Citations

AbstractBackgroundWe examined the course of cutaneous T‐cell lymphoma (CTCL), which has been associated with chronic lymphocytic leukemia (CLL) in patients withCLL.Materials and methodsA search was conducted of the master diagnosis index at our institution to identify patients with bothCLLandCTCLfrom 1980 to 2010. A retrospective chart review was then conducted.ResultsOf the 14 patients withCTCLandCLL, eight had mycosis fungoides (MF; two with patch stage, two with plaque stage, two with tumor stage, and two with erythrodermic stage), four had Sézary syndrome, one had natural killer cell lymphoma involving the skin, and one had peripheral T‐cell lymphoma involving the skin. Eight had concurrent diagnoses, five received aCLLdiagnosis first, and one received aCTCLdiagnosis first. Ten patients were deceased at the time of data abstraction due to unknown causes (n = 4), lymphoma (n = 2), pneumonia (n = 2),MF(n = 1), or respiratory failure (n = 1). Of the nine patients with concurrent or priorCTCL, seven were deceased, with a median time to death of 10.2 months (range, 6–89 months). Of the five patients withCLLprior toCTCL, three were deceased at 18, 27, and 47 months, respectively, after theCTCLdiagnosis. The median survival for the two groups was 12 and 47 months, respectively.ConclusionsPatients withCTCLconcurrent with or prior toCLLhave a worse overall survival than patients withCLLin whomCTCLlater develops. Larger studies are needed.

Central nervous system metastases as the presentation of primary cardiac sarcoma are a very rare entity, with only a few previously reported cases. Sarcomas specifically make up 10 to 20% of all primary cardiac tumors. Patients with primary cardiac tumors typically present with cardiac symptomatology that may include arrhythmias, obstruction to blood flow and valve function, or symptoms of heart failure. We report a unique case of a patient with a primary cardiac sarcoma who presented with progressive neurologic dysfunction secondary to brain metastases without any preceding cardiac symptoms. We describe our novel management of these unique cases and discuss the current medical and surgical approaches to treating neurologic metastases from cardiac sarcoma.

The American Society for Apheresis (ASFA) conducted a 1 day consensus conference on Thrombotic Thrombocytopenic Purpura (TTP) during its annual meeting in Atlanta, GA, on April 10, 2012. The authors of this article, a subcommittee of ASFA's Clinical Applications Committee, developed several questions with regard to definitions, classification, pathophysiology, diagnosis, management, and future research in TTP. These questions were provided to the seven invited speakers who are the experts in the field of TTP. Two moderators conducted the proceedings of the conference which was attended by more than 100 participants. After each presentation, there was an open discussion that included moderator‐selected written questions submitted by the audience. A medical writer‐generated transcript of the proceedings as well as each presentation was made available to the authors. Each summary was reviewed and approved by the respective speaker before submission of this article. The subcommittee also developed seven key questions for blinded, electronic polling conducted by the moderators to generate a consensus amongst the speakers. This article includes these presentation summaries as well as results of the electronic poll. J. Clin. Apheresis 29:148–167, 2014. © 2013 The Authors. Journal of Clinical Apheresis Published by Wiley Periodicals, Inc.

Abstract Purpose: Basal-like breast tumors are typically (ER/PR/HER2) triple-negative and are associated with a high incidence of brain metastases and poor clinical outcomes. The molecular chaperone αB-crystallin is predominantly expressed in triple-negative breast cancer (TNBC) and contributes to an aggressive tumor phenotype in preclinical models. We investigated the potential role of αB-crystallin in brain metastasis in TNBCs. Experimental Design: αB-crystallin expression in primary breast carcinomas and brain metastases was analyzed by immunohistochemistry among patients with breast cancer with brain metastases. αB-crystallin was overexpressed or silenced in two different TNBC cell lines. The effects on cell adhesion to human brain microvascular endothelial cells (HBMEC) or extracellular matrix proteins, transendothelial migration, and transmigration across a HBMEC/astrocyte coculture blood–brain barrier (BBB) model were examined. In addition, the effects of overexpressing or silencing αB-crystallin on brain metastasis in vivo were investigated using orthotopic TNBC models. Results: In a cohort of women with breast cancer brain metastasis, αB-crystallin expression in primary breast carcinomas was associated with poor overall survival and poor survival after brain metastasis, even among patients with TNBC. Stable overexpression of αB-crystallin in TNBC cells enhanced adhesion to HBMECs, transendothelial migration, and BBB transmigration in vitro, whereas silencing αB-crystallin inhibited these events. αB-crystallin promoted adhesion of TNBC cells to HBMECs, at least in part, through an α3β1 integrin–dependent mechanism. αB-crystallin overexpression promoted brain metastasis, whereas silencing αB-crystallin inhibited brain metastasis in orthotopic TNBC models. Conclusion: αB-crystallin is a novel regulator of brain metastasis in TNBC and represents a potential biomarker and drug target for this aggressive disease. Clin Cancer Res; 20(1); 56–67. ©2013 AACR.