Efficacy of Plerixafor for Peripheral Stem Cell Mobilisation in Autologous Transplantation: A Single Centre Study

Plerixafor is a stem cell mobilising agent, and when administered along with G-CSF has been shown to improve CD34+ stem cell collections in lymphoma and multiple myeloma patients compared to G-CSF alone. Patients who failed to mobilize <2.0 × 106 cells/kg on Day 1 collection received Plerixafor and G CSF for further collections. Study population was divided into two groups as plerixafor yes (PY) who are poor mobilizers and Plerixafor No (PN) who are good mobilizers. Out of 49 patients, 28 patients were in PY group and 21 patients in PN group. Median value of apheresis CD34 of day 1 was 1.75 (range 0.258 to 8.52) in PY group and 2.63 (range 1.06 to 6.29) in PN group and that of day 2 was 3.845 (range 0.317 to 13.89) in PY group and 3.18 (range 0.88 to 6.348) in PN group. Median value of total apheresis CD34 was 8.10 (range 4.33 to 18.66) in PY group and 7.58 (range 4.06 to 9.8) in PN group. Median day of neutrophil engraftment was 11.5 (range 9 - 22) in PY group and 11 (range 9 - 36) in PN group whereas median day of platelet engraftment was 14 (range 9 - 98) in PY group and 13 (range 11 - 98) in PN group. It can be concluded that the use of plerixafor not only enabled poor mobilizers of Lymphoma and Multiple Myeloma to collect adequate stem cells to proceed to ASCT, but also had early neutrophil and platelet engraftment which was comparable with good mobilizers.

Neuroendocrine carcinoma of gallbladder: report of 2 cases

BACKGROUND: Neuroendocrine carcinoma of the gall- bladder is rare. Its best treatment is not known. METHODS: Two patients underwent surgery earlier: one for suspected cholecystitis and the other for cholelithiasis. Magnetic resonance cholangiopancreatography ( MRCP ) showed residual lesions in the livers. The two patients un- derwent revision surgery followed by chemotherapy. RESULTS; Both patients tolerated the second stage surgery well, which was followed by chemotherapy with paclitaxel, ifosphamide and cisplatin for 6 cycles. They were treated this way for 8 months and 12 months post treatment, re- spectively. CONCLUSIONS: A proper diagnosis of neuroendocrine carcinoma is made often after surgery. As it is a slow grow- ing tumor and not very chemotherapeutically, sensitive sur- gery offers the best local control.

Correlation of Programmed Death Ligand-1 (PD-L1) Expression with Clinicopathological Features in Non-Small Cell Lung Carcinoma: Experience from a Tertiary Cancer Care Center in India

Background:?According to the GLOBOCAN 2018 report, the estimated incidence of lung cancer in India was 67,795 in both sexes. The treatment of advanced Non-small cell lung cancer (NSCLC) saw a major paradigm shift with recent advances in molecular-targeted therapy. Immune checkpoint blockade therapy is one such novel strategy with promising clinical benefits in advanced NSCLC. Programmed cell death receptor-1/Programmed cell death ligand-1 (PD-1/PD-L1) pathway is one such checkpoint and has thus become the current area of interest in the treatment of lung carcinoma. The PD-1/?PD-L1 pathway is under active investigation as it represents a promising therapeutic target in NSCLC. The expression of PD-L1 in tumor cells has been suggested as a predictive marker of the clinical response to PD-1/?PD-L1-targeted therapy. Methods: This study was carried out at the Department of Pathology, Health Care Global Specialty Hospital, Bangalore from May 2018 to May 2019. In this study, we analyzed pattern of PD-L1 expression by immunohistochemistry testing using our own Laboratory Developed Test (LDT) in NSCLC patients. Results:?Our study group comprised 50 patients of NSCLC. Among our study population, 40% of the patients exhibited PD-L1 immunopositivity (≥1%) with 28% of them having any expression (TPS 1% - 49%) and 12% of them having a high expression (TPS ≥ 50%) of PD-L1. Majority of them exhibited adenocarcinoma type of NSCLC under which the solid subtype showed a direct correlation with PD-L1 positivity (p-value: 0.004) with a poorly differentiated tumor histology being common in our population in relation to PD-L1 positivity (p-value: 0.043). PD-L1 expression did not correlate with age, gender, smoking status or clinical stage in our study. No association was found between tumor histology (SCC or AC) and driver mutation status with expression of PD-L1 in the present study. Conclusions: In our study, PD-L1 immunopositivity was found in 40% of patients and majority of them exhibited adenocarcinoma type of NSCLC. There was no correlation of PD-L1 expresion with age, gender, clinical stage, smoking status and tumor histology.