B-Cell Non-Hodgkin Research Articles

Intraocular Lymphoma and Metastatic Tumors of the Retina

Intraocular lymphomas (IOLs) are a rare, heterogeneous group of malignancies often misdiagnosed and underrecognized. These tumors are often non-Hodgkin's and B-cell type when they occur. Primary IOLs are classified into two groups: primary uveal lymphomas (PULs) and primary vitreoretinal lymphomas (PVRLs). PULs are small cells, low-to-moderately aggressive, relatively benign, and rarely associated with central nervous system (CNS) involvement. PVRLs often diffuse large B-cells, are highly aggressive, and are related to malignant primary CNS lymphoma. Secondary IOLs that metastasize to intraocular structures other than the CNS constitute the last group of IOLs. Secondary IOLs typically metastasize to the choroid and have a poor prognosis due to associated systemic disease. All IOLs are challenging to diagnose, leading to treatment delays. Metastatic tumors are the most common intraocular malignancies. However, metastases mainly occur in the choroid. Retinal metastases are much rarer. Primary tumor sites are the most common skin, gastrointestinal tract, lung, and breast cancers. A biopsy is helpful to confirm the diagnosis and may help locate the primary tumor. Radiotherapy is the most common treatment modality. A multidisciplinary approach is essential in treatment management. Despite successful treatment of retinal metastases, patients have a poor prognosis for survival of primary tumors. This review aims to increase awareness and share diagnostic clues and treatment strategies in these critical and insidious malignancies in light of current literature. IOLs and metastatic tumors of the retina will be evaluated separately under the headings.

IL-10 plus the EASIX score predict bleeding events after anti-CD19 CAR T-cell therapy.

Chimeric antigen receptor (CAR) T-cell-associated coagulopathy can cause bleeding events. To explore risk factors for hemorrhage after CAR T-cell therapy, we retrospectively analyzed routine indicators in 56 patients with non-Hodgkin lymphoma and B-cell acute lymphoblastic leukemia who received anti-CD19 CAR T-cell therapy. Disturbance of coagulation occurred mainly within one month post infusion, especially on day 7 and 14. The cumulative incidence of bleeding events within one month was 32.8%, with the median onset of 7 (range, 0-28) days. All bleeding events were grade 1-3. Patients who experienced bleeding events within one month had longer prothrombin time, higher IL-6, higher IL-10, and lower platelets before lymphodepletion. There were also correlations among coagulation-, inflammatory-, and tumor burden-related markers. Multi-variate analysis showed IL-10 (> 7.98 pg/mL; adjusted odds ratio [OR], 13.84; 95% confidence interval [CI], 2.03-94.36; P = 0.007) and the endothelial activation and stress index (EASIX, defined as dehydrogenase [U/L] × creatinine [mg/dL] / platelets [×109 cells/L]; >7.65; adjusted OR, 7.06; 95% CI, 1.03-48.23; P = 0.046) were significant risk factors for bleeding events. IL-10 plus the EASIX defined three risk groups for bleeding events with cumulative incidence of 100% (hazard ratio [HR], 14.47; 95% CI, 2.78-75.29; P < 0.0001), 38.5% (HR, 3.68; 95% CI, 0.82-16.67; P = 0.089), and 11.8% (reference), respectively. Future studies are needed to verify the risk assessment models for bleeding events after CAR T-cell treatment in larger cohorts.

