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A Cohort Study of the Prognostic Impact of Exon-16 EZH2 Mutations in a Mexican-Mestizo Population of Patients with Diffuse Large B-Cell Lymphoma
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Oñate-Ocaña, Luis F.

; Ponce-Martínez, Mayra

; Taja-Chayeb, Lucia

; Gutiérrez-Hernández, Olga

; Avilés-Salas, Alejandro

; Cantú-de-León, David

; Dueñas-González, Alfonso

; Candelaria-Hernández, Myrna

Revista de investigación clínica

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Dez 2021, Volume 73 Nº 6 Páginas 362 - 370

Resumo: En | Texto: En | PDF: En

ABSTRACT Background: Novel prognostic factors in patients with diffuse large B-cell lymphoma (DLBCL) are required in the era of Rituximab. Objective: The objective of the study was to study the prognostic impact of exon-16 enhancer-of-zeste homolog-2 (EZH2) mutations in patients with DLBCL. Methods: In a cohort of patients with DLBCL treated between 2015 and 2017, we analyzed the presence of EZH2 mutations and their association with clinical response (CR), relapse, progression-free survival (PFS), and overall survival (OS). Results: A total of 198 patients were included; of them, 30 (15.2%) had mutations at codon 641, in exon 16 of EZH2. Response was achieved in 151 patients (76.3%), and 43 (21.7%) relapsed or progressed during follow-up. EZH2 mutations were associated with relapse/progression (risk ratio [RR] 1.18; 95% confidence interval [CI] 0.98–1.42; p = 0.031), while a trend for not achieving a complete response was observed (RR: 0.876; 95%CI 0.74–1.038; p = 0.071). Of note, Tyr641His and Tyr641Ser EZH2 mutations were associated with shorter PFS (hazard ratio 3.234; 95% CI 1.149–9.1; p = 0.026). Conclusion: The presence of EZH2 mutations was negatively associated with relapse/progression and showed a trend for lack of complete response. Further studies are needed to define better the prognostic significance of these mutations in Mexican-Mestizo DLBCL patients.

https://doi.org/10.24875/ric.21000070 8 downloads

Central Nervous System International Prognostic Index Impacts Overall Survival in Diffuse Large B-cell Lymphoma Treated with R-Chop in a third Level Cancer Center from Mexico: A Survey of 642 Patients
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Solís-Armenta, Rubén

; Cacho-Díaz, Bernardo

; Gutiérrez-Hernández, Olga

; Candelaria-Hernández, Myrna

Revista de investigación clínica

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Ago 2021, Volume 73 Nº 4 Páginas 231 - 237

Resumo: En | Texto: En | PDF: En

Background: Central nervous system international prognosis index (CNS-IPI) is validated in European and the USA cancer databases. However, no validation has been done in Mexican population. Objective: The objective of the study was to assess the impact of the CNS-IPI on central nervous system (CNS) relapse and survival in Mexican patients with diffuse large B-cell lymphoma (DLBCL). Methods: In this retrospective analysis, clinical, biochemical, and histological variables and the CNS-IPI were analyzed. Results: Six hundred and forty-two patients with DBLCL were included in the study. The mean ± SD age was 56.8 ± 14.9 years. Most had an ECOG of 0-1: 75% (n = 484) had absence of B-symptoms and advanced disease (clinical stage: III-IV, n = 433, 67.4%). According to the CNS-IPI, almost one-half were in the low-risk category. According to the CNS-IPI, CNS relapse rate was 1.36% (95% CI: 83.2-92.8), 3.1% (95% CI: 132.4-162.8), and 7.4% (95% CI 61-91) for patients in the low-, intermediate-, and high-risk categories, respectively. The median overall survival in the high-risk group (CNS-IPI) was 22 months, and it has not been achieved after 80 months of follow-up for the other groups. Conclusions: CNS-IPI was associated with survival; therefore, we propose its use as a prognostic tool for prospective validation.

https://doi.org/10.24875/ric.21000010 105 downloads

Primary myocardial diffuse large B cell lymphoma. Report of one case
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Rubalcava Lara, Luis F.

