NEJM â Collection Updates for Leukemia/Lymphoma

CORRESPONDENCE: Somatic Mutations of and in the Leukemic Transformation of Myeloproliferative Neoplasms

Anthony Green, F.R.C.Path., F.Med.Sci. and Philip Beer, F.R.C.Path., Ph.D. — Thu, 28Â JanÂ 2010 00:00:00 -05:00

To the Editor: Somatic mutations affecting the R132 residue of isocitrate dehydrogenase 1 (IDH1) and the homologous IDH2 R172 occur in central nervous system tumors.12 Recently (in the Sept. 10...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 39-2009 â A 28-Year-Old Pregnant Woman with Acute Cardiac Failure

Thu, 17Â DecÂ 2009 00:00:00 -05:00

Dr. Brad W. Butcher (Medicine): A 28-year-old woman was admitted to this hospital 2 days post partum because of cardiac failure.

The patient had been well, except for gestational diabetes mellitus,...

CORRESPONDENCE: Aprepitant as an Antipruritic Agent?

Arnaud Duval, M.D. and Louis Dubertret, M.D., Ph.D. — Thu, 01Â OctÂ 2009 00:00:00 -05:00

To the Editor: The SÃ©zary syndrome is a leukemic, cutaneous, epidermotropic T-cell lymphoma. Pruritus, insomnia, and depression impair the quality of life and can lead to suicide.1 Substance P is...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Rendering the Leukemia Cell Susceptible to Attack

Dorothy A. Sipkins, M.D., Ph.D. — Thu, 24Â SepÂ 2009 00:00:00 -05:00

The cytokine interferon-Î± is thought to exert its antitumor effects through pleiotropic mechanisms, including the modulation of immune responses and the inhibition of angiogenesis.1 In addition, interferon-Î± inhibits growth and...

EDITORIAL: An Old AML Drug Revisited

HervÃ© Dombret, M.D., and Claude Gardin, M.D. — Thu, 24Â SepÂ 2009 00:00:00 -05:00

Acute myeloid leukemia (AML) is a heterogeneous hematologic cancer whose wide range of outcomes probably reflects the accumulation of various acquired mutations that block the differentiation of blood-cell progenitors or...

ORIGINAL ARTICLE: Anthracycline Dose Intensification in Acute Myeloid Leukemia

Thu, 24Â SepÂ 2009 00:00:00 -05:00

Background: In young adults with acute myeloid leukemia (AML), intensification of the anthracycline dose during induction therapy has improved the rate of complete remission but not of overall survival. We...

ORIGINAL ARTICLE: High-Dose Daunorubicin in Older Patients with Acute Myeloid Leukemia

Thu, 24Â SepÂ 2009 00:00:00 -05:00

Background: A complete remission is essential for prolonging survival in patients with acute myeloid leukemia (AML). Daunorubicin is a cornerstone of the induction regimen, but the optimal dose is unknown....

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 29-2009 â An 81-Year-Old Man with Weight Loss, Odynophagia, and Failure to Thrive

Thu, 17Â SepÂ 2009 00:00:00 -05:00

Dr. Jenica N. Upshaw (Medicine): An 81-year-old man was admitted to the hospital because of cough, weight loss, odynophagia, and failure to thrive.

The patient had been in his usual state...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 28-2009 â A 68-Year-Old Man with Fatigue, Cough, and Peripheral-Blood Monocytosis

Thu, 10Â SepÂ 2009 00:00:00 -05:00

Dr. Alfred Ian Lee (Oncology): A 68-year-old man was seen in the cancer center of this hospital because of fatigue, cough, and peripheral-blood monocytosis.

The patient had been well until approximately...

ORIGINAL ARTICLE: Recurring Mutations Found by Sequencing an Acute Myeloid Leukemia Genome

Thu, 10Â SepÂ 2009 00:00:00 -05:00

Background: The full complement of DNA mutations that are responsible for the pathogenesis of acute myeloid leukemia (AML) is not yet known.

Methods: We used massively parallel DNA sequencing to obtain...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 27-2009 â A 56-Year-Old Woman with Fever, Rash, and Lymphadenopathy

Jeremy S. Abramson, M.D., Subba Digumarthy, M.D., and Judith A. Ferry, M.D. — Thu, 27Â AugÂ 2009 00:00:00 -05:00

Dr. David T. Ting (Medical Oncology): A 56-year-old woman was admitted to this hospital because of fever, rash, and lymphadenopathy.

She had been well until 11 weeks earlier when, while residing...

EDITORIAL: Genetic Trickery â Escape of Leukemia from Immune Attack

John Barrett, M.D., and Bruce R. Blazar, M.D. — Thu, 30Â JulÂ 2009 00:00:00 -05:00

It is increasingly clear that neoplastic cells and the immune system are locked in a struggle in which each attempts to outmaneuver its opponent. One tactic that tumors use to...

ORIGINAL ARTICLE: Loss of Mismatched HLA in Leukemia after Stem-Cell Transplantation

Thu, 30Â JulÂ 2009 00:00:00 -05:00

Background: Transplantation of hematopoietic stem cells from partially matched family donors is a promising therapy for patients who have a hematologic cancer and are at high risk for relapse. The...

BOOK REVIEW:

Thu, 16Â JulÂ 2009 00:00:00 -05:00

Research on umbilical-cord blood has revolutionized the field of hematopoietic stem-cell transplantation, and umbilical-cord blood is now used in about 28% of all bone marrow and stem-cell transplants from unrelated...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 22-2009 â A 59-Year-Old Man with Skin and Pulmonary Lesions after Chemotherapy for Leukemia

Thu, 16Â JulÂ 2009 00:00:00 -05:00

Dr. Deborah L. Cummins (Dermatology): A 59-year-old man was seen by consultants in infectious disease and dermatology because of cutaneous and pulmonary lesions that developed after induction chemotherapy for acute...

CORRESPONDENCE: Molecular Outcome Prediction in Diffuse Large-B-Cell Lymphoma

Thu, 25Â JunÂ 2009 00:00:00 -05:00

To the Editor: Lenz et al. (Nov. 27 issue)1 report the results of an important study of gene expression and survival in patients with diffuse large-B-cell lymphoma. We reassessed the...

ORIGINAL ARTICLE: Treating Childhood Acute Lymphoblastic Leukemia without Cranial Irradiation

Thu, 25Â JunÂ 2009 00:00:00 -05:00

Background: Prophylactic cranial irradiation has been a standard treatment in children with acute lymphoblastic leukemia (ALL) who are at high risk for central nervous system (CNS) relapse.

Methods: We conducted a...

BOOK REVIEW:

Thu, 28Â MayÂ 2009 00:00:00 -05:00

The study of chronic lymphocytic leukemia (CLL) is a rapidly changing field. A new understanding of the nature of the disease, better delineation of its limits, and more effective treatments...

IMAGES IN CLINICAL MEDICINE: Pharyngeal Mass in a Patient with B-Cell Lymphoma

Chung-Ching Hung, M.D. and Jih-Chin Lee, M.D. — Thu, 28Â MayÂ 2009 00:00:00 -05:00

An 84-year-old man presented with an isolated sensation of a lump in the back of his throat and difficulty swallowing that had developed over several months. A year earlier, the...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Acute Promyelocytic Leukemia â Weapons of Mass Differentiation

Jonathan D. Licht, M.D. — Thu, 26Â FebÂ 2009 00:00:00 -05:00

Acute myeloid leukemia (AML) involves the immortalization of immature myeloid progenitors and is a heterogeneous disease. Current clinical practice separates AML into low-, intermediate-, and high-risk categories according to cytogenetic...

IMAGES IN CLINICAL MEDICINE: Leukocytosis and Sublingual Microvascular Blood Flow

Arend-Jan Meinders, M.D. and Paul Elbers, M.D. — Thu, 12Â FebÂ 2009 00:00:00 -05:00

A 51-year-old woman presented with a 3-month history of fatigue and a 2-week history of a nonproductive cough and night sweats. Chronic myeloid leukemia was diagnosed, with a leukocyte count...

EDITORIAL: The Secret Lives of Monoclonal B Cells

Robert F. Vogt, Jr., Ph.D., and Robert A. Kyle, M.D. — Thu, 12Â FebÂ 2009 00:00:00 -05:00

It seems that B cells, the lymphocytes responsible for producing antibodies, are eager to share their secrets. Their revelations were first uncovered indirectly in serum through reactions with microbes, cells,...

ORIGINAL ARTICLE: B-Cell Clones as Early Markers for Chronic Lymphocytic Leukemia

Thu, 12Â FebÂ 2009 00:00:00 -05:00

Background: Otherwise healthy persons with a small number of B-cell clones circulating in the peripheral blood have been designated as having monoclonal B-cell lymphocytosis (MBL). Hospital-based series indicate an excess...

EDITORIAL: Acute Lymphoblastic Leukemia â On the Wings of IKAROS

Katia Georgopoulos, Ph.D. — Thu, 29Â JanÂ 2009 00:00:00 -05:00

Acute lymphoblastic leukemia (ALL) with an immature B-cell immunophenotype (B-cellâprogenitor ALL) is a common cancer in children and adolescents, and it also occurs in adults. Cure rates of B-cellâprogenitor ALL...

ORIGINAL ARTICLE: Deletion of and Prognosis in Acute Lymphoblastic Leukemia

Thu, 29Â JanÂ 2009 00:00:00 -05:00

Background: Despite best current therapy, up to 20% of pediatric patients with acute lymphoblastic leukemia (ALL) have a relapse. Recent genomewide analyses have identified a high frequency of DNA copy-number...

BOOK REVIEW:

Thu, 15Â JanÂ 2009 00:00:00 -05:00

Research on the biologic basis of leukemias and lymphomas has revealed new molecular entities with distinctive genetic and epigenetic abnormalities. Correct diagnosis of these disorders affects their clinical management because...

ORIGINAL ARTICLE: Inhibition of the Bcl-x Deamidation Pathway in Myeloproliferative Disorders

Thu, 25Â DecÂ 2008 00:00:00 -05:00

Background: The myeloproliferative disorders are clonal disorders with frequent somatic gain-of-function alterations affecting tyrosine kinases. In these diseases, there is an increase in DNA damage and a risk of progression...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 39-2008 â A 51-Year-Old Woman with Splenomegaly and Anemia

Jeremy S. Abramson, M.D., Manjil Chatterji, M.D., Aliyah Rahemtullah, M.D. — Thu, 18Â DecÂ 2008 00:00:00 -05:00

Dr. Jeffrey A. Barnes (HematologyâOncology): A 51-year-old woman was admitted to this hospital because of anemia and splenomegaly. The patient was in her usual state of health until approximately 2...

EDITORIAL: Microenvironmental Protection in Diffuse Large-B-Cell Lymphoma

Charis Eng, M.D., Ph.D. — Thu, 27Â NovÂ 2008 00:00:00 -05:00

The recent coming of age of genomic techniques and bioinformatics tools has led to an unprecedented proliferation of publications on genomewide association studies and expression profiling for use in genetic...

ORIGINAL ARTICLE: Stromal Gene Signatures in Large-B-Cell Lymphomas

Thu, 27Â NovÂ 2008 00:00:00 -05:00

Background: The addition of rituximab to combination chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), or R-CHOP, has significantly improved the survival of patients with diffuse large-B-cell lymphoma. Whether gene-expression...

IMAGES IN CLINICAL MEDICINE: Binocular Proptosis in Orbital Lymphoma

Hielke J. Meulenbeld, M.D. and Wim Peters, M.D., Ph.D. — Thu, 06Â NovÂ 2008 00:00:00 -05:00

An 81-year-old man presented with a 7-month history of gradual, painless swelling and redness of both eyes. He reported blurred vision and weight loss of 10 kg (22 lb). The...

CLINICAL PROBLEM-SOLVING: Fool's Gold

Thu, 06Â NovÂ 2008 00:00:00 -05:00

A 20-year-old man presented to the emergency department after a syncopal episode. During the previous 2 weeks, he had had persistent low-grade fever, anorexia, rhinorrhea, and headache. On the morning...

IMAGES IN CLINICAL MEDICINE: Gingival Hypertrophy and Leukemia

Eric Tjwa, M.D. and Vera Mattijssen, M.D., Ph.D. — Thu, 16Â OctÂ 2008 00:00:00 -05:00

A 46-year-old woman who was not taking any medications presented with anemia and gingival hypertrophy that had been progressing over a period of 3 months. She was otherwise healthy. Histopathological...

IMAGES IN CLINICAL MEDICINE: Lymphadenopathy

Catherine S. Kim, M.D. and Maria Werner-Wasik, M.D. — Thu, 09Â OctÂ 2008 00:00:00 -05:00

A 61-year-old man with small lymphocytic lymphomaâchronic lymphocytic leukemia presented with neck stiffness and bilateral axillary discomfort associated with increasing, diffuse lymphadenopathy. He had received the diagnosis of small lymphocytic...

EDITORIAL: Monoclonal B-Cell Lymphocytosis â A Frequent Premalignant Condition

Guillaume Dighiero, M.D., Ph.D. — Thu, 07Â AugÂ 2008 00:00:00 -05:00

Chronic lymphocytic leukemia (CLL), a lymphoproliferative disorder of B cells, is the commonest form of leukemia in Western countries, with an incidence of 6 cases per 100,000 persons in North...

REVIEW ARTICLE: Monoclonal Antibody Therapy for B-Cell Non-Hodgkin's Lymphoma

Bruce D. Cheson, M.D., and John P. Leonard, M.D. — Thu, 07Â AugÂ 2008 00:00:00 -05:00

Non-Hodgkin's lymphoma is the most common hematologic cancer in adults, with more than 66,000 incident cases anticipated in the United States in 2008.1 Approximately 85% of non-Hodgkin's lymphomas in adults...

