Serous Involvement Research Articles

An uncommon cause of ascites: eosinophilic enterocolitis with serous involvement.

Primary eosinophilic gastrointestinal disorders are rare, characterized by eosinophilic infiltration without a secondary cause. Although esophageal involvement is most common, any part of the gastrointestinal tract can be affected. We present the case of a male with symptoms of abdominal distension, retrosternal heartburn, sporadic vomiting, and diarrhea. The patient exhibited hypereosinophilia and elevated IgE levels. Ultrasound revealed diffuse small bowel wall thickening and moderate ascites; diagnostic paracentesis showed leukocytosis with a predominance of eosinophils. A gastrocolonoscopy revealed macroscopically normal findings, but biopsies from the duodenum, ileum, and colon revealed marked eosinophilia. Additional tests were negative. The patient was diagnosed with eosinophilic enterocolitis and started on corticosteroid treatment, with satisfactory improvement. Two years later, the patient has not shown new manifestations of the disease. Eosinophilic ascites is a typical manifestation when serosal infiltration. This form of involvement is the least common but has a good prognosis, usually responding well to corticosteroids and without subsequent flares.

IBCL-490 POD24 and Serous Effusion Involvement Impact on Overall Survival in Follicular Lymphoma Attended at the National Cancer Institute in Mexico: A Survey of 370 Patients

Follicular lymphoma (FL) is the most common indolent lymphoma. However, outcomes with standard treatments are suboptimal. Therefore, the identification of factors influencing overall survival (OS) are required. Retrospective analysis, to identify factors influencing on overall survival (OS) in patients with FL. Patients ≥ 18 years of age, with histological diagnosis of FL, without previous treatment, attended at the Instituto Nacional de Cancerología (Mexico City, Mexico) from Jan-2010 to December 2020. Clinical, biochemical and histological variables were included. Descriptive analysis was done for demographic and clinical characteristics. Median and Standard deviation (SD) was used, as a measure of dispersion. OS was defined since diagnosis until the date of the last follow-up or death. Survival curves were calculated by the Kaplan-Meier method, and differences between subgroups were compared with the Log-Rank test. Cox-regression analysis was used to identify the variables associated with overall survival. We included 370 patients (female: 216, 58.4%), with a median age of 54.09±12.49 years. Most of them had advanced disease (n=301, 81%) and low grade (n=228, 61%). Bulky disease was documented in 42.2%, bone marrow involvement in 31%, extranodal disease in 29.7%, and serous involvement in 17.6%. Only 329 cases received treatment, and the most frequent schema was CHOP-rituximab (n=315, 95%). Response rates were as follows: CR 73.5%, PR 9.7%, SD 2.4%, PD 6.2% and undetermined in 8.2%. 56.8% of patients received rituximab maintenance and 88/241 patients had progression of disease within 2 years (POD24). Transformation to DLBCL was documented in 3.7%. In our proportional hazards model, serous involvement (p=0.0031, HR: 2.749, 95%CI: 1.406-5.417) and POD24 (p<0.0001, HR: 21.45, 95%CI: 10.05-49.76) were significantly associated with OS. Additionally, the HRs were calculated for patients with POD at 0-6 months (HR: 8.055, 95%CI: 4.118-14.44), 7-12m (HR: 2.754, 95%CI: 1.542-4.611), 13-18m (HR: 8.515, 95%CI: 3.5-17.67) & 19-24m (HR: 3.9, 95%CI: 2.157-6.612), suggesting a cut-off point at 18 could better represent high-risk population in our cohort. In a LATAM reference center, serous involvement at diagnosis and POD24 were significantly associated with worse OS in patients with FL.

CALM-AF10 Positive Acute Myeloid Leukemias: A French Cohort of 18 Patients.

The t(10;11)(p12–13;q14–21) is a very rare but recurring chromosomal translocation observed in patients with both ALL and AML resulting in the generation of a CALM–AF10 fusion gene. Although clinical features of CALM-AF10 positive ALL have been described, there are only few data about the clinical characteristics and outcome of AML patients. We have studied 18 AML patients treated in 11 French hematological centers. Patients were included in this study after an exhaustive survey in the main French hematological centers. Clinical and biological data were collected for 18 patients diagnosed between 01/1993 and 01/2008. The characteristics of patients were as follows: median age, 30y (10–77y); sex ratio (M/F) 1,25; median WBC count, 17.6 G/L (0.8–298) and 4 pts (22%) with WBC>100 G/L; median Hb, 9.4 g/L (5.4–12.6); median platelets, 84 G/L (10–238), median bone marrow blasts, 90% (35–98%). FAB subtypes were: 1 M0; 10 M1, 1 M2 and 6 M5. Extramedullary disease was found in 10 pts (56%) (gingival hypertrophy, 3/18; lymph nodes, 9/18; chloromas, 2/18; serous involvement, 2/18; hepatosplenomegaly, 1/18). Of note, 3 pts had previously received polychemotherapy for diffuse large B cell lymphoma (DLBCL) and 1pt for AML without cytogenetic analysis available at diagnosis. The t(10;11)(p12–13;q14–21) translocation was found as the sole chromosomal abnormality in 7 pts (39%) whereas 11 pts displayed additional abnormalities including high risk abnormalities (−7; 5q−; Ph+; 17p−) in 4 of them. Trisomies 4 and 19, frequently observed in our series, might be nonrandom secondary abnormalities in CALM-AF10 AMLs. In all cases, the presence of the CALM-AF10 rearrangement was confirmed either by RT-PCR or by FISH analysis. FLT3 mutations were screened in 6 samples but no FLT3-ITD mutation was detected. Immunophenotypic data showed that CD13, CD33, CD65, CD117, CD34, HLADR and MPO were expressed in 69%, 88%, 50%, 50%, 50%, 92% and 67% of cases, respectively. CD7 was also frequently expressed (9/11, 82%) whereas CD2, CD4, CD10 and CD19 were expressed only in a few cases. Induction chemotherapy using anthracyclines and aracytin was delivered in 17 patients, 3 of them received timed-sequential induction. At day 15, 8/14 pts receiving standard induction had more than 5% marrow blasts and received a second induction course. There was no early death and the response rate was 66% (11 CR + 1 CRi). Six patients underwent allogeneic stem-cell transplantation (Allo-SCT) (5 in CR1, 1 refractory), 4 pts consolidation chemotherapy alone and 2 pts autologous SCT while 1 patient died in CRi. Of note, the patient allografted with refractory disease achieved CR after allo-SCT and is alive at 12 months from diagnosis. 6 pts relapsed (3 after allo-SCT, 2 after auto-SCT and 1 after consolidation chemotherapy) and second CR was achieved in 5 but CR2 were short lasting except for two pts for which the duration of CR2 was 3 and 10 years, respectively. Among the 17 patients treated by induction chemotherapy, median overall survival was 18 months. With a median follow-up of 11 months (range, 2 to 181 months), the median remission duration and median OS for CR/CRi patients were 23 and 28 months, respectively. There were 3 long term survivors (> 3 years), 2 pts in CR1 who received chemotherapy only as consolidation therapy and one in CR3 after 2 allo-SCTs. CALM-AF10 AMLs are characterized by younger age, extramedullary involvement, and high relapse rate. Some cases may be therapy-related AMLs, secondary to chemotherapy for other hematological malignancies and particularly DLBCL. Although the prognosis is poor, long term response can be achieved in a subset of patients.