Research Progress on Molecular Diagnosis and Individualized Treatment for Malignant Lymphoma / 肿瘤防治研究

Lymphoma refers to a group of heterogeneous malignancies originating from the reticuloendothelial and lymphatic systems. The clinical manifestations, treatment strategies, and disease outcomes of different types of lymphoma considerably vary. Recent developments in high-throughput sequencing technologies have enhanced understanding of the pathogenesis and molecular stratification of lymphoma. In the era of new drugs, precise stratification and targeted drug selection can not only improve the prognosis of patients with lymphoma but also reduce the toxic side effects of traditional chemotherapy, ultimately achieving the accurate diagnosis and individualized treatment of tumors. This article reviews the research progress of molecular diagnosis and individualized treatment of different lymphoma subtypes and lymphoma-related research in important meetings such as ASCO, EHA, and ICML in 2023.

Linfoma de Burkitt primario de mama durante el embarazo / Primary Burkitt's Lymphoma of the Breast During Pregnancy

El linfoma de Burkitt es una neoplasia altamente agresiva y es un tipo raro de linfoma no Hodgkin localizado. Aunque los niños son los más frecuentemente afectados, en adultos ocurren principalmente durante el embarazo o el puerperio. La mama rara vez constituye la localización primaria del linfoma no Hodgkin. Se presenta un caso de linfoma de Burkitt primario de mama durante el embarazo. Paciente de 37 años con embarazo de 24 semanas quien presentó aumento de volumen difuso de mama derecha. La mama estaba aumentada de tamaño, dolorosa y homogénea con tumoración elástica y firme. La ecografía demostró inflamación difusa con tumoración heterogénea e hipoecoica con contornos ligeramente irregulares, marcadores tumorales estaban normales las pruebas serológicas fueron negativas. La biopsia de la lesión mostró tejido mamario reemplazado por células linfoideas de tamaño mediano con citoplasma basófilo y múltiples vacuolas. Estudios inmunohistoquímicos fueron positivos para el antígeno leucocitario común, CD10, CD20, CD43, Bcl-6. El análisis cromosómico reveló que más del 90 % de las células neoplásicas exhibieron translocación t llevando al diagnóstico final de linfoma de Burkitt de mama. Luego de evaluar las posibilidades terapéuticas y del consentimiento de la paciente se inició tratamiento citostático sistémico. Los linfomas primarios de mama son extremadamente raros. El linfoma de Burkitt primario de la mama es mucho menos común que los otros linfomas. Los métodos de clasificación, detección y tratamiento de esta afección siguen siendo objeto de debates e investigaciones(AU)

The Burkitt's lymphoma is a highly aggressive neoplasm and is a rare type of localized non-Hodgkin lymphoma. Although children are the most frequently affected, in adults they occur mainly during the pregnancy or the puerperium. The breast rarely constitutes the primary location for non-Hodgkin lymphoma. The study of a case of primary Burkitt lymphoma of the breast during pregnancy is presented. This is a 37 year old patient with a 24 week pregnancy who presented a diffuse increase in the volume of the right breast. The breast was enlarged, painful and homogeneous with a firm, elastic mass. The ultrasonography showed diffuse inflammation with a heterogeneous and hypoechoic tumor with slightly irregular contours. The tumor marker values were normal and the serological tests were negative. The biopsy of the lesion showed breast tissue replaced by medium-sized lymphoid cells with basophilic cytoplasm and multiple vacuoles. Immunohistochemically studies were positive for the common leukocyte antigen, CD10, CD20, CD43, Bcl-6. The chromosomal analysis revealed that more than 90 % of neoplastic cells exhibited t translocation leading to the final diagnosis of Burkitt lymphoma of the breast. After evaluating the therapeutic possibilities and the patient's consent, systemic cytostatic treatment was started. Primary breast lymphomas are extremely rare. The primary Burkitt lymphoma of the breast is much less common than other lymphomas. The methods of classification, detection, and the treatment of this condition continue to be the subject of debate and research(AU)

The Promoting Effect on the Gastric Emptying Function of Hangeshashinto was Confirmed by CT Images in Radiation therapy. A Case Report on Stomach Malignant Lymphoma with Dyspepsia / 日本東洋医学雑誌