Understanding the Role of Bispecific Antibodies in the Management of B-Cell Non-Hodgkin Lymphoma: A New Immunotherapy That Is Here to Stay

Non-Hodgkin lymphomas (NHLs) represent a diverse group of hematologic malignancies derived from various cells. B-cell NHLs represent the largest fraction of lymphomas diagnosed and treated in the United States. Standard chemo-immunotherapies with rituximab and multiagent cytotoxic regimens have proven to be effective in the management of these lymphoproliferative neoplasms; nonetheless, a considerable fraction of patients still experience relapse or have treatment-refractory disease. Therapeutic advances using novel immunotherapeutic agents as well as cell-based treatments, such as chimeric antigen receptor (CAR) T-cell therapies, have improved the outcomes of relapsed/refractory (R/R) B-cell NHL. Most of these new treatment strategies are not curative and most patients succumb to R/R disease, leaving this population with an unmet need for effective and well-tolerated therapeutic options. One of these up-and-coming options are bispecific antibodies (BsAb), either as single agent or in combination with other medications. Conclusion: BsAbs offer a novel “off the shelf” chemotherapy-free approach in the management of R/R B-cell NHL. Advancements in antibody construct design along with improved safety profile and clinical effectiveness of the most recent BsAbs suggest that these agents are a promising new option in the management of R/R B-cell NHL.

B-355 Measurable Residual Disease Detection in Mantle Cell Lymphoma (MCL) Subjects Using NGS B-Cell MRD Assay

Abstract Background Mantle Cell Lymphoma (MCL) is an aggressive, rare form of non-Hodgkin B-cell lymphoma. Measurable Residual Disease (MRD) assessment can provide useful information when assessing and tracking response to therapy, refining treatment and predicting clinical outcome for subjects with B-cell lymphoproliferative diseases. One method of MRD detection is to identify and track specific clonal immunoglobulin heavy chain (IGH) gene rearrangement sequences on a next-generation sequencing (NGS) platform. Here, we present the NGS-based B-cell MRD Assay with 10−6 sensitivity for detecting MRD in malignancies in mantle cell lymphoma (MCL). Methods Residual DNA samples from different specimen types (44 BM and 77 PB) at different post-treatment time points were obtained from anonymized 47 MCL subjects that had been enrolled in a study approved by the Spanish Group of Lymphoma and Autologous Stem Cell Transplantation (clinical trial: NCT02682641, publication reference: 10.1200/JCO.21.02321). 121 of these follow up samples were tested by the B-cell MRD Assay by tracking the clonal sequences detected in corresponding baseline samples. Among them, 90 follow up samples were paired PB and BM samples. The B-cell MRD Assay workflow consists of DNA extraction and PCR based library preparation with proprietary multiplex master mixes (MMx) targeting either IGH Framework 1 (FR1) or 3 (FR3) regions, which both track the patient- and tumor-specific CDR3 sequence. Purified libraries are then equimolar pooled and sequenced on Illumina’s NextSeq Dx platform. The FASTQ output files from sequencing are analyzed using Invivoscribe’s B-Cell MRD Software-NextSeqDx. Results from Invivoscribe were compared to the results from Salamanca lab that were generated by qPCR. Results Based on the results from B-cell MRD Assay, 115/121 (95%) samples were valid, 42/115 (37%) valid samples had, “MRD Detected”, and 73/115 (63%) samples had, “MRD Not Detected”, with an “MRD Detection” rate of 28% in PB and 50% in BM specimen types. When comparing MRD detectable status between paired PB and BM samples from 36 MCL subjects, 30/44 (68%) paired samples had same MRD call and were concordant, whereas 14/44 (32%) calls were discordant. More specifically, 12/14 (86%) discordant samples had PB specimen type with a “MRD Not detected” call, whereas the paired BM specimen showed a “MRD Detected” call. Overall, in comparison with the MRD results (n = 84) provided by Salamanca lab using qPCR method, the B-cell MRD Assay demonstrated concordance of 80%, PPA of 79%, and NPA of 80% for MRD detection in MCL samples. Conclusion Good concordance was observed between the qPCR used at Salamanca and Invivoscribe’s B-cell MRD assay. It was important to note that the BM specimen type was determined to be more sensitive in detecting MRD when compared to PB in assessment of paired PB and BM samples. These results demonstrate that the B-cell MRD Assay can be utilized for MRD detection in follow-up sample types for MCL subjects.

