Gastrite/microbiologia , Humanos , Linfoma não Hodgkin/tratamento farmacológico , Linfoma não Hodgkin/patologia , Masculino , Condução Nervosa , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/patologia
5.
Appl. cancer res ; 40(3): [1-5], 25 may 2020. ilus
Artigo em Inglês | LILACS | ID: biblio-1103868

RESUMO

Background: Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-hodgkin's lymphoma. In oral cavity represents approximately 2% of all malignancies. Case presentation: This report describes a rare mandibular involvement of DLBCL. A 56 year-old man was referred for evaluation of left mandible pain. In the anamnesis, the patient informed to be treating tooth pain in lasting 6 months. On oral evaluation, an intense mobility of the left mandibular second molar and a swelling in posterior left mandible were observed. Computed tomography showed a large osteolytic lesion affecting both mandibular body and ramus. An incisional biopsy was performed and according to histopathological and imumnohistochemical features, DLBCL was diagnosed. The treatment consisted of 8 cycles of R-CHOP and adjuvant radiotherapy. He is asymptomatic after 6 years. Conclusion: This case showed a rare bone presentation of DLBCL and such tumor should be considered as differential diagnosis of osteolytic lesion of the mandible.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Linfoma não Hodgkin , Neoplasias Mandibulares , Linfoma Difuso de Grandes Células B
6.
Crit Rev Oncol Hematol ; 150: 102945, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32353704

RESUMO

Autoimmune disorders are a spectrum of diseases caused by impaired self-tolerance of the immune system. Previous studies underscored the association between autoimmune disorders and lymphomas. However, only a few papers studied the exact mechanisms of this association. The effect of IL-2, IL-5, IL-6, IL-10 and TNF-α, contribution of NOTCH, FAS and MHC receptor families, the interplay of various immune cells, and the relation of immunosuppressive agents and development of autoimmune disorders are the proposed mechanisms for this association. Each individual autoimmune disorder associates with particular types of lymphomas and their common pathways are not necessarily similar to other pairs of autoimmune disorder-lymphomas. Thus, the lymphomas susceptibility in various autoimmune disorders could not be investigated through a single pathway. In this review, we demonstrate the association between each pair of autoimmune disorder-lymphoma and the underlying pathways. By clarifying these associations, follow-up plans could be made leading to early diagnosis of lymphomas.


Assuntos
Doenças Autoimunes/complicações , Imunossupressores/uso terapêutico , Linfoma não Hodgkin/complicações , Linfoma/etiologia , Doenças Autoimunes/tratamento farmacológico , Doenças Autoimunes/patologia , Humanos , Linfoma não Hodgkin/tratamento farmacológico , Linfoma não Hodgkin/patologia
7.
Ann Hematol ; 99(6): 1293-1302, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32296914

RESUMO

Cell-free DNA (cfDNA) can be released from tumor cells during proliferation and apoptosis; thus, a fraction of the cfDNA in patients with cancer is tumor-derived. However, the prognostic value of cfDNA in aggressive non-Hodgkin lymphoma (NHL) has not been determined. Between March 2017 and April 2019, plasma cfDNA was obtained from 158 patients with aggressive NHL who were registered in a prospective Samsung Medical Center lymphoma cohort (diffuse large B cell lymphoma (DLBCL), n = 51; T cell lymphoma (TCL), n = 51; NK/T cell lymphoma (NKTCL), n = 56). The concentration of cfDNA was estimated in longitudinal samples collected from patients with NHL before and during various chemotherapy regimens. In pretreatment samples, the median cfDNA concentration of all patients with aggressive lymphoma was 13.7 ng/dl (range 1.7-1792), which was significantly higher than that of healthy volunteers (median 7.4 ng, range 3.7-14.4, p < 0.001), and advanced stages showed a higher cfDNA level than earlier stages. Multivariate analysis identified high cfDNA as an independent factor for event-free survival that predicted poor prognosis in DLBCL (hazard ratio [HR] = 5.33, 95% confidence interval [CI] = 1.72-16.52, p = 0.003) and TCL (HR = 2.82, 95% CI = 1.10-7.20, p = 0.030). NKTCL patients with a high level of cfDNA had worse overall survival (HR = 4.71, 95% CI = 1.09-20.35, p = 0.037) compared with those with a low level of cfDNA. In this study, our results suggest the usefulness of pretreatment cfDNA as a prognostic marker for patients with DLBCL, TCL, and NKTCL.


