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Background: Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of non-Hodgkin lymphoma with uncommon clinical presentations and poor prognosis. The purpose of this study is to report the clinical features and outcome of IVLBCL in a single institution of Taiwan. Methods: Ten patients with IVLBCL diagnosed from June 2006 to January 2018 were retrospectively reviewed. Results: The median age was 61 (range 39–88) years. The most common presentation was fever (90%), cytopenia (90%), and confusion (50%). For all patients, the median progression free survival (PFS) and overall survival (OS) were 12.6 (95% confidence interval [CI] 0.0–76.1) and 18.8 (95% CI 0–59.3) months, respectively. Six patients received rituximab combined chemotherapy, and the other one patient was treated with chemotherapy alone. Six of seven (85.7%) patients achieved complete response after chemotherapy. The median PFS and OS for six patients who completed treatment were not reached. Three-year PFS and OS rates were 80% and 75%, respectively. Conclusion: Our study showed that patients might achieve durable remission after rituximab-based chemotherapy. The outcome of IVLBCL patients may further improve if early diagnosis and prompt treatment were made.

Background: Breast is an uncommon location of lymphoma involvement. The most common type of primary breast lymphoma (PBL) is diffuse large B-cell lymphoma (DLBCL). Rituximab is the widely used monoclonal antibody against CD20+ B-cell lymphoma, especially DLBCL. We aimed to analyze the clinical features, prognostic factors, and treatment outcome with or without rituximab in primary breast DLBCL. Methods: We retrospectively analyzed patients diagnosed with PBL from October 1987 to March 2012 in our hospital, excluding metastasis by whole-body computed tomography and bone marrow study. Results: Twenty-three patients were diagnosed with PBL. All were females. Eighteen patients were stage IE and five were stage IIE according to the Ann Arbor staging system. Two patients had lymphoma other than DLBCL. The median age of primary breast DLBCL patients was 48 years (range 27-79). Two were excluded from the analysis due to refusal or ineligibility for chemotherapy. No significant prognostic factor was found. Patients receiving chemotherapy with (RC) or without (C) rituximab were not significantly different in the 5-year overall survival (RC: 57.1%; C: 58.3%; p = 0.457) or progression-free survival (RC: 57.1%; C: 50.0%; p = 0.456). A high incidence of relapse in the central nervous system (CNS) (17.6%) was observed. Conclusions: In accordance with prior literature reports, our Taiwanese cohort of primary breast DLBCL seemed younger than those reported in Japan, Korea, and Western societies. Relapse in the CNS was not uncommon. The benefit of rituximab in addition to chemotherapy was not statistically significant. Treatment modality remained to be defined by further large-scale studies.

Background: Human tear film plays an important role in protecting the ocular surface against vari­ous pathogens. Dry eye, the major ocular complication of peripheral blood stem cell trans­plantation (PBSCT), may predispose bacterial colonization to the conjunctiva, and increase the risk of infectious keratitis. The aim of this study is to investigate the con­junctival bacterial flora in patients receiving PBSCT and to stratify the severity of dry eye for comparison. Methods: This cross-sectional study encompassed patients who received PBSCT from 2002 to 2008 in our hospital. At least 1 year after PBSCT, patients were re-evaluated for ocu­lar surface status, and bacterial culture of the conjunctival sac was performed. The eyes of patients were divided into three groups in accordance to the result of the Schirmer Ia test. In the control group, we enrolled dry-eye patients with underlying dis­ease other than hematopoietic stem cell transplantation of which the age range was simi­lar to the study group. Results: Thirty-six patients with 72 eyes were included in our study. The first group (n=36) was defined as having Schirmer Ia test result of 0-5 mm, and the culture of conjuncti­val sac were positive in 8 eyes (22%). The second group (n=20) was defined as having Schirmer Ia result between 6 and 9 mm, and 4 of which were positive for bacterial cul­ture (20%). In the third group (n=16) with Schirmer Ia result of ≧10mm, flora in pa­tients receiving PBSCT were coagulase-negative Staphylococci, Staphylococcus au­reus and Corynebacterium sp. The bacterial colonization rate in the post-PBSCT group was not higher than the control group (22.2% vs. 30.8%), and coagulase-nega­tive Staphylococci was the most common flora in the control group. Conclusion: Despite not having statistical significance, there seems to be a positive correlation be­tween the colonization rate and the severity of dry eye. However, bacterial profile iso­lated in post-PBSCT patients is not significantly different from other dry eye patients.