Neurolymphomatosis in Non-Hodgkin's Lymphoma

non-Hodgkin's lymphomas (NHLs) are a heterogeneous group of hematopoietic puffins, with diphun B-velicocyclotinous lymphoma accounting for 25% of all NHLs and having the greatest midline to axis growth (Leeuwenуе et al., 2014). Of all NHLs, the central and peripheral nervous systems are most often affected in diphytic B-lycocytic lymphoma (Padala, &amp; Kallam, 2022. Liu, &amp; Barta, 2019). In NHL, infiltration of cranial and peripheral nerves can be detected - neurolymphomatosis (NL) emerges. NL is a very rare condition and occurs in about 0.2% of patients with NHL (Baehring, Damek, Martin, Betensky &amp; Hochberg, 2003). These infiltrations can manifest with detection of mononeuropathy, multiple neuropathy, symmetric neuropathy or plexopathy (Grisold W., Grisold A., Marosi, Meng, &amp; Briani, 2015). The aim of the work was to study the features of the clinical course, diagnosis and treatment of neurolymphomatosis in the form of lesions of the trigeminal, facial cranial nerve and the left ulnar nerve in diffuse B-bollichelial non-Hodgkin lymphoma based on a clinical case. We present a review of a clinical case of peripheral nervous system involvement in a patient born in 1977 with diffuse B-cell non-Hodgkin's lymphoma. The diagnosis was established on the basis of clinical manifestations of lesions of the branches of the trigeminal and left facial nerves, the left ulnar nerve, magnetic resonance imaging of the head and brain, electroneuromyography, and immunohistochemical examination of the infiltrate biopsy from the affected buccal branch of the left facial nerve. In March 2022, the patient developed moderate peripheral paresis of the mimic muscles on the left side, burning pain with impaired tactile and pain sensitivity of the dorsum, wing of the nose, and left instep. A week later there was a decrease in the strength, tactile and pain sensitivity, and patience of the fourth and fifth fingers of the left hand. Within a month, the burning pain had spread to the left cheek, periorbital, and chin areas of the face. In 2021, the patient was diagnosed with B-bollichelial non-Hodgkin's lymphoma with involvement of the right axillary, supraclavicular lymph nodes, left breast, followed by chemotherapy and clinical remission. Magnetic resonance imaging of the head revealed a perineural lesion of the third branch of the right trigeminal nerve, the second branch of the left trigeminal nerve, and the cheek branch of the left facial nerve. Electroneuromyography revealed an axonal lesion of the left ulnar nerve. The results of examination of the infiltrate biopsy from the affected buccal branch of the facial nerve specimens confirmed non-Hodgkin's diffuse B-cell lymphoma, GCB-phenotype and nerve damage due to NHL. Treatment of multiple neuropathy with glucocorticosteroids, nonsteroidal anti-inflammatory drugs, acelicholinesterase inhibitors, and specific chemotherapy resulted in limited therapeutic effect. Prescribing pregabalin resulted in decreased reduction of neuropathic facial pain. Thus, neurolymphomatosis is a rather rare manifestation of non-Hodgkin's lymphomas, the use of magnetic resonance imaging of the head and brain as well as immunohistochemical examination of the affected nerve infiltrate biopsy is important to confirm the diagnosis.&#x0D; In the Ukrainian scientific medical literature, there are few descriptions of cases of neurolymphomatosis in NHL, although they occur in patients, and it is necessary to describe in more detail the peculiarities of the collicular course of the diagenesis and treatment in these cases.

How National Health Insurance Coverage Policy Affected the Use of Trastuzumab and Rituximab in China: A Bicentric Retrospective Study.

