bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic Value of Pleural Effusion in Hodgkin's Lymphoma Patients
Authors: Bhatt Nidhi , Brandt Gregory , Niebrugge Daniel , Khan Aziz U. 
Published: November 2019

Abstract
Background: There has been little investigation into the incidence or prognostic significance of a pleural effusion when present with the diagnosis of Hodgkin's Lymphoma. In our small clinical practice we had two patients with Hodgkin's lymphoma who presented with pleural effusion and subsequent poor outcomes, including relapse and eventual death. These events stemmed this retrospective study investigating the incidence of pleural effusion with the diagnosis of Hodgkin's disease and whether the presence of pleural effusion at the time of diagnosis would reveal any association with outcomes in a larger cohort of patients.
Procedure: A single centered retrospective chart review of 134 patients' age 0-50 with confirmed Hodgkin's lymphoma was performed. Charts were evaluated for the presence of any radiographic evidence of pleural effusion at the time of diagnosis, along with the patient's eventual outcome.
Result: 8/133 (6%) patients with Hodgkin's lymphoma had a pleural effusion at the time of diagnosis. Death is dependent on pleural effusion (p= 0.019) with 3 of 8 (37.5%) of patients that had pleural effusion who died.There is an 8.77 (CI 1.8 - 43.5) times greater odds of death for patients with pleural effusion versus those without pleural effusion.
Recurrence is dependent on pleural effusion (p= 0.0061) with 5/8 (62.5%) of patients that had pleural effusion who experienced recurrence.There is an 8.75 (CI 1.9 - 39.6) times greater odds of recurrence for patients with pleural effusion versus those without pleural effusion.
Of the 5 patients who had recurrence, as stated above 3 patients died, 1 patient was salvaged by stem cell transplant and another patient was recently diagnosed with relapse thus, clear outcome is yet to be determined
Conclusion: The presence of a pleural effusion at the time of diagnosis of Hodgkin's lymphoma is a rare finding, yet when present, was associated with death and recurrence. This finding may suggest a more aggressive initial treatment be required given the association with poor outcomes. An evaluation of a larger cohort of patients, along with a determination of the diagnostic stage, will be required to confirm prognostic potential.

Disclosures
No relevant conflicts of interest to declare.
Treating Hodgkin Lymphoma without Dacarbazine: A Lesson Learned from Thailand
Authors: Suwanban Tawatchai , Nakhakes Chajchawan , Lekhakula Arnuparp , Julamanee Jakrawadee , Norasetthada Lalita , Nawarawong Weerasak , Chansung Kanchana , Sirijerachai Chittima , Khuhapinant Archrob , Siritanaratanakul Noppadol , Bunworasate Udomsak , Intragumtornchai Tanin , Numbenjapon Tontanai , Prayongratana Kannadit , Nipharuck Pimjai , Chuncharunee Suporn , Wongkhantee Somchai , Wong Peerapon , Kanitsap Nonglak , Pornuipavee Rachanid , Makruasi Nisa 
Published: November 2019

Abstract
INTRODUCTION: Hodgkin lymphoma (HL) is curable if the patients are treated early and properly. Thailand is a country where public health care resources are limited and as such, dacarbazine was not listed in the national drug list, thus, cannot be reimbursed in patients under the Universal Coverage payment scheme which comprised 60-70% of all patients. This study was aimed to compare outcome differences between patients with HL who were treated with ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine), ABV (doxorubicin, bleomycin, vinblastine) and COP/ABV (cyclophosphamide, vincristine, prednisolone, procarbazine /ABV) as happened in the real world practice in Thailand.
METHODS: From the nationwide multicenter registry of 4,371 newly diagnosed lymphoma patients in Thailand from 2007 to 2014, there were 316 patients with HL. The data is part of the Thai Lymphoma Study Group Registry performed at the thirteen major medical centers in Thailand. The patients' characteristics, treatment options and outcomes were analyzed.
RESULTS: The median age was 42 years (range,13-89 years). Male: female was 1.3:1. Fifteen percent of the patients were older than 60 years. Histological subtypes were classical HL, nodular sclerosis, 45.3%, mixed cellularity, 28.6%, lymphocytic rich, 3.5%, lymphocytic depletion 5.1%, nodular lymphocytic predominant, 7.5% and unclassifiable, 10.5%. Fifty percent of patients were stage III/IV and 46% had B symptoms. Clinical characteristics were not significantly different between patients treated with ABVD, ABV and COP/ABV (Table 1). Treatment options were varied according to doctors' preference, hospital strategy and the reimbursement policy. ABVD was the most common prescribed regimen (32.7%); the other options included ABV (29.2 %), COP/ABV (13.1 %), CHOP (2.8 %) and radiotherapy only (1.6%). With a median follow-up of 32 months, patients treated with ABVD had superior 5 year overall survival rate over those treated with ABV (86.6% vs 47.7%, p < 0.001) and COP/ABV (86.6% vs 62.7%, p < 0.01)(Figure 1). Discrepancies in survivals could be demonstrated both in patients with limited as well as in advanced diseases (Figure 2).
CONCLUSION: ABVD yielded superior survival compared to ABV and COP/ABV. Dacarbazine is therefore an essential drug for the treatment of HL in developing countries.
Figure 1. Figure 1. Figure 2. Figure 2.

