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Objective: Our objective was to evaluate the frequency of expression and determine the expression levels of the NY-ESO-1 gene in patients with DLBCL as well as to examine its relationship with clinical parameters and survival. Methods: We analyzed NY-ESO-1 gene expression levels using real-time quantitative RT-PCR (RT-qPCR) in 112 patients with DLBCL. The associations between the expression of the NY-ESO-1 gene and the clinical variables were evaluated using the Chi-square test and Fisher’s exact test. Overall survival (OS) was determined using the Kaplan–Meier method. Result: The results showed that the NY-ESO-1 gene was expressed in 46.4% (52/112) of patients with DLBCL, and NY-ESO-1 gene expression was associated with clinical parameters such as LDH, clinical stage, and International Prognostic Index (IPI) (p ≤ 0.05). High levels of NY-ESO-1 gene expression were associated with advanced disease stages, and the survival rates after 5.3 years of tracking were lower in the patients expressing the NY-ESO-1 gene (66.4%) than in those not expressing the gene (23.1%). Conclusion: The expression levels of the NY-ESO-1 gene in patients with DLBCL may be of great utility for diagnosing and determining the prognosis of this disease.

Diffuse large B-cell lymphoma is the most common type of aggressive lymphoma. Patients that don’t respond to first-line therapy have a poor prognosis. Bone marrow transplant represents an effective and established salvage treatment for those patients, with curative potential. Autologous transplant uses the patient stem cell for rescue after high-dose myeloablative chemotherapy, while allogenic transplant relies on a different stem cell for a graft-versus-lymphoma effect. With distinct toxicity and capacity to induce remission, those therapies have great value in the management of patients with relapsed and refractory diffuse large B-cell lymphoma.

Introduction: The lymphocyte / monocyte index (ILM) has been described as an inflamatory prognostic parameter in many hematological diseases and solid tumors. The aim of the present study was to evaluate the prognostic value of the lymphocyte / monocyte index in the survival of patients with diffuse large B-cell lymphoma (LCGBD). Methods: The present is an analytical, longitudinal and non-experimental study. Patients diagnosed with diffuse large B-cell lymphoma of the Edgardo Rebagliati Martins hospital from 2010 to 2017 were selected. Results: 121 patients were included, 57% female, 66.1% older than 60 years. Regarding the Performance Status Zubrod, 66.5% corresponded to the degree of best forecast 0 and 1; 59.5% presented associated B symptoms. Nearly 60% were stages I and II and 57% presented extranodal involvement. We show that the ILM is significant for overall survival in the regression analysis of bivariate cox, not reaching significance in the multivariate. Conclusion: ILM is a potential simple and accessible prognostic biomarker for our population with diffuse large B-cell lymphoma. DOI:10.25176/RFMH.v19.n2.2068

Diffuse B-cell lymphoma is the most common type of non-Hodgkin lymphoma in adults characterized by its aggressiveness and wide location. The first sign of its presence is a rapidly growing mass of lymph nodes. The case of a 64-year-old patient is presented, with a pathological history of arterial hypertension, ex-smoker, who was admitted because for 3 months she had increased volume of the left lateral region of the neck. Clinical studies, imaging, aspiration cytology, medullogram and spinal biopsy and lymph node biopsy allowed diagnosis and staging to begin treatment with cyclophosphamide, doxorubicin, vincristine and prednisone plus the monoclonal antibody rituximab according to the protocol for these tumors. Two months after treatment, the reduction of ganglionic masses had been achieved. The case is presented because it is of interest to specialists and training personnel.

Background: Central Nervous System (CNS) relapse in Diffuse Large B-cell Lymphoma occurs mostly 6-8 months after disease onset. This has led to propose that CNS infiltration is an early event in the evolution of the disease. We intend to evaluate the role of magnetic resonance imaging (MR) at diagnosis to detect early SNC compromise. Materials and Methods: Prospective longitudinal cohort’s study in DGCB patients treated at Hospital de Clínicas between 2013 and 2015. Skull MRI was performed in all patients at diagnosis and lumbar puncture was done according to predefined risk factors. Results: 35 patients were analyzed. Median age: 68 years (24-85 years). Stage III-IV: 62%, 57% good prognosis according to RIPI score and 43% poor prognosis. MRI was performed in all patients, with no pathological findings in any of them. Twenty-one patients fullfilled criteria for cerebrospinal fluid study. Twenty-two patients were studied and received intrathecal methotrexate prophylaxis. Meningeal relapse was observed in a single patient who had negative studies at diagnosis and had received complete prophylaxis at the end of the 6 R-CHOP series. Conclusions: Only one of the 35 patients relapsed in the CNS. This patient had a noral MRI and CSF study at diagnosis and had received prophylaxis with intrathecal chemotherapy. This results lead us to believe that the value of MRI to detect early infiltration in asymptomatic patients at diagnosis is low.