ORIGINAL ARTICLE: Monoclonal B-Cell Lymphocytosis and Chronic Lymphocytic Leukemia

Thu, 07Â AugÂ 2008 00:00:00 -05:00

Background: A diagnosis of chronic lymphocytic leukemia (CLL) requires a count of over 5000 circulating CLL-phenotype cells per cubic millimeter. Asymptomatic persons with fewer CLL-phenotype cells have monoclonal B-cell lymphocytosis...

CLINICAL PROBLEM-SOLVING: A Joint Venture

Thu, 05Â JunÂ 2008 00:00:00 -05:00

A 59-year-old woman presented with new-onset oligoarthritis and extreme fatigue. The patient had been in her usual state of health until 6 weeks earlier, when she noted a gradual onset...

EDITORIAL: Diagnosis and Prognosis in Acute Myeloid Leukemia â The Art of Distinction

Bob LÃ¶wenberg, M.D., Ph.D. — Thu, 01Â MayÂ 2008 00:00:00 -05:00

The days when the microscope was the principal tool for classifying the various forms of acute myeloid leukemia (AML) and predicting the outcome of affected patients seem long past. The...

ORIGINAL ARTICLE: MicroRNA Expression in Cytogenetically Normal Acute Myeloid Leukemia

Thu, 01Â MayÂ 2008 00:00:00 -05:00

Background: A role of microRNAs in cancer has recently been recognized. However, little is known about the role of microRNAs in acute myeloid leukemia (AML).

Methods: Using microRNA expression profiling, we...

ORIGINAL ARTICLE: Mutations and Treatment Outcome in Cytogenetically Normal Acute Myeloid Leukemia

Thu, 01Â MayÂ 2008 00:00:00 -05:00

Background: Mutations occur in several genes in cytogenetically normal acute myeloid leukemia (AML) cells: the nucleophosmin gene (NPM1), the fms-related tyrosine kinase 3 gene (FLT3), the CCAAT/enhancer binding protein Î±...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 8-2008 â A 33-Year-Old Man with Fever, Abdominal Pain, and Pancytopenia after Renal Transplantation

Thu, 13Â MarÂ 2008 00:00:00 -05:00

Dr. Robert B. Den (Medicine): A 33-year-old man was admitted to this hospital because of fever, abdominal pain, and pancytopenia.

The patient had received a cadaveric renal allograft 15 years earlier...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 4-2008 â A 33-Year-Old Pregnant Woman with Swelling of the Left Breast and Shortness of Breath

Lawrence N. Shulman, M.D., Rachel A. Hitt, M.D., and Judith A. Ferry, M.D. — Thu, 31Â JanÂ 2008 00:00:00 -05:00

A 33-year-old pregnant woman was admitted to the hospital at 30.7 weeks' gestation because of swelling of the left breast, shortness of breath, and tachycardia.

The patient had received prenatal care...

IMAGES IN CLINICAL MEDICINE: Leukemic Gingival Infiltration

Aparna Mani, M.S. and David A. Lee, M.D. — Thu, 17Â JanÂ 2008 00:00:00 -05:00

An otherwise healthy 36-year-old man presented with a 6-day history of bleeding gums and abdominal pain in the left upper quadrant. He reported having had fevers, fatigue, decreased appetite, and...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 39-2007 â A 5-Month-Old Girl with Skin Lesions

Melissa M. Burnett, M.D., Mary S. Huang, M.D., and Rania M. Seliem, M.D. — Thu, 20Â DecÂ 2007 00:00:00 -05:00

Dr. Ruth Ann Vleugels (Dermatology): A 5-month-old girl was seen in the pediatric dermatology clinic because of a rash. She had been well until 3 months of age, when her...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 38-2007 â A 44-Year-Old Woman with Generalized, Painful, Ulcerated Skin Lesions

Vincent Liu, M.D., Corey S. Cutler, M.D., M.P.H., and Alison Z. Young, M.D. — Thu, 13Â DecÂ 2007 00:00:00 -05:00

Dr. Michael Sherling (Dermatology): A 44-year-old woman was admitted to this hospital because of generalized, painful, ulcerated cutaneous lesions.

The patient had been well, except for eczema, until 4 years before...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 33-2007 â A 49-Year-Old HIV-Positive Man with Anemia

Eyal C. Attar, M.D., Suzanne L. Aquino, M.D., and Robert P. Hasserjian, M.D. — Thu, 25Â OctÂ 2007 00:00:00 -05:00

A 49-year-old man infected with the human immunodeficiency virus (HIV) was seen in the hematology clinic at this hospital for evaluation of anemia.

Five weeks earlier (1 week before a routine...

IMAGES IN CLINICAL MEDICINE: FLT3 Mutation and Acute Myelogenous Leukemia with Leukostasis

Katherine A. Thornton, M.D. and Mark Levis, M.D., Ph.D. — Thu, 18Â OctÂ 2007 00:00:00 -05:00

A 59-year-old man presented with a sudden onset of abdominal pain in the left upper quadrant, associated with low-grade fever and shortness of breath. He had had a recent relapse...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 26-2007 â A 61-Year-Old Man with Recurrent Fevers

Thu, 23Â AugÂ 2007 00:00:00 -05:00

Dr. James J. Tolle (Pulmonary and Critical Care Medicine): A 61-year-old man was admitted to this hospital because of recurrent fevers. He had been well until approximately 3.5 months earlier,...

CLINICAL THERAPEUTICS: BCR-ABL Tyrosine Kinase Inhibitors for Chronic Myelogenous Leukemia

Charles A. Schiffer, M.D. — Thu, 19Â JulÂ 2007 00:00:00 -05:00

A 28-year-old woman is referred for advice about the management of recently diagnosed chronic myelogenous leukemia (CML). She was in excellent overall health but was incidentally found to have an...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: A New Mechanism of Leukemia Drug Resistance?

David A. Williams, M.D. — Thu, 05Â JulÂ 2007 00:00:00 -05:00

For the past three decades, researchers have been studying the interactions between hematopoietic stem cells and the surrounding cells of the bone marrow. The area where these interactions occur is...

IMAGES IN CLINICAL MEDICINE: Lymphomatous Infiltration of the Eyelids

Carole A. Cooke, M.R.C.Ophth. and Steve T. White, F.R.C.Ophth. — Thu, 10Â MayÂ 2007 00:00:00 -05:00

A healthy 70-year-old man presented with a 2-month history of painless swelling of his right upper and lower eyelids. The swelling had been treated with antibiotics, with no improvement. He...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: A Closer Look at Follicular Lymphoma

Louis M. Staudt, M.D., Ph.D. — Thu, 15Â FebÂ 2007 00:00:00 -05:00

A majority of healthy persons have, in their normal B cells, the defining event of follicular lymphoma â a t(14;18) translocation that brings together BCL2 and the gene encoding the...

PERSPECTIVE: Taking TRIPS to India â Novartis, Patent Law, and Access to Medicines

Thu, 08Â FebÂ 2007 00:00:00 -05:00

In August and September 2006, patients with cancer, lawyers for patient advocacy groups, and representatives of nongovernmental organizations (NGOs) converged on the offices of Novartis in Mumbai, India, to protest...

IMAGES IN CLINICAL MEDICINE: Hepatosplenic Candidiasis

Nermin Halkic, M.D. and Riadh Ksontini, M.D. — Thu, 25Â JanÂ 2007 00:00:00 -05:00

A 19-year-old woman underwent five cycles of chemotherapy for acute myelomonocytic leukemia that had been diagnosed 7 months earlier. During the last cycle of chemotherapy, neutropenia developed, lasting 22 days,...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Another Look at Imatinib Mesylate

Klaus Strebhardt, Ph.D., and Axel Ullrich, Ph.D. — Thu, 07Â DecÂ 2006 00:00:00 -05:00

Genetic abnormalities that occur during neoplastic transformation can cause the dysregulation of protein kinases â a critical event in tumorigenesis. The inhibition of protein kinases is one of the most...

ORIGINAL ARTICLE: Five-Year Follow-up of Patients Receiving Imatinib for Chronic Myeloid Leukemia

Thu, 07Â DecÂ 2006 00:00:00 -05:00

Background: The cause of chronic myeloid leukemia (CML) is a constitutively active BCR-ABL tyrosine kinase. Imatinib inhibits this kinase, and in a short-term study was superior to interferon alfa plus...

EDITORIAL: Circumventing Resistance to Kinase-Inhibitor Therapy

Brian J. Druker, M.D. — Thu, 15Â JunÂ 2006 00:00:00 -05:00

Throughout its history, chronic myeloid leukemia (CML) has set precedents for cancer research and therapy, ranging from the identification of the first specific chromosomal abnormality associated with cancer to the...

ORIGINAL ARTICLE: Nilotinib in Imatinib-Resistant CML and Philadelphia ChromosomeâPositive ALL

Thu, 15Â JunÂ 2006 00:00:00 -05:00

Background: Resistance to imatinib mesylate can occur in chronic myelogenous leukemia (CML). Preclinical in vitro studies have shown that nilotinib (AMN107), a new BCR-ABL tyrosine kinase inhibitor, is more potent...

ORIGINAL ARTICLE: Dasatinib in Imatinib-Resistant Philadelphia ChromosomeâPositive Leukemias

Thu, 15Â JunÂ 2006 00:00:00 -05:00

Background: The BCR-ABL tyrosine kinase inhibitor imatinib is effective in Philadelphia chromosomeâpositive (Ph-positive) leukemias, but relapse occurs, mainly as a result of the outgrowth of leukemic subclones with imatinib-resistant BCR-ABL...

EDITORIAL: Burkitt's Lymphoma â The Message from Microarrays

Nancy Lee Harris, M.D., and Sandra J. Horning, M.D. — Thu, 08Â JunÂ 2006 00:00:00 -05:00

Two articles in this issue of the Journal, by Dave et al.1 and Hummel et al.,2 report on the use of gene-expression microarray technology to improve the accuracy of the...

ORIGINAL ARTICLE: Molecular Diagnosis of Burkitt's Lymphoma

Thu, 08Â JunÂ 2006 00:00:00 -05:00

Background: The distinction between Burkitt's lymphoma and diffuse large-B-cell lymphoma is crucial because these two types of lymphoma require different treatments. We examined whether gene-expression profiling could reliably distinguish Burkitt's...

ORIGINAL ARTICLE: A Biologic Definition of Burkitt's Lymphoma from Transcriptional and Genomic Profiling

Thu, 08Â JunÂ 2006 00:00:00 -05:00

Background: The distinction between Burkitt's lymphoma and diffuse large-B-cell lymphoma is unclear. We used transcriptional and genomic profiling to define Burkitt's lymphoma more precisely and to distinguish subgroups in other...

ORIGINAL ARTICLE: Altered Bone and Mineral Metabolism in Patients Receiving Imatinib Mesylate

Thu, 11Â MayÂ 2006 00:00:00 -05:00

Background: Imatinib mesylate inhibits several tyrosine kinases, including BCR-ABL, the C-KIT receptor, and the platelet-derived growth factor receptors Î± and Î², all of which are associated with disease. We observed...

REVIEW ARTICLE: Treatment of Acute Lymphoblastic Leukemia

Ching-Hon Pui, M.D., and William E. Evans, Pharm.D. — Thu, 12Â JanÂ 2006 00:00:00 -05:00

Almost 4000 cases of acute lymphoblastic leukemia (ALL) are diagnosed annually in the United States, approximately two thirds of which are in children and adolescents, making ALL the most common...

ORIGINAL ARTICLE: A MicroRNA Signature Associated with Prognosis and Progression in Chronic Lymphocytic Leukemia

Thu, 27Â OctÂ 2005 00:00:00 -05:00

Background: MicroRNA expression profiles can be used to distinguish normal B cells from malignant B cells in patients with chronic lymphocytic leukemia (CLL). We investigated whether microRNA profiles are associated...

PERSPECTIVE: MicroRNAs as Oncogenes and Tumor Suppressors

Chang-Zheng Chen, Ph.D. — Thu, 27Â OctÂ 2005 00:00:00 -05:00

Recent discoveries related to microRNAs, RNA interference, small interfering RNAs (siRNAs), and small modulatory RNAs have revealed a new class of mechanisms of gene regulation that are mediated by small,...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 29-2005 â A 68-Year-Old Man with Periorbital Swelling, Rash, and Weakness

Thu, 22Â SepÂ 2005 00:00:00 -05:00

A 68-year-old man was admitted to the hospital because of a rash and muscle weakness.

He had been well until two weeks earlier, when, shortly after returning from a trip to...

IMAGES IN CLINICAL MEDICINE: Roth's Spots

Zsolt Varga, M.B., B.Chir. and Jiri Pavlu, M.D. — Thu, 08Â SepÂ 2005 00:00:00 -05:00

A 24-year-old man presented with a three-day history of a blurred patch near the center of his left visual field. He reported no fatigue or weight loss. Ophthalmoscopy showed venous...

IMAGES IN CLINICAL MEDICINE: Coagulase-Negative Staphylococcus within Neutrophils in Acute Leukemia

Francisco J. OrtuÃ±o, M.D., Ph.D. and Inmaculada Heras, M.D. — Thu, 25Â AugÂ 2005 00:00:00 -05:00

A 43-year-old man was admitted with a relapse of acute myelomonocytic leukemia eight months after having undergone autologous hematopoietic stem-cell transplantation. Fever (temperature, >39Â°C) developed within one day of the...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 22-2005 â An 81-Year-Old Man with Cough, Fever, and Altered Mental Status

Harry Hollander, M.D., Pamela W. Schaefer, M.D., and E. Tessa Hedley-Whyte, M.D. — Thu, 21Â JulÂ 2005 00:00:00 -05:00

Dr. Sherry Chou (Neurology): An 81-year-old man was admitted to the Massachusetts General Hospital in September because of fever, chills, productive cough, and diffuse weakness.

