bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of fine needle aspiration (FNA) cytology in assessment of cervical lymphadenopathy
Authors: Khillan R. , Sidhu G. S. , Axiotis C. , Braverman A. 
Published: August 2020

e19525 Background: The ability of FNA specimens to provide a definitive lymphoma diagnosis is controversial. Otolaryngolists routinely employ FNA for cervical lymph nodes which may have arisen from head and neck carcinomas, since incisional procedures may interfere with potentially curative surgery. Methods: The charts of 176 patients referred to the Kings County Hospital Center since 1996 for confirmed lymphoma were reviewed. All patients with cervical adenopathy are initially referred to the Otolaryngology service for biopsy, which is routinely FNA. Results: Of the 123 patients for whom pathological data was available, 37 had initial FNAs; 10 more FNAs (total 47) were done when the first was not diagnostic. Cervical adenopathy was the presentation in 27 of 37 patients (73%), 6 of whom also had disseminated adenopathy. Upper aerodigestive tract (UAT) fiberoscopy had been negative in 16 and not performed in 7. The FNA specimens contained interpretable material in 42 of 47 cases (89%). Five FNA specimens were diagnostic of lymphoma (11%), but the type was classifiable in only one. Thus, 32 initial FNA specimens were not diagnostic, nor were 10 repeat FNA's on the same patients. Of the 32 patients who initially had non-diagnostic FNAs, a lymphoma diagnosis and classification was ultimately established by a single excisional lymph node biopsy. Lymphoma diagnosis was delayed in 19 patients because of FNA by 10–941 days; median 38, mean 68 days. Conclusions: Though 90% were not diagnostic, FNA was routinely, and sometimes repeatedly performed in patients with cervical adenopathy, most of whom had no evidence of UAT neoplasms, and some of whom had disseminated adenopathy. Significant delays in diagnosis were the result. Decisions concerning biopsy technique in patients with cervical adenopathy should be made in the context of clinical presentation. No significant financial relationships to disclose.
Impaired endothelial function in Hodgkin lymphoma survivors receiving mediastinal radiation
Authors: Chen B. , Mahmud F. , Mangel J. , Vujovic O. , Rieder M. , Zelcer S. 
Published: August 2020

e19526 Background: Mediastinal radiation (RT) is a cause of premature coronary artery disease (CAD) in Hodgkin lymphoma survivors (HLS). Early detection of atherosclerosis may allow for improved health outcomes. Peripheral arterial tonometry (PAT) is a non-invasive technique that measures endothelial function (EF), as a surrogate marker of sub-clinical atherosclerosis. The objective of our study was to evaluate EF in HLS and age-matched controls using PAT and to determine the association of mediastinal RT. Methods: Cross sectional evaluation of 26 HLS age 12–30 years and within a minimum of two years from the completion of therapy and matched controls. Evaluation for CAD risk factors included measurement of body mass index and blood pressure, fasting lipoproteins and hsCRP. A standardized activity questionnaire (HAES, habitual activity estimation score) was completed by all participants. EF was measured using PAT hyperemia ratios (PAT-HR) in all subjects. Results: HLS and controls were similar for baseline variables (mean age 23.2 ± 5 yrs; 23.4 ± 4.6 yrs, p=0.35). HLS were on average 9.9 ± 3.9 yrs post treatment. No differences in EF or cardiovascular risk factors were observed between HLS survivors and controls. However impaired EF, as evidenced by lower PAT-HR (1.66 ± 0.18 vs. 2.08 ± 0.38, p<0.01) was seen in HLS (n=13) who received mantle/mediastinal RT (mean RT dose 2657 ± 971 cGy) compared to controls. Mean cumulative anthracycline dose did not differ between HLS who did or did not receive RT (224.1 ± 65.4 vs. 253 ± 70.3 mg/m2 p=0.18). These differences were not explained by alterations in lipoproteins or hsCRP, however activity scores were significantly lower in HLS compared with young adult controls (2.01 ± 1.1 vs. 3.6 ± 1.2 hrs daily, p=0.02). Conclusions: Impaired EF was observed in a small group of HLS who received mediastinal RT as compared to those who did not. Cancer survivors at risk may benefit from early assessment of EF as a sub-clinical marker of CAD. No significant financial relationships to disclose.
Snk/Plk2 CpG methylation in patients with multiple myeloma
Authors: Dasoula A. , Hatzimichael E. , Dranitsaris G. , Benetatos L. , Syed N. , Vassou A. , Stebbing J. , Crook T. , Bourantas K. 
Published: August 2020

