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Purpose Vincristine (VCR) often induces peripheral neuropathy (PN) as an adverse event. Currently, there is no consensus about prevention of vincristine-induced PN (VIPN). In this study, we aimed to investigate the efficacy of compression therapy using surgical gloves for preventing VIPN.Methods Patients with malignant lymphoma (vincristine-naïve) who were receiving chemotherapy with cyclophosphamide, doxorubicin, VCR, and prednisolone, with or without rituximab, every 3 weeks for six cycles were eligible. For every VCR infusion, each patient wore two one-size smaller gloves on one hand (study hand) for 90 min. The other hand was bare (control hand). PN was assessed at each treatment using common terminology criteria for adverse events ver. 4.0.Results Fifty-one patients with malignant lymphoma were enrolled and 44 were evaluated. The occurrence rates of grade ≥ 2 sensory PN were 13.6 and 13.6% in the study and control hands, respectively (p = 1.0) at 1 month after treatment. The occurrence rates of grade ≥ 2 motor PN were 15.9 and 15.9% in the study and control hands, respectively (p = 1.0).Conclusion Compression therapy using surgical gloves showed no significant effect for the prevention of VIPN.Trial registration First November 2018 National University Hospital Council of Japan (UMIN 000034145).

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Recurrent hotspot (p.Gly17Val) mutations in RHOA encoding a small GTPase, together with loss-of-function mutations in TET2 encoding an epigenetic regulator, are genetic hallmarks of angioimmunoblastic T-cell lymphoma (AITL). Mice expressing the p.Gly17Val RHOA mutant on a Tet2-null background succumbed to AITL-like T-cell lymphomas due to deregulated T-cell receptor (TCR) signaling. Using these mice to investigate therapeutics for AITL, we found that dasatinib, a multikinase inhibitor prolonged their survival through inhibition of hyperactivated TCR signaling. A phase I clinical trial study of dasatinib monotherapy in 5 patients with relapsed/refractory AITL was performed. Dasatinib was started at a dose of 100 mg/body once a day and continued until days 10–78 (median day 58). All the evaluable patients achieved partial responses. Our findings suggest that AITL is highly dependent on TCR signaling and that dasatinib could be a promising candidate drug for AITL treatment.Significance:Deregulated T-cell receptor signaling is a critical molecular event in angioimmunoblastic T-cell lymphoma and can be targeted with dasatinib.

This report describes a 56-year-old man who was diagnosed with myeloid sarcoma (MS) of the testis and right shoulder after receiving allogenic stem cell transplantation (allo-SCT) at the age of 47 for acute myeloid leukemia (AML) with inv (16) (p13.1;q22). Nine years after allo-SCT, he complained of a painful right testicular mass. He underwent orchiectomy, and the pathologic diagnosis was MS. Inv (16) was identified by fluorescence in situ hybridization (FISH) using testicular tumor specimens. 18F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) revealed FDG accumulation in the right shoulder. FISH analysis of bone marrow aspirate revealed no increase in blasts and ruled out CBFB-MYH11 fusion. Reinduction chemotherapy, consolidation, and local radiation therapy for the left testis and right shoulder were administered to him. After that, he received a second allo-SCT from an unrelated donor who was HLA-matched. As of 2 years after the second allo-SCT, recurrence of neither AML nor myeloid sarcoma has been observed. The recurrence of MSs without bone marrow involvement is frequently reported in single, multiple single organs, or multiple single regions. Even if MSs recur in a distant location, combining systemic and local treatment may be a better treatment strategy.

Recurrent hotspot (p.Gly17Val) mutations in RHOA encoding a small GTPase, together with loss-of-function mutations in TET2 encoding an epigenetic regulator, are genetic hallmarks of angioimmunoblastic T-cell lymphoma (AITL). Mice expressing the p.Gly17Val RHOA mutant on a Tet2-null background succumbed to AITL-like T-cell lymphomas due to deregulated T-cell receptor (TCR) signaling. Using these mice to investigate therapeutics for AITL, we found that dasatinib, a multikinase inhibitor prolonged their survival through inhibition of hyperactivated TCR signaling. A phase I clinical trial study of dasatinib monotherapy in 5 patients with relapsed/refractory AITL was performed. Dasatinib was started at a dose of 100 mg/body once a day and continued until days 10–78 (median day 58). All the evaluable patients achieved partial responses. Our findings suggest that AITL is highly dependent on TCR signaling and that dasatinib could be a promising candidate drug for AITL treatment. Significance: Deregulated T-cell receptor signaling is a critical molecular event in angioimmunoblastic T-cell lymphoma and can be targeted with dasatinib.

A 46-year-old man who had previously undergone open surgery for renal cell carcinoma (RCC) developed Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph-ALL). After the induction therapy, he achieved complete molecular remission. However, fever and bilateral buttock pain continued during the consolidation therapy. 18F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) showed FDG accumulation in both iliac bones and in the sacrum; however, no causative diseases, including relapse of Ph-ALL and RCC, were detected. Iliac bone marrow biopsy revealed bone marrow necrosis (BMN), the etiology of which was presumed to be the leukemia itself and the therapeutic response to chemotherapy. Fever resolution and buttock pain alleviation were observed over the next months. We observed diffuse fibrosis in the bone marrow at day 162 and day 364 after cord blood transplantation. Moreover, the FDG accumulation was significantly reduced on PET-CT. BMN is not widely recognized despite its potential association with hematologic malignancies. Additional cases of BMN should be reviewed to clarify BMN etiology and clinical features.

A 66-year-old male underwent prednisolone (PSL) therapy of 13 mg/day for rheumatoid arthritis (RA). Antiphospholipid antibody syndrome, neutrophilic dermatosis (ND), and myelodysplastic syndrome (MDS) developed. Treatment of MDS required red cell concentrate transfusion, and second courses of azacitidine therapy (75 mg/m