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Primary cutaneous marginal zone lymphoma (PCMZL) is an indolent disease. Treatment options include excision, local irradiation, interferon- α or chemotherapy. We present two patients with PCMZL and multiple skin lesions successfully treated with intralesional administration of the anti-CD20 monoclonal antibody rituximab. The first presented with four red skin lesions and the second with two. Biopsy of the largest lesion revealed marginal zone B-cell lymphoma in both patients. There was no evidence of systemic involvement in either patient. Both patients were treated with intralesional rituximab for 18 consecutive weeks. Skin lesions gradually regressed. Apart from mild local pain during the injection, no other adverse effects were observed. In conclusion, rituximab can be safely administered intralesionally in patients with PCMZL and can produce disease remission. [ABSTRACT FROM AUTHOR]

Kyrtsonis M-C, Vassilakopoulos TP, Siakantaris MP, Kokoris SI, Gribabis DA, Dimopoulou MN, Angelopoulou MK, Pangalis GA. Serum syndecan-1, basic fibroblast growth factor and osteoprotegerin in myeloma patients at diagnosis and during the course of the disease. Eur J Haematol 2004: 72: 252–258. © Blackwell Munksgaard 2004. Neovascularisation and bone resorption are related to myeloma disease activity. To investigate the possible prognostic importance of serum syndecan-1, basic fibroblast growth factor (bFGF) and osteoprotegerin (OPG) levels, the relationship between them, with parameters of disease activity and the effect of treatment on their levels. Twenty-seven patients were studied from diagnosis and an additional five from remission, for a median follow-up of 40 months. Twenty-three patients received chemotherapy plus bisphosphonates and nine only bisphosphonates. Sera from 11 healthy individuals (HI) were used as controls. Cytokines were determined by commercially available enzyme-linked immunosorbent assays (ELISA) kits. In HI, median syndecan-1 was 40 ng/mL (28–75), bFGF 8 pg/mL (7–30), OPG 35 pg/mL (4–100). Pretreatment median serum syndecan-1 was 177.5 ng/mL (34–3500), bFGF 11.5 pg/mL (8–65) and OPG 100 pg/mL (4–1000). Pretreatment syndecan-1, bFGF and OPG serum levels were increased in patients compared with HI ( P = 0.001, 0.03 and 0.01, respectively). Syndecan-1 and bFGF levels were correlated with stage ( P = 0.004 and 0.03, respectively). Both syndecan-1 and OPG levels were correlated with β2M ( P = 0.04 and 0.01, respectively). Patients with elevated syndecan-1 and bFGF serum levels had shorter survival than patients with normal levels ( P = 0.01 and 0.05, respectively). After chemotherapy syndecan-1 and OPG levels were found to be decreased in responders and syndecan-1 level was reduced in patients receiving bisphosphonates alone. Pretreatment syndecan-1, bFGF and OPG levels were found to be increased at diagnosis. Syndecan-1 and OPG fluctuated according to MM activity. Elevated serum syndecan-1 and bFGF levels predicted short survival. [ABSTRACT FROM AUTHOR]

Abstract: Objectives : To investigate the prognosis of patients with Hodgkin's lymphoma (HL) who relapse following a complete remission (CR) achieved by chemotherapy with or without radiotherapy (CT±RT), and to identify prognostic factors for freedom from second progression (FF 2 P). Methods : We analyzed the prognostic significance of the initial CT regimen (4 vs. 7–8 drugs), treatment-free interval (TFI), and demographic, clinical, and laboratory factors at the time of relapse and diagnosis, in 113 patients with HL, who relapsed after a CR achieved by CT±RT. Results : Conventional salvage CT±RT was administered in 107 patients, while six received RT only. The 5-yr FF 2 P was 24%, while the 10-yr survival after relapse (O 2 S) was 39% and was not afffected by the initial CT regimen. Multivariate analysis revealed that extranodal disease at relapse ( P <0.001), TFI<6 month ( P <0.001), >=5 involved sites at diagnosis ( P =0.04) and anemia at relapse ( P =0.03) were independent predictors of FF 2 P. 55% of patients had 0 or 1 of these adverse prognostic factors. The 5-yr FF 2 P of patients with 0, 1 or 2 adverse factors was 58%, 34% and 5% ( P <0.0001). The corresponding rates for 10-yr O 2 S were 68%, 51% and 25%, respectively ( P =0.002). Conclusions: Our data confirmed the significance of TFI and extranodal relapse and demonstrated a potential role for anemia at relapse and number of involved sites at diagnosis, for the prognosis of patients with HL relapsing after CT±RT. The combination of these prognostic factors defines a sizeable subgroup of patients with favorable outcome following conventional salvage therapy. [ABSTRACT FROM AUTHOR]

The prognostic value of baseline serum free light chain ratio (sFLCR) was investigated in 94 multiple myeloma (MM) patients. sFLCR was calculated as κ/ λ or λ/ κ, depending on the patients’ dominating monoclonal light chain. Median baseline sFLCR was 3·57 in κ-MM patients, 45·09 in λ-MM. ‘High’ sFLCR (≥ the observed median value for κ- and λ-MM respectively) correlated with elevated serum creatinine and lactate dehydrogenase, extensive marrow infiltration and light chain type MM. The 5-year disease-specific survival was 82% and 30% in patients with sFLCR lower than and equal or greater than the median, respectively ( P = 0·0001). sFLCR was an independent prognostic factor. [ABSTRACT FROM AUTHOR]

Summary. Bone marrow angiogenesis has recently been implicated in the pathophysiology and course of various haematological malignancies. Little is known, however, about the significance of this phenomenon in hairy cell leukaemia (HCL). We evaluated various morphometric characteristics of microvessels, highlighted by means of anti-CD34 immunohistochemistry, in the bone marrow of 44 patients with typical HCL, before and after treatment with interferon-α (IFN-α). Overall, bone marrow from 103 HCL patients and 20 controls was examined. Microvessel density (MVD) and several size- and shape-related parameters were quantified in the region of most intense vascularization using image analysis. MVD, size-related parameters and the percentage of branching microvessels were higher in HCL than in controls. Likewise, perimeter counts were higher in partial/non-responders than in complete responders. Achievement of complete response was accompanied by smaller calibre microvessels. IFN-α induced a decrease in MVD and branching values in cases with diffuse marrow involvement. In univariate analysis, progression-free survival was adversely affected by MVD, branching and major axis length. Multivariate analysis indicated that MVD/branching independently affected progression-free survival and the likelihood of complete response. Our data suggest that the generation of bone marrow microvessels indicated an increased risk of progression and IFN-α treatment failure in HCL. Furthermore, the prognostic significance of angiogenesis requires the concomitant assessment of MVD and the complexity of the microvascular network. [ABSTRACT FROM AUTHOR]