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1.
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
4.
Infez Med ; 27(3): 340-344, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31545781

RESUMO

Human autochthonous myiasis is uncommonly reported in Europe. This report describes a case of myiasis of a wound caused by Sarcophaga spp. Suffering from cutaneous lymphoma, the patient showed, at the level of his scalp lesions, the presence of larvae that were removed during curettage surgery; they were subsequently identified as belonging to the genus Sarcophaga. Preservation of these larvae in 10% formalin did not allow identification at the species level using molecular methods.


Assuntos
Neoplasias de Cabeça e Pescoço/complicações , Linfoma não Hodgkin/complicações , Miíase/parasitologia , Sarcofagídeos , Dermatoses do Couro Cabeludo/parasitologia , Neoplasias Cutâneas/complicações , Adulto , Animais , Evolução Fatal , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Linfoma não Hodgkin/patologia , Masculino , Miíase/patologia , Dermatoses do Couro Cabeludo/patologia , Neoplasias Cutâneas/patologia
5.
Surg Pathol Clin ; 12(3): 849-863, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31352991

RESUMO

Castleman disease (CD) is divided clinically into unicentric or multicentric type. Pathologically, CD is divided into hyaline-vascular and plasma cell variants. Unicentric CD is most common, about 75% of these cases are hyaline-vascular variant, and surgical excision is often curative. In contrast, there are a number of types of multicentric CD including HHV8-associated, idiopathic, and a subset of cases that arise in association with POEMS syndrome. Therapy is required for most patients with multicentric CD, but there is no consensus approach currently. As is evidence, the designation Castleman disease encompasses a heterogeneous group of diseases of varied pathogenesis and which require different therapies.


Assuntos
Hiperplasia do Linfonodo Gigante/patologia , Hiperplasia do Linfonodo Gigante/complicações , Hiperplasia do Linfonodo Gigante/terapia , Análise Citogenética/métodos , Diagnóstico Diferencial , Doença de Hodgkin/complicações , Doença de Hodgkin/patologia , Humanos , Imunofenotipagem , Doenças Linfáticas/complicações , Doenças Linfáticas/patologia , Linfoma não Hodgkin/complicações , Linfoma não Hodgkin/patologia , Neoplasias/complicações , Neoplasias/patologia , Síndrome POEMS/complicações , Síndrome POEMS/patologia , Prognóstico
7.
Health Qual Life Outcomes ; 17(1): 115, 2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31266501

RESUMO

BACKGROUND: Long-term lymphoma survivors often complain of persistent fatigue that remains unexplained. While largely reported in Hodgkin lymphoma (HL), long-term fatigue is poorly documented in non-Hodgkin lymphomas (NHL). Data collected in two cohort studies were used to illustrate the fatigue level changes with time in the two populations. METHODS: Two cross-sectional studies were conducted in 2009-2010 (HL) and in 2015 (NHL) in survivors enrolled in European Organisation for Research and Treatment of Cancer (EORTC) Lymphoma Group and Lymphoma Study Association (LYSA) trials. The same protocol and questionnaires were used in both studies including the Multidimensional Fatigue Inventory (MFI) tool to assess fatigue and a checklist of health disorders. Multivariate linear regression models were used in the two populations separately to assess the influence of time since diagnosis and primary treatment, age, gender, education level, cohabitation status, obesity and health disorders on fatigue level changes. Fatigue level changes were compared to general population data. RESULTS: Overall, data of 2023 HL and 1619 NHL survivors with fatigue assessment available (99 and 97% of cases, respectively) were analyzed. Crude levels of fatigue were similar in the two populations. Individuals who reported health disorders (61% of HL and 64% of NHL) displayed higher levels of fatigue than those who did not (P <  0.001). HL survivors showed increasing fatigue level with age while in NHL survivors mean fatigue level remained constant until age 70 and increased beyond. HL survivors showed fatigue changes with age higher than those of the general population with health disorders while NHL survivors were in between those of the general population with and without health disorders. CONCLUSIONS: Among lymphoma survivors progressive increase of fatigue level with time since treatment completion is a distinctive feature of HL. Our data suggest that changes in fatigue level are unlikely to only depend on treatment complications and health disorders. Investigations should be undertaken to identify which factors including biologic mechanisms could explain why a substantial proportion of survivors develop high level of fatigue.


