Cases Of Malignant Lymphoma Research Articles

Dupilumab-related late adverse events in patients with chronic rhinosinusitis with nasal polyps

Background Anti-IL-4 receptor α antibody (dupilumab) has demonstrated favorable sinonasal outcomes for chronic rhinosinusitis with nasal polyps (CRSwNP), which is mainly caused by type 2 inflammation. Although increased blood eosinophil levels and injection site symptoms are frequently observed as acute adverse events (AEs) of dupilumab, limited knowledge is available regarding the late AEs of dupilumab for CRSwNP. Objectives We investigated the late AEs following the initiation of dupilumab treatment for CRSwNP. Material and methods Fifty-one patients with CRSwNP treated with dupilumab for > 3 months were enrolled, and their clinical data were collected from their medical records. Results Six (11.8%) patients experienced late AEs. One case of eczema with pruritus, one case of psoriasis-like dermatitis, two cases of severe rash, one case of malignant lymphoma, and one case of alopecia areata were observed. Skin disorders were the most common late AEs in this study. It is a Th1-inflammatory disease, and its mechanism is thought to be due to the immune imbalance caused by dupilumab. We could not confirm whether malignant lymphoma in our case was caused by dupilumab use. Conclusions and significance Skin disorders are often late AEs associated with dupilumab; therefore, careful monitoring after dupilumab initiation should be considered.

Tattoos as a risk factor for malignant lymphoma: a population-based case–control study

The popularity of tattoos has increased dramatically over the last few decades. Tattoo ink often contains carcinogenic chemicals, e.g., primary aromatic amines, polycyclic aromatic hydrocarbons, and metals. The tattooing process invokes an immunologic response that causes translocation of tattoo ink from the injection site. Deposition of tattoo pigment in lymph nodes has been confirmed but the long-term health effects remain unexplored. We used Swedish National Authority Registers with full population coverage to investigate the association between tattoo exposure and overall malignant lymphoma as well as lymphoma subtypes. We performed a case-control study where we identified all incident cases of malignant lymphoma diagnosed between 2007 and 2017 in individuals aged 20-60 years in the Swedish National Cancer Register. Three random age- and sex-matched controls per case were sampled from the Total Population Register using incidence density sampling. We assessed exposure through a questionnaire in 2021, and data on potential confounders were retrieved from registers. We used multivariable logistic regression to estimate the incidence rate ratio (IRR) of malignant lymphoma in tattooed individuals. The study population consisted of 11,905 individuals, and the response rate was 54% among cases (n=1398) and 47% among controls (n=4193). The tattoo prevalence was 21% among cases and 18% among controls. Tattooed individuals had a higher adjusted risk of overall lymphoma (IRR=1.21; 95% CI 0.99-1.48). The risk of lymphoma was highest in individuals with less than two years between their first tattoo and the index year (IRR=1.81; 95% CI 1.03-3.20). The risk decreased with intermediate exposure duration (three to ten years) but increased again in individuals who received their first tattoo ≥11 years before the index year (IRR=1.19; 95% CI 0.94-1.50). We found no evidence of increasing risk with a larger area of total tattooed body surface. The risk associated with tattoo exposure seemed to be highest for diffuse large B-cell lymphoma (IRR 1.30; 95% CI 0.99-1.71) and follicular lymphoma (IRR 1.29; 95% CI 0.92-1.82). Our findings suggested that tattoo exposure was associated with an increased risk of malignant lymphoma. More epidemiologic research is urgently needed to establish causality. The Swedish Research Council for Health, Working Life and Welfare.

Clinical PD-1/PD-L1 Blockades in Combination Therapies for Lymphomas.

