Diffuse B-cell Research Articles

Development of Notch1 Positive T-Lineage Lymphomas or Splenic Marginal Zone Lymphomas with Pan-Hematopoietic or Pro-B Cell Specific Deletion of Trp53 with Distinct Differentially Dysregulated Pathways

Deletion of the tumor suppressor gene TP53 (Trp53 in mice) has been associated with the development of numerous human malignancies. TP53 acts as a central coordinator of the DNA damage response. In mice, pan-Trp53 deletion leads predominantly to the development of T-cell lymphomas, followed by B-cell lymphomas, sarcomas and teratomas. In order to dissect the role of Trp53 in the hematopoietic system, we created two different loss of function mouse models: Pan-hematopoietic Trp53 deletion using Vav1-Cre based deletion; and a B-cell-specific deletion was created using CD19-Cre.Vav1-p53CKO mice developed hematolymphoid malignancies with 100% penetrance by 12 months. Most malignancies observed were CD3e+ T-lineage lymphomas involving the thymus or spleen (37/45). Beyond 200 days, these mice predominantly developed mixed myeloid malignancies. The shift away from T-lineage malignancies in older mice may reflect aging-related decline of pre-malignant lymphoid progenitors and skewing to myeloid progenitors.Flow cytometric characterization of the T-lineage lymphomas identified a mix of tumors, including double-negative (CD4-CD8-), double-positive (CD4+CD8+), or single positive (CD4/CD8). In pre-malignant mice, Vav1-p53CKO thymocytes showed accelerated maturation with most of the cells in the DN4 stage, suggesting a bypass of the p53-dependent DN3 β-selection checkpoint. All T-lineage lymphomas showed overexpression of surface Notch1 as well as overexpression of Notch1 targets Hes1 and p21 at the transcript level. Consistent with prior data, normal murine thymocyte subsets showed high levels of expression of Notch1 target genes at the DN3 stage of development, which appears dysregulated in these T-lineage lymphomas. This Notch1 activation was found to be multifactorial with increased Mdm2 and decreased Numb levels seen in tumors. Overall, we demonstrate Notch1 activation and subsequent acceleration through the T-cell developmental stages in this model of pan-hematopoietic Trp53 deletion.The B-cell specific Trp53 knockout mice (CD19-P53CKO) (n=54) were followed up for up to 2 years. The majority (47/54) developed splenomegaly in an age-dependent manner. Histologic examination showed marginal zone expansion (6/54), frank low-grade marginal zone lymphoma (16/54) or diffuse splenic lymphoma (25/54). The disease was confined to the spleen in the case of lower-grade histology while higher grades correlated with liver and kidney involvement. Flow cytometric analysis of tumors showed B220+ CD19+ IgM+ cells. Interestingly, these tumors demonstrated low levels of Notch2 expression, which normally is highly expressed in marginal zone B-cells.In order to characterize pathogenesis, we sorted follicular and marginal zone B-cells from floxed P53 and pre-malignant CD19-P53CKO mice. RNA was isolated from all these fractions and the spleens of 5 CD19-P53KO mice with diffuse lymphoma and subjected to RNA-Seq. A comparison of the floxed p53 with the CD19-P53CKO fractions (follicular and marginal zone) revealed a highly similar transcriptome. On the other hand, p53-deficient lymphomas showed >10,000 genes significantly differentially expressed demonstrating the unique transcriptome which developed during malignant transformation.Pathway analysis of these genes using Gene Set Enrichment Analysis (GSEA) identified enrichment of PI3K, Rap1 and MAPK signaling pathways, which are associated with cellular proliferation. Overexpression of the PI3K pathway genes Ccne1, Sgk1, Mapk13 and Pik3cb were validated by qPCR in 10 independent tumor samples when compared to the splenic marginal zone fractions. In the B-cell lineage, Trp53 deficiency leads to the dysregulation of multiple genes involved in key cellular signaling pathways, including the PI3K/MAPK pathway.In summary, pan hematopoietic deletion of Trp53 led to T-lineage lymphoma in young mice and myeloid tumors in older mice; with activation of Notch1 signaling in the former. B-cell specific deletion of Trp53 led to splenic marginal zone and diffuse B-cell lymphoma with transcriptional dysregulation of key signaling molecules. Hence, tumorigenesis by Trp53 deletion is tightly linked to lineage and appears to dysregulate key signaling pathways that are operant in those lineages, potentially identifying novel strategies for therapeutic interventions in P53 dependent human hematolymphoid malignancies. DisclosuresNo relevant conflicts of interest to declare.

