Hodgkin lymphoma(HL)is a heterogenous lymphoproliferative disorder of B-cell origin and represents one of the most common malignancies in children and young adults.In addition to well-known underlying factors-such as ...Hodgkin lymphoma(HL)is a heterogenous lymphoproliferative disorder of B-cell origin and represents one of the most common malignancies in children and young adults.In addition to well-known underlying factors-such as Epstein-Barr virus infection-the familial aggregation demonstrated in large population studies suggested a genetic predisposition.First-degree relatives of patients with HL have an approximately threefold increased risk of developing the disease compared to the general population.These observations have recently prompted several whole-genome studies in affected families,identifying variants possibly implicated in lymphomagenesis,including alterations in DICER1(a member of the ribonuclease III family),POT1(protection of telomeres 1),KDR(kinase insert domain receptor),KLHDC8B(kelch domain-containing protein 8B),PAX5(paired box protein 5),GATA3(GATA binding protein 3),IRF7(interferon regulatory factor 7),EEF2KMT(eukaryotic elongation factor 2 lysine methyltransferase),and POLR1E(RNA polymerase I subunit E).In this article,we review current insights into the etiopathogenesis and risks of familial HL,and present case reports involving two sisters diagnosed with HL nearly 17 years apart.Recognizing the risk for first-degree relatives may potentially increase awareness of early symptoms among family members of HL patients,leading to earlier diagnosis and better outcomes.Conversely,understanding that the hereditary risk,though higher than in the general population,remains relatively low may provide reassurance for affected families.展开更多
AIM:To investigate the clinical characteristics and treatment outcomes,including visual function and overall survival(OS)of patients with ocular adnexal diffuse large B-cell lymphoma(OA-DLBCL).METHODS:This retrospecti...AIM:To investigate the clinical characteristics and treatment outcomes,including visual function and overall survival(OS)of patients with ocular adnexal diffuse large B-cell lymphoma(OA-DLBCL).METHODS:This retrospective cohort study enrolled 29 patients diagnosed with OA-DLBCL based on histopathological biopsy between 2006 and 2023.Patients were stratified into two subgroups:primary OA-DLBCL(no prior history of lymphoma)and secondary OA-DLBCL(history of DLBCL at non-ocular adnexal sites).OS was defined as the time interval from OA-DLBCL diagnosis to death from any cause.Survival analysis was performed using the Kaplan–Meier method,and prognostic factors affecting OS were identified using multivariate Cox proportional hazards regression with a stepwise selection approach.RESULTS:The cohort included 24 patients with primary OA-DLBCL(13 males,11 females;mean age:61.36±18.29y)and 5 patients with secondary OA-DLBCL(2 males,3 females;mean age:50.94±18.17y).Among the primary OA-DLBCL subgroup,12 patients(50%)presented with advanced disease(Ann Arbor stage IIIE–IV),and 16 patients(66%)were classified as T4 disease according to the tumor-node-metastasis(TNM)staging system.The mean final visual acuity was 1.72±1.10 in the primary group and 0.90±1.18 in the secondary group.The 5-year OS rate for the entire cohort was 27.7%.Multivariate analysis identified five factors significantly associated with poor survival outcomes:epiphora[adjusted hazard ratio(aHR),36.95],atherosclerotic cardiovascular disease(aHR,10.08),human immunodeficiency virus(HIV)infection(aHR,12.47),M1 stage(aHR,6.99),and secondary OA-DLBCL(aHR,6.03;all P<0.05).The median OS was 1.68y for primary OA-DLBCL and 1.12y for secondary OA-DLBCL.CONCLUSION:A substantial proportion of patients with primary OA-DLBCL present with advanced-stage disease at diagnosis.Epiphora,atherosclerotic cardiovascular disease,HIV infection,M1 stage,and secondary OA-DLBCL are independent prognostic factors for poor survival outcomes.These findings emphasize the urgent need for optimized therapeutic strategies and early screening protocols to improve the management of OA-DLBCL,particularly in developing countries.展开更多
Background:The prognostic significance of the chemokine receptor CCR7 in diffuse large B-cell lymphoma(DLBCL)has been reported previously.However,the detailed mechanisms of CCR7 in DLBCL,particularly regarding its int...Background:The prognostic significance of the chemokine receptor CCR7 in diffuse large B-cell lymphoma(DLBCL)has been reported previously.However,the detailed mechanisms of CCR7 in DLBCL,particularly regarding its interaction with lenalidomide treatment,are not fully understood.Methods:Our study utilized bioinformatics approaches to identify hub genes in SU-DHL-2 cell lines treated with lenalidomide compared to control groups.Immunohistochemical data and clinical information from 122 patients with DLBCL were analyzed to assess the correlation of CCR7 and p-ERK1/2 expression with the prognosis of DLBCL.Furthermore,in vitro and in vivo experiments were conducted to clarify the role of CCR7 in the response of DLBCL to lenalidomide treatment.Results:Our bioinformatics analysis pinpointed CCR7 as a hub gene in the context of lenalidomide treatment in DLBCL.Notably,31.14%and 36.0%(44/122)of DLBCL cases showed positive expression for CCR7 and ERK1/2 respectively,establishing them as independent prognostic factors for adverse outcomes in DLBCL via multivariate Cox regression analysis.Additionally,our studies demonstrated that the external application of the protein CCL21 promoted proliferation,migration,invasion,and activation of the ERK1/2 pathway in SU-DHL-2 and OCI-LY3 cell lines with high levels of CCR7 expression.This effect was mitigated by CCR7 silencing through siRNA,application of ERK inhibitors,or lenalidomide treatment.In vivo experiments reinforced the efficacy of lenalidomide,significantly reducing tumor growth rate,tumor mass,serum total LDH levels,and expression of CCR7 and p-ERK1/2 in a SUDHL-2 xenograft model in nude mice(p<0.05).Conclusion:Our study clarifies the potential role of the CCL21/CCR7/ERK1/2 axis in the therapeutic effects of lenalidomide in DLBCL treatment.展开更多
BACKGROUND Mantle cell lymphoma(MCL)is an aggressive B-cell non-Hodgkin lymphoma that rarely presents with cutaneous involvement,which typically occurs in advanced disease stages.Primary cutaneous manifestations are p...BACKGROUND Mantle cell lymphoma(MCL)is an aggressive B-cell non-Hodgkin lymphoma that rarely presents with cutaneous involvement,which typically occurs in advanced disease stages.Primary cutaneous manifestations are particularly uncommon and frequently misdiagnosed.We report a diagnostically challenging case of MCL that first appeared as a nodule on the lower leg.CASE SUMMARY An elderly female had a painless red nodule on the front of her right lower leg for six months.Positron emission tomography-computed tomography showed a soft tissue mass at the same site and increased activity in the right groin lymph nodes.Skin and lymph node biopsies,along with immunostaining,confirmed MCL.The patient began combination chemotherapy,resulting in a marked improvement of skin lesions and lymphadenopathy after two weeks.CONCLUSION Cutaneous manifestations,though uncommon,may serve as the initial clinical presentation of MCL.Dermatologists and pathologists should maintain heigh-tened awareness of this diagnostic possibility when evaluating persistent,atypical cutaneous nodules,particularly in elderly patients.Histopathological evaluation with complete immunophenotypic profiling is paramount for accurate diagnosis.展开更多
