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Inotuzumab ozogamicin (InO) is an antibody‐drug conjugate approved for the treatment of relapsed/refractory B‐cell acute lymphoblastic leukemia (ALL). Several clinical trials are investigating InO in combination with low‐intensity chemotherapy or other anti‐ALL–targeted therapies in the salvage and frontline settings, notably in older adults who often cannot tolerate intensive chemotherapy and tend to have higher‐risk disease. InO is also increasingly used to bridge patients to hematopoietic stem cell transplantation (HSCT), in sequence with chimeric antigen receptor T‐cell therapy, to eliminate measurable residual disease and to prevent post‐HSCT relapse. Veno‐occlusive disease/sinusoidal obstruction syndrome is a potential complication of InO treatment, particularly when followed by HSCT. Herein, the authors review the historical development and current status of InO, strategies for mitigating the risk of InO‐related veno‐occlusive disease/sinusoidal obstruction syndrome, and future directions for InO research and clinical use. Inotuzumab ozogamicin is approved to treat relapsed/refractory B‐cell acute lymphoblastic leukemia but is increasingly used in other treatment settings. The authors review the historical development and current status of inotuzumab ozogamicin in adult B‐cell acute lymphoblastic leukemia. [ABSTRACT FROM AUTHOR]

Key Clinical Message: HHV8‐ and EBV‐negative primary effusion lymphoma is an extremely rare neoplasm involving body cavities without detectable tumor mass. It usually presents in elderly patients without known immunodeficiency. Compared to primary effusion lymphoma, it has a better prognosis. Primary effusion lymphoma (PEL) is a rare non‐Hodgkin lymphoma confined exclusively to body cavities without detectable tumor masses. The term PEL‐like is an entity similar to PEL in clinical presentation but without relation to human herpesvirus 8 (HHV8). We report a case of HHV8‐ and EBV‐negative primary effusion‐based lymphoma. [ABSTRACT FROM AUTHOR]

Summary: The prognosis of t(1;19)(q23;p13)/transcription factor 3‐pre‐B‐cell leukaemia homeobox 1 (TCF3‐PBX1) in adolescent and adult patients with acute lymphoblastic leukaemia (ALL) treated with measurable residual disease (MRD)‐oriented trials remains controversial. In the present study, we analysed the outcome of adolescent and adult patients with t(1;19)(q23;p13) enrolled in paediatric‐inspired trials. The patients with TCF3‐PBX1 showed similar MRD clearance and did not have different survival compared with other B‐cell precursor ALL patients. However, patients with TCF3‐PBX1 had a significantly higher cumulative incidence of relapse, especially among patients aged ≥35 years carrying additional cytogenetic alterations. These patients might benefit from additional/intensified therapy (e.g. immunotherapy in first complete remission with or without subsequent haematopoietic stem cell transplantation). [ABSTRACT FROM AUTHOR]

Background: A single-arm, phase 2 trial demonstrated the efficacy and safety of blinatumomab, a bispecific T-cell-engaging antibody construct, in patients with relapsed/refractory (r/r) Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL), a rare hematologic malignancy with limited treatment options. This study compared outcomes with blinatumomab with those of a historical control treated with the standard of care (SOC).Methods: The blinatumomab trial enrolled adult patients with Ph+ ALL who were r/r to at least 1 second-generation tyrosine kinase inhibitor (n = 45). Propensity score analysis (PSA) was used to compare outcomes with blinatumomab with those of an external cohort of similar patients receiving SOC chemotherapy (n = 55). The PSA mitigated confounding variables between studies by adjusting for imbalances in the age at diagnosis and start of treatment, sex, duration from diagnosis to most recent treatment, prior allogeneic hematopoietic stem cell transplantation, prior salvage therapy, and number of salvage therapies. Bayesian data augmentation was applied to improve power to 80% with data from a phase 3 blinatumomab study in r/r Philadelphia chromosome-negative ALL.Results: In the PSA, the rate of complete remission or complete remission with partial hematologic recovery was 36% for blinatumomab and 25% for SOC, and this resulted in an odds ratio of 1.54 (95% confidence interval [CI], 0.61-3.89) or 1.70 (95% credible interval [CrI], 0.94-2.94) with Bayesian data augmentation. Overall survival favored blinatumomab over SOC, with a hazard ratio of 0.81 (95% CI, 0.57-1.14) or 0.77 (95% CrI, 0.61-0.96) with Bayesian data augmentation.Conclusions: These results further support blinatumomab as a treatment option for patients with r/r Ph+ ALL. [ABSTRACT FROM AUTHOR]