e19532 Background: We previously showed that polo like kinase 2 (Snk/Plk2) is subject to methylation-dependent transcriptional silencing in a very high frequency in Burkitt lymphomas. Here, we have examined CpG methylation in Snk/Plk2 in a well-characterized series of multiple myeloma (MM) patients. Methods: Bone marrow samples from individuals with MM were obtained at diagnosis and in 5 cases at disease progression as well. Genomic DNA was isolated and bisulphite modification was performed using commercially available kits. The methylation-specific polymerase chain reaction (MSP) was employed to study its methylation status. Control methylated and unmethylated genomic DNAs were included in each experiment. Ten bone marrow samples from individuals proven to have no haematological malignancy, served as negative controls. Logistic regression analyses were used to measure the association between gene methylation and the development of advanced disease (DS≥II), extramedullary disease, bone disease, anemia (Hb 10 mg/dl), serum albumin and beta 2 microglobulin levels. Results: We analyzed the methylation of Snk/Plk2 in 45 cases of MM (24 male, 21 female, mean age 66.4 years ±12.4). Classical cytogenetic analysis was available in 30/45 patients and none of them was found to have chromosome 13 abnormalities. No sample from the control population was found methylated. The Snk/Plk2 promoter was found to be methylated in 27/45 patients (60%). Median survival of patients in whom the Snk/Plk2 CpG island was methylated was 7.1 years compared to a median survival of 8.8 years for unmethylated. However Snk/Plk2 methylation was not a predictor of excess mortality (HR=0.6, p=0.5), bone lytic lesions (OR=0.56, p=0.3), anemia (OR=0.5, p=0.3) or advanced stage as defined above (OR=0.8, p=0.7). Conclusions: Snk/Plk2 DNA Methylation is a frequent event in patients with multiple myeloma. There was no association between the methylation status of the gene and relevant clinical parameters. Further evaluation in a larger sample of patients is needed in order to better define the prognostic and clinical value if any of Snk/Plk2 methylation in MM. No significant financial relationships to disclose.
A retrospective chart review study of relapsed or refractory multiple myeloma (MM) patients (Pts): A look into historical treatment (Tx) patterns
Authors: Zaman F. , Reece D. E. , Teixeira B. L. , Yoong K. , Camacho F. , Plante R. K. 
Published: August 2020

e19535 Background: New Tx options have become available on the market or as investigational agents in Canada for relapsed/refractory MM in the last few years. These new Tx options include IMiDs [thalidomide, lenalidomide (Revlimid)] and a proteosome inhibitor [bortezomib (Velcade)]. These new agents are changing both the Tx patterns as well as the clinical outcome of this disease. New combination regimens of both new agents and older generic drugs are also being investigated. Methods: This retrospective analysis included all relapsed/refractory MM Pts who initiated drug Tx between Jul-06 and Jun-07 at Princess Margaret Hospital, Toronto, ON. Historical data collection focused on prior Tx (types), duration and efficacy. Results: This analysis included all prior historical Tx data Dec-96 to Jul-07) from 151 Pts. 62% of Pts were male. Time from diagnosis to 1st initial Tx was 1.7 (SD±4.2) months. Of the 25 Pts who had cytogenetics analyzed by FISH, 6 Pts had deletion 13q, 4 Pts had translocation involving chromosome 14 [including partner gene translocations on chromosomes 4 (2 Pts) and 11 (1 Pt)] and no Pts had deletion p53. 76.8% of Pts received at least 1 stem cell transplant (SCT) with 7.9% of Pts receiving 2 SCTs prior to current study Tx. Historical 1st line & 2nd line Txs, respectively, were cyclophosphamide ± steroid (14.6%, 28.3%), IMiD-based (17.2%, 40.2%), melphalan + prednisone (14.6%, 9.8%), vincristine + adriamycin + dex (69.5%, 5.4%), steroid monotherapy (23.8%, 22.8%), bortezomib based (0.7%, 15.2%), and other (6.0%, 6.5%). Overall best RRs (≥MR) during historical 1st & 2nd line Tx were 92.6% and 83.3% (≥ minimal response), respectively, with a corresponding 15.6% & 11.9% combined CR + near CR rate, respectively, across all regimens reported. Historical median TTP following 1st, 2nd, and 3rd line of Tx were 21.5 (95% CI: 18.9, 24.3), 20.2 (95% CI: 16.9, 22.8), and 10.0 (95% CI: 5.5, 16.6) months, respectively. Conclusions: This is the first known historical analysis of real world MM Txs in Canada from a large tertiary centre. Historical data suggests the common use of older drugs such as alkylating agents. This usage pattern may be different than in other countries where the accessibility of newer agents to treat MM is easier than in Canada. [Table: see text]
Autologous stem cell transplant in peripheral T cell lymphomas: Single institution 10-year retrospective analysis
Authors: Vigil C. E. , Ayala E. , Sokol L. 
Published: August 2020