Assuntos
Ácidos Nucleicos Livres/sangue , Linfoma não Hodgkin/sangue , Linfoma não Hodgkin/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Estudos de Coortes , Feminino , Humanos , Linfoma não Hodgkin/diagnóstico , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica/patologia , Prognóstico , Estudos Prospectivos , Taxa de Sobrevida/tendências , Adulto Jovem
8.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(2): 484-487, 2020 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-32319383

RESUMO

OBJECTIVE: To investigate the prognostic influencing factors of primary central nervous system lymphoma (PCNSL) patients with diffuse large B-cell immunophenotype. METHODS: 42 PCNSL patients with diffuse large B-cell lymphoma treated in our hospital from March 2011 to October 2017 were enrolled. The effects of different treatments on overall survival of patients were analyzied. RESULTS: The analysis for 42 PCNSL patients with diffuse large B-cell immunophenotype showed that there was no affect of their clinical characteristics,such as sex, age, CSF protein content, treatment with and without temozolomide and rituximab on overall survival of the patients(P>0.05). And it was found that active treatment and the application of conventional intrathecal injection and methotrexate in the treatment could effectively prolong the overall survival time of patients. CONCLUSION: Early diagnosis of PCNSL and active standardized treatment can significantly prolong the survival time of patients, and it is further emphasized that the necessity of conventional intrathecal injection to prolong the survival of patients.


Assuntos
Neoplasias do Sistema Nervoso Central , Linfoma Difuso de Grandes Células B , Linfoma não Hodgkin , Linfócitos B , Humanos , Prognóstico
9.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(2): 488-494, 2020 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-32319384

RESUMO

OBJECTIVE: To compare and evaluate the sensitivity, specificity, and prognostic value of various assays for bone marrow involvement in patients with non-Hodgkin's lymphoma (NHL). METHODS: A total of 351 patients with NHL who underwent concurrent bone marrow biopsy in Third Hospital of Peking University from January 2013 to November 2017 were selected. Bone marrow biopsy (BMB), flow cytometry (FCM), gene rearrangement detection, and bone marrow morphology examination were performed for evaluation of bone marrow involvement. Bone marrow biopsy was used as the gold standard, the sensitivity and specificity of FCM, gene rearrangement and bone marrow morphology of bone marrow aspirate were analyzed, and their ROC curves were drawn. In the survival analysis of 77 patients with NHL, the overall survival (OS) time, progression-free survival (PFS) time, and complete remission rate (CRR) were counted. The survival of patients in the FCM positive group, the gene rearrangement positive group, the positive control group (BMB positive group) and the negative control group were compared. RESULTS: The detection rate of flow cytometry and gene rearrangement of bone marrow aspirate both were higher than that of bone marrow biopsy and bone marrow morphological examination, showing better diagnostic efficacy. The sensitivity of the combined method of flow cytometry and gene rearrangement was 82.5%, while the specificity was 90% and the AUC was 0.863. The gene rearrangement detection of bone marrow aspirate possessed the role suggesting the poor prognosis for NHL patients. The 3-year survival rate of patients in the gene rearrangement-positive group (RG group) was lower than that of patients in the no-bone involvement group (All negative group) (P<0.05). Although the survival curve of patient in RG group was not significantly different from that of patients in All negative group (P<0.1), it still showed a poor prognosis for NHL patients. And the significance of predicting death risk was reflected in Cox regression model (P<0.05). There was no statistical difference in the prognosis of patients in the FCM-positive group (FCM group). CONCLUSION: In the bone marrow aspirate tests, flow cytometry and gene rearrangement detection have good diagnostic efficiency, and gene rearrangement can suggest the prognosis of patients. The combined detection efficacy of two methods is better.


