Search

Epstein Barr virus positive (EBV+) immunodeficiency-associated lymphoproliferative disorders (IA-LPD) are heterogeneous diseases with variable treatment strategies that are not well-defined. A 68-year-old woman with systemic lupus erythematosus developed EBV+ B-cell polymorphic lymphoproliferative disease (LPD). Positron emission tomography computed tomography (PET/CT) showed a large nasopharyngeal mass, multiple pulmonary lesions, splenomegaly and disseminated lymphadenopathy. Plasma EBV DNA was grossly elevated to 1.5 × 104 IU/mL. There were three paraproteins. Treatment with O-CHOP (obinutuzumab, cyclophosphamide, adriamycin, vincristine, prednisolone) led to undetectable plasma EBV DNA, suggesting eradiation of the EBV-positive malignant clone. However, radiologic abnormalities were still present on PET/CT, and paraprotein persisted. A nasopharyngeal re-biopsy showed infiltration with EBV-negative plasma cells. On treatment with lenalidomide, she finally achieved complete metabolic response. Molecular analysis showed that the EBV+ B-cell LPD and the EBV– plasma cell lesion exhibited identical immunoglobulin gene rearrangements. Next generation sequencing revealed that the EBV+ B-LPD showed mutation in only one gene (TP53), a profile typical of EBV-driven lymphoid neoplasms. However, the EBV– plasma cell lesion showed mutations in five genes (TP53, SF3B1, STAT5B, CD79B and CRKL), suggesting that these mutations instead of EBV infection were the oncogenic driver. The presence of both EBV+ and EBV– lesions, which showed different mutational profiles, indicated clonal heterogeneity that might be of biologic and therapeutic significance. [ABSTRACT FROM AUTHOR]

Epstein-Barr virus-positive diffuse large B-cell lymphoma after frontline brentuximab vedotin treatment of classical Hodgkin lymphoma Right axillary lymph node biopsy showed mixed cellularity classical Hodgkin lymphoma (cHL) (Fig. 1 Mixed cellularity classical Hodgkin lymphoma treated with frontline brentuximab vedotin, and subsequent development of Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma, polymorphic type. Cervical lymph node biopsy showed Epstein-Barr virus-positive diffuse large B-cell lymphoma (EBV+ DLBCL), polymorphic pattern [[4]], non-germinal centre B-cell (non-GCB, Hans algorithm) in origin immunohistochemically (Fig. [Extracted from the article]

Five patients with refractory/relapsed classical Hodgkin lymphoma (cHL), four having failed multiple lines of chemotherapy and brentuximab vedotin, were treated with low-dose pembrolizumab (median dose 100 mg, range: 100-200 mg, every 3 weeks). Complete response (CR) was achieved in four patients (80%), after a median cumulative dose of merely 495 (300-800) milligrams. Three CR patients have continued to receive pembrolizumab for a median of 16 (14-25) cycles, remaining in CR for a median of 18 (9-18) months. One CR patient underwent autologous hematopoietic stem cell transplantation and has remained in CR for 9 months. Partial response (PR) was achieved in one patient (20%), after a cumulative dose of 400 mg. The overall response rate was therefore 100% (CR: 80%; PR: 20%). Toxicity was virtually absent, with only grade 1 diarrhea and eczema each observed in one patient. Low-dose pembrolizumab was highly efficacious, achieving responses with minimal toxicity and at much lower costs. [ABSTRACT FROM AUTHOR]

The article focuses on a study related to thrombopoietin mimetics eltrombopag and romiplostim in the treatment of refractory aplastic anaemia (AA). It mentions hyperpigmentation considered as common side effect of eltrombopag. It also mentions need for investigation of thrombopoietin receptor expression on melanocytes or gut cells.

The article presents a case study of 74-year-old man with progressive cervical lymphadenopathy. Topics discussed include follicular T cell lymphoma such as angioimmunoblastic T cell lymphoma (AITL) and peripheral T cell lymphoma; the use of lenalidomide treatment for follicular T cell lymphoma and an identification of Epstein Barr virus (EBV) with non-neoplastic B cells.

The article presents a case study of a 35-year-old woman suffering from anaplastic large cell lymphoma (ALCL). She was in a drug regimen and underwent haematopoietic stem cell transplantation (HSCT). She was being relapsed with ALCL in spite of intake of the drug regimen. She was given Pembrolizumab along with liposomal amphotericin observing a complete remission of relapsed ALCL.