Assuntos
Sobreviventes de Câncer , Fadiga/etiologia , Doença de Hodgkin/complicações , Linfoma não Hodgkin/complicações , Qualidade de Vida , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Doença de Hodgkin/psicologia , Humanos , Modelos Lineares , Linfoma não Hodgkin/psicologia , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
8.
BMJ Case Rep ; 12(6)2019 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-31256047

RESUMO

Glioblastoma multiforme is an astrocyte-derived tumour representing the most aggressive primary brain malignancy. The median overall survival is 10-12 months, but it drops to 3-8.5 months for the cohort with more than 65 years old, which account to half of all patients. Initial management in this patient population aims to balance overall patient survival and quality of life with the inherent risks of treatment intervention, which include maximal safe tumour resection, radiation and temozolomide (TMZ) chemotherapy. This is accomplished through risk stratification as a function of patient age, functional status, comorbidities, tumour location and methylguanine methyltransferase promoter methylation status. We describe the care of a patient with prolonged febrile neutropaenia, with a rare but fatal complication from TMZ-induced idiosyncratic reaction, leading to aplastic anaemia and a provoking diagnosis of low-grade B-cell non-Hodgkin's lymphoma.


Assuntos
Anemia Aplástica/induzido quimicamente , Antineoplásicos Alquilantes/efeitos adversos , Neoplasias Encefálicas/complicações , Glioblastoma/complicações , Linfoma não Hodgkin/complicações , Temozolomida/efeitos adversos , Idoso de 80 Anos ou mais , Encéfalo , Neoplasias Encefálicas/tratamento farmacológico , Neoplasias Encefálicas/patologia , Evolução Fatal , Glioblastoma/tratamento farmacológico , Glioblastoma/patologia , Humanos , Achados Incidentais , Masculino
9.
Rev. bras. ter. intensiva ; 31(2): 258-261, abr.-jun. 2019. tab
Artigo em Português | LILACS | ID: biblio-1013769

RESUMO

RESUMO A segurança e a eficácia do rituximabe em pacientes com comprometimento renal não foram estabelecidas, e o mesmo ocorre com os efeitos da hemodiálise nos níveis séricos de rituximabe. Atualmente, apenas alguns relatos de caso avaliaram o nível sérico de rituximabe antes e após a diálise. Não foram até aqui publicados dados relativos ao uso de rituximabe em pacientes sob terapia de substituição renal contínua. Os autores apresentam um caso referente a uma mulher com 59 anos de idade atendida com quadro de tetraparesia paraneoplásica. Ela foi admitida no serviço de medicina intensiva devido a hemorragia alveolar com insuficiência respiratória e lesão renal aguda, que necessitou da utilização de terapia de substituição renal contínua. Após os procedimentos diagnósticos, estabeleceu-se o diagnóstico de linfoma linfoplasmocítico. Deu-se início ao tratamento com rituximabe e ciclofosfamida. Os níveis de rituximabe foram determinados no soro e no dialisato. Não se encontrou qualquer nível de rituximabe no dialisato. A paciente faleceu após 2 meses no serviço de medicina intensiva por pneumonia nosocomial causada por Pseudomonas aeruginosa resistente a múltiplos fármacos.


