Comparison of Access to Novel Drugs for Lymphoma and Chronic Lymphocytic Leukemia Between India and the United States.

This review will compare and contrast the costs and access to novel drugs for treating chronic lymphocytic leukemia (CLL) and lymphoma in the United States and India during the last 5 years. Clinical outcomes for patients with hematologic malignancies have improved significantly since the approval of immunotherapeutic and targeted therapies. These new treatments have had an impact on overall outcomes and have helped determine the design for translational research and future trials.

Rosai-Dorfman Disease: The MD Anderson Cancer Center Experience.

Background: Rosai-Dorfman disease (RDD) is a rare disorder composed of a proliferation of histiocytes with varied clinical manifestations.

Patients And Methods: In this retrospective observational study, we obtained demographic, clinical, and outcome data from the medical records of 10 adult patients with RDD seen in the Department of Lymphoma and Myeloma at MD Anderson Cancer Center between 1995 and 2015.

Results: Patients had a median age of 56 years (range, 20-81 years) with equal gender distribution.

Targeted therapies for Hodgkin lymphoma: results of recent trials.

Many patients with Hodgkin lymphoma (HL) can be cured with standard chemotherapy with high long term survival rates. Considering the increased risks of various toxicities following therapy, options are evolving towards avoidance of radiation and reduction of therapy duration, with results similar to those currently achieved with improved quality of life. However, 20-30% of patients still develop recurrence during or following initial therapy, depending upon what chemotherapy regimen is administered.

Lenalidomide in relapsed refractory non-Hodgkin's lymphoma: An Indian perspective.

Background: Lenalidomide an immunomodulatory agent has shown activity in relapsed/refractory lymphoma. This study was conducted to evaluate its efficacy and optimal dose in Indian patients with relapsed/refractory lymphoma who were unable or unwilling to undergo autologous hematopoietic stem cell transplant.

Materials And Methods: Patients received oral lenalidomide at 20 mg on days 1-21 every 28 days until disease progression or unacceptable toxicity.

Cancer immunotherapy: Strategies for personalization and combinatorial approaches.

The results of recent clinical trials using novel immunotherapy strategies such as immune checkpoint blockade and adoptive T-cell therapy approaches including CAR T-cell therapy have clearly established immunotherapy as an important modality for the treatment of cancer besides the traditional approaches of surgery, radiotherapy, and chemotherapy or targeted therapy. However, to date immunotherapy has been shown to induce durable clinical benefit in only a fraction of the patients. The use of combination strategies is likely to increase the number of patients that might benefit from immunotherapy.

Anaplastic lymphoma kinase (ALK) positive anaplastic large cell lymphoma (ALCL) of breast in a patient without a breast implant.

Non-Hodgkin lymphoma of the breast is an uncommon entity accounting for approximately 0.5% of malignant breast neoplasms and around 3% of extranodal lymphomas. Most cases of anaplastic large cell lymphoma (ALCL) of the breast have been associated with breast implants, and a few ALCL aris.

Primary Diffuse large B-Cell lymphoma of testis: A single centre experience and review of literature.

Background: Primary testicular lymphoma constitutes 1-2% of Non-Hodgkin's lymphomas affecting elderly men >60 years of age. Most often it is a Diffuse large B cell lymphoma (DLBCL) and treatment involves multimodality approach involving surgery, chemotherapy and radiotherapy. Outcome remains poor in spite of aggressive therapy.

Gefitinib-induced skin ulceration in metastatic adenocarcinoma lung.

We report a case of gefitinib-induced skin ulceration in a 50-year-old female with metastatic adenocarcinoma of lung who developed this adverse effect 2 weeks following initiation of gefitinib at a dose of 250 mg/day. The ulcer improved with stopping gefitinib for 2 weeks and also addition of topical steroids and antibiotics. We are reporting this case to create awareness among treating oncologists of this adverse effect and also prompt interruption of therapy and topical steroids/antibiotics is useful to treat this adverse event.

Candidal renal papillary necrosis conquered.

Renal papillary necrosis due to Candida albicans is a rare but treatable cause of acute renal failure. We report this case of a middle aged male with history of type 2 diabetes mellitus who presented with infected right lower extremity and right lower lobe pneumonitis with hypotension. Though, he improved initially, during his stay in the hospital, he developed acute renal failure.

FIP1L1-PDGFRA-Positive Chronic Eosinophilic Leukemia: A Low-Burden Disease with Dramatic Response to Imatinib - A Report of 5 Cases from South India.

Objective: Eosinophilia associated with FIP1L1-PDGFRA rearrangement represents a subset of chronic eosinophilic leukemia and affected patients are sensitive to imatinib treatment. This study was undertaken to learn the prevalence and associated clinicopathologic and genetic features of FIP1L1-PDGFRA rearrangement in a cohort of 26 adult patients presenting with profound eosinophilia (>1.5x10(9)/L).

Primary breast diffuse large B cell lymphoma - report of 6 cases from South India with review of literature.

