[Hodgkin's lymphoma associated with thrombotic microangiopathy: case report and literature review]

We report a 51-year-old woman, who presented thrombotic microangiopathy associated with Hodgkin's lymphoma relapse after three years of complete remission. After treatment with corticotherapy, plasmatherapy, rituximab and chemotherapy, complete remission of thrombotic microangiopathy and Hodgkin's lymphoma was observed. Our literature review notes eight cases of thrombotic microangiopathy associated with Hodgkin's lymphoma

[Chronic myeloid leukemia and inhibitors of tyrosine kinase]

Chronic myeloid leukemia is a hematological malignancy in the group of myeloproliferative syndromes. It is characterized by the presence of an acquired genetic abnormality at the hematopoietic stem cells, the Philadelphia chromosome. Inhibitors of tyrosine kinase, whose leader is imatinib, has profoundly changed the therapeutic management and prognosis of this malignancy. The failure of imatinib treatment is due to resistance mechanisms that are not all fully characterized. However, cross and multiple resistance remain difficult to treat and require a better understanding of their mechanisms to overcome residual disease in the near future. The persistence of a long term residual disease associated with the presence of quiescent leukemic cells, and the occurrence of relapse led to the development of second and third generation inhibitors tyrosine kinase and the combination of these inhibitors with therapeutic immunomodulators such as interferon alpha, or vaccination protocols are discussed. The purpose of this review is to update on the molecular abnormalities found in chronic myeloid leukemia with emphasis on mechanisms of imatinib resistance and the current therapeutic strategy in the era of new generations of inhibitors of tyrosine kinase

[Primary gastric lymphoma: a retrospective series of 35 cases]

Primary gastric non Hodgkin's lymphoma [PGNHL] is the most common site of extranodal malignant lymphoma. It is a rare subtype of malignancy, for which no consensus exists about treatment. The purpose of This paper was to assess the management of PGNHL. Between January 1992 and December 2001,35 patients were retrospectively evaluated. Of the 35 patients, with a mean age of 44 years old Signs, and symptoms are unspecific. 20[57,1%] were in stage IE/IIEI. 15 patients [42,8%] were in stage 11E2,IIIE,IVE. These patients were treated with primary surgery with or without chemotherapy [11;31,4%]; primary chemotherapy [CT] alone with surgery in one patient [21: 60%] and three patients with gastric MALT lymphoma were treated by Helicobacter pylori eradication. The 5 year survival rates of the 35 patients are 62, 86%. There was no significant difference in the 5 year survival rate between the patients with low grade lymphoma and the patients with large grade Iymphoma [75% versus 60%, P=0,467]. The 5-year survival rates for stage I/IIEl and IIE2/lIl/lV patients were 80%, 53,3% respectively [p < 0.144]. Of the 11 primary surgical groups with or without chemotherapy, the 5 year survival rate is 90, 9%. Of the 21 patients who received CT, alone or combined with surgery, the survival rate is 52,4%. There was significant difference between the two groups [P=0,05]. Of the 3 patients with low-grade mucosa-associated lymphoid tissue [MALT] lymphoma with only oral anti-Helicobacter pylori regimen remained disease free after a median follow-up of two years. This study suggested that primary surgical resection may be important factor predicting the long-term survival of patients with primary gastric NHL. H. pylori eradication therapy was an effective first-line treatment for patients with gastric MALT lymphoma

Hematopoietic precursors cell transplants for autoimmunes diseases

High dose therapy with autologus stem cell transplantation for auto-immune disease resistant to conventional therapy appear to be warranted. It is used for systemic sclerosis, vasculitides, systemic lupus erythematosus, myositis and auto-immune cytopenia. Comparison of various conditioning regimens indicates that a combination conditioning with low-dose total body irradiation and high-dose cyclophosphamide is optimal. First results are good but further studies are needed to evaluate this protocol