Disclosures
Khuhapinant: Roche: Honoraria.
Follicular Lymphoma B Cells Generate Functional Regulatory T Cells Via ICOS/ICOSL Pathway and Are Inhibited By Intratumoral Tregs
Authors: Olive Daniel , LE Suong Khieu , Thibult marie-Laure , gondois-Rey Francoise , Granjeaud Samuel , Fest Thierry , Imene Azzaoui , Bouabdallah Reda , Broussais Florence , Xerri Luc , Leroux Dominique , Caux Christophe , Caux Christine 
Published: November 2019

Abstract
The prognosis of follicular lymphoma (FL) patients is suspected to be influenced by tumor infiltrating regulatory T cells (Tregs). The mechanism of Tregs enrichment in FL and their impact on malignant FL B cells remains to be elucidated. We analyzed 46 fresh lymph node biopsy samples including FL (n = 20), diffuse large B cell lymphoma (DLBCL; n = 10), classical Hodgkin lymphoma (cHL; n = 9) and reactive lymphadenitis (rL; n = 7). Using multicolor flow cytometry and cell sorting, we observed an accumulation of CD25high CD127low/- Tregs in FL tissues. These Tregs comprised activated ICOS+ Tregs which were able to suppress not only conventional T cells, but also FL B cells. These FL B cells were able to express ICOSL in vitro and to generate CD25high Foxp3high Tregs expressing ICOS. Tregs generation was associated with ICOS/ICOSL engagement and was abrogated by antagonist anti-ICOS and anti-ICOSL antibodies. Interaction between Tregs and FL B cells resulted in ICOSL downregulation on FL B cells. These data highlight the role of Tregs in FL pathogenesis and suggest that targeting the ICOS/ICOSL pathway may be a promising immunotherapy in FL

Disclosures
No relevant conflicts of interest to declare.
Prevalence and Prognostic Impact of CD30 and EBV Co-Expression in Korean Patients with EBV-Positive DLBCL of the Elderly
Authors: Hong Jung Yong , Park Keon Woo , Ko Young Hyeh , Kim Seok Jin , Kim Won Seog 
Published: November 2019

Abstract
The prognostic impact of EBV-positivity in EBV-positive DLBCL of the elderly is controversial. Previous Asian studies have shown consistent poor prognostic impact of EBV-positivity. Recent Western study has shown no significant prognostic impact of EBV-positivity alone. However, the study found that CD30 and EBV co-expression is associated with an adverse outcome and suggested CD30 co-expression might be associated with different prognostic impact of EBV-positivity between Asian and Western populations.
We retrospectively analyzed 26 Korean patients with EBV-positive DLBCL of the elderly diagnosed at Samsung Medical Center and had adequate amount and quality of paraffin-embedded biopsy specimen for additional immunostaining of CD30. EBV RNA was detected by an ISH technique and a positive reaction was defined as more than 20% of examined cells showing nuclear positivity. Cell of origin was assigned using Hans immunohistochemical algorithm.
Prevalence of CD30 co-expression in EBV-positive DLBCL of the elderly was 65.4% (17/26) and 50.0% (13/26) using a >0% cut-off and a >30% cut-off, respectively. There was no statistically significant difference of survival between cases with CD30 co-expression and case without CD30 co-expression. However, the cases with CD30 co-expression showed a modest trend of worse overall survival (OS) (median OS, 12.5 months [95%CI 1.5-23.4] versus not reached, P = 0.279) and progression-free survival (PFS) (median PFS, 7.4 [95%CI 5.7-9.1] versus 34.2 months [95%CI 0.0-89.1], P = 0.430) using >0% cut-off. Among 17 patients with CD30 and EBV co-expression, most of patients (88%, 15/17) showed non-germinal center B-cell like (GCB) DLBCL.
Substantial proportion of Korean patients with EBV-positive DLBCL of the elderly showed CD30 co-expression. CD30 co-expression in EBV-positive DLBCL of the elderly showed a modest trend of an adverse outcomes without statistical significance. Further validation study with larger population is warranted. Considering previously known contradictory trend of better outcome in CD30 positive cases with EBV-negative and GCB type DLBCL, we also need to investigate the possible distinct pathobiology of CD30 positivity in EBV-positive DLBCL of the elderly.

