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    Mantle cell lymphoma treatment: plus ça change…
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    Abstract Primary testicular non‐Hodgkin lymphoma ( NHL ) is a rare entity with the most common histologic subtype consisting of diffuse large B‐cell lymphoma ( DLBCL ). Patients with primary testicular lymphoma ( PTL ) have a poor prognosis and a higher propensity for relapse. Also rare are composite lymphomas ( CL ) defined as two or more morphologically and phenotypically distinct lymphomas coexisting in a single organ or tissue. Here we present the first reported case of primary testicular composite lymphoma consisting of DLBCL and mantle cell lymphoma ( MCL ).
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    Mantle-cell lymphoma is a lymphoma subtype characterized by the overexpression of cyclin D1 and the dysregulation of the cell cycle. Many secondary genetic events contribute to growth in mantle-cell lymphoma, including the loss of DNA damage-response capacity, the activation of cell-survival pathways, and the inhibition of apoptosis.1,2 The prognosis in mantle-cell lymphoma is the worst among B-cell lymphomas. Remissions achieved with conventional chemotherapy are often short-lived, and very intensive regimens, including stem-cell transplantation, seem necessary to improve the outcome, but they are feasible in only a limited number of patients.3 Ibrutinib (PCI-32765) is an orally active irreversible inhibitor of . . .
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    We retrospectively investigated the outcome of 30 newly diagnosed patients with mantle cell lymphoma treated with high-dose therapy and autologous stem cell transplantation in first response. With a median follow-up of 55 months, the 5-year overall-survival is 62%, the 5-year progression-free-survival is 40% and no secondary malignancy has occurred.
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    We report on a series of 24 patients with newly diagnosed mantle cell lymphoma treated with four to six courses of DHAP-rituximab followed by autologous stem cell transplantation for patients <65 years. Three-year overall survival (OS) and event free survival (EFS) rates were 69% and 65% respectively, for the 24 patients. In intent-to-treat analysis, 3-year OS and EFS were 75% and 76% for the 17 patients < 65 years old. This treatment is quite feasible and compares favourably with other regimens.
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