Lymphatics

10 pages, 1421 KiB

Open AccessArticle

FDG PET/CT as a Tool for Early Detection of Bleomycin-Induced Pulmonary Toxicity

by Hira Shaikh, Zulfa Omer, Roman A. Jandarov, Morgan P. McBee, Jennifer Scheler, Bruce Mahoney and Tahir Latif

Lymphatics 2023, 1(1), 45-54; https://doi.org/10.3390/lymphatics1010006 - 7 Jun 2023

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Abstract

Bleomycin-induced pulmonary toxicity (BPT) is a serious and potentially fatal complication of bleomycin, a key component of Hodgkin lymphoma (HL) treatment. Before ours, only one published study evaluated the predictability of 18F-FDG-PET/CT for the early diagnosis of BPT. In this retrospective cohort study, 18F-FDG-PET/CT scans of adult HL patients treated with bleomycin at an urban academic center over five years were assessed by radiologists blinded to the clinical information, and scans were correlated with clinical BPT. We found 11 HL patients with 54 interim or end-of-treatment 18F-FDG-PET/CT scans who had received bleomycin. Five of the eleven (5/11, 45%) patients had radiographic changes in PET/CT and developed clinical BPT. Patients with clinical BPT had higher FDG uptake in lungs compared to those who did not (SUV_max mean 2.66 (CI 1.8–3.7) vs. 0.86 (CI 0.4–1.9), Mann–Whitney U test, p < 0.05). In a separate cohort analysis, we compared HL patients with clinical BPT (9/25, 36%) and without clinical BPT (16/25, 64%) to assess potential risk factors. Low hemoglobin (p = 0.037) and high ESR values (p = 0.0289) were associated with clinical BPT. Furthermore, gender, stage, histology, prior lung radiation, G-CSF, or steroids did not significantly confer a higher risk of BPT. 18F-FDG-PET/CT imaging, which is routinely used to assess treatment response in HL, is useful for early detection of BPT, which can have high mortality and morbidity. Full article

(This article belongs to the Collection Radiation Oncology)

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11 pages, 308 KiB

Open AccessEditor’s ChoiceCommentary

What Is Next in Pediatric B-Cell Precursor Acute Lymphoblastic Leukemia

by Aimee C. Talleur, Ching-Hon Pui and Seth E. Karol

Lymphatics 2023, 1(1), 34-44; https://doi.org/10.3390/lymphatics1010005 - 12 May 2023

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Abstract

Cure rates now exceed 90% in many contemporary trials for children with B-cell acute lymphoblastic leukemia (B-ALL). However, treatment remains suboptimal, and therapy is toxic for all patients. New treatment options potentially offer the chance to reduce both treatment resistance and toxicity. Here, we review recent advances in ALL diagnostics, chemotherapy, and immunotherapy. In addition to describing recently published results, we also attempt to project the impact of these new developments into the future to imagine what B-ALL therapy may look like in the next few years. Full article

(This article belongs to the Collection Acute Lymphoblastic Leukemia (ALL))

9 pages, 805 KiB

Open AccessArticle

Lymphoscintigraphy versus Indocyanine Green Lymphography—Which Should Be the Gold Standard for Lymphedema Imaging?

by Brian A. Figueroa, Jacob D. Lammers, Mazen Al-Malak, Sonia Pandey and Wei F. Chen

Lymphatics 2023, 1(1), 25-33; https://doi.org/10.3390/lymphatics1010004 - 5 May 2023

Viewed by 4656

Abstract

Early detection and treatment can slow the progression of lymphedema. To diagnose lymphedema in the subclinical phase, a sensitive imaging modality is required. Radioisotope-based lymphoscintigraphy (LSG) has been the “gold standard” for a century. Indocyanine green lymphography (ICGL) is being used at our institute for diagnosing and grading all lymphedema patients. In this study, ICGL disease detection rate was compared to that of LSG. Chart review of all patients who presented for lymphedema consult between February 2020 and April 2022 was conducted. Patients who underwent both LSG and ICG for extremity edema in symptomatic/asymptomatic limbs were included. A total of 50 limbs in 23 patients met the inclusion criteria. Of those, 37 were symptomatic and 13 were asymptomatic. LSG detected lymphatic dysfunction in 26/37(70%) of the symptomatic limbs while ICG detected the same in 37/37(100%) limbs (p < 0.01). In the asymptomatic group, LSG detected the disease in 1/13(8%) limbs while ICG detected lymphatic dysfunction in 8/13 (62%) limbs (p < 0.01). LSG missed symptomatic limbs 30% of the time, whereas ICG did not miss any symptomatic limbs (p < 0.01). LSG missed asymptomatic disease 54% of the time (p < 0.01) compared to ICG. In conclusion, ICG lymphography was determined to have a higher lymphatic dysfunction detection rate compared to LSG. Full article