Despite high complete remission (CR) rates with frontline therapy, relapses are frequent in adults with T‐cell acute lymphoblastic leukemia (T‐ALL) with limited salvage options. We analyzed the outcomes and prognostic factors for CR to salvage therapy and overall survival (OS) of patients with R/R T‐ALL included in two prospective measurable residual disease‐oriented trials. Seventy‐five patients (70 relapsed, 5 refractory) were identified. Relapses occurred in bone marrow, isolated or combined in 50 patients, and in the central nervous system (CNS; isolated or combined) in 20. Second CR was attained in 30/75 patients (40%). Treatment with FLAG‐Ida and isolated CNS relapse were independently associated with a higher CR rate after first salvage therapy. The median OS was 6.2 (95% confidence interval [CI], 3.9–8.6) months, with a 4‐year OS probability of 18% (95% CI, 9%–27%). No differences in survival were observed according to the treatment with hematopoietic stem cell transplantation in patients in CR after first salvage therapy. Multivariable analysis showed a ≥12‐month interval between first CR and relapse, CR after first salvage therapy and isolated CNS relapse as favorable prognostic factors for OS with hazard ratios (HR) (95% CI) of 1.931 (1.109–3.362), 2.958 (1.640–5.334), and 2.976 (1.157–7.655), respectively. This study confirms the poor outcomes of adults with R/R T‐ALL among whom FLAG‐Ida was the best of the rescue therapies evaluated. Late relapse, CR after first rescue therapy and isolated CNS relapse showed prognostic impact on survival. More effective rescue therapies are needed in adults with R/R T‐ALL. [ABSTRACT FROM AUTHOR]

Primary mediastinal large B‐cell lymphoma (PMBCL) is a rare aggressive B‐cell lymphoma characterized by the frequent presence of amplification and translocation events at 9p24.1, resulting in the expression of the programmed cell death‐1 (PD‐1) ligands PD‐L1 and PD‐L2. Pembrolizumab, a humanized anti‐PD‐1 monoclonal antibody, binds PD‐1 and blocks this interaction, enhancing the activity of the immune system against tumor cells, and has shown activity in PMBCL and in some cases of primary and secondary central nervous system (CNS) lymphoma. We report the case of a 40‐year‐old woman diagnosed with relapsed PMBCL and secondary CNS involvement who responded to pembrolizumab monotherapy, allowing for a later allogeneic stem cell transplant. [ABSTRACT FROM AUTHOR]

Background: Blinatumomab is a CD19 BiTE (bispecific T‐cell engager) immuno‐oncology therapy that mediates the lysis of cells expressing CD19. Methods: A pooled analysis of long‐term follow‐up data from 2 phase 2 studies that evaluated blinatumomab in heavily pretreated adults with Philadelphia chromosome–negative, relapsed/refractory B‐cell precursor acute lymphoblastic leukemia was conducted. Results: A total of 259 patients were included in the analysis. The median overall survival (OS) among all patients, regardless of response, was 7.5 months (95% confidence interval [CI], 5.5‐8.5 months); the median follow‐up time for OS was 36.0 months (range, 0.3‐60.8 months). The median relapse‐free survival (RFS) among patients who achieved a complete remission (CR) or complete remission with partial hematologic recovery (CRh) in the first 2 cycles (n = 123) was 7.7 months (95% CI, 6.2‐10.0 months); the median follow‐up time for RFS was 35.0 months (range, 9.5‐59.5 months). OS and RFS plateaued with 3‐year rates of 17.7% and 23.4%, respectively. The cumulative incidence function of the time to relapse, with death not due to relapse considered a competing risk, for patients who achieved a CR/CRh within 2 cycles of treatment also plateaued with a 3‐year relapse rate of 59.3%. For patients who achieved a CR/CRh with blinatumomab followed by allogeneic hematopoietic stem cell transplantation while in continuous CR, the median OS was 18.1 months (95% CI, 10.3‐30.0 months) with a 3‐year survival rate of 37.2%. Conclusions: These data suggest that long‐term survival is possible after blinatumomab therapy. Lay Summary: Immuno‐oncology therapies such as blinatumomab activate the patient's own immune system to kill cancer cells.This study combined follow‐up data from 2 blinatumomab‐related clinical trials to evaluate long‐term survival in patients with relapsed and/or refractory B‐cell precursor acute lymphoblastic leukemia at high risk for unfavorable outcomes.Among patients who achieved a deep response with blinatumomab, one‐third lived 3 years or longer. These findings suggest that long‐term survival is possible after treatment with blinatumomab. Patients achieving remission after blinatumomab can have a durable response. The survival plateau indicates a high probability of a cure in those patients responding to blinatumomab and alive after 3 years. [ABSTRACT FROM AUTHOR]

