scholarly journals Clonally Related Plasmablastic Lymphoma Simultaneously Occurring with Diffuse Large B-Cell Lymphoma

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Norisato Hashimoto ◽  
Tomoki Ueda ◽  
Shinichiro Hiraiwa ◽  
Takuma Tajiri ◽  
Naoya Nakamura ◽  
...  
Keyword(s):  
B Cell ◽  
Dna Analysis ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Plasmablastic Lymphoma ◽  
Aggressive Lymphoma ◽  
Large B Cell Lymphoma ◽  
Cdr3 Region ◽  
Myc Gene ◽  
Large B Cell

Plasmablastic lymphoma (PBL) is a rare aggressive lymphoma. Although it was first described in HIV- (human immunodeficiency virus-) infected patients, PBL has been diagnosed in patients with other immunodeficiencies as well as in immunocompetent patients. PBL immunohistochemically expresses plasmacytic markers and lacks pan B-cell markers. The cells of origin of PBL are considered to be plasmablasts. MYC gene rearrangement and MYC overexpression are frequently found in PBL, but the pathogenesis of PBL is yet to be elucidated. Here, we report a case of composite lymphoma of PBL and diffuse large B-cell lymphoma (DLBCL); that is, PBL in the urinary bladder and DLBCL in the nasal cavity occurred simultaneously. We extracted DNA from the two lymphomas for polymerase chain reaction and sequenced the amplified immunoglobulin heavy variable genes and the complementarity-determining region- (CDR-) 3. The sequence of the CDR3 region of both tumors matched. MYC rearrangement was found in the bladder tumor but not in the nasal tumor. The patient was treated with R-CHOP (rituximab, cyclophosphamide, vincristine, doxorubicin, and prednisone), and durable remission had been obtained. The results of the DNA analysis indicated that both PBL and DLBCL emerged from common postgerminal B cells. This case may help to elucidate the pathogenesis of PBL.

Changes in Frequency of Surveillance Imaging of Survivors of Diffuse Large B-Cell Lymphoma After the American Society of Hematology Choosing Wisely Recommendations

2020 ◽  
pp. OP.20.00362
Author(s):  
Urshila Durani ◽  
Dennis Asante ◽  
Herbert C. Heien ◽  
Carrie A. Thompson ◽  
Thorvardur Halfdanarson ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Choosing Wisely ◽  
Aggressive Lymphoma ◽  
Large B Cell Lymphoma ◽  
Period 2 ◽  
Surveillance Imaging ◽  
American Society ◽  
Large B Cell

In 2013, the American Society of Hematology (ASH) published recommendations with Choosing Wisely to limit surveillance imaging in aggressive lymphoma. We studied surveillance imaging practice patterns for diffuse large B-cell lymphoma (DLBCL) before and after the ASH Choosing Wisely campaign. We used OptumLabs Data Warehouse, a national insurance claims database, to retrospectively study imaging frequency in survivors of DLBCL from 2008 to 2016. Three time periods were defined: Period 1 (2008 to 2010), Period 2 (2011 to 2013), and Period 3 (2014 to 2016). One thousand four hundred seventy-two patients were included. Median follow up was approximately 2 years. During the first and second years of surveillance, imaging remained stable between Period 1 (years 1 and 2: 199 [91%] and 137 [83%], respectively) and Period 2 (years 1 and 2: 257 [88%] and 172 [77%], respectively; P = .38), but decreased in Period 3 (years 1 and 2: 315 [78%] and 83 [61%], respectively; P < .01). In a multivariable logistic regression, year after 2012 was a significant predictor of decreased overuse (more than two scans per year in the first year of surveillance; [odds ratio, 0.49 for 2013 v 2008; P = .02]). Our study demonstrated the rate of surveillance scans—both computed tomography and positron emission tomography imaging—in DLBCL decreased after the ASH Choosing Wisely campaign. Multiple factors, such as changes in recommendations, reimbursement, and provider knowledge base, may have all contributed and should be studied further.