Cancer is a significant health concern and is China's leading cause of mortality. Targeted therapies, such as trastuzumab and rituximab, have enhanced clinical treatment efficacy. However, their high costs burden patients and healthcare systems considerably. Patient demographic factors further influence the utilization of these expensive drugs. On September 1, 2017, China implemented the National Health Insurance Coverage (NHIC) policy, necessitating additional real-world evidence to assess its impact on patients. Data on human epidermal growth factor receptor 2-positive breast cancer and CD20-positive non-Hodgkin B-cell lymphoma patients were gathered in Jiangsu Cancer Hospital and Fujian Cancer Hospital from September 2015 to August 2019, including demographic and clinical information. All eligible patients were divided into two groups. Univariate analysis and multivariable logistic regression were used to investigate the differences between subgroups. An interrupted time-series regression was used to examine the change in trastuzumab and rituximab utilization percentages. Before and after the NHIC policy, utilization of trastuzumab increased from 61.13% to 75.10%, and the increase was statistically significant. Rituximab therapy increased statistically significantly from 64.79% to 74.88%. The key factor influencing trastuzumab and rituximab use was the NHIC policy. With policy implementation, medical insurance status, occupations, and cancer disease stage affected trastuzumab and rituximab use. The NHIC policy is essential to the utilization of trastuzumab and rituximab, and the patient's income level and repayment abilities continue to impact the use of innovative anti-cancer drugs. Appropriate steps, such as reducing the urban-rural gap and broadening medical insurance coverage, would enable more people to access novel anti-cancer drugs.

ABCL-433 Treatment Outcomes of Patients With HIV-Associated High-Grade B-Cell Non-Hodgkin Lymphomas Treated With DA-EPOCH-R: Single Institutional Experience

ABCL-433 Treatment Outcomes of Patients With HIV-Associated High-Grade B-Cell Non-Hodgkin Lymphomas Treated With DA-EPOCH-R: Single Institutional Experience

ABCL-323 Hypoxia-Specific Imaging Before CAR-T Therapy in Relapsed and Refractory B-Cell Non-Hodgkin Lymphoma

ABCL-323 Hypoxia-Specific Imaging Before CAR-T Therapy in Relapsed and Refractory B-Cell Non-Hodgkin Lymphoma

POSTER: ABCL-433 Treatment Outcomes of Patients With HIV-Associated High-Grade B-Cell Non-Hodgkin Lymphomas Treated With DA-EPOCH-R: Single Institutional Experience

POSTER: ABCL-433 Treatment Outcomes of Patients With HIV-Associated High-Grade B-Cell Non-Hodgkin Lymphomas Treated With DA-EPOCH-R: Single Institutional Experience

POSTER: IBCL-489 Mosunetuzumab Retreatment Is Effective and Well-Tolerated in Patients With Relapsed or Refractory B-cell Non-Hodgkin Lymphoma

POSTER: IBCL-489 Mosunetuzumab Retreatment Is Effective and Well-Tolerated in Patients With Relapsed or Refractory B-cell Non-Hodgkin Lymphoma

IBCL-489 Mosunetuzumab Retreatment Is Effective and Well-Tolerated in Patients With Relapsed or Refractory B-cell Non-Hodgkin Lymphoma

IBCL-489 Mosunetuzumab Retreatment Is Effective and Well-Tolerated in Patients With Relapsed or Refractory B-cell Non-Hodgkin Lymphoma

Role of non-Helicobacter pylori gastric Helicobacters in helicobacter pylori-negative gastric mucosa-associated lymphoid tissue lymphoma.

Marginal zone lymphomas rank as the third most prevalent form of non-Hodgkin B-cell lymphoma, trailing behind diffuse large B-cell lymphoma and follicular lymphoma. Gastric mucosa-associated lymphoid tissue lymphoma (GML) is a low-grade B-cell neoplasia frequently correlated with Helicobacter pylori (H. pylori)-induced chronic gastritis. On the other hand, a specific subset of individuals diagnosed with GML does not exhibit H. pylori infection. In contrast to its H. pylori-positive counterpart, it was previously believed that H. pylori-negative GML was less likely to respond to antimicrobial therapy. Despite this, surprisingly, in-creasing evidence supports that a considerable proportion of patients with H. pylori-negative GML show complete histopathological remission after bacterial eradication therapy. Nonetheless, the precise mechanisms underlying this treatment responsiveness are not yet fully comprehended. In recent years, there has been growing interest in investigating the role of non-H. pylori gastric helicobacters (NHPHs) in the pathogenesis of H. pylori-negative GML. However, additional research is required to establish the causal relationship between NHPHs and GML. In this minireview, we examined the current understanding and proposed prospects on the involvement of NHPHs in H. pylori-negative GML, as well as their potential response to bacterial eradication therapy.

