Primary esophageal lymphoma is very rare, and most reported cases are histologically mucosa-associated lymphoid tissue lymphoma. Therefore, the principle treatment strategy for primary esophageal lymphoma focuses on local treatments, such as endoscopic mucosal resection or radiation therapy, but systemic chemotherapy plays the central role in the treatment of diffuse large B cell lymphoma (DLBCL). Generally, standard treatment for DLBCL is six or three cycles of R-CHOP chemotherapy followed by involved field radiation therapy according to stage. However, the optimal treatment strategy for primary esophageal DLBCL, and the role of additional radiation is not settled, due to a paucity of cases. Moreover, the clinical characteristics related to the etiology and natural course are also unknown. Here, we present two cases of primary esophageal DLBCL with a literature review.
Drug Therapy ; Esophagus ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Large B-Cell, Diffuse

This paper reports a case of malignant histiocytic lymphoma mainly in the frontal region with intracranial extradural extension. Operation was performed to remove the mass but the tumor began to recur rapidly. And so under the condition that the operative wound was not fully healed, the patient received radiotheray and chemotherapy postoperatively, with remarkable regession of the tumor.
Drug Therapy ; Humans ; Lymphoma ; Lymphoma, Large B-Cell, Diffuse* ; Scalp* ; Wounds and Injuries

<b>BACKGROUNDb>Rituximab in combination with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) significantly prolonged event-free survival in first-line chemotherapy for patients with diffuse large B-cell lymphoma (DLBCL). But relapse and refractory DLBCL occur frequently. Although rituximab is effective, its role in salvage therapy after autologous transplant remains unclear. Maintenance therapy with rituximab in responding patients after first line chemotherapy may be a useful novel approach capable of eradicating minimal residual disease and to bring survival benefit. This systematic review and meta-analysis evaluated the effects of rituximab maintenance treatment and salvage therapy of patients with DLBCL.

<b>METHODSb>We performed a systematic review and meta-analysis of randomized controlled trials and compared rituximab maintenance or salvage therapy at relapse with observation. We searched the Cochrane Library, PubMed, EMBASE, conference proceedings, databases of ongoing trials, and references of published trials. Two reviewers independently assessed the quality of the trials and extracted data. Hazard ratios for time-to-event data were estimated and pooled.

<b>RESULTSb>Seven trials including 1470 DLBCL patients were included in this systematic review and meta-analysis. Patients treated with maintenance rituximab have better overall survival (OS) and event-free survival (EFS) than patients in the observation arm, but there was no statistical significance. Patients who received rituximab salvage therapy for relapse or refractory DLBCL have statistically significantly better OS [HR of death = 0.72, 95% CI (0.55-0.94), P = 0.02], progression-free survival (PFS) [HR = 0.61, 95% CI (0.52-0.72), P < 0.05], odds ratio (OR) [RR = 1.26, 95% CI (1.07-1.47), P = 0.004] than patients in the observation arm. The rate of infection-related adverse events was higher with rituximab treatment [RR = 1.37, 95% CI = (1.14 - 1.65) P =0.001].

<b>CONCLUSIONSb>After first-line chemotherapy, the two rituximab-combined treatment strategies, including maintenance and salvage therapies can bring survival benefit. But due to the few studies, the low methodological quality assessment and the low outcome evidence quality, it's not confirmed that the two strategies are better than normal chemotherapy regimens. More high-quality randomized controlled trials are still needed to provide reliable evidence. The higher rate of infections after rituximab therapy should be taken into consideration when making treatment decisions.

OBJECTIVE: To investigate the effect of arsenic disulfide (AS METHODS: The human DLBCL cell OCI-LY3 was treated with different concentrations of AS RESULTS: The DLBCL cell viability was decreased significantly at 24, 48 or 72 h as cultured with itraconazole. Along with the increasing of itraconazole concentration, the DLBCL cell viability was significantly reduced as compared with that in control group, and the results showed statistically significant(r=-0.690，r=-0.639, r=-0.833, r=-0.808, r=-0.578). The inhibitory and apoptosis rates of the cells were significantly increased as compared with those of the single drug-treated group after treated by the combination of itraconazole and AS CONCLUSION Itraconazole can inhibit proliferation of DLBCL cells in a concentration-and time-dependent manner. In addition, the combination of AS
Apoptosis ; Arsenicals ; Hedgehog Proteins ; Humans ; Itraconazole/pharmacology* ; Lymphoma, Large B-Cell, Diffuse/drug therapy* ; Sulfides

Objective:b> To investigate the potential value of CT Radiomics model in predicting the response to first-line chemotherapy in diffuse large B-cell lymphoma (DLBCL). Methods:b> Pre-treatment CT images and clinical data of DLBCL patients treated at Shanxi Cancer Hospital from January 2013 to May 2018 were retrospectively analyzed and divided into refractory patients (73 cases) and non-refractory patients (57 cases) according to the Lugano 2014 efficacy evaluation criteria. The least absolute shrinkage and selection operator (LASSO) regression algorithm, univariate and multivariate logistic regression analyses were used to screen out clinical factors and CT radiomics features associated with efficacy response, followed by radiomics model and nomogram model. Receiver operating characteristic (ROC) curve, calibration curve and clinical decision curve were used to evaluate the models in terms of the diagnostic efficacy, calibration and clinical value in predicting chemotherapy response. Results:b> Based on pre-chemotherapy CT images, 850 CT texture features were extracted from each patient, and 6 features highly correlated with the first-line chemotherapy effect of DLBCL were selected, including 1 first order feature, 1 gray level co-occurence matrix, 3 grey level dependence matrix, 1 neighboring grey tone difference matrix. Then, the corresponding radiomics model was established, whose ROC curves showed AUC values of 0.82 (95% CI: 0.76-0.89) and 0.73 (95% CI: 0.60-0.86) in the training and validation groups, respectively. The nomogram model, built by combining validated clinical factors (Ann Arbor stage, serum LDH level) and CT radiomics features, showed an AUC of 0.95 (95% CI: 0.90-0.99) and 0.91 (95% CI: 0.82-1.00) in the training group and the validation group, respectively, with significantly better diagnostic efficacy than that of the radiomics model. In addition, the calibration curve and clinical decision curve showed that the nomogram model had good consistency and high clinical value in the assessment of DLBCL efficacy. Conclusion:b> The nomogram model based on clinical factors and radiomics features shows potential clinical value in predicting the response to first-line chemotherapy of DLBCL patients.
Humans ; Retrospective Studies ; Lymphoma, Large B-Cell, Diffuse/drug therapy* ; Algorithms ; Niacinamide ; Tomography, X-Ray Computed