e19538 Background: Peripheral T-cell lymphoma is a rare entitydisease, compromising 10% of non-Hodgkin's lymphoma worldwide and 5% of all lymphoid neoplasms in the United States. The long-term survival of conventional therapies has led the exploration of alternatives. High-dose chemotherapy followed by autologous haematopoietic stem cell transplantation, has been explored in recent years with little experiences. We are reporting our single-institute data in this population. Methods: A retrospective analysis on patients with diagnosis of peripheral T-cell lymphoma receiving autologous stem cell transplant was conducted (January 1997 to July 2008). The patients were stratified according to their International Prognostic Index (IPI), disease status at the time of transplant and histology type. Results: Twenty-nine subjects were identified, with a median age of 51; 13 patients had Anaplastic T cell, 18 patient had PTCL-nos, and 6 patients with angioimmunoblastic T cell lymphoma. Seventeen patients (58.62%) presented with an aa IPI score greater than 2.4 patients were in complete remission, 15 at first relapse, 4 in greater than 1 episode, and 6 with refractory disease at the time of transplantion.Kaplan Meier overall survival (OS) 72 and relapse free survival (RFS) was 62 at 1 year respectively. A multivariate analysis and new risk stratification based on the IPI score system and disease status at time of transplant were employed. We found that the lower risk category demonstrated a higher likelihood of longer survival HR 3.4. However, such outcome was not statistically significant (p = 0.1360). Conclusions: The status at time of transplant with new methods for evaluation of minimal residual disease may help in assessing outcome. Larger prospective studies investigating innovative regimens is warranted. No significant financial relationships to disclose.
Analysis of prognostic factors in patients with EBV positive diffuse large B cell lymphoma of the elderly
Authors: Morales D. , Beltran B. , Hurtado de Mendoza F. , Riva L. , Quiñones P. 
Published: August 2020

e19542 Background: EBV positive diffuse large B cell lymphoma of the elderly is a new entity included in the Fourth edition of WHO Classification. It usually affects elderly patients and has a poor survival. It believed to be related to immunesenescence. Aim: The goal of this study was to evaluate clinical characteristics and survival of EBV positive diffuse large B cell lymphoma of the elderly from Peruvian patients. Methods: Between January 2002 and June 2008, eleven patients with EBV positive diffuse large B cell lymphoma of the elderly were included in the analysis. All cases were positive to the presence of EBV encoded RNA (EBER) by CISH and CD20 and/or Pax-5 expression by immunohistochemistry.Clinical data were reviewed retrospectively and patient's biopsies were analyzed for the immunohistochemical expression of BCL6, CD10, CD30 and MUM-1/IRF4 by tissue microarray (TMA) technique.. The survival analysis was performed using the Kaplan - Meier method. Results: The mean age was 72 years old (range 34–85), only two patients had less than 70 years old. B symptoms occurred in 6/11 (54%); ECOG 0–2 ( n=3) and >2 (n=8). Stage: I (n=1), II (n=1), III (n=5) and IV (n=4). The IPI risk score was: low (n=1), low intermediate (n=1), high intermediate (n=5) and high (n=4). Extranodal disease occurred in 6/11 (54%) patients: pleura (n=2), suprarenal gland (n=1), stomach (n=1), cecum (n=1), bone (1), skin (1) and bone marrow (n=1). One was HTLV-1 carrier. Ten cases (83%) were of the Non-GC and 1 case was GC. Three cases were CD30 positivity. Index Prognostic model (age/B symptoms) for this entity was: 0 factors (n=0), 1 factor (n=7) with median survival 9 months; and 2 factors (n=4) with median survival of 1.5 months. Six patients had not received chemotherapy because they had bad status performance and 5 received CHOP-21 regimen. Overall response was 40%. Complete response (n=2), partial response (n=0) and progressive disease (n=3). Median survival was 6.4 months. Only one patient had a long survival (42.5 months). Conclusions: EBV positive diffuse large B cell lymphoma of the elderly was related to high IPI, poor ECOG, frequent extranodal disease, poor response to treatment and very short survival. It is the first report of this entity in a non-Asian population. No significant financial relationships to disclose.
Correlation between expression of MCM6, a new proliferative marker, and treatment outcome in patients with Hodgkin's disease
Authors: Khodadad K. , Karimi S. , Esfahani Monfared Z. 
Published: August 2020