ABSTRACT Rituximab safety and efficacy in patients with renal impairment have not been established, nor have the effects of hemodialysis on serum rituximab level. There are only a few published case reports assessing serum rituximab level pre- and postdialysis. No data have been published regarding the usage of rituximab in patients with continuous renal replacement therapy. The authors present a case of a 59-year-old female patient who presented with paraneoplastic tetraparesis. She was admitted to the intensive care unit due to alveolar hemorrhage with respiratory failure and acute kidney injury requiring continuous renal replacement therapy. After a diagnostic workup, the diagnosis of lymphoplasmacytic lymphoma was established. Therapy with rituximab and cyclophosphamide was started. Rituximab levels were determined in serum and dialysate. No rituximab was found in the dialysate. The patient died after 2 months in the intensive care unit from nosocomial pneumonia due to multidrug-resistant Pseudomonas aeruginosa.


Assuntos
Humanos , Feminino , Linfoma não Hodgkin/tratamento farmacológico , Lesão Renal Aguda/terapia , Rituximab/uso terapêutico , Antineoplásicos Imunológicos/uso terapêutico , Terapia de Substituição Renal Contínua , Linfoma não Hodgkin/complicações , Evolução Fatal , Lesão Renal Aguda/complicações , Pessoa de Meia-Idade
10.
Tuberk Toraks ; 67(1): 77-82, 2019 Mar.
Artigo em Turco | MEDLINE | ID: mdl-31130139

RESUMO

Non-Hodgkin lymphoma (NHL) is a clonal proliferative disease of B or T cell progenitors originating from lymph nodes or extranodal lymphatic tissue. There are several pulmonary complications associated with NHL. We aimed to discuss two pulmonary complications with high morbidity and mortality associated with lymphoma in our patient followed up with COPD and NHL. Seventy one years old male patient was admitted to the emergency department with sudden onset of dyspnea and chest pain. He had a history of bronchodilator use for COPD for 18 years and chemotherapy and local radiotherapy because of NHL 8 years ago. In terms of pulmonary thromboembolism (PTE), it was evaluated as clinically low-medium risk group. Pulmonary CT angiography was performed to diagnose PTE. Unilateral subcutaneous pleural fluid was detected in the chest radiography performed in the emergency room where he was admitted to the hospital due to increased dyspnea under low molecular weight heparin (LMWH) treatment. Triglyceride level > 110 mg/dL was observed in pleural fluid sampled by thoracentesis and diagnosed as chylothorax. He was followed by a pleuroken stool diet and received only one course of chemotherapy because of relapse NHL. Her general condition deteriorated and the patient died. The incidence of thrombosis in hematological oncology varies between 2% and 58%. PTE is a complication that must be considered in case of sudden onset of shortness of breath in hematologic oncologies. Increased shortness of breath under effective PTE treatment was considered as a secondary event and chylothorax, another pulmonary complication, was detected especially in lymphoma. Our patient with lymphoma was presented because of pulmonary complications associated with lymphoma.


Assuntos
Pulmão/diagnóstico por imagem , Linfoma não Hodgkin/complicações , Doença Pulmonar Obstrutiva Crônica/complicações , Embolia Pulmonar/etiologia , Idoso , Angiografia por Tomografia Computadorizada , Evolução Fatal , Humanos , Linfonodos/patologia , Linfoma não Hodgkin/diagnóstico , Masculino , Recidiva Local de Neoplasia , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Embolia Pulmonar/diagnóstico
11.
Indian J Pathol Microbiol ; 62(2): 319-322, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30971567

RESUMO

Emperipolesis is the hallmark finding for Rosai-Dorfman disease. Till now many studies in literatures have shown emperipolesis as a finding in other benign as well as malignant conditions. Very few cases of malignant lymphoma have this phenomenon. Herewith, we put forward a rare case of lymphoma with clinical presentation showing involvement of spleen, liver, lymph nodes as well as lleo-cecal region. Light microscopy revealed large to medium sized lymphoid cells with intervening plenty of histiocytes showing evidence of emperipolesis that mimics Rosai Dorfmann disease. Due to atypical clinical presentations we thought of lymphoma as a differential diagnosis. Further immunohistochemistry was performed using histiocytic as well as lymphoid markers. To our surprise, it turns out to be Non Hodgkin Lymphoma with extensive emperipolesis which is extremely rare in thorough literature search. This case is presented due to its unique clinical as well as histological presentations.