BACKGROUND The concept of“duodenal-type follicular lymphoma(FL)”has already been established as a disease entity.On the other hand,because FL that develops in the colorectum is a rare disease,its clinical characteri...BACKGROUND The concept of“duodenal-type follicular lymphoma(FL)”has already been established as a disease entity.On the other hand,because FL that develops in the colorectum is a rare disease,its clinical characteristics,including its treatment and outcome,are poorly understood.AIM To clarify the characteristic clinical features of colorectal FL.METHODS We identified 5 patients with FL from December 2010 to July 2022 whose colorectal lesions were confirmed by endoscopic biopsy at our hospital and retrospectively examined their clinical features,including endoscopic findings,treatment,and long-term outcomes.RESULTS The median age of the patients was 70 years(range 62-74 years,3 males and 2 females),and 2 patients were considered to have systemic FL lesions.Endoscopic findings revealed elavated lesions in all 5 patients(polypoid 3,flat elavated 1,papular 1).Only 1 patient underwent therapeutic intervention,and 4 patients chose watchful waiting.Except for 1 patient in which the lesion spontaneously regressed,the disease recurred or progressed in 4 patients,3 of whom eventually achieved near complete remission with the administration of rituximab and bendamustine(±polatuzumab vedotin).The 5 patients in this study were still alive or exhibited long-term survival before death;the survival time ranged from 8-29 years after the onset of lymphoma.CONCLUSION In the present study,colorectal FL progressed slowly,and overall survival was good because it was sensitive to anticancer drugs even after the disease progressed without initial therapeutic intervention.展开更多
BACKGROUND Primary cardiac lymphoma(PCL)is a rare subset of cardiac tumors,often diagnosed late due to nonspecific symptoms.It predominantly affects immunocompromised individuals,primarily in the pericardium and right...BACKGROUND Primary cardiac lymphoma(PCL)is a rare subset of cardiac tumors,often diagnosed late due to nonspecific symptoms.It predominantly affects immunocompromised individuals,primarily in the pericardium and right heart.Late diagnosis mimics common cardiac ailments,leading to poor prognosis.AIM To systematically review the efficacy of rituximab in treating PCL either alone or in various chemotherapeutic regimens.Secondary objectives include evaluating morphological subtypes,assessing treatment regimens,and analyzing outcomes focusing on remission and adverse events.METHODS Following PRISMA guidelines,a comprehensive literature search was conducted across multiple databases,including PubMed,Hinari,Web of Science,and Scopus.English-language studies reporting the use of rituximab in treating PCL in humans were included.Study selection involved initial screening of titles and abstracts followed by full-text examination and data extraction.RESULTS Thirty-three case reports involving 36 patients were included in this systematic review.Diffuse large B-cell lymphoma was the predominant morphological subtype observed.The rituximab,cyclophosphamide,doxorubicin,oncovin,and prednisolone regimen emerged as the most commonly employed treatment strategy,indicating widespread acceptance and efficacy in PCL management.Combination therapies,including surgical intervention,showed promise in achieving complete remission,while some studies reported mortality despite aggressive treatment approaches.CONCLUSION Rituximab,particularly in combination with chemotherapy regimens,represents a significant advancement in PCL management,offering hope for improved patient outcomes.However,challenges such as variable treatment responses and adverse events underscore the complexity of managing PCL.Further research is warranted to refine therapeutic strategies and enhance diagnostic approaches for this rare cardiac malignancy.展开更多
BACKGROUND T/histiocyte-rich large B-cell lymphoma(T/HRBCL)is a highly aggressive subtype of diffuse large B-cell lymphoma characterized histologically by the presence of a few neoplastic large B cells amidst an abund...BACKGROUND T/histiocyte-rich large B-cell lymphoma(T/HRBCL)is a highly aggressive subtype of diffuse large B-cell lymphoma characterized histologically by the presence of a few neoplastic large B cells amidst an abundant background of reactive T lymphocytes and/or histiocytes.T/HRBCL commonly affects the lymph nodes,followed by extranodal sites,such as the spleen,liver,and bone marrow,with rare occurrences in the gastrointestinal tract.Primary gastrointestinal T/HRBCL lacks specific clinical and endoscopic manifestations,and it is difficult to differentiate from inflammatory diseases,nodular lymphocyte predominant Hodgkin lymphoma,and other diseases on a histological basis,thereby hindering early diagnosis.CASE SUMMARY A 63-year-old man was hospitalized with a one-month history of jaundice and weight loss of approximately 3 kg.Laboratory tests revealed increased hepatic parameters in a cholestatic pattern and elevated carbohydrate antigen 19-9 levels.An abdominal computed tomography scan revealed a low-density mass within the descending duodenum and dilation of the bile and pancreatic ducts.He was clinically diagnosed with a duodenal tumor.During surgery,a 7.0 cm×8.0 cm mass was identified within the descending duodenum,so pancreaticoduodenectomy and cholecystectomy were performed.Following operative biopsy,the tumor was diagnosed as primary duodenal T/HRBCL.The patient refused postoperative chemotherapy and died four months after surgery.CONCLUSION Primary duodenal T/HRBCL is an extremely rare and highly aggressive malignancy.The initial treatment strategies should be based on the original site of the tumor,the disease stage,and the patient's physical condition.Chemotherapy-based comprehensive treatment is still the main treatment method for primary gastrointestinal T/HRBCL.展开更多
Background:Primary bone marrow diffuse large B-cell lymphoma(PBM-DLBCL)represents an uncommon yet clinically aggressive hematologic malignancy.Despite its significant clinical impact,this entity lacks standardized dia...Background:Primary bone marrow diffuse large B-cell lymphoma(PBM-DLBCL)represents an uncommon yet clinically aggressive hematologic malignancy.Despite its significant clinical impact,this entity lacks standardized diagnostic criteria in current WHO classifications.Methods:We performed a retrospective analysis of 55 PBM-DLBCL cases from our institutional database and published literature(2001–2022)to characterize disease features and identify prognostic factors,with particular focus on assessing how different treatment regimens influence therapeutic efficacy and long-term outcomes.Results:The data suggested a potential link between international prognostic index(IPI)scores and poorer survival,albeit without conclusive statistical evidence(p 0.05).Treatment=response emerged as a significant prognostic factor,and patients with complete response(CR)demonstrating superior survival in Cox univariate and multivariate analysis(p 0.001).Intensive therapeutic regimens were associated with<improved clinical outcomes compared to conventional therapies.While incorporating rituximab into conventional chemotherapy regimens has demonstrated superior clinical outcomes compared to chemotherapy alone in PBM-DLBCL patients.Conclusion:Our findings highlight the aggressive nature of PBM-DLBCL and underscore the importance of early recognition,risk stratification,and optimized treatment selection for this rare disease entity.展开更多
Because human immunodeficiency virus(HIV)-associated Burkitt lymphoma(BL)has a poor prognosis new therapeutic approaches need to be developed1.Axicabtagene ciloleucel(axi-cel)is an anti-CD19 CAR-T cell commercially av...Because human immunodeficiency virus(HIV)-associated Burkitt lymphoma(BL)has a poor prognosis new therapeutic approaches need to be developed1.Axicabtagene ciloleucel(axi-cel)is an anti-CD19 CAR-T cell commercially available FDA-approved product for patients with relapsed or refractory(R/R)large B-cell lymphoma(LBCL).However,axi-cel has not been approved by the FDA for use in patients with R/R BL.展开更多
