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Abbreviated chemotherapy for limited-stage diffuse large B-cell lymphoma after complete resection
조정민,윤덕현,이상욱,박찬식,Jooryung Huh,Kyoungmin Lee,강은희,Shin Kim,서철원 대한혈액학회 2014 Blood Research Vol.49 No.2
Background Abbreviated chemotherapy followed by radiotherapy or full cycles of chemotherapy is recommended as a standard treatment for limited-stage (LS) diffuse large B-cell lymphoma (DLBCL). After complete resection of tumors, however, Burkitt and childhood B-cell Non-Hodgkin lymphoma show favorable outcomes, even after abbreviated chemotherapy of only 2 or 3 cycles. We investigated the effectiveness of abbreviated chemotherapy in patients with LS DLBCL after complete tumor resection. Methods We retrospectively reviewed 18 patients with LS DLBCL who underwent complete tumor resection followed by either 3 or 4 cycles of chemotherapy between March 2002 and May 2010. Results With a median follow-up period of 57.9 months (range, 31.8‒130.2 months), no patients experienced disease relapse or progression; however, 1 patient experienced secondary acute myeloid leukemia during follow-up. The 5-year progression-free survival rate and overall survival rate were 93.3% and 94.1%, respectively. Conclusion These results warrant further investigation into abbreviated chemotherapy as an alternative treatment for patients who have undergone complete resection of LS DLBCL.
Detection of Epstein - Barr Virus Encoded RNA in Cutaneous T - cell Lymphoproliferative Disorders
Chang, Sung Eun,Huh, Jooryung,Choi, Jee Ho,Sung, Kyung Jeh,Moon, Kee Chan,Koh, Jai Kyoung,Yoon, Ghil Suk 대한피부과학회 2000 Annals of Dermatology Vol.12 No.3
Background: Recent reports suggest that Epstein-Barr virus (EBV) may play an important role in such a wide spectrum of human neoplasia. Recently, peripheral T cell lymphomas and particularly, angiocentric lymphomas (ACL), increasingly are reported to be associated with EBV. Nasal-type and nasal T/NK cell lymphoma (TNKL) have recently been reported to comprise most of ACLs. The prognosis of these tumors has been extremely poor. Objective: The purpose of this study was to investigate EBV association in primary or secondary cutaneous T-cell lymphoproliferative disorders and to identify any prognostic association. Methods: Thirty six patients with primary or secondary cutaneous T-cell lymphoproliferative (CTCL) disorders were examined to evaluate the presence of Epstein-Barr virus using in situ hybridization for EBV-encoded RNA (EBER). Results : EBER was detected in tumor cells in one third of the total cases (13/36); 4/4 secondary skin lymphoma from nasal TNKL, 8/8 primary cutaneous nasal type TNKLs and 1/5 mycosis fungoides (MF). EBER was not detected in the following disease: 6 cases of anaplastic large cell lymphomas (ALCL) including 2 cases of probable NK-like T cell lineage, 3 lymphomatoid papulosis, 2 CD56(-) T cell ACLs and 7 subcutaneous panniculitic T-cell lymphomas (SPTL) by Revised European-American Lymphoma (REAL) classification and recent concept of further classification into NK-cell lineage. One case of T-cell pseudolymphoma as a negative control was also negative in EBER. Conclusion : High incidence of EBV was observed in primary or secondary CTCLs in Koreans, with predilection for nasal and nasal type TNKL. In MFs, an erythrodermic MF with fatal outcome was associated with EBV and the EBV detection might reflect worse prognosis in MFs as seen in an aggressive course of nasal and nasal type TNKLs.