e19547 Background: MCM6 is a proliferative marker, which in contrary to Ki67, is involved in all cell cycle phases, including early G1. We evaluated MCM6 expression in Hodgkin's disease (HD) patients in order to find any correlation between MCM6 expression and treatment outcome. Methods: Formalin-fixed paraffin-embedded lymph node specimens of 55 patients with HD treated with ABVD regimen (± radiotherapy) were assessed for MCM6 expression by IHC. The percentage of nuclear positivity in RS and mononuclear Hodgkin cells was evaluated in each case. Clinical data, response to treatment and relapse rates were obtained from patients’ medical records. These data were analyzed by SPSS software. Results: Mean MCM6 expression was 80.7% (ranging 35%-99%) with no significant difference between histology subtypes. In univariate analysis, MCM6 expression was not statistically significant for B-symptoms (P=0.27), sex (P=0.91), stage (P=0.18) and response to treatment (P=0.53), but was significant for age (P=0.008) (≤23 vs >23 yrs old). The MCM6 mean expression between relapsed and non-relapsed groups was marginally significant (21% vs 29.4%, P=0.057). In multivariate analysis, we evaluated MCM6 expression, B-symptoms, stage, response rate and age for relapse. None of risk factors were statistically significant predictor for relapse, including MCM6 expression (P=0.238), however, were significant regarding to response (P<0.001) and stage (P=0.048). We divided patients in 4 quartiles based on their MCM6 expression (Q1<74.25%, N=13, Q2=74.26–85.5%, N=14, Q3=85.6–91.75%, N=13, Q4>91.75%, N=12). Relapse and PFS were not significantly different between these quartiles (P=0.27 and P=0.83, respectively). Conclusions: Our study on a limited number of patients revealed MCM6 is not a strong predictor for treatment outcome in patients with HD. Our findings can be possibly explained by early G1 arrest of tumor cells and the role of cytokine production in pathogenesis of HD. We believe determining the accurate predictive role of proliferative markers needs to be focused on the markers which are exclusively involved in S phase. No significant financial relationships to disclose.
Effect of dosing cycles on safety of denileukin diftitox (Dd) in cutaneous T-cell lymphoma (CTCL) patients: Integrated analysis of three phase III studies
Authors: Kim Y. , Beynon J. 
Published: August 2020

e19557 Background: Dd is a novel IL-2 receptor-targeted recombinant fusion protein that is approved for treatment of persistent/recurrent CTCL expressing CD25. To date, Dd is the most extensively studied agent in CTCL. The safety of Dd was assessed with respect to dosing cycle in CTCL subjects in 3 large phase III studies: 93–04–10 (study 10), L4389–11 (study 11) and L4389–14 (study 14). Methods: Subjects received Dd doses of 9 or 18 mcg/kg IV daily for 5 days, repeating every 21 days for up to 8 cycles; study 11 also included a placebo arm. Subjects in studies 10 and 11 were CD25(+); study 14 also included CD25(-) subjects. Safety data from these studies were integrated and are presented by dosing cycle. Results: Table 1 shows a summary of all reported adverse events (AEs) by cycle for the 3 studies. For subjects completing at least 4 cycles of Dd treatment the incidence of any AEs was lower in the 3rd and 4th cycles as compared to the 1st and 2nd cycles and the incidence of AEs continued to decrease after cycle 4. Conclusions: In the studies analyzed, the incidence of AEs decreased with each subsequent treatment cycle for subjects receiving Dd. [Table: see text] [Table: see text]
Non-Hodgkin's lymphoma (NHL) patients at a VA medical center: Comorbidity and treatment
Authors: Srinivas S. , Cholankeril M. , Chang V. T. , Morales-Muyuela E. , Duque L. , Toomey K. , Kasimis B. 
Published: August 2020