Assuntos
Medula Óssea , Linfoma não Hodgkin , Exame de Medula Óssea , Citometria de Fluxo , Humanos , Prognóstico
10.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(2): 500-506, 2020 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-32319386

RESUMO

OBJECTIVE: To investigate the clinical characteristics and prognostic factors of children with non-Hodgkin's lymphoma of different pathological subtypes. METHODS: Ninety-three patients with newly-diagnosed childhood NHL in Fujian Medical University Union Hospital from March 2011 to September 2017 were salected. The diagnosis of patients was performed according to the World Health Organization classification of tumors 2008 ys. The chemotherapy regimens were based on immune phenotype, pathological type and clinical stages. The 5-years event-free survival rate (EFS) were calculated and analyzed by Kaplan-Meier method, and difference of survival rate between groups were compared. The possible factors influencing 5-years EFS was analyzed using Cox proportional hazards model. RESULTS: Among the 93 patients, male to female ratio was 2.88:1, the median age at diagnosis was 6 (0.9 to 13) years old. According to pathological types, Burkitt's lymphoma was the most common, follow by ALK+ anaplastic large-cell lymphoma (ALCL) and lymphoblastic lymphoma (LBL). Clinically, the most common initial symptoms observed at diagnosis were swelling of superficial lymph node, and abdominal pain and abdominal mass in mature B-cell neoplasms, and the swelling of mediastinal lymph nodes in LBL, and hemophagocytic syndrome (HPS) in mature T-cell and natural killer cell NHL. Seventy-nine cases completed 2 courses of induction chemotherapy, and 64 cases (81.01%) reached complete remission (CR). In a median follow up for 32.5(1.0-88.5) months, ten patients (11.90%) relapsed, the median relapsed time was 5.7(3.4-15.7) months. 5-year EFS rate in 84 patients received standardized treatments were (77.1±4.9)%. As compared with lymphoblastic lymphoma and extranodal NK/T cell lymphoma, there was a trend towards better outcomes in B-LBL, and mature B-cell neoplasms and ALK+ ALCL showing 5-year EFS was (86.2±5.2)% and (93.8±6.1)% vs (53.3%±16.1)% and (28.6±17.1)%. Univariate analysis showed that B symptoms, LDH level, secondary HLH, immunophenotype, pathological subtypes, clinical stage and whether reached CR after induction chemotherapy significantly correlated with prognosis. Cox regression analysis showed that no CR after 2 courses was an independent unfavorable prognostic factor (HR0.001, 95%CI: 0.000-0.122). CONCLUSION: The clinical characteristics and prognosis of patients with NHL of different pathological types are different. Whether reached CR after induction chemotherapy is the imdependent risk factor affecting the prognosis.


Assuntos
Linfoma não Hodgkin , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica , Criança , Pré-Escolar , Intervalo Livre de Doença , Feminino , Humanos , Lactente , Masculino , Prognóstico , Estudos Retrospectivos
11.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(2): 682-685, 2020 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-32319416

RESUMO

Abstract  Chemokines and their receptors play an important role in development and migration of normal immune cells. In recent years, relevant studies have shown that the expression of chemokine receptor on the surface of non-Hodgkin's lymphoma cells is up-regulated, which regulates the disease's occurrence and metastasis, and influences prognosis of patients. Agents targeting chemokine receptors are under research and applied in hematopoietic stem cell mobilization and anti-lymphoma therapy. A new family of atypical chemokines has been gradually discovered and shown the anti-lymphoma effect, which is potential to become a new theraputic method. In this review, the research advance of chemokines and their receptors in non-Hodgkin's lymphoma is summarized.


Assuntos
Linfoma não Hodgkin , Quimiocinas , Mobilização de Células-Tronco Hematopoéticas , Humanos , Receptores de Quimiocinas
12.
Anticancer Res ; 40(4): 2373-2377, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32234940

RESUMO

BACKGROUND/AIM: The clinical significance of surgery for secondary small intestinal non-Hodgkin's lymphomas (NHL) remains unknown. This study aimed to investigate the efficacy of resection for both primary and secondary small intestinal NHL. PATIENTS AND METHODS: Twenty patients with small intestinal lymphoma who underwent surgical resection at our Institute between 2009 and 2017 were retrospectively evaluated. The clinicopathological and surgery-related factors were reviewed. We also analyzed their surgical outcomes such as postoperative complications, perforation rate, and overall survival (OS). RESULTS: In total, 13 (65%) and 7 (35%) patients had primary and secondary lymphomas, respectively. A total of 70% of patients were diagnosed with aggressive-type lymphomas. A total of 15 (75%) patients had Lugano system stage IV. Only one (5%) patient experienced postoperative grade II deep vein thrombosis and pulmonary embolism. The 3-year OS rate after surgery was 59.6%. CONCLUSION: Surgical resection prior to chemotherapy is a feasible and safe therapeutic strategy for small intestinal NHL.