The authors report a case of diffuse large B-cell lymphoma (DLBL) of the oral cavity. The patient was a 73-year-old white man who first presented at the Division of Stomatology with a large nodular mass in the hard palate and a nodular lesion in the upper lip, which were diagnosed as DLBL. The patient was treated with eight cycles of CHOP chemotherapy (cyclophosphamide, doxorubicin, vincristine and prednisone), but the disease recurred 22 months after the end of the therapy. Both primary sites hard palate and upper lip were involved again and the patient was resubmitted to chemotherapy.Se reporta un caso de linfoma difuso de células B grandes (DLBL) de la cavidad bucal. Se trata de un paciente masculino, blanco, de 73 años de edad, que se presentó a la División de Estomatología, con una masa nodular difusa en el paladar duro y una lesión nodular en el labio superior, diagnosticadas como DLBL. El paciente fue tratado con ocho ciclos de quimioterapia CHOP (ciclofosfamida, doxorrubicina, vincristina, prednisona), pero se constató recidiva de la enfermedad en ambos sitios primarios, en el paladar duro y en el labio superior a los 22 meses después del término de la terapia. El paciente fue sometido de nuevo a la quimioterapia.

Non-Hodgkin’s lymphomas are common and comprise a heterogeneous group of neoplasms, with diffuse large B-cell lymphoma (DLBCL) accounting for more than 60% of cases. Moreover, DLBCL presents with a variety of clinical characteristics, genetic profiles, and therapeutic responses. We aimed to improve progression-free survival, total survival, and objective results in an DLBCL subgroup. However, another subgroup demonstrated poor responses. Therefore, it is necessary to design treatment programs based on clinical, immunohistochemical, and genetic profiles, grouping cases properly to identify correct therapeutic modalities for each lymphoma subtype. Currently, these neoplasms are classified as high- and low-risk lymphomas, and therapeutic regimens are being developed to complement conventional R-CHOP, such as R-DA-EPOCH, R2CHOP, IR-CHOP, VR-CHOP, and eveRCHOP, which are expected to improve outcomes.

Introduction: The inclusion of rituximab for treatment of diffuse large B cell lymphoma (DLBCL) generated the need to re-assess the conventionally employed prognostic factors and to explore others that could be useful for prognostic purposes. Objective: To describe the most important clinical, hematological, biochemical and immunohistochemical factors that have been useful for prognostic purposes in follow-up studies of patients with DLBCL treated with chemotherapy plus rituximab. Results: The following factors were found to have prognostic significance: the revised International Prognostic Index, bone marrow infiltration, the presence of a bulky mass, CD5 expression and the percentage of Ki-67 expression. Contrariwise, the application of other factors remains controversial: conventional IPI, Bcl-2 and Bcl-6 expression, and the immunohistochemical profile.

Objectives: The aim of this study was to evaluate the efficacy and toxicity of high-dose rituximab (HD-R) in combination with autologous stem cell transplantation (auto-SCT) in patients with relapsed or refractory diffuse large B cell lymphoma (DLBCL)., Methods: There were 22 patients in the HD-R group, to whom rituximab was administered during stem cell mobilization (375mg/m 2 1 day before and 7 days after chemotherapy) and after transplantation (1000mg/m 2 on days +1 and +8). In the control group, the procedure was the same as that in the HD-R group but without rituximab. We observed the safety, tolerability, adverse effects and immune reconstitution of HD-R therapy. The log-rank test, univariate analysis and multivariate Cox regression analysis were used to evaluate the effect of HD-R on survival., Results: In total, 22 relapsed or refractory DLBCL patients were treated with HD-R. No dose-limiting toxicities were observed except for CD19 + B cell reconstruction in the first 6 months after SCT. There were 20 relapsed or refractory DLBCL patients in the control group. The 3-year progression-free survival (PFS) and overall survival (OS) greatly improved in the HD-R group compared to that in the control group (63.8% vs. 35.0%, P=0.028 and 80.1% vs. 50.0%, P=0.035, respectively). The univariate and multivariate analyses demonstrated that HD-R and the time to relapse were independent prognostic factors for OS and PFS., Conclusion: HD-R in combination with auto-SCT is a feasible and promising treatment for patients with relapsed or refractory DLBCL., (Copyright © 2019 Elsevier España, S.L.U. All rights reserved.)

Primary colorectal lymphoma is a rare form of presentation of gastrointestinal tract lymphomas. Inflammatory bowel disease and its treatment are risk factors for its development. We report a 47-year-old male patient with Ulcerative Colitis of two years of evolution, treated initially with azathioprine and later on with infliximab. Due to a relapse in symptoms after the second dose of infliximab, a new coloncoscopy was performed showing a rectal ulcerative lesion, corresponding to a large cell Non-Hodgkin's Lymphoma. The patient was successfully treated with RCHOP chemotherapy (Rituximab cyclophosphamide doxorubicin vincristine prednisone). He is currently in disease remission.