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Practical Approach to Molecular Biology in Hematopathology
Published in Harold R. Schumacher, William A. Rock, Sanford A. Stass, Handbook of Hematologic Pathology, 2019
Anwar Mikhael, Harold R. Schumacher
Analysis of the genomic organization of the Ig and TCR gene loci has become a sensitive tool to assess clonality and to establish cell lineage of lymphoproliferative disorders (Table 2). Gene rearrangement studies are sensitive enough to detect as low as 1–5% tumor-cell associated DNA in a sample Ig and TCR gene rearrangement analysis will determine whether a proliferative process is mono-, poly-, or oligoclonal. This technique has complemented histologic examination in the evaluation of residual and recurrent lymphoproliferative disease. Table 3 provides a guideline for the interpretation of Ig and TCR gene rearrangement results.
The Role of Epstein-Barr Virus in Burkitt’S Lymphoma and Nasopharyngeal Carcinoma
Published in Fred Rapp, Oncogenic Herpesviruses, 2019
Successful induction of lymphoproliferative disease resembling malignant lymphoma was first reported by Shope et al.10 and Epstein et al.11,12 Shope and colleagues10 inoculated transforming EBV from B95-8 cells into cotton-topped marmosets (Saguinus oedipus). Three out of four animals developed fatal reticuloproliferative disease. The cotton-topped marmoset proved to be particularly susceptible to EBV infections induced by the B95-8 isolate.66 An additional tumor has been obtained with EBV derived from the Kaplan line isolated from a case of infectious mononucleosis.13
Transplantation
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
CTLA-4Ig (belatocept, LEA29Y) is a fusion protein comprising the extracellular domain of CTLA-4 fused to human immunoglobulin (Ig) Fc. It binds to the co-stimulatory ligands CD80 and CD86 expressed on antigen-presenting cells and, as a result, prevents them from delivering the co-stimulatory signals to the T cells that are required for full T-cell activation. It has recently been shown in renal transplantation to provide an effective alternative to CNIs when given by regular intravenous injection, thereby avoiding the metabolic, cardiovascular and nephrotoxic effects of CNIs. Although its future looks very promising, a potential concern is that it may be associated with an increased risk of post-transplant lymphoproliferative disease (PTLD).
Oral manifestations of extranodal lymphomas – a review of the literature with emphasis on clinical implications for the practicing dentist
Published in Acta Odontologica Scandinavica, 2022
Malin Höglund Wetter, Ulf Mattsson
Three-hundred and twenty-one cases (217 men and 104 women; mean age 45.6 years, SD 20.5) were found. The average time from debut of symptoms to clinical examination was 3.1 months (SD 5.3). The most common subjective symptom was that the patient had noted a swelling/tumour mass or ulceration, but the lesion itself was not necessarily accompanied by pain or major discomfort (Tables 2a and 2b). The clinical size varied, but the fact that 157 cases (63%) had a largest diameter exceeding 3 cm indicated that the growth rate could be relatively fast. A tentative diagnosis had been given in 167 cases and included a wide variety of both malignant and non-malignant alternatives. Malignancy of any sort was considered as a diagnostic alternative in 66 cases, but lymphoma or lymphoproliferative disease was only specified in 11 cases. Also, as shown in Table 3, a large number of patients were initially treated under a tentative diagnosis of dental origin.
Optic nerve biopsy in leukemic infiltrative optic neuropathy: a case report and review of the literature
Published in Orbit, 2022
Paul D. Chamberlain, Christopher R. Dermarkarian, M. Brent Woodland, Richard C. Allen, Nagham Al-Zubidi
Optic nerve infiltration is a rare, vision-threatening complication of leukemia and lymphoma.1,2 Patients frequently present with decreased visual acuity, visual field defects, or diplopia and funduscopic examination may reveal an edematous disc and peripapillary hemorrhages.3,4 In the setting of active lymphoproliferative disease, the diagnosis is often presumed and patients can be treated empirically with radiation and chemotherapy.2,3 If a biopsy is considered, surgeons may prefer an optic nerve sheath biopsy, given the high likelihood of permanent vision loss with biopsy of the optic nerve itself. There are relatively few reports in the literature of optic nerve biopsy for patients with presumed infiltrative optic neuropathy; of the limited case reports in the current literature, only two of these specifically report sheath involvement.3,4 We present a case of biopsy-proven leukemic optic neuropathy without optic nerve sheath or cerebrospinal fluid (CSF) involvement and discuss the need for optic nerve biopsy in this patient population.
Transitioning Select Chemotherapeutics to the Outpatient Setting Improves Care and Reduces Costs
Published in Oncology Issues, 2021
Since 2015 when we transitioned certain rituximab administrations to the outpatient setting, we decreased our inpatient bed stays, reduced our inpatient chemotherapy costs, and increased the use of our own specialty pharmacy for patients receiving intravenous rituximab combination regimens, as well as an increased use of this model post-implementation for standard order sets. However, not every patient receiving rituximab can be treated in the outpatient setting. Accordingly, we have developed patient restrictions for rituximab in the outpatient setting, including:Immune thrombocytopenic purpura—dose-reduced rituximab, 100 mg9.Cold agglutinin disease.Post-transplant lymphoproliferative disease.Autoimmune hemolytic anemia.Prolonged chemotherapy inpatient stays requiring continued treatment.Infusion reaction or need for rituximab desensitization.