Background: Pediatric‐based or ‐inspired trials have improved the prognosis of adolescents and young adults (AYA) with Philadelphia chromosome‐negative (Ph‐neg) acute lymphoblastic leukemia (ALL). Methods: This study reports the results of treatment of the ALLRE08 trial, a full pediatric trial for AYA aged 15‐30 years with standard‐risk (SR) ALL. Results: From 2008 to 2018, 89 patients (38 adolescents [15‐18 years] and 51 young adults [YA, 19‐30 years], median age: 20 [15‐29] years) were enrolled in the ALLRE08 trial. The complete response (CR) was 95%. Twenty‐two patients were transferred to a high‐risk (HR) protocol because of poor marrow response on day 14 (n = 20) or high‐level of end‐induction minimal residual response (MRD ≥ 0.25%, n = 2). Cumulative incidence of relapse (CIR) at 5 years was 35% (95%CI: 23%‐47%), with significant differences between adolescents and YA: 13% (4%‐28%) vs 52% (34%‐67%), P =.012. No treatment‐related mortality was observed in 66/66 patients following the ALLRE08 trial vs 3/23 patients moved to a HR trial. The estimated 5‐year overall survival (OS) was 74% (95%CI: 63%‐85%), with significantly higher rates for adolescents vs YA: 87% (95%CI: 74%‐100%) vs 63% (46%‐80%), P =.021. Although CIR or OS were lower in patients who were transferred to a HR trial, the differences were not statistically significant (CIR: 34% [21%‐47%] vs 37% [14%‐61%]; OS: 78% [66%‐90%] vs 61% [31%;91%]). Conclusion: A full pediatric trial is feasible and effective for AYA with Ph‐neg, SR‐ALL, with better results for adolescents than for YA. Outcome of patients with poor early response rescued with a HR trial was not significantly inferior. [ABSTRACT FROM AUTHOR]

Objectives: To clarify the impact of histological grades in follicular lymphoma. Methods: We retrospectively analysed 250 patients diagnosed with FL treated with chemoimmunotherapy: 188 patients were grades 1‐2 and 62 grade 3A. Results: In our series, grade 3A FL patients were older, higher proportion of localised disease and lower bone marrow infiltration at diagnosis comparing grades 1‐2 FL patients. Estimated six‐year progression‐free survival and time to progression showed no differences between both groups [grade 3A: 56% (95%CI: 39%‐73%) and 51% (95%CI: 41%‐61%) vs grades 1‐2:55% (95%CI: 46%‐63%) and 57% (95%CI: 49%‐65%), P =.782 and P =.521, respectively]. Estimated six‐year overall survival was lower, 76% (95%CI: 64%‐88%) for the grade 3A group than grades 1‐2 83% (95%CI: 77%‐89%); P =.044. In addition to that, cumulative incidence curves of death not related to lymphoma at 10 years between groups were as follows: [0.26 (95%CI: 0.25‐0.27) and 0.05 (95%CI: 0.04‐0.06) for G3AFL and G1‐2FL, respectively], P =.010. Grade 3A FL showed in PFS curve no relapses after 6 years. These results were absolutely reproduced in 199 patients receiving R‐CHOP regimen as induction. Conclusions: Our results indicate similar long‐term outcomes in terms of progression‐free survival and time to progression in grades 1‐2 and 3A. No relapses were observed in G3AFL group after 6 years. [ABSTRACT FROM AUTHOR]

Background: Disease recurrence occurs in 20% to 40% of adults with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) who are treated with chemotherapy and tyrosine kinase inhibitors (TKIs). In the current study, the authors report the incidence, treatment, and outcome after first disease recurrence in young and older adults treated in the ALL Ph08 trial (ClinicalTrials.gov identifier NCT01491763).Methods: Patients aged 18 to 55 years with de novo Ph+ ALL were treated with imatinib concurrently with standard-dose induction and consolidation therapy followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT) when possible. In patients with first disease recurrence, the authors analyzed the type of recurrence, timing, location, presence of kinase domain mutations, type of treatment, and outcomes.Results: Of the 125 patients, 28 patients (22%) developed disease recurrence before (4 patients) or after (24 patients) HSCT, with the recurrences being molecular in 11 patients (39%) and overt in 17 patients (61%). T315I was the most common mutation noted at the time of disease recurrence. Change in TKI was the most frequent treatment for patients with molecular disease recurrence whereas rescue chemotherapy and TKI change followed by second allo-HSCT when possible were performed for the most part in patients with overt disease recurrence. A total of 20 patients (71%) achieved response. The median disease-free survival (DFS) and overall survival (OS) were 8.5 months and 15.3 months, respectively. A trend for better DFS and OS was observed in patients with molecular recurrence compared with those with overt recurrence (median of 16.9 months vs 6.3 months [P = .05] and 28.7 months vs 11.5 months [P = .05] for DFS and OS, respectively).Conclusions: Disease recurrence was frequent in young and older adults with Ph+ ALL who were treated with imatinib and chemotherapy with HSCT. Although the majority of patients responded to rescue therapy, their outcomes were poor, especially with regard to overt disease recurrence. [ABSTRACT FROM AUTHOR]

