We report the clinical findings of 21 consecutive patients affected by mediastinal large B-cell lymphoma with sclerosis. This type of lymphoma is a recently described histopathologic entity characterized on clinical grounds by distinctive features, which, according to our series, can be summarized as follows: young age (median, 30 years; range, 15 to 42 years), prevalence of females over males (15 v six), rare occurrence of superficial lymph node enlargement (three of 21 patients), and involvement of unusual extranodal sites (kidney six, adrenal cortex two patients). The clinical course appears to be closely related to treatment. In fact, complete remission (CR) was not obtained in the six patients submitted to conventional cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or CHOP plus bleomycin (CHOP-Bleo) regimens until 1985, as opposed to 13 CRs reached in the 15 patients subsequently treated with more aggressive regimens after 1985 (methotrexate with leucovorin, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin [MACOP-B], 12 patients; methotrexate, bleomycin, doxorubicin, cyclophosphamide, vincristine, and dexamethasone [M-BACOD], two patients; and vincristine, cyclophosphamide, fluorouracil, cytarabine, doxorubicin, methotrexate, and prednisone [F-MACHOP], one patient; plus involved-field radiotherapy, 10 patients). Among the 13 patients who achieved a CR, only one relapse was observed at 10 months. The median overall survival of complete responders after an observation period of 11 to 69 months has not yet been reached, and the event-free survival curve indicates that 90% of patients who achieve CR may be potentially cured.

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This schedule represents a feasible treatment and the high pathological response rate is extremely encouraging; the doses found in the last dose-level are the basis for an ongoing phase II study at our institution.

This randomized phase II trial was performed to define the activity and toxicity of the combination of dacarbazine (DTIC), carmustine (BCNU), cisplatin (DDP) and tamoxifen (DBDT regimen) versus DTIC alone in patients with metastatic melanoma. Sixty patients with metastatic melanoma were randomly assigned to receive BCNU 150 mg/m2 intravenously (i.v.) on day 1, cisplatin 25 mg/m2 i.v. daily on days 1 to 3, DTIC 220 mg/m2 i.v. daily on days 1 to 3 and tamoxifen 160 mg orally daily for 7 days prior to chemotherapy (DBDT arm; arm A). Treatment cycles were repeated every 28 days, while BCNU was given every two cycles. The DTIC arm (arm B) patients received DTIC alone 1200 mg/m2 i.v. on day 1, repeated every 21 days. Patients were evaluated every two cycles; responding patients continued the treatment for a maximum of 12 cycles. The overall response rate was 26% in the DBDT arm and 5% in the DTIC arm. Complete responses were 2.5% for DBDT and 0% for DTIC. The median progression-free survival and the median survival were 4 and 9 months, respectively for DBDT, and 2 and 7 months for DTIC. DBDT was associated with significant haematological toxicity: 33% of the patients experienced a grade III or IV neutropenia and 28% a grade III or IV thrombocytopenia. In conclusion, the overall response rate obtained with DBDT was greater than that obtained with DTIC alone; however, this combination increases toxicity with limited impact on overall survival.

A comparison of 692 early invasive breast cancer with, and 1564 without, a family history of breast cancer showed that the former were younger at diagnosis (P ¼ 0.002), had smaller tumours (P ¼ 0.012), were more frequently oestrogen receptor positive (P ¼ 0.006) and diagnosed preclinically (Po0.001). A long recognised risk factor for breast cancer is a family history of the disease, although the majority of affected women do not have an affected close relative, and only 5 -10% do have a true hereditary predisposition (Carter, 2001). The overall risk of developing breast cancer is 1.9-3.9 times higher in women with an affected mother or sister (Collaborative Group on Hormonal Factors in Breast Cancer, 2001), but only a few studies have investigated the characteristics of breast cancer in women with a family history. We analysed the pathological, biological and clinical features of breast cancer in patients with (FH þ ) and without (FHÀ) a family history of breast cancer, the former being further subdivided into those with an affected first-or second-degree relative. MATERIALS AND METHODSA total of 2256 women with early invasive operable breast cancer, who underwent surgery at Verona Hospitals between January 1992 and April 2001, were asked at their first visit whether they had any first-or second-degree relatives who had had breast cancer. Our analysis first compared those reporting at least one affected relative (FH þ ) with those reporting no affected relative (FHÀ); subsequently, the FH þ patients were divided into those with at least one first-degree relative (1st DFH) and those with only second-degree relatives with breast cancer (2nd DFH): only firstand second-degree relatives were considered in order to reduce ascertainment bias. Answers were always checked at the subsequent visit (at the time of the first cycle for the patients receiving chemotherapy, after 3 months for the others).All of the patients were assigned a UICC pathological TNM stage. On the basis of pathologist-defined tumour size, patients were divided into three categories: pT1 (o2 cm), pT2 (2 -5 cm) and pT3 (45 cm); the number of pathologically positive axillary nodes was divided into none, o3, 4 -10 and 410; tumour grading was recorded as G1 (well differentiated), G2 (moderately differentiated) or G3 (undifferentiated).Immunohistochemistry (IHC) defined oestrogen (ER) and progesterone receptor (PgR) status and was considered positive if more than 10% of the cells were stained for either. The replicative cell fraction was IHC stained using the Ki-67 monoclonal antibody (Mab-DAKO-PC); given the lack of an accepted cutoff point, the results were arbitrarily classified as low, medium or high (p10%, 11 -25% or 425% of stained cells). CerbB-2 levels were determined by IHC using the DAKO-PC monoclonal antibody, and considered positive if at least one cell was stained.At their first visit to the Department of Medical Oncology, all patients were asked about their disease presentation and divided into those who underwent mammography and ultrasonogra...