Chronic hepatitis caused by persistent parvovirus B19 infection

<p>Abstract</p> <p>Background</p> <p>Human infection with parvovirus B19 may lead to a diverse spectrum of clinical manifestations, including benign erythema infectiosum in children, transient aplastic crisis in patients with haemolytic anaemia, and congenital hydrops foetalis. These different diseases represent direct consequences of the ability of parvovirus B19 to target the erythroid cell lineage. However, accumulating evidence suggests that this virus can also infect other cell types resulting in diverse clinical manifestations, of which the pathogenesis remains to be fully elucidated. This has prompted important questions regarding the tropism of the virus and its possible involvement in a broad range of infectious and autoimmune medical conditions.</p> <p>Case Presentation</p> <p>Here, we present an unusual case of persistent parvovirus B19 infection as a cause of chronic hepatitis. This patient had persistent parvovirus B19 viraemia over a period of more than four years and displayed signs of chronic hepatitis evidenced by fluctuating elevated levels of ALAT and a liver biopsy demonstrating chronic hepatitis. Other known causes of hepatitis and liver damage were excluded. In addition, the patient was evaluated for immunodeficiency, since she had lymphopenia both prior to and following clearance of parvovirus B19 infection.</p> <p>Conclusions</p> <p>In this case report, we describe the current knowledge on the natural history and pathogenesis of parvovirus B19 infection, and discuss the existing evidence of parvovirus B19 as a cause of acute and chronic hepatitis. We suggest that parvovirus B19 was the direct cause of this patient's chronic hepatitis, and that she had an idiopathic lymphopenia, which may have predisposed her to persistent infection, rather than bone marrow depression secondary to infection. In addition, we propose that her liver involvement may have represented a viral reservoir. Finally, we suggest that clinicians should be aware of parvovirus B19 as an unusual aetiology of chronic hepatitis, when other causes have been ruled out.</p

Successful treatment of B-cell prolymphocytic leukemia with monoclonal anti-CD20 antibody

We report a patient with B-cell prolymphocytic leukemia (PLL) who was treated successfully with the monoclonal anti-CD20 antibody (rituximab). The patient had recurrent infections due to relative neutropenia, secondary to bone marrow infiltration. After treatment with monoclonal anti-CD20 antibodies (rituximab) 375 mg-m2 weekly for 4 weeks, complete remission was obtained. It was documented by normalization of peripheral blood counts, disappearance of organomegaly, and by molecular cytogenetics-fluorescent in situ hybridization (FISH) on bone marrow cells. She remains in complete remission 8 months following the discontinuation of treatment. This is the second reported case of successful treatment of B-cell PLL with rituximab. © Springer-Verlag 2003.ANDERSON KC, 1984, BLOOD, V63, P1424; Boye J, 2003, ANN ONCOL, V14, P520, DOI 10.1093-annonc-mdg175; Byrd JC, 1999, J CLIN ONCOL, V17, P791; Czuczman MS, 1999, J CLIN ONCOL, V17, P268; Maloney DG, 1997, BLOOD, V90, P2188; McLaughlin P, 1998, J CLIN ONCOL, V16, P2825; Perz J, 2002, LEUKEMIA LYMPHOMA, V43, P149, DOI 10.1080-10428190290000338; REFF ME, 1994, BLOOD, V83, P435; TEDDER TE, 1994, IMMUNOL TODAY, V15, P450, DOI 10.1016-0167-5699(94)90276-3; Vartholomatos G, 1999, ACTA HAEMATOL-BASEL, V102, P94, DOI 10.1159-000040977140

Cisplatin plus vinorelbine (PVn) as a salvage regimen for refractory breast cancer

Breast cancer is regarded as a systemic disease even when tumors are completely resected. In patients with advanced breast cancer the overall prognosis is poor, but the disease is not uniformly fatal. Vinorelbine has proved to be effective when given as a single agent in this setting. Since it has a moderate to severe myelotoxic effect, a combination of vinorelbine with cisplatin, which is a weak myelotoxic drug, is ideal for the treatment of patients with advanced disease. In this paper, we report on a patient with advanced breast cancer who attained complete response of 14 months duration to a cisplatin-vinorelbine combination after progression during treatment with paclitaxel and doxorubicin. © 2004 Elsevier Ltd. All rights reserved.BERNARD A, 1998, P AN M AM SOC CLIN, V17, P491; Biganzoli L, 2002, J CLIN ONCOL, V20, P3114, DOI 10.1200-JCO.2002.11.005; CROS S, 1989, SEMIN ONCOL, V16, P15; GARCIACONDE J, 1994, ANN ONCOL, V5, P854; Gunel N, 2000, TUMORI, V86, P283; Hsu C, 2002, CANCER, V95, P2044, DOI 10.1002-cncr.10951; KOLARIC K, 1991, CANCER CHEMOTH PHARM, V27, P409, DOI 10.1007-BF00688868; Mustacchi G, 2002, ANN ONCOL, V13, P1730, DOI 10.1093-annonc-mdf290; NABHOLTZ JM, 1999, P AN M AM SOC CLIN, V18, P127; Nagourney RA, 2000, J CLIN ONCOL, V18, P2245; Naruse I, 2002, JPN J CANCER RES, V93, P574; Pegram MD, 1999, SEMIN ONCOL, V26, P89; Ray-Coquard I, 1998, CANCER, V82, P134, DOI 10.1002-(SICI)1097-0142(19980101)82:1134::AID-CNCR163.0.CO;2-3; Shamseddine AI, 1999, AM J CLIN ONCOL-CANC, V22, P298, DOI 10.1097-00000421-199906000-00018; SLEDGE CW, 1988, J CLIN ONCOL, V12, P1811; VALERO V, 1995, J CLIN ONCOL, V13, P2886; WEBER BL, 1995, J CLIN ONCOL, V13, P272232