Immunotherapy with the programmed cell death protein 1 (PD-1)/PD-1 ligand (PD-L1) blockade has revolutionized the treatment of advanced solid cancers. However, these clinical benefits have been limited to cases of malignant lymphomas, showing promising results for only classic Hodgkin lymphoma (cHL) and primary mediastinal B-cell lymphoma (PMBCL). To bring clinical benefits to more patients with lymphoma, numerous combination therapies involving PD-1/PD-L1 blockade have been tested in clinical trials in both frontline and relapsed/refractory settings. This article reviews the current landscape of combination therapies with PD-1/PD-L1 blockade for lymphoma and discusses the potential therapeutic approaches. An interim analysis of a phase 3 study demonstrated increased progression-free survival with nivolumab combination therapy over the current frontline treatment in patients with advanced-stage cHL. The results of combination therapies for aggressive B-cell lymphomas, except for PMBCL, have been disappointing. Several clinical trials of combined PD-1/PD-L1 blockade and Bruton's tyrosine kinase inhibitors are exploring its efficacy in patients with chronic lymphocytic leukemia (CLL) with Richter transformation. Several T-cell lymphoma subtypes respond to PD-1/PD-L1 blockade monotherapy. Further clinical trials are underway to investigate appropriate combination regimens with PD-1/PD-L1 blockade, especially for cHL, CLL with Richter transformation, and T-cell lymphoma, in both frontline and relapsed/refractory settings.

Impact of COVID-19 on cancer treatment: Results from 18 hospital-based cancer registries in Tochigi prefecture

Objectives To show the impact of COVID-19 on cancer treatment in Tochigi prefecture.Methods The number of cancer cases registered in Tochigi prefecture before (2019) and after (2020) COVID-19 was compared using cancer registry data from 18 member hospitals of the Tochigi Prefecture Cancer Care Collaboration Council. Data were compared by sex, age, patient's address at the time of diagnosis, month of diagnosis, cancer site, cancer stage, and treatment. Data on screenings for stomach, colorectum, lung, female breast, cervix, and prostate cancers were investigated in detail.Results The total number of registered cancer cases was 19,748 in 2019 and 18,912 in 2020 (a decrease of 836 cases [-4.2%]). Among the total cases, there were 11,223 and 10,511 males in 2019 and 2020, respectively (a decrease of 712 cases [-6.3%]) and 8,525 and 8,401 females in 2019 and 2020, respectively (a decrease of 124 cases [-1.5%]). The decrease was greater among males than among females. There was no decrease in the number of registered patients aged <40 years between 2019 and 2020. Based on the patients' address at the time of diagnosis, there was no decrease in the number of cases from outside of the Tochigi prefecture. Regarding the month of diagnosis, there was a notable decrease in the number of registered patients in May and August of 2020. Among the decrease of 836 cases detected by screening, 689(82.4%) were cases of stomach, lung, colorectum, female breast, cervix, and prostate cancer. The number of registered cases of malignant lymphoma, leukemia, and cancer of the oral cavity and pharynx, pancreas, bone and soft tissue, corpus uteri, and bladder did not decrease between 2019 and 2020. In terms of stage of cancer, the number of registered cases of carcinoma in situ, localized cancer, and regional lymph node metastases was lower in 2020 than in 2019, but there was no decrease in the number of registered cases of distant metastases or regional extension.Conclusion The number of cancer cases registered in 2020 was lower than in 2019, and the degree of change varied by age, hospital, site, whether the case was detected by screening, and stage of cancer. In particular, a marked decrease was observed in the number of cases detected by screening. Furthermore, the decrease in the number of cancer cases registered in May and August of 2020 were believed to be due to the peak in the spread of COVID-19 and the associated declaration of a state of emergency.