Assuntos
Emperipolese , Linfoma não Hodgkin/diagnóstico , Biomarcadores , Colectomia , Diagnóstico Diferencial , Histiócitos/patologia , Histiocitose Sinusal/diagnóstico , Histiocitose Sinusal/patologia , Humanos , Imuno-Histoquímica , Fígado/patologia , Fígado/cirurgia , Linfonodos/patologia , Linfoma não Hodgkin/complicações , Masculino , Pessoa de Meia-Idade , Baço/anormalidades , Baço/patologia , Esplenectomia
12.
J Am Acad Dermatol ; 80(6): 1544-1549, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30981429

RESUMO

BACKGROUND: Paraneoplastic pemphigus (PNP) occurs more often in patients with hematologic malignancies (HMs) than in patients with solid cancer. Lung bronchiolitis obliterans (BO) is a severe complication of PNP. OBJECTIVE: To determine the precise clinical and biologic features of HM-associated PNP and identify factors associated with mortality and survival. METHODS: Systematic review of previously described cases of PNP associated with HMs. RESULTS: A total of 144 patients were included. The HMs were non-Hodgkin lymphoma (52.78%), chronic lymphocytic leukemia (22.92%), Castleman disease (18.60%), and other underlying hematologic malignancy (5.70%). The mortality rate was 57%, and most deaths occurred within the first year after the diagnosis of PNP. Multivariate analysis showed that (1) the presence of antienvoplakin antibodies and BO were significantly associated with death, and (2) a toxic epidermal necrolysis-like clinical pattern, bullous pemphigoid-like clinical pattern, and BO were significantly associated with decreased survival. LIMITATION: Only case reports with sufficient mortality data were included. CONCLUSION: PNP associated with HM has a high mortality rate. The toxic epidermal necrolysis-like and BO-associated forms are independent survival factors in PNP associated with HMs.


Assuntos
Neoplasias Hematológicas/complicações , Síndromes Paraneoplásicas/mortalidade , Pênfigo/mortalidade , Idoso , Biomarcadores , Biópsia , Bronquiolite Obliterante/etiologia , Hiperplasia do Linfonodo Gigante/complicações , Feminino , Humanos , Estimativa de Kaplan-Meier , Leucemia Linfocítica Crônica de Células B/complicações , Linfoma não Hodgkin/complicações , Masculino , Pessoa de Meia-Idade , Especificidade de Órgãos , Síndromes Paraneoplásicas/etiologia , Síndromes Paraneoplásicas/patologia , Pênfigo/etiologia , Pênfigo/patologia , Prognóstico , Modelos de Riscos Proporcionais , Fatores de Risco , Pele/química , Pele/patologia
13.
Clin Liver Dis ; 23(2): 293-308, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30947878

RESUMO

Hepatic abnormalities in patients with lymphoproliferative disorders are common and can occur from direct infiltration by abnormal cells, bile duct obstruction, paraneoplastic syndrome, hemophagocytic syndrome, drug-induced liver injury, opportunistic infections, and reactivation of viral hepatitis. Hepatic involvement by lymphoma is often in association with systemic disease and rarely seen as a primary hepatic lymphoma. Vanishing bile duct syndrome is a well-known complication of Hodgkin disease. Antiviral prophylaxis for hepatitis B virus (HBV) reactivation is recommended for all HBsAg+ patients undergoing chemotherapy and all resolved HBV patients undergoing rituximab therapy and stem cell transplantation.