BACKGROUND Mucosa-associated lymphoid tissue(MALT)lymphoma is a subtype of extranodal marginal zone lymphoma,typically occurring in mucosal sites such as the stomach,salivary glands,and lungs.This study aims to analyz...BACKGROUND Mucosa-associated lymphoid tissue(MALT)lymphoma is a subtype of extranodal marginal zone lymphoma,typically occurring in mucosal sites such as the stomach,salivary glands,and lungs.This study aims to analyze the demographic and clinicopathologic characteristics of patients with gastric MALT lymphoma in the United States and evaluate the interaction between age and gender on survival outcomes.AIM To analyze the demographic and clinicopathologic characteristics of patients with gastric MALT lymphoma in the United States and evaluate the interaction between age and gender on survival outcomes.METHODS A retrospective cohort study was conducted using the Surveillance,Epidemiology,and End Results(SEER)database,which included 2453 patients diagnosed with MALT lymphoma from 2010 to 2021.Data were analyzed for demographic factors,tumor characteristics,treatment modalities,and survival outcomes.A Cox proportional hazards regression model was used to identify predictors of overall mortality and cancer-specific mortality.RESULTS The study predominantly included Non-Hispanic White patients(62.78%),with nearly equal gender distribution(50.31%females,49.69%males),and most diagnoses occurring in individuals aged 60-79 years.The majority of tumors were localized(80.07%).Multivariate analysis identified older age,male gender,advanced tumor stage,and socioeconomic factors—such as annual income and marital status—as independent predictors of mortality.No significant interaction between age and gender on mortality outcomes was observed.CONCLUSION Sociodemographic factors,including advanced age,male gender,annual income,and marital status,as well as advanced tumor stage,significantly impacted survival outcomes in patients with MALT lymphoma.Radiotherapy was associated with a reduction in overall mortality.Early detection is crucial for optimizing outcomes,as localized disease responds well to available treatment modalities.展开更多
BACKGROUND Primary testicular lymphoma(PTL)is a rare,aggressive malignancy,representing a small fraction of testicular tumors and non-Hodgkin lymphomas,yet it is the most common testicular malignancy in older men.Diff...BACKGROUND Primary testicular lymphoma(PTL)is a rare,aggressive malignancy,representing a small fraction of testicular tumors and non-Hodgkin lymphomas,yet it is the most common testicular malignancy in older men.Diffuse large B-cell lymphoma(DLBCL),which is typically the aggressive subtype,dominates PTL and shows diffuse B-cell infiltration.Venous tumor thrombus,uncommon in lymphomas,is uniquely reported in this case of testicular DLBCL with gonadal vein involvement.CASE SUMMARY A 62-year-old man presented with a two-month history of painless left testicular swelling and stiffness.Diagnostic imaging[ultrasonography,computed tomography(CT),and 18F-fluorodeoxyglucose positron emission tomography/CT(18FFDG-PET/CT)]revealed bilateral testicular masses and a gonadal vein tumor thrombus(SUVmax 16.5).Left orchiectomy confirmed DLBCL with CD20,Bcl-2,and MUM1 positivity(Ki-67:approximately 80%).The disease was staged as Ann Arbor stage IVA(International Prognostic Index score 3,high-intermediate risk).The patient received Rituximab,Polatuzumab Vedotin,Cyclophosphamide,Epirubicin,and Prednisolone chemotherapy,completing the first cycle with good tolerability.No adverse events were reported,and follow-up is ongoing to assess long-term outcomes.This case highlights the diagnostic utility of 18F-FDGPET/CT and the importance of multidisciplinary management in rare PTL presentations with tumor thrombus.CONCLUSION This case demonstrates the diagnostic complexities of PTL with gonadal vein tumor thrombus,underscoring the importance of considering lymphoma in elderly patients with testicular masses and venous involvement.A multi-disciplinary team including urologists,hematologists,and radiation oncologists is needed to ensure appropriate therapy.展开更多
BACKGROUND Childhood intestinal lymphoma is characterized by its insidious onset and the absence of specific clinical symptoms.The thinner abdominal wall in children significantly aids in the ultrasound visualization ...BACKGROUND Childhood intestinal lymphoma is characterized by its insidious onset and the absence of specific clinical symptoms.The thinner abdominal wall in children significantly aids in the ultrasound visualization of the abdominal cavity and intestines.Although many typical cases of intestinal lymphoma can be diagnosed through ultrasound,physicians often either overlook these values or assume that ultrasound has limited diagnostic value for intestinal lymphoma.AIM To clarify the diagnosis of intestinal lymphoma and classify its severity using ultrasound,as well as to correlate this with prognosis.METHODS The correlation between ultrasound diagnostic outcomes,laboratory indicators,and clinical prognosis was analyzed to demonstrate the effectiveness of ultrasound in assessing the severity of intestinal lymphoma and to provide new evidence for the diagnosis and treatment of the disease in children.A retro-spective analysis was conducted on the sonographic images and case data of 28 children diagnosed with intestinal lymphoma and confirmed by surgical pathology.Additionally,we sought to determine the correlation between ultrasonic classification of lymphoma,lactate dehydrogenase(LDH)values,pathological classification,and prognosis.RESULTS Ultrasound was utilized to categorize 28 cases of intestinal lymphoma into focal segmental(15 cases)and extensive(13 cases)types.Ultrasound classification and LDH levels were significantly correlated with prognosis(P<0.05),while pathological type,age,gender,and treatment modality showed no significant correlation(P>0.05).Among ultrasound manifestations,there was a significant difference in LDH levels between the segmental and extensive groups(P<0.05).The prognosis for children with extensive intestinal lymphoma was poorer than that for children with localized segmental intestinal lymphoma(P<0.05).CONCLUSION Ultrasound can be used in the diagnosis and classification of intestinal lymphoma in children.Extensive intestinal lymphoma is associated with significantly elevated LDH and poor prognosis.展开更多
Chimeric antigen receptor-T(CAR-T)cell therapy is a precise immunotherapy for lymphoma.However,its long-term efficacy faces many challenges related to tumor cell heterogeneity,interference from immunosuppressive micro...Chimeric antigen receptor-T(CAR-T)cell therapy is a precise immunotherapy for lymphoma.However,its long-term efficacy faces many challenges related to tumor cell heterogeneity,interference from immunosuppressive microenvironments,CAR-T cell exhaustion,and unmanageable adverse events.Diverse modifications have been introduced into conventional CAR-T cells to overcome these obstacles;examples include addition of recognition sites to prevent immune escape,coupling of cytokine domains to enhance killing ability,blocking of immune checkpoint signals to resist tumor microenvironments,and inclusion of suicide systems or safety switches to improve safety and flexibility.With increasing understanding of the importance of metabolism and epigenetics in cancer and cytotherapy,glycolysis,methylation,and acetylation have become crucial CAR-T cell therapeutic targets.Universal and in situ CAR-T cells are also expected to be used in clinical applications,thus providing hope to patients with relapsed/refractory lymphomas.展开更多
(+)-Strebloside,a significant bioactive compound isolated from the roots of Streblus asper Lour.,demonstrates inhibitory effects against multiple malignancies.However,its specific function and underlying mechanistic p...(+)-Strebloside,a significant bioactive compound isolated from the roots of Streblus asper Lour.,demonstrates inhibitory effects against multiple malignancies.However,its specific function and underlying mechanistic pathways in Non-Hodgkin lymphoma(NHL)remain unexplored.This investigation sought to elucidate the role and potential mechanisms of(+)-strebloside-induced NHL cell death.The results demonstrated that(+)-strebloside significantly induced apoptosis and ferroptosis in NHL cells,including those from Raji cell-derived xenograft models.Mechanistic analyses revealed that(+)-strebloside enhanced six-transmembrane epithelial antigen of prostate 3(STEAP3)-induced ferroptosis in NHL,and STEAP3 inhibition reduced the proliferation-inhibitory effects of(+)-strebloside.Furthermore,(+)-strebloside suppressed NHL proliferation through the mitogen-activated protein kinase(MAPK)pathway,and extracellular signal-regulated kinase(ERK)inhibition diminished the proliferation-inhibitory activity induced by(+)-strebloside.These findings indicate that(+)-strebloside presents promising therapeutic potential for NHL treatment.展开更多