Two weeks before admission, a cough...

PERSPECTIVE: A Unifying Mutation in Chronic Myeloproliferative Disorders

John M. Goldman, D.M. — Thu, 28Â AprÂ 2005 00:00:00 -05:00

In 1892, Louis Vaquez of Paris described a patient with cyanotic polycythemia; the autopsy disclosed massive enlargement of the spleen and liver. In 1903, William Osler, then at Johns Hopkins...

EDITORIAL: Insights into Leukemogenesis from Therapy-Related Leukemia

Jens Pedersen-Bjergaard, M.D., Ph.D. — Thu, 14Â AprÂ 2005 00:00:00 -05:00

Therapy-related acute myeloid leukemia (AML), often presenting as therapy-related myelodysplasia, is the most serious long-term complication of cancer chemotherapy. This disease offers a unique opportunity to study leukemogenesis by relating...

ORIGINAL ARTICLE: DNA Topoisomerase II in Therapy-Related Acute Promyelocytic Leukemia

Thu, 14Â AprÂ 2005 00:00:00 -05:00

Background: Chromosomal translocations leading to chimeric oncoproteins are important in leukemogenesis, but how they form is unclear. We studied acute promyelocytic leukemia (APL) with the t(15;17) translocation that developed after...

EDITORIAL: Defining the Stages of Aggressive Non-Hodgkin's Lymphoma â A Work in Progress

James O. Armitage, M.D. — Thu, 24Â MarÂ 2005 00:00:00 -05:00

It is well known that localized cancers, including aggressive non-Hodgkin's lymphoma, have a better prognosis than cancers that have spread. When the results of treatment for aggressive non-Hodgkin's lymphoma are...

ORIGINAL ARTICLE: ACVBP versus CHOP plus Radiotherapy for Localized Aggressive Lymphoma

Thu, 24Â MarÂ 2005 00:00:00 -05:00

Background: Chemoradiotherapy is standard treatment for localized aggressive lymphoma. To determine the optimal therapy for nonelderly persons with low-risk localized lymphoma, we conducted a randomized trial comparing chemoradiotherapy with chemotherapy...

REVIEW ARTICLE: Chronic Lymphocytic Leukemia

Nicholas Chiorazzi, M.D., Kanti R. Rai, M.B., B.S., and Manlio Ferrarini, M.D. — Thu, 24Â FebÂ 2005 00:00:00 -05:00

05022431.xml When chronic lymphocytic leukemia (CLL) was last reviewed in the Journal,1 it was considered a homogeneous disease of immature, immune-incompetent, minimally self-renewing B cells,2 which accumulate relentlessly because...

EDITORIAL: Radioimmunotherapy â Hot New Treatment for Lymphoma

Joseph M. Connors, M.D. — Thu, 03Â FebÂ 2005 00:00:00 -05:00

Follicular lymphoma, one of the two most common lymphoid neoplasms in North America and Europe,1 is diagnosed in approximately 15,000 adults in North America each year.2 More than 90 percent...

ORIGINAL ARTICLE: I-Tositumomab Therapy as Initial Treatment for Follicular Lymphoma

Thu, 03Â FebÂ 2005 00:00:00 -05:00

Background: Advanced-stage follicular B-cell lymphoma is considered incurable. Anti-CD20 radioimmunotherapy is effective in patients who have had a relapse after chemotherapy or who have refractory follicular lymphoma, but it has...

EDITORIAL: Mutations in Acute Myelogenous Leukemia

Silvia Grisendi, Ph.D., and Pier Paolo Pandolfi, M.D., Ph.D. — Thu, 20Â JanÂ 2005 00:00:00 -05:00

Nucleophosmin (NPM) is a multifunctional phosphoprotein to which both tumor-suppressor and oncogenic functions have been attributed. Chromosomal translocations involving the NPM1 gene occur not infrequently in myeloid and lymphoid cancers....

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 2-2005 â A 39-Year-Old Woman with Headache, Stiff Neck, and Photophobia

Karen K. Ballen, M.D., and Robert P. Hasserjian, M.D. — Thu, 20Â JanÂ 2005 00:00:00 -05:00

A 39-year-old woman was admitted to the hospital because of a recurring headache, photophobia, and a stiff neck.

The woman had been well until three months earlier, when a headache developed...

ORIGINAL ARTICLE: Cytoplasmic Nucleophosmin in Acute Myelogenous Leukemia with a Normal Karyotype

Thu, 20Â JanÂ 2005 00:00:00 -05:00

Background: Nucleophosmin (NPM), a nucleocytoplasmic shuttling protein with prominent nucleolar localization, regulates the ARF-p53 tumor-suppressor pathway. Translocations involving the NPM gene cause cytoplasmic dislocation of the NPM protein.

Methods: We used...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 1-2005 â A 35-Year-Old Woman with Difficulty Walking, Headache, and Nausea

Thu, 13Â JanÂ 2005 00:00:00 -05:00

A 35-year-old woman was admitted to the emergency department because of difficulty walking, headache, and nausea.

Two weeks before admission, the patient had noticed that her gait had become increasingly unbalanced,...

ORIGINAL ARTICLE: Palifermin for Oral Mucositis after Intensive Therapy for Hematologic Cancers

Thu, 16Â DecÂ 2004 00:00:00 -05:00

Background: Oral mucositis is a complication of intensive chemotherapy and radiotherapy with no effective treatment. We tested the ability of palifermin (recombinant human keratinocyte growth factor) to decrease oral mucosal...

ORIGINAL ARTICLE: Mutation of in Familial Acute Myeloid Leukemia

Thu, 02Â DecÂ 2004 00:00:00 -05:00

We describe a family in whom three members affected by acute myeloid leukemia (AML) had an identical, 212delC mutation in CEBPA, the gene encoding the granulocytic differentiation factor C/EBPÎ±. Unaffected...

PERSPECTIVE: Disruption of C/EBPÎ± Function in Acute Myeloid Leukemia

Stefan FrÃ¶hling, M.D., and Hartmut DÃ¶hner, M.D. — Thu, 02Â DecÂ 2004 00:00:00 -05:00

In acute myeloid leukemia (AML), the most common type of acute leukemia in adults, there is clonal expansion and arrested maturation of myeloid precursor cells in the bone marrow, frequently...

EDITORIAL: Cord-Blood Transplantation in Patients with Leukemia â A Real Alternative for Adults

Miguel A. Sanz, M.D., Ph.D. — Thu, 25Â NovÂ 2004 00:00:00 -05:00

A steady stream of advances in allogeneic hematopoietic stem-cell transplantation has not only improved the clinical outcome in a variety of malignant and nonmalignant diseases but also widened the indications...

ORIGINAL ARTICLE: Transplants of Umbilical-Cord Blood or Bone Marrow from Unrelated Donors in Adults with Acute Leukemia

Thu, 25Â NovÂ 2004 00:00:00 -05:00

Background: Promising results of cord-blood transplants from unrelated donors have been reported in adults.

Methods: We compared outcomes in 682 adults with acute leukemia who received a hematopoietic stem-cell transplant from...

ORIGINAL ARTICLE: Outcomes after Transplantation of Cord Blood or Bone Marrow from Unrelated Donors in Adults with Leukemia

Thu, 25Â NovÂ 2004 00:00:00 -05:00

Background: Data regarding the outcome of cord-blood transplantation in adults are scant, despite the fact that these grafts are increasingly used in adults.

Methods: We compared the outcomes of the transplantation...

PERSPECTIVE: The Cord-Blood-Bank Controversies

Robert Steinbrook, M.D. — Thu, 25Â NovÂ 2004 00:00:00 -05:00

Umbilical-cord blood is increasingly used as a source of stem cells to repopulate the bone marrow in the treatment of life-threatening diseases in children and adults (as discussed in this...

ORIGINAL ARTICLE: Prediction of Survival in Follicular Lymphoma Based on Molecular Features of Tumor-Infiltrating Immune Cells

Thu, 18Â NovÂ 2004 00:00:00 -05:00

Background: Patients with follicular lymphoma may survive for periods of less than 1 year to more than 20 years after diagnosis. We used gene-expression profiles of tumor-biopsy specimens obtained at...

PERSPECTIVE: Prognosis in Follicular Lymphoma â It's in the Microenvironment

Ralf KÃ¼ppers, Ph.D. — Thu, 18Â NovÂ 2004 00:00:00 -05:00

Considerable clinical heterogeneity and wide variation in survival among patients are characteristic of many B-cell lymphomas. Prognostic markers that predict the clinical behavior of such tumors with greater accuracy than...

IMAGES IN CLINICAL MEDICINE: Giant Left Atrium

Roderick Tung, M.D. and Roman DeSanctis, M.D. — Thu, 30Â SepÂ 2004 00:00:00 -05:00

A 59-year-old woman with a history of rheumatic heart disease presented with an eight-month history of increasing ascites. Her condition was complicated by mitral stenosis, which had required a BjorkâShiley...

ORIGINAL ARTICLE: Inherited Perforin and Mutations in a Patient with Autoimmune Lymphoproliferative Syndrome and Lymphoma

Thu, 30Â SepÂ 2004 00:00:00 -05:00

A 27-year-old man with the autoimmune lymphoproliferative syndrome and a large-B-cell lymphoma had heterozygous mutations in the Fas and perforin (Prf1) genes. The Fas mutation was inherited from his healthy...

ORIGINAL ARTICLE: ZAP-70 Compared with Immunoglobulin Heavy-Chain Gene Mutation Status as a Predictor of Disease Progression in Chronic Lymphocytic Leukemia

Thu, 26Â AugÂ 2004 00:00:00 -05:00

Background: The course of chronic lymphocytic leukemia (CLL) is variable. In aggressive disease, the CLL cells usually express an unmutated immunoglobulin heavy-chain variable-region gene (IgVH) and the 70-kD zeta-associated protein...

PERSPECTIVE: Predicting Progression â ZAP-70 in CLL

Terry J. Hamblin, M.D. — Thu, 26Â AugÂ 2004 00:00:00 -05:00

The harder we look, the more we find. Diagnoses of chronic lymphocytic leukemia (CLL) are becoming more common because we are looking harder. With sensitive techniques, a monoclonal population of...

ORIGINAL ARTICLE: GranulocyteâMacrophage Progenitors as Candidate Leukemic Stem Cells in Blast-Crisis CML

Thu, 12Â AugÂ 2004 00:00:00 -05:00

Background: The progression of chronic myelogenous leukemia (CML) to blast crisis is supported by self-renewing leukemic stem cells. In normal mouse hematopoietic stem cells, the process of self-renewal involves the...

PERSPECTIVE: Chronic Myelogenous Leukemia â Identifying the Hydra's Heads

Michael F. Clarke, M.D. — Thu, 12Â AugÂ 2004 00:00:00 -05:00

Chronic myelogenous leukemia (CML) begins as an indolent disease in which the myeloid lineages in the bone marrow and blood gradually expand. Untreated, this chronic phase of CML inexorably progresses...

EDITORIAL: Childhood Leukemia â New Advances and Challenges

Naomi J. Winick, M.D., William L. Carroll, M.D., and Stephen P. Hunger, M.D. — Thu, 05Â AugÂ 2004 00:00:00 -05:00

Since 1970, the rate of cure of acute lymphoblastic leukemia (ALL) in children has increased dramatically, from less than 30 percent to approximately 80 percent. This remarkable improvement has resulted...

ORIGINAL ARTICLE: Loss of Smad3 in Acute T-Cell Lymphoblastic Leukemia

Thu, 05Â AugÂ 2004 00:00:00 -05:00

Background: The receptors for transforming growth factor Î² (TGF-Î²) and their signaling intermediates make up an important tumor-suppressor pathway. The role of one of these intermediates â Smad3 â in...

ORIGINAL ARTICLE: Gene-Expression Patterns in Drug-Resistant Acute Lymphoblastic Leukemia Cells and Response to Treatment

Thu, 05Â AugÂ 2004 00:00:00 -05:00

Background: 04080528.xml 04080528.xml 04080528.xml 04080528.xml 04080528.xml Childhood acute lymphoblastic leukemia (ALL) is curable with chemotherapy in approximately 80 percent of patients. However, the cause of treatment failure in the remaining...

PERSPECTIVE: TGF-Î² Signaling, Tumor Suppression, and Acute Lymphoblastic Leukemia

James R. Downing, M.D. — Thu, 05Â AugÂ 2004 00:00:00 -05:00

The emergence of a single cancer cell is an extremely complex process that depends not only on the escape of a normal cell from growth-control mechanisms but also on the...

ORIGINAL ARTICLE: Lymphoma-Specific Genetic Aberrations in Microvascular Endothelial Cells in B-Cell Lymphomas

Thu, 15Â JulÂ 2004 00:00:00 -05:00

Background: The growth of most tumors depends on the formation of new blood vessels. In contrast to genetically unstable tumor cells, the endothelial cells of tumor vessels are considered to...

PERSPECTIVE: Neoplastic Angiogenesis â Not All Blood Vessels Are Created Equal

Isaiah J. Fidler, D.V.M., Ph.D., and Lee M. Ellis, M.D. — Thu, 15Â JulÂ 2004 00:00:00 -05:00

The primary cause of death from cancer is the progressive growth of metastases that are resistant to conventional therapies. The site of metastasis from primary neoplasms is not random. Indeed,...

ORIGINAL ARTICLE: The Effect of Dexrazoxane on Myocardial Injury in Doxorubicin-Treated Children with Acute Lymphoblastic Leukemia

Thu, 08Â JulÂ 2004 00:00:00 -05:00

Background: Doxorubicin chemotherapy is very effective in children with acute lymphoblastic leukemia (ALL) but also injures myocardial cells. Dexrazoxane, a free-radical scavenger, may protect the heart from doxorubicin-associated damage.