A 75-year-old woman visited a hospital complaining of nausea and anorexia. She was diagnosed with stomach malignant lymphoma, and 6 courses of R-CHOP therapy were performed. Since complete remission was obtained, consolidation radiotherapy was decided. When performing radiation therapy on the stomach, it is desirable to carry it out in an empty stomach. For this reason, it is necessary to skip meals before irradiation. However, in this case, scar stenosis remained in gastric vestibular, and there was always a complaint of stomach discomfort. The treatment plan CT was taken without meals, and full stomach was observed. The patient was judged to be unavoidable due to an organic passage disorder, and a treatment plan was made with a full stomach, and radiotherapy was started. However, she was administered hangeshashinto from the first day of radiation therapy, and stomach discomfort quickly improved. CT was performed again, confirming that the stomach volume was reduced. In this case, in addition to scar stenosis in the stomach, it seems that functional dyspepsia was also involved. It is considered that the promoting effect on gastric emptying function of hangeshashinto was confirmed by CT images.

Relationship between resilience and quality of life among inpatient with malignant lymphoma / 中国实用护理杂志

Objective To investigate the level of resilience and quality of life among inpatient with malignant lymphoma, and to examine the relationship between resilience and quality of life. Methods A convenience samples of 137 patients with malignant lymphoma was selected from March 2017 to March 2018. Self-designed questionnaires, Connor-Davidson Resilience Scale (CD-RISC10), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-core (EORTC QLQ-C30) were used to assess the social-demographic and clinical related information, resilience and quality of life. Results The score of CD-RISC10 was (21.0±4.9) points, and the score general health of EORTC QLQ-C30 was (48.7 ± 24.8) points; Pearson analysis showed that resilience was significantly positively associated with quality of life (r=0.209-0.395, P<0.01). Multiple stepwise regression analysis showed that age, BMI, tumor types, pain, and resilience could significantly predict variance of QOL (P<0.05). Conclusions The resilience was positively correlated with quality of life among patients withmalignant lymphoma;age, BMI, tumor types, pain, and resilience were significant influence factor of QOL. It might provide a new sight to improve quality of life by resilience training for clinical interventions among patients with malignant lymphoma.

Minimally Invasive Cardiac Surgery for Left Ventricular Aneurysm with Large Mobile Thrombus Formation after Chemotherapy for Malignant Lymphoma / 日本心臓血管外科学会雑誌

We report a case of minimally invasive surgery (MICS) for left ventricular aneurysm with a large mobile thrombus, which appeared after chemotherapy for malignant lymphoma. A 42-year-old man with a postinfarction left ventricular aneurysm was admitted to our hospital to receive chemotherapy for malignant lymphoma. Eight days after the first administration of anticancer drugs, echocardiography revealed a large mobile thrombus in the left ventricular aneurysm that was absent on admission. The patient was referred to our department, and left ventricular endoplasty was performed through a small left thoracotomy. He recovered rapidly, and chemotherapy was resumed a month after surgery. This suggests MICS to be a valuable option for left ventricular aneurysm repair.

Clinical study of peripheral blood T cell subsets in patients with malignant lymphoma by flow cytometry / 实用肿瘤学杂志