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6 pages, 259 KiB

Open AccessCommunication

Predictor Factors for the Detection of Positive Nodes in Patients Undergoing Radical Prostatectomy and Lymph Node Dissection

by Victoria Muñoz Guillermo, Antonio Rosino Sánchez, Arancha Pardo Martínez, Isabel Barceló Bayonas, Carlos Carrillo George and Tomás Fernández Aparicio

Lymphatics 2023, 1(1), 19-24; https://doi.org/10.3390/lymphatics1010003 - 13 Feb 2023

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Abstract

Background: The detection of positive lymph nodes after a lymph node dissection changes the clinical prognosis; therefore, we evaluated what factors help us predict the presence of positive lymph nodes. Methods: A retrospective analysis of all radical prostatectomies and extended lymph node dissection performed from January 2010 to October 2018 in our centre was conducted. The variables included in the Briganti nomogram (preoperative PSA, Gleason biopsy, percentage of cores, and clinical stage) were considered, as well as perineural invasion and involvement of the seminal vesicles in the prostate biopsy; Results: A total of 110 lymph node dissections are obtained. Patient mean age is 64.18 years (46.55–75.91). Of the 110 lymphadenectomies performed, 16 patients (14.5%) presented positive nodes. Presenting infiltrated seminal vesicles, perineural invasion, higher PSA, higher clinical stage, higher Gleason biopsy and percentage of cores is more likely to have statistically significant lymph node involvement (p < 0.05). In the multivariate analysis, the percentage of positive core, together with the involvement of the seminal vesicles and Gleason ≥ 4 in the majority are predictor factors for positive nodes (p < 0.01); Conclusions: The percentage of positive cores, the involvement of the seminal vesicles, and the majority Gleason ≥ 4 are independent predictors of lymph node involvement in prostate cancer. Full article

17 pages, 4708 KiB

Open AccessReview

The Role of Sentinel Node Mapping and Lymphadenectomies in Veterinary Surgical Oncology

by Patricia Beer, Lavinia E. Chiti and Mirja C. Nolff

Lymphatics 2023, 1(1), 2-18; https://doi.org/10.3390/lymphatics1010002 - 10 Jan 2023

Cited by 10 | Viewed by 3580

Abstract

Lymph node status is an important prognostic factor in multiple oncologic conditions in humans and companion animals. In addition, the resection of the affected nodes can have a substantial therapeutic effect on various cancer subtypes in both species. Given the impact on prognosis and management, it is paramount to identify and remove affected nodes. While this can be achieved by removing predefined patterns of nodes (regional lymphadenectomy/resection of defined lymphatic stations), modern approaches increasingly utilize sentinel node mapping to identify the draining nodes to decrease the mortality of lymphadenectomies. Recent studies have shown that dogs have more comparable anatomy of the lymphatic system to humans than other animal models such as rodents or pigs. Given the fact that dogs develop spontaneous cancer types that share several similarities to their human counterparts, they represent a valuable translational model. The management of the lymphatic basin and sentinel node mapping have gained increased attention in veterinary surgical oncology in recent years. The present review aims at summarizing the resulting findings and their impact on patient management. Full article

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1 pages, 183 KiB

Open AccessEditorial

Publisher’s Note: Lymphatics, a New Open Access Journal

by Ioana Craciun and Varsha Gandhi

Lymphatics 2023, 1(1), 1; https://doi.org/10.3390/lymphatics1010001 - 23 Nov 2022

Viewed by 2138

Abstract

Five different organs, namely the bone marrow, spleen, thymus, lymph nodes, and a network of lymphatic vessels, constitute “lymphatics” [...] Full article

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Lymphatics, Volume 1, Issue 1 (June 2023) – 6 articles

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