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This document is a guideline published in the British Journal of Haematology that provides healthcare professionals with clear guidance on the diagnosis and management of patients with marginal zone lymphoma (MZL). MZL is a group of clinically indolent mature B-cell lymphomas that arise from memory B cells in the marginal zones of secondary lymphoid tissues. The guideline discusses the different subtypes of MZL, diagnostic methods, and potential aetiological factors. It also includes information on treatment options for different stages of MZL, including radiotherapy, systemic therapy, and targeted agents. The document emphasizes the importance of individualized patient care and shared decision making. [Extracted from the article]

If AF rate control is not possible pharmacologically, then atrioventricular node (AVN) ablation and cardiac resynchronisation therapy (CRT) pacemaker implantation may be considered for symptomatic fast AF when CLL-related prognosis is more than one year.66,67 Recent studies have shown that the leading cause of death for AF patients already treated with appropriate anticoagulation is heart failure. Second, there are multiple drug interactions between ibrutinib and antiarrhythmic agents used for rate and rhythm control (amiodarone, digoxin, verapamil and diltiazem) via CYP3A4 hepatic metabolism.63-65 Atrial fibrillation ablation targeting the pulmonary veins is not recommended as it rarely offers long term AF-free survival. Keywords: ibrutinib; bruton tyrosine kinase inhibitor; atrial fibrillation; hypertension; sudden cardiac death; cardiovascular complication EN ibrutinib bruton tyrosine kinase inhibitor atrial fibrillation hypertension sudden cardiac death cardiovascular complication 70 78 9 12/27/21 20220101 NES 220101 Methodology This Good Practice Paper was compiled according to the British Society for Haematology (BSH) process at BSH Guidelines Development Process (PDF). GRAPH Footnotes 1 A recent alert from an unpublished clinical trial (FLAIR: a phase III, randomised controlled trial comparing the use of ibrutinib and rituximab [IR] versus FCR versus ibrutinib and venetoclax in treatment naïve CLL patients) reported that patients in the ibrutinib and rituximab (IR) arm have an elevated risk of sudden cardiac death if they were on ACE inhibitor treatment at study entry versus patients not on ACE inhibitors at study entry. [Extracted from the article]

Keywords: Differential diagnosis; BRAF V600E mutation; hairy Cell Leukaemia; Hairy cell variant; therapy EN Differential diagnosis BRAF V600E mutation hairy Cell Leukaemia Hairy cell variant therapy 730 737 8 12/07/20 20201201 NES 201201 Methodology This guideline was compiled according to the BSH process (https://b-s-h.org.uk/guidelines). Cytoplasm is abundant and pale blue, with circumferential "hairy" projections.9 Discrete cytoplasmic vacuoles or rod-shaped inclusions (ribosome lamellar complexes) may be seen.3 Bone marrow aspirate and trephine biopsy Bone marrow aspiration is frequently unsuccessful, reflecting fibrosis induced by the hairy cell infiltrate. In a single-centre follow-up study of 242 patients,41 18 patients treated with cladribine (12 as first-line and six as second-line therapy) who remained in PR after bone marrow reassessment received a repeat treatment with cladribine 4-7 months after initial treatment, leading to CR in 14 patients, of whom all but one remained in CR at a median follow-up of 6 years. Treatment of relapsed or refractory classical HCL Despite the durable remissions achieved with front-line therapy, approximately 50% of patients will relapse. [Extracted from the article]

We reviewed eight cases that were diagnosed before 1995 with B-prolymphocytic leukaemia (B-PLL) harbouring t(11;14)(q13;q32) and/or cyclin D1 staining. Thirteen B-PLL patients without t(11;14) were selected as controls. Peripheral blood, bone marrow and histological sections were re-examined without cytogenetic information. Final diagnosis was made using morphology, cytogenetics, immunophenotype and immunohistochemistry. Clinical characteristics were similar for both groups except for younger age, male predominance and extranodal involvement in cases with t(11;14). CD5 was more frequently positive in the t(11;14)+ group (80%) than in the t(11;14)− group (31%). Surface membrane immunoglobulin was strongly expressed by all t(11;14)+ cases, but only 45% of t(11;14)− cases. Histopathological and cytological review of cases with t(11;14) showed an infiltrate with a mixture of cells, some resembling prolymphocytes and others with mantle cell lymphoma (MCL) morphology. Blood films of cases with t(11;14) showed features suggestive of B-PLL in three, and in others, a mixture of cells resembling MCL and nucleolated ones; none corresponded to the blastoid form of MCL. We suggest that ‘B-PLL’ with t(11;14) may represent a splenomegalic form of MCL evolving with leukaemia. These cases illustrate the importance of tissue diagnosis with cyclin D1 staining and fluorescence in situ hybridization analysis in B-cell leukaemia with prolymphocytic features. [ABSTRACT FROM AUTHOR]

The article presents obituaries for several surgeons including Terence Edward O'Brien, Prabhakar Shankar Phatak, and John Anthony Rumble.