Quality of life patients treated with rituximab intravenous versus subcutaneous in B-cell lymphomas: results from outpatient Hematooncology Clinic in Lodz

Introduction: Nowadays, rituximab is available both as intravenous (IV) and subcutaneous (SC) formulations. The aim of this study is to compare quality of life (QOL) of patients treated in Hematooncology Clinic in Lodz with B-cell nonHodgkin lymphoma (B-NHL) treated with rituximab IV and SC. Material and Methods: In 50 adult patients with B-NHL diagnosis we assessed QOL by three different questionnaries (EORTC QLQ-C30, FACT/ GOG-NTx and EQ-5D). We compared it between patients treated with rituximab IV and SC. Results: In comparison of general condition in EQ-5D-3L and EORTC QLQ-C30 questionnaire patients treated with rituximab SC felt statistically better than with IV administration (p<0.01). In SC group general health was evaluated for 72 while in IV for only 58,1. According to FACT/GOG-NTx questionnaire SC group had significantly better physical well-being. In SC group we observed statistically more complete responses (CR) 21 (88%) versus 17 (65%) in IV group. Moreover, trend was observed in emotional well-being in favor of SC treatment. Discussion: In our study we observed for the first time in the literature statistical difference in frequency of vomiting, nausea, and lack of appetite mentioned from our patients in questionnarie. It is very important that this findings were not published in any other study comparing SC and IV route od administration. Also looking at economic side of SC administration, this type of dosing. As a result it should be preferred form for B-cell lymphoma patients.

Genetic variations in tumor necrosis factor related apoptosis-inducing ligand receptor-1 (TRAIL-R1) gene and the susceptibility to B cell nonhodgkin lymphoma in Egypt

BACKGROUND: Dysregulated apoptosis is a hallmark of cancer development and progression. TRAIL and its receptors (R1 and R2) are key players in the extrinsic apoptotic pathway. Genetic alteration or blockade of TRAIL-R1 may alter its apoptotic function, and subsequently provide growth advantage to neoplastic cells. OBJECTIVE: to investigate the possible association between -C626G, -A683C and -A1322G single nucleotide polymorphisms (SNPs) of TRAIL-R1 gene and the susceptibility to B-NHL in a cohort of Egyptians. METHODS: Genotypic analysis was performed for 100 newly diagnosed B-NHL patients and 150 age and gender matched healthy controls. RESULTS: The polymorphic alleles of -C626G and -A1322G conferred almost twofold increased risk of B-NHL (OR = 1.76; 95%CI = 1.01–3.22 and OR = 1.89; 95%CI = 1.01–3.75 respectively). There was no statistical difference in the distribution of TRAIL-R1-A683C alleles/genotypes between B-NHL patients and controls. B-NHL risk increased when -C626G and -A1322G polymorphic genotypes were co-inherited (OR = 3.57; 95%CI = 1.29–9.84). The risk conferred by -C626G SNP increased for DLBCL (OR = 3.39, 95% CI: 1.61–7.16). CONCLUSION: TRAIL-R1–C626G and -A1322G polymorphisms could be considered as molecular risk factors for B-NHL especially DLBCL. The data provided by the current study constitute an initial millstone towards developing a large-scale dataset for genetic variations that could contribute to lymphomagenesis in Egyptian population.

Acute Liver Failure as the Leading Manifestation of Spontaneous Tumour Lysis Syndrome in a Patient with NonHodgkin Lymphoma: Do Current Diagnostic Criteria of Tumour Lysis Syndrome Need Re-Evaluation?

Tumour lysis syndrome (TLS) is a group of pathophysiological processes caused by rapid degradation of tumour cells with subsequent release of intracellular contents into the extracellular space. It is characterized by the development of systemic metabolic disturbances with or without clinical manifestations. The process usually occurs in highly proliferative, large tumours after induction of cytotoxic therapy. Rarely, however, spontaneous TLS can develop, as well as signs of multiorgan failure triggered by an excessive metabolic load and sterile inflammation. The combination of the aforementioned is thus quite unique. Here, we present a 63-year-old male in which spontaneous TLS was accompanied with acute liver failure and delineated underlying nonHodgkin lymphoma. Initial laboratory findings included hyperkalaemia, hyperphosphataemia, hypocalcaemia, uraemia, and increased creatinine levels indicating the onset of TLS with acute kidney injury. Moreover, the patient showed signs of jaundice, coagulopathy, and hepatic encephalopathy. Development of TLS with multiorgan failure prompted rapid initiation of critical care management, including vigorous intravenous fluid therapy, allopurinol treatment, high flow continuous venovenous haemodiafiltration, and commencement of chemotherapy. The case highlights the possibility of TLS as a differential diagnosis in patients presenting with multiorgan failure and the importance of early detection of this potentially challenging and fatal diagnosis.