; Aviles-Salas, Alejandro

; Candelaria, Myrna

Revista médica de Chile

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Ago 2021, Volume 149 Nº 8 Páginas 1231 - 1235

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

ABSTRACT Primary myocardial involvement of Diffuse Large B-Cell lymphoma is extremely rare, accounting for 0.5 % of all lymphomas. We report a 65-year-old male, presenting with an acute cardiac tamponade, which was drained. A pericardial window with myocardial biopsy was carried out, disclosing a diffuse large B cell lymphoma. He received 6 cycles of rituximab, cyclophosphamide, vincristine, and prednisone (R-CVP), without response. Finally, a palliative chemotherapy with gemcitabine plus oxaliplatin was prescribed.

El linfoma difuso de células grandes B, primario del miocardio es muy raro. Presentamos un varón de 65 años que se presentó con un taponamiento cardíaco agudo que fue drenado. La biopsia miocárdica un mostró linfoma difuso de células grandes B, primario de miocardio. El paciente recibió 6 ciclos de quimioterapia con rituximab, ciclofosfamida, vincristina y prednisona sin respuesta. Finalmente se optó por una quimioterapia paliativa con gemcitabina y oxaliplatino.

https://doi.org/10.4067/s0034-98872021000801231 24 downloads

18f-Fluorodeoxyglucose Positron Emission Tomography Versus Bone Marrow Biopsy for the Evaluation of Bone Marrow Infiltration in Newly Diagnosed Lymphoma Patients
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Aguado-Vázquez, Tania M.

; Olivas-Martínez, Antonio

; Cancino-Ramos, Uvi

; Zúüiga-Tamayo, Diego A.

; Lome-Maldonado, María del C. A.

; Rivas-Vera, Silvia

; García-Pérez, Francisco O.

; Candelaria-Hernández, Myrna G.

Revista de investigación clínica

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Abr 2021, Volume 73 Nº 2 Páginas 79 - 86

Resumo: En | Texto: En | PDF: En

ABSTRACT Background: Bone marrow evaluation (BME) is crucial for establishing an accurate staging and prognosis in lymphoma patients. Objective: The objective of the study was to study the diagnostic performance of 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) against bone marrow biopsy (BMB) for BME. Methods: Five hundred patient files of newly diagnosed lymphoma patients treated at an academic medical center were reviewed for BME at diagnosis by BMB and FDG PET-CT. Diagnostic performance of FDG PET-CT for detecting bone marrow infiltration (BMI) was assessed, as well as clinical predictors for positive BMB and positive FDG PET-CT. Results: BMB was positive in 16.3% of all patients, and 28.7% had a positive FDG PET-CT for BMI. Overall, the sensitivity of FDG PET-CT was 74.1% and specificity 80.1%. As for predictors for BMB and FDG PET-CT positivity, B symptoms and thrombocytopenia were independent factors for BMI. Seventy-four patients had discordant results between BMB and FDG PET-CT, non-Hodgkin lymphoma (NHL) having the most significant discordance. This discrepancy did not affect treatment. Conclusions: FDG PET-CT shows excellent performance for the detection of BMI in Hodgkin lymphoma. For diffuse large B-cell lymphoma, we recommend performing BMB and FDG PET-CT as complementary tests. In all other NHL, a unilateral BMB is mandatory at diagnosis.

https://doi.org/10.24875/ric.20000239 142 downloads

Late-Onset Hematological Toxicity (LOHT) in Patients with B-Cell Lymphomas: A Survey in 758 Cases
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Palacios-Campos, Adriana

; Dueüas-González, Alfonso

; Gutiérrez-Hernández, Olga

; Candelaria-Hernández, Myrna

Revista de investigación clínica

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Abr 2021, Volume 73 Nº 2 Páginas 72 - 78