Evaluation of Brain Atrophy after One Year of Whole Brain Irradiation Using Voxel Based Morphometry

Whole-brain irradiation has often been used for metastatic brain tumors and in prophylactic irradiation, but there are few reports on the frequency of cognitive decline and brain atrophy. We attempted to adapt an objective method of measuring brain atrophy to patients after whole-brain irradiation, Using Voxel based morphometry (VBM) measured from MRI to determine if brain atrophy has occurred one year after whole brain irradiation. VBM is a method to measure the change in signal intensity when an atrophic brain is transformed into a normal brain by Deformable Image Registration. We use VBM to measure brain atrophy before and one year after irradiation in patients who received whole brain irradiation at our institution. The MRI used for the analysis was a contrast-enhanced T1-weighted image, Sagittal cross-sectional images of 1 mm thickness were obtained from the whole brain using the 3D variable flip angle turbo spin echo sequence, which is clinically used at our hospital for the cancer patient's management. The subjects were 28 patients who had undergone whole-brain irradiation at our hospital and for whom MRIs were available before treatment and after one year. The cases analyzed included patients who received prophylactic Cranial irradiation (PCI) in cases of small cell lung cancer obtained complete remission. Z-scores obtained from the medial temporal lobe were compared before and after whole brain irradiation treatment to quantitatively assess brain atrophy. The Z-score is the normalized difference between the voxel values obtained from the normal group average and the individual case. There were 15 cases of lung cancer, 5 cases of malignant lymphoma, 5 cases of breast cancer, and 3 cases of various types of cancer, with an average age of 65 years. Cases with tumors or brain edema in the vicinity of the hippocampus were excluded. Various irradiation doses were used, but the commonly used radiation doses were 23.4 Gy/13Fr (lymphoma), 25 Gy/10 Fr (PCI), 35 Gy/14 Fr (multiple metastasis). A Paired-samples one sided t-test was performed to Mean z-score of positive values within the medial temporal lobe before and one year after whole brain irradiation. This number reflects the degree of atrophy within the region of interest and is determined as mild atrophy if it is greater than 1.0. The mean Z-score was found to increase at a risk of 0.01 after whole brain irradiation. This means that brain atrophy is progressing after whole brain irradiation. Hippocampal atrophy becomes apparent about a year after whole brain irradiation. It suggests that brain atrophy occurs after radiotherapy. The problem with this study is that the effects of chemotherapy-induced brain atrophy and aging cannot be ruled out.

A Case of Mucosa-Associated Lymphoid Tissue Lymphoma (MALT Lymphoma) in Hypopharynx: A Case Report

Malignant lymphoma rarely occurs in the larynx and hypopharynx. Few cases of malignant lymphoma in the larynx were reported in Korea. However, malignant lymphoma in the hypopharynx had been not reported in Korea. A 68-year-old woman came to the outpatient clinic with a foreign body sensation in her throat. A round, smooth margin, bright pink-colored mass was confirmed by the laryngoscopy. The patient took neck computer tomography. A small bulging of mucosa was observed, but there was no peripheral infiltration or abnormally enlarged lymph nodes. We did excision using CO2 LASER. She was finally diagnosed with mucosa-associated lymphoid tissue lymphoma (MALT lymphoma). After diagnosis, several image studies confirmed that there was no metastatic lesion. She got only radiotherapy after that and kept a complete response state for over 2 years.

Case-based similar image retrieval for weakly annotated large histopathological images of malignant lymphoma using deep metric learning.

In the present study, we propose a novel case-based similar image retrieval (SIR) method for hematoxylin and eosin (H&E) stained histopathological images of malignant lymphoma. When a whole slide image (WSI) is used as an input query, it is desirable to be able to retrieve similar cases by focusing on image patches in pathologically important regions such as tumor cells. To address this problem, we employ attention-based multiple instance learning, which enables us to focus on tumor-specific regions when the similarity between cases is computed. Moreover, we employ contrastive distance metric learning to incorporate immunohistochemical (IHC) staining patterns as useful supervised information for defining appropriate similarity between heterogeneous malignant lymphoma cases. In the experiment with 249 malignant lymphoma patients, we confirmed that the proposed method exhibited higher evaluation measures than the baseline case-based SIR methods. Furthermore, the subjective evaluation by pathologists revealed that our similarity measure using IHC staining patterns is appropriate for representing the similarity of H&E stained tissue images for malignant lymphoma.

