Joanna Romejko-Jarosinska

The first case of human dirofilarosis in Poland was recorded in 2007. Until that time our country was free of Dirofilaria repens. Recent studies show that 21,4- 60% of dogs in Warsaw region harbour microfilariae, therefore it is becoming a growing problem in Central Europe. In April 2013 a subconjunctival D. repens was removed from the eye of 61-year-old woman. It was the twenty first case of this disease in Poland, the third case of eye dirofilaria and the fourth autochtonous case. The patient had never been abroad, so it was the first case of autochtonous human ocular dirofilariosis in Poland. Nine months after the D. repens had been removed, a MALT lymphoma was discovered. In the article we discuss whether a MALT lymphoma of the lacrimal gland of the eye, previously affected by the parasite, may be the consequence of the invasion.

E18543 Background: IGEV (ifosfamide, gemcitabine, vinorelbine, and prednisolone) is an active regimen increasingly used in relapsed/refractory Hodgkin lymphoma (HL) before autologous stem cell transplantation with CR and adequate CD34+ cell collection rate of more than 50% and 90%, respectively. No substantial non-hematological toxicity had been reported so far. Methods: Between December 2009 and October 2010, 12 patients (pts): 5 female and 7 male, median age of 35, range: 23-51, with refractory HL received IGEV regimen. 10 pts were diagnosed with refractory classical HL NS type, one male pts had HL transformed from follicular lymphoma, one female pts had classical HL partly transformed to diffuse large B-cell lymphoma and additionally received rituximab. Results: Of a total of 44 cycles followed by G-CSF support, 4 (9%) were delayed and dose reduced due to grade 3/4 hematologic toxicity. 6 pts, 5 female and 1 male (50%) experienced cutaneous toxicity including grade 3/4 reactions in 4/6 pts (60%). Skin symptoms included rash, maculopapular pruritic eruptions and vesicular erythema with serous effusion in 2 pts. Lesions were itchy or burning, located on the trunk and extremities. Skin symptoms occurred repeatedly after each cycle and resolved within 10-14 days with glucocorticoid and antihistaminic treatment. In 1 case, IGEV chemotherapy was terminated due to prolonged itching and burning sensations. Of 11 evaluable pts, 7 responded (64%) with CR in 4 pts (36%). Conclusions: Reportedly, rate of cutaneous adverse events related to gemcitabine monotherapy is up to 30%. Unexpectedly high incidence of skin events in our pts might have resulted from peculiar toxic synergy of combination agents. The only clinical characteristic apparently related to skin toxicity of gemcitabine was female sex.

E18534 Background: Rituximab is part of nearly all protocols for treatment of B-cell lymphoma and long infusion time demanded by the product monograph has created a burden for busy hemato-oncology units and limited the number of patients who may receive treatment on time. Looking for a solution we performed an exploratory non-randomized study to evaluate safety of rapid infusion as described by Sehn et al (Blood 2007). Methods: Between January and December 2008, 125 patients with B-cell CD20+ lymphoma: DLBCL n= 80, BL n=6, FL n=22, MZL n=11, MCL n=4, CLL n=2, were enrolled into the study. Treatment regimens were: R-CHOP n=82, R-CVP n=22, BFM-like n=14, monotherapy n=5, rituximab maintenance n=2. All patients received first rituximab dose (375 mg/sqm) by standard procedure. Subsequently, patients received rapid (528 doses) or standard-rate infusion (n=123) if appropriate by physician's judgment. Results: Median number of rapid rituximab infusions was 5 (range: 1-9), and median infusion time was 111 minutes (range: 90-180). During the first delivery 8 of 123 patients (6.5%) had minor infusion reactions including hypertension, tachycardia, rash, chills, sore throat, and fever. These patients had no reactions on subsequent rapid infusions. During a total of 528 rapid infusions, there were 14 grade 1 or grade 2 reactions (2.7%) in 11 patients, including hypertension, hypotension, anxiety with shortness of breath, or bradycardia. There were no reactions on subsequent standard-rate infusions (n=123). We were unable to identify factors predicting for occurrence of infusion reactions: infusion rate standard vs. rapid (HR=1.53, 95% CI [0.68, 3.45], p=0.306), sex, age, histology, B symptoms, bulky disease, were all non-significant. Conclusions: With 1 year follow up, we conclude that abbreviated rituximab delivery starting from the second cycle is equally safe as a standard-rate infusion and may be routinely used in clinical practice. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Roche Roche Roche