Deoxyribonucleic acid microarrays allow researchers to measure mRNA levels of thousands of genes in a single experiment and could be useful for diagnostic purposes in patients with acute myeloid leukaemia (AML). We assessed the feasibility of the AML profiler (Skyline™ Array) in genetic stratification of patients with de novo AML and compared the results with those obtained using the standard cytogenetic and molecular approach. Diagnostic bone marrow from 31 consecutive de novo AML cases was used to test MLL-PTD, FLT3-ITD and TKD, NPM1 and CEBPAdm mutations. Purified RNA was used to assess RUNX1-RUNX1T1, PML-RARα and CBFβ-MYH11 rearrangements. RNA remnants underwent gene expression profiling analysis using the AML profiler, which detects chromosomal aberrations: t(8;21), t(15;17), inv(16), mutations (CEBPAdm, ABD-NPM1) and BAALC and EVI1 expression. Thirty cases were successfully analysed with both methods. Five cases had FLT3-ITD. In one case, a t(8;21) was correctly detected by both methods. Four cases had inv(16); in one, the RNA quality was unsatisfactory and it was not hybridized, and in the other three, the AML profiler detected the genetic lesion - this being a rare type I translocation in one case. Two cases with acute promyelocytic leukaemia were diagnosed by both methods. Results for NPM1 mutations were concordant in all but two cases (2/11, non-ABD mutations). Analysis of costs and turnaround times showed that the AML profiler was no more expensive than the conventional molecular approach. These results suggest that the AML profiler could be useful in multicentre trials to rapidly identify patients with AML with a good prognosis. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective Clinical trials for patients with multiple myeloma (MM) using novel agent (NA)-based regimens before autologous stem cell transplantation ( SCT) have shown improvement in response rates and progression-free survival ( PFS); however they have failed to identify a significant overall survival ( OS) benefit. The aim of this study was to analyze the potential impact of initial induction on the feasibility and outcome of subsequent treatment lines in a real clinical practice setting. Methods Patients with consecutive MM <70 years of age diagnosed between 1999 and 2009 were prospectively registered and classified as having received conventional chemotherapy induction regimens with new agents available at relapse ( CC cohort, 89 patients) or as treated with NAs upfront ( NA cohort, 65 patients). Results Patients in the NA cohort demonstrated a superior median PFS (2.8 years vs 1.6 years, P=.03) and also a median PFS from diagnosis to second progression (5.2 years vs 2.7 years, P=.003). After a median follow-up of 7 years, clear differences in OS were observed (7.97 years in NA cohort compared to 3.35 years in CC cohort, P<.001). Conclusions New agent-based first-line induction treatments provide benefits in both PFS and beyond that point, contributing to a significant improvement in OS. [ABSTRACT FROM AUTHOR]

Objective Somatic mutations in ASXL1 seem to have a negative prognostic impact in patients with several myeloid neoplasms, including myelofibrosis ( MF). The aim of this work was to determine the prevalence and profile of ASXL1 mutations in MF. Methods We analyzed mutations in ASXL1 in 70 consecutive MF patients from 8 Spanish hospitals by means of Sanger sequencing, as well as JAK2, CALR , and MPL mutations. Results ASXL1 mutations were found in 16/70 (23%) of cases, most commonly p.Gly646TrpfsX12 (5/16). Most mutations (13/16) were frameshift mutations. Of 54 ASXL1- wild-type patients, 32 (59%) had at least one single nucleotide polymorphism ( SNP), 27 of them had g.78128 C> T, g.79017 A> C, and g.79085 T> C [triple SNP ( TSNP) patients]. The 5-yr overall survival probability of TSNP patients was 67% (95% CI, 43-91%) vs. 90% (95% CI, 77-100%) in ASXL1- WT patients ( P = 0.152). Conclusion ASXL1 mutations were found in 23% of cases, p.Gly646TrpfsX12 being the most frequent. About 85% of mutations were found only in individual cases and 46% had not previously been reported, a pattern also seen in other series. Fifty percent of ASXL1- WT patients had a combination of three specific SNPs that might have a prognostic correlation that needs to be determined in larger series. [ABSTRACT FROM AUTHOR]