CD19-targeted chimeric antigen receptor T-cell therapy in patients with concurrent B-cell Non-Hodgkin lymphoma and rheumatic autoimmune diseases: a propensity score matching study.

Rheumatic autoimmune diseases not only involve the production of autoantibodies but also demonstrate T-cell dysfunction. In patients with concurrent B-cell non-Hodgkin lymphoma (NHL) and rheumatic autoimmune diseases, the safety and efficacy of CD19-targeted chimeric antigen receptor (CAR) T-cell therapy are unknown. Using an aggregated electronic health record database, patients with rheumatic autoimmune diseases (auto group) were compared to propensity score-matched patients without rheumatic autoimmune diseases (non-auto group). From 1/2019 to 1/2023, 58 (4.3%) of 1,363 patients who received CD19-targeted CAR T-cell therapy had concurrent rheumatic autoimmune diseases. Both groups had similar incidence, severity, and management of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Moreover, the two groups had similar time-to-next treatment or death (hazard ratio [HR] 0.97, 95% confidence interval [CI] 0.60 to 1.59, log-rank p = 0.91) and overall survival (HR 0.90, 95%CI 0.46 to 1.78, p = 0.76). Following CAR T-cell infusion, patients with rheumatic autoimmune diseases achieved decreased inflammatory markers, seronegative conversion of autoantibodies, as well as reduced use of steroids and disease-modifying anti-rheumatic drugs. In conclusion, the safety and efficacy of CAR T-cell therapy were not affected in patients with rheumatic autoimmune diseases. Moreover, they achieved better biochemical control of underlying rheumatic diseases.

Investigation of Molecular Mechanisms Involved in Hepatitis B Virus Associated B-cell NonHodgkin Lymphoma (B-NHL)

The Non-Hodgkin Lymphoma (NHL) is a heterogeneous group of malignancies ranked as the most common haematological cancer worldwide, more than 544 000 new cases being reported in 2020. More recent epidemiological studies have shown an increased risk of several types of B-cell Lymphoma development, the most prevalent being diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL) subtypes, in patients infected with hepatitis B virus (HBV). These patients are more difficult to treat and their survival rate is lower compared to uninfected people. HBV is known as a hepatotropic virus, although viral HBV-DNA has been identified in extrahepatic tissues, such as kidney, pancreas or peripheral blood mononuclear cells (PBMC). However, the mechanistic relationship between HBV infection and lymphoid cancer is not known. Preliminary data have shown that NTCP, the specific HBV receptor is expressed in normal B cells. After exposure to HBV viral particles, B cells become capable of producing viral core antigens (HBcAg). Antiviral roles and/or cancer-promotion functions in B-cells of APOBEC3 deaminases overexpression remain to be determined.

Low-dose CT radiomics features-based neural networks predict lymphoma types

BackgroundFluorodeoxyglucose positron emission tomography (PET)–computed tomography (CT) is preferred for pretreatment staging and treatment planning in patients with lymphoma. This study aims to train and validate the neural networks (NN) for predicting lymphoma types using low-dose CT radiomics.ResultsFew radiomics features were stable in intraclass correlation coefficient and coefficient of variation analysis (n = 119). High collinear ones with variance inflation factor were eliminated (n = 56). Twenty-four features were selected with the least absolute shrinkage and selection operator regression for network training. NN had 75.76% predictive accuracy in the validation set and has 0.73 (95% CI 0.55–0.91) area under the curve (AUC) to differentiate Hodgkin lymphoma from non-Hodgkin lymphoma. NN which was used to differentiate B-cell lymphoma from T-cell lymphoma had 78.79% predictive accuracy and has 0.81 (95% CI 0.63–0.99) AUC.ConclusionsIn this study, in which we used low-dose CT images of PET–CT scans, predictions of the neural network were near acceptable lower bound for Hodgkin and non-Hodgkin lymphoma discrimination, and B-cell and T-cell lymphoma differentiation.