Resumo: En | Texto: En | PDF: En

ABSTRACT Background: The increasing survival of patients with non-Hodgkin lymphoma has allowed the diagnosis of long-term complications, including late-onset hematological toxicity (LOHT), transitory cytopenias, or therapy-related myeloid neoplasm (t-MDS/t-AML). Objective: The objective of the study was to determine the frequency and clinical evolution of LOHT in patients with lymphoproliferative malignancies. Materials and Methods: Two cohorts of patients B-cell lymphomas were reviewed. Patients who achieved full hematologic recovery at the end of treatment, and thereafter developed any degree of cytopenia were included in the study. Clinical and biochemical parameters were compared between patients with and without cytopenias with X2 test. Bi- and multivariate analyses were performed to evaluate factors associated with the development of late-onset cytopenias. Results: Of 758 patients enrolled, 19 developed cytopenias (2.5%). Transitory cytopenia was documented in 6 cases, 3 developed ICUS, 8 t-MDS, and 2 t-AML. In patients with FL, only hemoglobin < 12 g/dL (p = 0.032) and >6 nodal areas (p = 0.037) at diagnosis were factors statistically significant for the development of cytopenia. During cytopenias, 55% of patients died. Conclusions: LOHT constitutes a cause of morbidity and mortality in 2.5% of lymphoma patients treated with different therapy regimens.

https://doi.org/10.24875/ric.20000351 129 downloads

Grupo de Estudio Latinoamericano de Linfoproliferativos (GELL) para el manejo del linfoma en estado de pandemia SARS CoV-2 / COVID 19
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Ospina-Idárraga, Juan Alejandro

; Martínez-Cordero, Humberto

; Idrobo-Quintero, Henry

; Ortiz-Alfaro, Conrad

; Martínez-Correa, Lina María

; García, Juan Esteban

; Malpica, Luis

; Castillo, Jorge

; Torres, María Alejandra

; Villela, Luis

; Candelaria, Myrna

; Glasenapp, Alana Von

; Beltrán, Brady

; Paredes, Sally

; Castro, Denisse

; Prates, Virginia

; Fiad, Lorena

; Di, Marcos

; Riva, Eloísa

; Abello-Polo, Virginia

; Choque, Juan Antonio

; Peña, Camila

; Rojas, Christine

; Valvert-Gamboa, Fabiola

Revista Colombiana de Cancerología

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Dez 2020, Volume 24 Supl. 1 Páginas 192 - 226

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

Resumen En diciembre de 2019 se detectó por primera vez en China la existencia del SARS-CoV2, causante de la enfermedad COVID-19. El virus rápidamente se propagó por Europa y Asia, tardándose un par de meses antes de llegar a América Latina. Se ha demostrado que los pacientes que desarrollan una enfermedad severa y que tienen mayor riesgo de mortalidad por COVID-19 son aquellos con edades avanzadas y que presentan por lo menos una enfermedad crónica, incluyendo el cáncer. Debido a lo anterior, surgen muchas dudas en el grupo de profesionales encargados de brindar tratamiento a pacientes con cáncer durante la pandemia, pues se debe equilibrar el riesgo-beneficio de proveer tratamiento a pacientes que se encuentran de base con un riesgo incrementado para tener manifestaciones severas por COVID-19. En este consenso planteamos recomendaciones para los profesionales en hematología que brindan tratamiento a pacientes que padecen de algún tipo de linfoma, con el fin de aclarar el panorama clínico durante la pandemia.

Abstract The existence of SARS-CoV2, the cause of COVID 19 disease, was detected for the first time in China in December 2019. The virus quickly spread across Europe and Asia, taking a couple months to reach Latin America. It has been shown that elderly patients and those with chronic diseases, including cancer, have a higher risk of mortality from COVID-19. Consequently, many doubts arise in the group of health professionals responsible for treating patients with cancer during the pandemic, as they must balance the risk-benefit of delivering treatment to patients with an increased risk for severe manifestations resulting from COVID-19. In this consensus we propose recommendations for hematology professionals who provide treatment to patients suffering from some type of lymphoma, with the aim of clarifying the clinical picture during the pandemic.

https://doi.org/10.35509/01239015.690 437 downloads

Transitory response of a myelodysplastic syndrome with deletion of chromosome 5q to thalidomide. Report of one case
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Palacios-Campos, Adriana

; Gutierrez, Olga

; Fabian-Morales, Eunice

; Avilés, Alejandro

; Candelaria, Myrna

Revista médica de Chile

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Set 2020, Volume 148 Nº 9 Páginas 1357 - 1361