Background & Aims: De novo hepatitis B virus (HBV)-related hepatitis after chemotherapy results in high morbidity and mortality. We evaluate the clinical course of de novo HBV-related hepatitis after chemotherapy. Methods: Two hundred forty-four consecutive hepatitis B surface antigen (HBsAg)-negative lymphoma patients treated with chemotherapy were followed up for a median of 12.4 (range, 0.1–65.0) months. Serially collected serum samples were analyzed for hepatitis, serum HBV DNA, and HBsAg seroreversion. Results: Eight of the 244 patients (3.3%) developed de novo HBV-related hepatitis. A 100-fold increase in serum HBV DNA preceded de novo HBV-related hepatitis by a median of 18.5 (range, 12–28) weeks. All 8 patients had normal serum alanine aminotransaminase level when the 100-fold increase in serum HBV DNA occurred. Patients with de novo HBV-related hepatitis were more likely to have occult HBV infection before chemotherapy. Direct sequencing results showed that these 8 patients had de novo HBV-related hepatitis from reactivation of occult HBV infection. Three of the 8 patients with de novo HBV-related hepatitis compared with 6 of the 236 patients without de novo HBV-related hepatitis developed fulminant hepatic failure (37.5% vs 2.5%, respectively, P < .001). On multivariate Cox analysis, de novo HBV-related hepatitis was independently associated with a higher risk of fulminant hepatic failure (relative risk, 29.854; 95% confidence interval: 4.844–183.980; P < .001). Conclusions: Close surveillance for a 100-fold increase in HBV DNA is recommended for HBsAg-negative patients treated with chemotherapy so that early commencement of antiviral therapy can be initiated before the occurrence of de novo HBV-related hepatitis. [Copyright &y& Elsevier]

The article presents a case study of a 55-year-old man who was diagnosed with acute promyelocytic leukemia (APL). His Karyotyping and molecular analysis showed PML-RARA of the BCR3 isoform while his induction treatment with all-trans retinoic acid (ATRA) and idarubicin resulted in first complete remission.

A letter to the editor is presented which discusses a case study of a 19 year old man related to the treatment of Subcutaneous panniculitis-like T cell lymphoma (SPTCL) with haemophagocytic syndrome (HPS) and diagnosis of macrophage activation syndrome.

The article presents a case study of a 51-year-old man with abdominal, pelvic and cervical lymphadenopathy. He was taken to the hospital. He underwent biopsy of para spinal mass revealing double hit lymphoma. He was treated with a combination of lenalidomide and Pembrolizumab leading to disease remission. He is currently getting ready to receive allogeneic hematopoietic stem cell transplantation.

The article discusses the case of a patient with acute promyelocytic leukemia (APL) arising from primary myelofibrosis. Topics discussed include molecular analysis of peripheral blood which revealed mutation of JAK2 V617F gene and PML-RARA gene fusion, the results of marrow trephine biopsy, and the management of the patient using all-trans-retinoic acid (ATRA), daunorubicin and corticosteroids.

The article presents a case study of a 59-year old man who suffered from mycosis fungoides (MF). Topics discussed include presence of lesions in the right shoulder of the patient as found by the positron emission tomography computed tomography (PET/CT), treatment with romidepsin, histone deacetylase (HDAC) inhibitor and administration of alemtuzumab to treat foot lesion. Also mentioned is the possible effectiveness of alemtuzumab in large cell transformation (LCT) of the MF.

The article describes a case of pure red cell aplasia (PRCA) associated with CD20+ myeloma in a 41-year-old woman with severe anaemia. A 2-centimeter 18-fluorodeoxyglucose-avid pelvic lymph node was identified in the patient through positron emission tomography. The case indicated that treatment with rituximab led to complete PRCA remission.

The article presents a case study of a 42-year-old man diagnosed with pancytopenia, impaired renal function, and septicemia. He was referred for treatment of acute promyelocytic leukemia (APL) in first relapse. The article discusses the use of oral arsenic trioxide for treatment of acute promyelocytic leukemia along with hemodialysis.

The article presents a case study of a 68-year-old man who was presented with cervical lymphadenopathy, bilateral tonsillar enlargement and ulcerations. It mentions that bone marrow examination reveals acute myeloid leukemia (AML) and pathological features were consistent with Langerhans cell histiocytosis (LCH). It discusses the use of vinblastine, etoposide and cyclophosphamide for the treatment.