Central nervous system ( CNS) involvement is reportedly more common in acquired immunodeficiency syndrome ( AIDS)-related lymphomas ( ARL). We describe factors and outcomes associated with CNS involvement at baseline ( CNSB) and relapse ( CNSR) in 886 patients with newly diagnosed ARL. Of 886 patients, 800 received either intrathecal ( IT) therapy for CNSB or IT prophylaxis. CNSB was found in 13%. CNSB was not associated with reduced overall survival ( OS). There was no difference in the prevalence of CNSB between the pre-combination antiretroviral therapy ( cART) and cART eras. 5·3% of patients experienced CNSR at a median of 4·2 months after diagnosis (12% if CNSB; 4% if not). Median OS after CNSR was 1·6 months. On multivariate analysis, only CNSB [hazard ratio ( HR) 3·68, P = 0·005] and complete response to initial therapy ( HR 0·14, P < 0·0001) were significantly associated with CNSR. When restricted to patients without CNSB, IT CNS prophylaxis with 3 vs. 1 agent did not significantly impact the risk of CNSR. Despite IT CNS prophylaxis, 5% of patients experienced CNSR. Our data confirms that CNSR in ARL occurs early and has a poor outcome. Complete response to initial therapy was associated with a reduced frequency of CNSR. Although CNSB conferred an increased risk for CNSR, it did not impact OS. [ABSTRACT FROM AUTHOR]

The article focuses on s study related to Follicular lymphoma (FL) treated with immunochemotherapy and mentions clinico-biological features, treatment and survival of patients with histological Grades 3A and 1-2 FL. Topics discussed include survival analyses for progression-free survival (PFS) and overall survival (OS); lower risk of transformation for Grade 3A or 1-2 FL patients; and better PFS in Grade 3A patients treated with a cumulative rituximab strategy.

Objectives: A multicentre prospective non-randomised study of de novo acute myeloid leukaemia (AML) in patients aged ≥70 yr was designed to reduce toxicity and achieve acceptable complete remission (CR) rates. Methods: The outpatient treatment included induction with oral fludarabine, subcutaneous cytarabine and subcutaneous filgrastim (FAG). The patients received more induction cycles according to the response achieved. If there was no response to induction with FAG, the following induction cycle included oral idarubicin, subcutaneous cytarabine and subcutaneous filgrastim (IAG). Patients achieving CR received one intensification (FAG on response to previous FAG or alternatively IAG) and one consolidation cycle (IAG). Results: Thirty patients were enrolled from April 2004 to June 2007. The median age was 73 yr (range 70–77). Fifteen patients (50%) achieved CR. The 2-yr DFS was 29% (95% CI, 5–47%), and the 2-yr OS was 23% (95% CI, 12–35%). Twenty-five of 69 cycles (36%) were managed on a completely outpatient basis. The median hospital stay per cycle was 10 d (95% CI, 3–25). Conclusions: This study demonstrates the tolerability and efficacy of a semi-intensive treatment in elderly de novo patients with AML managed on an outpatient basis, without substantial toxicity. [ABSTRACT FROM AUTHOR]

Background: Some copy number alterations (CNAs) have independent prognostic significance for adults with acute lymphoblastic leukemia (ALL).Methods: This study analyzed via multiplex ligation-dependent probe amplification the frequency and prognostic impact of CNAs of 12 genetic regions in 142 adolescents and adults with de novo precursor B-cell ALL.Results: The cyclin-dependent kinase inhibitor 2A/B (CDKN2A/B) deletion (59 of 142 or 42%) was the most frequent CNA, and it was followed by Ikaros family zinc finger 1 (IKZF1) losses (49 of 142 or 35%). IKZF1 deletions were more prevalent in Philadelphia chromosome (Ph)-positive ALL and were associated with advanced age and high white blood cell (WBC) counts. The multivariate analysis showed that advanced age and early B-cell factor 1 (EBF1) deletions were associated with chemotherapy resistance in both the whole series (hazard ratios, 0.949 and 0.135, respectively) and the Ph-negative subgroup (hazard ratios, 0.946 and 0.118, respectively). High WBC counts and focal IKZF1 deletions correlated with disease recurrence (hazard ratios, 1.005 and 1.869, respectively), whereas advanced age and CDKN2A/B losses influenced overall survival in both the whole series (hazard ratios, 1.038 and 2.545, respectively) and the Ph-negative subgroup (hazard ratios, 1.044 and 2.105, respectively).Conclusions: Deletions of EBF1, IKZF1, and CDKN2A/B have an independent adverse prognosis for adolescents and adults with B-precursor ALL, and this suggests that these CNAs should be included in the initial risk assessment of ALL. [ABSTRACT FROM AUTHOR]

The article discusses a study of a patients with stage II–IV follicular lymphoma following watchful waiting (WW), and showing a similar overall survival (OS) to that of patients treated immediately after diagnosis. It mentions time-to-treatment when comparing WW with any other treatment as it compares delaying therapy.