A Case of Malignant Lymphoma with Remarkable Thickening of Both Ventricular and Atrial Wall

A Case of Malignant Lymphoma with Remarkable Thickening of Both Ventricular and Atrial Wall

Role of immunoglobulin heavy and light chain gene rearrangement analysis in differentiating between benign and malignant bone marrow B-cell lymphoid aggregates

Lymphoid aggregates are found in a minority of bone marrow biopsy and aspirate specimens, and when present, the distinction between benign and malignant aggregates can represent a diagnostic challenge. Morphologic and immunophenotypic evaluation of the aggregates can aid in that distinction but in a few cases, detection of immunoglobulin heavy chain (IGH) and kappa light chain (IGK) gene rearrangements may be needed to rule in or out a malignant disease process. We studied the role of testing for IGH/IGK rearrangements in the distinction between benign and malignant B cell-predominant lymphoid aggregates. Only a few studies have addressed this issue and most lacked an adequate number of cases for establishing statistical significance. Our study retrospectively evaluated 120 bone marrow aspirate and biopsy specimens, 79 cases originally diagnosed with benign lymphoid aggregates [4,5], and 41 demonstrating a B-cell lymphoma with malignant aggregates. Immunohistochemical stains were performed on all cases in our study and flow cytometry results were available in the vast majority of cases (98%). All patients included in our study but 9 had at least 2 years of clinical follow-up information. Of the malignant lymphoma cases, IGH/IGK rearrangements were demonstrated by polymerase chain reactionin 60% of the cases. Moreover, clonal rearrangements were identified in 15% of the cases with benign aggregates. After at least 2 years of follow-up, only one case with a positive clonality study occurring in the setting of morphologically benign-appearing bone marrow lymphoid aggregates experienced a relapse of non-Hodgkin lymphoma. Molecular analysis of the IGH and IGK genes may have utility in confirming the presence of malignancy in bone marrow aspirates and biopsy specimens. False-negative results, however, are possible due to testing limitations and sampling issues. Moreover, patients with conditions such as autoimmune disorders or infectious diseases are shown to also develop clonal B-cell lymphoid aggregates. As a result, we recommend a thorough morphological examination, informative immunohistochemical staining, accurate flow cytometric analysis, and current IGH/IGK rearrangement testing when evaluating bone marrow specimens containing B cell-predominant lymphoid aggregates, with the knowledge that molecular clonality results should be carefully interpreted in the context of morphological and immunophenotypic findings to prevent misdiagnosis.

Primary Malignant Lymphoma Presenting as an Isolated Epidural Mass.

Primary central nervous system lymphoma is a rare form of extranodal non-Hodgkin’s lymphoma that occurs in the brain, spinal cord, leptomeninges, or eyes and typically remains confined to the central nervous system. Among them, malignant lymphoma presenting as a primary tumor of the spinal cord is extremely uncommon, and epidural mass formation is known to occur in only 0.8–2.8% of cases of malignant lymphomas. Furthermore, primary malignant lymphoma presenting as an isolated epidural mass is much rarer. Here, we report a case of primary malignant lymphoma of the thoracic spine presenting as an isolated epidural mass that did not involve the vertebral body or posterior element. Surgical decompression is essential to prevent further neurological deterioration. Here, we present a successful treatment strategy for this rare case.

Safety and efficacy of high-dose cytarabine MEAM therapy and other treatments for auto-peripheral blood stem cell transplantation: A retrospective comparative study.