Assuntos
Hepatopatias/etiologia , Transtornos Linfoproliferativos/complicações , Transtornos Linfoproliferativos/tratamento farmacológico , Infecções Oportunistas/complicações , Síndromes Paraneoplásicas/etiologia , Hepacivirus/fisiologia , Vírus da Hepatite B/fisiologia , Hepatite B Crônica/etiologia , Hepatite C Crônica/etiologia , Doença de Hodgkin/complicações , Humanos , Neoplasias Hepáticas/etiologia , Linfoma não Hodgkin/complicações , Transtornos Linfoproliferativos/etiologia , Transplante de Órgãos/efeitos adversos , Ativação Viral
14.
Clin Nucl Med ; 44(6): e409-e412, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30985428

RESUMO

A 64-year-old man was treated with multiagent chemotherapy owing to high-grade non-Hodgkin lymphoma presenting as a bulky disease involving the spleen. Interim and posttreatment sequential FDG PET/CT scans revealed a residual splenic mass showing markedly intense FDG uptake suspected of a residual viable lymphoma. To definitely decide about the appropriate treatment, a laparoscopic splenectomy was performed. Histopathologic specimen was compatible with the rare diagnosis of postchemotherapy histiocyte-rich pseudotumor of the spleen, a potential pitfall simulating viable disease on FDG PET/CT.


Assuntos
Granuloma de Células Plasmáticas/diagnóstico por imagem , Linfoma não Hodgkin/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Baço/diagnóstico por imagem , Antineoplásicos/efeitos adversos , Diagnóstico Diferencial , Fluordesoxiglucose F18 , Granuloma de Células Plasmáticas/induzido quimicamente , Histiócitos , Humanos , Linfoma não Hodgkin/complicações , Masculino , Pessoa de Meia-Idade , Neoplasia Residual/diagnóstico por imagem , Compostos Radiofarmacêuticos , Baço/patologia
15.
Ann Hematol ; 98(8): 1953-1959, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31025161

RESUMO

The change in the incidence of lymphomas in function of the presence or absence of sustained virological response after anti-hepatitis C therapy in a cohort of human immunodeficiency (HIV)-hepatitis C (HCV) viruses coinfected patients was analyzed. A prospective cohort of 755 HIV-HCV coinfected patients who received their first anti-HCV therapy, based on interferon + ribavirin schemas, was evaluated. Incidence and histologic types of lymphomas were analyzed in two periods: (1) before administration of anti-HCV therapy and (2) after anti-HCV therapy. The association between lymphoma incidence and demographic, HIV- (minimum CD4+ cell count and CD4+ cell count at diagnosis of lymphoma, antiretroviral therapy, maximal HIV load and HIV load at diagnosis of lymphoma) and HCV-related variables (HCV load, genotype, sustained viral response to anti-HCV therapy) were analyzed. A total of 13 lymphomas [incidence rate (95% confidence interval), 0.72 (0.33-1.11) × 1000 person-years, time from HIV diagnosis to lymphoma diagnosis (median, interquartile range), 15 (11-19) years] were diagnosed. Nine of them were non-Hodgkin and four Hodgkin lymphomas. The median CD4+ T cell count at diagnosis of lymphoma was 457/mm3, with only two cases with values lower than 200/mm3. The incidence rate of non-Hodgkin lymphomas was similar pre- and post-anti HCV therapy [0.33 (0.00-0.65) vs 0.68 (0.08-1.26) × 1000 person-years, respectively, p > 0.05]. Patients with sustained virologic HCV response showed similar incidence rate of lymphomas than that of those without anti-HCV response. In conclusion, anti-HCV therapy does not modify the incidence rate of lymphomas in HIV-HCV coinfected patients.