The Impact of Relative Dose Intensity of Rituximab-CHOP on Survival in Diffuse Large B-Cell Lymphoma Patients

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4931-4931
Author(s):  
Yoshiki Terada ◽  
Hirohisa Nakamae ◽  
Ran Moriguchi ◽  
Hiroshi Kanashima ◽  
Erina Sakamoto ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Dose Intensity ◽  
B Cell Lymphoma ◽  
Aggressive Lymphoma ◽  
Factors Influencing ◽  
Large B Cell Lymphoma ◽  
The Impact ◽  
Large B Cell ◽  
Significant Factors

Abstract Background. Recently several retrospective studies showed that relative dose intensity (RDI) in combination chemotherapy including CHOP significantly influences survival in aggressive lymphoma. Based on these data, maintaining high RDI in chemotherapy by, for example, prophylactic granulocyte colony-stimulating factor (G-CSF) administration has been attempted to obtain better outcome. Moreover, rituximab, a chimeric monoclonal anti CD20 antibody combined with CHOP chemotherapy (R-CHOP) has significantly ameliorated the outcome in patients with diffuse large B-cell lymphoma (DLBL). However, it is unclear if higher RDI even in combination with rituximab will improve outcome in B cell type aggressive lymphoma. Hence, in the current study, we retrospectively analyzed the impact of RDI in R-CHOP as an initial treatment on survival of patients with DLBL. Furthermore, we determined the factors influencing RDI. Patients and Methods. We studied 100 previously untreated DLBL patients who underwent more than 3 courses of R-CHOP chemotherapies at 5 institutions from December 2003 to February 2008. The median age of the patients was 60 years old (range 19–79). The median number of R-CHOP course was 6 (range, 3–8). In the current study, the RDI was calculated by averaging the delivered RDIs of cyclophosphamide (CY) and adriamycin (ADR) for all chemotherapy courses. Results. The median average RDI of CY and ADR (CY/ADR-RDI) in all patients was 87.9%. Twenty three of 100 patients were treated with RDI less than 75 %. With a median follow-up of 21.2 months, the probability of 4-year overall survival (OS) was significantly higher in patients with higher RDI (&gt;=75%) than that in patients with lower RDI (&lt;75%) (78.6 % vs. 60%; P = 0.01). In univariate Cox regression model to identify prognostic factors for OS, RDI [hazard ratio (HR) = 0.7 per 0.1 of RDI; 95% CI 0.6– 0.9; P = 0.02] and high/high-intermediate International Prognostic Index (IPI) (HR = 4.7; 95% CI 1.3–17; P = 0.04) were significant factors influencing OS. In multivariate model, RDI was only a significant factor influencing OS (HR = 0.8 per 0.1 of RDI; 95% CI 0.6–1.0; P = 0.04). In multivariate logistic analysis to determine factors influencing RDI, elderly patients (&gt;=51 ) [odds ratio (OR) = 0.2; 95% CI 0.1–0.7; P = 0.01] and high/high-intermediate IPI (OR = 0.3; 95% CI 0.1–1.0; P = 0.04) were significant factors for reduced RDI, whereas prophylactic G-CSF (OR = 3.2; 95% CI 1.1–9.3; P = 0.04) was found to be a significant factor for increased RDI. Conclusion. In newly diagnosed DLBL patients, the current results demonstrated that high RDI in CHOP even when combined with rituximab was significantly associated with better survival and higher RDI could be effectively maintained by G-CSF.

Evidence of c-myc gene abnormalities in mediastinal large B-cell lymphoma of young adult age [see comments]

Blood ◽  
1991 ◽  
Vol 78 (3) ◽  
pp. 780-788
Author(s):  
A Scarpa ◽  
L Borgato ◽  
M Chilosi ◽  
P Capelli ◽  
F Menestrina ◽  
...  
Keyword(s):  
B Cell ◽  
Dna Sequences ◽  
Epstein Barr Virus ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Barr Virus ◽  
Large B Cell Lymphoma ◽  
Myc Gene ◽  
Epstein Barr ◽  
Large B Cell

Six cases of mediastinal large B-cell lymphoma (MLCL) with sclerosis were analyzed for the presence and patterns of c-myc and bcl-2 loci rearrangements, and for the presence of Epstein-Barr virus DNA sequences by Southern blot hybridization, c-myc gene alterations were found in three of six cases. Two cases showed the presence of mutations or small rearrangements at the 3′ end of the first exon. The c-myc gene abnormalities found in these two cases are similar to those observed in the translocation 8;14 of the endemic Burkitt's lymphomas or in its variants t(2;8) and t(8;22). A third case showed a major rearrangement of c-myc gene, with truncation within its first intron, similar to those observed in sporadic Burkitt's and in acquired immunodeficiency- associated lymphomas. None of the cases displayed bcl-2 gene rearrangements or contained viral sequences. Our data suggest a possible role for a translocation-mediated c-myc activation in the pathogenesis of MLCL. Conversely, bcl-2 gene and Epstein-Barr virus do not appear to be involved in the pathogenesis of these peculiar lymphomas. The association between c-myc structural modifications and MLCL also seems to be of relevance in light of the peculiar tendency of this tumor to involve unusual extranodal site (eg, kidney), reminiscent of the spreading attitude of Burkitt's limphomas.

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