The MEAM regimen consisting of ranimustine (MCNU), etoposide (ETP), cytarabine (Ara-C), and melphalan (MEL) is widely used before auto-peripheral blood stem cell transplantation (auto-PBSCT) for malignant lymphoma in Japan. The MEAM regimen generally consists of 200-400mg/m2 for 4 days, but we decided to increase the dosage of Ara-C from the standard to 2g/m2 for 2 days with the aim of increasing drug transferability to the central nervous system. We evaluate the safety and therapeutic efficacy of high-dose Ara-C MEAM therapy. The high-dose Ara-C MEAM protocol consisted of MCNU 300mg/m2 on day -7, ETP 200mg/m2 on days -6, -5, -4, -3 and Ara-C 2g/m2 on day -4 -3, and MEL 140mg/m2 on day -2. We retrospectively analyzed 37 cases of malignant lymphoma at our institution between May 2014 and July 2020. All patients got engraftment and there were no cases of treatment-related mortality. In all cases, the 3-year overall survival (OS) and progression-free survival (PFS) after transplantation were 80.6% and 65.7%, respectively. Twenty-one cases of diffuse large B-cell lymphoma recurrence, for which there is proven usefulness of auto-PBSCT, showed good results after transplantation, with the 3-year OS and PFS after transplantation being 100% and 74.3%, respectively. The safety and efficacy of high-dose Ara-C MEAM therapy were demonstrated, but the expected therapeutic effect on central nervous system lesions could not be fully evaluated owing to the small number of cases.

Malignant lymphoma of the oral cavity: A single-center study of 28 cases

This study aimed to determine the clinicopathological features, treatment methods and prognosis in patients with malignant lymphoma of the oral cavity. We retrospectively examined 28 cases of malignant lymphoma of the oral cavity based on the novel World Health Organization pathological classification. The most common primary site was the upper gingival area (32.1%) and the most frequent initial symptom was painless swelling (48.5%); 7.1% of cases were stage III and 21.4% were stage IV according to the Ann Arbor classification. The most common histologic type was diffuse large B-cell lymphoma. Clinically, 14.3% of cases were classified as highly aggressive, and three-quarters of these cases were ulcerated. The most common type of chemotherapy was R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone), which was used in 28.6% of patients. Five-year overall survival was 69.7% for all cases and 53.5% for those with diffuse large B-cell lymphoma. Patients with an Ann Arbor disease classification of stage III or IV and histologically aggressive disease are not uncommon and have poor prognosis. Therefore, prompt biopsy is needed for painless swelling of the upper gingiva to perform differential diagnosis of malignant lymphoma of the oral cavity.

A Case of Primary B-Cell Lymphoma of the Gallbladder

Introduction: Non-epithelial malignant tumors of the gallbladder account for only about 2% of all malignant tumors of the gallbladder, and lymphoma of the gallbladder is even rarer. We herein report a case of malignant lymphoma of the gallbladder diagnosed incidentally after cholecystectomy.

A Case of Malignant Lymphoma of the Ileocecum which was Difficult to Differentiate from an Ileocolic Arterial Aneurysm Rupture

A Case of Malignant Lymphoma of the Ileocecum which was Difficult to Differentiate from an Ileocolic Arterial Aneurysm Rupture

Three cases of malignant lymphoma diagnosed by bone lesion

Three cases of malignant lymphoma diagnosed by bone lesion

Survival analysis of 8785 malignant lymphoma cases in the oral and nasal cavities in the USA: a cohort study

ObjectiveTo identify the factors associated with the survival of malignant Hodgkin and non-Hodgkin lymphomas in oral and nasal cavities.Study design. Retrospective cohort survival analysis.MethodsThe Surveillance, Epidemiology and End Results 18...

Prognostic Value of Single-Photon Emission Computed Tomography of Left Ventricular Synchronized with ECG for Cardiotoxicity Assessment in Patients with Malignant Lymphoma after High Dose Chemotherapy with Autologous Stem Cell Transplantation

