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Chronic myelogenous leukemia at blast crisis with a T-cell phenotype (T-ALL CML-BC) at diagnosis, without any prior history of CML is extremely rare. After the introduction of tyrosine kinase inhibitors (TKIs), CML patients have a median survival comparable to general population and accelerated/blast crisis are rarely encountered. Most CML patients (80%) transform into acute myeloid leukemia and the rest into B-ALL. Anecdotal cases of Ph+ T-ALL, either de novo or in the context of CML-BC have been reported. Left shift in the blood, the presence of splenomegaly/extramedullary infiltration and the occurrence of BCR::ABL1 rearrangement in both the blastic population, as well as in the myeloid cell compartment are key points in differentiating de novo Ph+ T-ALL from T-ALL CML-BC. The latter is a rare entity, characterized by extramedullary disease, p210 transcript and clonal evolution. Lack of preceding CML does not rule out the diagnosis of T-ALL CML-BC. Prompt TKI treatment with ALL-directed therapy followed by allogeneic stem cell transplantation may offer long-term survival in this otherwise poor prognosis entity. In this paper, we describe a patient with T-ALL CML-BC at presentation, still alive 51 months after diagnosis and we offer a review of the literature on this rare subject. All clinical and laboratory features are provided in order to distinguish de novo Ph+ T-ALL from T-ALL CML-BC, underscoring the prognostic and therapeutic significance of such a differentiation. [ABSTRACT FROM AUTHOR]

PET/CT was not performed prior to surgery but the localized nature of the lesion was confirmed by the negative post-surgery PET/CT after the complete resection of the lesion, which had been transformed to anaplastic large cell lymphoma (ALK-negative). It is important to note that there were no other patients within the two cohorts of pediatric and adult cHL patients with 9 and 410 relapsed/refractory cases respectively, in whom a surgery-only approach was applied and failed. At least 70-80% of the patients with Hodgkin lymphoma (HL) can be cured with first-line therapy with the improvement of staging methods and the introduction of increasingly effective chemotherapy regimens during the last 50 years [[1]]. [Extracted from the article]

The article discusses the treatment of splenic marginal zone lymphoma (SMZL) and the lack of randomized trials, highlighting the use of rituximab infusions for the treatment. It examines the bone marrow for complete response (CR), the impact of rituximab on the disease progression, and the overall survival (OS) rate.

To the editor Classic Hodgkin Lymphoma (cHL) and Primary Mediastinal Large B-Cell Lymphoma (PMLBCL)have been widely studied as separate entities but are poorly covered as metachronous pathologies in the literature. After a median follow-up of 45 months, we identified three cases, all of which had been reviewed at the time of cHL occurrence and both the diagnosis of PMLBCL and cHL had been confirmed by expert hematopathologists and there was no evidence of synchronous cHL or grey zone lymphoma. Assuming a background crude annual rate of 3/100.000 persons for cHL [9], 0.063 cases would have been expected on average over 2,093 person-years of observation of our PMLBCL cohort, measured from primary treatment initiation to the development of cHL, relapse/progression of PMLBCL or death from any cause without prior disease-related event. [Extracted from the article]