The nutritional impact of CD19-targeted CAR-T therapy versus BEAM chemotherapy for adult patients with lymphoma.

Chimeric antigen receptor T (CAR-T) cell therapy is a novel therapy demonstrating durable remissions in patients with refractory or relapsing non-Hodgkin's B-cell lymphoma. Maintaining a patient's nutritional status has been demonstrated to improve outcomes in cancer treatment. However, no studies have investigated how CAR-T therapy affects nutritional status, nor compared its impact with other cancer treatments for this patient group. The primary aim of the present study was to investigate the effect of CAR-T therapy on the prevalence of nutrition impact symptoms (NIS) and nutritional status within 30 days post-treatment of patients with lymphoma compared to a conditioning regimen for autologous haematopoetic stem cell transplant (carmustine/BCNU, Etoposide, cytarabine/Ara-C, Melphalan [BEAM] auto-haematopoetic stem cell transplant [HSCT]). Clinical notes of patients with lymphoma who underwent either CAR-T therapy or BEAM auto-HSCT between 2018 and 2021 were reviewed. Data extracted included body weight measurements and NIS, including decreased appetite, nausea, vomiting, diarrhoea, constipation, mucositis, cytokine release syndrome (CRS) and neurotoxicity at baseline and 30 ± 7 days post-treatment. In total, 129 adults with lymphoma (n = 88 CAR-T vs. n = 41 BEAM) were included. Nutritional status was assessed in both groups at baseline prior to treatment. Mean absolute weight change was significantly different between groups (3.05 kg in CAR-T, -5.9 kg in BEAM, p ≤ 0.001). This was also significant when weight loss was categorised into percentage weight loss (p = 0.01). CAR-T patients experienced a significantly lower prevalence of decreased appetite (52.3% vs. 97.6%) nausea (25% vs. 78%,) vomiting (10.2% vs. 53.7%), diarrhoea (43.2% vs. 96.7%) and mucositis (5.7% vs. 75.6%) combined across all levels of severity compared to BEAM chemotherapy (all p ≤ 0.01). CRS and neurotoxicity, which are specific side effects of CAR-T therapy, were moderately positively associated with weight loss. Weight loss, percentage weight loss and NIS were significantly reduced in CAR-T compared to BEAM treatment. However, patients who experienced neurotoxicity during treatment did have significant weight loss.

Prognostic Factors and Treatment Outcome of Relapsing and Refractory Pediatric Mature B-cell Non-Hodgkin Lymphoma, Children's Cancer Hospital Egypt Experience.

Relapsed non-Hodgkin lymphoma treated by chemotherapy and hematopoietic stem cell transplantation (HSCT) has a dismal prognosis. It is a retrospective study, including pediatric patients diagnosed as mature B-cell non-Hodgkin lymphoma who were primarily refractory or relapsed over 8 years at CCHE. The aim of the study was to analyze the prognostic factors and outcomes of this group of patients. Our result is, 53 of 750 (7%) patients were included. Thirty-four (64.2%) patients had Burkitt lymphoma. Forty-eight (90.6%) patients received LMB 96 protocol initially. The median delay of duration between chemotherapy cycles in first-line treatment was 37 days. Thirty-five (66%) patients relapsed, 23 (65.7%) of them relapsed early, whereas 18 (34%) had tumor progression. Thirty-one (58.5%) patients presented with stage IV at the time of relapse. rituximab, ifosfamide, carboplatin, etoposide was the second line of treatment in 42 (79.24%) patients, and complete second remission was achieved only in 13 (24.3%) patients. Allogeneic HSCT was done for 4 (7.5%) patients, and auto HSCT was done for 3 (5.7%) patients. Three years of overall survival for relapsed and progressed patients were 35.3% and 11.1%, respectively, with a P-value of 0.009. Three years overall survival for patients who underwent HSCT was 85.7% compared with 18.1% for no HSCT with a P-value of 0.007. The relapse rate is higher than literatures because of the delay of duration between chemotherapy cycles in first-line treatment and more advanced stage at time of relapse. Progression of the disease had a worse outcome than relapse. HSCT in patients with the second remission markedly improved the outcome.