Objectives:This study aimed to generate a theoretical framework based on empirical data to explain the behavioral patterns closely related to young and middle-aged patients with lymphoma throughout the disease.Methods...Objectives:This study aimed to generate a theoretical framework based on empirical data to explain the behavioral patterns closely related to young and middle-aged patients with lymphoma throughout the disease.Methods:This study followed the classic grounded theory methodology,involving procedures such as theoretical sampling,substantive coding,theoretical coding,constant comparison,and memo writing and sorting.Multiple data types were used based on the principle of“all is data,”including 34 participants providing interview data along with observation notes and 40 relevant secondary texts from the“Lymphoma House”network platform and the“Lymphoma House 086”public account.Two autobiographical books written by lymphoma patients were also selected as data resources.Data collection and analysis were conducted in an iterative process until theoretical saturation was reached.The COREQ checklist was followed to report this study.Results:The main concern of middle-aged and young patients with lymphoma was identifiedas restoring normality,while managing uncertainty was the main behavioral pattern for restoring normality.Uncertainty consists of two interrelated types:inherent uncertainty of illness and perceived uncertainty of patients.Four strategies are used to manage uncertainty:reconstructing certainty,adaptive coping,defensive buffering,and compensatory changing.Managing uncertainty is influenced by disease characteristics and perceptions,social resources,and cultural concepts.The consequence of managing uncertainty is reaching a new normality.Conclusions:Pervasive uncertainty significantly affects the daily lives of young and middle-aged patients with lymphoma.Consequently,strategies for managing disease-related uncertainty to sustain normality are commonly observed in this population.This theoretical framework for addressing uncertainty can serve as a foundation for understanding and developing tailored interventions to manage uncertainty.Future research should focus on managing uncertainty to help patients restore normality.展开更多
BACKGROUND The primary lymphomas of mucosa associated lymphoid tissue(MALT)of the gallbladder(GB)is an extremely rare of non-Hodgkin lymphoma.Many patients exhibit symptoms like gallstone disease,and in some cases,the...BACKGROUND The primary lymphomas of mucosa associated lymphoid tissue(MALT)of the gallbladder(GB)is an extremely rare of non-Hodgkin lymphoma.Many patients exhibit symptoms like gallstone disease,and in some cases,the lymphoma may be detected through imaging even without apparent symptoms.Only 19 cases of primary MALT lymphoma in the GB have been previously reported.Differential diagnosis from typical GB carcinoma based solely on imaging findings can be challenging,and definitive diagnosis often requires surgical intervention.CASE SUMMARY We present a patient in an 82-year-old man who was initially diagnosed with prostate cancer but incidentally detected GB wall thickening from magnetic resonance imaging conducted for prostatic surgery and subsequent radical cholecystectomy revealed primary MALT lymphoma of the GB.The patient was followed up by a medical oncologist,and after discussion,the decision was made to continue observation with close monitoring without systemic chemotherapy given the asymptomatic presentation.The patient has been free of recurrence for 16 months after the surgery.Although precise diagnosis before the surgery was difficult in this case,preoperative examinations revealed a submucosal tumor-like lesion.CONCLUSION MALT lymphoma of GB remains little known in many previous studies.It is really difficult to preoperatively diagnose.The combination of clinical presentation,postoperative histology and immunohistochemistry contribute to diagnosis and carry out appropriate management.展开更多
Objective:Our previous studies have indicated potentially higher proliferative activity of tumor cells in Chinese patients with mantle-cell lymphoma(MCL)than those in Western.Given the success and tolerability of R-DA...Objective:Our previous studies have indicated potentially higher proliferative activity of tumor cells in Chinese patients with mantle-cell lymphoma(MCL)than those in Western.Given the success and tolerability of R-DA-EDOCH immunochemotherapy in treating aggressive B-cell lymphomas,we designed a prospective,phase 3 trial to explore the efficacy and safety of alternating R-DA-EDOCH/R-DHAP induction therapy for young patients with newly diagnosed MCL.The primary endpoint was the complete remission rate(CRR)at the end of induction(EOI).Methods:A total of 55 patients were enrolled.The CRR at the EOI was 89.1%[95%confidence interval(CI)78%±96%],and the overall response rate was 98.1%(95%CI 90%±100%).Most patients with bone marrow involvement quickly attained minimal residual disease(MRD)negative status,with a 95.7%rate at the EOI.Results:The 3-year progression-free survival(PFS)and overall survival rates were 66.3%and 83.2%,respectively.No patients discontinued treatment because of adverse events.Univariate analysis identified pathologic morphology and TP53 mutations as risk factors for PFS.However,high tumor proliferative activity and certain cytogenetic abnormalities showed no significant adverse prognostic significance.Conclusions:Intensive therapy based on a high cytarabine dose and continuously administered EDOCH achieved a high MRDnegative rate and provides an optional induction choice for young patients with MCL with high-risk factors.展开更多
INTRODUCTION Pulmonary hypertension(PH)is a complex syndrome arising from diverse underlying conditions and characterized by elevated pulmonary arterial pressure.Current clinical guidelines classify PH into five categ...INTRODUCTION Pulmonary hypertension(PH)is a complex syndrome arising from diverse underlying conditions and characterized by elevated pulmonary arterial pressure.Current clinical guidelines classify PH into five categories based on pathophysiology,clinical presentation,and hemodynamic characteristics.展开更多
BACKGROUND Indolent T-cell lymphoma of the gastrointestinal tract(iTCL-GI)is a rare mature T-cell lymphoma that has been formally recognized as a distinct entity in the 5th Edition World Health Organization Classifica...BACKGROUND Indolent T-cell lymphoma of the gastrointestinal tract(iTCL-GI)is a rare mature T-cell lymphoma that has been formally recognized as a distinct entity in the 5th Edition World Health Organization Classification of Tumours of Haematolymphoid Tumours.However,the coexistence of iTCL-GI with epithelial malignancies is rare in clinical practice.This study reports a case of iTCL-GI with gastric signet-ring cell carcinoma(SRCC).We aim to increase diagnostic awareness among clinicians and pathologists regarding multiple primary tumors.CASE SUMMARY A 65-year-old female presented with a 5-month history of lower abdominal pain,bloating,and vomiting.An abdominal computed tomography scan revealed irregular thickening of the gastric wall.Endoscopy revealed diffuse mucosal edema and rigid mucosa along the lesser curvature of the gastric body.There was a 1.5 cm mucosal protrusion on the greater curvature.Biopsy revealed that the lamina propria was expanded by a dense,nondestructive infiltrate of small lymphocytes in the greater curvature,which were characterized by a CD3+/CD8+/TIA-1+immunophenotype with a low Ki-67 index.Clonal T-cell receptor rearrangement was detected,but the Epstein-Barr virus encoded RNA's was negative.Lesions on the lesser curvature of the gastric body were confirmed to be SRCCs.After three months of follow-up,the patient completed four cycles of chemotherapy targeting the SRCC.While her abdominal pain improved,she experienced a weight loss of 5 kg.CONCLUSION Clinicians and pathologists must integrate assessment of these rare cases to prevent misdiagnosis and guide clinical practice.展开更多
