RESUMO
In the past decade, patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) were treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) therapy. Standard treatment is now changing as a result of deeper understanding of underlying biologic differences of such lymphomas. One of the most powerful predictors of an adverse outcome on R-CHOP therapy is the presence of a MYC gene rearrangement (MYC+ lymphoma). Determination of MYC gene rearrangement by FISH (fluorescent in situ hybridisation) has recently become a standard diagnostic procedure. In this paper, an overview of current literature on MYC function and MYC+ lymphoma patient outcome is presented. Furthermore, we present 26 patients from our tertiary referral centre who were diagnosed with MYC+ lymphoma between 2009 and 2014. In our patient series, we confirm the dismal prognosis of MYC+ lymphoma patients. Intensification of classical chemotherapy does not lead to better overall survival, justifying new treatment modalities. First line therapy should be more specifically targeted against MYC and the genes and proteins that are deregulated by MYC. To this end, the first clinical trial in which MYC+ patients will be offered targeted treatment has recently been launched.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais/genética , Rearranjo Gênico , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Proteínas Proto-Oncogênicas c-myc/genética , Adulto , Idoso , Feminino , Predisposição Genética para Doença , Humanos , Hibridização in Situ Fluorescente , Linfoma Difuso de Grandes Células B/genética , Linfoma Difuso de Grandes Células B/mortalidade , Linfoma Difuso de Grandes Células B/patologia , Masculino , Pessoa de Meia-Idade , Terapia de Alvo Molecular , Seleção de Pacientes , Fenótipo , Medicina de Precisão , Valor Preditivo dos Testes , Análise de Sobrevida , Resultado do TratamentoAssuntos
Hiperplasia Angiolinfoide com Eosinofilia/patologia , Linfonodos/patologia , Glândula Parótida/patologia , Hiperplasia Angiolinfoide com Eosinofilia/diagnóstico , Hiperplasia Angiolinfoide com Eosinofilia/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Esteroides/uso terapêuticoRESUMO
INTRODUCTION: Heparin-induced allergic reactions may cause problems if heparin administration is needed for thrombo-embolic disease in pregnancy. CASE REPORTS: We report two cases of hypersensitivity to low molecular weight heparin (LMWH) in pregnancy. DISCUSSION: Alternative methods and new antithrombotic agents are discussed.
Assuntos
Anticoagulantes/efeitos adversos , Toxidermias/etiologia , Heparina de Baixo Peso Molecular/efeitos adversos , Adulto , Anticoagulantes/uso terapêutico , Fator V/genética , Feminino , Heparina de Baixo Peso Molecular/uso terapêutico , Humanos , Gravidez , Embolia Pulmonar/prevenção & controle , Trombose Venosa/tratamento farmacológicoRESUMO
We describe a patient, in whom giant liver hemangioma (GLH) was found by ultrasound study in screening for hypertension. Two of her sisters also had GLH. One of them had become symptomatic and the hemangioma was successfully removed. The other sisters were carefully watched. Our patient didn't need any intervention in 4 years of follow-up. The pathogenesis of GLH is still unknown. Recent investigations show a role of the TIE receptor/angiopoietin system in vascular malformations. In literature we only found two other reports about a familial occurrence of liver hemangiomas. A genetic defect in familial GLH has not yet been identified.