e19559 Background: We hypothesized that measures of comorbidity may help explain the number of treatments administered to patients with non-Hodgkin's lymphoma. Methods: We performed a retrospective, IRB approved protocol, using chart review of all patients diagnosed with non-Hodgkin's lymphoma at the VANJHCS from January 1, 1997 through December 31, 2008. Records were reviewed for demographic, clinical, pathological data, the number of chemotherapy regimens, radiation therapy, and total number of treatments and survival. We tabulated the Charlson Comorbidity Index (CMI), the Kaplan-Feinstein Comorbidity Index (KFI), the Cumulative Illness Rating Scale (CIRS), International Prognostic Index (IPI), and performance status (PS) were tabulated for 100 patients seen at a VA Medical Center. Results: There were 100 patients with median (M) age 62 years (27–89). There were 61 deaths (61%) with M survival(MS) 1068 days(13–3976). The M Stage was 1(0–4), M LDH was 204 IU/L (88–1905), M Hgb 12.3gm/dL (7.3–17.4), M Albumin was 3.8g/dl(1.2–5.4), M Zubrod Performance Status(PS) was 1(0–4) in 50 pts(50%). The M CMI was 6(1–12), M KFI was 3(1–3), M CIRS17 was 1.7(1–3.15). The M total number of systemic therapy regimens received was 1(0–4.5), M radiotherapy was 0(0–1) and the overall M total treatment regimens used was 1 (0–4.5). IPI was a significant predictor in the use of radiation therapy (p<0.054) but did not correlate with the use systemic therapy. The CMI was a predictor of the use of systemic chemotherapy (p<0.007), and the total number of treatments received (p<0.011), but not the KFI or the CIRS 17. The performance status did not predict for the number of treatments. In a Cox regression analysis, the number of treatments did not affect survival. Conclusions: This data provides evidence that one measure of comorbidity, the CMI, may partially explain the number of systemic therapy treatments, and total treatments received by NHL patients. Further work in larger groups of pts is warranted. No significant financial relationships to disclose.
The clinicopathological spectrum of HIV-associated lymphoma: Eleven-year-experience in a general hospital in Peru
Authors: Vera L. , Reategui R. , Beltran B. , Morales D. , Capellino A. , Desposorio C. , Castillo J. 
Published: August 2020

e19561 Background: The clinicopathological spectrum of HIV-associated lymphomas in developing countries has not been clearly defined. Thus, this study is aimed to describe these features in cases from a Peruvian population. Methods: This is a retrospective review of the clinical records of patients with diagnosis of HIV in our institution from March 1997 to March 2008. We reviewed 2502 clinical records. The statistical method was descriptive and survival was calculated using the Kaplan-Meier method. Results: Forty-eight patients with HIV-associated lymphoma were identified. Male:female ratio was 15:1. Median age was 42 years (range 27 to 70). 32 patients (67%) had clinical stage III-IV, B symptoms 35 (73%), the International Prognostic Index was low-risk 20 patients (42%), low-intermediate risk 15 patients (31%), high-intermediate risk 10 patients (21%) and high-risk 3 patients (6%). CD4 count lower than 100 cells/uL was 11 patients (23%). The CD4 count median was 184 cells/uL. The nodal localization in 27 patients (56%) was lightly higher. Forty-four cases (92%) were diagnosed with non-Hodgkin lymphoma (NHL) and 4 cases (8%) with Hodgkin lymphoma (HL). From the 44 NHL cases, 40 cases (91%) were of B-cell origin; 23 cases (57.5%) had diffuse large B-cell, 9 cases (22.5%) had Burkitt, 3 cases (7.5%) had plasmablastic, 2 cases (5%) had primary CNS, 2 cases (5%) had MALT and 1 case (2.5%) had primary effusion lymphoma. The remaining 4 cases (9%) were of T-cell origin; 3 cases (75%) had peripheral T-cell lymphoma NOS and 1 case (25%) was ALK-negative anaplastic large cell lymphoma. Only 16 patients (33%) were receiving HAART previously the diagnosis of NHL and 33 patients (68%) received any oncology treatment. Conclusions: This entity is aggressive and frequently has extranodal involvement. Also a high proportion of T-cells lymphomas are found. These findings are in concordance with one prior report of another general hospital from Peru. No significant financial relationships to disclose.