A case of primary oral mucosal diffuse large B-cell lymphoma(DLBCL)due to long-term use of methotrexate(MTX)for the treatment of rheumatoid arthritis(RA)was admitted to the Department of Hematology,Fujian Medical University Union Hospital.We analyzed and discussed the clinical features,diagnosis and treatment,and prognosis of specific malignant lymphoma induced by MTX in this RA patient.Our purpose is to improve the awareness and knowledge of other iatrogenic immunodeficiency-associated lymphoproliferative disorders of clinicians and pathologists.This study provides a new reference for the clinical diagnosis and treatment of MTX-associated DLBCL.
Arthritis, Rheumatoid/drug therapy* ; Humans ; Lymphoma, Large B-Cell, Diffuse/drug therapy* ; Lymphoproliferative Disorders ; Methotrexate/adverse effects*

CD19 chimeric antigen receptor T-cell (CAR-T) therapy, a genetically engineered cell therapy, showed unprecedented efficacy in the treatment of relapsed or refractory diffuse large B-cell lymphoma. Two agents, axicabtagene ciloleucel and tisagenlecleucel, were approved by the Food and Drug Administration in 2017. However, CAR-T therapy is a treatment with complex logistics and high costs, as well as inherent adverse events, including cytokine-release syndrome and neurotoxicity. In addition, predictive biomarkers for efficacy and toxicity are lacking. Industry-academy cooperation is urgently required to develop CAR-T therapy that is effective, safe, and affordable for patients in Korea.
B-Lymphocytes ; Biomarkers ; Cell- and Tissue-Based Therapy ; Humans ; Korea ; Lymphoma, B-Cell ; Lymphoma, Large B-Cell, Diffuse ; Organization and Administration ; Receptors, Antigen ; T-Lymphocytes ; United States Food and Drug Administration

PURPOSE: The aim of this study was to evaluate the clinical features, histologic classification and treatment outcomes of patients with malignant lymphoma of the eye. METHODS: The participants included 22 patients with malignant lymphoma of the orbit and ocular adnexa treated at our hospital between May 1994 and September 2001. The authors retrospectively analyzed the sex, age, location of mass, histopathologic type, stage and results of the treatment. RESULTS: Of the 22 patients, 14 cases were male and 8 were female. The age ranged from 26 to 68 years (mean age 43 years). The most common presenting complaint was slowly growing mass of the eye. Histopathologic studies revealed extranodal marginal zone B-cell lymphoma, MALT type in 20 cases (91%). The stages of lymphomas were included I AE in 14 cases (63%), II AE in 3 cases (14%), III AE in 3 cases (14%) and IV A in 2 cases (9%). Patients received radiotherapy and/or chemotherapy. Twenty out of 22 cases (91%) achieved a complete remission. During the mean follow-up of 26 months, two patients died of progression of the disease; one patient had extranodal marginal zone B-cell lymphoma, MALT type of stage III AE and the other patient had diffuse large cell lymphoma of stage II AE. CONCLUSIONS: Radiotherapy can produce durable remission in the majority of the patients with localized primary orbital lymphoma. Chemotherapy should be performed for the patients with highly malignant lymphomas or lymphomas with systemic manifestations.
Classification ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Lymphoma* ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Large B-Cell, Diffuse ; Male ; Orbit* ; Radiotherapy ; Retrospective Studies

<b>OBJECTIVEb>To report the diagnosis, differential diagnosis and treatment of three rare cases of primary bone marrow diffuse large B cell lymphoma (DLBCL), and to improve the recognition of this disease.

<b>METHODSb>The clinical characteristics, therapeutic course and the outcome of these patients were reviewed. Meanwhile, a series of examinations including morphology, flow cytometry, immunohistochemistry and molecular biology of bone marrow samples were also performed.

<b>RESULTSb>These three patients who were old at the onset age (56, 60 and 70 years old), primarily revealed as abnormal blood count and experienced an aggressive course of disease. Physical and imaging examination showed no enlargement of lymph node, liver and spleen, the patients were finally diagnosed as primary bone marrow DLBCL by bone marrow morphology, flow cytometry and immunohistochemistry analyses. They were treated with rituximab combined chemotherapy, which achieved a complete response, but still need longer follow-up to further evaluate their survival.

<b>CONCLUSIONb>Primary bone marrow DLBCL was encountered rarely in clinical practice, and this is the first report in China. Further investigation of pathogenesis and therapeutic strategies of this rare disease was warranted.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; L-Lactate Dehydrogenase ; blood ; Lymphoma, Large B-Cell, Diffuse ; blood ; diagnosis ; drug therapy ; Male