ABSTRACT
The cryoprotectant dimethyl sulfoxide (DMSO) is known to have toxic side effects, yet guidelines for its use in stem cell transplantation do not exist. To assess current practice in the use of DMSO and the incidence of DMSO-related complications, a single page questionnaire was mailed to 444 EBMT centres involved in autologous transplantation. The responses from 97 centres showed a wide variation in practice between transplant units regarding the concentration of DMSO used, daily DMSO dose restriction and the use of cell washing. The overall incidence of DMSO toxicity was approximately one in 70 transplants and most cases were cardiovascular and respiratory in nature. There was a trend to reduced complication rates in centres using lower concentrations of DMSO or washing cells prior to return. A large-scale prospective study of the strategies for reduction in exposure to DMSO and reduction in toxic effects is required before guidelines in the use of DMSO in stem cell cryopreservation can be promulgated.
Subject(s)
Bone Marrow Transplantation/methods , Cryopreservation/methods , Dimethyl Sulfoxide/pharmacology , Stem Cell Transplantation/methods , Cryopreservation/instrumentation , Cryoprotective Agents/pharmacology , Dimethyl Sulfoxide/chemistry , Dimethyl Sulfoxide/toxicity , Humans , Prospective Studies , Stem Cell Transplantation/instrumentation , Surveys and QuestionnairesABSTRACT
Fourteen cases of breast lymphoma, identified from hospital records between 1990 and 2004, were reclassified according to the World Health Organisation criteria. Primary cases occurred more frequently and all cases were of B cell origin, predominantly involving the right breast. Most primary cases were diffuse large B cell lymphomas, whereas secondary cases were heterogeneous in type and most had a poor prognosis.
Subject(s)
Breast Neoplasms/classification , Lymphoma/classification , Aged , Aged, 80 and over , B-Lymphocytes/pathology , Breast Neoplasms/pathology , Breast Neoplasms/secondary , Breast Neoplasms, Male/classification , Breast Neoplasms, Male/pathology , Female , Humans , Lymphoma/pathology , Lymphoma, B-Cell/classification , Lymphoma, B-Cell/pathology , Male , Middle Aged , Prognosis , World Health OrganizationSubject(s)
Bone Marrow Transplantation , Immunotherapy, Adoptive , Leukemia, Myeloid/therapy , Psoriasis/complications , Psoriasis/therapy , Acute Disease , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Humans , Leukemia, Myeloid/complications , Leukemia, Myeloid/drug therapy , Leukemia, Myeloid/immunology , Lymphocyte Depletion , Lymphocyte Transfusion , Male , Psoriasis/immunology , Recurrence , T-Lymphocytes/immunology , T-Lymphocytes/pathology , T-Lymphocytes/transplantation , Treatment OutcomeSubject(s)
Cryoprotective Agents/toxicity , Dimethyl Sulfoxide/toxicity , Neurotoxicity Syndromes/etiology , Stem Cell Transplantation/adverse effects , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Combined Modality Therapy , Cryopreservation , Female , Hematopoietic Stem Cells/cytology , Hematopoietic Stem Cells/drug effects , Humans , Middle Aged , Multiple Myeloma/drug therapy , Multiple Myeloma/therapy , Treatment OutcomeABSTRACT
Breast lymphoma accounts for less than 1% of all non-Hodgkin's lymphomas (NHLs) and approximately 0.1% of all breast neoplasms. Most breast lymphomas are classified as diffuse large B cell or mucosa associated lymphoid tissue (MALT) lymphomas. The case of a 53 year old woman presenting with a breast mass and found to have mantle cell lymphoma is described. Core biopsy of the breast lesion showed a B cell NHL, probably of large cell type and of high grade. Morphological and immunophenotypic analysis of peripheral blood and bone marrow samples suggested a mantle cell lymphoma (MCL). This was confirmed by the detection of a t(11;14) in the bone marrow aspirate and breast tissue by polymerase chain reaction analysis. There have been no previous reports of an MCL presenting as a breast lump. Because a diagnosis of MCL has prognostic and therapeutic implications, this case highlights the need for an awareness of MCL presenting in this way, and the requirement for specialised investigations in its detection.