FEATURES OF THE CUMULATIVE INCIDENCE OF LYMPHOMAS IN DIFFERENT REGIONS OF THE CHERKASY REGION

The aim is to compare the cumulative incidence of Hodgkin's lymphoma and non-Hodgkin's lymphomas between conditionally clean and polluted regions of the Cherkasy region in 2001, 2014.
 Materials and methods. The incidence of Hodgkin's lymphoma and non-Hodgkin's lymphomas in conditionally clean, radioactive, chemical and radioactively and chemically contaminated regions of the Cherkasy region per 100 thousand population according to the All-Ukrainian census conducted in 2001 and published by the State Statistical Service of Ukraine in 2014.
 Results. According to the results of our study, in 2001, in the chemically contaminated region of the Cherkasy region, there was an increase in the incidence of mainly diffuse large B-cell lymphoma by 3.781 (p = 0.043) times compared to its conditionally clean territory (1.076; 0.022-2.130 versus 4.070; 0.082-8.058 per 100 thousand population, respectively). In the chemically contaminated area in 2014, a 3.314 times (p = 0.035) higher level of cumulative incidence of unspecified lymphomas was also revealed (1.793; 0.358-3.228 versus 5.945; 0.734-11.156 per 100 thousand population, respectively) compared to clean areas of the Cherkasy region.
 Conclusions. Thus, the results of our study showed that in 2001, living in a chemically contaminated area increased the growth of the cumulative incidence of diffuse B-cell lymphoma, and in 2014 - lymphomas of an unspecified type.

Misdiagnosis of diabetic foot ulcer in patients with undiagnosed skin malignancies.

A growing number of studies report dermal malignancies mimicking diabetic foot ulcers (DFUs). We reviewed clinical cases reporting malignant tumours misdiagnosed to be DFU aiming to identify factors contributing to misdiagnosis. We systematically searched in PubMed for clinical cases reporting on misdiagnosis of DFU in patients with cancer. A chi‐square analysis was conducted to show the link between the incidence of initial DFU misdiagnosis and patient age, gender and wound duration. Lesions misdiagnosed to be DFU were subsequently diagnosed as melanoma (68% of the cases), Kaposi's sarcoma (14%), squamous cell carcinoma (11%), mantle cell lymphoma, and diffuse B‐cell lymphoma (both by 4%). Older age (≥65 years) was associated with a significantly increased risk of malignancy masked as DFU (OR: 2.452; 95% CI: 1.132 to 5.312; P value = .019). The risk of such suspicion in older patients (age ≥ 65 years) was 145% higher than in younger patients (age < 65 years). Clinicians should maintain a high level of awareness towards potentially malignant foot lesions in elderly patients with diabetes (age ≥ 65).

Formation of necrotizing vasculitis in the patient with diffuse B-cell large cell lymphoma on immune checkpoint inhibitor (PD-1) therapy

INTRODUCTION: Immune checkpoint inhibitors (ICIs) have significantly improved the prognosis and clinical outcomes for patients with malignancies in many types of cancer. Nivolumab is a human monoclonal antibody that blocks the interaction between PD-1 and PD-L1/2, thereby preventing inhibition of T-cells, which contributes to the antitumor response. The use of ICT can lead to autoimmune aggression and the development of adverse events. Most of these are eliminated on their own after ICT therapy and steroid treatment have been discontinued.&#x0D; CLINICAL CASE DESCRIPTION: A 73-year-old patient with recurrent large B-cell lymphoma, on the background of R-CHOP, R-CHOP-mini, R-GDOx therapy incomplete clinical effect and frequent relapses have been registered. On immunohistochemistry, PD-L1 was positive in 90 % of the tumor cells. A decision has been made to administer the checkpoint inhibitor (PD-1) nivolumab, which developed a necrotizing vasculitis after three injections.&#x0D; CONCLUSION: On temporary withdrawal of the drug and administration of prednisolone at a dose of 1 mg/kg/day, the skin has recovered completely. When the PD-1 inhibitor was reapplied, there was no recurrence of autoimmune aggression. The treatment has been continued in the full way.

Critical role of the high mobility group A proteins in hematological malignancies.

