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The concomitant presence of del(5q) and JAK2V617F mutation is an infrequent event which occurs in rare patients with peculiar cytogenetic, molecular, morphological and clinical features, resembling those of both myelodysplastic syndromes and myeloproliferative neoplasms. Lenalidomide may induce rapid, profound, and long-lasting responses in a subset of these patients. However, the mechanism(s) by which the drug acts in these conditions remain not completely elucidated. A new case report and a review of all cases published so far in this setting are provided. Furthermore, the possibility of categorizing - from a clinical, pathological, and biological point of view - for at least some of these patients as a potential distinct entity is discussed. [ABSTRACT FROM AUTHOR]

Aim We evaluated the prognostic significance of standardized uptake value ( SUVmax), metabolic tumor volume ( MTV), and total lesion glycolysis ( TLG) obtained by F-18 FDG PET/ CT ( PET/ CT) in patients with diffuse large B-cell Lymphomas ( DLBCL) presenting intermediate IPI score. Material and Methods Fifty-two patients (61 ± 13 yr) underwent PET/ CT before the first-line chemotherapy. The mean SUVmax value, the summed MTV (cm3; 42% threshold), and the cumulative TLG (g) were registered. The patients were followed up 18 months thereafter (range 3-41 months). The PET/ CT results were compared to the event-free survival ( EFS). Results At univariate analysis, SUVmax and lactate dehydrogenase ( LDH) levels were predictive, but discordantly. The Kaplan- Meier survival analysis for SUVmax showed a significant better EFS in patients presenting higher values as compared to those having lesser ( P = 0.0002, HR 0.13). Summed MTV and cumulative TLG were not suitable for predicting EFS. Conclusion Despite the availability of new tools for the quantitative assessment of disease activity on PET/ CT, the SUVmax rather than MTV and TLG remains the only predictor for EFS in DLBCL patients. The magnitude of glycolytic activity rather than the amount of metabolically active burden holds a predominant value for determining the response to chemotherapy in DLBCL. [ABSTRACT FROM AUTHOR]

We report a patient with chronic lymphocytic leukemia (CLL) in whom a leukemic involvement of prostate and penis occurred in the advanced phase of his disease. Obstructive urinary symptoms were indicative of prostatic CLL infiltration, followed by the occurrence of an ulcerative lesion on the glans. Histologic examination confirmed the neoplastic B-cell infiltration. Both localizations responded to conventional treatments. A review of the literature confirms that leukemic involvement of the genito-urinary system is uncommon in CLL patients. However, it should be considered in CLL patients with urologic symptoms and a long history of the disease. [ABSTRACT FROM AUTHOR]

A prospective, multicenter, randomized trial comparing pamidronate administration (60--90 mg once a month for 1 year) versus simple observation in 177 patients with asymptomatic myeloma was performed to explore whether the administration of this drug reduces the rate of and/or the time to progression to overt, symptomatic disease. No relevant side effects were recorded in pamidronate-treated patients. With a minimum follow-up of 5 years for live patients, there were 56/89 (62.9%%) progressions in the pamidronate-treated group and 55/88 (62.5%%) within the controls ( p == NS). Median time to progression was 46 and 48 months, respectively ( p == NS). Overall survival was also similar between the two groups. Skeletal-related events at the time of progression were observed in 40/55 (72.7%%) controls, but only in 22/56 (39.2%%) pamidronate-treated patients ( p == 0.009). In conclusion, the administration of pamidronate in asymptomatic myeloma, while reducing bone involvement at progression, did not decrease the risk of transformation and the time to progression into overt myeloma. [ABSTRACT FROM AUTHOR]

The article presents case studies of two patients showing spontaneous remission (SR) to monoclonal B-lymphocytosis (MBL) after a diagnosis of early stage chronic lymphocytic leukemia (CLL) and the case of another patient with advanced CLL who experienced an unexpected remission before starting any specific anti-CLL therapy after being treated with with lamivudine for hepatitis B virus infection. The need for further research on CLL is discussed.

Neutropenia and febrile neutropenia (FN) are frequent and potentially fatal toxicities of myelosuppressive anticancer treatments. The introduction of granulocyte colony-stimulating factors (G-CSFs) in clinical practice has remarkably reduced the duration and severity of neutropenia, as well as the incidence of FN, thus allowing the administration of chemotherapeutic agents at the optimal dose and time with lower risk. The current scenario of G-CSFs in Europe includes filgrastim, lenograstim, some G-CSF biosimilars, and pegfilgrastim. Recently, a novel long-acting G-CSF, lipegfilgrastim, became available. Lipegfilgrastim is a glycopegylated G-CSF, alternative to pegfilgrastim, and has shown in randomized trials, to be equivalent to pegfilgrastim in reducing the incidence of severe neutropenia and FN in patients with breast cancer receiving chemotherapy, with a similar safety profile. Furthermore, lipegfilgrastim was more effective than the placebo in reducing the incidence of severe neutropenia, its duration, and time to absolute neutrophil count recovery, in patients with non-small cell lung cancer receiving myelosuppressive therapy. Although the number of studies currently published is still limited, lipegfilgrastim seems to be a promising drug in the management of chemotherapy-induced neutropenia.

The concomitant presence of del(5q) and JAK2(V617F) mutation is an infrequent event which occurs in rare patients with peculiar cytogenetic, molecular, morphological and clinical features, resembling those of both myelodysplastic syndromes and myeloproliferative neoplasms. Lenalidomide may induce rapid, profound, and long-lasting responses in a subset of these patients. However, the mechanism(s) by which the drug acts in these conditions remain not completely elucidated. A new case report and a review of all cases published so far in this setting are provided. Furthermore, the possibility of categorizing - from a clinical, pathological, and biological point of view - for at least some of these patients as a potential distinct entity is discussed.