Assuntos
Intestino Delgado/cirurgia , Linfoma não Hodgkin/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Intervalo Livre de Doença , Feminino , Humanos , Intestino Delgado/efeitos dos fármacos , Intestino Delgado/patologia , Linfoma não Hodgkin/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
13.
Nihon Shokakibyo Gakkai Zasshi ; 117(4): 334-344, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32281575

RESUMO

We report the case of a 61-year-old woman with a collision cancer of primary squamous cell carcinoma (SCC) and adenocarcinoma in the stomach that was cured surgically. She achieved complete remission after treatment (R-CHOP and radiation therapy;40.8Gy/22Fr) for a non-Hodgkin's lymphoma of diffuse large B cell type from September 2016 to April 2017. In August 2018, endoscopic findings showed a type 3 tumor with a white coat on the posterior wall of the upper gastric body. A biopsied specimen showed that the tumor was a SCC. Total gastrectomy, distal pancreatectomy, splenectomy, and D2 lymph node dissection were performed. Pathological examination showed a SCC invasion to the spleen, and normal gastric mucosa between the esophagus and SCC of the stomach. Based on the pathological TNM classification, the tumors were T4N1M0 (Stage IIIB) for the SCC and T1N0M0 (Stage IA) for the adenocarcinoma of the stomach. The patient received adjuvant chemotherapy with S-1, and was recurrence free at 9 months after the surgery.


Assuntos
Adenocarcinoma , Carcinoma de Células Escamosas , Linfoma não Hodgkin , Neoplasias Gástricas , Linfócitos B , Feminino , Gastrectomia , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia
14.
J Laryngol Otol ; 134(5): 460-462, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32308160

RESUMO

BACKGROUND: Patients with non-Hodgkin's lymphoma and chronic lymphocytic leukaemia are at an elevated risk of further malignancy. Head and neck squamous cell carcinoma often presents with cervical lymph node metastasis, and can pose a diagnostic challenge in patients with non-Hodgkin's lymphoma or chronic lymphocytic leukaemia who may have pre-existing palpable neck nodes. METHODS: A retrospective case review of a health board was conducted to identify patients with head and neck squamous cell carcinoma with a previous diagnosis of non-Hodgkin's lymphoma or chronic lymphocytic leukaemia. RESULTS: Four patients with head and neck squamous cell carcinoma that developed after non-Hodgkin's lymphoma or chronic lymphocytic leukaemia were identified. Two patients had a background of non-Hodgkin's lymphoma treated with chemotherapy. The remaining two patients had a background of chronic lymphocytic leukaemia under active surveillance. Three out of the four patients died within 30 months of diagnosis. CONCLUSION: Head and neck squamous cell carcinoma following non-Hodgkin's lymphoma or chronic lymphocytic leukaemia is aggressive. A heightened clinical suspicion is essential to facilitate early diagnosis and treatment of head and neck squamous cell carcinoma in patients with dual pathology.


Assuntos
Neoplasias de Cabeça e Pescoço/diagnóstico , Leucemia Linfocítica Crônica de Células B/terapia , Linfoma não Hodgkin/terapia , Segunda Neoplasia Primária/diagnóstico , Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimiorradioterapia , Evolução Fatal , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias da Língua/diagnóstico
17.
Crit Rev Oncol Hematol ; 148: 102892, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32120328

RESUMO

BACKGROUND: Incidence and mortality rates of childhood cancer represent a global public health issue, however, the worldwide prevalence of head and neck cancer in pediatric patients (HNCPP) is still unknown. Therefore, this study aimed to describe the frequency and distribution of HNCPP worldwide. METHODS: A specific search strategy was performed using MEDLINE, Scopus, and EMBASE to include studies based on hospital records, national cancer registries, and pathology files. Studies quality was assessed using the risk of bias checklist of the Joanna Briggs Institute Critical Appraisal. RESULTS: Nineteen publications (15,970 cases) were included. Global frequency ranged from 0.25 % to 15 %. Male patients older than 10 years of age were most affected by lymphomas, followed by carcinomas and sarcomas. Non-Hodgkin lymphoma, Hodgkin lymphoma, rhabdomyosarcoma, thyroid carcinoma, and nasopharyngeal carcinoma were the main histopathological subtypes. Neck/lymph nodes were anatomical hotspots. CONCLUSIONS: This HNCPP global overview may guide secondary prevention strategies and future etiological studies.