Methods: To...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 19-2004 â A 12-Year-Old Boy with Fatigue and Eosinophilia

Mary S. Huang, M.D., and Robert P. Hasserjian, M.D. — Thu, 17Â JunÂ 2004 00:00:00 -05:00

A 12-year-old boy was evaluated in the hematology clinic of this hospital because of fatigue and peripheral-blood eosinophilia. For one week, he had had fatigue that had caused him to...

IMAGES IN CLINICAL MEDICINE: Gas Gangrene

Stephen M. Schexnayder, M.D. and Sarah G. Klein, M.D. — Thu, 17Â JunÂ 2004 00:00:00 -05:00

A 12-year-old boy with acute myelogenous leukemia that had been diagnosed two months earlier presented to a hospital with fever and leg pain. He had received intravenous cytarabine two weeks...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 15-2004 â A 31-Year-Old Man with Bilateral Testicular Enlargement

Karen K. Ballen, M.D., and Robert P. Hasserjian, M.D. — Thu, 13Â MayÂ 2004 00:00:00 -05:00

A 31-year-old man was admitted to the hospital because of a testicular mass.

The patient had been well until three months before admission, when he noted bilateral testicular swelling that coincided...

REVIEW ARTICLE: The Pathogenesis of Mycosis Fungoides

Michael Girardi, M.D., Peter W. Heald, M.D., and Lynn D. Wilson, M.D., M.P.H. — Thu, 06Â MayÂ 2004 00:00:00 -05:00

Cutaneous T-cell lymphoma represents a complex array of disorders with various manifestations, clinical courses, and therapeutic considerations. Mycosis fungoides â in which the skin is variably affected by flat patches,...

IMAGES IN CLINICAL MEDICINE: The Mount Fuji Sign

Josef G. Heckmann, M.D. and Oliver Ganslandt, M.D. — Thu, 29Â AprÂ 2004 00:00:00 -05:00

A 53-year-old woman was admitted because of progressive right-sided hemiparesis and aphasia. A computed tomographic (CT) scan of the brain revealed a space-occupying supratentorial lesion. A biopsy through a burr...

ORIGINAL ARTICLE: Prediction of Survival in Diffuse Large-B-Cell Lymphoma Based on the Expression of Six Genes

Thu, 29Â AprÂ 2004 00:00:00 -05:00

Background: Several gene-expression signatures can be used to predict the prognosis in diffuse large-B-cell lymphoma, but the lack of practical tests for a genome-scale analysis has restricted the use of...

EDITORIAL: Gene-Expression Profiling in Acute Myeloid Leukemia

David Grimwade, Ph.D., and Torsten Haferlach, M.D. — Thu, 15Â AprÂ 2004 00:00:00 -05:00

The past three decades have seen considerable advances in our understanding of the underlying mechanisms of acute myeloid leukemia (AML) and dramatic improvements in treatment. At present, decisions about therapy...

ORIGINAL ARTICLE: Prognostically Useful Gene-Expression Profiles in Acute Myeloid Leukemia

Thu, 15Â AprÂ 2004 00:00:00 -05:00

Background: In patients with acute myeloid leukemia (AML) a combination of methods must be used to classify the disease, make therapeutic decisions, and determine the prognosis. However, this combined approach...

ORIGINAL ARTICLE: Use of Gene-Expression Profiling to Identify Prognostic Subclasses in Adult Acute Myeloid Leukemia

Thu, 15Â AprÂ 2004 00:00:00 -05:00

Background: In patients with acute myeloid leukemia (AML), the presence or absence of recurrent cytogenetic aberrations is used to identify the appropriate therapy. However, the current classification system does not...

PERSPECTIVE: Microarrays and Clinical Investigations

Edison T. Liu, M.D., and Krishna R. Karuturi, Ph.D. — Thu, 15Â AprÂ 2004 00:00:00 -05:00

Two articles in this issue of the Journal tell a similar story: primary acute myeloid leukemia (AML) may be divided into subclasses according to gene-expression profiles. Given the number of...

REVIEW ARTICLE: Acute Lymphoblastic Leukemia

Ching-Hon Pui, M.D., Mary V. Relling, Pharm.D., and James R. Downing, M.D. — Thu, 08Â AprÂ 2004 00:00:00 -05:00

The rate of success in the treatment of acute lymphoblastic leukemia (ALL) has increased steadily since the 1960s. 04040831.xml 04040831.xml The five-year event-free survival rate is nearly 80 percent for...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 10-2004 â A 58-Year-Old Man with Acute Myeloid Leukemia and Fever after Chemotherapy

Jay A. Fishman, M.D., Bimalangshu R. Dey, M.D., and Robert P. Hasserjian, M.D. — Thu, 25Â MarÂ 2004 00:00:00 -05:00

Dr. Bimalangshu R. Dey: A 58-year-old man with a large sacral ulcer was admitted to the hospital for chemotherapy to treat acute myeloid leukemia.

The patient had had recurrent infections...

REVIEW ARTICLE: Persistence of the EpsteinâBarr Virus and the Origins of Associated Lymphomas

David A. Thorley-Lawson, Ph.D., and Andrew Gross, M.D. — Thu, 25Â MarÂ 2004 00:00:00 -05:00

EpsteinâBarr virus (EBV) is perhaps best known for its ability to immortalize human B lymphocytes in culture.1 This property makes it a candidate for causing human disease, particularly cancer and...

ORIGINAL ARTICLE: Initial Treatment of Aggressive Lymphoma with High-Dose Chemotherapy and Autologous Stem-Cell Support

Thu, 25Â MarÂ 2004 00:00:00 -05:00

Background: The efficacy of first-line intensive chemotherapy plus transplantation of autologous hematopoietic stem cells in adults with disseminated aggressive lymphoma is unknown.

Methods: We compared high-dose therapy plus autologous stem-cell support...

PERSPECTIVE: Who Should Receive Myeloablative Therapy for Lymphoma?

T. Andrew Lister, M.D. — Thu, 25Â MarÂ 2004 00:00:00 -05:00

The lymphomas are a heterogeneous group of cancers of the lymphoid system that are of increasing importance to the medical community. There has been a threefold increase in the incidence...

ORIGINAL ARTICLE: Immunoproliferative Small Intestinal Disease Associated with

Thu, 15Â JanÂ 2004 00:00:00 -05:00

Background: Immunoproliferative small intestinal disease (also known as alpha chain disease) is a form of lymphoma that arises in small intestinal mucosa-associated lymphoid tissue (MALT) and is associated with the...

PERSPECTIVE: Bacterial Infection and MALT Lymphoma

Julie Parsonnet, M.D., and Peter G. Isaacson, F.R.C.Path. — Thu, 15Â JanÂ 2004 00:00:00 -05:00

Fifty years ago, the idea that infectious agents caused lymphoma would have seemed heretical. Although viruses were known to cause tumors in animals, they were not considered a cause of...

IMAGES IN CLINICAL MEDICINE: Oral Lichen Planus as a Clinical Sign of Graft-versus-Host Disease

Mordechai Findler,, M.D., D.M.D. and Adi A. Garfunkel, D.M.D. — Thu, 04Â DecÂ 2003 00:00:00 -05:00

A 19-year-old woman had acute lymphocytic leukemia. While she was in her first remission, she underwent bone marrow transplantation. Three months later, she had an oral eruption consistent with lichen...

REVIEW ARTICLE: Chronic Myeloid Leukemia â Advances in Biology and New Approaches to Treatment

John M. Goldman, F.R.C.P., and Junia V. Melo, M.D., Ph.D. — Thu, 09Â OctÂ 2003 00:00:00 -05:00

Chronic myeloid leukemia (CML) was probably the first form of leukemia to be recognized as a distinct entity. In 1845, two patients were described as having massive splenomegaly associated with...

ORIGINAL ARTICLE: Frequency of Major Molecular Responses to Imatinib or Interferon Alfa plus Cytarabine in Newly Diagnosed Chronic Myeloid Leukemia

Thu, 09Â OctÂ 2003 00:00:00 -05:00

Background: In a randomized trial, 1106 patients with chronic myeloid leukemia (CML) in chronic phase were assigned to imatinib or interferon alfa plus cytarabine as initial therapy. We measured levels...

PERSPECTIVE: Minimal Residual Disease in Chronic Myeloid Leukemia

Bob LÃ¶wenberg, M.D., Ph.D. — Thu, 09Â OctÂ 2003 00:00:00 -05:00

For many years hematologists have used the microscope to identify a complete remission of leukemia after treatment with chemotherapy. In a hematologic complete remission, we know that a large portion...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 31-2003 â A 44-Year-Old Man with HIV Infection and a Right Atrial Mass

Thu, 02Â OctÂ 2003 00:00:00 -05:00

A 44-year-old man was seen in the clinic because of a right atrial mass.

Six years earlier, the patient had been found to have Pneumocystis carinii pneumonia and human immunodeficiency virus...

ORIGINAL ARTICLE: Characteristics of Hodgkin's Lymphoma after Infectious Mononucleosis

Thu, 02Â OctÂ 2003 00:00:00 -05:00

Background: Infectious mononucleosisârelated EpsteinâBarr virus (EBV) infection has been associated with an increased risk of Hodgkin's lymphoma in young adults. Whether the association is causal remains unclear.

Methods: We compared the...

PERSPECTIVE: Infection and Lymphoma

Richard Ambinder, M.D., Ph.D. — Thu, 02Â OctÂ 2003 00:00:00 -05:00

The persistence of the eponyms âHodgkinâ and âReedâSternbergâ and the noncommittal descriptor âdiseaseâ underscores the uncertainties long associated with the multinucleated giant cells that Sternberg believed to be a manifestation...

IMAGES IN CLINICAL MEDICINE: Hyperleukocytosis in Acute Myeloid Leukemia

Michael J. Mauro, M.D. — Thu, 21Â AugÂ 2003 00:00:00 -05:00

A 26-year-old woman was referred for progressive fatigue, dyspnea, blurred vision, and near-syncope. At presentation, she had marked pallor, pyrexia, diffuse nontender lymphadenopathy, and both preretinal and retinal hemorrhages. The...

ORIGINAL ARTICLE: Effect of Priming with Granulocyte Colony-Stimulating Factor on the Outcome of Chemotherapy for Acute Myeloid Leukemia

Thu, 21Â AugÂ 2003 00:00:00 -05:00

Background: Sensitization of leukemic cells with hematopoietic growth factors may enhance the cytotoxicity of chemotherapy in acute myeloid leukemia (AML).

Methods: In a multicenter randomized trial, we assigned patients (age range,...

PERSPECTIVE: Hematopoietic Growth Factors and the Future of Therapeutic Research on Acute Myeloid Leukemia

Charles A. Schiffer, M.D. — Thu, 21Â AugÂ 2003 00:00:00 -05:00

Acute myeloid leukemia (AML) is a malignant disease resulting from acquired mutations that block the differentiation of primitive hematopoietic cells and thereby cause immature myeloid precursors to accumulate. The leukemia...

ORIGINAL ARTICLE: Extended Follow-up of Long-Term Survivors of Childhood Acute Lymphoblastic Leukemia

Thu, 14Â AugÂ 2003 00:00:00 -05:00

Background: Children who survive acute lymphoblastic leukemia are at risk for leukemia-related or treatment-related complications, which can adversely affect survival and socioeconomic status. We determined the long-term survival and the...

PERSPECTIVE: Childhood Leukemia â Successes and Challenges for Survivors

Joseph V. Simone, M.D. — Thu, 14Â AugÂ 2003 00:00:00 -05:00

I was a brand-new fellow in pediatric hematologyâoncology, in July 1963, when I first cared for a child with acute leukemia. By then, with chemotherapy we were able to induce...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 23-2003 â A 79-Year-Old Woman with Gastric Lymphoma and Erosive Mucosal and Cutaneous Lesions

A. Razzaque Ahmed, M.D., Mathew M. Avram, M.D., J.D., and Lyn M. Duncan, M.D. — Thu, 24Â JulÂ 2003 00:00:00 -05:00

A 79-year-old woman with a gastric B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) type was admitted to the hospital because of erosive mucosal and cutaneous lesions.

The patient had been...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 19-2003 â A Five-Day-Old Girl with Leukocytosis and a Worsening Rash from Birth

Lawrence C. Wolfe, M.D., Howard J. Weinstein, M.D., and Judith A. Ferry, M.D. — Thu, 19Â JunÂ 2003 00:00:00 -05:00

A five-day-old girl was admitted to the hospital because of a worsening rash from birth and leukocytosis with blasts.

The infant was delivered at 40 weeks' gestation by a 24-year-old woman...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 18-2003 â A 15-Year-Old Girl with Pain in the Left Leg and Back, Pruritus, and Thoracic Lymphadenopathy

Leslie E. Lehmann, M.D., Sudha Anupindi, M.D., and Nancy Lee Harris, M.D. — Thu, 12Â JunÂ 2003 00:00:00 -05:00

A 15-year-old girl was admitted to the hospital because of pain in the left leg and back, pruritus, thoracic lymphadenopathy, and multiple pulmonary nodules.

The patient had been well until 11...

IMAGES IN CLINICAL MEDICINE: Lymphoma-Associated âIvory Ribâ

Kenneth S. Stewart, D.O. and Donald L. Steinweg, M.D. — Thu, 12Â JunÂ 2003 00:00:00 -05:00

An 81-year-old woman was admitted with increasing generalized weakness, anorexia, and a weight loss of 7 kg (15 lb) over the previous three months. The only finding on physical examination...