Ayurvedic treatment of a case diagnosed as AIDS and diffuse large B cell lymphoma - Case report

Non-Hodgkin's lymphoma (NHL) is recognized as the most common form of lymphoma. Among the various subtypes of NHL, diffuse large B-cell lymphoma (DLBCL) stands out as the predominant type, constituting approximately 30 percent of all lymphomas. DLBCL has an annual incidence rate of 2.9 per 100,000 in men and 1.5 per 100,000 in women in India. It is a rapidly growing and aggressive form of NHL. A 40-year-old male patient presented with a chief complaint of abdominal pain and discomfort persisting for 4-5 months. The patient had previously been diagnosed with AIDS (Acquired immune deficiency syndrome - a retroviral disease) and non-Hodgkin's lymphoma Diffuse Large B-Cell Lymphoma (DLBCL) on 29-04-14. Ileal resection had already been performed on 20-01-2014, and the patient received the initial cycle of CHOP (cyclophosphamide, doxorubicin [Adriamycin], vincristine [Oncovin], prednisolone) chemotherapy on 02-04-14. The MIB index was measured at 70%. The report on 22-04-14 indicated the presence of a few enlarged lymph nodes scattered in the mesentery and paraaortic regions. The patient declined further cycles of chemotherapy. Based on Ayurvedic diagnosis, the patient initially exhibited symptoms resembling Arsha (hemorrhoids) and Gulma (tumor), followed by Grahani Daurbalya (improper digestion). At the time of examination, he had severe Pandu. Considering the pathology and symptomatology, a prescription of Heeraka Bhasma + Chaturmukha Rasa, Triphala + Kapardika Bhasma + Panchamrita Parpati + Patola (Trichosanthus cucmerina) + Dhanvayasa (fegoniacretica), TapyadiLoha + Navyasootashekhara + Vanga + Asthimajja Pachaka (Guduchi + Amalaki + Musta) + Kukkutanakhi (Tectaria coadunate) along with 10 ml of Rohitakarishta and Krimikuthara Rasa was prescribed. After seven months of treatment, the symptoms subsided. No adverse events were reported during the seven-month treatment and follow-up period. In conclusion, this case study demonstrates the safe and effective treatment of these diseases using Ayurveda. It improved the patient's health and quality of life, resolving the issue of swollen lymph nodes. The patient survived for over four years thereafter.

Dorsal intraspinal B-cell Non-Hodgkin lymphoma in two patients

Non-Hodgkin Lymphoma is rarely diagnosed as spinal cord compression syndrome. Caused by an epidural mass, this complication is often encountered in the late stage of the disease. We report two cases presenting symptoms of low thoracic spinal cord compression due to an epidural tumor on the MRI. Possible complications that may occur and how to prevent adverse events during surgery are essential. This case is of special interest for being a low-incidence pathology in a rare location. The case is of high interest because of the importance of resecting the lesion to prevent sequels and the complexity of its management and highlights the importance of considering the diagnosis of this event.

PCR20 Improvements in Symptoms, Impact of Treatment, and Satisfaction with Treatment Among Patients with Relapsed or Refractory B-Cell Non-Hodgkin Lymphoma Treated with Subcutaneous Epcoritamab

To qualitatively understand patients’ experience of being treated with subcutaneous epcoritamab for relapsed/refractory non-Hodgkin B-cell lymphoma (R/R B-NHL).