Assuntos
Saúde Global , Neoplasias de Cabeça e Pescoço/epidemiologia , Pediatria , Adolescente , Distribuição por Idade , Criança , Feminino , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Incidência , Linfoma/epidemiologia , Linfoma/patologia , Linfoma não Hodgkin/epidemiologia , Linfoma não Hodgkin/patologia , Masculino , Neoplasias Nasofaríngeas/epidemiologia , Neoplasias Nasofaríngeas/patologia , Sarcoma/epidemiologia , Sarcoma/patologia , Distribuição por Sexo , Neoplasias da Glândula Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/patologia
18.
Lancet Haematol ; 7(4): e295-e308, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32135128

RESUMO

BACKGROUND: Patients treated for non-Hodgkin lymphoma are at risk of cardiovascular adverse events, with the risk of heart failure being particularly high. A regimen of cyclophosphamide, doxorubicin, vincristine, and prednisone, with (R-CHOP) or without (CHOP) rituximab is the standard first-line treatment for aggressive non-Hodgkin lymphoma, and doxorubicin and cyclophosphamide are both associated with left ventricular dysfunction. The aim of this systematic review and meta-analysis was to evaluate the cardiovascular toxicity of this regimen. METHODS: We systematically searched PubMed, EMBASE, and the Cochrane Library from database inception to June 3, 2019, for clinical trials and observational studies in adult patients with non-Hodgkin lymphoma (diffuse large B-cell lymphoma, follicular lymphoma, mantle cell lymphoma, peripheral T-cell lymphoma, and non-Hodgkin lymphoma not otherwise specified) that received first-line treatment with R-CHOP or CHOP. Studies reporting on cardiovascular adverse events and treatment-related cardiovascular mortality were included. Abstracts and articles not written in English were excluded. The main outcomes were the proportion of patients with grade 3-4 cardiovascular adverse events and heart failure. Meta-analyses of one-sample proportions were done in all patients receiving CHOP or R-CHOP. Subgroup analyses on summary estimates were done to determine the effect of number of CHOP or R-CHOP cycles, cycle interval, age, and sex. FINDINGS: Of 2314 identified entries, 137 studies (21 211 patients) published between April, 1984, and June, 2019 were eligible (9541 patients treated with CHOP, 11 293 patients treated with R-CHOP, 377 both regimens used in the study; median follow-up 39·0 months [IQR 25·5-52·8]). From the included studies, 85 subgroups were treated with CHOP, 76 with R-CHOP, and in four studies both CHOP and R-CHOP were used without a subdivision in separate groups. The pooled proportion for grade 3-4 cardiovascular adverse events, based on 77 studies (n=14 351 patients), was 2·35% (95% CI 1·81-2·93; heterogeneity test Q=326·21; τ2=0·0042; I2=71·40%; p<0·0001). For heart failure, the pooled proportion, based on 38 studies (n=5936 patients), was 4·62% (2·25-7·65; heterogeneity test Q=527·33; τ2=0·0384; I2=95·05%; p<0·0001), with a significant increase in reported heart failure from 1·64% (95% CI 0·82-2·65) to 11·72% (3·00-24·53) when cardiac function was evaluated post-chemotherapy (p=0·017). 53 (39%) of 137 studies were rated as having high risk of bias for incomplete outcome data and 54 (39%) for selective reporting. INTERPRETATION: The considerable increase of reported heart failures with cardiac monitoring, indicates that this complication often remains undiagnosed in patients with non-Hodgkin lymphoma who received first-line R-CHOP or CHOP. Our findings are of importance to raise awareness of this complication among clinicians treating patients with non-Hodgkin lymphoma and stresses the need for cardiac monitoring during and after chemotherapy. Prompt initiation of treatment for heart failure in the presymptomatic phase can mitigate the progression to more advanced heart failure stages. FUNDING: None.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Doenças Cardiovasculares/etiologia , Linfoma não Hodgkin/tratamento farmacológico , Rituximab/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Doenças Cardiovasculares/patologia , Ciclofosfamida/administração & dosagem , Ciclofosfamida/efeitos adversos , Ciclofosfamida/uso terapêutico , Doxorrubicina/administração & dosagem , Doxorrubicina/efeitos adversos , Doxorrubicina/uso terapêutico , Humanos , Prednisona/administração & dosagem , Prednisona/efeitos adversos , Prednisona/uso terapêutico , Rituximab/efeitos adversos , Índice de Gravidade de Doença , Vincristina/administração & dosagem , Vincristina/efeitos adversos , Vincristina/uso terapêutico
19.
Rev Assoc Med Bras (1992) ; 66(1): 25-30, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32130377

