Lymphoproliferative disorders

L-Asparaginase is used for the treatment of appropriate lymphoproliferative disorders in two clinical trials, L-asparaginase was used in combination with chemotherapy for the treatment of refractory acute nonlymphocytic leukemia in children (24) and adults (25). A moderate efficacy, attributable to the enzyme, was demonstrated in both trials. 

Prevention Minimize immunosuppressant doses avoid sun exposure (sunblock, hats, clothing) routine self-exams (skin, lymph nodes) yearly gynecologic/prostate exams AZA particularly associated with skin cancers CSA/TAC may be associated with lymphoproliferative disorders (lymphomas)... 

Cyclosporine demonstrates immunosuppressive activity by inhibiting the first phase of T-cell activation. It also inhibits release of inflammatory mediators from mast cells, basophils, and polymorphonuclear cells. It is used in the treatment of both cutaneous and arthritis manifestations of severe psoriasis. The usual dose is between 2.5 and 5 mg/kg/day given in two divided doses. Adverse effects include nephrotoxicity, hypertension, hypomagnesemia, hyperkalemia, alterations in liver function tests, elevations of serum lipids, GI intolerance, paresthesias, hypertrichosis, and gingival hyperplasia. Cumulative treatment for more than 2 years may increase the risk of malignancy, including skin cancers and lymphoproliferative disorders. 

Intracavernosal injection therapy should be used cautiously in patients at risk of priapism (e.g., sickle cell disease or lymphoproliferative disorders) and bleeding complications secondary to injections. 

Borlando, L.R., Redondo, C., Alvarez, B., Jimenez, C., Criado, L.M., Flores, J., Marcos, M.A. Martinez, A.C., Balomenos D., and Carrera, A.C., Increased phosphoinositide 3-kinase activity induces a lymphoproliferative disorder and contributes to tumor generation in vivo. (2000) FASEB J. 14 895-903. 

Faro, A., Interferon-alpha and its effects on post-transplant lymphoproliferative disorders. Springer Semin Immunopathol, 1998. 20(3 ) 425-36. 

Patient should be monitored for signs of infection and/or lymphoproliferative disorders... 

Warnings Should be administered in facilities equipped and staffed with adequate laboratory and supportive medical resources Administration of proteins may cause possible anaphylactoid reactions (none reported) Immunosuppressive therapies increase risk for lymphoproliferative disorders and opportunistic infections (incidence in basiliximab-treated patients is similar to placebo)... 

A4. Ahmad, E., Garcia, D., and Davis, B. H., Clinical utility of CD23 and FMC7 antigen coexistent expression in B-cell lymphoproliferative disorder subclassification. Cytometry 50, 1-7 (2002). 

F15. Foucar, K., Chronic lymphoid leukemias and lymphoproliferative disorders. Mod. Pathol. 12, 141-150(1999). 

K32. Kummer, J. A., Vermeer, M. H., Dukers, D., Meijer, C. J., and Willemze, R., Most primary cutaneous CD30-positive lymphoproliferative disorders have a CD4-positive cytotoxic T-cell phenotype. J. Invest. Dermatol. 109, 636-640 (1997). 

P2. Paulli, M., Berti, E., Rosso, R., Boveri, E., Kindi, S., Klersy, C., Lazzarino, M., Borroni, G., Menestrina, F., Santucci, M., et al. CD30/Ki-1-positive lymphoproliferative disorders of the skin—Clinicopathologic correlation and statistical analysis of 86 cases A multicentric study from the European Organization for Research and Treatment of Cancer Cutaneous Lymphoma Project Group. J. Clin. Oncol. 13, 1343-1354 (1995). 

Rl. Raible, M. D., Hsi, E. D., and Alkan, S., Bcl-6 protein expression by follicle center lymphomas. A marker for differentiating follicle center lymphomas from other low-grade lymphoproliferative disorders. Am. J. Clin. Pathol. 112, 101-107 (1999). 

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