ORIGINAL ARTICLE: Involved-Field Radiotherapy for Advanced Hodgkin's Lymphoma

Thu, 12Â JunÂ 2003 00:00:00 -05:00

Background: The use of involved-field radiotherapy after chemotherapy for advanced Hodgkin's lymphoma is controversial.

Methods: We randomly assigned patients with previously untreated stage III or IV Hodgkin's lymphoma who were in...

ORIGINAL ARTICLE: Standard and Increased-Dose BEACOPP Chemotherapy Compared with COPP-ABVD for Advanced Hodgkin's Disease

Thu, 12Â JunÂ 2003 00:00:00 -05:00

Background: Faced with unsatisfactory results of treatment for advanced Hodgkin's disease, we investigated three combinations of chemotherapy.

Methods: From 1993 to 1998, 1201 eligible patients 15 to 65 years of age...

PERSPECTIVE: Hodgkin's Disease â Clinical Trials and Travails

Vincent T. DeVita, Jr., M.D. — Thu, 12Â JunÂ 2003 00:00:00 -05:00

The two articles on Hodgkin's disease in this issue of the Journal â one by Aleman et al. (pages 2396â2406) and one by Diehl et al. (pages 2386â2395) â provide...

EDITORIAL: Determining the Clinical Course and Outcome in Chronic Lymphocytic Leukemia

Kanti R. Rai, M.B., B.S., and Nicholas Chiorazzi, M.D. — Thu, 01Â MayÂ 2003 00:00:00 -05:00

The typical patient with chronic lymphocytic leukemia (CLL) presents to his physician at the time of a routine physical examination as an asymptomatic man who has reached the time in...

REVIEW ARTICLE: Molecular Diagnosis of the Hematologic Cancers

Louis M. Staudt, M.D., Ph.D. — Thu, 01Â MayÂ 2003 00:00:00 -05:00

The diagnosis of the hematologic cancers presents a daunting challenge. The many stages of normal hematopoietic differentiation give rise to a number of biologically and clinically distinct cancers. Inherited DNA-sequence...

ORIGINAL ARTICLE: ZAP-70 Expression as a Surrogate for Immunoglobulin-Variable-Region Mutations in Chronic Lymphocytic Leukemia

Thu, 01Â MayÂ 2003 00:00:00 -05:00

Background: The mutational status of immunoglobulin heavy-chain variable-region (IgVH) genes in the leukemic cells of chronic lymphocytic leukemia (CLL) is an important prognostic factor in the disease. We investigated whether...

IMAGES IN CLINICAL MEDICINE: Tumor Pseudosyncytiae

Gregory J. Kato, M.D. and David M. Loeb, M.D. — Thu, 03Â AprÂ 2003 00:00:00 -05:00

A seven-year-old boy presented to a community hospital with a three-week history of cough and weight loss without fever. He was treated with oral and then intravenous antibiotics, without clinical...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 10-2003 â A 72-Year-Old Man with Rapidly Progressive Leukemia, Rash, and Multiorgan Failure

Francine M. Foss, M.D., Suzanne L. Aquino, M.D., and Judith A. Ferry, M.D. — Thu, 27Â MarÂ 2003 00:00:00 -05:00

A 72-year-old man was transferred to this hospital from another hospital because of rapidly progressive leukemia and multiorgan failure.

The patient had lost an unknown amount of weight during the preceding...

ORIGINAL ARTICLE: Imatinib Compared with Interferon and Low-Dose Cytarabine for Newly Diagnosed Chronic-Phase Chronic Myeloid Leukemia

Thu, 13Â MarÂ 2003 00:00:00 -05:00

Background: Imatinib, a selective inhibitor of the BCR-ABL tyrosine kinase, produces high response rates in patients with chronic-phase chronic myeloid leukemia (CML) who have had no response to interferon alfa....

EDITORIAL: Imatinib Mesylate â The New Gold Standard for Treatment of Chronic Myeloid Leukemia

Karl Peggs, M.A., and Stephen Mackinnon, M.D. — Thu, 13Â MarÂ 2003 00:00:00 -05:00

Chronic myeloid leukemia (CML) is a clonal stem-cell disorder in which the reciprocal translocation t(9;22) generates two novel fusion genes: BCR-ABL on the derivative 22qâ (Philadelphia) chromosome, and ABL-BCR on...

IMAGES IN CLINICAL MEDICINE: Bilateral Striatal Necrosis Associated with Infection

Miriam van Buiren, M.D. and Markus Uhl, M.D. — Thu, 20Â FebÂ 2003 00:00:00 -05:00

Fever and neutropenia developed in a 14-year-old girl after she received intensive chemotherapy for her third relapse of preâB-cell acute lymphocytic leukemia, including intrathecal therapy with methotrexate, cytarabine, and prednisone....

PERSPECTIVE: Risks and Benefits of Gene Therapy

Philip Noguchi, M.D. — Thu, 16Â JanÂ 2003 00:00:00 -05:00

Updated information on this topic from the Food and Drug Administration is available at http://www.fda.gov/bbs/topics/ANSWERS/2003/ANS01190.html.

Although most of today's gene-therapy trials are targeted to cancer, there is renewed interest in pursuing...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 38-2002 â A 54-Year-Old Man with Hypercalcemia, Renal Dysfunction, and an Enlarged Liver

John K. Erban and Zuoquin Tang — Thu, 12Â DecÂ 2002 00:00:00 -05:00

A 54-year-old man was admitted to the hospital because of possible metastatic carcinoma with hypercalcemia and renal dysfunction.

The patient had been in good health until about six weeks earlier. At...

ORIGINAL ARTICLE: Response to Imatinib Mesylate in Patients with Chronic Myeloproliferative Diseases with Rearrangements of the Platelet-Derived Growth Factor Receptor Beta

Thu, 15Â AugÂ 2002 00:00:00 -05:00

Background: A small proportion of patients with chronic myeloproliferative diseases have constitutive activation of the gene for platelet-derived growth factor receptor beta (PDGFRB), which encodes a receptor tyrosine kinase. The...

ORIGINAL ARTICLE: Regression of Splenic Lymphoma with Villous Lymphocytes after Treatment of Hepatitis C Virus Infection

Thu, 11Â JulÂ 2002 00:00:00 -05:00

Background: Some epidemiologic studies suggest a link between hepatitis C virus (HCV) infection and some B-cell non-Hodgkin's lymphomas. We undertook this study after a patient with splenic lymphoma with villous...

PERSPECTIVE: Viruses and Lymphomas

Thu, 11Â JulÂ 2002 00:00:00 -05:00

Do viruses cause lymphomas? Yes, at least some viruses can. The first evidence was found in the 1960s, when EpsteinâBarr virus (EBV) was detected in an explanted Burkitt's lymphoma. Today's...

ORIGINAL ARTICLE: Use of an Inactivated Varicella Vaccine in Recipients of Hematopoietic-Cell Transplants

Thu, 04Â JulÂ 2002 00:00:00 -05:00

Background: The reactivation of varicellaâzoster virus from latency causes zoster and is common among recipients of hematopoietic-cell transplants.

Methods: We randomly assigned patients who were scheduled to undergo autologous hematopoietic-cell transplantation...

EDITORIAL: Molecular Characteristics of Diffuse Large-B-Cell Lymphoma

Thu, 20Â JunÂ 2002 00:00:00 -05:00

The utility of disease classifications depends greatly on the tools used. The lower the resolving power, the more subjective and controversial the interpretation. As has been the case throughout the...

ORIGINAL ARTICLE: The Use of Molecular Profiling to Predict Survival after Chemotherapy for Diffuse Large-B-Cell Lymphoma

Thu, 20Â JunÂ 2002 00:00:00 -05:00

Background: The survival of patients with diffuse large-B-cell lymphoma after chemotherapy is influenced by molecular features of the tumors. We used the gene-expression profiles of these lymphomas to develop a...

IMAGES IN CLINICAL MEDICINE: Retinal Hemorrhages in Acute Leukemia

Michael J. Leach, M.B., Ch.B. — Thu, 06Â JunÂ 2002 00:00:00 -05:00

Figure 1. A 26-year-old man presented with acute myeloid leukemia (FrenchâAmericanâBritish stage M1) in January 1996. The leukemic blasts showed complex cytogenetic abnormalities, including a 3q26 break point, an abnormality...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 10-2002 â A 52-Year-Old Woman with Recurrent Unsteadiness, Slurred Speech, and Fatigue

Lloyd M. Alderson and Ivana Delalle — Thu, 28Â MarÂ 2002 00:00:00 -05:00

A 52-year-old right-handed woman was admitted to the neurologic clinic because of ataxia and fatigue.

The patient had been well until four months earlier, when she had had a Ã¢â¬Åsinus infectionÃ¢â¬Â...

REVIEW ARTICLE: Imatinib Mesylate â A New Oral Targeted Therapy

David G. Savage, M.D., and Karen H. Antman, M.D. — Thu, 28Â FebÂ 2002 00:00:00 -05:00

Imatinib (Gleevec, Novartis, Basel, Switzerland), formerly referred to as STI571, is an inhibitor of specific protein tyrosine kinases that was targeted to the platelet-derived growth factor (PDGF) receptor (Figure 1)....

ORIGINAL ARTICLE: Hematologic and Cytogenetic Responses to Imatinib Mesylate in Chronic Myelogenous Leukemia

Thu, 28Â FebÂ 2002 00:00:00 -05:00

Background: Chronic myelogenous leukemia (CML) is caused by the BCR-ABL tyrosine kinase, the product of the Philadelphia chromosome. Imatinib mesylate, formerly STI571, is a selective inhibitor of this kinase.

Methods: A...

EDITORIAL: CHOP plus Rituximab â Balancing Facts and Opinion

Thu, 24Â JanÂ 2002 00:00:00 -05:00

Research on the treatment of the non-Hodgkin's lymphomas has finally emerged from decades of stagnation. These lymphomas, which usually arise from B lymphocytes, are the fifth most common type of...

IMAGES IN CLINICAL MEDICINE: Aspergilloma

Ayhan Ulusakarya, M.D. — Thu, 24Â JanÂ 2002 00:00:00 -05:00

Figure 1. A 45-year-old man was admitted for relapse of acute promyelocytic leukemia nine months after the first remission. Severe neutropenia had developed after salvage chemotherapy with mitoxantrone, cytarabine, and...

ORIGINAL ARTICLE: CHOP Chemotherapy plus Rituximab Compared with CHOP Alone in Elderly Patients with Diffuse Large-B-Cell Lymphoma

Thu, 24Â JanÂ 2002 00:00:00 -05:00

Background: The standard treatment for patients with diffuse large-B-cell lymphoma is cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP). Rituximab, a chimeric monoclonal antibody against the CD20 B-cell antigen, has therapeutic activity...

IMAGES IN CLINICAL MEDICINE: Systemic Mast-Cell Disease (Mastocytosis)

Lars M. Asmis, M.D. and Christophe Girardet, M.D. — Thu, 17Â JanÂ 2002 00:00:00 -05:00

Figure 1. A 71-year-old man presented with hepatosplenomegaly and multiple macular, hyperpigmented, nonpruritic skin lesions on the trunk, legs, and arms (Panel A). The hemoglobin level was 9.1 g per...

ORIGINAL ARTICLE: Major-Histocompatibility-Complex Class I Alleles and Antigens in Hematopoietic-Cell Transplantation

Thu, 20Â DecÂ 2001 00:00:00 -05:00

Background: Successful engraftment of hematopoietic stem cells from unrelated donors is influenced by disparities between the donor and recipient for HLA-A, B, and C alleles. Disparities between HLA sequence polymorphisms...

ORIGINAL ARTICLE: Transmission of a T-Cell Lymphoma by Allogeneic Bone Marrow Transplantation

Thu, 15Â NovÂ 2001 00:00:00 -05:00

Secondary cancer is a well-established long-term complication of bone marrow transplantation.123 These post-transplantation cancers are usually associated with exposure to radiation, other genotoxic agents, or EpsteinâBarr virus; in rare cases,...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 34-2001 â A 54-Year-Old Woman with Multiple Sclerosis, Prolonged Fever, and Skin Nodules

Joseph O. Jacobson and Laurence de Leval — Thu, 08Â NovÂ 2001 00:00:00 -05:00

A 54-year-old woman was admitted to the hospital with fever of unknown origin of one year's duration.

The patient was confined to a bed because of multiple sclerosis of 20 years'...

EDITORIAL: A Magic Bullet for Cancer â How Near and How Far?

Thu, 26Â JulÂ 2001 00:00:00 -05:00

The search for effective and specific antineoplastic therapy has led to considerable interest in antitumor antibodies. Attempts to treat cancer with antibodies date back to the early 1900s, but progress...

ORIGINAL ARTICLE: Efficacy of the Anti-CD22 Recombinant Immunotoxin BL22 in Chemotherapy-Resistant Hairy-Cell Leukemia

Thu, 26Â JulÂ 2001 00:00:00 -05:00

Background: Hairy-cell leukemia that is resistant to treatment with purine analogues, including cladribine, has a poor prognosis. We tested the safety and efficacy of an immunotoxin directed against a surface...

EDITORIAL: Targeting the BCR-ABL Tyrosine Kinase in Chronic Myeloid Leukemia

Thu, 05Â AprÂ 2001 00:00:00 -05:00

Chronic myeloid leukemia (CML) is one of the most remarkable cancers.12 It was probably the first type of leukemia to be recognized, in the 1840s, as a distinct entity. A...

ORIGINAL ARTICLE: Activity of a Specific Inhibitor of the BCR-ABL Tyrosine Kinase in the Blast Crisis of Chronic Myeloid Leukemia and Acute Lymphoblastic Leukemia with the Philadelphia Chromosome

Thu, 05Â AprÂ 2001 00:00:00 -05:00

Background: BCR-ABL, a constitutively activated tyrosine kinase, is the product of the Philadelphia (Ph) chromosome. This enzyme is present in virtually all cases of chronic myeloid leukemia (CML) throughout the...