Introduction: High-dose chemotherapy (HDC) with autologous hematopoietic stem cells transplantation (auto-HSCT) is currently widely used for the treatment of relapsed and refractory to standard chemotherapy cases of malignant lymphomas. Examination of patients for evaluation cardiotoxic effect of HDC and auto-HSCT is usually performed with an electrocardiography and echocardiography. The method of single photon emission computed tomography of the left ventricular(LV) myocardium, synchronized with the patient's ECG (Gated - SPECT) is rarely used to assess cardiotoxic effect of HDC and auto-HSCT, and its prognostic value in this field is not determined.Objective: to evaluate perfusion and regional myocardial function of the left ventricle (LV) using Gated-SPECT in malignant lymphomas patients receiving HDC and auto-HSCT. To evaluate whether the age and conditioning regimens influence the worsening of indices of hyperperfusion according to Gated-SPECT.Materials and methods: The study included 127 patients (67 with Hodgkin's lymphoma, 28 with non-Hodgkin's lymphoma, 32 with multiple myeloma). The median age was 37 year (range: 19 to 68 years); 80 females, 47 males. Gated-SPECT was used for assessment of perfusion and regional left ventricular function at rest before the HDC and auto-HSCT (point 1) and at discharge (point 2). The each study was performed on a double-headed rotating gamma camera «Forte» (Philips, USA) after intravenous injection of 740 MBq of technetium-99m-methoxyisobutylisonitrile (99mTc-MIBI). Gated-SPECT was used to measure the conventional parameters (total hypoperfusion defect, total LVEF) and also to measure regional myocardial perfusion and thickening used the 20-segment “bull's eye” model (the LV myocardium was divided into 20 segments).Results: The total area of hypoperfusion, expressed as a percentage of the area of the left ventricular myocardial wall did not change significantly during treatment (p> 0,05). However, segmental analysis of regional myocardial perfusion has revealed a statistically significant decrease in the median level uptake of the 99mTc-MIBI in 1,2,3,4,5,6,7,8,9,10,11,13,14,16,17,19,20 segments (p =0,01). The total ejection fraction (TEF) decreased, but change was not significant (median TEF at point 1 was 60,4 %, at point 2 - 59,9 %). But it showed a statistically significant decrease in median of local systolic thickening in 2,3,4,5,6,8,9,11,12,14,15,18,19,20 segments (p <0,05).It was also found that there was no correlation in the age of patients with hypoperfusion changes in the time of admission, but after treatment there was a direct significant weak correlation between these indices (R = 0.22, p = 0.01), So, older patient patient, have the greater size of the general hypoperfusion zone (Table 1).The analysis showed that the conditioning regimen (BEAM, high doses of melphalan or CBV) did not affect the index of the general hypoperfusion zone, which was established when comparing the parameters between pairs: ВЕАМ and high doses of melphalan, ВЕАМ and CBV, CBV and high doses of melphalan. Significant changes of general hypoperfusion zone were not detected when compare this indices at the time patients was admitted to the hospital with indices at the time of discharge from the hospital, that is, after HDC and auto-HSCTConclusions:HDC and auto-HSCT significantly change perfusion and regional LV myocardial function in patients with malignant lymphomas. Changes revealed evidence of diffuse myocardial damage. There was no difference in general hypoperfusion zone between different conditioning regimen before and after the treatment. Gated-SPECT can be considered as a promising method for assessing cardiac HDC and auto-HSCT. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Clinical Observation on 98 Cases of Hematological Malignancies Treated with Autologous Hematopoietic Stem Cell Transplantation Cryopreserved By Ladder-Style Freezing from Low Temperature Refrigerator to Liquid Nitrogen

