Precursor B cell lymphoblastic lymphoma (B-LBL) is quite uncommon and it usually manifests as an extranodal disease. Although B-LBL may present with bone involvement, it is a very rare manifestation of B-LBL as a primary solitary bone tumor. Here, we report a case of precursor B-LBL presenting with solitary bone tumor and a review of a total of seven adult patients reported previously in the literature. We described demographic and clinical characteristics of these patients with unique presentation and discussed treatment options. Unlike previous reports except one case, our patient underwent allogeneic stem cell transplantation (allo-SCT) due to refractory disease. She is alive without evidence of disease by the post-transplant 12th month. B-LBL has an aggressive clinical course in adult patients and allo-SCT may be the best treatment option.

Recently, the cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) regimen plus rituximab (R-CHOP) have been used widely to treat patients with newly diagnosed diffuse large B cell lymphoma (DLBCL) and it has also been reported to improve the outcome of DLBCL. We represent a retrospective analysis of newly diagnosed DLBCL patients between the years of 2003–2005 to evaluate the impact of R-CHOP therapy on response rates. Patients with DLBCL between 20–80 years of age (median: 46.0 and mean 56.2 ± 14.92) received 6 cycles of R-CHOP (n=28). For comparison, DLBCL patients between 15–76 years of age (median: 60.5 and mean 47.3 ± 16.6) who received 6 courses of CHOP therapy (n=30) were used as the control group. All patients received classical CHOP (cyclophosphamide 750 mg/m m2, doxorubicin 50 mg/m2, vincristine 1.4 mg/m m2 on day 1 and prednisone 40 mg/m m2 for 5 days) every 4 weeks. In R-CHOP group, rituximab 375 mg/m m2 was administered one day before CHOP chemotherapy. The median follow-up for R-CHOP and CHOP groups were 15.66 ± 5.90 (7–29) and 21.79 ± 9.20 (8–46) months, respectively. The International Prognostic Index (IPI) scores were not significantly different between these groups (median IPI of R-CHOP: 2.0 and mean IPI 2.01.27 ± 1.16 versus median IPI of CHOP: 1.0 and mean IPI 1.88 ± 1.26). Complete response (CR) and complete undetermined response (CuR) rate for R-CHOP was 92% (26 of 28 patients) which was statistically significantly higher than CHOP (24 of 30 patients, 80%) (p=0.004). Partial response (PR) rates for R-CHOP and CHOP groups were 7% (2 of 28 patients) and 10% (3 of 30 patients), respectively. While there were no unresponsive patients in the R-CHOP group, refractory disease rate was 10% (3 of 30 patients) in the CHOP group. Relapse rates during the follow up period were 13% (4 of 30 patients) for CHOP and 4% (1 of 28 patients) for R-CHOP group (p<.0001). No long-term toxicity appeared to be associated with the addition of rituximab to the CHOP combination. These results also confirmed the benefit of the addition of rituximab to standard CHOP chemotherapy in DLBCL even in young patients with low IPI scores.

e11540 Background: Tumor marker monitoring is generally performed by the physicians, although in many guidelines, it has not been recommended for breast cancer. In this study, we aimed to research the role of CEA and CA15.3 levels in metastatic process. Methods: In between years 2000 January and 2011 August, the documents of 482 female patients followed by breast cancer diagnosis in Medical Oncology and Radiation Oncology clinics of Kartal Dr. Lutfu Kirdar Education and Research Hospital, were evaluated retrospectively. Results: To determine the role of CEA and CA15.3 levels in evaluation of metastatic process, ROC analysis was performed and its cut-off values were 1.3 ng/ml and 14 U/ml, respectively. Sensitivities of CA15.3 and CEA levels were detected as 83.33% and 87.50%; specificities were 40.80% and 41.14%, respectively. Evaluation of the relationship between CEA and CA15.3 levels and the status of hormone receptors by ROC analysis showed the cut-off values as 26 U/ml and 1,6 ng/ml, respectively. In determination of endocrine sensitivity, the sensitivities of tumor markers elevation were 88.17% and 54.12%, respectively. Their specificities were 26.92% and 73.08%. CEA level elevation in hormone sensitive patients was statistically significant (p: 0.007). When sensitivity and specificity of CA15.3 and CEA levels on detection of c-erbB2 positivity were evaluated by ROC analysis, cut-off values were determined as 17 U/ml and 1,7 ng/ml. Sensitivities of these distinctive cut-off values were found as 58.8% and 71.15% and specificities were 60% and 51.67% (p: 0.017). When the relation between CA15.3 and CEA levels and node involvement was evaluated by ROC analysis, cut-off values were respectively 16 U/ml and 0.9 ng/ml. Their sensitivities were 53.45% and 87.93% and specificities were 55.56% and 51.67%, respectively. Conclusions: The levels of tumor markers have been suggested to have a significant role in prognosis of the disease with respecttothe correlation between different histopathological and clinical features and tumor markers. Randomised controlled prospective studies planned and performed in this issue may clarify this uncertainity.