Assuntos
Antivirais/uso terapêutico , Infecções por HIV/tratamento farmacológico , Hepatite C Crônica/tratamento farmacológico , Doença de Hodgkin/tratamento farmacológico , Interferon alfa-2/uso terapêutico , Linfoma não Hodgkin/tratamento farmacológico , Ribavirina/uso terapêutico , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Terapia Antirretroviral de Alta Atividade/métodos , Contagem de Linfócito CD4 , Linfócitos T CD4-Positivos/efeitos dos fármacos , Linfócitos T CD4-Positivos/patologia , Linfócitos T CD4-Positivos/virologia , Coinfecção , Combinação de Medicamentos , HIV/efeitos dos fármacos , HIV/crescimento & desenvolvimento , Infecções por HIV/complicações , Infecções por HIV/patologia , Infecções por HIV/virologia , Hepacivirus/efeitos dos fármacos , Hepacivirus/crescimento & desenvolvimento , Hepatite C Crônica/complicações , Hepatite C Crônica/patologia , Hepatite C Crônica/virologia , Doença de Hodgkin/complicações , Doença de Hodgkin/patologia , Doença de Hodgkin/virologia , Humanos , Linfoma não Hodgkin/complicações , Linfoma não Hodgkin/patologia , Linfoma não Hodgkin/virologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Carga Viral/efeitos dos fármacos
16.
Medicine (Baltimore) ; 98(10): e14802, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30855498

RESUMO

RATIONALE: Primary renal lymphoma (PRL) is a rare malignancy due to the absence of lymphatic tissues in the kidney, and patients with PRL have been reported to have a poor prognosis due to its rapid invasiveness and limited treatment strategies. Colon cancer is the third most common cancer, and has a high mortality rate. Both malignant diseases predominantly affected elderly men; however, a case with concomitant occurrence of the 2 cancers is extremely rare. PATIENT CONCERNS: A 78-year-old male patient with abdominal pain came to our hospital. Computed tomography (CT) indicated malignant masses in the left kidney, left adrenal gland, and the lower part of the descending colon. DIAGNOSES: PRL and colon cancer were diagnosed based on pathological examinations. INTERVENTIONS: The patient was treated with laparoscopic radical nephrectomy and laparoscopic radical resection of colon cancer. OUTCOMES: The patient was then transferred to the intensive care unit (ICU) because of poor condition after surgery. He died 3 months after discharge without receiving any other treatment. LESSONS: It is worth thinking about whether surgery was reasonable for elderly patients with double malignancies, or palliative treatment to improve the quality of life was more meaningful. This case also contributes to the understanding of the 2 malignancies and highlights the need to pay more attention to patients with multiple primary malignant neoplasms (MPMNs), explore genetic features, and investigate treatments with more survival benefits.


Assuntos
Adenocarcinoma/diagnóstico , Neoplasias do Colo/diagnóstico , Neoplasias Renais/diagnóstico , Linfoma não Hodgkin/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Adenocarcinoma/complicações , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Idoso , Neoplasias do Colo/complicações , Neoplasias do Colo/patologia , Neoplasias do Colo/cirurgia , Cuidados Críticos , Diagnóstico Diferencial , Evolução Fatal , Humanos , Neoplasias Renais/complicações , Neoplasias Renais/patologia , Neoplasias Renais/cirurgia , Linfoma não Hodgkin/complicações , Linfoma não Hodgkin/patologia , Linfoma não Hodgkin/cirurgia , Masculino , Neoplasias Primárias Múltiplas/patologia , Neoplasias Primárias Múltiplas/cirurgia
17.
Hematol Oncol ; 37(3): 261-269, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30916804

