Search

Summary: Management of classical Hodgkin lymphoma in older patients is challenging due to poor tolerance of the chemotherapy regimens used in younger patients. We modified the BEACOPP regimen (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine and prednisolone), whereby bleomycin and etoposide were removed and cyclophosphamide dose was reduced, for older patients with co‐morbidities. Here we present data from the first 41 patients treated with 'ACOPP' across 3 centres, demonstrating that it can be delivered, with a favourable toxicity profile (TRM 2%) and promising efficacy (2‐year PFS and OS, 73% (95% CI: 52–94) and 93% (95% CI: 80–100) respectively). [ABSTRACT FROM AUTHOR]

The article discusses a guideline compiled by the British Society for Haematology (BSH) for the management of mantle cell lymphoma (MCL). Topics covered include first line management for early stage and advanced stage MCL as well as indications for treatment, how to determine patients fit for autologous stem cell transplant, and therapeutic algorithm for alternative immunochemotherapy, Bruton tyrosine kinase (BTK) inhibitor or other targeted therapy.

The article discusses the diagnosis and investigation of patients with mantle cell lymphoma (MCL. Topics covered include the latest information on molecular pathology, the use of positron emission tomography/computed tomography (PET/CT) scanning in staging and response assessment, and biological prognostic factors of MCL.

Thrombosis is a well-recognized complication of asparaginase therapy for acute lymphoblastic leukemia (ALL), associated with the depletion of antithrombin (AT). Following a high incidence of thrombotic episodes during induction therapy for ALL in our tertiary referral center, we prospectively instituted a protocol of AT replacement. Forty-five consecutive adolescents and adults with ALL treated with asparaginase-containing phase I induction protocols were included in this observational study. Fifteen received standard therapy with no replacement; the subsequent 30 were managed with the protocol described. One or more low AT levels (<70 iu/dl) were recorded in 76% of patients in the cohort managed using the protocol, resulting them in receiving an AT replacement. There was a significant reduction in the incidence of thrombosis with this strategy (0/30 vs. 5/15,p < 0.001). We suggest that such a strategy should be studied in a prospective randomized sub-study within the context of a national ALL trial. [ABSTRACT FROM PUBLISHER]

The article discusses the Safety and diagnostic yield of splenic core biopsy and discusses an approach using combined Haematology/Radiology assessment in a tertiary referral centre. Topics include how the core biopsy of the spleen is performed less often than in other solid organs due to a perceived increased risk of post-procedure haemorrhage.

The article discusses a study which identified a series of 5 consecutive patients presenting with hypomegakaryocytic thrombocytopenia (HMT) and low-to-intermediate risk myelodysplastic syndrome (MDS). Topics covered include the clinical characteristics of patients, the role of immune dysregulation in the pathophysiology of MDS, and the response of patients to ciclosporin (CsA) therapy.

Positron emission tomography-computed tomography (PET-CT) scanning has been shown to be more sensitive than bone marrow biopsy (BMB) in detecting bone marrow involvement (BMI) in classical Hodgkin lymphoma (cHL). In this 5-year retrospective series, 93 (54%) of all new cases of cHL were staged using PET-CT and BMB. PET-CT identified focal bone marrow uptake in 17/93 (18.3%), whilst only five of these (29.4%) were confirmed by BMB. Abnormal pelvic uptake was seen on PET-CT in these five cases. The other 12 cases were missed, giving BMB a sensitivity of 29.4% and a specificity of 100%. PET-CT upstaged 9.7% of patients compared to CT alone. BMB upstaged only one patient; however, this patient was already stage IV on PET-CT. BMB did not alter clinical management in any case. Bone positivity on PET-CT appeared to correlate with anemia, raised lactate dehydrogenase (LDH) and B symptoms. BMB has little or nothing to offer staging cHL in the PET-CT era. [ABSTRACT FROM AUTHOR]