Background: Programmed cooling - 196℃ liquid nitrogen preservation and non- programmed cooling - 80℃ low temperature refrigerator preservation have been widely used in Auto- HSCT. Programmed cooling and - 196℃ liquid nitrogen preservation can set the rate of temperature fall in advance and standardize the cooling process, reducing the damage to hematopoietic stem cells caused by temperature fall. But programmed cooling is a time-consuming process and it needs to purchase expensive control rate freezer. Non- programmed cooling - 80℃ low temperature refrigerator preservation is easy to operate, but it cannot keep a long preservation period. Since 2002, we tried combining two preservation methods into one: first we placed freezer bags in - 80℃ low temperature refrigerator and then placed them in -196℃ liquid nitrogen tank for long-term preservation, with the purpose of prolonging the cryopreservation of stem cells.Method:We observed the influence of cryopreservation of hematopoietic stem cells with ladder-style freezing from low temperature refrigerator to liquid nitrogen in transplantation treatment of hematological malignancies, and analyzed the survival condition of patients after hematopoietic stem cell transplantation.We retrospectively analyzed the clinical datas of 98 patients with hematological malignancies treated by hematopoietic stem cell transplantation from 2002-01 to 2016-12 in our center.Results: 98 patients, 56 males and 42 females, aged 14-69 years (avenge age36.46±14.19 years). Disease subtypes: 10 cases of acute lymphoblastic leukemia(ALL), 24 cases of acute non- lymphoblastic leukemia(ANLL) , 11 cases of multiple myeloma(MM), 53 cases of malignant lymphoma(ML). One case failed in implantation due to intracranial hemorrhage and the other 97 cases all succeeded in hematopoietic reconstitution. The median survival time was 47 months and the average follow-up time was 50.11 months. The average time needed to neutrophil count ≥0.5×109/L was 9.24±1.89d, and the average time needed to platelet count≥20×109/L without platelet transfusion for 3 days was 11.04±1.84d. The median survival time was 47.6 months (1~80 months). The overall survival rates of 1 year, 3-year and 5-year were (97.2±1.9) %, (84.2±4.6) % and (77.8±5.6) %, respectively. PFS (progression-free survival) of patients in 3 years and 5 years were (74.4±5.1)% and (61.2±6.2)% (Figure1), which is consistent with data reported by other transplantation centers. In this study, it is found that the application of auto-HSCT has significantly improved OS and PFS of patients with acute leukemia, malignant lymphoma and multiple myeloma, but there is no significant difference in OS and PFS among three groups(Figure2)(P=0.537). The survival condition of CR1 patients was better than no-CR1 patients(Figure3). The complication about transplantation mainly were digestive tract symptoms. 9.18% patients complicated with liver function injury and 58.16% patients got infection.We continuously improved cryophylactic agent and obtained cryoprotectant formed by 3%hydroxyethyl starch, 4% albumin and 5% DMSO to replace the traditional 10% DMSO cryoprotectant used in programmed cooling. During stem cell infusion, the occurrence rate of complication was 8.16%, significant lower than the occurrence rate of adverse events occurring in the usage of 10% DMSO cryoprotectant.Conclusions: ladder-style freezing from low temperature refrigerator to liquid nitrogen with cryoprotectant that is formed by 3% hydroxyethyl starch, 4% albumin and 5% dimethyl sulfoxide (DMSO) for cryopreservation of hematopoietic stem cells. It can reach the same clinical transplantation effect with traditional programmed cooling freezing method in autologous hematopoietic stem cells transplantation (auto-HSCT) and can effectively improve OS, PFS of hematological malignancies. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

A case of malignant lymphoma associated with pancreatic masses in which endoscopic ultrasound-guided fine-needle biopsy was useful for diagnosis

A case of malignant lymphoma associated with pancreatic masses in which endoscopic ultrasound-guided fine-needle biopsy was useful for diagnosis

Bone Marrow Examination of Malignant Lymphomas in Korea: Eleven-Year Experience in a Single Institution

