Large-cell neuroendocrine tumor of the prostate: a case report and review of the literature.

BACKGROUND: Primitive neuroendocrine prostate neoplasms are rarely reported. This entity comprises carcinoïd tumors and poorly differentiated neuroendocrine tumors, mainly those of the small-cell type. Large-cell-type primitive tumors are exceptional, and only nine cases are reported in the literature. Similar to neuroendocrine tumors of the prostate, large-cell-type primitive tumors may be observed in the context of conventional adenocarcinoma during androgen deprivation therapy or as prostatic metastasis of a distant neuroendocrine tumor, mainly pulmonary neoplasms. CASE PRESENTATION: We report a Caucasian case of a mixed prostatic carcinoma, with the largest component being the large-cell neuroendocine carcinoma, in a patient who underwent a total prostatectomy for a localized cancer. Diagnostic, histological, therapeutic and evolutive aspects are reported and discussed. CONCLUSIONS: Large-cell primitive prostate neuroendocrine carcinoma is a rare but aggressive histological entity, which can be associated or not with an adenocarcinomatous component. Mixed forms have a better outcome, mainly when diagnosed at an early stage.

Mobilization of peripheral blood progenitor cells after DHAP regimen with or without rituximab: a large multicenter comparative study in patients with malignant lymphoma.

DHAP regimen is commonly used in patients with lymphoma. It is routinely used in combination with the monoclonal anti-CD20 antibody rituximab (R-DHAP), particularly for peripheral blood stem cell (PBSC) mobilization. The aim of this study was to assess the impact of rituximab on PBSC mobilization in patients with lymphoma receiving DHAP chemotherapy. We retrospectively reviewed the data of patients treated by DHAP or R-DHAP regimens as PBSC mobilization protocol between July 1998 and June 2005. Sixty-nine patients were included in the study: 21 in the DHAP group and 48 in the R-DHAP group. Both groups were not statistically different in term of clinical and biological presentation of the disease. The first cytapheresis was performed at day 10 in the R-DHAP group versus day 11 in the DHAP group. In contrast, the number of circulating CD34(+) cells was higher, but not significant, in the R-DHAP group than the DHAP group, namely 9.7x10(6) CD34(+) cells/kg and 6.1x10(6) CD34(+) cells/kg, respectively. Finally, the complete remission status at time of harvest was the only one factor associated with poor mobilization on multivariate analysis. In conclusion, our results show that rituximab does not impair PBSC collection.

[Dose density and dose intensity in the treatment of breast cancer]. / Densité de dose et intensité de dose dans le traitement du cancer du sein.

Since 10 years, high-dose chemotherapy has been evaluated for the treatment of breast cancer in numerous randomized clinical trials. Preliminary results of some of these studies have shown an advantage in relapse-free survival in both metastatic and high-risk breast cancer. Although follow-up is short in most of the studies, no impact on overall survival has been detected. Based on available results, high-dose chemotherapy cannot be proposed either in metastatic or in high-risk breast cancer patients outside a clinical trial. Conversely, two randomized trials have demonstrated that dose-dense scheduled chemotherapy with G-CSF support, containing an anthracycline, cyclophosphamide and paclitaxel, improves clinical outcomes compared with the same regimen administered every 3 weeks. These results establish dose-dense scheduled chemotherapy containing an anthracycline and paclitaxel as an option for the adjuvant treatment of positive lymph nodes breast cancer patients. Data are not sufficient to conclude in the neoadjuvant and metastatic setting. High-dose chemotherapy and dose-dense chemotherapy seem to increase the pathological complete response rate in inflammatory breast cancer. However, prospective and comparative survival data are lacking.