Objective The aim of this study was to investigate the effect of flow cytometry on peripheral blood T cell subsets in patients with malignant lymphoma and its relationship with clinicopathological and tumor types.Methods Ninety-eight patients with malignant lymphoma treated in our hospital from August 2014 to September 2016 were selected as the study group.Ninety-eight healthy subjects were selected as the control group.The peripheral blood T cell subsets(CD3 +,CD4 +,CD8 +,CD4 +/CD8 +)were detected in patients and healthy controls by flow cytometry.Results The levels of CD3 +and CD4 +/CD8 +in the study group were (55.63±11.25)and(1.32±0.62),respectively,which were significantly lower than those(68.96±12.63)and (1.59±0.59)of the control group(P<0.05).The levels of CD4 +and CD8 +were(33.67±8.14)and(26.02±4.67),respectively in the study group,were no difference from the control group(34.12±8.33)and(25.67±4.53)(P>0.05).The levels of CD3+and CD4 +/CD8 +in patients with Hodgkin's lymphoma were(54.63±11.36),(1.22±0.65),respectively,and(55.52±12.02),(1.34±0.71)for non-hodgkin lymphoma.They were significantly decreoseg in the control group(68.96±12.63 for CD3 +and 1.59±0.59 for CD4 +/CD8 +) (P<0.05).The level of CD4 +and CD8 +were no difference amoupst Hodgkin's lymphoma(33.78±8.23 for CD4 +and 25.74±4.88 for CD8 +),non-Hodgkin's lymphoma(25.74±4.88 for CD4 +and 33.62±8.74 for CD8 +)and control group(34.12±8.33 for CD4 +and 25.67±4.53 for CD8 +)(P>0.05).The levels of CD3 +,CD4+and CD4 +/CD8 +in patients with Ⅲ ~Ⅳ stage malignant lymphoma were(52.66±12.47), (28.25±6.32)and(1.30±0.62),respectively,which were significantly lower than those(68.96±12.63), (34.12±8.33)and(1.59±0.59)in the control group(P<0.05).The level of CD3 +in patients with phase Ⅰ-Ⅱ malignant lymphoma(58.63±11.85)was significantly lower than that in the control group(68.96±12.63)(P<0.05).The level of CD8 +in patients with phase Ⅰ-Ⅱ malignant lymphoma(29.63±3.57)was significantly higher than that in the control group(25.67±4.53)(P<0.05).Conclusion The detection of peripheral blood T cell subsets by flow cytometry can be used as an important methods to diagnose the disease,staging and immune status of patients with malignant lymphoma,which has high application value.

Clinical study of peripheral blood T cell subsets in patients with malignant lymphoma by flow cytometry / 实用肿瘤学杂志

Objective The aim of this study was to investigate the effect of flow cytometry on peripheral blood T cell subsets in patients with malignant lymphoma and its relationship with clinicopathological and tumor types.Methods Ninety-eight patients with malignant lymphoma treated in our hospital from August 2014 to September 2016 were selected as the study group.Ninety-eight healthy subjects were selected as the control group.The peripheral blood T cell subsets(CD3 +,CD4 +,CD8 +,CD4 +/CD8 +)were detected in patients and healthy controls by flow cytometry.Results The levels of CD3 +and CD4 +/CD8 +in the study group were (55.63±11.25)and(1.32±0.62),respectively,which were significantly lower than those(68.96±12.63)and (1.59±0.59)of the control group(P<0.05).The levels of CD4 +and CD8 +were(33.67±8.14)and(26.02±4.67),respectively in the study group,were no difference from the control group(34.12±8.33)and(25.67±4.53)(P>0.05).The levels of CD3+and CD4 +/CD8 +in patients with Hodgkin's lymphoma were(54.63±11.36),(1.22±0.65),respectively,and(55.52±12.02),(1.34±0.71)for non-hodgkin lymphoma.They were significantly decreoseg in the control group(68.96±12.63 for CD3 +and 1.59±0.59 for CD4 +/CD8 +) (P<0.05).The level of CD4 +and CD8 +were no difference amoupst Hodgkin's lymphoma(33.78±8.23 for CD4 +and 25.74±4.88 for CD8 +),non-Hodgkin's lymphoma(25.74±4.88 for CD4 +and 33.62±8.74 for CD8 +)and control group(34.12±8.33 for CD4 +and 25.67±4.53 for CD8 +)(P>0.05).The levels of CD3 +,CD4+and CD4 +/CD8 +in patients with Ⅲ ~Ⅳ stage malignant lymphoma were(52.66±12.47), (28.25±6.32)and(1.30±0.62),respectively,which were significantly lower than those(68.96±12.63), (34.12±8.33)and(1.59±0.59)in the control group(P<0.05).The level of CD3 +in patients with phase Ⅰ-Ⅱ malignant lymphoma(58.63±11.85)was significantly lower than that in the control group(68.96±12.63)(P<0.05).The level of CD8 +in patients with phase Ⅰ-Ⅱ malignant lymphoma(29.63±3.57)was significantly higher than that in the control group(25.67±4.53)(P<0.05).Conclusion The detection of peripheral blood T cell subsets by flow cytometry can be used as an important methods to diagnose the disease,staging and immune status of patients with malignant lymphoma,which has high application value.

