Primary follicular and marginal-zone lymphoma of the breast: clinical features, prognostic factors and outcome: a study by the International Extranodal Lymphoma Study Group

Background: Primary breast lymphoma (PBL) of low-grade histology is a rare disease. This multicentric retrospective study was carried out to determine clinical features, prognosis and relapse. Patients and methods: Patients with histologically proven, previously untreated follicular or marginal-zone PBL (MZL PBL) diagnosed from 1980 to 2003 were included in the study. Major end points were progression-free survival (PFS), overall survival (OS) and potential prognostic factors. Results: We collected data on 60 cases of PBL [36 follicular and 24 marginal-zone lymphoma (MZL)]. Stage was IE or IIE in 57 patients and IVE in three patients due to bilateral breast involvement. Surgery, chemotherapy and radiotherapy (RT), alone or in combination, were used as first-line treatments in 67%, 42% and 52% of patients, respectively. Overall response rate was 98%, with a 93% complete response rate. Five-year PFS were 56% for MZL and 49% for follicular PBL (P = 0.62). Relapses were mostly in distant sites (18 of 23 cases); no patients relapsed within RT fields. Conclusions: Our data showed an indolent behaviour of MZL PBL, comparable to other primary extranodal MZL. Conversely, patients with follicular PBL had inferior PFS and OS when compared with limited-stage nodal follicular non-Hodgkin's lymphomas, suggesting an adverse prognostic role of primary breast localisation in this histological subgrou

Project Finance

An essay on the use of project finance in the field of firm's alternative financial policie

Arranger certification in project finance

Using a sample of 4,122 project finance loans worth $769 billion arranged from 1991 to 2005, we demonstrate that certification by prestigious lead arranging banks creates economic value by reducing overall loan spreads compared to loans arranged by less prestigious arrangers. Banks participating in these loan syndicates, rather than the project sponsors, pay for this certification. They do so by allowing top tier arrangers to keep larger fractions of the upfront arranging fees. Results are robust to the correction for the endogenous choice of loans by prestigious arrangers and indicate that certification is even more valuable during periods of extreme financial stress

Arranger certification in project finance

Though it is highly plausible that third-party certification could create value in capital market financing, empirical research has yielded ambiguous evidence of this, due to confounding influences and multiple impacts. We examine certification by lead arrangers of project finance (PF) syndicated loans, because PF vehicle companies are stand-alone entities, created for a single purpose, with all valuation impacts contained in the project financing package. Using a sample of 4,122 project finance loans, worth $769 billion, arranged between 1991 and 2005, we show that certification by prestigious lead arranging banks creates economic value by reducing overall loan spreads compared to loans arranged by less prestigious arrangers, and by allowing larger and more highly leveraged PF deals to be funded. Banks participating in these loan syndicates, rather than the project sponsors, are the parties that pay for certification, and do so by allowing top-tier arrangers to keep larger fractions of the up-front arranging fees

ERCC1 Expression in Diffuse Large B-Cell Lymphoma Patients Treated with a Cisplatin-Based Regimen: A Brief Communication

There is growing interest in defining biomarkers that could predict response to different chemotherapeutic agents. Excision repair cross complement 1 (ERCC1) enzyme has been shown to predict benefit of cisplatin in different types of cancer. As cisplatin-based regimens are frequently used in the salvage treatment of diffuse large B-cell lymphomas (DLBCL), a small pilot study was conducted to determine whether ERCC1 is expressed in this disease or not. Out of seven patients examined, only one had a 25% ERCC1 expression, which could represent a tumour truly expressing this marker. However, expression was not able to predict response to treatment. It remains unclear whether ERCC1 could serve as a predictive marker for cisplatin in this disease requiring further studies

Bronchial-associated lymphoid tissue (BALT) lymphoma: a retrospective analysis

17547 Background: Systemic CT in BALT lymphoma is the accepted therapy for those pts where surgery isn't radical or possible. There is not a standard systemic treatment for this uncommon lymphoma however its indolent behavior and the relative asymptomatic outcome, allows on systemic therapy delay and may justify the use of less toxic CT agents

Bronchial-associated lymphoid tissue (BALT) lymphoma: a retrospective analysis

17547 Background: Systemic CT in BALT lymphoma is the accepted therapy for those pts where surgery isn't radical or possible. There is not a standard systemic treatment for this uncommon lymphoma however its indolent behavior and the relative asymptomatic outcome, allows on systemic therapy delay and may justify the use of less toxic CT agents

A retrospective international study on primary extranodal marginal zone lymphomas of the lung (BALT lymphoma) on behalf of the international lymphoma study group (IELSG)

Primary lymphoma of the lung is a rare entity. Clinical features, optimal treatment, role of surgery and outcomes are not well defined, and the follow-up is variable in published data. Clinical data of 205 patients who were confirmed to have bronchus mucosa-associated lymphoid tissue lymphoma from December 1986 to December 2011 in 17 different centres worldwide were evaluated. Fifty-five per cent of the patients were female. The median age at diagnosis was 62(range 28-88)years. Only 9% had a history of exposure to toxic substances, while about 45% of the patients had a history of smoking. Ten per cent of the patients had autoimmune disease at presentation, and 19% patients had a reported preexisting lung disease. Treatment modalities included surgery alone in 63 patients (30%), radiotherapy in 3 (2%), antibiotics in 1 (1%) and systemic treatment in 128 (62%). Patients receiving a local approach, mainly surgical resection, experienced significantly improved progression-free survival (p=0.003) versus those receiving a systemic treatment. There were no other significant differences among treatment modalities. The survival data confirm the indolent nature of the disease. Local therapy (surgery or radiotherapy) results in long-term disease-free survival for patients with localized disease. Systemic treatment, including alkylating-containing regimens, can be reserved to patients in relapse after incomplete surgical excision or for patients with advanced disease