Disclosures
No relevant conflicts of interest to declare.
Anaplastic Large Cell Lymphoma of the Breast: Incidence, Patterns of Care, and Outcome in the US Population
Authors: Chalasani Pratima , Go Ronald S. , Parsons Benjamin , Al-Hamadani Mohammed 
Published: November 2019

Abstract
Background:
Anaplastic large cell lymphoma (ALCL) of the breast is a recently described clinicopathologic entity, almost always associated with breast implants, and does not overexpress the anaplastic lymphoma kinase (ALK) protein. Using the two largest US cancer databases, we describe its incidence, patterns of care, and clinical outcome.
Methods:
Incidence rate was calculated using 2000-2011 data from the Surveillance, Epidemiology, and End Results (SEER) Program and age-adjusted to the US 2000 standard population. For patient level data, we used the National Cancer Data Base (NCDB) Participant User File. We included all adult patients diagnosed from 1998-2011 with ALCL (ICD-O-3: 99714) who had breast as the primary site.
Results:
The incidence of breast ALCL was 0.001 per million. We identified 61 cases from NCDB. All of the patients were females and they were predominantly White (88.5%). The median age at diagnosis was 64 years (range, 18-90). The stage distribution was I (45.9%), II (21.3%), III (0%), IV (9.8%), and unknown (21.3%). The pattern of initial treatment was surgery alone (13.1%), chemotherapy alone (32.7%), chemotherapy and radiation (19.7%), surgery and chemotherapy (4.9%), surgery and radiation (4.9%), and tri-modality treatment (13.1%). In 7 patients (11.5%), no treatment was given. Two patients (1.6%) received stem cell transplant (1 autologous, 1 allogeneic) as part of initial treatment, one after chemotherapy and another one after surgery and chemotherapy. Overall survival data was available for patients diagnosed in 1998-2006 (29 patients). The median overall survival was 149.8 months (range, 2.6-157.9).
Conclusions:
ALCL of the breast is very rare. It presents mainly as early stage disease with very good prognosis. The patterns of care varied, although most patients received chemotherapy as part of the initial treatment.
Table 1. Treatment type received Frequency Percent Cumulative Frequency Cumulative Percent Chemo only 20 32.79 20 32.79 Surgery only 8 13.11 28 45.90 Chemo, Radiation, No surgery 12 19.67 40 65.57 Chemo, Surgery, No radiation 3 4.92 43 70.49 Radiation, Surgery, No Chemo 3 4.92 46 75.41 All three combined 8 13.11 54 88.52 Nothing 7 11.48 61 100.00

Disclosures
Parsons: Celgene: Speakers Bureau.
Lymphocyte/Monocyte Ratio (LMR) at Diagnosis Is Predictive of Survival with Post Transplant Lymphoproliferative Disease (PTLD) after Renal Transplant: An Analysis of 96 Patients of a Brazilian Cohort
Authors: Perini Guilherme Fleury , Cavalcanti Egyla M , Garibaldi Junior Joao , Penna Adriana M. Damasco , Pestana Jose Osmar Medina , Bordin Jose Orlando , Zampieri Filho Jose Pedro , Baiocchi Otavio C. G. 
Published: November 2019