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

ABSTRACT Myelodysplastic syndrome with deletion of chromosome 5q (5q-syndrome) has a favorable prognosis and a low risk of transformation to acute myeloid leukemia, when treated with lenalidomide. Azacitidine leads to complete remission even as second-line therapy and in patients with clonal evolution. We report a 70 years old female without previous exposure to myelotoxic drugs, presenting with three weeks with fatigue and dyspnea. She had anemia with normal white blood cell and platelet count. Bone marrow biopsy showed 50% cellularity and the karyotype analysis revealed a (5) (q33q34) deletion in 22% of the metaphases. A diagnosis of 5q-syndrome with low risk calculated using the Revised International Prognostic Scoring System (IPSS-R), was made. Since lenalidomide was not affordable, thalidomide 100 mg/day was initiated, achieving transfusion independence for three years. Afterwards, she developed pancytopenia and a bone marrow biopsy showed erythroid and megakaryocyte dysplasia with a complex karyotype, which worsened prognosis (IPSS-R of five points). Therefore, azacitidine (by donation) was administered. She achieved complete remission with a normal karyotype and completed 12 cycles of treatment. Thereafter, she relapsed and received only supportive care for a year. She suffered an ischemic stroke and died two weeks later.

El síndrome mielodisplásico con deleción del cromosoma 5q (síndrome 5q) tiene un pronóstico favorable y riesgo bajo de transformación a leucemia aguda en pacientes que son tratados con lenalidomida (tratamiento estándar). El uso Azactidina tiene respuestas completas incluso como segunda línea de tratamiento en pacientes con evolución clonal. Presentamos una mujer de 71 años, sin exposición a mielotóxicos que debutó con un síndrome anémico. Se realizó biopsia de medula ósea que mostró celularidad del 50% y en el análisis citogenético se detectó una deleción del cromosoma 5 en 22% de las metafases analizadas, lo que llevó al diagnóstico de Síndrome 5q- de riesgo bajo de acuerdo con el puntaje IPSS-R (Revised International Prognostic Scoring System). Ya que no se pudo costear lenalidomida, se trató con talidomida (100 mg/día). Permaneció tres años sin requerir soporte transfusional. Posteriormente, presentó pancitopenia y en el nuevo aspirado de médula ósea se observó displasia de la serie roja y megacariocitos, con cariotipo complejo y peor pronóstico (IPSS-R 5 puntos). Se trató con 12 ciclos de azacitidina con lo que logró respuesta completa. Recayó 12 meses después y continuó manejo de soporte por un año. Finalmente falleció debido a un accidente vascular cerebral.

583 downloads

Differences in stroke patterns and outcomes between cancer and non-cancer patients
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Cacho-Díaz, Bernardo

; Spínola-Maroño, Héctor

; Mendoza-Olivas, Laura G.

; Salmerón-Moreno, Karen

; Monroy-Sosa, Alejandro

; Cantú-Brito, Carlos

; Candelaria-Hernández, Myrna G.

Revista mexicana de neurociencia

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Fev 2020, Volume 21 Nº 1 Páginas 3 - 8

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract Introduction: One in 10 patients with stroke concurrently has cancer; however, the impact of their combination on survival has not been well established; consequently, stroke and cancer are likely to have unrecognized associations. Objective: The objective of the study was to compare the stroke risk factors, presentations, and outcomes between stroke patients with and without cancer, to recognize this as an added hazard element that might impact mortality rates. Methods: Data were prospectively acquired at a cancer referral center from March 2011 to February 2018. Patients with histologically confirmed diagnosis of cancer, who were sent for neuro-oncology consultation and showed evidence by MRI of suffering a stroke during follow-up were compared with a previously reported cohort of patients with stroke and similar demographic characteristics (RENAMEVASC and PREMIER studies), employing Student's t-test after determining the mean and standard deviation using Hazen's equation. Results: A total of 270 patients with cancer-related stroke were compared to 2000 patients with non-cancer stroke. Stroke risk factors for the cohort of patients with cancer were dyslipidemia, alcohol abuse, and tobacco use, with a median follow-up after the stroke of 13.8 months. Mortality rates at 30 and 90-days were similar between both groups; however, at 6 and 12-months they were higher in patients with cancer-related stroke (6 months: 37 vs. 23%, RR 1.62, p < 0.0001; 12 months: 43 vs. 29%, RR 1.48, p = 0.00001). Conclusion: Mid-term and long-term survival rates were worse in cancer patients with stroke compared with those without cancer.

