Analysis of frequency of ocular location and value of chemiotherapy in treating advanced non-Hodgkin lymphoma

INTRODUCTION Choice of therapeutic methods depends on lymphoma’s location. Extranodal non-Hodgkin lymphoma (NHL) are treated with radiotherapy, chemotherapy and surgery. MATERIAL AND METHODS A retrospective analysis of patients with advanced NHL treated between year 2003 and 2009 in Clinic of Oncology and Chemotherapy in Katowice, 19 patients had goggled eyes, 11 in one side and 8 in both sides. 14 patients from that group had diagnosed ocular form of lymphoma (9 women and 5 men). After histological analysis 6 patients were diagnosed with DLBCL, 2 SLL, 4 MALT, 2 FL. 5 patients didn’t have any kind of lymphoma. Chemotherapy was established after histological results, DLBCL according to program R – CHOP, SLL program COP or R – CVP, MALT program COP and FL R – CVP. RESULTS After chemotherapy: DLBCL = 5 CR + 1 PD, SLL = 1 CR + 1 PR, MALT = 1 CR + 3 PR, FL = 2 CR and two deaths (DLBCL, FL). A recurrence was observed in 1 patient with FL after 11moths. Progression was observed in 1 patient with DLBCL after 12 months, 1 patient with SLL after 21 months and 1 with MALT after 27 months. CONCLUSIONS Ocular infi ltration in case of advanced form of NHL doesn’t aggravate patients’ prognosis. The standard chemotherapy is an effi cient form of treatment which ensures the retreat of infi ltration in ocular in the majority of cases. The eff ect is permanent among patients with progression as well.WSTĘP Zajęcie narządów i tkanek pozalimfatycznych jest ważne w przebiegu i leczeniu non-Hodgkin lymphoma (NHL). MATERIAŁ I METODY Dokonano retrospektywnej analizy 411 przypadków chorych z zaawansowanym NHL (CS III–IV). U 19 (4,6%) pacjentów stwierdzono wytrzeszcz gałek ocznych. U 14 (3,4%) pacjentów z wytrzeszczem stwierdzono rozrost chłoniakowy w oczodole (przedział wieku 27–80 lat). Podtyp DLBCL stwierdzono u 6 pacjentów, SLL u 2, MALT u 4, FL u 2. U 5 chorych nie potwierdzono nacieku chłoniakowego w oczodole. Ze względu na zaawansowaną postać choroby pacjentów kwalifi kowano do chemioterapii według następujących schematów: DLBCL 6 – 8 x R – CHOP, SLL 6 x COP lub R – CVP, MALT 4 – 6 x COP, FL 8 x R – CVP. WYNIKI DLBCL = 5 CR + 1 PD, SLL = 1 CR + 1 PR, MALT = 1 CR + 3 PR, FL = 2 CR. Czas obserwacji chorych 5–69 miesięcy. Wznowa u 1 chorego z FL po 11 miesiącach, progresja u 1 chorego z DLBCL po 12 miesiącach, u 1 chorej z SLL po 21 miesiącach i 1 chorej z MALT po 27 miesiącach 2 zgony (DLBCL, FL). U żadnego chorego po skutecznej chemioterapii nie wystąpił nawrót zmian w oczodole. WNIOSKI Naciek chłoniakowy oczodołu w zaawansowanych NHL nie pogarsza rokowania chorych. Standardowa chemioterapia jest skutecznym leczeniem zapewniającym w większości przypadków trwałe ustąpienie nacieku. Dotychczasowa obserwacja wskazuje, że efekt ten jest trwały także u chorych, u których doszło do progresji lub wznowy choroby w innej lokalizacji

Comparison of Adrenal Tumor Size in Ultrasound Examinations with and without the Use of a Contrast Agent

Background and objectives: Patients diagnosed with incidentally found adrenal tumors (incidentaloma) that do not meet the criteria for surgical treatment require follow-ups with repeated imaging. The aim of this study is to compare the accuracy of the measurements of the adrenal tumor size in ultrasound (US) with and without contrast in comparison to computed tomography (CT) or magnetic resonance (MRI). Further, this study attempts to answer the question of whether contrast-enhanced ultrasound (CEUS) can improve imaging accuracy and replace CT/MRI in the monitoring of patients with adrenal tumors. Materials and Methods: The retrospective analysis included 79 adult patients with adrenal incidentalomas not exceeding a dimension of 6 cm who underwent a CT or MRI scan, US, and CEUS with the use of SonoVue in two-dimensional (2D) and three-dimensional (3D) projections and Doppler techniques. Tumor vascularization in CEUS was classified as follows: peripheral, peripheral-central, central, or poor. Results: Of 79 adrenal tumors, 48.1% showed peripheral, 29.1% showed poor, 21.5% showed peripheral-central, and only 1.3% showed central vascularization. The median volume of tumors detected with CEUS (69.9 cm3) was significantly higher than with US (44.5 cm3) and CT or MRI (57.1 cm3). The relative error of the adrenal volume with CEUS compared with CT or MRI was significantly higher than with standard US, regardless of the type of tumor vascularization. Conclusions: CEUS does not improve the accuracy of adrenal tumor size assessment regardless of the type of vascularization

High efficacy of BGD (bendamustine, gemcitabine, and dexamethasone) in relapsed/refractory Hodgkin Lymphoma

The optimal salvage therapy in relapsed/refractory Hodgkin lymphoma (R/R HL) has not been defined so far. The goal of this multicenter retrospective study was to evaluate efficacy and safety of BGD (bendamustine, gemcitabine, dexamethasone) as a second or subsequent line of therapy in classical R/R HL. We have evaluated 92 consecutive R/R HL patients treated with BGD. Median age was 34.5 (19–82) years. Fifty-eight patients (63%) had received 2 or more lines of chemotherapy, 32 patients (34.8%) radiotherapy, and 21 patients (22.8%) an autologous hematopoietic stem cell transplantation (autoHCT). Forty-four patients (47.8%) were resistant to first line of chemotherapy. BGD therapy consisted of bendamustine 90 mg/m(2) on days 1 and 2, gemcitabine 800 mg/m(2) on days 1 and 4, dexamethasone 40 mg on days 1–4. Median number of BGD cycles was 4 (2–7). The following adverse events ≥ 3 grade were noted: neutropenia (22.8%), thrombocytopenia (20.7%), anemia (15.2%), infections (10.9%), AST/ALT increase (2.2%), and skin rush (1.1%). After BGD therapy, 51 (55.4%) patients achieved complete remission, 23 (25%)—partial response, 7 (7.6%)—stable disease, and 11 (12%) patients experienced progression disease. AutoHCT was conducted in 42 (45.7%) patients after BGD therapy, and allogeneic HCT (alloHCT) in 16 (17.4%) patients. Median progression-free survival was 21 months. BGD is a highly effective, well-tolerated salvage regimen for patients with R/R HL, providing an excellent bridge to auto- or alloHCT