Abstract
Introduction: Post-Transplant Lymphoproliferative Disease (PTLD) is a well-recognized group of lymphoid and or plasmacytic proliferations that occur following both solid organ (SOT) and allogenic hematopoietic stem cell transplantation (HSCT) as a result of immunossupression. A continuum of disease has been described, including early lesions, polymorphic PTLD and monomorphic PTLD. Epstein-bar virus (EBV) is considered the most important causative factor, with EBV positivity observed within up 90% of tumor lymphocytes. There is paucity of prognostic factors in PTLD, but studies have shown that IPI, Performance status and number of disease sites are related to mortality. LMR has shown to be prognostic in different lymphomas, including Hodgkin's Lymphoma (HL), Diffuse Large B-cell lymphomas among others.
Objectives: To assess the role of lymphocyte/monocyte ratio at diagnosis in predicting outcome and survival in PTLD patients.
Patient and Methods: This is a retrospective study conducted by the Universidade Federal de São Paulo, São Paulo, Brazil. Only confirmed cases of PTLD, diagnosed from 2001 to 2015, with clinical, epidemiological and laboratorial parameters available were included in this study. Event was defined as treatment related mortality, progression (defined as time for initiation of salvage therapy) or relapse. Patients with conflicted data or loss of follow up were excluded from the analysis.
Results: A total of 98 patients were diagnosed with PTLD in the study period. Two patients were excluded from the analysis due to conflict clinical data. Median age at diagnosis was 41.4 years (range from 4-74), with a 0,6:1 Female:Male ratio. Median time of transplant to PTLD was 56 months (range 0-967). Twenty-six patients (27%) received anti-thymocyte globulin (ATG), and the most common immunossupressive regimens consisted of cyclosporine or tacrolimus associated with prednisone and azathioprine (68,7%). Monomorphic PTLD was observed in 78% of patients, and two patients presented with HL. With a median follow up of 33.3 months, 35% of patients died. In a univariate analysis, the number of extranodal sites and LMR were associated with worst survival (p=0.026 and p=0.004).
Conclusions: PTLD is a known complication of immunossupresion, usually related to EBV. In our cohort of 96 kidney recipients with PTLD, LMR and number of extranodal sites was associated with inferior outcome.

Disclosures
No relevant conflicts of interest to declare.
The Prognostic Significance of 13q Deletion with Different Size in Patients with B-CLPD
Authors: Xiong Wenjie , Li Heng , Yi Shuhua , Li Zengjun , Liu Wei , Lv Rui , Zou Dehui , Qiu Lugui 
Published: November 2019

Abstract
Background: Deletion of 13q14 is the most frequent abnormality in chronic lymphocytic leukemia (CLL). Deletion at of 13q with vary sizes have been described, documenting different involved genes with different deletion area. But the prognostic significance of different deletion size is not well explored and this interesting phenomenon has not been described in other B-cell chronic lymphoproliferative disorders (B-CLPD).
Patients and Methods: Interphase fluorescence in situ hybridization (FISH) using locus-specific probes (RB1, D13S25) was performed to detect 13q14 deletions on 344 untreated cases with B-CLPD, including 304 CLL patients and 166 other B-CLPD patients. Different 13q14 deletion area was delineated by RB1 and D13S25.
Results: (a) Totally, 145 of 304 CLL patients (47.9%) had 13q14 deletion, which was significantly higher than it in other B-CLPD (25/167, 15.0%; p=.000). 77 of 304 CLL patients (25.3%) and 14 of 166 other B-CLPD patients (8.4%) had RB1 deletion. RB1 deletion always accompanied with D13S25 deletion in both CLL and other B-CLPD, which indicated large area deletion in 13q14. But some patients had only D13S25 deletion without RB1 deletion, indicating small area deletion in 13q14. Of the 145 CLL cases with 13q14 deletion, 73(50.3%) had small deletion and 72 (49.7%) with large deletion. The incidence of small and large deletion in 21 other B-CLPD with 13q14 deletion were in 12(48.0%) and 113(52.0%) patients respectively.
(b) In CLL cases, the time to first therapy in the cases with 13q14 deletion was 25 months longer than 16 months in the cases without 13q14 deletion (P=0.035). The progression-free survival (PFS) in cases with 13q14 deletion was also significantly longer (P=0.023) than those without the aberration. In other B-CLPD cases, the PFS and OS in cases with 13q14 deletion was significantly shorter (P=0.030) than those without the aberration. Moreover, large deletions (from RB1 to D13S25) were associated with a significantly shorter (p< 0.05) TFT as well as overall survival (57.5 vs. 135.0 months, p=.075)compared with small deletions.
Conclusions: The deletion of 13q can influence clinical outcome of BCLPD and vary in size both in CLL and in other BCLPDs. The deletion size displayed as a poor prognostic factor in other BCLPD cases, which implies the usage of both 13q probes is proposed.