The high mobility group A (HMGA) protein family is composed of three non‐histone chromatin remodeling proteins that act as architectural transcriptional factors. Indeed, although HMGA proteins lack transcriptional activity per se, they bind the minor groove of DNA at AT‐rich sequences, and, interacting with the transcription machinery, are able to modify chromatin modeling, thus regulating the expression of several genes. HMGA proteins have been deeply involved in embryogenesis process, and a large volume of studies has pointed out their key role in human cancer. Here, we review the studies on the role of the HMGA proteins in human hematological malignancies: they are overexpressed in most of the cases and their expression correlates with a reduced survival. In some cases, such as in acute lymphoblastic leukemia and acute myelogenous leukemia, HMGA2 gene rearrangements have been also described. Finally, recent studies evidence a synergism between HMGA and EZH2 in diffuse B‐cell lymphomas, suggesting an innovative therapy for this disease based on the inhibition of the function of both these proteins.

838P Rituximab and non-pegylated liposomial doxorubincin (R-NPLD) treatment in patients 80 years of age or older affected by diffuse large B-cell lymphoma (DLBCL): A 2020 update and implications of clinical and pathological factors

In 2018 we report a rituximab plus nonpegylated liposomial doxorubicin (R-NPLD) combination for patients 80 years or older with diffuse B cell lymphoma (DLBCL) or grade 3 b follicular lymphoma. The overall 3-year survival, cause-specific survival and progression-free survival rates were 46%, 55%, and 44%, respectively. According to these results, R-NPLD has become the new standard treatment in patients > 80 years old with aggressive B lymphoma, in our institution. To better investigate the prognostic role of clinical and pathological factors, we analyzed the same combination in a larger cohort of patient 80 years or older with DLBCL.

Les lymphomes non-Hodgkiniens cardiaques

Cardiac non-Hodgkin lymphoma (CNHL) is a rare extranodal lymphoma with a poor prognosis. Secondary cardiac lymphoma is more frequent than primary cardiac lymphoma. CNHL often involves the right side of the heart. Diagnosis of CNHL can be suggested by echocardiography and magnetic resonance imaging. Cytological examination of pericardial fluid or histological of cardiac tissue is essential. The majority of cases are diffuse B-cell lymphoma. A prompt immediate diagnosis and early treatment are essential for better outcome. Management should be individualized and the most effective treatment is chemotherapy containing anthracycline variably combined with radiotherapy. A multidisciplinary approach is essential to the successful treatment of CNHL.

Chimeric antigen receptor T‑cell therapy for B-cell non-Hodgkin lymphoma: opportunities and challenges

B-cell non-Hodgkin lymphoma (NHL) is the most common hematologic malignant neoplasm. Despite the improvement of immunochemotherapy, a significant number of patients have a refractory form of the disease. CAR T-cell therapy (therapy with T-lymphocytes with a chimeric antigen receptor (CAR)) is considered the most promising and effective therapy for overcoming chemorefractory B-cell NHL. Based on promising results from key studies, the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have approved anti-CD19 CAR T-cell therapy for relapsing / refractory diffuse B-cell lymphoma. However, several controversial issues remain, including the optimal management of toxicity, overcoming relapses after CAR T-cell therapy, and improving the production platform of CAR T-cells. This review describes the results of recent clinical research and development, as well as the prospects for the development of CAR T-cell therapy for B-cell NHL.

Primary diffuse B-cell thyroid lymphoma: A case report

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

A rare case of nodular lymphocyte predominant Hodgkin lymphoma, which developed 5 years after successful treatment of diffuse large B-cell lymphoma

Nodular lymphocyte predominant Hodgkin lymphoma (NLHLP) – B-cell lymphoma, which has been historically added to the group of Hodgkin's lymphomas, despite the peculiarities of the clinical course, treatment and prognosis, as well as morphological and immunophenotypical differences. In 75% of cases, the disease is detected at early stages (I–II according to Ann Arbor classification), has an indolent course and a favorable prognosis with 10-years an overall survival rate, more than 80%. Despite this, with long-term follow-up and the development of frequent relapses, transformation into diffuse large-cell B-cell lymphoma (DCBCL) or T-lymphocyte/histiocyte-rich DCBCL can occur, isolated cases in children. In the world literature, there are isolated cases of the development of NLHLP after treatment of DCBKL in adults, while among the pediatric population, cases have not been described. This article presents a clinical case of DCBKL in a 10-year-old child who, 5 years after the end of treatment, developed nodular Hodgkin's lymphoma with lymphocytic predominance. The patient's parents agreed to use the information, including the child's photo, in scientific research and publications.

