Pretransplantation 18F-Fluorodeoxyglucose positron emission tomography scan predicts outcome in patients with recurrent Hodgkin lymphoma or aggressive non-hodgkin lymphoma undergoing reduced-intensity conditioning follone by allogeneic stem cell transplantation

Background: The use of positron emission tomography (PET) scanning in Hodgkin lymphoma (HL) and aggressive non-Hodgkin lymphoma (HG-NHL) has recognized prognostic value in patients who are receiving chemotherapy or undergoing autologous stem cell transplantation (SCT). In contrast, the role of PET before reduced-intensity conditioning (RIC) and followed by allogeneic SCT has not been investigated to date. Methods: PET was used to assess 80 patients who had chemosensitive disease (34 patients with HG-NHL and 46 patients with HL) before they underwent allogeneic SCT: 42 patients had negative PET studies, and 38 patients had positive PET studies. Patients underwent allograft from matched related siblings (n = 41) or alternative donors (n = 39). Results: At the time of the last follow-up, 48 patients were alive (60%), and 32 had died. The 3-year cumulative incidence of nonrecurrence mortality and disease recurrence was 17% and 40%, respectively. The cumulative incidence of disease recurrence was significantly lower in the PET-negative patients (25% vs 56%; P =.007), but there was no significant difference between the patients with or without chronic graft-versus-host disease (P =.400). The patients who had negative PET studies before undergoing allogenic SCT also had significantly better outcomes in terms of 3-year overall survival (76% vs 33%; P =.001) and 3-year progression-free survival (73% vs 31%; P =.001). On multivariate analysis, overall survival was influenced by PET status (hazard ratio [HR], 3.35), performance status (HR, 5.15), and type of donor (HR, 6.26 for haploidentical vs sibling; HR, 1.94 for matched unrelated donor vs sibling). Conclusions: The current results indicated that PET scanning appears to be an accurate tool for assessing prognosis in patients who are eligible for RIC allografting

18F-fluorodeoxyglucose positron emission tomography-positive sarcoidosis after chemoradiotherapy for Hodgkin’s disease: a case report

<p>Abstract</p> <p>Introduction</p> <p>The occurrence of granulomatous disease in the setting of Hodgkin's disease is rare; however, when it occurs it can pose significant clinical and diagnostic challenges for physicians treating these patients.</p> <p>Case presentation</p> <p>We report the case of a 33-year-old Caucasian woman of Mediterranean descent with newly diagnosed ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET)/computed tomography (CT) scan-positive, early-stage Hodgkin's disease involving the cervical nodes who, despite having an excellent clinical response to chemotherapy, had a persistent ¹⁸F-FDG PET scan-positive study, which was suggestive of residual or progressive disease. A subsequent biopsy of her post-chemotherapy PET-positive nodes demonstrated sarcoidosis with no evidence of Hodgkin's disease.</p> <p>Conclusion</p> <p>This case highlights the fact that abnormalities observed on posttherapy PET/CT scans in patients with Hodgkin's disease are not always due to residual or progressive disease. An association between Hodgkin's disease and/or its treatment with an increased incidence of granulomatous disease appears to exist. Certain patterns of ¹⁸F-FDG uptake observed on PET/CT scans may suggest other pathologies, such as granulomatous inflammation, and because of the significant differences in prognosis and management, clinicians should maintain a low threshold of confidence for basing their diagnosis on histopathological evaluations when PET/CT results appear to be incongruent with the patient's clinical response.</p

donor selection for adults and pediatrics

It is known that multiple factors impact on transplantation outcome; the heaviest ones are disease-related (disease refractoriness, phase, clonal abnormalities, etc. in malignancies and disease type and associated rejection risk in non-malignant diseases) and patient-related (age, comorbidities, infectious diseases/colonization, etc.). Moreover, donor-related issues and stem cell source may influence the extent of disease control and transplant-related mortality

Pulmonary candidiasis in a heroin addict: some remarks on its aetiology and pathogenesis

We describe a case of pulmonary candidiasis in a 26-year old drug-addict who had been recently submitted to a porto-caval bypass operation. This opportunistic infection appeared after an injection of heroin. The same patient was also found to suffer from a severe cellular immune response defect. No opportunistic fungal infections were observed, despite the frequent use of intravenous heroin, in a group of 20 parenteral drug addicts. The latter patients, however, were showing only minor abnormalities of their immunological status. Although in this case the main cause of the disease may have been the injection of heroin contaminated with the infecting organism, other important factors contributing to the development of opportunistic mycoses seem to be a reduced microbicidal capacity of the polymorphonuclear leukocytes and an impaired cell-mediated immunity

Attempt to treat acute type B hepatitis with an orally administered thymic extract (thymomodulin): preliminary results

A double-blind trial with thymomodulin (TM) was performed in a consecutive series of 50 inpatients affected with acute type B hepatitis. Twenty-six randomly selected patients received TM (Leucotrofina, Ellem), 1 ampoule b.i.d. per os for 30 days, and 24 patients received the same amount of placebo for the same period. TM-treated patients showed accelerated AST and ALT decrease and an earlier HBsAg clearance. However, only the difference in ALT decrease was statistically significant in comparison with the controls (p less than 0.02). Before the treatment was started, lymphocyte subsets, as determined by monoclonal antibodies, showed a different pattern in the two groups despite strict randomization. Nevertheless, by the end of the trial, mean T4+/T8+ ratios were increased in the treated group, but remained unchanged in the control group. The trends in the two groups were significantly different (p less than 0.005). Further information is expected from a long-term follow-up

Albendazole in the treatment of cystic hydatid disease

Four cases of cystic hydatid disease treated with albendazole are described. The first patient had previously undergone surgical treatment with only partial removal of her hepatic cysts. The size of the remaining cyst resulted remarkably reduced after three courses of the drug. The second patient had recurrent hydatid disease involving the lumbar spine. After therapy, an evident diminution in the size of the cyst was detected. Two patients (one with a partially calcified cyst of the liver, the other one with multiple pulmonary lesions) did not show any objective evidence of improvement. Failures were probably due to the presence of calcified or thick-walled cysts. In all the patients, neither side-effects were observed, nor recurrences were noted during a 2 years' follow-up. In cystic hydatid disease, whenever radical surgical procedures are impracticable, albendazole treatment can achieve significant clinical results