Prospective identification of candidates for deferred therapy is not standardized and many patients receive immediate therapy regardless of risk. We conducted a retrospective, multi-center cohort analysis of MCL patients with comprehensive clinical data to examine the use and safety of deferred therapy for newly diagnosed patients. Previously untreated patients ≥18 years-old with MCL diagnosed in 1993-2015 at five academic sites were included. Of 395 patients, 72 (18%) received deferred therapy (defined as receipt of first treatment >90 days following initial diagnosis). Patients receiving deferred therapy were more likely to have an ECOG performance status of 0 (67 versus 44% p = .001), have no B symptoms (83 versus 65% p = .003) and have normal LDH levels at diagnosis (87 versus 55% p < .001). In multivariable analysis, deferred therapy was not associated with a significant difference in OS (HR 0.64: 95% CI 0.22-1.84, p = .407).
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http://dx.doi.org/10.1080/10428194.2018.1455973 | DOI Listing |
Radiat Oncol
January 2025
Department of Oncology, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing, 400010, China.
Background: Patients with non-small cell lung cancer (NSCLC) are prone to developing brain metastases (BMs), particularly those with epidermal growth factor receptor (EGFR) mutations. In clinical practice, treatment-naïve EGFR-mutant NSCLC patients with asymptomatic BMs tend to choose EGFR-tyrosine kinase inhibitors (TKIs) as first-line therapy and defer intracranial radiotherapy (RT). However, the effectiveness of upfront intracranial RT remains unclear.
View Article and Find Full Text PDFBMC Ophthalmol
January 2025
Department of Surgery, St. Jude Children's Research Hospital, Memphis, TN, USA.
Background: Cutaneous melanoma is the leading cause of death from cutaneous malignancy and tends to metastasize lymphatically and hematogenously to the lung, liver, brain, and bone; it is a rare source of metastatic disease to the eye. Herein we provide a case report of cutaneous melanoma metastatic to the ciliary body and choroid involving clinical examination, slit lamp photography, and B-scan ultrasonography.
Result: A 55-year-old female with known metastatic cutaneous melanoma presented with pain, a large ciliochoroidal mass, visual decline, and diffuse intraocular inflammation.
Cureus
December 2024
Internal Medicine, Larkin Community Hospital, South Miami, USA.
We report a rare case of a 45-year-old Asian male patient with concurrent multiple myeloma (MM), immune thrombocytopenic purpura (ITP), and thalassemia trait, presenting with severe thrombocytopenia, back pain, and bleeding manifestations. The diagnosis was established through a combination of laboratory findings, imaging, and bone marrow biopsy, revealing 90% plasma cell involvement and KRAS/BRCA2 mutations. Management focused on controlling ITP with corticosteroids, rituximab, and platelet transfusions while addressing immunosuppression risks.
View Article and Find Full Text PDFJBJS Case Connect
October 2024
Department of Orthopedic Oncology, MD Anderson Cancer Center, Houston, Texas.
Case: A 72-year-old woman with undifferentiated pleomorphic sarcoma of the thigh received neoadjuvant chemotherapy and radiotherapy. She underwent wide resection and was scheduled for prophylactic fixation of the femur. However, prophylactic fixation was deferred secondary to COVID-19 pandemic.
View Article and Find Full Text PDFProg Cardiovasc Dis
January 2025
Department of Cardiology, St Francis Hospital and Heart Center, Roslyn, New York, USA; New York Institute of Technology, Old Westbury, New York, USA. Electronic address:
Coronary artery disease (CAD) is the leading cause of mortality among patients with chronic kidney disease (CKD), presenting unique challenges in diagnosis and management. Advanced CKD patients often present with atypical symptoms, and conventional diagnostic and interventional approaches carry risks, including contrast-induced nephropathy and the potential need for renal replacement therapy. These risks have led to the phenomenon of "renalism," where necessary procedures may be deferred due to concerns over renal injury.
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