Short and long-read genome sequencing methodologies for somatic variant detection; genomic analysis of a patient with diffuse large B-cell lymphoma

Recent advances in throughput and accuracy mean that the Oxford Nanopore Technologies PromethION platform is a now a viable solution for genome sequencing. Much of the validation of bioinformatic tools for this long-read data has focussed on calling germline variants (including structural variants). Somatic variants are outnumbered many-fold by germline variants and their detection is further complicated by the effects of tumour purity/subclonality. Here, we evaluate the extent to which Nanopore sequencing enables detection and analysis of somatic variation. We do this through sequencing tumour and germline genomes for a patient with diffuse B-cell lymphoma and comparing results with 150 bp short-read sequencing of the same samples. Calling germline single nucleotide variants (SNVs) from specific chromosomes of the long-read data achieved good specificity and sensitivity. However, results of somatic SNV calling highlight the need for the development of specialised joint calling algorithms. We find the comparative genome-wide performance of different tools varies significantly between structural variant types, and suggest long reads are especially advantageous for calling large somatic deletions and duplications. Finally, we highlight the utility of long reads for phasing clinically relevant variants, confirming that a somatic 1.6 Mb deletion and a p.(Arg249Met) mutation involving TP53 are oriented in trans.

Assessment of bone marrow status in diffuse B-cell large cell lymphoma: PET/CT capabilities

The aim of this work was to present the results of a retrospective study of 35 patients with morphologically diagnosed diffuse B-cell large cell lymphoma with bone marrow damage from 22 to 82 years old, median 63 years. There were 27 men and 8 women. After histological confirmation, all patients performed positron emission tomography combined with computed tomography with 18F-fluorodeoxyglucose (FDG PET/CT) followed by bone marrow trepanobiopsy. Specific bone marrow lesions were detected in 100% of cases with PET/CT and in 68.6% of cases with trepanobiopsy. Diffuse bone marrow damage was detected in 24 (68.6%) cases, focal – in 10 (28.6%) patients and in 1 (2.8%) patient – a mixed variant. The data obtained indicate the predominance of diffuse damage to the bone marrow. The statistical analysis established the value of the standardized maximum absorption coefficient of FDG SUVmax for bone marrow damage equal more than 3.58. Sensitivity was at 90% and a specificity was at 92%. The sensitivity of the PET/CT method is higher with focal lesions of the bone marrow than with diffuse. SUVmax was 10.26 ± 1.67 and 2.86 ± 0.09, respectively. The differences between them are significant (p &lt; 0.0001). PET/CT is a non-invasive method of metabolic imaging allows you to assess the condition of the bone marrow and other extranodal symptoms of the disease at the stage of diagnosis, treatment and follow-up. It can replace the traditional method of bone marrow biopsy with diffuse B-cell large cell lymphoma.

Diffuse Small B-Cell Lymphoma: A High-Grade Malignancy.

The most common subtype of lymphoma in the dog is diffuse large B-cell lymphoma (DLBCL). The remaining forms of B-cell lymphoma in dogs are categorized as small-to-intermediate in size and include marginal zone, follicular, mantle cell, and small-cell lymphocytic lymphoma. Marginal zone lymphoma and follicular lymphoma have readily identifiable unique histologic features while other forms of small B-cell lymphoma in the dog are poorly described by histopathology. Forty-seven cases of nodal small B-cell lymphoma identified by flow cytometry (small cell size based on forward scatter) with concurrent histopathology were reviewed. These cases fell into 3 histologic subtypes: marginal zone lymphoma, follicular lymphoma, and a diffuse form of small B-cell lymphoma with consistent features. As a descriptive term, we refer to the latter subtype as diffuse small B-cell lymphoma (DSBCL) until it can be further characterized by gene expression profiling and other molecular tools. Clinical presentation of DSBCL was compared to cases of histologically confirmed DLBCL and clinical follow-up was obtained for 22 of the 27 cases of DSBCL. This subset of diffuse small B-cell lymphoma had an overall median survival of 140 days. The expression of CD21, class II MHC and CD25 by flow cytometry did not differ between DSBCL and the other histologic subtypes of small cell B-cell lymphoma making histopathology the only current method of classification.

Epidural analgesia in patients with thrombocytopenia. Clinical case

The article presents a clinical case of a 25-year-old patient with progressive diffuse B-cell lymphoma with lesions of the S2 nerve root, accompanied by pain syndrome that is not relieved by systemic multimodal analgesia using opioids, antiepileptic and non-steroidal anti-inflammatory drugs. Polyneuropathy, secondary immunodeficiency, thrombocytopenia grade IV refractory to platelet concentrate transfusion, Guillain-Barre syndrome, impaired the somatic status and intensified the pain syndrome. Local anesthetics epidural port was successfully implanted to improve quality of analgesia. As a result of prolonged epidural infusion of 0.2% ropivacaine with titration rate from 4 to 7 ml/hour depending on the severity of the pain syndrome, that significantly improved patients quality of life was achieved by reducing the intensity of pain and increasing duration of night sleep. In the early postoperative and long-term follow-up periods (14 days), there were no hemorrhagic and infectious complications associated with the use of the epidural port.