Objective:This study aimed to investigate the epidemiological characteristics and treatment regimens of non-Hodgkin lymphoma(NHL)in China through a retrospective analysis of 9,064 NHL cases.Methods:Clinical data of 9,...Objective:This study aimed to investigate the epidemiological characteristics and treatment regimens of non-Hodgkin lymphoma(NHL)in China through a retrospective analysis of 9,064 NHL cases.Methods:Clinical data of 9,064 patients were collected from 555 hospitals in 28 provinces of China.Results:Among 9,064 NHL patients,there were 5,241 males(57.8%)and 3,823 females(42.2%),with a male-to-female ratio of 1.37:1.Patients aged≥45 years accounted for 89.6%,with a mean age of 61.87±13.30 years.The predominant NHL subtypes were diffuse large B-cell lymphoma(DLBCL,45.2%),chronic lymphocytic leukemia/small lymphocytic lymphoma(CLL/SLL,19.8%),marginal zone lymphoma(MZL,13.9%),mantle cell lymphoma(MCL,9.7%),and central nervous system lymphoma(CNSL,4.3%).Combination therapy served as the primary treatment modality across all NHL subtypes.Conclusions:NHL in China demonstrates male predominance and primarily affects middle-aged and elderly populations,with combination chemotherapy remaining the mainstay therapeutic approach.展开更多
文摘Hodgkin lymphoma(HL)is a heterogenous lymphoproliferative disorder of B-cell origin and represents one of the most common malignancies in children and young adults.In addition to well-known underlying factors-such as Epstein-Barr virus infection-the familial aggregation demonstrated in large population studies suggested a genetic predisposition.First-degree relatives of patients with HL have an approximately threefold increased risk of developing the disease compared to the general population.These observations have recently prompted several whole-genome studies in affected families,identifying variants possibly implicated in lymphomagenesis,including alterations in DICER1(a member of the ribonuclease III family),POT1(protection of telomeres 1),KDR(kinase insert domain receptor),KLHDC8B(kelch domain-containing protein 8B),PAX5(paired box protein 5),GATA3(GATA binding protein 3),IRF7(interferon regulatory factor 7),EEF2KMT(eukaryotic elongation factor 2 lysine methyltransferase),and POLR1E(RNA polymerase I subunit E).In this article,we review current insights into the etiopathogenesis and risks of familial HL,and present case reports involving two sisters diagnosed with HL nearly 17 years apart.Recognizing the risk for first-degree relatives may potentially increase awareness of early symptoms among family members of HL patients,leading to earlier diagnosis and better outcomes.Conversely,understanding that the hereditary risk,though higher than in the general population,remains relatively low may provide reassurance for affected families.
基金Supported by the Faculty of Medicine,Prince of Songkla University.Wainipitapong S has received grants from the Faculty of Medicine,Prince of Songkla University。
文摘AIM:To investigate the clinical characteristics and treatment outcomes,including visual function and overall survival(OS)of patients with ocular adnexal diffuse large B-cell lymphoma(OA-DLBCL).METHODS:This retrospective cohort study enrolled 29 patients diagnosed with OA-DLBCL based on histopathological biopsy between 2006 and 2023.Patients were stratified into two subgroups:primary OA-DLBCL(no prior history of lymphoma)and secondary OA-DLBCL(history of DLBCL at non-ocular adnexal sites).OS was defined as the time interval from OA-DLBCL diagnosis to death from any cause.Survival analysis was performed using the Kaplan–Meier method,and prognostic factors affecting OS were identified using multivariate Cox proportional hazards regression with a stepwise selection approach.RESULTS:The cohort included 24 patients with primary OA-DLBCL(13 males,11 females;mean age:61.36±18.29y)and 5 patients with secondary OA-DLBCL(2 males,3 females;mean age:50.94±18.17y).Among the primary OA-DLBCL subgroup,12 patients(50%)presented with advanced disease(Ann Arbor stage IIIE–IV),and 16 patients(66%)were classified as T4 disease according to the tumor-node-metastasis(TNM)staging system.The mean final visual acuity was 1.72±1.10 in the primary group and 0.90±1.18 in the secondary group.The 5-year OS rate for the entire cohort was 27.7%.Multivariate analysis identified five factors significantly associated with poor survival outcomes:epiphora[adjusted hazard ratio(aHR),36.95],atherosclerotic cardiovascular disease(aHR,10.08),human immunodeficiency virus(HIV)infection(aHR,12.47),M1 stage(aHR,6.99),and secondary OA-DLBCL(aHR,6.03;all P<0.05).The median OS was 1.68y for primary OA-DLBCL and 1.12y for secondary OA-DLBCL.CONCLUSION:A substantial proportion of patients with primary OA-DLBCL present with advanced-stage disease at diagnosis.Epiphora,atherosclerotic cardiovascular disease,HIV infection,M1 stage,and secondary OA-DLBCL are independent prognostic factors for poor survival outcomes.These findings emphasize the urgent need for optimized therapeutic strategies and early screening protocols to improve the management of OA-DLBCL,particularly in developing countries.
基金supported by the Key Research and Development Program of Science and Technology Department of Guizhou Province(No.20204Y147).
文摘Background:The prognostic significance of the chemokine receptor CCR7 in diffuse large B-cell lymphoma(DLBCL)has been reported previously.However,the detailed mechanisms of CCR7 in DLBCL,particularly regarding its interaction with lenalidomide treatment,are not fully understood.Methods:Our study utilized bioinformatics approaches to identify hub genes in SU-DHL-2 cell lines treated with lenalidomide compared to control groups.Immunohistochemical data and clinical information from 122 patients with DLBCL were analyzed to assess the correlation of CCR7 and p-ERK1/2 expression with the prognosis of DLBCL.Furthermore,in vitro and in vivo experiments were conducted to clarify the role of CCR7 in the response of DLBCL to lenalidomide treatment.Results:Our bioinformatics analysis pinpointed CCR7 as a hub gene in the context of lenalidomide treatment in DLBCL.Notably,31.14%and 36.0%(44/122)of DLBCL cases showed positive expression for CCR7 and ERK1/2 respectively,establishing them as independent prognostic factors for adverse outcomes in DLBCL via multivariate Cox regression analysis.Additionally,our studies demonstrated that the external application of the protein CCL21 promoted proliferation,migration,invasion,and activation of the ERK1/2 pathway in SU-DHL-2 and OCI-LY3 cell lines with high levels of CCR7 expression.This effect was mitigated by CCR7 silencing through siRNA,application of ERK inhibitors,or lenalidomide treatment.In vivo experiments reinforced the efficacy of lenalidomide,significantly reducing tumor growth rate,tumor mass,serum total LDH levels,and expression of CCR7 and p-ERK1/2 in a SUDHL-2 xenograft model in nude mice(p<0.05).Conclusion:Our study clarifies the potential role of the CCL21/CCR7/ERK1/2 axis in the therapeutic effects of lenalidomide in DLBCL treatment.
基金Supported by the Department of Science and Technology of Sichuan Province,No.2023NSFSC0724.
文摘BACKGROUND Mantle cell lymphoma(MCL)is an aggressive B-cell non-Hodgkin lymphoma that rarely presents with cutaneous involvement,which typically occurs in advanced disease stages.Primary cutaneous manifestations are particularly uncommon and frequently misdiagnosed.We report a diagnostically challenging case of MCL that first appeared as a nodule on the lower leg.CASE SUMMARY An elderly female had a painless red nodule on the front of her right lower leg for six months.Positron emission tomography-computed tomography showed a soft tissue mass at the same site and increased activity in the right groin lymph nodes.Skin and lymph node biopsies,along with immunostaining,confirmed MCL.The patient began combination chemotherapy,resulting in a marked improvement of skin lesions and lymphadenopathy after two weeks.CONCLUSION Cutaneous manifestations,though uncommon,may serve as the initial clinical presentation of MCL.Dermatologists and pathologists should maintain heigh-tened awareness of this diagnostic possibility when evaluating persistent,atypical cutaneous nodules,particularly in elderly patients.Histopathological evaluation with complete immunophenotypic profiling is paramount for accurate diagnosis.
