Prostate cancer and chronic lymphocytic leukemia

The association between prostate cancer and chronic lymphocytic leukemia (CLL) is rare.We report a case of 69 year old man who presented a CLL, classified as Binet stage C, treated with FCR protocol. After six cycles of chemotherapy, itwas in complete remission. Eighteen months after the end of treatment, the patient presented with dysuria and back pain. Digital rectal examination revealed an indurated prostate. The PSA was elevated to 1103 ng/ml. Prostate biopsy with histopathologic study showed poorly differentiated prostate adenocarcinoma (Gleason score: 8). Staging workup revealed bone metastases. Adjuvant radiotherapy and pulpectomy associated with bisphosphonates and analgesics was proposed. The association between CLL and prostate cancer appears too frequent to be accidental.Keywords: Prostate cancer; Chronic lymphocytic leukaemia; TreatmentAfrican Journal of Urology (2013) 19, 35–3

Management of Pediatric Tumor Lysis Syndrome

Introduction: Tumor lysis syndrome (TLS) is a serious complication of malignancies and can result in renal failure or death. Review: In tumors with a high proliferative rate with a relatively large mass and a high sensitivity to cytotoxic agents, the initiation of therapy often results in the rapid release of intracellular anions, cations and the metabolic products of proteins and nucleic acids into the bloodstream. The increased concentrations of uric acid, phosphates, potassium and urea can overwhelm the body’s homeostatic mechanisms to process and excrete these materials and result in the clinical spectrum associated with TLS. Typical clinical sequelae include gastrointestinal disturbances, neuromuscular effects, cardiovascular complications, acute renal failure and death. Tumor lysis syndrome can also compromise the efficacy or administration of curative therapies. Available evidence suggests that the incidence of clinical TLS is approximately 3–7% for acute leukemias and 4–11% for lymphomas. Pediatric cancers are the leading cause of death by disease in children. The most common pediatric cancers include the leukemias, lymphomas, central nervous system tumors and neuroblastoma. Thus, TLS is a major concern to practitioners caring for pediatric oncology patients. Given the complexity of TLS prevention and treatment, a multidisciplinary approach involving the collaboration of medical oncologists/ hematologists and nephrologists has the greatest potential of ensuring optimal patient outcomes. Rehydration is fundamental in the management of TLS in addition to the current standard therapy for hyperuricemia which include rasburicase and allopurinol. Conclusion: The early recognition and treatment of metabolic abnormalities often prevents the severe and life-threatening complications associated with tumor lysis syndrome.Keyswords: Acute Renal Failure; Burkitt’s Lymphoma; Hematologic Malignancies; Hydration; Tumor Lysis Syndrom

Chest wall tumor at relapse of multiple myeloma

We report the case of a 70-year-old Moroccan man who was diagnosed with stage IIIA IgA kappa multiple myeloma according to Durie and Salmon classification. He was an alcohol abuser and heavy smoker (2 packs per day). He was admitted to our department for thoracic pain, persistent and increasing. He also complained of mild shortness of breath and poor appetite. Initial physical examination was normal. Laboratory investigations showed a hemoglobin of 12 g/dL, MCV of 83fL, white cell count of 3,900/ L and platelet of 174,000/L

Cancer de la prostate et leucémie lymphoïde chronique

RésuméL'association entre cancer de la prostate et leucémie lymphoïde chronique (LLC) est rare. Nous rapportons l'observation d'un patient âgé de 69ans qui a présenté une LLC, classée stade C de Binet, traité par protocole FCR. Après 6 cures de chimiothérapie, il était en rémission complète. Dix huit mois après la fin du traitement, le patient a consulté pour dysurie et douleur lombaire. Le toucher rectal retrouvait une prostate indurée. Le PSA était élevé à 1103 ng/ml. La biopsie prostatique avec étude anatomopathologique a objectivé un adénocarcinome prostatique peu différencié (score de Gleason: 8). Le bilan d'extension retrouvait des métastases osseuses. Un traitement adjuvant par pulpectomie et radiothérapie associé aux biphosphonates et antalgiques était proposé.L'association entre LLC et cancer de la prostate parait plus fréquente pour être fortuite.AbstractThe association between prostate cancer and chronic lymphocytic leukemia (CLL) is rare. We report a case of 69 year old man who presented a CLL, classified as Binet stage C, treated with FCR protocol. After six cycles of chemotherapy, it was in complete remission. Eighteen months after the end of treatment, the patient presented with dysuria and back pain. Digital rectal examination revealed an indurated prostate. The PSA was elevated to 1103 ng/ml. Prostate biopsy with histopathologic study showed poorly differentiated prostate adenocarcinoma (Gleason score: 8). Staging workup revealed bone metastases. Adjuvant radiotherapy and pulpectomy associated with bisphosphonates and analgesics was proposed.The association between CLL and prostate cancer appears too frequent to be accidental

Monoclonal antibodies in hematological malignancies: Past, present and future

Much progress has been made during the last few decades in the treatment of hematological malignancies. Monoclonal antibodies (MoAbs) represent a major advance toward a targeted therapy that can dramatically improve the antitumor effect with a substantial reduction of toxicity derived from therapy. Unlike many small molecules, MoAbs offer unique target specificity. Several MoAbs are now in clinical use for hematologic malignancies therapy, and many others are currently undergoing clinical evaluation. This review summarizes the state-of-the-art MoAbs treatment, beginning with an overview of the scientific background to their synthesis, mechanism of action and choice of target antigen, mainly focusing on those antibodies that are currently in use in clinical practice. Despite these advances, significant challenges remain in the identification of optimal cellular targets, antibody forms and treatment schedules for therapeutic applications

Epigastric discomfort during pregnancy presenting as gastric Burkitt lymphoma

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