J. Collazo-Jaloma

MAGE-A3 expression is an adverse prognostic factor in diffuse large B-cell lymphoma.

Abstract This study evaluates the prognostic value of MAGE-A3 expression in 28 diffuse large B-cell lymphoma (DLBCL) patients. A significant association was observed between MAGE-A3 expressions, assessed by quantitative real-time RT-polymerase chain reaction (PCR), with advanced stages of disease (P<0·05). Elevated serum lactate dehydrogenase (LDH) levels and International Prognostic Index (IPI) score were significantly higher in MAGE-A3-positive patients (P = 0·025 and P = 0·004, respectively). Expression of MAGE-A3 was associated with poor response to treatment and a significantly shorter overall survival (P<0·001). Our data address new information in the association of MAGE-A3 expression and poor prognosis in DLBCL patients.

Zigomicosis (mucormicosis) cutánea en paciente con leucemia

Resumen —La zigomicosis (mucormicosis) cutanea es una enfermedad rara, causada por hongos Zygomycetes oportunistas, que se asocia en primer lugar a diabetes descompensada y en segundo lugar a padecimientos hematologicos como leucemias. Presentamos el caso de una paciente de 21 anos con leucemia linfoblastica aguda tipo L2 que presento en la nariz una lesion necrotica de color negroviolacea, indurada, que se extendia a la fosa nasal derecha y al paladar duro. El diagnostico clinico fue de zigomicosis (mucormicosis) cutanea inicial con extension posterior a senos paranasales y paladar. Se dio tratamiento con anfotericina B a dosis habituales, sin mejoria y con fallecimiento posterior de la paciente. Se discute si la zigomicosis fue cutanea primaria con extension a estructuras adyacentes o cutanea secundaria, posterior a un cuadro rinocerebral.

Effect of metformin on the survival of patients with ALL who express high levels of the ABCB1 drug resistance gene

BackgroundIn acute lymphoblastic leukemia (ALL), high ABCB1 gene expression has been associated with treatment resistance, which affects patient prognosis. Many preclinical reports and retrospective population studies have shown an anti-cancer effect of metformin. Therefore, the objective of this study was to assess the effect of metformin on the treatment regimen in patients with ALL who exhibited high levels of ABCB1 gene expression and to determine its impact on overall survival.MethodsA total of 102 patients with ALL were recruited; one group (n = 26) received metformin, and the other received chemotherapy (n = 76). Measurement of ABCB1 transcript expression was performed using qRT-PCR prior to treatment initiation. Survival analysis was performed using Kaplan–Meier curves. The impact of both the type of treatment and the level of expression on the response (remission or relapse) was analyzed by calculating the odds ratio.ResultsThe survival of patients with high ABCB1 expression was lower than those with low or absent ABCB1 gene expression (p = 0.030). In the individual analysis, we identified a benefit to adding metformin in the group of patients with high ABCB1 gene expression (p = 0.025). In the metformin user group, the drug acted as a protective factor against both therapeutic failure (odds ratio [OR] 0.07, 95% confidence interval [CI] 0.0037–1.53) and early relapse (OR 0.05, 95% CI 0.0028–1.153).ConclusionThe combined use of metformin with chemotherapy is effective in patients with elevated levels of ABCB1 gene expression. Trial registration NCT 03118128: NCT

Edad y recuento leucocitario como factores pronósticos en leucemia linfoblástica aguda: cohorte hgmla07

In order to establish the cutoff with prognostic implications for white blood cell count and age at diagnosis in adults with acute lymphoblastic leukemia (ALL), we conducted an observational, descriptive and analytical study nested in a retrospective cohort of patients with ALL treated by institutional protocol HGMLAL07 during 2007-2014. We study 255 patients, the 52.9% (n=135) were female and 47.1% (n=120) were male. The mean age was 31 (16-80) years-old. The disease-free survival (DFS) decreases in both genders after 20 years-old (p = 0.001). Leukocyte count average was 56.1 x 109/L (0.1-850 x 109/L). DFS decreases significantly from an equal or greater leukocyte count of 20 x 109/L (p<0.05). With this results, we can conclude that use foreign cutoff for age and leukocyte count could determine a bad prognosis stratification and a consequent suboptimal treatment.