ORIGINAL ARTICLE: Efficacy and Safety of a Specific Inhibitor of the BCR-ABL Tyrosine Kinase in Chronic Myeloid Leukemia

Thu, 05Â AprÂ 2001 00:00:00 -05:00

Background: BCR-ABL is a constitutively activated tyrosine kinase that causes chronic myeloid leukemia (CML). Since tyrosine kinase activity is essential to the transforming function of BCR-ABL, an inhibitor of the...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 9-2001 â A 64-Year-Old Woman with Peripheral Neuropathy, Paraproteinemia, and Lymphadenopathy

Kenneth C. Gorson, E. Tessa Hedley-Whyte, Martha M. Skinner — Thu, 22Â MarÂ 2001 00:00:00 -05:00

A 64-year-old, right-handed woman was admitted to the hospital because of motor and sensory impairment in her right arm.

Two years before admission, generalized lymphadenopathy had been diagnosed. At that time,...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 8-2001 â A 61-Year-Old Man with Transient Quadriplegia and Apnea

Eric T.Wong, David N. Louis — Thu, 15Â MarÂ 2001 00:00:00 -05:00

A 61-year-old man was admitted to the hospital because of transient quadriplegia and apnea.

The patient had been well until the morning of admission, when stiffness and pain developed in his...

ORIGINAL ARTICLE: Genomic Aberrations and Survival in Chronic Lymphocytic Leukemia

Thu, 28Â DecÂ 2000 00:00:00 -05:00

Background: Fluorescence in situ hybridization has improved the detection of genomic aberrations in chronic lymphocytic leukemia. We used this method to identify chromosomal abnormalities in patients with chronic lymphocytic leukemia...

EDITORIAL: When and How to Treat Chronic Lymphocytic Leukemia

Thu, 14Â DecÂ 2000 00:00:00 -05:00

Chronic lymphocytic leukemia (CLL), the most common form of leukemia in adults, is usually recognized first by the patient's primary care physician. When the patient has other medical problems â...

ORIGINAL ARTICLE: Fludarabine Compared with Chlorambucil as Primary Therapy for Chronic Lymphocytic Leukemia

Thu, 14Â DecÂ 2000 00:00:00 -05:00

Background: Fludarabine is an effective treatment for chronic lymphocytic leukemia that does not respond to initial treatment with chlorambucil. We compared the efficacy of fludarabine with that of chlorambucil in...

REVIEW ARTICLE: EpsteinâBarr Virus Infection

Jeffrey I. Cohen, M.D. — Thu, 17Â AugÂ 2000 00:00:00 -05:00

The EpsteinâBarr virus (EBV) was discovered 36 years ago by electron microscopy of cells cultured from Burkitt's lymphoma tissue by Epstein, Achong, and Barr.1 Four years later, in 1968, EBV...

ORIGINAL ARTICLE: Acromegaly Caused by Secretion of Growth Hormone by a Non-Hodgkin's Lymphoma

Thu, 22Â JunÂ 2000 00:00:00 -05:00

Acromegaly is a systemic disorder caused by sustained hypersecretion of growth hormone. The typical features include thickening of the skin, enlargement of the hands, feet, and mandible, and visceromegaly.12 Active...

ORIGINAL ARTICLE: Outcome of Treatment in Children with Philadelphia ChromosomeâPositive Acute Lymphoblastic Leukemia

Thu, 06Â AprÂ 2000 00:00:00 -05:00

Background: Children with Philadelphia chromosomeâpositive acute lymphoblastic leukemia (Ph-positive ALL) have a poor prognosis, and there is no consensus on the optimal treatment for this variant of ALL.

Methods: We reviewed...

ORIGINAL ARTICLE: HTLV-IIâAssociated Cutaneous T-Cell Lymphoma in a Patient with HIV-1 Infection

Thu, 30Â MarÂ 2000 00:00:00 -05:00

Patients infected with human immunodeficiency virus type 1 (HIV-1) are susceptible to neoplasms, including Kaposi's sarcoma, non-Hodgkin's lymphoma, and anal and cervical carcinoma.12345 Some of these neoplasms have been associated...

REVIEW ARTICLE: Cellular Origin of Human B-Cell Lymphomas

Thu, 11Â NovÂ 1999 00:00:00 -05:00

The origin of human lymphomas has been studied by various approaches, including histology and immunophenotyping. In some types of lymphoma these studies suggested the cellular origin, but in many instances...

REVIEW ARTICLE: Acute Myeloid Leukemia

Bob LÃ¶wenberg, M.D., James R. Downing, M.D., and Alan Burnett, M.D. — Thu, 30Â SepÂ 1999 00:00:00 -05:00

Acute myeloid leukemia (AML) is characterized by an increase in the number of myeloid cells in the marrow and an arrest in their maturation, frequently resulting in hematopoietic insufficiency (granulocytopenia,...

ORIGINAL ARTICLE: Donor-Derived Acute Promyelocytic Leukemia in a Liver-Transplant Recipient

Thu, 09Â SepÂ 1999 00:00:00 -05:00

The long-term survival of donor lymphoid cells in recipients of solid-organ transplants or of fetal lymphocytes that cross the placenta and enter the maternal circulation has been established,123 but the...

REVIEW ARTICLE: The Biology of Chronic Myeloid Leukemia

Thu, 15Â JulÂ 1999 00:00:00 -05:00

Chronic myeloid leukemia (CML) is a clonal myeloproliferative expansion of transformed, primitive hematopoietic progenitor cells. It involves myeloid, monocytic, erythroid, megakaryocytic, B-lymphoid, and occasionally T-lymphoid lineages.1 CML was the first...

IMAGES IN CLINICAL MEDICINE: Cystic Lymphoma of the Brain

Irwin A. Keller, M.D. and Robert N. Greco, M.D. — Thu, 15Â JulÂ 1999 00:00:00 -05:00

Figure 1. A 47-year-old afebrile man infected with the human immunodeficiency virus presented with headache, weakness of the left arm, a CD4 count of 2 per cubic millimeter, and white-cell...

ORIGINAL ARTICLE: Transplacental Transmission of Natural-Killer-Cell Lymphoma

Thu, 08Â JulÂ 1999 00:00:00 -05:00

The placenta is an organ of embryonic origin that supports the growing fetus by facilitating the transfer of nutrients from the mother. It is not well understood how the allogeneic...

ORIGINAL ARTICLE: Long-Term Survival and Late Deaths after Allogeneic Bone Marrow Transplantation

Thu, 01Â JulÂ 1999 00:00:00 -05:00

Background: and Methods: It is uncertain whether mortality rates among patients who have undergone bone marrow transplantation return to the level of the mortality rates of the general population. We...

REVIEW ARTICLE: Chronic Myeloid Leukemia

Charles L. Sawyers, M.D. — Thu, 29Â AprÂ 1999 00:00:00 -05:00

In the past decade clinical and laboratory studies have led to important new insights into the biology of chronic myeloid leukemia (CML). Basic science has defined the molecular pathogenesis of...

EDITORIAL: Precursors of Hodgkin's Disease and B-Cell Lymphomas

Thu, 22Â AprÂ 1999 00:00:00 -05:00

Nearly a century after ReedâSternberg cells in Hodgkin's disease were first described, information about these unusual cells has begun to accumulate rapidly. Cytogenetic studies have clearly demonstrated that, in a...

ORIGINAL ARTICLE: Identification of Common Germinal-Center B-Cell Precursors in Two Patients with Both Hodgkin's Disease and Non-Hodgkin's Lymphoma

Thu, 22Â AprÂ 1999 00:00:00 -05:00

Background: Hodgkin's disease and non-Hodgkin's B-cell lymphoma occasionally occur in the same patient. The identification of a common precursor of the two types of lymphoma would show definitively that ReedâSternberg...

ORIGINAL ARTICLE: Central Hypothyroidism Associated with Retinoid X ReceptorâSelective Ligands

Thu, 08Â AprÂ 1999 00:00:00 -05:00

Background: The occurrence of symptomatic central hypothyroidism (characterized by low serum thyrotropin and thyroxine concentrations) in a patient with cutaneous T-cell lymphoma during therapy with the retinoid X receptorâselective ligand...

ORIGINAL ARTICLE: Annexin II and Bleeding in Acute Promyelocytic Leukemia

Thu, 01Â AprÂ 1999 00:00:00 -05:00

Background: Acute promyelocytic leukemia (APL) is associated with a hemorrhagic disorder of unknown cause that responds to treatment with all-trans-retinoic acid.

Methods: We studied a newly described receptor for fibrinolytic proteins,...

ORIGINAL ARTICLE: Risk of Leukemia after Platinum-Based Chemotherapy for Ovarian Cancer

Thu, 04Â FebÂ 1999 00:00:00 -05:00

Background: Platinum-based chemotherapy is the cornerstone of modern treatment for ovarian, testicular, and other cancers, but few investigations have quantified the late sequelae of such treatment.

Methods: We conducted a caseâcontrol...

EDITORIAL: Transplantation in First Remission of Acute Myeloid Leukemia

Thu, 03Â DecÂ 1998 00:00:00 -05:00

In patients under the age of 60 who have acute myeloid leukemia, chemotherapy now routinely produces a complete remission in 70 to 80 percent of cases.12 Since it is generally...

IMAGES IN CLINICAL MEDICINE: Acute Febrile Neutrophilic Dermatosis in Acute Myelogenous Leukemia

Michel Starobinski, M.D. and Denis Salomon, M.D. — Thu, 03Â DecÂ 1998 00:00:00 -05:00

Figure 1. Several erythematous nodules and papulopustules developed on the arms (Panel A), upper legs, and face of a 57-year-old man, accompanied by a fever (temperature as high as 40Â°C)...

ORIGINAL ARTICLE: Chemotherapy Compared with Autologous or Allogeneic Bone Marrow Transplantation in the Management of Acute Myeloid Leukemia in First Remission

Thu, 03Â DecÂ 1998 00:00:00 -05:00

Background: In young adults with acute myeloid leukemia, intensive chemotherapy during the initial remission improves the long-term outcome, but the role of bone marrow transplantation is uncertain. We compared high-dose...

EDITORIAL: Prognostic Factors in Advanced Hodgkin's Disease â Can They Guide Therapeutic Decisions?

Thu, 19Â NovÂ 1998 00:00:00 -05:00

Advanced Hodgkin's disease is usually defined according to the Ann Arbor clinical staging system. Patients often have stage III disease (involvement of lymph nodes on both sides of the diaphragm)...

IMAGES IN CLINICAL MEDICINE: Chylous Effusion in Hodgkin's Disease

Philippe C. Bishop, M.D. and Patrick C. Elwood, M.D. — Thu, 19Â NovÂ 1998 00:00:00 -05:00

Figure 1. A 54-year-old man who had had stage IVA follicular small-cleaved-cell lymphoma for 10 years was admitted with a 3-week history of progressive cough, shortness of breath, fatigue, and...

ORIGINAL ARTICLE: A Prognostic Score for Advanced Hodgkin's Disease

Thu, 19Â NovÂ 1998 00:00:00 -05:00

Background: Two thirds of patients with advanced Hodgkin's disease are cured with current approaches to treatment. Prediction of the outcome is important to avoid overtreating some patients and to identify...

EDITORIAL: Arsenic â New Life for an Old Potion

Thu, 05Â NovÂ 1998 00:00:00 -05:00

One of our gentlemen found time to say `How delicious!'â declares Aunt Abby to a mortified Mortimer after he discovers a corpse in the 1944 movie classic Arsenic and Old...

IMAGES IN CLINICAL MEDICINE: Bone Marrow Involvement in Acute Leukemia

R.P. Junghans, Ph.D., M.D. — Thu, 05Â NovÂ 1998 00:00:00 -05:00

Figure 1. A genetically engineered, humanized antibody against CD25 (Tac, the interleukin-2âreceptor Î± chain) was labeled with indium-111 and administered to a patient with CD25+ B-cell lymphoblastic leukemia at a...

ORIGINAL ARTICLE: Complete Remission after Treatment of Acute Promyelocytic Leukemia with Arsenic Trioxide

Thu, 05Â NovÂ 1998 00:00:00 -05:00

Background: Two reports from China have suggested that arsenic trioxide can induce complete remissions in patients with acute promyelocytic leukemia (APL). We evaluated this drug in patients with APL in...

EDITORIAL: The Quest for a Bone Marrow Donor â Optimal or Maximal HLA Matching?

Thu, 22Â OctÂ 1998 00:00:00 -05:00

Bone marrow transplantation was first used successfully exactly 30 years ago, in children with congenital immune deficiencies.1 The demonstration that bone marrow transplantation was also effective in treating aplastic anemia...

ORIGINAL ARTICLE: Treatment of High-Risk Acute Leukemia with T-CellâDepleted Stem Cells from Related Donors with One Fully Mismatched HLA Haplotype

Thu, 22Â OctÂ 1998 00:00:00 -05:00

Background: In this study we tried to achieve successful transplantation in patients with acute leukemia with the use of hematopoietic stem cells from donors who shared only one HLA haplotype...

EDITORIAL: Quantifying Leukemia

Thu, 27Â AugÂ 1998 00:00:00 -05:00

Measurement is the backbone of science, and the science of hematology is no exception. For many years, the number of normal or abnormal cells in the blood and bone marrow...

REVIEW ARTICLE: Acute Lymphoblastic Leukemia

Ching-Hon Pui, M.D., and William E. Evans, Pharm.D. — Thu, 27Â AugÂ 1998 00:00:00 -05:00

Acute lymphoblastic leukemia (ALL) is diagnosed in 3000 to 4000 persons in the United States each year; two thirds of them are children.12 The current rate of cure of nearly...

