1,720,974 research outputs found
Infectious aetiology of marginal zone lymphoma and role of anti-infective therapy
Get PDFMarginal zone lymphomas have been associated with several infectious agents covering both viral and bacterial pathogens and in some cases a clear aetiological role has been established. Pathogenetic mechanisms are currently not completely understood. However, the role of chronic stimulation of the host immune response with persistent lymphocyte activation represents the most convincing explanation for lymphoproliferation. Gastric MALT lymphoma is strictly associated with Helicobacter pylori infection and various eradicating protocols, developed due to increasing antibiotic resistance, represent the first line therapy for gastric MALT. The response rate to eradication is good with 80% of response at 1 year; this finding is also noteworthy because it recapitulates cancer cured only by the antibacterial approach and it satisfies the Koch postulates of causation, establishing a causative relationship between Hp and gastric MALT lymphoma. Patients with chronic HCV infection have 5 times higher risk to develop MZL, in particular, an association with splenic and nodal MZL has been shown in several studies. Moreover, there is evidence of lymphoma regression after antiviral therapy with interferon+ribavirin, thus raising hope that newly available drugs, extremely efficient against HCV replication, could improve outcome also in HCV-driven lymphomas. Another case-study are represented by those rare cases of MZL localized to orbital fat and eye conjunctivas that have been associated with Chlamydophila psittaci infection carried by birds. Efficacy of antibacterial therapy against C. psittaci are conflicting and generally poorer than gastric MALT. Finally, some case reports will cover the relationship between primary cutaneous B-cell Lymphomas and Borrelia Burgdorferi
Splenic marginal zone lymphoma: Prognostic factors, role of watch and wait policy, and other therapeutic approaches in the rituximab era
No full textSplenic marginal zone lymphoma (SMZL) is an indolent lymphoma in which watch and wait (W&W) approach as well as splenectomy and chemo-immunotherapy are usually recommended. The role of the different approaches in relation to risk factors was evaluated. One hundred patients with SMZL were retrospectively studied. Median age was 65 years. HCV positivity was 3.1%. The 10-year overall-survival was 95.1% (CI: 90-100%). Sixty-two asymptomatic, low tumour burden patients were submitted to W&W. A low-risk group not requiring treatment was identified. Patients requiring treatment received splenectomy (36), chemotherapy-alone (27) and rituximab ± chemotherapy (16). In multivariate analysis, negative predictors for starting treatment were female-sex, splenomegaly, ECOG ≥ 1. Patients with low IIL-Score had a better 5-year TFT (24%). The median TFT of the W&W cohort was 58.5 months; at 10 years, 17% of patients were still on W&W. Splenectomy and rituximab ± chemotherapy showed similar results, while chemotherapy alone proved inferior. This real-life single-centre study of SMZL confirmed its very good prognosis with a survival likelihood overlapping that of general population. The prognostic role of IIL-Score was confirmed. The W&W approach allowed a median PFS longer than in follicular lymphoma. Finally, our data confirm the inferiority of chemotherapy compared to splenectomy and rituximab ± chemotherapy
Spermatogenesis in Hodgkin's lymphoma patients: a retrospective study of semen quality before and after different chemotherapy regimens
No full textIs spermatogenesis impairment caused by Hodgkin's lymphoma (HL) itself or by the various treatments
Regression of a case of Multiple Myeloma with antiviral treatment in a patient with chronic HCV infection.
No full textWe report a case of a 54 year old patient with Multiple Myeloma (MM) and chronic HCV infection. In 2005 MM was diagnosed and a chemotherapy was prescribed. Before starting treatment a chronic HCV infection was found. When she came to our Institution for a second opinion, chemotherapy treatment was not considered immediately necessary so the patient was treated for the HCV chronic infection (Pegilated alpha-Interferon 180 μg/week and Ribavirin 1000 mg p.o./day). After one month of treatment she presented a reduction of Bence Jones protein (BJ) that further decreased in the following three months. The antiviral treatment was suspended after six months and a re-evaluation showed a complete viral response and a regression of MM. Sixty-eight months after the end of antiviral treatment the patient is asymptomatic and presents a condition compatible with an M-GUS. While the association between HCV infection and non-Hodgkin's lymphoma is consolidated and it is clearly demonstrated that antiviral treatment in these patients can induce a high proportion of partial and complete remission, a similar effect was never described in MM. The response obtained in our patient may suggest a possible a role of HCV in the pathogenesis of M
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Early clearance of hairy cell leukaemia in the bone marrow after first‐line treatment with cladribine predicts a favourable outcome
No full textFirst-line purine nucleoside analogues (PNAs) in hairy cell leukaemia (HCL) allow
deep and long-lasting responses. We retrospectively analysed 53 HCL patients treated
frontline with cladribine and assessed for response at 2 and 6months after treatment
to evaluate the kinetics of response. The estimated median progression-free survival
was significantly different according to the degree of residual HCL infiltrate detected
by immunohistochemistry at the bone marrow biopsy at 2months (≤5% vs. >5%,
247 vs. 132months, respectively, p=0.033), but not at 6months (p=0.79). Our data
suggest a favourable prognostic impact of early marrow HCL clearance in patients
treated with cladribine
Impact of different treatment approaches on pregnancy outcomes in 99 women treated for Hodgkin lymphoma
No full textPurpose: The aim of this study was to evaluate the pregnancy outcomes in women with Hodgkin
lymphoma (HL) diagnosis, treated between 1972 and 1999 at Department of Radiotherapy
and Hematology of University “Sapienza” of Roma.