( Changhoon Yoo ),( Dok Hyun Yoon ),( Shin Kim ),( Chan Sik Park ),( Jooryung Huh ),( Sang Wook Lee ),( Jung Sun Park ),( Cheolwon Suh ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Although serum Beta-2 microglobulin (B2M) has been suggested as a prognostic factor for several hematologic malignancies, this was rarely investigated in marginal zone lymphoma (NZL). Materials: Between January, 2000, and May, 2013, a total of 270 patients with non-gastric (NG)-MZL were identified from database of Asan Medical Center, Seoul, Korea. Among them, pretreatment baseline serum B2M was available in 204 patients. Progression-free survival (PFS) and overall survival (OS) were compared according to the level of B2M with cut-off value of 2.5 mg/L. Results: Median age of study population was 51 year-old (range, 16-81) and 85 (42%) patients were male. Thirty (15%) patients had nodal MZL and 174 (85%) had extranodal MALToma. B2M =2.5 mg/L was related with more adverse clinical features, such as poor performance status, =2 extranodal sites, advanced stage (III-IV), anemia, elevated LDH, bone marrow invasion, and higher IPI risk group. In univariate analysis, serum B2M (<2.5 mg/L vs =2.5 mg/L) was significantly associated with PFS (p<0.001) and OS (p<0.001). In multivariate analysis including B2M and International Prognostic Index (IPI), serum B2M =2.5 mg/L was an independent adverse prognostic factor in terms of PFS (hazard ratio [HR]=3.7, 95% CI, 1.5-9.1; p=0.005) and OS (HR=7.5, 95% CI, 1.7-32.7; p=0.008). In analysis including Korean MZL Prognostic Index (MZLPI: nodal MZL, ECOG performance status =2 and advanced stage), B2MG =2.5 mg/L was also significant for PFS (HR=3.5, 95% CI, 1.5-7.7; p=0.003) and OS (HR=7.3, 95% CI 1.9- 28.2; p=0.004). Conclusion: In patients with NG-MZL, baseline serum B2M is a powerful prognostic factor for PFS and OS, independent of validated prognostic indexes, such as MZLPI and IPI.
Kim, Soo Hee,Choe, Ji-young,Jeon, Yoonkyong,Huh, Jooryung,Jung, Hye Ra,Choi, Yoo-Duk,Kim, Hyun-Jung,Cha, Hee Jeong,Park, Weon Seo,Kim, Ji Eun BMJ Publishing Group Ltd 2013 Journal of clinical pathology Vol.66 No.7
<P><B>Aims</B></P><P>Although the tumour cells of Hodgkin lymphoma (HL) are derived from mature B-cells, the lineage infidelity of Hodgkin/Reed–Sternberg cells (HRSs) often causes diagnostic problems. Recently introduced HRS markers are also positive for follicular dendritic cells (FDCs). We investigated the expression of several FDC markers in HL and anaplastic large cell lymphoma (ALCL) and evaluated their diagnostic efficacy.</P><P><B>Methods</B></P><P>Eighty-five cases of HL and 52 cases of ALCL were included in this study. Immunohistochemistry was performed for glioma-associated homologue (GLI) 3, class III β-tubulin (TUBB3), fascin, clusterin, γ-synuclein, podoplanin, syntenin, CD21, CD35 and EGFR.</P><P><B>Results</B></P><P>HRSs were diffusely positive for GLI3, fascin and TUBB3; the mean positivity rates per case were 94% for GLI3, 82% for fascin, 69% for TUBB3, 17% for clusterin, 17% for γ-synuclein and 14% for syntenin. Podoplanin, CD21, CD35 and EGFR were almost negative. However, the frequency of marker expression was not associated with the histologic subtype or the presence of Epstein–Barr virus (EBV). ALCL showed a similar pattern to HL, but the overall frequency of positivity was lower than that observed in HL. The mean positivity rates were 56% for GLI3, 62% for fascin, 58% for TUBB3 and 21% for clusterin. The other markers were nearly negative. Anaplastic large cell lymphoma kinase positivity did not affect the expression rates.</P><P><B>Conclusions</B></P><P>This study confirmed the frequent expression of FDC markers in HL and ALCL. Especially, GLI3, fascin and TUBB3 are the most sensitive markers. Further studies are required to evaluate the association between FDCs, HRSs and ALCL cells.</P>