Hb H Disease and Multiple Myeloma

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Recurrent GI bleeding and surgery following the initial response to imatinib therapy in GIST of the stomach

[No abstract available]Baum M, 1996, LANCET, V347, P260, DOI 10.1016-S0140-6736(96)90433-X; Coffey JC, 2003, LANCET ONCOL, V4, P760, DOI 10.1016-S1470-2045(03)01282-8; DeMatteo RP, 2000, ANN SURG, V231, P51, DOI 10.1097-00000658-200001000-00008; Demetri GD, 2002, NEW ENGL J MED, V347, P472, DOI 10.1056-NEJMoa020461; FORTNER JG, 1993, J SURG ONCOL, V53, P191, DOI 10.1002-jso.2930530313; Gorre ME, 2001, SCIENCE, V293, P876, DOI 10.1126-science.1062538; HOLMGREN L, 1995, NAT MED, V1, P149, DOI 10.1038-nm0295-149; Joensuu H, 2001, NEW ENGL J MED, V344, P1052, DOI 10.1056-NEJM200104053441404; Joensuu H, 2002, LANCET ONCOL, V3, P655, DOI 10.1016-S1470-2045(02)00899-9; KREIKER J, 2002, LEBAN MED J, V50, P226; Miettinen M, 2001, VIRCHOWS ARCH, V438, P1, DOI 10.1007-s004280000338; POLLOCK RE, 1989, SEMIN SURG ONCOL, V5, P414, DOI 10.1002-ssu.2980050607; Savage DG, 2002, NEW ENGL J MED, V346, P683; Sawaki A, 2003, J GASTROENTEROL, V38, P690, DOI 10.1007-s00535-002-1124-1; Sturgeon C, 2003, SURG ONCOL, V12, P21, DOI 10.1016-S0960-7404(02)00074-9; Yamamoto S, 2003, J GASTROENTEROL, V38, P896, DOI 10.1007-s00535-002-1168-232

Cisplatin and vinorelbine (PVn) for the treatment of advanced breast cancer: 10 Years of experience

Breast cancer is the most common malignancy in women throughout the world. It is the leading cause of cancer death of women aged andgt; 50 years. Cisplatin and vinorelbine are active as single agents in advanced breast cancer but their combination was not studied before. We conducted three phase II trials using this combination in advanced breast cancer. Hereby, we describe our experience over a 10-year period at the American University of Beirut using this combination in metastatic disease as 1st and 2nd line therapy as well as in the neoadjuvant setting in patients with locally advanced disease. Our data will be compared with other groups using the same regimen for the management of advanced breast carcinoma

Metastatic thymoma to the peritoneum: A case report

Thymomas usually consist of mostly benign histology, yet their malignant potential and distant metastasis remains unpredictable. Extrathoracic distant metastasis of malignant thymomas to the peritoneum are rare and only two cases are noted in the literature. We report a third case of diffuse intraperitoneal metastasis from an epithelial cell-based thymoma of the mediastinum. Metastasis to the peritoneum occurred 3 frac(1, 2) years after the initial diagnosis. Our case is noted for its aggressive behavior and relatively short interval of distant metastasis to the peritoneum despite four different chemotherapeutic regimens and radiation therapy. © 2005 Elsevier Ltd. All rights reserved

Cisplatin and vinorelbine (PVn) for the treatment of advanced breast cancer: 10 Years of experience

Breast cancer is the most common malignancy in women throughout the world. It is the leading cause of cancer death of women aged andgt; 50 years. Cisplatin and vinorelbine are active as single agents in advanced breast cancer but their combination was not studied before. We conducted three phase II trials using this combination in advanced breast cancer. Hereby, we describe our experience over a 10-year period at the American University of Beirut using this combination in metastatic disease as 1st and 2nd line therapy as well as in the neoadjuvant setting in patients with locally advanced disease. Our data will be compared with other groups using the same regimen for the management of advanced breast carcinoma

Cisplatin and vinorelbine (PVn) for the treatment of advanced breast cancer: 10 Years of experience

Breast cancer is the most common malignancy in women throughout the world. It is the leading cause of cancer death of women aged andgt; 50 years. Cisplatin and vinorelbine are active as single agents in advanced breast cancer but their combination was not studied before. We conducted three phase II trials using this combination in advanced breast cancer. Hereby, we describe our experience over a 10-year period at the American University of Beirut using this combination in metastatic disease as 1st and 2nd line therapy as well as in the neoadjuvant setting in patients with locally advanced disease. Our data will be compared with other groups using the same regimen for the management of advanced breast carcinoma