Anca Roxana LUPU

Latest posts by Anca Roxana LUPU (see all)

Secondary Acute Lymphoblastic Leukemia after Hodgkin’s Lymphoma or a Coincidental Association of Two Hematological Malignancies? - July 2, 2015
Onset Risk Factors and Treatment Response Features of Refractory Hodgkin Lymphoma - July 2, 2015
The Impact of 2-(18) Fluoro-2- Deoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT) in Treatment Strategy of Hodgkin Lymphoma-Current Hematologic Concepts - June 30, 2015

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Secondary Acute Lymphoblastic Leukemia after Hodgkin’s Lymphoma or a Coincidental Association of Two Hematological Malignancies?

Mihaela TEVET, Cornel DRAGAN, Carmen SAGUNA, Doina BARBU and Anca Roxana LUPU

ABSTRACT

Secondary acute lymphoblastic leukaemia (sALL), defined as acute lymphoblastic leukaemia following another malignancy, irrespective of previous treatment, is a rare disease, and its biological characteristics have not been accurately described. We report the case of a 24-year old patient followed for Hodgkin’s lymphoma at our clinic, who develops and is diagnosed, less than a year after obtaining complete remission, as having pro-B acute lymphoblastic leukaemia This case has been a real diagnostic and treatment challenge, as sALL following another haematological malignancy is quite rare. Conclusion: It is necessary to better identify the prognostic factors of haematological malignancies in order to prevent the appearance of sALL.

Keywords: secondary acute leukaemia, Hodgkin’s lymphoma, immunophenotyping, 11q23 mutation, alkilating agents, prognostic factors

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Onset Risk Factors and Treatment Response Features of Refractory Hodgkin Lymphoma

Oana STANCA, Anca Mariana CIOBAN, Anca Roxana LUPU, Cecilia GHIMICI, Irina TRIANTAFYLLIDIS, Andrei COLITA and Ileana Delia MUT

ABSTRACT

Background: The International Prognostic Factors Project on Advanced Hodgkin lymphoma (HL) developed a seven factor prognostic score consisting of gender, age, stage, serum albumin, hemoglobin, leukocytosis and lymphocytopenia for the newly diagnosed Hodgkin disease patients in advanced stages, who receive chemotherapy.

Objectives: The purpose of this study was to determine whether this prognostic score would also be useful for refractory Hodgkin lymphoma patients in monitoring response to treatment.

Material and method: In the period 2000-2012, we performed a study on a group of 91 patients to show that the prognostic factors identified by the International Prognostic Factors (IPF) score affect the event- free survival (EFS) and the overall survival (OS). Our study also intends to show that the results of these factors change with the treatment response in patients with HL included in the category of patients with refractory disease.

Results: B symptoms, onset lymph node, more than 3 areas involved, bulky disease, extranodal involvement, low serum albumin, erythrocytes sedimentation rate (ESR), C reactive protein (CRP), lactic dehydrogenase (LDH) and anemia were associated with poorer EFS and OS. Male gender, stage, histological type, age (>45 years) and leukocytosis were not associated with significantly poorer outcomes.

Conclusions: the prognostic score for advanced disease is also useful in predicting relapse in patients with HL and early detection of response in patients with refractory HL.

Keywords: Follicular lymphoma, diagnosis, prognosis

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The Impact of 2-(18) Fluoro-2- Deoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT) in Treatment Strategy of Hodgkin Lymphoma-Current Hematologic Concepts

Oana STANCA, Anca Roxana LUPU, Anca CIOBANU, Irina TRIANTAFYLLIDIS, Cecilia GHIMICI and Ileana Delia MUT

ABSTRACT

Positron emission tomography/computed tomography (PET/CT) is useful in staging of Hodgkin lymphoma (HL), for early response – adapted therapy and choosing an individualized therapy, and is useful in determination of disease extent in relapsed and refractory Hodgkin lymphoma. Interim PET using 2-(18) fluoro-2-deoxyglucose(FDG) and low dose CT performed in one scanning session (FDG-PET/ CT) helps to predict outcome in Hodgkin lymphoma and to asses therapeutic stratification.