文摘BACKGROUND The concept of“duodenal-type follicular lymphoma(FL)”has already been established as a disease entity.On the other hand,because FL that develops in the colorectum is a rare disease,its clinical characteristics,including its treatment and outcome,are poorly understood.AIM To clarify the characteristic clinical features of colorectal FL.METHODS We identified 5 patients with FL from December 2010 to July 2022 whose colorectal lesions were confirmed by endoscopic biopsy at our hospital and retrospectively examined their clinical features,including endoscopic findings,treatment,and long-term outcomes.RESULTS The median age of the patients was 70 years(range 62-74 years,3 males and 2 females),and 2 patients were considered to have systemic FL lesions.Endoscopic findings revealed elavated lesions in all 5 patients(polypoid 3,flat elavated 1,papular 1).Only 1 patient underwent therapeutic intervention,and 4 patients chose watchful waiting.Except for 1 patient in which the lesion spontaneously regressed,the disease recurred or progressed in 4 patients,3 of whom eventually achieved near complete remission with the administration of rituximab and bendamustine(±polatuzumab vedotin).The 5 patients in this study were still alive or exhibited long-term survival before death;the survival time ranged from 8-29 years after the onset of lymphoma.CONCLUSION In the present study,colorectal FL progressed slowly,and overall survival was good because it was sensitive to anticancer drugs even after the disease progressed without initial therapeutic intervention.
文摘BACKGROUND Primary cardiac lymphoma(PCL)is a rare subset of cardiac tumors,often diagnosed late due to nonspecific symptoms.It predominantly affects immunocompromised individuals,primarily in the pericardium and right heart.Late diagnosis mimics common cardiac ailments,leading to poor prognosis.AIM To systematically review the efficacy of rituximab in treating PCL either alone or in various chemotherapeutic regimens.Secondary objectives include evaluating morphological subtypes,assessing treatment regimens,and analyzing outcomes focusing on remission and adverse events.METHODS Following PRISMA guidelines,a comprehensive literature search was conducted across multiple databases,including PubMed,Hinari,Web of Science,and Scopus.English-language studies reporting the use of rituximab in treating PCL in humans were included.Study selection involved initial screening of titles and abstracts followed by full-text examination and data extraction.RESULTS Thirty-three case reports involving 36 patients were included in this systematic review.Diffuse large B-cell lymphoma was the predominant morphological subtype observed.The rituximab,cyclophosphamide,doxorubicin,oncovin,and prednisolone regimen emerged as the most commonly employed treatment strategy,indicating widespread acceptance and efficacy in PCL management.Combination therapies,including surgical intervention,showed promise in achieving complete remission,while some studies reported mortality despite aggressive treatment approaches.CONCLUSION Rituximab,particularly in combination with chemotherapy regimens,represents a significant advancement in PCL management,offering hope for improved patient outcomes.However,challenges such as variable treatment responses and adverse events underscore the complexity of managing PCL.Further research is warranted to refine therapeutic strategies and enhance diagnostic approaches for this rare cardiac malignancy.
文摘BACKGROUND T/histiocyte-rich large B-cell lymphoma(T/HRBCL)is a highly aggressive subtype of diffuse large B-cell lymphoma characterized histologically by the presence of a few neoplastic large B cells amidst an abundant background of reactive T lymphocytes and/or histiocytes.T/HRBCL commonly affects the lymph nodes,followed by extranodal sites,such as the spleen,liver,and bone marrow,with rare occurrences in the gastrointestinal tract.Primary gastrointestinal T/HRBCL lacks specific clinical and endoscopic manifestations,and it is difficult to differentiate from inflammatory diseases,nodular lymphocyte predominant Hodgkin lymphoma,and other diseases on a histological basis,thereby hindering early diagnosis.CASE SUMMARY A 63-year-old man was hospitalized with a one-month history of jaundice and weight loss of approximately 3 kg.Laboratory tests revealed increased hepatic parameters in a cholestatic pattern and elevated carbohydrate antigen 19-9 levels.An abdominal computed tomography scan revealed a low-density mass within the descending duodenum and dilation of the bile and pancreatic ducts.He was clinically diagnosed with a duodenal tumor.During surgery,a 7.0 cm×8.0 cm mass was identified within the descending duodenum,so pancreaticoduodenectomy and cholecystectomy were performed.Following operative biopsy,the tumor was diagnosed as primary duodenal T/HRBCL.The patient refused postoperative chemotherapy and died four months after surgery.CONCLUSION Primary duodenal T/HRBCL is an extremely rare and highly aggressive malignancy.The initial treatment strategies should be based on the original site of the tumor,the disease stage,and the patient's physical condition.Chemotherapy-based comprehensive treatment is still the main treatment method for primary gastrointestinal T/HRBCL.
基金supported by grants from the Jinling Hospital Affiliated to Medical School of Nanjing University(2023LCZLXB055).
文摘Background:Primary bone marrow diffuse large B-cell lymphoma(PBM-DLBCL)represents an uncommon yet clinically aggressive hematologic malignancy.Despite its significant clinical impact,this entity lacks standardized diagnostic criteria in current WHO classifications.Methods:We performed a retrospective analysis of 55 PBM-DLBCL cases from our institutional database and published literature(2001–2022)to characterize disease features and identify prognostic factors,with particular focus on assessing how different treatment regimens influence therapeutic efficacy and long-term outcomes.Results:The data suggested a potential link between international prognostic index(IPI)scores and poorer survival,albeit without conclusive statistical evidence(p 0.05).Treatment=response emerged as a significant prognostic factor,and patients with complete response(CR)demonstrating superior survival in Cox univariate and multivariate analysis(p 0.001).Intensive therapeutic regimens were associated with<improved clinical outcomes compared to conventional therapies.While incorporating rituximab into conventional chemotherapy regimens has demonstrated superior clinical outcomes compared to chemotherapy alone in PBM-DLBCL patients.Conclusion:Our findings highlight the aggressive nature of PBM-DLBCL and underscore the importance of early recognition,risk stratification,and optimized treatment selection for this rare disease entity.
基金supported by the Sponsored by Tianjin Health Research Project(Grant No.TJWJ2023ZD003)the Chinese Society of Clinical Oncology Beijing Xisike Clinical Oncology Research Foundation(Grant Nos.Y-NCJH202201-0027 and Y-2022YMJN/MS-0001).
文摘Because human immunodeficiency virus(HIV)-associated Burkitt lymphoma(BL)has a poor prognosis new therapeutic approaches need to be developed1.Axicabtagene ciloleucel(axi-cel)is an anti-CD19 CAR-T cell commercially available FDA-approved product for patients with relapsed or refractory(R/R)large B-cell lymphoma(LBCL).However,axi-cel has not been approved by the FDA for use in patients with R/R BL.
文摘BACKGROUND Mucosa-associated lymphoid tissue(MALT)lymphoma is a subtype of extranodal marginal zone lymphoma,typically occurring in mucosal sites such as the stomach,salivary glands,and lungs.This study aims to analyze the demographic and clinicopathologic characteristics of patients with gastric MALT lymphoma in the United States and evaluate the interaction between age and gender on survival outcomes.AIM To analyze the demographic and clinicopathologic characteristics of patients with gastric MALT lymphoma in the United States and evaluate the interaction between age and gender on survival outcomes.METHODS A retrospective cohort study was conducted using the Surveillance,Epidemiology,and End Results(SEER)database,which included 2453 patients diagnosed with MALT lymphoma from 2010 to 2021.Data were analyzed for demographic factors,tumor characteristics,treatment modalities,and survival outcomes.A Cox proportional hazards regression model was used to identify predictors of overall mortality and cancer-specific mortality.RESULTS The study predominantly included Non-Hispanic White patients(62.78%),with nearly equal gender distribution(50.31%females,49.69%males),and most diagnoses occurring in individuals aged 60-79 years.The majority of tumors were localized(80.07%).Multivariate analysis identified older age,male gender,advanced tumor stage,and socioeconomic factors—such as annual income and marital status—as independent predictors of mortality.No significant interaction between age and gender on mortality outcomes was observed.CONCLUSION Sociodemographic factors,including advanced age,male gender,annual income,and marital status,as well as advanced tumor stage,significantly impacted survival outcomes in patients with MALT lymphoma.Radiotherapy was associated with a reduction in overall mortality.Early detection is crucial for optimizing outcomes,as localized disease responds well to available treatment modalities.
文摘BACKGROUND Primary testicular lymphoma(PTL)is a rare,aggressive malignancy,representing a small fraction of testicular tumors and non-Hodgkin lymphomas,yet it is the most common testicular malignancy in older men.Diffuse large B-cell lymphoma(DLBCL),which is typically the aggressive subtype,dominates PTL and shows diffuse B-cell infiltration.Venous tumor thrombus,uncommon in lymphomas,is uniquely reported in this case of testicular DLBCL with gonadal vein involvement.CASE SUMMARY A 62-year-old man presented with a two-month history of painless left testicular swelling and stiffness.Diagnostic imaging[ultrasonography,computed tomography(CT),and 18F-fluorodeoxyglucose positron emission tomography/CT(18FFDG-PET/CT)]revealed bilateral testicular masses and a gonadal vein tumor thrombus(SUVmax 16.5).Left orchiectomy confirmed DLBCL with CD20,Bcl-2,and MUM1 positivity(Ki-67:approximately 80%).The disease was staged as Ann Arbor stage IVA(International Prognostic Index score 3,high-intermediate risk).The patient received Rituximab,Polatuzumab Vedotin,Cyclophosphamide,Epirubicin,and Prednisolone chemotherapy,completing the first cycle with good tolerability.No adverse events were reported,and follow-up is ongoing to assess long-term outcomes.This case highlights the diagnostic utility of 18F-FDGPET/CT and the importance of multidisciplinary management in rare PTL presentations with tumor thrombus.CONCLUSION This case demonstrates the diagnostic complexities of PTL with gonadal vein tumor thrombus,underscoring the importance of considering lymphoma in elderly patients with testicular masses and venous involvement.A multi-disciplinary team including urologists,hematologists,and radiation oncologists is needed to ensure appropriate therapy.
基金Supported by the Fujian Province Science and Technology Innovation Joint Fund Project,No.2021Y9188。
文摘BACKGROUND Childhood intestinal lymphoma is characterized by its insidious onset and the absence of specific clinical symptoms.The thinner abdominal wall in children significantly aids in the ultrasound visualization of the abdominal cavity and intestines.Although many typical cases of intestinal lymphoma can be diagnosed through ultrasound,physicians often either overlook these values or assume that ultrasound has limited diagnostic value for intestinal lymphoma.AIM To clarify the diagnosis of intestinal lymphoma and classify its severity using ultrasound,as well as to correlate this with prognosis.METHODS The correlation between ultrasound diagnostic outcomes,laboratory indicators,and clinical prognosis was analyzed to demonstrate the effectiveness of ultrasound in assessing the severity of intestinal lymphoma and to provide new evidence for the diagnosis and treatment of the disease in children.A retro-spective analysis was conducted on the sonographic images and case data of 28 children diagnosed with intestinal lymphoma and confirmed by surgical pathology.Additionally,we sought to determine the correlation between ultrasonic classification of lymphoma,lactate dehydrogenase(LDH)values,pathological classification,and prognosis.RESULTS Ultrasound was utilized to categorize 28 cases of intestinal lymphoma into focal segmental(15 cases)and extensive(13 cases)types.Ultrasound classification and LDH levels were significantly correlated with prognosis(P<0.05),while pathological type,age,gender,and treatment modality showed no significant correlation(P>0.05).Among ultrasound manifestations,there was a significant difference in LDH levels between the segmental and extensive groups(P<0.05).The prognosis for children with extensive intestinal lymphoma was poorer than that for children with localized segmental intestinal lymphoma(P<0.05).CONCLUSION Ultrasound can be used in the diagnosis and classification of intestinal lymphoma in children.Extensive intestinal lymphoma is associated with significantly elevated LDH and poor prognosis.
基金supported by grants from the Science Technology Department of Zhejiang Province(Grant No.2021C03117)Noncommunicable Chronic DiseasesNational Science and Technology Major Project(Grant No.2023ZD0501300)+1 种基金National Natural Science Foundation of China(Grant No.82170219)Zhejiang Provincial Natural Science Foundation of China(Grant No.LQ24H080009)。
文摘Chimeric antigen receptor-T(CAR-T)cell therapy is a precise immunotherapy for lymphoma.However,its long-term efficacy faces many challenges related to tumor cell heterogeneity,interference from immunosuppressive microenvironments,CAR-T cell exhaustion,and unmanageable adverse events.Diverse modifications have been introduced into conventional CAR-T cells to overcome these obstacles;examples include addition of recognition sites to prevent immune escape,coupling of cytokine domains to enhance killing ability,blocking of immune checkpoint signals to resist tumor microenvironments,and inclusion of suicide systems or safety switches to improve safety and flexibility.With increasing understanding of the importance of metabolism and epigenetics in cancer and cytotherapy,glycolysis,methylation,and acetylation have become crucial CAR-T cell therapeutic targets.Universal and in situ CAR-T cells are also expected to be used in clinical applications,thus providing hope to patients with relapsed/refractory lymphomas.
基金supported by the"Double First-Class"University Project(No.CPU2018GY34).
文摘(+)-Strebloside,a significant bioactive compound isolated from the roots of Streblus asper Lour.,demonstrates inhibitory effects against multiple malignancies.However,its specific function and underlying mechanistic pathways in Non-Hodgkin lymphoma(NHL)remain unexplored.This investigation sought to elucidate the role and potential mechanisms of(+)-strebloside-induced NHL cell death.The results demonstrated that(+)-strebloside significantly induced apoptosis and ferroptosis in NHL cells,including those from Raji cell-derived xenograft models.Mechanistic analyses revealed that(+)-strebloside enhanced six-transmembrane epithelial antigen of prostate 3(STEAP3)-induced ferroptosis in NHL,and STEAP3 inhibition reduced the proliferation-inhibitory effects of(+)-strebloside.Furthermore,(+)-strebloside suppressed NHL proliferation through the mitogen-activated protein kinase(MAPK)pathway,and extracellular signal-regulated kinase(ERK)inhibition diminished the proliferation-inhibitory activity induced by(+)-strebloside.These findings indicate that(+)-strebloside presents promising therapeutic potential for NHL treatment.
基金supported by the Postgraduate Supervision Fund within the School of Nursing at Fujian Medical University(No.110013)。
文摘Objectives:This study aimed to generate a theoretical framework based on empirical data to explain the behavioral patterns closely related to young and middle-aged patients with lymphoma throughout the disease.Methods:This study followed the classic grounded theory methodology,involving procedures such as theoretical sampling,substantive coding,theoretical coding,constant comparison,and memo writing and sorting.Multiple data types were used based on the principle of“all is data,”including 34 participants providing interview data along with observation notes and 40 relevant secondary texts from the“Lymphoma House”network platform and the“Lymphoma House 086”public account.Two autobiographical books written by lymphoma patients were also selected as data resources.Data collection and analysis were conducted in an iterative process until theoretical saturation was reached.The COREQ checklist was followed to report this study.Results:The main concern of middle-aged and young patients with lymphoma was identifiedas restoring normality,while managing uncertainty was the main behavioral pattern for restoring normality.Uncertainty consists of two interrelated types:inherent uncertainty of illness and perceived uncertainty of patients.Four strategies are used to manage uncertainty:reconstructing certainty,adaptive coping,defensive buffering,and compensatory changing.Managing uncertainty is influenced by disease characteristics and perceptions,social resources,and cultural concepts.The consequence of managing uncertainty is reaching a new normality.Conclusions:Pervasive uncertainty significantly affects the daily lives of young and middle-aged patients with lymphoma.Consequently,strategies for managing disease-related uncertainty to sustain normality are commonly observed in this population.This theoretical framework for addressing uncertainty can serve as a foundation for understanding and developing tailored interventions to manage uncertainty.Future research should focus on managing uncertainty to help patients restore normality.
文摘BACKGROUND The primary lymphomas of mucosa associated lymphoid tissue(MALT)of the gallbladder(GB)is an extremely rare of non-Hodgkin lymphoma.Many patients exhibit symptoms like gallstone disease,and in some cases,the lymphoma may be detected through imaging even without apparent symptoms.Only 19 cases of primary MALT lymphoma in the GB have been previously reported.Differential diagnosis from typical GB carcinoma based solely on imaging findings can be challenging,and definitive diagnosis often requires surgical intervention.CASE SUMMARY We present a patient in an 82-year-old man who was initially diagnosed with prostate cancer but incidentally detected GB wall thickening from magnetic resonance imaging conducted for prostatic surgery and subsequent radical cholecystectomy revealed primary MALT lymphoma of the GB.The patient was followed up by a medical oncologist,and after discussion,the decision was made to continue observation with close monitoring without systemic chemotherapy given the asymptomatic presentation.The patient has been free of recurrence for 16 months after the surgery.Although precise diagnosis before the surgery was difficult in this case,preoperative examinations revealed a submucosal tumor-like lesion.CONCLUSION MALT lymphoma of GB remains little known in many previous studies.It is really difficult to preoperatively diagnose.The combination of clinical presentation,postoperative histology and immunohistochemistry contribute to diagnosis and carry out appropriate management.
基金supported by grants from the National Natural Science Foundation of China(Grant Nos.82200215,82170193,and 82370197)the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(Grant No.2022-I2M-1-002)。
文摘Objective:Our previous studies have indicated potentially higher proliferative activity of tumor cells in Chinese patients with mantle-cell lymphoma(MCL)than those in Western.Given the success and tolerability of R-DA-EDOCH immunochemotherapy in treating aggressive B-cell lymphomas,we designed a prospective,phase 3 trial to explore the efficacy and safety of alternating R-DA-EDOCH/R-DHAP induction therapy for young patients with newly diagnosed MCL.The primary endpoint was the complete remission rate(CRR)at the end of induction(EOI).Methods:A total of 55 patients were enrolled.The CRR at the EOI was 89.1%[95%confidence interval(CI)78%±96%],and the overall response rate was 98.1%(95%CI 90%±100%).Most patients with bone marrow involvement quickly attained minimal residual disease(MRD)negative status,with a 95.7%rate at the EOI.Results:The 3-year progression-free survival(PFS)and overall survival rates were 66.3%and 83.2%,respectively.No patients discontinued treatment because of adverse events.Univariate analysis identified pathologic morphology and TP53 mutations as risk factors for PFS.However,high tumor proliferative activity and certain cytogenetic abnormalities showed no significant adverse prognostic significance.Conclusions:Intensive therapy based on a high cytarabine dose and continuously administered EDOCH achieved a high MRDnegative rate and provides an optional induction choice for young patients with MCL with high-risk factors.
文摘INTRODUCTION Pulmonary hypertension(PH)is a complex syndrome arising from diverse underlying conditions and characterized by elevated pulmonary arterial pressure.Current clinical guidelines classify PH into five categories based on pathophysiology,clinical presentation,and hemodynamic characteristics.
基金Supported by Key Disciplines of The Sixth Cycle of Tongji Hospital,No.ZDTS24-BLShanghai Municipal Science and Technology Commission 2021"Science and Technology Innovation Action Plan"Medical Innovation Research Project,No.21Y11908800Clinical Research Project of Tongji Hospital of Tongji University,No.ITJ(ZD)2206.
文摘BACKGROUND Indolent T-cell lymphoma of the gastrointestinal tract(iTCL-GI)is a rare mature T-cell lymphoma that has been formally recognized as a distinct entity in the 5th Edition World Health Organization Classification of Tumours of Haematolymphoid Tumours.However,the coexistence of iTCL-GI with epithelial malignancies is rare in clinical practice.This study reports a case of iTCL-GI with gastric signet-ring cell carcinoma(SRCC).We aim to increase diagnostic awareness among clinicians and pathologists regarding multiple primary tumors.CASE SUMMARY A 65-year-old female presented with a 5-month history of lower abdominal pain,bloating,and vomiting.An abdominal computed tomography scan revealed irregular thickening of the gastric wall.Endoscopy revealed diffuse mucosal edema and rigid mucosa along the lesser curvature of the gastric body.There was a 1.5 cm mucosal protrusion on the greater curvature.Biopsy revealed that the lamina propria was expanded by a dense,nondestructive infiltrate of small lymphocytes in the greater curvature,which were characterized by a CD3+/CD8+/TIA-1+immunophenotype with a low Ki-67 index.Clonal T-cell receptor rearrangement was detected,but the Epstein-Barr virus encoded RNA's was negative.Lesions on the lesser curvature of the gastric body were confirmed to be SRCCs.After three months of follow-up,the patient completed four cycles of chemotherapy targeting the SRCC.While her abdominal pain improved,she experienced a weight loss of 5 kg.CONCLUSION Clinicians and pathologists must integrate assessment of these rare cases to prevent misdiagnosis and guide clinical practice.
文摘Objective:This study aimed to investigate the epidemiological characteristics and treatment regimens of non-Hodgkin lymphoma(NHL)in China through a retrospective analysis of 9,064 NHL cases.Methods:Clinical data of 9,064 patients were collected from 555 hospitals in 28 provinces of China.Results:Among 9,064 NHL patients,there were 5,241 males(57.8%)and 3,823 females(42.2%),with a male-to-female ratio of 1.37:1.Patients aged≥45 years accounted for 89.6%,with a mean age of 61.87±13.30 years.The predominant NHL subtypes were diffuse large B-cell lymphoma(DLBCL,45.2%),chronic lymphocytic leukemia/small lymphocytic lymphoma(CLL/SLL,19.8%),marginal zone lymphoma(MZL,13.9%),mantle cell lymphoma(MCL,9.7%),and central nervous system lymphoma(CNSL,4.3%).Combination therapy served as the primary treatment modality across all NHL subtypes.Conclusions:NHL in China demonstrates male predominance and primarily affects middle-aged and elderly populations,with combination chemotherapy remaining the mainstay therapeutic approach.
