Journal of Integrative Oncology

Previously chronicled as “Old histiocytic sarcoma” or “Old reticulum cell sarcoma”, Diffuse Large B Cell Lymphoma (DLBCL) is a composite and aggressive non-hodgkin’s lymphoma. An estimated 40% of lymphomas with multi-various disorders comprise the High-Grade B Cell Lymphoma (HGBCL). The mean age of detection may be at 60 years. Extra nodal and DLBCL comprise 40% instances with a half (50%) depicting progressive disease. The World Health Organization (WHO) categorization highlights the specific molecular attributes of the lymphoma such as the genomic rearrangements of the MYC and BCL2 and/or BCL6. Co-existent genetic anomalies may define the aggressive “Double Hit (DH) lymphoma” with a poor prognosis, initially scripted in 1988. DLBCL may emerge in the South Asian subcontinent with the prevalence identical to that of the developed world (30%-40%), though the incidence of the disorder may be enhanced in the Asian countries (60%-70%). The majority (>80%) of the individuals with an aggressive B Cell Double Hit Lymphoma (HGBCL DH) may elucidate concomitant translocations in the MYC and BCL2 genes. The remainder (20%) of the persons may depict concordant MYC and BCL6 translocations along with the enunciation of the BCL2 gene with an absence of the BCL2 translocation which may not influence the disease outcome. The Double Expresser Lymphomas (DE DLBCL), as exemplified by the co-existent MYC and BCL2, may depict a poor outcome, although superior to the “Double Hits (DHs)”. The DE DLBCL may be incorporated as the DLBCL Not Otherwise Specified (DLBCL NOS) by the WHO.

Objectives: To study the costs and utilities associated with the use of positron emission tomography-computed tomography (PET/CT) surveillance for the first remission.
Methods: A systematic MEDLINE search was conducted by pairing relevant keywords to identify English language articles describing costs and utilities involved with the usage of PET/CT surveillance in patients with Diffused Large B Cell Lymphoma (DLBCL).
Results: PET/CT resulted in similar medical costs along with similar clinical outcomes as compared to no surveillance (Korean won 2,499,689 vs 5,229,901, p<0.755). Additionally, in a Markov decision-analytic model with 2-year time horizon, PET/CT surveillance had a small but insignificant benefit over no surveillance in terms of qualityadjusted life years (QALYs) gained (CT, 0.020 QALYs; PET/CT, 0.025 QALYs). This led to high ICERs per QALY gained ($164,960- $168,750).
Conclusions: As surveillance for the first remission with PET/CT is providing similar clinical and utility outcomes at a significantly high cost, we do not support routine surveillance for follow-up of DLBCL and suggest its usage should be adopted more wisely in patients with DLBCL.

There are many side effects known from post-mastectomy. Most disabling are pain and restricted range of motion of shoulder joint due to post Cancer Mastectomy induced lymphadenopathy. Limited arm or shoulder movement further affects the individual’s functional and social well-being. With the aim to reduce the lymphedema either we lose range and strength or vice versa. Hence the aim of the present study was to evaluate the effectiveness of the novel physiotherapy protocol for the post-mastectomy and radiotherapy-induced lymphadenopathy and restricted range of motion. A 62 years old female was included in the study. Baseline data were recorded by visual analog scale, forearm girth measurements and Hospital Anxiety and Depression (HAD) scale. Results were then noted at 1st, 2nd, 3rd, 4th, 5th and 6th month of the study. Studies proved Matrix Rhythm Therapy to be beneficial in reducing lymphedema, pain incising functional and social well-being when combined with another conventional method.