RESUMO

OBJECTIVE: Describe the clinical and demographic characteristics of pediatric patients with non-Hodgkin's lymphoma (NHL) enrolled in a tertiary unit of Pediatric Hematology between 1982-2015. PATIENTS AND METHODS: A retrospective cohort study of 140 patients aged 16 years or less with NHL. Demographic characteristics, data on diagnosis, and outcomes were analyzed. The overall survival (OS) analysis and stratification by the most frequent histological subtypes were performed using the Kaplan-Meier method. RESULTS: One hundred and thirty-six patients with de novo NHL and four with NHL as a second malignancy were analyzed. The median age at diagnosis was 6.4 years (interquartile range, 4.2 to 11.1 years); 101 patients were males. Four patients had primary immunodeficiency, four had human immunodeficiency virus, two post-liver transplantation, and one had autoimmune lymphoproliferative syndrome. The most frequent histological type was NHL of mature B- cell (B-NHL-B; 67.1%), with Burkitt's lymphoma being the most frequent subtype, and lymphoblastic lymphoma (LBL, 21.4%). The main clinical manifestation at the diagnosis was abdominal tumors (41.4%). During the follow-up time, 13 patients relapsed, but five of them reached a second remission. Thirty-five patients died, and 103 remained alive in clinical remission. No contact was possible for two patients. The OS at 5 years was 74.5% (± 3.8%). The OS estimated for patients with LBL, NHL-B, and the remaining was 80.4%±7.9%, 72.8%±4.7%, and 74.5%±11%, respectively (P = 0.58). CONCLUSION: Our results are comparable with cohorts from other middle-income countries.


Assuntos
Linfoma não Hodgkin/mortalidade , Adolescente , Distribuição por Idade , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Linfoma não Hodgkin/patologia , Masculino , Estudos Retrospectivos , Distribuição por Sexo
20.
Adv Clin Exp Med ; 29(2): 197-202, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32154678

RESUMO

BACKGROUND: Post-transplantation lymphoproliferative disorder (PTLD) is a complication of organ transplantation and a life-threatening condition. Children who underwent organ transplantation are at risk of developing lymphoproliferative disorders and, among them, non-Hodgkin lymphoma (NHL) is the most serious. OBJECTIVES: The objective of this study was to describe the clinical course of NHL after liver and kidney transplantation. MATERIAL AND METHODS: Retrospective analysis of medical records of children who underwent liver/kidney transplantation and developed NHL. RESULTS: Nine children were identified, all girls, 6 after liver and 3 after kidney transplantations. Age at transplantation ranged from 1 year to 13 years (median: 4 years), while age at lymphoma diagnosis from 4 to 17 years (median: 12 years). Time from transplantation to lymphoma diagnosis ranged from 7 months to 12 years (median: 9 years). All but 1 patient developed mature B-cell lymphoma, 4 children - diffuse large B-cell lymphoma (DLBCL), 2 children - Burkitt's lymphoma, 1 child - mature B-cell leukemia, 1 child - Burkitt-like lymphoma, while 1 patient was diagnosed with T-cell lymphoblastic lymphoma. High levels of Epstein-Barr virus (EBV) DNA were found in blood of 3 patients, and EBV in tissue samples was detected in 4 patients. Six patients presented with stage III and 2 with stage IV disease. Two patients had graft involvement. Three children received chemotherapy according to R-CHOP, 3 LMB protocol (2 with addition of rituximab), while 1 received CHOP and 5 courses of COP. T-cell lymphoma patient was treated with Euro-LB protocol. Six out of 8 treated patients are alive with a median follow-up of 6 years. Two children died from disease progression during treatment and 1 from cerebral herniation before starting therapy. All patients experienced at least 1 toxic episode of grade 3 and 4 according to Common Toxicity Criteria Adverse Event (CTCAE). Complications of chemotherapy were manageable and there were no transplanted organ failures. CONCLUSIONS: Our study provides further data on the treatment and outcome of monomorphic PTLD and indicates that it is feasible to treat solid organ recipients with multiagent chemotherapy.


Assuntos
Transplante de Rim/efeitos adversos , Transplante de Fígado/efeitos adversos , Linfoma não Hodgkin/etiologia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Linfoma não Hodgkin/tratamento farmacológico , Estudos Retrospectivos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA