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A 31-year-old g1p0 caucasian woman in the seventh month of pregnancy is referred for management of her T2N0Mx "triple-negative" breast cancer.
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Hepatitis B virus (HBV) reactivation after rituximab or other immune suppressive therapies may lead to serious adverse outcomes. The authors retrospectively reviewed HBV serology of CD20 positive B-cell lymphoma without active HBV (i.e., negative HBsAg) before and after rituximab. Of the 230 tested, 56 (24%) were anti-HBc positive; the five cases of HBV reactivation all occurred in these 56 patients. Moreover, four of the five were anti-HBs negative (a.k.a, isolated anti-HBc). All received entacavir with the only HBV complication of transaminitis. None of the anti-HBc negative patients reactivated. Isolated anti-HBc, particularly lacking anti-HBs, may be at heightened risk of HBV reactivation after rituximab.
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In a multinational trial of erlotinib (Tarceva®) for patients with advanced NSCLC following conventional chemotherapy, improved progression-free and overall survival were demonstrated. The improvement was approximately one week for PFS and one month for OS. However, for the subset with demonstrable activating mutations in the EGFR gene, the benefit of erlotinib treatment was more substantial.
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Breast cancer occurs in approximately 1 in 100,000 men each year, a rate that is slightly less than 1% of that in women.
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WHO recommendations for antiviral use for H1N1 flu; antibiotic use trends for acute respiratory tract infection; denosumab clears FDA Expert Panel; FDA Actions.
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High-dose chemotherapy and autologous hematopoietic stem cell transplant (ASCT) is standard therapy for relapsed or refractory diffuse large B-cell lymphoma after salvage chemotherapy. In this retrospective study of 39 patients with diffuse large B-cell lymphoma (DLCL) who had undergone ASCT, the authors assessed outcomes based on post-salvage pre-ASCT PET imaging. PET scans were positive in 17 (44%) and negative in 22 (56%) after salvage. A negative PET scan predicted for less relapse and better three-year OS at 81%, compared to 39% for PET-positive patients. Results are excellent for patients achieving PET negativity prior to ASCT; the optimal approach for PET-positive patients remains undefined.
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A 61-year-old man presented to the emergency room with back pain of approximately one month duration. His medical history was significant for hypertension, for which he received diltiazem 180 mg daily. His weight had been stable at 175 lbs and, other than back pain, he suffered no constitutional symptoms. He has worked as an auto mechanic for 40 years. He smokes approximately 20 cigarettes a day and has done so for all of his adult years. He has no family history of cancer.