Methods and Materials: We retrospectively studied 99 female patients that conceived after
treatment for HL. Fifty-nine (59%) were treated with chemotherapy and radiotherapy, 32
(32%) with radiotherapy alone as supradiaphragmatic or as infradiaphragmatic and 8 (8%)
patients with chemotherapy alone.
Results: Ninety-nine patients reported 145 pregnancies. We observed 132 deliveries (2 of them
twin births) after a median of 55 months (range, 14e278 months) from the end of therapy. Twelve
women (12%) experienced 13 miscarriages after a median of 50 months (range, 13e120) from
the end of therapy. We recorded 9/132 (7%) premature births and 3/134 babies (2%) were underweight
at the time of birth.We recorded 2 cases of congenital malformations. No statistical differences
were recorded when adverse pregnancy outcomes were analyzed with respect to
chemotherapy alone, radiotherapy alone, or combined therapy.
Conclusions: No significant associations between pregnancy outcomes and therapeutic
approaches were found. In particular, the infradiaphragmatic radiotherapy showed no statistical
association with miscarriages, premature birth, and low birth weight at term when compared with
other therapeutic approaches.Purpose: The aim of this study was to evaluate the pregnancy outcomes in women with Hodgkin
lymphoma (HL) diagnosis, treated between 1972 and 1999 at Department of Radiotherapy
and Hematology of University “Sapienza” of Roma.
Methods and Materials: We retrospectively studied 99 female patients that conceived after
treatment for HL. Fifty-nine (59%) were treated with chemotherapy and radiotherapy, 32
(32%) with radiotherapy alone as supradiaphragmatic or as infradiaphragmatic and 8 (8%)
patients with chemotherapy alone.
Results: Ninety-nine patients reported 145 pregnancies. We observed 132 deliveries (2 of them
twin births) after a median of 55 months (range, 14e278 months) from the end of therapy. Twelve
women (12%) experienced 13 miscarriages after a median of 50 months (range, 13e120) from
the end of therapy. We recorded 9/132 (7%) premature births and 3/134 babies (2%) were underweight
at the time of birth.We recorded 2 cases of congenital malformations. No statistical differences
were recorded when adverse pregnancy outcomes were analyzed with respect to
chemotherapy alone, radiotherapy alone, or combined therapy.
Conclusions: No significant associations between pregnancy outcomes and therapeutic
approaches were found. In particular, the infradiaphragmatic radiotherapy showed no statistical
association with miscarriages, premature birth, and low birth weight at term when compared with
other therapeutic approaches
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Risk of secondary hypogammaglobulinaemia after Rituximab and Fludarabine in indolent non-Hodgkin lymphomas: a retrospective cohort study
No full textThe occurrence of secondary hypogammaglobulinemia (SH) after chemo-immunotherapy represents a potential side effect in patients with indolent non-Hodgkin lymphomas (iNHL). Few data are available on SH occurring after chemotherapy and/or Rituximab (R). We retrospectively investigated the incidence and the risk factors for SH and infectious complications in patients with iNHL after chemo-immunotherapy. Two hundred and sixty six patients treated between 1993 and 2011 were studied. Patients with a basal hypogammaglobulinemia or a monoclonal component were excluded. The incidence of SH was 2.2×1000 person-years (95% CI 1.6-2.9). Exposure to Fludarabine-based schedules (Fbs)±R was associated with a hazard ratio (HR) of 18.1 (95% CI: 4.3-77.0). Conversely, exposure to CHOP±R or CVP±R was not a risk factor (HR 0.3, 95% CI: 0.1-0.8; HR 0.3, 95% CI: 0.08-1.4, respectively). The role of R was studied comparing cohorts differing only for R; no differences were found comparing R-CHOP/R-CVP versus CHOP/CVP (HR 1.07, 95% CI: 0.38-3.05) and R-Fbs versus Fbs (HR 2.07, 95% CI: 0.62-6.99). Autologous stem cell transplantation (ASCT) is also a risk factor (HR: 5.2, 95% CI 2.1-13.0). SH patients presented a high risk for pneumonia development (HR 7.07 95% CI: 2.68-18.44). We recommend monitoring of serum immunoglobulins in an attempt to reduce the probability of infection after Fbs or ASCT
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