Resumen Introducción: Uno de cada 10 pacientes que sufre un EVC tiene algún tipo de cáncer concomitante, sin embargo, el impacto de esta combinación no ha sido bien establecido. En consecuencia, es probable que el EVC y el cáncer presenten asociaciones no reconocidas. Objetivo: Comparar factores de riesgo, formas de presentación y desenlace en pacientes con cáncer y sin cáncer que sufrieron EVC, en función de reconocerlo como elemento adicional de riesgo que puede impactar sobre las tasas de mortalidad. Métodos: Se recopilaron datos prospectivamente en un centro de referencia oncológico desde marzo 2011 a febrero 2018. Pacientes con diagnóstico de cáncer confirmado por histopatología que fueron enviados a consulta de neuro-oncología y evidenciaron por medio de IRM algún tipo de EVC durante el seguimiento, se compararon contra una cohorte previamente reportada de pacientes con EVC sin relación a cáncer y características demográficas similares (estudios RENAMEVASC y PREMIER), empleando t de Student después de determinar la media y la desviación estándar con la ecuación de Hozo. Resultados: Se comparó un total de 270 pacientes con EVC relacionado a cáncer contra 2,000 pacientes con EVC. Los factores de riesgo de EVC para la cohorte de pacientes con cáncer fueron dislipidemia, abuso de alcohol y uso de tabaco, con una mediana de seguimiento de 13.8 meses después del EVC. La tasa de mortalidad a 30 y 90 días fue similar en ambos grupos; sin embargo, a 6 y 12 meses fue mayor en el grupo de EVC relacionado a cáncer (6 meses: 37% vs. 23%, RR 1.62, p < 0.0001; 12 meses: 43% vs. 29%, RR 1.48, p = 0.00001). Conclusión: A mediano y largo plazo las tasas de supervivencia empeoraron en pacientes con EVC relacionado a cáncer.

https://doi.org/10.24875/rmn.19000102 9 downloads

Clinical characteristics of primary extranodal versus nodal diffuse large B-Cell Lymphoma: A retrospective cohort study in a cancer center
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Candelaria, Myrna

; Oñate-Ocaña, Luis F.

; Corona-Herrera, Judith

; Barrera-Carmona, Cristina

; Ponce-Martínez, Mayra

; Gutiérrez-Hernández, Olga

; Avilés-Salas, Alejandro

; Cacho-Díaz, Bernardo

Revista de investigación clínica

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Out 2019, Volume 71 Nº 5 Páginas 349 - 358

Resumo: En | Texto: En | PDF: En

Background The outcome of patients with primary extranodal diffuse large B-cell lymphoma (PE-DLBCL) varies according to the primary site involved. Primary gastrointestinal, breast, bone, craniofacial, and testicular DLBCL are rare extranodal manifestations of DLBCL. Objective The objective of the study was to describe the clinical course of patients with PE-DLBCL disease in a referral cancer center. Results From 637 patients, 51 (8.77%) were considered as having PE-DLBCL (25 gastrointestinal, 12 craniofacial, 6 breast, 5 bone, and 3 with primary testicular DLBCL). Complete remission was higher in all PE-DLBCL sites (100% in testicular, 92.6% craniofacial, 83.3% breast, 80% bone, and 80% gastrointestinal) compared with 73.3% in nodal DLBCL. Although 2 cases with breast PE-DLBC relapsed, they achieved a complete response with chemotherapy. The overall survival at 5 years was 100%, 80%, 78%, 58%, 58%, and 62% for patients with primary breast, primary bone, gastrointestinal, primary craniofacial, primary testicular, and nodal DLBCL, respectively. Conclusions PE-DLBCLs constitute rare, primary sites of lymphoproliferative disorders in most cases, with localized disease and good prognosis. They require a combined chemoimmunotherapy with radiotherapy in most cases to improve local and systemic disease.

https://doi.org/10.24875/ric.19003027 90 downloads

10.

Mesilato de imatinib como tratamiento de primera línea en pacientes con leucemia mieloide crónica Filadelfia + (LMC-Ph+) en fase acelerada (FA), en comparación con fase crónica (FC)
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Hurtado Monroy, Rafael

; Vicente Hernández, Berenice

; Sarre Álvarez, Diego

; Vargas Viveros, Pablo

; Candelaria Hernández, Myrna

; Rojas Sotelo, Montserrat

; Best Aguilera, Carlos Roberto

; Cruz Velásquez, Judith

Acta médica Grupo Ángeles

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Set 2018, Volume 16 Nº 3 Páginas 204 - 208

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract: Introduction: The accelerated phase is a condition of progression of the CML. Our first line of treatment is imatinib mesylate (IM); however, there is no information on long-term outcomes in AP. Material and methods: We conducted a retrospective comparative study of patients with CML Ph+. Patients with CP received IM 400 mg/day and patients with AP 600 mg/day, both were followed with cytogenetic studies with fluorescence in situ hybridization (FISH) (minimum 200 nuclei analyzed) every three months. Results: The median time for the complete cytogenetic response (CCyR) was eight months in CP and 12 months in AP. The length of this response in CP was 73 months in 100% of patients and 30 months in 42.9% of AP. The median survival (follow-up of 120 months) was 70 months in AP and 150 months in CP (p < 0.0001). The median long-term free-disease and overall survival was 73 months in CP and 30 months in AP. Conclusions: The AP has lower CCyR and survival, which suggests the need to change the initial treatment.

Resumen: Introducción: La fase acelerada es un estado de progresión de la LMC Ph+. Nuestra primera línea de tratamiento es el mesilato de imatinib (MI); sin embargo, no se tiene información sobre resultados a largo plazo en FA. Material y métodos: Se realizó un estudio retrospectivo, comparativo de pacientes con LCM Ph+. Los casos de FC recibieron MI 400 mg/día y los de FA 600 mg/día y seguimiento con estudios citogenéticos con hibridización in situ por fluorescencia (FISH) (mínimo 200 núcleos analizados) cada tres meses. Resultados: La mediana de tiempo para la respuesta citogenética completa (RCgC) fue de ocho meses en FC y 12 meses en FA. La duración de esta respuesta en FC fue de 73 meses en el 100% de los pacientes y 30 meses en el 42.9% de la FA. La mediana de supervivencia (seguimiento de 120 meses) en FA fue 70 meses y en FC 150 meses (p < 0.0001). La mediana libre de enfermedad y supervivencia libre de eventos fue de 73 meses en FC y 30 meses en FA. Conclusiones: En FA se obtiene menor RCgC y menor supervivencia, lo cual sugiere la necesidad de un cambio desde su manejo inicial.

798 downloads

11.

Transformación leucémica en paciente con linfoma folicular e hiperleucocitosis al diagnóstico
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Burgos Canales, Sebastián

; Avilés-Salas, Alejandro

; Gutiérrez Hernández, Olga

; Ponce Hernández, Mayra

; Candelaria, Myrna

Revista Cubana de Hematología, Inmunología y Hemoterapia

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Mar 2018, Volume 34 Nº 1 Páginas 83 - 88

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Follicular lymphoma rarely presents with a leukemic phase and this should be considered a negative prognostic factor. Also, follicular lymphoma and myelodysplastic syndrome association has not been previously reported. Herein we present a patient who debuted with marked hyperleukocytosis and was diagnosed with follicular lymphoma, receiving CHOP-R and FCR after she relapsed. Several months later, secondary myelodysplastic changes were observed in her bone marrow. She received supportive therapy and finally progressed into acute myeloid leukemia. Although secondary myelodysplasia is known to be produced by chemotherapy, this patient additionally had trisomy 11, previously described in myelodysplasia and Burkitt's lymphoma, which could be linked to progression to acute myeloid leukemia.

La fase leucémica como presentación de un linfoma folicular es rara y debe ser considerada factor de mal pronóstico. Por otra parte, la asociación entre linfoma folicular y síndrome mielodisplásico no se ha descrito. Se presenta el caso de una paciente en la que se detectó marcada leucocitosis y a la que se diagnosticó un linfoma folicular. Recibió quimioterapia con R-CHOP y FCR cuando recayó. Meses después, se realizó un aspirado medular en el cual se observaron cambios compatibles con mielodisplasia, únicamente recibió terapia de soporte y finalmente evolucionó a leucemia mieloide aguda. Aunque se conoce que la mielodisplasia puede ser secundaria al uso de quimioterapia, la paciente presentó además trisomía del cromosoma 11, descrita previamente en mielodisplasia y linfoma tipo Burkitt, la cual pudiera estar en relación con la evolución a leucemia mieloide aguda.