Research on Characteristics of Compound Kushen Injection in The Treatment of Patients with Malignant Lymphoma: A Real-world Study / 世界科学技术-中医药现代化

This study was aimed to analyze the clinical characteristics of Compound Kushen Injection in the treatment of patients with malignant lymphoma in the real world based on the electronic medical record,and to provide a reference for its rational application.The electronic medical data of 3 674 patients with malignant lymphoma using Compound Kushen Injection was extracted.General information,diagnostic information,and medication information were analyzed on the basis of frequency and rate of descriptive analysis.The results showed that the average age of patients was 54.95 yearsold,with more males than females.Patients were mainly from the department of oncology and hematology.Based on hospital outcomes in hospitalized patients,the clinical total effective rate was 66.15％.The single medication dosage was mostly 10-20 ml.The course of treatment was mainly 4-14 days.The common western medications in combination included dexamethasone,tropisetron injection,metoclopramide tablet,thymopolypeptides injection,cyclophosphamide injection,and etc.Common pharmacological effects of combined western medicine included anti-tumor chemotherapy drugs,immunomodulatory drugs,glucocorticoid drugs,antibiotic drugs and so on.It was concluded that the clinical dosage,scope of malignant lymphoma treatment using Compound Kushen Injection in the real world were consistent with the specification.And characteristics of the crowd using Compound Kushen injection is clear and in line with the general rule of malignant lymphoma and clinical positioning of varieties.Based on the hospital outcomes,the clinical efficacy is determined to have precise effect on hospitalized patients.The drug combination type is extensive.

Clinical analysis of autologous peripheral blood hematopoietic stem cell mobilization regimen in 61 lymphoma patients / 中国肿瘤临床

Objective:To compare the efficacy between chemotherapy with granulocyte colony-stimulating factor (G-CSF) and chemo-therapy with G-CSF and granulocyte-macrophage colony-stimulating factor (GM-CSF) for the mobilization of peripheral blood hemato-poietic stem cells and hematological recovery post-transplantation in patients with malignant lymphoma. Methods:Autologous pe-ripheral blood hematopoietic stem cell mobilization data of 61 malignant lymphoma patients who were treated with chemotherapy plus G-CSF or chemotherapy plus G-CSF and GM-CSF from May 2008 to October 2016 were included in this study. The mobilization effi-cacy and hematopoietic recovery were analyzed. Results:During mobilization, White blood cells (WBC) of all patients decreased to 1.0×109/L and platelets (PLT) dropped to 40×109/L. The successful mobilization rates of CD34+cell are 52.5%in chemotherapy plus G-CSF group and 90.5%in chemotherapy plus G-CSF+GM-CSF group (P=0.003). All patients successfully underwent hematopoietic recon-struction without transplantation-related mortality. Conclusion: Although chemotherapy with G-CSF+GM-CSF can significantly in-crease the effect of autologous peripheral blood hematopoietic stem cell mobilization, the reconstruction of hematopoietic function after transplantation and side reaction between the two groups are the same. Thus, chemotherapy with G-CSF+GM-CSF is not superior to chemotherapy with G-CSF in mobilizing autologous peripheral blood hematopoietic stem cells.

Three Cases of Treating Malignant Lymphoma withLiujun Ermu Decotion Used by ZHANG Pei-tong / 中国中医药信息杂志

Malignant lymphoma comes from the lymphoid tissues, which is closely related to immune. The tumor occurs mainly in lymph nodes, but also can occur in the lymph nodes and non-lymphoid tissues. Western medicine treatment for lymphoma is often recurrence after chemotherapy and radiotherapy. TCM not only can play a role in reducing toxicity and increasing the effect of chemotherapy, but also has a good effect on the prevention and treatment of recurrence and metastasis. Professor ZHANG Pei-tong in tumor department of Guang’anmen Hospital of China Academy of Chinese Medicine Sciences usesLiujun Ermu Decotion, which has very good efficacy for malignant lymphoma. This article concluded the clinical experience of Professor ZHANG Pei-tong in usingLiujun ErmuDecotion.