Diffuse B-cell lymphoma in a submandibular gland: A very rare case presentation in a 23 years old

Introduction: Malignant lymphomas of a salivary gland originate from either a lymph node (nodal) or from the parenchymal tissue of a lymphoid organ (extranodal). Primary lymphomas of the salivary glands are rare in nature, accounting for 1.7–7.4% of all salivary gland tumor

Radiotherapy of Patients with a Relapses and Refractory Hodgkin’s and Diffuse B-cell Large Cell Lymphoma (Lecture)

The lecture materials are based on 40 years of experience of the A.M. Granov Russian Research Center of Radiology and Surgical Technologies and the International Lymphoma Radiotherapy Group (ILROG). The rationale and clinical scenarios for the use of radiation therapy for the unfavorable course of Hodgkin’s lymphoma and diffuse large B-cell lymphoma are presented.

Analysis of clinical characteristics, treatment and survival of elderly patients with large diffuse B-cell lymphoma

Objective: To analyze the clinical feature,treatment and survival outcome of elderly patients older than 80 years with large diffuse B-cell lymphoma. Methods: A total of 46 patients aged over 80 years with large diffuse B-cell lymphoma who were treated in Third Hospital of Peking University during the period from 2002 to 2018 were retrospectively analyzed, and the clinical features, laboratory data, survival and prognostic factors were included in Kaplan-Meier and prognostic analysis. Results: Patients older than 80 years old accounted for 15.7% (46/293) in all elderly patients, and the median age was 83 years old. There were 78.3% (36/46)patients who belonged to stage Ⅲ or Ⅳ, 63%(29/46) who had more than two extranodal organ involvement, and the higher proliferation index(Ki-67≥80%) was present in 53.7%(22/41) patients. Immunohistochemistry showed that 37% patients in 27 cases were double-expressed DLBCL. With a median follow-up of 25 months, the overall response rate (ORR) for the whole group was 63.0%, the complete response (CR) rate was 36.4%, the 2, 3-year progression-free survival (PFS) rate was 49.9% and 41.7%, the 2, 3-year overall survival (OS) rate was 54.6% and 43.6% respectively. The ORR for patients who received anthracycline-based therapies and non-anthracycline-based therapies were 81.8% and 55.0%, and the 3-year OS rate were 50.0% and 39.0%, respectively, but the difference was not statistically significant (P>0.05). 45.5% patients had hematologic toxicity of Grade Ⅲ or above, and 56.8% patients experienced infections during the treatment. Among the patients who died, the treatment-related mortality rate in group with high score of Charlson comorbidity index(CCI) was higher (43.8% vs 16.7%, P=0.03) . The National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) score, nodal involvement area ≥3, 6 cycles of chemotherapy, CCI score, initial treatment outcome and refractory-relapsed were predictive of overall survival. Multivariate analysis indicated the CCI score (HR=6.463, P=0.008) and initial treatment outcome (HR=0.086, P=0.001) were independent prognostic risk factors. Conclusions: The clinical and pathological features of patients older than 80 years were highly aggressive with poor chemotherapy tolerance and high adverse reaction rate. Anthracycline-based therapies may be less important in the treatment of DLBCL patients aged over 80 years. Patients with high CCI score have higher treatment-related mortality and CCI can help identify elderly patients who are suitable for larger chemotherapy dose.