MYC and BCL2 gene translocations and protein expression have recently demonstrated to be of prognostic significance in systemic diffuse large B-cell lymphoma (DLBCL). However, their role in primary central nervous system DLBCL (CNS-DLBCL) prognosis has been scarcely analyzed. We studied the immunophenotype, the status of the MYC, BCL2, and BCL6 genes and the clinical features of a series of 42 CNS-DLBCL and evaluated their prognostic significance. We found high MYC protein expression in 43% of cases, and this was associated with lower overall survival (OS). Cases with concurrent expression of MYC and BCL2 showed a lower OS, although the difference did not reach statistical significance. Translocations involving the MYC or BCL2 genes were not detected. The BCL6 gene was frequently translocated, but was unrelated to survival. We conclude that MYC protein expression detected by immunohistochemistry identifies a CNS-DLBCL subset with worse prognosis and may contribute to a more accurate risk stratification of CNS-DLBCL patients. [ABSTRACT FROM AUTHOR]

Background Oral mucositis ( OM) is a common complication of conditioning regimens with high-dose melphalan ( HDmel). This retrospective cohort study analyzes the impact of oral cryotherapy ( OC) or room temperature saline rinses on the prevention of OM in patients with multiple myeloma ( MM) or lymphoid neoplasias submitted to autologous stem cell transplantation ( ASCT) in a single center. Patients and methods From August 2006 to July 2011, 134 consecutive patients were enrolled. Two consecutive groups were included: Non- OC (August 2006 to April 2009, 68 patients) and OC (May 2009 to July 2011, 66 cases). MM cases (78, 58%) received HDmel as the conditioning regimen and 56 patients (42%) with lymphoma received BEAM. Results The non- OC and OC groups were comparable for the main clinicobiologic features and type of neoplasia. OM was more frequent and severe in patients receiving BEAM as the conditioning therapy. The group of OC showed less frequent and less severe mucositis and fewer days on antibiotics. No differences were observed in the duration of OM, need for parenteral nutrition and narcotics, and the length of hospital stay on comparison with the OC and non- OC groups. By multivariate analyses, OC was an independent favorable prognostic factor for OM development. Conclusions This study shows that OC is more effective than saline rinses in the prevention of OM in patients with lymphoma and myeloma receiving conditioning regimens with HDmel for ASCT. [ABSTRACT FROM AUTHOR]

The status of umbilical cord blood transplantation ( UCBT) in adults with Philadelphia-positive acute lymphoblastic leukaemia (Ph+ ALL) and the impact of minimal residual disease ( MRD) before transplant are not well established. We analysed 98 patients receiving UCBT for Ph+ ALL in first ( CR1) or second ( CR2) complete remission ( CR1, n = 79; CR2, n = 19) with MRD available before UCBT (92% analysed by reverse transcription polymerase chain reaction). Median age was 38 years and median follow-up was 36 months; 63% of patients received myeloablative conditioning and 42% received double-unit UCBT. Eighty-three patients were treated with at least one tyrosine kinase inhibitor before UCBT. MRD was negative (−) in 39 and positive (+) in 59 patients. Three-year cumulative incidence of relapse was 34%; 45% in MRD+ and 16% in MRD− patients ( P =0·013). Three-year cumulative incidence of non-relapse mortality was 31%; it was increased in patients older than 35 years ( P = 0·02). Leukaemia-free survival ( LFS) at 3 years was 36%; 27% in MRD+ and 49% in MRD− patients ( P = 0·05), and 41% for CR1 and 14% for CR2 ( P = 0·008). Multivariate analysis identified only CR1 as being associated with improved LFS. In conclusion, MRD+ before UCBT is associated with increased relapse. Strategies to decrease relapse in UCBT recipients with Ph+ ALL and MRD+ are needed. [ABSTRACT FROM AUTHOR]