Keywords: PET/CT, Hodgkin lymphoma, stage, response to treatment

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Ibrutinib, a Novel Agent in Relapsed or Refractory Chronic Lymphocytic Leukemia

Ana-Maria IVANESCU, Madalina OPREA, Andrei TURBATU, Andrei COLITA and Anca Roxana LUPU

ABSTRACT

Refractory or relapsed chronic lymphocytic leukemia is still a hematologic malignancy with an unfavorable evolution after several lines of chemotherapy, even when associated with immunotherapy.

The additional presence of adverse prognostic factors such as17p deletion, 11 q deletion, unmutated IgVH genes, CD 38 and ZAP 70 expression further limits therapeutic possibilities.

Over the past two years numerous studies have focused on finding new therapeutic options useful in cases of relapsed or refractory chronic lymphocytic leukemia.

Ibrutinib is a new agent that has shown efficacy in treating these cases, the benefits of response and survival rate having been obtained using Ibrutinib as monotherapy, as well as in combination with immunotherapy or chemotherapy

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Composite Diffuse Large B-Cell Lymphoma and Follicular B-Cell Lymphoma – Case Report and Review of Literature

Andrei TURBATU, Marilena STOIAN, Iulian BREZEAN, Victor Constantin Ion STOICA, Andrei COLITA, Camelia DOBREA, Nicoleta STATE, Cosmin IONESCU, Ana-Maria IVANESCU, Madalina OPREA, Cecilia GHIMICI and Anca Roxana LUPU

ABSTRACT

Composite lymphoma refers to the co-occurrence of two or more morphologically and immunophenotypically separate lymphomas in the same topographic site at the time of clinical presentation. It is an infrequent type of lymphoid neoplasm, present in lymphoid tissue and may be due to the existence of two genetically related neoplasms such as transformation of a single lymphoma into another more aggressive lymphoma or be due to the presence of two clonally unrelated lymphomas. This paper is presenting a case of diffuse non-Hodgkin large B-cell lymphoma with areas of low grade and high grade follicular non-Hodgkin B-cell lymphoma in a retroperitoneal lymph node and spleen of an 62 year old woman. Histopathological examination and immunohistochemistry features proved the diagnosis of composite lymphoma.

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Influence of the JAK2 V617F Mutation and Inherited Thrombophilia on the Thrombotic Risk among Patients with Myeloproliferative Disorders

Mihaela TEVET, Razvan IONESCU, Cornel DRAGAN and Anca Roxana LUPU

ABSTRACT

Background: A number of studies showed that the JAK2 V617F mutation increases the thrombotic risk in patients with myeloproliferative disorders (MPN) while others did not reveal this correlation, and it is unknown whether inherited thrombophilia is an additive risk factor in mutated subjects. Our aim was to clarify the contribution of JAK2 V617F to a hypercoagulable state, as well as its interaction with other thrombophilic factors in patients with thrombosis and myeloproliferative disorders.

Method: We studied 192 patients with myeloproliferative disorders, 90 with Essential thrombocytemia (ET), 42 with Polycythemia vera (PV) and 60 with Primary or idiopathic myelofibrosis (PMI). From these patients a subgroup of only 62 patients underwent laboratory screening for thrombophilia.

Results: The JAK2 V617F mutation was present in 62.8% patients with myeloproliferative disorders, 97.6% with PV, 54.5 % with ET and 53.44% patients with PMI. The mutated patients had a relative risk (RR) for thrombosis at any time of 2.94 in comparison with „wild-type” patients which was 0.93; in those patients having both the mutation and thrombophilia the RR was 3.56 (95% CI 2.41-7.34) compared to patients with neither the mutation nor thrombophilia, suggesting an additive interaction between the two risk factors.

Conclusion: In patients with myeloproliferatives neoplasias, the thrombotic risk is higher in the JAK2 V617F-mutated subgroup and it is further increased by the presence of inherited thrombophilia (especially by the presence of mutated F V Leiden and lupus anticoagulant).

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Anca Roxana LUPU

Latest posts by Anca Roxana LUPU (see all)

Articles signed on MÆDICA, JCM:

Secondary Acute Lymphoblastic Leukemia after Hodgkin’s Lymphoma or a Coincidental Association of Two Hematological Malignancies?

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