Progress of T-cell lymphoma treatment / 白血病·淋巴瘤

The 14th International Conference on Malignant Lymphoma (ICML) was held in Lugano, Switzerland from June 14, 2017 to June 17, 2017. More than 3500 lymphoma experts and scholars attended this unprecedented conference. In particular, the Joint Forum on Union for China Lymphoma Investigators (UCLI)-ICML jointly organised by UCLI and ICML had greatly improved Chinese academic status in the field of lymphoma worldwide. Chinese experience on the treatment of T-cell lymphoma was exchanged during the conference. This paper reviews the recent progress in treatment of T-cell lymphoma in the meeting.

Molecular Testing of Lymphoproliferative Disorders: Current Status and Perspectives

Molecular pathologic testing plays an important role for the diagnosis, prognostication and decision of treatment strategy in lymphoproliferative disease. Here, we briefly review the molecular tests currently used for lymphoproliferative disease and those which will be implicated in clinical practice in the near future. Specifically, this guideline addresses the clonality test for B- and T-cell proliferative lesions, molecular cytogenetic tests for malignant lymphoma, determination of cell-of-origin in diffuse large B-cell lymphoma, and molecular genetic alterations incorporated in the 2016 revision of the World Health Organization classification of lymphoid neoplasms. Finally, a new perspective on the next-generation sequencing for diagnostic, prognostic, and therapeutic purpose in malignant lymphoma will be summarized.

CTLA-4 and PD-1:the potential immunotherapeutic targets for malignant lymphoma / 中华微生物学和免疫学杂志

The human immune system has the regulatory functions of eradicating pathogens and limiting excessive inflammation, which protect the surrounding tissue from being damaged. The immune bal-ance of self-limiting is mainly controlled by complex interactions between antigen-presenting cells ( APCs ) and T cells. However, the immune balance is destroyed in cancer, which results in immune evasion and tumor metastasis or promotes the development of drug resistance. Immune checkpoints play critical roles in the immune system. Therefore, blocking tumor immune evasion by targeting the immune checkpoints has be-come a research focus in the treatment of relapsed or refractory malignant tumors. Currently, in the studies of malignant lymphomas, some phaseⅠ/Ⅱclinical studies of immune checkpoint inhibitors have achieved sur-prising results. This review will discuss the regulation and immunotherapy of immune checkpoints in malig-nant lymphomas.

Treatment progress of malignant lymphoma：reports from the 57th American Society of Hematology annual meeting / 白血病·淋巴瘤

In recent years, there has been significant progress in the treatment of malignant lymphoma, new drugs and new treatment strategies continue to emerge, such as chimeric antigen receptor (CAR) T cells immunotherapy. The issue of malignant lymphoma has received a lot of attention. The recent progress of malignant lymphoma reported in the 57th American Society of Hematology annual meeting were briefly introduced in this article.

A Case of Pediatric Nodal Marginal Zone Lymphoma / 소아외과

Lymph node enlargement is a common finding in children suggesting normal or benign. Palpable nodes which are large, hard or fixed must be examined carefully to rule out malignant diseases. In this case, a 15-year-old boy presented to our hospital to inspect the palpable mass at his post-auricular area being found 2 months ago. It was diagnosed as nodal marginal zone lymphoma (NMZL) through excisional biopsy and immunohistochemistry. NMZL is very rare, especially in children and young adults, but occurs locally in most cases with a good prognosis compared to adults. We described a rare case of NMZL diagnosed in adolescent.

Malignant Lymphoma of the pelvis A case report

Lipomas are most common benign tumours derived from adipose tissue. Lipoma breast is somewhat difficult to diagnose clinically because of fatty consistency of breast. Lipoma breast measuring more than 10 cm in diameter or weighing more than 1 kg is called giant lipoma of breast which is infrequently observed because of rarity in size and location, with only very few case reports available in literature. Here, we have reported a case of this rare entity in 80 years old female who presented with complaints of painless lump in her right breast at our hospital

Chronic Lymphocytic Inflammation with Pontine Perivascular Enhancement Responsive to Steroids with a Significant Elevation of beta-2 Microglobulin Levels

Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a relapsing-remitting disorder for which steroid administration is a key to control the progression. CLIPPERS can exhibit radiological features similar to malignant lymphoma, whose diagnosis is confounded by prior steroid administration. We report a case of CLIPPERS accompanied by abnormal elevation of beta-2 microglobulin in the cerebrospinal fluid (CSF). A 62-year-old man started to experience numbness in all fingers of his left hand one year ago, which gradually extended to his body trunk and legs on both sides. Magnetic resonance imaging demonstrated numerous small enhancing spots scattered in his brain and spinal cord. CSF levels of beta-2 microglobulin were elevated; although this often indicates central nervous system involvement in leukemia and lymphoma, the lesions were diagnosed as CLIPPERS based on the pathological findings from a biopsy specimen. We emphasize the importance of biopsy to differentiate between CLIPPERS and malignant lymphoma because the temporary radiological response to steroid might be the same in both diseases but the treatment strategies regarding the use of steroid are quite different.

The latest progress of chronic lymphocytic leukemia: reports from the 13th International Conference on Malignant Lymphoma, Lugano / 白血病·淋巴瘤

The 13th International Conference on Malignant Lymphoma (ICMC) was held in Lugano, Switzerland from June 17 to 20, 2015.There was the enormous progress in the treatment of chronic lymphocytic leukemia in the past years, especially in 2014, 4 new agents for the treatment of chronic lymphocytic leukemia were approved in USA and Europe, which caused great attention on the issue of chronic lymphocytic leukemia.The latest progress of chronic lymphocytic leukemia reported at the conference was briefly introduced in this paper.

Psychological experience of adolescent malignant lymphoma patients: a qualitative research / 中国实用护理杂志

Objective This research aims to provide a theoretical basis for the nursing care for adolescent malignant lymphoma patients by probing into their emotional experience.Methods In-depth interview of qualitative study is adopted in the interviews with 9 adolescent malignant lymphoma patients,while Colaizzi' s seven-step data analytical approach is utilized to analyze and sort the data before the main idea is concluded and refined.Results These adolescent malignant lymphoma patients,with complicated psychological changes and a suicidal tendency,find it hard to cope with stress.Conclusions Nursing care should be provided to such patients and there should be a respect for their rights to know their disease as well as a timely crisis intervention to those who have a suicidal tendency.Furthermore,due attention should be given to the mental states of the family members and the stability of the family of the patients.We also call for the love and more support for these patients from the government and caring people in society.

Effect of autologous hematopoietic stem cell transplantation on serum trace elements and lactate dehydrogenase activity in patients with malignant lymphoma / 中国生化药物杂志

Objective To investigate effect of autologous hematopoietic stem cell transplantation on serum trace elements and lactate dehydrogenase activity in patients with malignant lymphoma.Methods 80 patients with malignant lymphoma collected in our hospital from May 2013 to May 2014,40 cases in each group, Hodgkin lymphoma ( HL) patients were treated with ABVD ( doxorubicin, bleomycin, vincristine, dacarbazine) regimen of chemotherapy; Non-Hodgkin,s lymphoma ( NHL) patients were treated with standard CHOP ( cyclophosphamide, vincristine, epirubicin, dexamethasone) regimen of chemotherapy of two group.Chemotherapy drugs combined with granulocyte colony stimulating factor ( G-CSF) was used to mobilize APBSC.Application of 10μg/(kg? d)G-CSF 5 in bone marrow suppression after chemotherapy, detected white cell increased 3.0 ×109/L , platelets rose to 50 ×109/L, collected APBSC,The frozen stock solution of cell was joined and frozen.24 h after pre-treatment, the frozen peripheral blood hematopoietic stem cells of the subclavian vein was transfused for patients in experimental group.Control group continued to receive chemotherapy. After treatment, the Cu level, Zn level and lactate dehydrogenase activity were detected in all patients.ResuIts After treatment, Zn levels of two groups increased (P<0.05), Cu and Cu/Zn levels decreased (P<0.05).Compared with control group, the level of Zn was higher in experimental group (P<0.05), and the level of Cu and Cu/Zn was lower (P<0.05).After treatment, the lactate dehydrogenase activity of two groups decreased (P<0.05), and experimental group was more lower than control groupy (P<0.05).ConcIusion Autologous hematopoietic stem cell transplantation can significantly reduce the level of Cu in patients with malignant lymphoma , elevate Zn level and decrease the activity of lactate dehydrogenase, which has guiding significance for clinical.