Tapia G, Lopez R, Muñoz-Mármol A M, Mate J L, Sanz C, Marginet R, Navarro J-T, Ribera J-M & Ariza A (2011) Histopathology 59, 672-678 Immunohistochemical detection of MYC protein correlates with MYC gene status in aggressive B cell lymphomas Aims: MYC gene translocation entails a bad prognosis and a poor response to rituximab-cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) in diffuse large B cell lymphomas (DLBCL), and more intensive chemotherapy regimens could be more effective in those cases. Its evaluation requires cytogenetic or fluorescence in-situ hybridization (FISH) studies, which are expensive and not widely available. The aim of this work was to find an immunohistochemical marker able to be used as a screening tool to identify MYC translocations. Methods and results: Aggressive B cell lymphomas in which MYC status was assessed during their diagnostic work-up between 2007 and 2010 were collected, their immunophenotype was re-evaluated, and were stratified according to the Hans algorithm. Two tissue microarrays were built in order to evaluate MYC protein expression with a commercially available antibody. The study was performed on 56 specimens: nine Burkitt lymphomas (eight translocated), 45 DLBCLs (nine translocated) and two lymphomas with intermediate features (both translocated). Only MYC protein expression detected by immunohistochemistry correlated with MYC translocation. No relationship was seen between MYC gene copies and protein expression. Conclusions: MYC protein expression detected by immunohistochemistry using a commercially available antibody correlates with MYC gene translocation, and could be used as a screening tool to select those cases in which confirmatory genetic testing is mandatory. [ABSTRACT FROM AUTHOR]

Background and aim: Flow cytometry (FCM) analysis of cerebrospinal fluid (CSF) is more sensitive than conventional cytology (CC) for diagnosis of lymphomatous meningeosis, but the clinical significance of occult central nervous system (CNS) disease (positive FCM with negative CC) remains unknown. Patients and methods: CSF samples from 105 patients with newly diagnosed aggressive lymphomas at high risk of CNS involvement were prospectively studied by both CC and FCM, and results were correlated with cumulative incidence of CNS relapse and overall survival (OS). Patients were divided into three groups: 1) patients without CNS involvement (CC−/FCM−; n = 83); 2) individuals with occult CNS disease (FCM+/CC−; n = 15); and 3) cases with CNS disease (CC+/FCM+; n = 7). Results: Six cases showed CNS relapse or progression: two in Group 1 (2.4%), two in Group 2 (13%) and two in Group 3 (28.5%) (Group 2 vs. 1, P = 0.04; Group 3 vs. 1, P < 0.001). Patients from Groups 2 ( P = 0.05) and 3 ( P < 0.001) also showed a higher cumulative incidence of CNS relapse than those from Group 1. Significant differences were observed in OS between FCM−/CC− and FCM+/CC+ cases ( P = 0.02), while patients with occult CNS disease (FCM+/CC−) displayed intermediate OS rates, although differences did not reach statistical significance. Conclusions: The presence of occult CNS involvement at diagnosis in patients with NHL at high risk of CNS disease is associated with a higher probability of CNS relapse. [ABSTRACT FROM AUTHOR]

The article reports on the study that evaluates the outcome and toxicity of HIV-positive patients with Burkitt lymphoma/leukemia (BL). It cites that the clinical characteristics of 19 patients were comparable to HIV-negative patients. As a result, it is concluded that intensive immunochemotherapy could be administrated safety to patients with HIV infection.

Immunochemotherapy with cyclophosphamide, adriamycin, vincristine, prednisone and rituximab (R-CHOP) is the standard treatment in non-immunosuppressed patients with diffuse large B-cell lymphoma (DLBCL), but its adequacy has not been definitively established in patients with human immunodeficiency virus (HIV)-related lymphoma. This phase II trial aimed to evaluate the safety and efficacy of six cycles of R-CHOP in patients with HIV-related DLBCL and to determine whether response to highly active antiretroviral therapy (HAART) had prognostic impact. Patients were eligible if they had performance status <3 and absence of active opportunistic infections. Eighty-one patients were enrolled, 57 in stages III or IV, International Prognostic Index (IPI) 0 or 1 ( n = 26), 2 ( n = 19), 3 ( n = 20) and 4 or 5 ( n = 16), and median CD4 lymphocyte count of 0·158 × 109/l. The main adverse events were neutropenia (48% of cycles) and infections (10% of cycles), which were fatal in seven patients. Complete response was achieved in 55 (69%) patients, with an estimated 3-year disease-free survival of 77% and 3-year overall survival of 56%. IPI score and virological response to HAART were the prognostic parameters for response and survival. In HIV-related DLBCL R-CHOP is feasible, safe and effective. The prognosis depends on lymphoma-related parameters and on the response to HAART. [ABSTRACT FROM AUTHOR]

