Mantle cell lymphoma (MCL) is defined according to WHO classification 2008 as a B-cell neoplasm generally composed of monomorphic small to medium-sized lymphoid cells with irregular nuclear contours. Neoplastic transformed cells (centroblasts), paraimmunoblasts and proliferation centers are absent. Skin is rarely affected at advanced stages or when a large cell transformation occurs. Primary skin involvement of mantle cell lymphoma is extremely rare. Only several cases are reported in the literature. We describe another case of primary cutaneous MCL with blastoid morphology and no extracutaneous dissemination during 2 years. The differential diagnosis included primary cutaneous large B-cell lymphomas. Clinical, morphological and molecular data of other described cases with cutaneous MCL are discussed.

The purpose of this trial was to evaluate the role of high doses Ara-C consolidation, maintenance chemotherapy, bone marrow transplantation (BMT) by assessing the long-term results of adult patients (pts) with acute myeloid leukemia (AML) according to AML-06.06 treatment protocol. During the period 2006-2009, 216 AML pts (except M3 and secondary AML) were included in this study. 143 of them were randomized in 2 groups. Chemotherapy consisted of conventional dose Ara-C + daunorubicin as the first induction course «7+3», High dose Ara-C + Mitoxantrone (HAM) as the second induction/consolidation course, HAM as the third course was applied if no complete remission (CR) after the first course has been achieved or High dose Ara-C (HiDAC) as the third course if CR was obtained after the first course, the fourth and the fifth courses with HiDAC, and two randomized arms of maintenance: «5+2» (AraC + Mercaptopurine) versus stop chemotherapy (randomization was performed before the treatment start). BMT was performed after 3, or 4, or 5 consolidation courses (26 AlloBMT, 10 AutoBMT). CR was obtained in 155 pts (72 %). If CR was obtained during the first 60 days of treatment then 5-year leukemia-free survival (LFS) was 38 %, if later 18 % (p = 0,0244). OS was similar. 5-year LFS in cytogenetic low and intermediate risk groups was 37 %, and in high risk groups 8 % (p = 0,0044). In cytogenetic low risk group 5-year overall survival was 100 % in inv(16) pts and 20 % in t(8;21) pts (p = 0736). If lactate dehydrogenase (LDH) activity was 1500 U/l and higher, 5-year LFS was 8 %, if lower 23 %, p = 0,0011). 5-year LFS in AutoBMT pts was 40 %, in AlloBMT pts 32 %, in chemotherapy pts 25 % (p = 0,4464). Relapse probability was 83 % in no-maintenance randomization group and 50 % in maintenance group (p = 0,0667). Dose intensification and maintenance chemotherapy have shown high antileukemic efficacy in limited groups of AML pts (low LDH, inv(16), WBC < 40 x 10 9/l). High LDH activity at the diagnosis, high risk cytogenetic group should be managed with other treatment approaches. Introducing BMT technologies may provide some benefit in some groups of AML pts. We have to emphasize that there were some differences in the results in t(8;21) pts comparing with published data.

The results of primary analysis of infectious complications monitoring in 203 primary patients with acute leukemia, myeloma, lymphogranulomatosis, lymphoma are presented. The structure of infectious complications in these patients was evaluated for different stages of chemotherapy. Causes of mortality before cytostatic therapy were detected. The regularities of the infectious complications emergence with consideration for diagnosis, therapy intensity and stage, and disease phase were detected.

A female patient with myeloid leukemia developed disseminated fusariosis during the period of myelotoxic agranulocytosis after a course of chemotherapy. The disease manifested by high fever, sinusitis, multiple infiltrations of the skin similar to ecthyma gangrenosum. Mycologic analysis of skin biopsy specimen detected mycelial fungi Fusarium spp. Voricona-sole therapy during 3 months led to regression of the infectious process.