ORIGINAL ARTICLE: Clinical Significance of Minimal Residual Disease in Childhood Acute Lymphoblastic Leukemia

Thu, 27Â AugÂ 1998 00:00:00 -05:00

Background: and Methods: The implications of the detection of residual disease after treatment of acute lymphoblastic leukemia (ALL) are unclear. We conducted a prospective study at 11 centers to determine...

EDITORIAL: Chemoradiotherapy for Localized Non-Hodgkin's Lymphoma

Thu, 02Â JulÂ 1998 00:00:00 -05:00

The search for the optimal treatment for localized intermediate- and high-grade non-Hodgkin's lymphoma has progressed through several phases in recent decades. In the 1960s and early 1970s, irradiation had a...

ORIGINAL ARTICLE: Chemotherapy Alone Compared with Chemotherapy plus Radiotherapy for Localized Intermediate- and High-Grade Non-Hodgkin's Lymphoma

Thu, 02Â JulÂ 1998 00:00:00 -05:00

Background: Patients with clinically localized, intermediate- or high-grade non-Hodgkin's lymphoma usually receive initial treatment with a doxorubicin-containing regimen such as cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP). Pilot studies suggest that...

ORIGINAL ARTICLE: Augmented Post-Induction Therapy for Children with High-Risk Acute Lymphoblastic Leukemia and a Slow Response to Initial Therapy

Thu, 04Â JunÂ 1998 00:00:00 -05:00

Background: Children with high-risk acute lymphoblastic leukemia (ALL) who have a slow response to initial chemotherapy (more than 25 percent blasts in the bone marrow on day 7) have a...

ORIGINAL ARTICLE: Chlorambucil in Indolent Chronic Lymphocytic Leukemia

Thu, 21Â MayÂ 1998 00:00:00 -05:00

Background: To determine whether chlorambucil treatment benefits patients with indolent chronic lymphocytic leukemia (CLL), we conducted two randomized trials in 1535 patients with previously untreated stage A CLL.

Methods: In the...

EDITORIAL: EpsteinâBarr Virus in Action in Vivo

Thu, 14Â MayÂ 1998 00:00:00 -05:00

EpsteinâBarr virus (EBV), a B-lymphotropic herpesvirus carried by almost everyone as a lifelong asymptomatic infection, is implicated in the pathogenesis of at least three malignant disorders of B cells.1 One...

ORIGINAL ARTICLE: EpsteinâBarr Virus and a Cellular Signaling Pathway in Lymphomas from Immunosuppressed Patients

David Liebowitz, M.D., Ph.D. — Thu, 14Â MayÂ 1998 00:00:00 -05:00

Background: EpsteinâBarr virus (EBV) is associated with various malignant and benign lymphoproliferative disorders. It also efficiently transforms human B lymphocytes in vitro. The latent membrane protein 1 (LMP1) of EBV-infected...

EDITORIAL: A Chance of Cure for Every Patient with Chronic Myeloid Leukemia?

Thu, 02Â AprÂ 1998 00:00:00 -05:00

Transplantation of marrow from an unrelated donor offers the possibility of a cure for the 70 percent of patients with chronic myeloid leukemia (CML) who can tolerate the procedure and...

IMAGES IN CLINICAL MEDICINE: Chloroma in Acute Myelogenous Leukemia

Christian Sauter, M.D. and Emanuel Jacky, M.D. — Thu, 02Â AprÂ 1998 00:00:00 -05:00

Figure 1. Panel A shows a leukemic infiltrate in the skin of a 62-year-old patient with acute myelogenous leukemia (subtype M2 according to the FrenchâAmericanâBritish system of classification). Chloromas usually...

ORIGINAL ARTICLE: Bone Marrow Transplants from Unrelated Donors for Patients with Chronic Myeloid Leukemia

Thu, 02Â AprÂ 1998 00:00:00 -05:00

Background: Chronic myeloid leukemia can be cured by marrow transplantation from an HLA-identical sibling donor. The use of transplants from unrelated donors is an option for the 70 percent of...

ORIGINAL ARTICLE: Molecular Analysis of the Progression from âAssociated Chronic Gastritis to Mucosa-Associated Lymphoid-Tissue Lymphoma of the Stomach

Thu, 19Â MarÂ 1998 00:00:00 -05:00

Several lines of evidence suggest a link between chronic gastritis due to Helicobacter pylori and mucosa-associated lymphoid-tissue (MALT) lymphoma of the stomach.12 A close epidemiologic association has been reported.345 The...

ORIGINAL ARTICLE: Conventional Compared with Individualized Chemotherapy for Childhood Acute Lymphoblastic Leukemia

Thu, 19Â FebÂ 1998 00:00:00 -05:00

Background: The rate of clearance of antileukemic agents differs by a factor of 3 to 10 among children with acute lymphoblastic leukemia. We hypothesized that the outcome of treatment would...

ORIGINAL ARTICLE: The Threshold for Prophylactic Platelet Transfusions in Adults with Acute Myeloid Leukemia

Thu, 25Â DecÂ 1997 00:00:00 -05:00

Background: Prophylactic platelet transfusions are usually administered to patients receiving myelotoxic chemotherapy when their platelet count falls below 20,000 per cubic millimeter. Some observations suggest that lower platelet counts can...

EDITORIAL: Limiting Therapy for Limited Childhood Non-Hodgkin's Lymphoma

Thu, 30Â OctÂ 1997 00:00:00 -05:00

During the first half of this century, surgery and radiation were the only effective treatments for cancer, and cure was possible only in patients with localized disease. The introduction of...

ORIGINAL ARTICLE: Treatment of Children and Young Adults with Early-Stage Non-Hodgkin's Lymphoma

Thu, 30Â OctÂ 1997 00:00:00 -05:00

Background: Children and young adults with early-stage non-Hodgkin's lymphoma have an excellent prognosis, but treatment is prolonged and is associated with many side effects. We performed two studies to determine...

EDITORIAL: Differentiation Therapy for Acute Promyelocytic Leukemia

Thu, 09Â OctÂ 1997 00:00:00 -05:00

Until recently, chemotherapy and hematopoietic stem-cell transplantation were the only therapeutic options in acute leukemia. The idea of restoring normal differentiation in primitive leukemic cells seemed unrealistic until the effect...

IMAGES IN CLINICAL MEDICINE: Pathologic Fracture

GraÃ§a M. Dores, M.D. and Marilyn E. Miller, M.D. — Thu, 09Â OctÂ 1997 00:00:00 -05:00

Figure 1. A 65-year-old man had T-cell, large-cell non-Hodgkin's lymphoma of the right temporalis muscle with localized bone destruction. Computed tomography of the chest, abdomen, and pelvis showed no evidence...

ORIGINAL ARTICLE: All--Retinoic Acid in Acute Promyelocytic Leukemia

Thu, 09Â OctÂ 1997 00:00:00 -05:00

Background: All-trans-retinoic acid induces complete remission in acute promyelocytic leukemia. However, it is not clear whether induction therapy with all-trans-retinoic acid is superior to chemotherapy alone or whether maintenance treatment...

ORIGINAL ARTICLE: Mutations of the p53 Gene as a Prognostic Factor in Aggressive B-Cell Lymphoma

Thu, 21Â AugÂ 1997 00:00:00 -05:00

Background: Mutations of the p53 gene are associated with a poor prognosis in several types of cancer. We investigated the prognostic importance of p53 mutations in patients with aggressive B-cell...

EDITORIAL: Hodgkin's Disease â Time for a Change

Thu, 14Â AugÂ 1997 00:00:00 -05:00

ReedâSternberg cells and their variants have long held fascination for students of Hodgkin's disease. What are these cells, and how do they relate to the clinical manifestations of the lymphoma?...

ORIGINAL ARTICLE: Clonality in Nodular Lymphocyte-Predominant Hodgkin's Disease

Thu, 14Â AugÂ 1997 00:00:00 -05:00

Background: There is general agreement that lymphocytic and histiocytic (L&H) cells, the variants of ReedâSternberg cells in nodular lymphocyte-predominant Hodgkin's disease, belong to the B-cell lineage. However, the clonality of...

ORIGINAL ARTICLE: Origin of Nodular Lymphocyte-Predominant Hodgkin's Disease from a Clonal Expansion of Highly Mutated Germinal-Center B Cells

Thu, 14Â AugÂ 1997 00:00:00 -05:00

Background: The atypical cells of nodular lymphocyte-predominant Hodgkin's disease, designated lymphocytic and histiocytic (L&H) cells, have a B-cell phenotype. To clarify the clonality of these cells, we studied rearranged immunoglobulin...

EDITORIAL: Optimizing Treatment for Chronic Myeloid Leukemia

Thu, 24Â JulÂ 1997 00:00:00 -05:00

Chronic myeloid leukemia has fascinated hematologists and others for 150 years. It was probably the first form of leukemia to be recognized as an entity in its own right; and...

ORIGINAL ARTICLE: Interferon Alfa-2b Combined with Cytarabine versus Interferon Alone in Chronic Myelogenous Leukemia

Thu, 24Â JulÂ 1997 00:00:00 -05:00

Background: Treatment with interferon prolongs survival in chronic myelogenous leukemia. We conducted a clinical trial to assess the efficacy of treatment with a combination of interferon and cytarabine.

Methods: Previously untreated...

ORIGINAL ARTICLE: Residential Exposure to Magnetic Fields and Acute Lymphoblastic Leukemia in Children

Thu, 03Â JulÂ 1997 00:00:00 -05:00

Background: Previous studies found associations between childhood leukemia and surrogate indicators of exposure to magnetic fields (the power-line classification scheme known as âwire codingâ), but not between childhood leukemia and...

EDITORIAL: Hematopoietic Growth Factors â Not Whether, but When and Where

Thu, 19Â JunÂ 1997 00:00:00 -05:00

Many studies have appraised the value of treatment with granulocyte colony-stimulating factor (G-CSF) or granulocyteâmacrophage colony-stimulating factor (GM-CSF) in ameliorating chemotherapy-induced neutropenia. The principal aim of this treatment is to...

ORIGINAL ARTICLE: Human Granulocyte Colony-Stimulating Factor after Induction Chemotherapy in Children with Acute Lymphoblastic Leukemia

Thu, 19Â JunÂ 1997 00:00:00 -05:00

Background: Recombinant human granulocyte colony-stimulating factor (G-CSF, or filgrastim) hastens the recovery from neutropenia after intensive chemotherapy, but its role in the management of childhood leukemia is unclear.

Methods: We randomly...

ORIGINAL ARTICLE: Low-Dose Compared with Standard-Dose m-BACOD Chemotherapy for Non-Hodgkin's Lymphoma Associated with Human Immunodeficiency Virus Infection

Thu, 05Â JunÂ 1997 00:00:00 -05:00

Background: Reduced doses of cytotoxic chemotherapy or standard-dose therapy plus a myeloid colony-stimulating factor decreases hematologic toxicity and its complications in patients with non-Hodgkin's lymphoma associated with infection with the...

IMAGES IN CLINICAL MEDICINE: Cutaneous Lesions in Diffuse Large-B-Cell Lymphoma

Paolo Paredi, M.D. and Oreste Pierluigi, M.D. — Thu, 01Â MayÂ 1997 00:00:00 -05:00

Figure 1. A 65-year-old man was admitted to our hospital with fatigue, weight loss, night sweats, and multiple pruritic erythematous nodules and plaques on his left shoulder, one of which...

EDITORIAL: Silence of the Leukemic Clone

Thu, 30Â JanÂ 1997 00:00:00 -05:00

The success of treatment for childhood acute lymphoblastic leukemia (ALL) has been justifiably lauded. Some 70 percent of patients who receive optimal therapy and support can now expect to have...

ORIGINAL ARTICLE: Spontaneous Remission in a Patient with Chronic Myelogenous Leukemia

Thu, 30Â JanÂ 1997 00:00:00 -05:00

In chronic myelogenous leukemia (CML) the Philadelphia (Ph) chromosome originates from a reciprocal translocation, t(9;22)(q34;q11),1 that generates a chimeric BCR-ABL gene.2 The disease is incurable without bone marrow transplantation. In...

ORIGINAL ARTICLE: Measurement of Residual Leukemia during Remission in Childhood Acute Lymphoblastic Leukemia

Thu, 30Â JanÂ 1997 00:00:00 -05:00

Background: Complete remission of B-precursor acute lymphoblastic leukemia (ALL) has traditionally been defined as the near absence of lymphoblasts in a light-microscopical examination of stained bone marrow smears, but a...

REVIEW ARTICLE: Intrinsic and Acquired Resistance to Methotrexate in Acute Leukemia

Thu, 03Â OctÂ 1996 00:00:00 -05:00

Methotrexate, a folic acid antagonist, is used extensively not only for the treatment of cancer but also for the treatment of rheumatoid arthritis, psoriasis, and autoimmune disease and for the...

ORIGINAL ARTICLE: Cord-Blood Transplantation from an Unrelated Donor in an Adult with Chronic Myelogenous Leukemia

Thu, 18Â JulÂ 1996 00:00:00 -05:00

To circumvent the problems inherent in allogeneic bone marrow transplantation, allogeneic cord blood has been studied as an alternative source of hematopoietic stem cells. Preliminary results with cord blood from...

ORIGINAL ARTICLE: Autologous Bone Marrow Transplantation versus Intensive Consolidation Chemotherapy for Acute Myeloid Leukemia in Childhood

Thu, 30Â MayÂ 1996 00:00:00 -05:00

Background: The value of autologous bone marrow transplantation in the treatment of children with acute myeloid leukemia (AML) is unknown. We compared autologous bone marrow transplantation with intensive consolidation chemotherapy...