The breast is an uncommon site of involvement in non-Hodgkin lymphoma, and primary breast lymphoma (PBL) is a disease localized to one or both breasts with or without regional lymph nodes involvement. The objectives of the study were to review the clinical profile, epidemiological parameters and assess the outcomes exclusively in women with primary diffuse large B cell lymphoma (DLBCL) of breast. This was a retrospective observational study done at Kidwai Memorial Institute of Oncology, Bangalore, India.

A single center experience in 266 patients of infantile malignancies.

Introduction: The diagnosis and management of cancer in infantile age group is a significant challenge to pediatric oncologists. Malignancies occurring in infants often have different clinical and biological behavior in comparison to older children. This study was performed with an aim to find out the profile of infantile cancers at a tertiary care cancer center in South India.

An unusual case of pulmonary granulocytic sarcoma treated with combined chemotherapy and radiation.

We report an unusual case of a 6-year-old male child who presented with fever and a cough of one month's duration. A bone marrow aspiration and cytogenetics were suggestive of acute myeloid leukaemia with t(8;21)(q22;q22). A chest x-ray and computed tomography of the thorax showed a soft tissue lesion in the right lung.

An unusual case of Waldenstrom's macroglobulinemia presented with nasopharyngeal involvement.

We report a rare case of a 68-year-old male who presented with fever, weight loss, nasal blockage, and epistaxis. Examination revealed cervical and axillary lymphadenopathy with no evidence of organomegaly. On evaluation, bone marrow aspiration showed lymphoplasmacytic infiltration.

Human immunodeficiency virus - associated lymphomas: a neglected domain.

Background: Human immunodeficiency virus (HIV) associated lymphoma is an important public health concern; however, the epidemiological data available from India is sparse.

Aims: The present study was carried out at a tertiary cancer care center in South India to analyze the scenario of HIV-associated lymphoma.

Materials And Methods: This was a retrospective observational study conducted at our center, on consecutive patients diagnosed with HIV-associated lymphoma, from January 2008 to December 2012.

Primary breast lymphoma in males-a report of two cases with a review of the literature.

Primary breast lymphoma (PBL) in males is a rare clinical entity and has been reported in anecdotal case reports up until now. We report two cases of PBL from a tertiary care centre in Southern India. A 46-year-old male presented with a lump in the right breast with right axillary lymphadenopathy; a biopsy with immunohistochemistry showed neoplastic cells positive for CD 20 and negative for CD 30, epithelial membrane antigen, anaplastic lymphoma kinase, suggestive of diffuse large B cell lymphoma stage IIEA.

Melioidosis presenting with mediastinal lymphadenopathy masquerading as malignancy: a case report.

Introduction: Melioidosis, endemic in Thailand and in the Northern Territory of Australia is an emerging infectious disease in India which can present with varied forms. A case of melioidosis, presenting as a rare anterior mediastinal mass which can masquerade as malignancy or tuberculosis, is described here. With treatment, our patient initially showed an increase in the size of mediastinal node and development of new submandibular node.

Clinical profile of brucellosis from a tertiary care center in southern India.

Objective: To highlight the spectrum of clinical manifestations, labs, complications, treatment and outcome of brucellosis.

Methods: Retrospective study was conducted in Kasturba Medical College, Manipal University, Karnataka, India which included 68 confirmed cases of brucellosis from January 2006- April 2010. Diagnosis of brucellosis was made by culturing the sera/body fluids by standard BACTEC method (or) by testing the sera for Brucella agglutinins using the standard agglutination test (SAT).

A case report of herpetic and candidal esophagitis in an immunocompetent adult.

Reports of combined candidal and herpetic esophagitis in immunocompetent states are rare and sporadic. A 44-year-old previously healthy lady presented with a one week history of progressive dysphagia, odynophagia and fever. Esophagogastroduodenoscopy (EGD) showed extensive desquamation of the entire esophagus except for distal 4 cm.

Posterior reversible encephalopathy syndrome in a patient with hepatitis B induced type 1 membranoproliferative glomerulonephritis.

Posterior reversible encephalopathy syndrome (PRES) is a rare complication of nephrotic syndrome and corticosteroid therapy. Here, we discuss an 18 year old man with type 1 membranoproliferative glomerulonephritis (MPGN) secondary to hepatitis B infection who developed posterior leukoencephalopathy while on therapy with lamivudine and prednisone. He developed seizures and vision loss.

Scrub typhus in Southern India: are we doing enough?

Scrub typhus is a potentially fatal infectious disease caused by Orientia tsutsugamushi. We report on a retrospective analysis of clinical manifestations, lab investigations and outcome of patients admitted to our hospital from January 2009 to December 2009 with scrub typhus. The Weil-Felix test was the serological method used to diagnose scrub typhus.

Disseminated histoplasmosis in an AIDS patient: a rare case from southern India.

We present a case of disseminated histoplasmosis with acquired immunodeficiency syndrome (AIDS). A 38-year-old woman presented with fever, cough, dysphagia, significant weight loss and a loss of appetite. She also suffered from anaemia and cervical lymphadenopathy.