IntroductionMalignant lymphoma is a various group of disease with distinct histopathologic characteristic, innumerable clinical presentation and biologic behaviors. According to geographic location and races, malignant lymphoma shows diverse clinicopathologic characteristics. Initial diagnosis of lymphoma usually performed by pathologic review of lymph node or other tissue biopsies, however histopathologic examination, except bone marrow (BM), are sometimes not available because of patient's condition or clinical aspects. BM examination plays a role of the initial investigation in such cases. In this study, we analyzed the ratio of lymphoma BM involvement in total BM examination and ratio of BM as initial investigative specimen in lymphoma BM involvement during 11 years. Favored BM involvement pattern of each malignant lymphoma was also reviewed.MethodA total of 1164 cases were retrospectively reviewed for evaluation of BM lymphoma involvement from January 2006 to December 2016 at Gachon University Gil Medical Center in Korea. Two expert hematologists examined the lymphoma BM involvement and involvement pattern. BM involvement patterns were classified into five groups according to previous studies; focal nonparatrabecular, focal paratrabecular, intrasinosoidal, diffuse interstitial, and diffuse solid. Histopathologic diagnoses of lymph node or other tissues were reviewed if they were available. Statistical analysis was performed using spearman correlation for inter-annual trend assessment.ResultsA total of 6324 cases of BM studies were done during 11 years, of which 1164 (18.4%) were malignant lymphoma. 258 (22.2%) cases were initially investigated by BM specimen. The rate of initial investigation by BM specimen was eventually increased during study period (P=0.019); 17.3% in 2006 and 24.4% in 2016. Total numbers of total BM study tend to increase throughout study period (P< 0.001), however there was no statistically significant for annual increasing in proportion of malignant lymphoma (P=0.385).(Table 1)Of 1164 malignant lymphoma cases, 891 (76.7%) were B-cell lymphoma (BCL), 204 (17.6%) T/NK-cell lymphoma (TCL) and 67 (5.8%) Hodgkin lymphoma. Diffuse large B cell lymphoma (DLBCL) was most common in BCL(558, 48.0%), followed by marginal zone B-cell lymphoma of MALT(168, 14.5%), mantle cell lymphoma (MCL) (41, 3.5%), follicular lymphoma (FL) (36, 3.1%), Burkitt's lymphoma (BL) (20, 1.7%), and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) (19, 1.6%). Among the TCLs, the commonest type was Extranodal NK/T-cell lymphoma (62, 5.3%), followed by Peripheral T-cell lymphoma (PTCL) (57, 4.9%), Angioimmunoblastic T-cell lymphoma (AITL) (43, 3.7%), Anaplastic large-cell lymphoma (19, 1.6%), and Enteropathy-associated T-cell lymphoma (10, 1.0%). Prevalence in DLBCL, FL and CLL/SLL was significantly increased during the study period (P<0.028).Of 202 cases of BM lymphoma involvement, 150(16.9%) were BCL, 45 (21.6%) TCL and 7 (9.9%) Hodgkin lymphoma. In BCL the most frequenly involved subtype was CLL/SLL (84.2%), followed by BL (70%), MCL (48.8%), FL (47.2%), and DLBCL (14.7%). In TCL, the most frequently involved subtype was PTCL (35.1%), followed by AITL (27.9%). (Table 2.)The most common involvement pattern of CLL was diffuse interstitial and diffuse solid (40%) pattern. BL showed diffuse solid pattern (55.6%) most commonly. MCL mainly presented both focal nonparatrabecular and diffuse interstitial(27.8%) patterns. FL showed focal paratrabecular and diffuse solid(31.3%) pattern. Diffuse interstitial pattern(39.7%) was mainly observed in DLBCL. PTCL showed diffuse interstitial(27.8%) pattern, AITL presented focal nonparatrabecular and diffuse interstitial pattern(33.3%). (Table 3.)ConslusionThis study demonstrates that initial investigation of malignant lymphoma by BM specimen increases during 2006-2016. The result may represent of growing importance of BM study as initial investigation tools for malignant lymphoma. Thus more efforts should be also made to diagnose malignant lymphoma by additional laboratory testing such as flowcytometry, chromosomal study, molecular study, and FISH analysis. Lymphoid neoplasm incidence and BM involvement frequency in western countries were well known through large-scale studies. This study also presented increasing in incidence of DLBCL, FL and CLL/SLL in Korean during 11 years [Display omitted] DisclosuresNo relevant conflicts of interest to declare.