RESUMO

Survival rates of patients with non-Hodgkin lymphoma (NHL) have improved over the last decade. However, cardiotoxicities remain important adverse consequences of treatment with chemotherapy and radiation, although the burden of cardiovascular mortality (CVM) in such patients remains unknown. We conducted a retrospective cohort study of patients greater than or equal to 20 years of age diagnosed with diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL), and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) between 2000 and 2013 using data extracted from the United States Surveillance, Epidemiology, and End Results (SEER) database. Our primary endpoint was CVM. The association between NHL and CVM was evaluated using multivariable Cox regression analysis after adjusting for other patient characteristics. We calculated standardized mortality ratios (SMRs) for CVM, comparing NHL patients with the general population. We identified 153 983 patients who met the inclusion criteria (69 329 with DLBCL, 48 650 with CLL/SLL, and 36 004 with FL). The median follow-up was 37 months (interquartile range, 10-78 months); the mean patient age was 66.24 (±14.69) years; 84 924 (55.2%) were men; 134 720 (87.5%) were White, and 131 912 (85.7%) did not receive radiation therapy. Overall, 9017 patients (5.8%) died from cardiovascular disease, and we found that NHL patients had a higher risk of CVM than the general population, after adjusting for age (SMR 15.2, 95% confidence interval: 14.89-15.52). The rates of CVM were 5.1%, 8%, and 4.4% in patients with DLBCL, CLL/SLL, and FL, respectively. Furthermore, across all NHL subtypes, older age, higher stage at the time of diagnosis (particularly stage 4), male sex, and living in the south were associated with higher risks of CVM. Our data suggest that risk assessment and careful cardiac monitoring are recommended for NHL patients, particularly those with the CLL/SLL subtypes.


Assuntos
Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/mortalidade , Linfoma não Hodgkin/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/epidemiologia , Estudos de Coortes , Feminino , Humanos , Incidência , Estimativa de Kaplan-Meier , Leucemia Linfocítica Crônica de Células B/complicações , Leucemia Linfocítica Crônica de Células B/epidemiologia , Leucemia Linfocítica Crônica de Células B/mortalidade , Linfoma Folicular/complicações , Linfoma Folicular/epidemiologia , Linfoma Folicular/mortalidade , Linfoma Difuso de Grandes Células B/complicações , Linfoma Difuso de Grandes Células B/epidemiologia , Linfoma Difuso de Grandes Células B/mortalidade , Linfoma não Hodgkin/epidemiologia , Linfoma não Hodgkin/mortalidade , Masculino , Pessoa de Meia-Idade , Mortalidade , Estadiamento de Neoplasias , Estudos Retrospectivos , Medição de Risco , Programa de SEER , Resultado do Tratamento , Estados Unidos , Adulto Jovem
19.
Rheumatology (Oxford) ; 58(7): 1245-1249, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-30726952

RESUMO

OBJECTIVES: We conducted this nationwide population-based study in Taiwan to investigate whether there is a bidirectional relationship between SLE and non-Hodgkin's lymphoma (NHL). METHODS: Using the National Health Insurance Research Database of Taiwan, we identified 16 417 patients with new-onset SLE without previous cancer and 25 069 patients with new-onset NHL without previous SLE as two non-overlapping cohorts from 1998-2012, and followed them until 2013. Standardized incidence ratio (SIR) for NHL in the patients with SLE and SIR for SLE in the patients with NHL were compared with the general population. RESULTS: Among the 16 417 patients with SLE, 512 developed cancers, including 34 with NHL. The highest SIR was that for NHL (SIR 4.2, 95% CI 2.9, 5.9) in site-specific cancer risk analysis. Among the 25 069 patients with NHL, 14 developed SLE, and the SIR was also increased (SIR 2.0, 95% CI 1.1, 3.4). The SIRs of the patients with SLE to develop NHL and the patients with NHL to develop SLE were both highest within the first year after the diagnosis of each disease. CONCLUSION: This nationwide population-based study is the first study to report a bidirectional relationship between SLE and NHL. This finding may suggest being alert for the patients with SLE or NHL who have early sings of the other disease in clinical care.


Assuntos
Lúpus Eritematoso Sistêmico/complicações , Linfoma não Hodgkin/complicações , Adolescente , Adulto , Criança , Estudos de Coortes , Bases de Dados Factuais , Feminino , Seguimentos , Humanos , Incidência , Lúpus Eritematoso Sistêmico/epidemiologia , Linfoma não Hodgkin/epidemiologia , Masculino , Pessoa de Meia-Idade , Medição de Risco/métodos , Taiwan/epidemiologia , Adulto Jovem
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