A multicenter retrospective study on the real-world outcomes of autologous vs. allogeneic hematopoietic stem cell transplantation for peripheral T-cell lymphoma in China / 中华医学杂志(英文版)

BACKGROUND@#There were few studies on real-world data about autologous hematopoietic stem cell transplantation (auto-HSCT) or allogeneic HSCT (allo-HSCT) in peripheral T-cell lymphoma (PTCL). This study aimed to investigate the clinical outcomes of patients who received auto-HSCT or allo-HSCT in China.@*METHODS@#From July 2007 to June 2017, a total of 128 patients who received auto-HSCT (n  = 72) or allo-HSCT (n  = 56) at eight medical centers across China were included in this study. We retrospectively collected their demographic and clinical data and compared the clinical outcomes between groups.@*RESULTS@#Patients receiving allo-HSCT were more likely to be diagnosed with stage III or IV disease (95% vs. 82%, P = 0.027), bone marrow involvement (42% vs. 15%, P = 0.001), chemotherapy-resistant disease (41% vs. 8%, P = 0.001), and progression disease (32% vs. 4%, P < 0.001) at transplantation than those receiving auto-HSCT. With a median follow-up of 30 (2-143) months, 3-year overall survival (OS) and progression-free survival (PFS) in the auto-HSCT group were 70%(48/63) and 59%(42/63), respectively. Three-year OS and PFS for allo-HSCT recipients were 46%(27/54) and 44%(29/54), respectively. There was no difference in relapse rate (34%[17/63] in auto-HSCT vs. 29%[15/54] in allo-HSCT, P = 0.840). Three-year non-relapse mortality rate in auto-HSCT recipients was 6%(4/63) compared with 27%(14/54) for allo-HSCT recipients (P = 0.004). Subanalyses showed that patients with lower prognostic index scores for PTCL (PIT) who received auto-HSCT in an upfront setting had a better outcome than patients with higher PIT scores (3-year OS: 85% vs. 40%, P = 0.003). Patients with complete remission (CR) undergoing auto-HSCT had better survival (3-year OS: 88% vs. 48% in allo-HSCT, P = 0.008). For patients beyond CR, the outcome of patients who received allo-HSCT was similar to that in the atuo-HSCT group (3-year OS: 51% vs. 46%, P = 0.300).@*CONCLUSIONS@#Our study provided real-world data about auto-HSCT and allo-HSCT in China. Auto-HSCT seemed to be associated with better survival for patients in good condition (lower PIT score and/or better disease control). For patients possessing unfavorable characteristics, the survival of patients receiving allo-HSCT group was similar to that in the auto-HSCT group.

Peripheral T-cell lymphoma not otherwise specified with oral manifestation: a case report / Linfoma periférico de células T no especificado con manifestación oral: reporte de caso

Peripheral T-Cell Lymphoma Not Otherwise Specified it is a rare type of Non-Hodgkin t-cells malignant tumor whose oral manifestations are difficult to diagnose. A case of a 48-year-old male with a hemi-maxillary lesion histological and immunohistochemically compatible with Peripheral T-Cell Lymphoma not otherwise specified is presented. A case of a 48-year-old male with a hemi-maxillary lesion histological and immunohistochemically compatible with Peripheral T-Cell Lymphoma not otherwise specified is presented. The patient treatment consisted of chemotherapy, but after the second cycle, died from immunosuppressive complications. Early stage diagnosis of oral lesions is imperative to avoid aggressive treatment and low overall survival rate of such pathologies.

Introducción: El linfoma periférico de células T no especificado es un tipo raro de tumor maligno no Hodgkin de células T cuyas manifestaciones orales son difíciles de diagnosticar. Se presenta el caso de un varón de 48 años con lesión hemimaxilar histológica e inmunohistoquímicamente compatible con linfoma periférico de células T no especificado. El tratamiento del paciente consistió en quimioterapia, pero después del segundo ciclo, falleció por complicaciones inmunosupresoras. El diagnóstico temprano de las lesiones orales es imperativo para evitar un tratamiento agresivo y la baja tasa de supervivencia.

Sinusite complicada ou algo mais? Relato de caso / Complicated sinusitis or something else? Case report.

JUSTIFICATIVA E OBJETIVOS: O linfoma periférico de células NK e T tipo nasal é de difícil diagnóstico, em se considerando vários aspectos tais como a relativa raridade da doença, diversidade dos achados clínicos, necessidade de exames complementares sofisticados, amostras adequa­das para biópsia e, ainda, um confuso padrão morfológico celular. Este cenário propicia retardo de tempo para obten­ção do diagnóstico final, tempo este precioso, em se consi­derando a agressividade e refratariedade aos tratamentos. O objetivo deste artigo foi relatar um caso deste tipo de linfoma "mascarado" por sinusite e que, ainda com trata­mento instituído, motivou o óbito do paciente. RELATO DO CASO: Paciente do sexo masculino, 22 anos, apresentando sinusite havia seis meses sem resposta ao tra­tamento com antibióticos e procedimentos cirúrgicos com biópsia. Internado na enfermaria de Clínica Médica, devi­do a persistência de sintomas sugestivos de sinusite crônica, apresentando edema periorbitário à direita, lesão ulcerada na hemiface direita e ausência de linfonodos. Os exames de imagem foram compatíveis com sinusite e biópsia prévia demonstrou processo inflamatório inespecífico, sem células atípicas. Foi realizado ultra-sonografia (US) de abdômen que demonstrou hepatoesplenomegalia. O paciente apresentou pneumonia nosocomial, hemorragia digestiva alta piora da função renal e hepática; após o resultado do exame ­anatomopatológico da biópsia de pele compatível com linfoma, foi iniciado tratamento com imunossupressor, porém sem resposta adequada e consequente evolução ao óbito. CONCLUSÃO: O diagnóstico precoce do linfoma periférico de células NK e T tipo nasal a despeito de sua raridade é de extrema relevância pela necessidade de tratamento precoce.