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  • 1
    ISSN: 1569-8041
    Keywords: cytogenetics ; fluorescence in situ hybridization ; mantle-cell lymphoma ; translocation t(11;14)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The chromosomal translocation t(11;14)(q13;q32) is thehallmark of mantle cell lymphoma (MCL) in which it can be detectedcytogenetically in about 75% of cases. The t(11;14) translocationjuxtaposes the bcl-1 locus in chromosome band 11q13 next to the IgH locus inchromosome band 14q32 and, thus, leads to deregulation of the cell cycleregulatory protein cyclin D1, which is encoded by the CCND1 gene localizedat the telomeric border of the bcl-1-locus. MCL has the worst prognosis ofall low-grade non-Hodgkin‘s lymphomas (NHL). In some instances, however,histopathologic differentiation between MCL and other low-grade B-cell NHLis difficult. Therefore, detection of the t(11;14) translocation is ofessential diagnostic value for the risk-adjusted management of patients withMCL. Unfortunately, chromosome analyses are frequently hampered by the lowyield and quality of tumor metaphases. As the 11q13 breakpoints arescattered over a region of more than 120 kb the application of moleculargenetic techniques is also limited. Patients and methods: We established an interphase fluorescence in situhybridization (FISH) approach for the detection of the t(11;14)translocation by use of a cosmid probe hybridizing to the IgH constantregion and a YAC spanning the bcl-1 region. Cells containing a t(11;14)translocation show a co-localisation of the signals for IgH and bcl-1. Eightcontrol samples and 15 MCL specimens were investigated. Results: According to our control studies, samples containing more than10% of cells with this signal constellation can be diagnosed ascarrying a clonal t(11;14) translocation. All eleven MCL found to carry thet(11;14) translocation by chromosome analysis were positive in our FISHassay. Additionally, two of four MCL lacking a clonal t(11;14) translocationby chromosome analysis were shown to carry this aberration in 14% and37% of interphase nuclei. Southern blot data indicate that our FISHassay reliably detects the t(11;14) translocation irrespective of thelocation of the breakpoints within the bcl-1 region. Conclusions: The described interphase FISH assay provides a reliable androutinely applicable tool for diagnosis of the t(11;14) translocation.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1433-7339
    Keywords: Home-care services ; Cancer center ; Hospital stay ; Place of death
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The clinical data on terminal cancer patients who have died since the establishment of a program of collaboration between community services and the cancer center of Canton of Ticino, southern Switzerland, were retrospectively analyzed to describe the characteristics of patients seen and the effect on them of a home-care program coordinated by the cancer center. The home-care program is based on five geographically grouped community-based domiciliary services, with the addition of one nurse responsible for coordination and one physician from the oncology center. Selection criteria for participation in the home-care program are defined. The main outcome measures were: number of hospitalizations and median hospital stay during the last 3 months of life; reasons for and median length of last hospitalization; place of death of patients who had home care and those who did not. In the group of 993 patients analyzed, the median contact time with the cancer center was 9.5 months (10th percentile: 1 month, 90th percentile: 71 months); the most frequent neoplasm was lung cancer (22%) with the briefest contact time (7.5 months; 10th percentile: 1 month; 90th percentile: 21 months); 13.5% of patients were never hospitalized; half of the patients had a total hospital stay of 24 days or longer and 23% died at home. The sociodemographic and medical characteristics of home-care users were similar to those of the home-care nonusers and to those of the overall group. In the group of home-care users (32% of the total) 22% were never hospitalized, half of the patients had a total hospital stay of 17 days or longer, and 43.5% of them died at home. These values were significantly different (P〈0.001) from those reported in the group of home-care non-users. Palliative care, provided at home through community-based domiciliary services, is associated with less frequent and shorter hospitalizations in the last 3 months of life. Medical oncology and palliative treatments should be mutually complementary to improve patients care. Cancer centers should be involved in the planning and coordination of supportive-care domiciliary services.
    Type of Medium: Electronic Resource
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