Background and Aims: Lymphomas of the gastrointestinal tract represent a rare pathology, frequently associated with a poor outcome. This study aimed to determine the prognostic factors of digestive tract lymphomas and to evaluate the role of endoscopy in the diagnosis and outcome. Methods: Our prospective study evaluated a number of 63 patients diagnosed with digestive tract lymphomas. Results: The mean age of the patients was 62 years ± 13.1 years. Most of the patients had B-cell lymphoma (88.8%). Localization was represented by the stomach (44.4%), followed by the small bowel (25.4%) and the oropharynx (14.2%). Diffuse large B-cell lymphoma was the most common subtype (52.3%), followed by Mantle cell lymphoma (15.8%) and MALT (14.2%). T-cell lymphoma was present in a small number of patients. Anaplastic large cell lymphoma was the most common subtype of T-cell lymphoma (6.35%) and was localized in the small bowel. One-quarter of the patients had complications such as bleeding, obstruction, or perforation. Chemotherapy alone (38.1%) was the most common treatment option, followed by surgery (28.5%). Endoscopic examination and sampling biopsy were performed on 74.6% of the patients included in the study, with a positive diagnosis for lymphoma in 58.7% of the cases. Age (p=0.208), higher ECOG values (p=0.0487), and level of albumin (p=0.0355) were independent prognostic factors for overall survival. Endoscopic monitoring impacted overall survival (p<0.0001), due to the early detection of relapse. Conclusions: Age, high ECOG value, and low albumin levels are independent prognostic factors for overall survival. Early diagnosis of recurrent gastrointestinal tract lymphomas by endoscopy increases overall survival.

ATL is a rare but a highly aggressive T-cell neoplasm associated with human T-cell leukemia virus-1 (HTLV-1) infection. Human T-cell lymphotropic virus type-1 (HTLV-1) is a oncogenic retrovirus responsible for the development of adult T-cell leukemia (ATL), but also for other non-malignant diseases, such as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). HTLV-1 has a higher prevalence in Japan, the Caribbean, South America, intertropical Africa, Romania, and northern Iran. ATL patients can have an extensive spectrum of neurological manifestations. Numerous factors can be implicated, such as central nervous system infiltrates, neurolymphomatosis, complications to medication or allogeneic stem cell transplantation, HAM/TSP, infections, metabolic disturbances. The neurological complications are not always easy to recognize and treat. Thus, this review underlines the necessity of a multidisciplinary approach in ATL patients with neurological symptomatology.

Background and Objectives: Adult T-cell leukemia/lymphoma (ATLL) is a highly aggressive T-cell lymphoproliferative disease associated with the human T-cell lymphotropic virus type I (HTLV-1). ATLL is a rare disease, found more frequently in HTLV-1-endemic areas, Romania being one of them. Despite treatment advances, the prognosis remains dismal. We aimed to describe the clinical, biological, and survival outcome features of Romanian patients with aggressive-type ATLL. Materials and Methods: We report the data of a prospective, observational, and unicentric study of all 20 patients diagnosed with lymphoma and acute types of ATLL at our center over the past 12 years. Data were collected from the patients’ medical records. Results: Lymphoma-type ATLL (60%) was more common than acute-type ATLL (40%). Median age at diagnosis was 40.5 years, and most patients were female. Laboratory data revealed significant differences between acute and lymphoma-type ATLL, namely, higher leukocyte (p = 0.02) and lymphocyte counts (p = 0.02) and higher levels of corrected calcium (p = 0.001) in acute-type ATLL. All patients received chemotherapy, and only two underwent allogeneic stem cell transplantation. Only six patients obtained a complete or partial response to chemotherapy, mostly the lymphoma-type ones. The median survival for all patients was 6.37 months, with higher survival in the lymphoma-type ATLL (8.16 months) than in the acute-type (3.60 months). Normal calcium levels (p = 0.011), uric acid (p = 0.005), BUN score (p = 0.000), JCOG-PI moderate risk (p = 0.038), and obtaining complete or partial response (p = 0.037) were associated with higher survival. Conclusion: Aggressive-type ATLL among Romanian patients presents distinct characteristics, including younger age at diagnosis, female predominance, and higher incidence of lymphoma-type ATLL compared to currently reported data. Survival remains very low, with all subtypes experiencing a median survival of less than one year.

Adult T-cell leukemia/lymphoma (ATLL) is an aggressive neoplasm of the T-cells caused by the infection with human T-cell lymphotropic virus type-1 (HTLV-1). ATLL is classified into four subtypes, namely acute, lymphoma, chronic, and smoldering. The acute, lymphoma and chronic unfavorable types are considered aggressive forms of ATLL. We present some peripheral blood smear images of a patient diagnosed with acute type ATLL.

Metastatic cancers, particularly those involving bone mar­row metastases, present significant challenges in cli­ni­cal ma­nagement. The presence of bone marrow me­tas­tases cri­ti­cally influences cancer treatment strategies, ne­ces­si­ta­ting comprehensive patient assessments. Diagnostic con­­fir­­ma­­tion involves imaging studies and bone mar­row biop­sy or aspiration, with histopathological and im­mu­no­his­to­che­mi­cal exams. The prognosis for patients with bone mar­row metastases is generally poor. Complications from mye­lo­sup­pres­sion and advanced disease stages further com­pli­cate the ma­nage­ment. This article presents two cases of solid tumors with bone marrow metastases, highlighting the diverse pre­sen­ta­tions of such metastases. These cases emphasize the importance of bone marrow evaluation in patients with solid tumors who exhibit unexplained blood ab­nor­malities, as this assessment is crucial for accurate diag­nosis, informed treat­ment decisions, and improved prognosis.

The SARS-CoV-2 pandemic and its specific respiratory pathology has generated extensive research that has highlighted the specific nature of the disease (COVID-19). Thrombotic processes in the macrocirculation and microcirculation were among the first reported, accompanying respiratory (pulmonary) manifestations. Of the COVID-19 complications, thrombosis in the venous system (venous thrombosis and pulmonary embolism) and the atrial system (stroke) are the most numerous and severe in terms of evolution and prognosis. The prophylaxis of thrombotic processes in COVID-19, initially empirical, has gained a scientific basis based on research and experience of clinicians. The current paper presents general data on macro- and microcirculatory thrombosis and the rationale for thromboprophylaxis. Thromboprophylaxis in non-hospitalized COVID-19 patients, “non-critical” and “critical” hospitalized patients and possible post-hospital thromboprophylaxis are presented. Heparins (HGMM and HNF) are the most commonly indicated and used antithrombotic agents. Other antithrombotic agents - antiplatelets and direct anticoagulants (oral - DOAC) have a very limited and possibly negative role in thromboprophylaxis in COVID-19.