12.

Neoplasia blástica de células dendríticas plasmocitoides. Casos clínicos
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Avilés-Salas, Alejandro

; Candelaria, Myrna

; Ponce, Mayra

; Cañavera-Constantino, Abraham

; Burgos, Sebastián

Revista médica de Chile

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Set 2017, Volume 145 Nº 9 Páginas 1208 - 1212

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Blastic plasmacytoid dendritic cell neoplasm is a rare hematological malignancy derived from immature plasmacytoid dendritic cells. The tumor cells have an immature blastic appearance, and diagnosis is based on the expression of CD4, CD56 y CD123 in the absence of other lymphoid, natural killer, or myeloid antigens. The majority of affected individuals are older people with a mean age of 66 years. Male to female ratio is approximately 3:1. Common presentation includes cutaneous lesions followed by tumor dissemination. Treatment with conventional chemotherapy is ineffective and allogeneic hematopoietic stem cell transplantation is required to achieve remission. We report three male patients, aged 23, 27 and 51 years with the disease. All had multiple, infiltrated pink plaques and nodules on the skin of their face, neck and thorax, measuring 1 to 12 cm in diameter. All tumors were histologically characterized by a monotonous proliferation of medium size cells with blastic features. Tumor cells were positive for CD123, CD56, CD4 and CD7 in all cases. After a mean of follow-up of 14.6 months, one patient died of the disease, one patient is alive and the disease relapsed after 17 months of remission and one patient is alive with no evidence of the disease.

https://doi.org/10.4067/s0034-98872017000901208 1975 downloads

13.

Linfoma de células grandes B originado en enfermedad de Castleman. Reporte de un caso y revisión de la literatura
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Avilés-Salas, Alejandro

; Candelaria, Myrna

; Sevilla-Lizcano, Diana Brisa

; Burgos, Sebastián

Revista médica de Chile

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Jul 2017, Volume 145 Nº 7 Páginas 945 - 949

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We report a 73-year-old female patient with Castleman's disease coexistent with large B cell type non-Hodgkin's lymphoma in a right axillary lymphadenopathy. An excisional biopsy was performed: microscopically, the lymph node revealed the presence of numerous plasma cells and small lymphoid cells characteristic of Castleman's disease. An analysis of another portion of the specimen revealed lymphoid cells with large abnormal nuclei gathered locally that were CDD 79+, CD 38+ and MUM-1+ as well as positive for Kaposi sarcoma-associated herpesvirus and negative for Epstein Barr virus encoded RNA-1 (EBER).

https://doi.org/10.4067/s0034-98872017000700945 1865 downloads

14.

Advances in the diagnosis and control of lymphomas
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Candelaria, Myrna

Salud Pública de México

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Abr 2016, Volume 58 Nº 2 Páginas 296 - 301

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Abstract Lymphoproliferative disorders have increased in last decades. Immunohistochemistry analysis is required to categorize them in different clinical entities, as has been stablished by WHO. Advances in imaging have set the PET-CT as a standard staging procedure in most cases. Knowledge of the biology of these malignancies has allowed therapeutic advances with different approaches, including development of monoclonal antibodies, conjugated antibodies, immunomodulatory agents, as well as inhibition of specific pathways. Although new drugs are promising, the cost-benefit impact requires to be evaluated in pharmacoeconomic clinical trials.

Resumen Los padecimientos linfoproliferativos han incrementado en las últimas décadas. Es fundamental la evaluación con inmunohistoquímica para clasificarlos en las diferentes entidades que establece la clasificación de la OMS. Los avances en técnicas de imagen han colocado al PET-CT como un procedimiento de estadificación estándar. El conocimiento de la biología de estas neoplasias ha permitido avances terapéuticos con el desarrollo de anticuerpos monoclonales solos o conjugados, como agentes inmunomoduladores, así como a través de la inhibición de vías específicas. Aun cuando los resultados con estos nuevos fármacos son promisorios, el impacto costo-beneficio requiere evaluarse en estudios prospectivos con análisis farmacoeconómico.

769 downloads

15.

Advances in the diagnosis and control of lymphomas
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Candelaria, Myrna

Salud Pública de México

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Abr 2016, Volume 58 Nº 2 Páginas 296 - 301

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

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