The clinicopathologic features and response to treatment of patients with Nonhodgkin Lymphoma: A single-center experiment in Turkey

Objective: We aimed to compare laboratory features, histopathological types, response to treatment of patients with non hodgkin lymphoma in our department and other regions. Methods: A total of 80 patients nonhodgkin lymphoma were evaluated. Because we had only 80 patients with complete data, we used T test for comparison of groups. We evaluated the parameters affecting surveillance with cox regression analysis. Results: The most common histological types of nonhodgkins lymphoma was diffuse large b cell lymphoma (n: 63, 78.75%). Thirty-nine percent of all patients had anemia, 32% had hypoalbunemia, 71.25% had elevated serum LDH, 32.5% had elevated serum ß2 microglobulin value. Advanced age, the presence of bulky disease, elevated Ki-67 level, IPI score, refractory to first line treatment were found to be correlated with shorter survival time. We treated 77 (96.25%) patients with doxorubicin containing regimen. Complete and partial remission rates of first line treatment were 77.5% and 10%, respectively. Seven (8.75%) patients died because of disease progression and 1 (1.25%) patient died due to sepsis. Conclusion: The frequency of lymphoma subtypes, clinical characteristics, treatment outcomes and survival rate vary from region to region. Therefore it is important to determine dissimilarity of these parameters for improve of survey. How to cite this:Yildirim R, Sincan G. The clinicopathologic features and response to treatment of patients with Nonhodgkin Lymphoma; A single-center experiment in Turkey. Pak J Med Sci. 2019;35(1):82-85. doi: https://doi.org/10.12669/pjms.35.1.415 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

SPATIAL DISTRUBITON OF CHILDREN TREATED BY CANCER IN ZONGULDAK, TURKEY

This research is focused on the examination of child cancer cases in Zonguldak (Turkey) descriptively in epidemiological aspect thanks to GIS. Universe of the study is composed of 60 children between 0-19 years old, treated in Children Oncology Clinic of Health Application and Research Center in BEU. Whole universe was reached without selecting a sample in the study. Data were collected by using a form prepared by obtaining expert advice and they were applied to children and their parents at study dates. Results were expressed as percentages. Chi-Square test was used in intergroup comparisons, results were assessed within 95% confidence interval and p&lt;0.05 was considered as statistically significant. Variables that were used in the study were assessed, recorded in prepared data collection form and distribution maps were produced. When disease diagnosis of the children participated in the study were evaluated, it was observed that 33.3% (n=20) were being treated for ALL, 13.3% (n=8) for Medullablastoma and 11.7% (n=7) for Hodgkin-nonHodgkin Lymphoma. It was detected that 31.7% (n=19) were in Ereğli, 31.7% (n=19) were in Central district and 18.3% (n=11) were in Çaycuma, when the places where children were living were evaluated. Statistically significant difference was found (p=0.016) comparing disease diagnosis with living place, and overall distribution map of the number of cancer cases was produced in this context. This is the first research subjecting the distribution of cancer cases for Zonguldak province.

SPATIAL DISTRUBITON OF CHILDREN TREATED BY CANCER IN ZONGULDAK, TURKEY

This research is focused on the examination of child cancer cases in Zonguldak (Turkey) descriptively in epidemiological aspect thanks to GIS. Universe of the study is composed of 60 children between 0-19 years old, treated in Children Oncology Clinic of Health Application and Research Center in BEU. Whole universe was reached without selecting a sample in the study. Data were collected by using a form prepared by obtaining expert advice and they were applied to children and their parents at study dates. Results were expressed as percentages. Chi-Square test was used in intergroup comparisons, results were assessed within 95% confidence interval and p&lt;0.05 was considered as statistically significant. Variables that were used in the study were assessed, recorded in prepared data collection form and distribution maps were produced. When disease diagnosis of the children participated in the study were evaluated, it was observed that 33.3% (n=20) were being treated for ALL, 13.3% (n=8) for Medullablastoma and 11.7% (n=7) for Hodgkin-nonHodgkin Lymphoma. It was detected that 31.7% (n=19) were in Ereğli, 31.7% (n=19) were in Central district and 18.3% (n=11) were in Çaycuma, when the places where children were living were evaluated. Statistically significant difference was found (p=0.016) comparing disease diagnosis with living place, and overall distribution map of the number of cancer cases was produced in this context. This is the first research subjecting the distribution of cancer cases for Zonguldak province.