REVIEW ARTICLE: Non-Hodgkin's Lymphoma in Childhood

John T. Sandlund, M.D., James R. Downing, M.D., and William M. Crist, M.D. — Thu, 09Â MayÂ 1996 00:00:00 -05:00

Lymphomas are the third most common group of cancers in children and adolescents in the United States, accounting for approximately 13 percent of newly diagnosed cancers in this age group.1...

EDITORIAL: Second Cancers after Hodgkin's Disease in Childhood

Thu, 21Â MarÂ 1996 00:00:00 -05:00

The treatment of Hodgkin's disease is a model of successful therapy for childhood cancer, with cure rates of over 90 percent expected from chemotherapy regimens and low-dose radiation (15 to...

ORIGINAL ARTICLE: Breast Cancer and Other Second Neoplasms after Childhood Hodgkin's Disease

Thu, 21Â MarÂ 1996 00:00:00 -05:00

Background: Patients who survive Hodgkin's disease are at increased risk for second neoplasms. As survival times increase, solid tumors are emerging as a serious long-term complication.

Methods: The Late Effects Study...

NEJM â Collection Updates for Leukemia/Lymphoma

CORRESPONDENCE: Somatic Mutations of and in the Leukemic Transformation of Myeloproliferative Neoplasms

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 39-2009 â A 28-Year-Old Pregnant Woman with Acute Cardiac Failure

CORRESPONDENCE: Aprepitant as an Antipruritic Agent?

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Rendering the Leukemia Cell Susceptible to Attack

EDITORIAL: An Old AML Drug Revisited

ORIGINAL ARTICLE: Anthracycline Dose Intensification in Acute Myeloid Leukemia

ORIGINAL ARTICLE: High-Dose Daunorubicin in Older Patients with Acute Myeloid Leukemia

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 29-2009 â An 81-Year-Old Man with Weight Loss, Odynophagia, and Failure to Thrive

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 28-2009 â A 68-Year-Old Man with Fatigue, Cough, and Peripheral-Blood Monocytosis

ORIGINAL ARTICLE: Recurring Mutations Found by Sequencing an Acute Myeloid Leukemia Genome

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 27-2009 â A 56-Year-Old Woman with Fever, Rash, and Lymphadenopathy

EDITORIAL: Genetic Trickery â Escape of Leukemia from Immune Attack

ORIGINAL ARTICLE: Loss of Mismatched HLA in Leukemia after Stem-Cell Transplantation

BOOK REVIEW:

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 22-2009 â A 59-Year-Old Man with Skin and Pulmonary Lesions after Chemotherapy for Leukemia

CORRESPONDENCE: Molecular Outcome Prediction in Diffuse Large-B-Cell Lymphoma

ORIGINAL ARTICLE: Treating Childhood Acute Lymphoblastic Leukemia without Cranial Irradiation

BOOK REVIEW:

IMAGES IN CLINICAL MEDICINE: Pharyngeal Mass in a Patient with B-Cell Lymphoma

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Acute Promyelocytic Leukemia â Weapons of Mass Differentiation

IMAGES IN CLINICAL MEDICINE: Leukocytosis and Sublingual Microvascular Blood Flow

EDITORIAL: The Secret Lives of Monoclonal B Cells

ORIGINAL ARTICLE: B-Cell Clones as Early Markers for Chronic Lymphocytic Leukemia

EDITORIAL: Acute Lymphoblastic Leukemia â On the Wings of IKAROS

ORIGINAL ARTICLE: Deletion of and Prognosis in Acute Lymphoblastic Leukemia

BOOK REVIEW:

ORIGINAL ARTICLE: Inhibition of the Bcl-x Deamidation Pathway in Myeloproliferative Disorders

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 39-2008 â A 51-Year-Old Woman with Splenomegaly and Anemia

EDITORIAL: Microenvironmental Protection in Diffuse Large-B-Cell Lymphoma

ORIGINAL ARTICLE: Stromal Gene Signatures in Large-B-Cell Lymphomas

IMAGES IN CLINICAL MEDICINE: Binocular Proptosis in Orbital Lymphoma

CLINICAL PROBLEM-SOLVING: Fool's Gold

IMAGES IN CLINICAL MEDICINE: Gingival Hypertrophy and Leukemia

IMAGES IN CLINICAL MEDICINE: Lymphadenopathy

EDITORIAL: Monoclonal B-Cell Lymphocytosis â A Frequent Premalignant Condition

REVIEW ARTICLE: Monoclonal Antibody Therapy for B-Cell Non-Hodgkin's Lymphoma

ORIGINAL ARTICLE: Monoclonal B-Cell Lymphocytosis and Chronic Lymphocytic Leukemia

CLINICAL PROBLEM-SOLVING: A Joint Venture

EDITORIAL: Diagnosis and Prognosis in Acute Myeloid Leukemia â The Art of Distinction

ORIGINAL ARTICLE: MicroRNA Expression in Cytogenetically Normal Acute Myeloid Leukemia

ORIGINAL ARTICLE: Mutations and Treatment Outcome in Cytogenetically Normal Acute Myeloid Leukemia

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 8-2008 â A 33-Year-Old Man with Fever, Abdominal Pain, and Pancytopenia after Renal Transplantation

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 4-2008 â A 33-Year-Old Pregnant Woman with Swelling of the Left Breast and Shortness of Breath

IMAGES IN CLINICAL MEDICINE: Leukemic Gingival Infiltration

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 39-2007 â A 5-Month-Old Girl with Skin Lesions

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 38-2007 â A 44-Year-Old Woman with Generalized, Painful, Ulcerated Skin Lesions

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 33-2007 â A 49-Year-Old HIV-Positive Man with Anemia

IMAGES IN CLINICAL MEDICINE: FLT3 Mutation and Acute Myelogenous Leukemia with Leukostasis

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 26-2007 â A 61-Year-Old Man with Recurrent Fevers

CLINICAL THERAPEUTICS: BCR-ABL Tyrosine Kinase Inhibitors for Chronic Myelogenous Leukemia

CLINICAL IMPLICATIONS OF BASIC RESEARCH: A New Mechanism of Leukemia Drug Resistance?

IMAGES IN CLINICAL MEDICINE: Lymphomatous Infiltration of the Eyelids

CLINICAL IMPLICATIONS OF BASIC RESEARCH: A Closer Look at Follicular Lymphoma

PERSPECTIVE: Taking TRIPS to India â Novartis, Patent Law, and Access to Medicines

IMAGES IN CLINICAL MEDICINE: Hepatosplenic Candidiasis

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Another Look at Imatinib Mesylate

ORIGINAL ARTICLE: Five-Year Follow-up of Patients Receiving Imatinib for Chronic Myeloid Leukemia

EDITORIAL: Circumventing Resistance to Kinase-Inhibitor Therapy

ORIGINAL ARTICLE: Nilotinib in Imatinib-Resistant CML and Philadelphia ChromosomeâPositive ALL

ORIGINAL ARTICLE: Dasatinib in Imatinib-Resistant Philadelphia ChromosomeâPositive Leukemias

EDITORIAL: Burkitt's Lymphoma â The Message from Microarrays

ORIGINAL ARTICLE: Molecular Diagnosis of Burkitt's Lymphoma

ORIGINAL ARTICLE: A Biologic Definition of Burkitt's Lymphoma from Transcriptional and Genomic Profiling

ORIGINAL ARTICLE: Altered Bone and Mineral Metabolism in Patients Receiving Imatinib Mesylate

REVIEW ARTICLE: Treatment of Acute Lymphoblastic Leukemia

ORIGINAL ARTICLE: A MicroRNA Signature Associated with Prognosis and Progression in Chronic Lymphocytic Leukemia

PERSPECTIVE: MicroRNAs as Oncogenes and Tumor Suppressors

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 29-2005 â A 68-Year-Old Man with Periorbital Swelling, Rash, and Weakness

IMAGES IN CLINICAL MEDICINE: Roth's Spots

IMAGES IN CLINICAL MEDICINE: Coagulase-Negative Staphylococcus within Neutrophils in Acute Leukemia

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 22-2005 â An 81-Year-Old Man with Cough, Fever, and Altered Mental Status

PERSPECTIVE: A Unifying Mutation in Chronic Myeloproliferative Disorders

EDITORIAL: Insights into Leukemogenesis from Therapy-Related Leukemia

ORIGINAL ARTICLE: DNA Topoisomerase II in Therapy-Related Acute Promyelocytic Leukemia

EDITORIAL: Defining the Stages of Aggressive Non-Hodgkin's Lymphoma â A Work in Progress

ORIGINAL ARTICLE: ACVBP versus CHOP plus Radiotherapy for Localized Aggressive Lymphoma

REVIEW ARTICLE: Chronic Lymphocytic Leukemia

EDITORIAL: Radioimmunotherapy â Hot New Treatment for Lymphoma

ORIGINAL ARTICLE: I-Tositumomab Therapy as Initial Treatment for Follicular Lymphoma

NEJM â Collection Updates for Leukemia/Lymphoma

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 39-2009 â A 28-Year-Old Pregnant Woman with Acute Cardiac Failure

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 29-2009 â An 81-Year-Old Man with Weight Loss, Odynophagia, and Failure to Thrive

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 28-2009 â A 68-Year-Old Man with Fatigue, Cough, and Peripheral-Blood Monocytosis

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 27-2009 â A 56-Year-Old Woman with Fever, Rash, and Lymphadenopathy

EDITORIAL: Genetic Trickery â Escape of Leukemia from Immune Attack

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 22-2009 â A 59-Year-Old Man with Skin and Pulmonary Lesions after Chemotherapy for Leukemia

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Acute Promyelocytic Leukemia â Weapons of Mass Differentiation

EDITORIAL: Acute Lymphoblastic Leukemia â On the Wings of IKAROS

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 39-2008 â A 51-Year-Old Woman with Splenomegaly and Anemia

EDITORIAL: Monoclonal B-Cell Lymphocytosis â A Frequent Premalignant Condition

EDITORIAL: Diagnosis and Prognosis in Acute Myeloid Leukemia â The Art of Distinction

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 8-2008 â A 33-Year-Old Man with Fever, Abdominal Pain, and Pancytopenia after Renal Transplantation

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 4-2008 â A 33-Year-Old Pregnant Woman with Swelling of the Left Breast and Shortness of Breath

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 39-2007 â A 5-Month-Old Girl with Skin Lesions

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 38-2007 â A 44-Year-Old Woman with Generalized, Painful, Ulcerated Skin Lesions

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 33-2007 â A 49-Year-Old HIV-Positive Man with Anemia

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 26-2007 â A 61-Year-Old Man with Recurrent Fevers

PERSPECTIVE: Taking TRIPS to India â Novartis, Patent Law, and Access to Medicines

ORIGINAL ARTICLE: Nilotinib in Imatinib-Resistant CML and Philadelphia ChromosomeâPositive ALL

ORIGINAL ARTICLE: Dasatinib in Imatinib-Resistant Philadelphia ChromosomeâPositive Leukemias

EDITORIAL: Burkitt's Lymphoma â The Message from Microarrays

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 29-2005 â A 68-Year-Old Man with Periorbital Swelling, Rash, and Weakness

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 22-2005 â An 81-Year-Old Man with Cough, Fever, and Altered Mental Status

EDITORIAL: Defining the Stages of Aggressive Non-Hodgkin's Lymphoma â A Work in Progress

EDITORIAL: Radioimmunotherapy â Hot New Treatment for Lymphoma

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 2-2005 â A 39-Year-Old Woman with Headache, Stiff Neck, and Photophobia

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 1-2005 â A 35-Year-Old Woman with Difficulty Walking, Headache, and Nausea

EDITORIAL: Cord-Blood Transplantation in Patients with Leukemia â A Real Alternative for Adults

PERSPECTIVE: Prognosis in Follicular Lymphoma â It's in the Microenvironment

PERSPECTIVE: Predicting Progression â ZAP-70 in CLL

ORIGINAL ARTICLE: GranulocyteâMacrophage Progenitors as Candidate Leukemic Stem Cells in Blast-Crisis CML

PERSPECTIVE: Chronic Myelogenous Leukemia â Identifying the Hydra's Heads

EDITORIAL: Childhood Leukemia â New Advances and Challenges

PERSPECTIVE: Neoplastic Angiogenesis â Not All Blood Vessels Are Created Equal

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 19-2004 â A 12-Year-Old Boy with Fatigue and Eosinophilia

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 15-2004 â A 31-Year-Old Man with Bilateral Testicular Enlargement

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 10-2004 â A 58-Year-Old Man with Acute Myeloid Leukemia and Fever after Chemotherapy

REVIEW ARTICLE: Persistence of the EpsteinâBarr Virus and the Origins of Associated Lymphomas

REVIEW ARTICLE: Chronic Myeloid Leukemia â Advances in Biology and New Approaches to Treatment

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 31-2003 â A 44-Year-Old Man with HIV Infection and a Right Atrial Mass

PERSPECTIVE: Childhood Leukemia â Successes and Challenges for Survivors

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 23-2003 â A 79-Year-Old Woman with Gastric Lymphoma and Erosive Mucosal and Cutaneous Lesions

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 19-2003 â A Five-Day-Old Girl with Leukocytosis and a Worsening Rash from Birth

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 18-2003 â A 15-Year-Old Girl with Pain in the Left Leg and Back, Pruritus, and Thoracic Lymphadenopathy

IMAGES IN CLINICAL MEDICINE: Lymphoma-Associated âIvory Ribâ

PERSPECTIVE: Hodgkin's Disease â Clinical Trials and Travails

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 10-2003 â A 72-Year-Old Man with Rapidly Progressive Leukemia, Rash, and Multiorgan Failure

EDITORIAL: Imatinib Mesylate â The New Gold Standard for Treatment of Chronic Myeloid Leukemia