ABSTRACT
PURPOSE OF REVIEW: Peripheral T cell lymphoma (PTCL) is a heterogeneous group of lymphoproliferative neoplasms, with at least 29 distinct entities described in current WHO classification. Using present diagnostic approaches, more than a third of PTCL cases cannot be classified, hence designated as PTCL-not otherwise specified (PTCL-NOS). Herein, we summarize the current genomic findings and their role in the molecular pathogenesis in different PTCL entities. RECENT FINDINGS: Gene expression profiling (GEP) studies have identified distinct molecular signatures for accurate diagnosis and elucidated oncogenic pathways enriched in major PTCL entities. Furthermore, genomic characterization has identified recurrent somatic mutations and potential therapeutic targets. Further efforts are underway to develop genetically faithful murine models. GEP studies have identified molecular subgroups of PTCL, characterized by distinct genetic and epigenetic alterations. Understanding the molecular mechanisms of T cell lymphomagenesis using in vivo model will help to reveal novel therapeutic targets.
Subject(s)
Gene Expression Profiling , Gene Expression Regulation, Neoplastic , Lymphoma, T-Cell, Peripheral , Animals , Humans , Lymphoma, T-Cell, Peripheral/classification , Lymphoma, T-Cell, Peripheral/genetics , Lymphoma, T-Cell, Peripheral/immunology , Lymphoma, T-Cell, Peripheral/therapy , Mice , Neoplasms, Experimental/classification , Neoplasms, Experimental/genetics , Neoplasms, Experimental/immunology , Neoplasms, Experimental/therapy , World Health OrganizationABSTRACT
AIM: To evaluate practice patterns of hematopoietic cell transplantation (HCT) for acute lymphoblastic leukemia. MATERIALS & METHODS: We utilized the National Cancer Database to extract patient-level data of adults (aged 18-80 years) diagnosed with acute lymbhoblastic leukemia between 2003 and 2012. We performed multivariable logistic regression to determine variables associated with the use of HCT. RESULTS: Out of a total of 11,871 patients, 12.7% received HCT. In a multivariate analysis, older age, male sex, higher Charlson co-morbidity score, nonacademic treatment center, poor education and Medicare/Medicaid or no insurance were associated with lower likelihood of receiving HCT. CONCLUSION: Our study demonstrates variations in the utilization of HCT based on socioeconomic and health system factors.
Subject(s)
Hematopoietic Stem Cell Transplantation/statistics & numerical data , Practice Patterns, Physicians'/statistics & numerical data , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , Adult , Age Factors , Aged , Comorbidity , Educational Status , Female , Humans , Male , Medicaid/statistics & numerical data , Medicare/statistics & numerical data , Middle Aged , Precursor Cell Lymphoblastic Leukemia-Lymphoma/epidemiology , Sex Factors , Transplantation, Homologous/statistics & numerical data , United States , Young AdultABSTRACT
A sixty-eight-year-old male with a past medical history of recurrent cocaine use presented to the emergency department with recurrent diarrhea and was found to have a white blood cell (WBC) count of 1.9 × 109/L with agranulocytosis (absolute neutrophil count (ANC) of 95 cell/mm3). At admission, the patient disclosed that he used cocaine earlier during the day, and a urine drug screen tested positive for this. On hospital day one, the patient was found to have a fever with a maximum temperature of 313.6 K. After ruling out other causes and noting the quick turnaround of his neutropenia after four days of cocaine abstinence, the patient's neutropenia was attributed to levamisole-adulterated cocaine.