Background and aim: Only 20–30% of elderly patients with acute lymphoblastic leukemia (ALL) are enrolled in clinical trials because of co-morbid disorders or poor performance status. We present the results of treatment of Philadelphia chromosome-negative (Ph−) ALL patients over 55 yr treated in the PETHEMA ALL-96 trial. Patients and methods: From 1996 to 2006, 33 patients ⩾55 yr with Ph− ALL were included. Induction therapy was vincristine, daunorubicin, prednisone, asparaginase, and cyclophosphamide over 5 weeks. Central nervous system (CNS) prophylaxis involved triple intrathecal (IT) therapy, 14 doses over the first year. Consolidation-1 included mercaptopurine, methotrexate, teniposide and cytarabine, followed by one consolidation-2 cycle similar to the induction cycle. Maintenance consisted of mercaptopurine and methotrexate up to 2 yr in complete remission (CR) with monthly reinduction cycles (vincristine, prednisone and asparaginase) during the first year. Results: Median (range) age was 65 yr (56–77). Phenotype (30 patients): early-pre-B 7, common/pre-B 18, T 5. Cytogenetics (28 patients): normal 12, complex 10, t(4;11) 2 and other 4. CR was achieved in 19/33 (57.6%) patients, early death occurred in 12 (36.4%) and 2 (6%) were resistant. Overall survival and disease-free survival probabilities (2 yr, 95% CI) were 39% (21%–57%) and 46% (22%–70%), respectively (median follow up of 24 months). Removal of asparaginase and cyclophosphamide from the induction decreased induction death (OR 0.119, CI 95% 0.022–0.637, P = 0.013) and increased survival (20% vs. 52%, P = 0.05). Conclusions: The prognosis of elderly Ph− ALL patients is poor. In this study, less intensive induction decreased toxic death, allowing delivery of planned consolidation therapy and increased survival probability. [ABSTRACT FROM AUTHOR]

Examines the influence of high active anti-retroviral therapy (HAART) on the response to treatment of AIDS. Combination of HAART with protease and reverse transcriptase inhibitors; Treatment of AIDS-related non-Hodgkin's lymphoma; Implications on the result of HAART to patients.

The article focuses on a study which examines patients having HIV-related non-Hodgkin lymphoma (NHL) and compares death cause of patients treated with and without combination antiretroviral therapy (cART). According to the study, there are different causes of death of patients including neoplasms, lymphoma relapse and infections. It also shows that patients with successful treatment of HIV-related NHL are at risk of death by infection-related AIDS-defining cancer (ADC) as well as non-ADC.

Some malignant tumors in childhood require high-dose chemotherapy with stem cell support to achieve a cure. In patients heavily pretreated with myelosuppressive chemotherapy or irradiation, granulocyte colony-stimulating factor (G-CSF) may fail to mobilize stem cells from the bone marrow. Based on the experience with lymphoma and myeloma patients in whom peripheral blood-derived stem cell (PBSC) collection following mobilization with G-CSF failed, we successfully employed plerixafor in a 14-year-old female diagnosed with Ewing's sarcoma in early relapse treated with three lines of chemotherapy in whom PBSC could not be mobilized using either G-CSF alone or G-CSF following chemotherapy. No side effects were observed. Plerixafor may be an effective and safe agent for stem cell collection in pediatric patients with solid tumors, although new studies addressed to evaluate its effectiveness and safety are needed. J. Clin. Apheresis 27:260-262, 2012. © 2012 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

he article offers information on the highly active antiretroviral treatment (HAART) which is done for the long-term follow-up of patients suffering from human immunodeficiency virus (HIV) related diffuse large B-cell lymphoma (DLBCL) in complete response (CR). It mentions that use of HAART has improved the prognosis of HIV related lymphomas, leading to an increase in survival, similar to that of the non-immunosuppressed patients in some matched cohort studies.

Mononuclear cell leukapheresis requires good-quality venous access. Catheter placement and removal of the catheter may be associated with life-threatening local or systemic complications. Thus, prompt recognition of these complications and appropriate therapy can be life-saving. We report the case of a young man who presented with an air embolism following removal of a jugular venous catheter after peripheral blood stem cell collection. We have reviewed the signs and symptoms presented by the patient and the methodology used to remove the catheter. Catheter removal requires careful attention in order to avoid potentially serious complications. J. Clin. Apheresis © 2005 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

Reports on the rituximab treatment of patients with pure red cell aplasia complicating chronic lymphocytic leukemia. Efficacy of rituximab in patients with follicular non-Hodgkin's lymphoma; Benefit of the therapy in patients with autoimmune diseases; Prevention of lymphoproliferative disease.