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Introduction: In epidemiological studies, chronic inflammation or previous major infection have revealed to be associated with an increased risk of developing Hodgkin lymphoma (HL). The association of chronic inflammation with the disease outcome is poorly defined. In this retrospective study based on 92 consecutive HL patients, we explored the incidence of previous inflammatory processes or previous major infection in newly diagnosed HL patients and their association with treatment outcome. Methods: Medical history before lymphoma diagnosis including previous infection; dental inflammation; cutaneous problems; and inflammatory respiratory, gastrointestinal, or musculoskeletal diseases was collected from the patient records. Also clinical HL presentation, given treatments, and the disease outcome were recorded. Results: Forty-six percent of HL patients had some of the studied inflammatory factor at the time of diagnosis. Chronic dermatological diseases were present in 16.3% of patients, and they were associated with an improved relapse-free survival (p = 0.028). Dermatological issues were also associated with early-stage disease and the absence of B-symptoms. Other studied inflammatory factors were not associated with any clinical variables or treatment outcome. Conclusion: Our results demonstrated that among patients with HL, preexisting cutaneous symptoms are associated with a limited-stage disease, the absence of B-symptoms, and favorable prognosis.

The purpose of this RNA sequencing study was to investigate the biological mechanism underlying how the transcription factors (TFs) Twist1 and Zeb1 influence the prognosis of mycosis fungoides (MF). We used laser-captured microdissection to dissect malignant T-cells obtained from 40 skin biopsies from 40 MF patients with stage I–IV disease. Immunohistochemistry (IHC) was used to determinate the protein expression levels of Twist1 and Zeb1. Based on RNA sequencing, principal component analysis (PCA), differential expression (DE) analysis, ingenuity pathway analysis (IPA), and hub gene analysis were performed between the high and low Twist1 IHC expression cases. The DNA from 28 samples was used to analyze the TWIST1 promoter methylation level. In the PCA, Twist1 IHC expression seemed to classify cases into different groups. The DE analysis yielded 321 significant genes. In the IPA, 228 significant upstream regulators and 177 significant master regulators/causal networks were identified. In the hub gene analysis, 28 hub genes were found. The methylation level of TWIST1 promoter regions did not correlate with Twist1 protein expression. Zeb1 protein expression did not show any major correlation with global RNA expression in the PCA. Many of the observed genes and pathways associated with high Twist1 expression are known to be involved in immunoregulation, lymphocyte differentiation, and aggressive tumor biology. In conclusion, Twist1 might be an important regulator in the disease progression of MF.

Primary central nervous system lymphoma (PCNSL) is an aggressive brain disease where lymphocytes invade along perivascular spaces of arteries and veins. The invasion markedly changes (peri)vascular structures but its effect on physiological brain pulsations has not been previously studied. Using physiological magnetic resonance encephalography (MREG

BackgroundVenous thromboembolic events (VTEs) remain a major cause of mortality and morbidity among lymphoma patients. Accurate risk-prediction models are lacking, however, especially in the high VTE risk subgroup of diffuse large B-cell lymphoma (DLBCL). The relationship between patient-, disease- and treatment-related factors and the VTE risk is yet incompletely defined in this disease entity. MethodsIn this retrospective study, we analyzed the risk factors for VTEs in DLBCL patients treated with first-line (1L) chemoimmunotherapy in Kuopio and Oulu University Hospitals (2010-2019). Univariate and multivariate analysis (Cox regression) of VTE risk factors was performed. Two novel VTE risk scores were developed and compared by ROC (receiver operating characteristic) analysis.ResultsVTE occurred in 17.2% (n=59) in the whole population, of which seven cases occurred during anticoagulant therapy. Statistically significant risk factors for VTE included age >65 years, ECOG (Eastern Cooperative Oncology Group) >1, thrombophilia, bulky disease, LDH > ULN (lactate dehydrogenase; upper limit of normal) and IPI (International Prognostic Index) 4-5. In a multivariate Cox regression model, previous history of thrombophilia and bulky disease were independent risk factors for VTE (p=0.000 and p=0.032, respectively). VTE at 1L had no significant effect on survival (overall survival, progression-free survival or disease-specific survival) at 2 or 5 years of follow-up. Two different VTE risk scores were tested in DLBCL patients treated in 1L. ROC analysis was used to assess the ability of the score to classify VTE risk. A risk score 2 (age >65/LDH > ULN/ ECOG>1/thrombophilia = 1 p., bulky disease 2 p.) received a higher ROC value (0.680) than risk score 1. In the “high risk” group (5 p., according to risk score 2), VTE risk was increased, at 35.3%. ConclusionsThrombophilia and bulky disease were independent risk factors for VTE in 1L-treated DLBCL patients. A novel VTE risk score was developed, to be further qualified.