Disclosures
No relevant conflicts of interest to declare.
Efficacy of Vindesine + Dexamethasone (VDS+Dexa.) in Elderly Patients with Relapsed or Refractory Malignant Lymphoma
Authors: Yuasa Hiromi , Wakita Hisashi , Matsuura Yasuhiro , Inagaki Shunichirou , Arai Hironori , Utsu Yoshikazu , Masuda Shinichi , Aotsuka Nobuyuki , Sunami Shosuke 
Published: November 2019

Abstract
Background; The number of non-Hodgkin's lymphoma (NHL) patients in the elderly has been increasing due to the long-lived society. It is not rare to treat elderly NHL patients aged over 85 years old. Individualizing the doses of cancer chemotherapy agents and progress in supportive therapy has improved the prognosis for elderly patients with NHL. Prolonged hospitalization elderly patients have adverse effects, which include dementia, difficulty in walking, and depression. Optimal treatment for these patients is unknown. Patients and Methods; In our hospital between April 2012 and December 2014, we treated 19 elderly patients (85 and over 85 years) with NHL as outpatients with VDS 3mg (day 1) and Dexa. (day 1-4) which repeated every 3 weeks for as long as possible. Results; Complete remission was achieved in 5 patients and partial remission in 6; the median duration of survival was 14 months. Adverse effects included leukopenia in 1 patient (<1,000 cells/μl), thrombocytopenia in 1patient (<5×104 cells/μl). Conclusion; VDS+Dexa. is useful in elderly patients because of its low hematological and non-hematological toxicity. These results indicate that VDS+Dexa. is effective and safe for the treatment of NHL in elderly patients. This outpatient chemotherapy caused no serious adverse reactions.

Disclosures
No relevant conflicts of interest to declare.
Successful Experience of Treatment of Angioimmunoblastic T-Cell Lymphoma By Prolonged Therapy
Authors: Chernova Natalia G. , Vinogradova Yulia E. , Sidorova Yulia V. , Kovrigina Alla M. , Gabeeva Nelly G. , Zvonkov Eugene E. , Parovichnikova Elena N. , Savchenko Valeri G. 
Published: November 2019

Abstract
Introduction: Angioimmunoblastic T-cell lymphoma (AITL) is a rare tumor derived from follicular T-helper and characterized by low response rate and relapsing course to standard therapy. CHOP-like therapy shows 70-80 % of overall response rate, though 2-year progression-free survival is observed only in 30-40 % of patients. Unsatisfactory results of treatment angioimmunoblastic T-cell lymphoma by ÑÍÎÐ-like therapy require searching new approaches to therapy.
Aim: To define a rational approach to treatment of angioimmunoblastic T-cell lymphoma.
Patients and methods: Ñlinical outcomes of 23 patients with newly diagnosed AITL treated between June 2002 and July 2015 we retrospectively analyzed. The diagnosis was verified according to WHO classification.
Results: Among the 23 patients 14 men and 9 women were included with a median age of 63 (range, 29-81). Twenty-two of 23 patients had Ann Arbor stage IV. Bone marrow involvement was detected in 21 of 23 cases by histological investigation. Nine of 23 patients received CHOP-like therapy; other 14 patients were treated prolonged therapy. Eight (89%) of 9 patients after CHOP-like therapy had treatment failure. Time to disease progression ranged from 1 to 7 months (median 3). Fourteen of 23 patients were treated by prolonged therapy consisting of low dose cytotoxic drugs weekly and supporting the therapy by interferon-A and thalidomide. Supporting therapy has administrated after achieving complete remission and was continued in 2 years. Prolonged therapy wasn't finished in 3 patients with severe infections and somatic pathology. Eleven (79%) of 14 patients treated by prolonged therapy achieved complete remission, treatment was finished only in 5 of 11 patients; follow-up varies from 3 to 67 months, a median 29. Univariate analysis of progression-free survival curves showed that prolonged therapy is more effective than CHOP-like therapy (p < 0.01) (Fig.1). Prolonged therapy was performed in 4 of 8 patients with progression disease after CHOP-like therapy; 2 patients achieved a complete remission, continuing 41 and 77 months.
Conclusion: Although, this was a small retrospective study, the results show that efficiency of prolonged therapy is better than CHOP-like therapy in patients withangioimmunoblastic T-cell lymphoma. Prolonged therapy allows preventing early treatment failures.
Figure 1. Figure 1.

Disclosures
No relevant conflicts of interest to declare.