CTNI-64. MATRIX REGIMEN FOR NEWLY DIAGNOSED PRIMARY DIFFUSE B-CELL LYMPHOMA OF THE CENTRAL NERVOUS SYSTEM

Abstract We report our experience treating 16 patients with newly diagnosed primary diffuse B-cell lymphoma of the central nervous system with the MATRix regimen as reported by Ferreri, et al in 2016. The median age was 66 years (y); 8 patients were men and 8 were women. Fourteen had cerebral mass lesions, 1 had a paraspinal mass, and 1 leptomeningeal disease. Treatment consisted of 4 cycles of rituximab 375 mg/sq m (Days 1, 6); methotrexate 3.5 g/sq m (Day 2); cytarabine 2 g/sq m every 12 h (Days 3, 4); and thiotepa 30 mg/sq m (Day 5). Patients without disease progression received carmustine 400 mg/sq m and thiotepa 4 X 5 mg/kg followed by autologous bone marrow transplantation. Four patients were switched to MATRix after 6 cycles of methotrexate and rituximab and received only 2 initial cycles including cytarabine and thiotepa. Overall, 12 patients completed initial chemotherapy. Eleven of these 12 went on to transplantation; one patient had early disease progression and did not proceed to transplantation. All 4 patients over 70 y died early after 1–2 cycles; the median age of these was 80 y, and the causes of early death were neutropenic fever, septic thrombophlebitis, and cardiac arrest. One patient who completed the entire regimen including transplantation died of fungal pneumonia; the other 11 experienced no serious acute toxicity. One patient had late disease progression; one developed symptomatic leukoencephalopathy. Nine of the 16 patients remain alive. At a median follow-up of 23 months, median time to progression was 421 days and overall survival 564 days. These preliminary data suggest that the MATRix regimen in safe and highly effective in the newly diagnosed setting. However, the high incidence of early death in patients over 70 y suggests that the regimen may be too toxic for elderly individuals.

Клініко-гематологічна характеристика пацієнтів з неходжскінськими лімфомами, які перебували на лікуванні у Національному військово-медичному клінічному центрі «Головний військовий клінічний госпіталь» з 2015 по 2019 р.

SummaryBackground. Non-Hodgkin’s lymphoma (NHL) is a group of hemoblastoses fromlymphoid cells, part of chronic lymphoproliferative diseases, including more than 50tumors that are derivatives of lymphocytes and can affect lymph nodes, primary andsecondary lymphatic organs (bone marrow, lymph nodes, thymus, thymus). According tothe results of the general annual indicators of blood malignancies for 10 years (2007–2011 and 1998–2004), the incidence rate of NHL increased 2.6 times. The incidencerate varies worldwide. The average incidence rate, which includes age, for both sexes is9.3 cases per 100,000 people – in more developed regions, and in less developedregions – 4.2 cases per 100,000 people. It should be noted that according to the resultsof the WHO, NHL is almost twice as often diagnosed in males. Non-Hodgkin’slymphoma accounts for about 5% of deaths per year.Purpose of the stydy. Aassessment of compliance of NHL patients with localprotocols and standards of diagnosis and treatment in the hematology clinic of theNational Military Medical Clinical Center «Main Military Clinical Hospital» (NМMCC«MMCH») based on a retrospective analysis of data of patients treated for the periodfrom January 2015 till December 2019.Materials and methods. A retrospective analysis of data of 120 patients with NHLwho were treated in the Haematology clinic of NМMCC «MMCH» from January 2015till December 2019 was performed. The diagnosis of NHL was made according to WHOstandards. Staging of lymphoid leukaemia / lymphoma of small lymphocytes (LL/LSL)was performed according to J. Binet criteria. The general condition of the patients wasanalysed according to the objective scale of assessment of the number and severity ofcomorbidities CIRS (Cumulative Illness Rating Score) ECOG (Eastern CooperativeOncology Group). Evaluated the results of cytostatic antitumor treatment, maintenancetherapy, follow-up of patients.Results. The age of the 120 people we examined with NHL, who were treated in theHaematology clinic of the NММCC MMCH from January 2015 to December 2019, rangedfrom 21 to 70 years. In the structure of our examined patients, 34 persons (35.83%) were with adiagnosis of diffuse B-cell lymphoma, chronic LL/LSL – 45 patients (37.50%), lymphoma fromcells of the marginal zone – 13 persons (10.83 %), follicular lymphoma – 3 people (2.5%),mantle cell lymphoma – 11 patients (9.17%), Castleman’s lymphoma – 2 patients (1.67%),gastric MALT lymphoma – 3 people (2.5%).Conclusions. We conducted a retrospective analysis of data of 120 people withchronic lymphoproliferative diseases who were treated at the Haematology clinic ofNМMСC «MMCH» from January 2015 till December 2019, and found compliance withlocal protocols and standards for diagnosis and treatment of NHL.

Cauda Equina Syndrome as A Clinical Presentation of Extradural Diffuse B-Cell Non-Hodgkin’s Lymphoma: Case Report and Literature Review

Diffuse B-Cell Lymphoma corresponds to the most frequent pathological entity within the spectrum of Non-Hodgkin’s Lymphoma, with reported annual incidence of 24% in the U.S. literature.