Background: Diffuse large B-cell lymphoma (DLBCL) is considered the most common lymphoid malignancy that represented about 35 % of adult nonHodgkin lymphomas (NHL). Although most patients can be cured with the Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone (R-CHOP) regimen, many patients die due to relapsed disease. In this study, we aim to assess the clinicopathological characteristics of relapsed DLBCL, not otherwise specified (NOS). Methods: This is a retrospective study conducted on 16 cases of relapsed DLBCL (relapsed group). Meanwhile, 27 cases with DLBCL who capable of attaining complete remission (CR) for 36 months were used as control (CR group). Results: clinically, most patients in the relapsed group were male (62.5%). The relapsed group had a significant difference in comparison to the CR group as regard bone marrow involvement (P = 0.003), serum lactate dehydrogenase (LDH) level (P = 0.005), B symptoms (P = 0.007), performance status (PS) (P = 0.008), international prognostic index (IPI) (P = 0.000) and age-adjusted IPI (P = 0.017). Pathologically, relapsed DLBCL was associated with negative CD10 expression (P = 0.001), negative BCL6 expression (P = 0.047), and nongerminal center B-cell (non-GCB) phenotype (P = 0.018). Conclusions: patients with bone marrow involvement, abnormal serum LDH level, B symptoms, poor PS, intermediate to high IPI & AA-IPI, non-GCB phenotype, lower CD10, and BCL6 expression are more likely to relapse.

Background: Diffuse large B-cell lymphoma (DLBCL) is considered the most common lymphoid malignancy that represented about 35 % of adult nonHodgkin lymphomas (NHL). Although most patients can be cured with the Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone (R-CHOP) regimen, many patients die due to relapsed disease. In this study, we aim to assess the clinicopathological characteristics of relapsed DLBCL, not otherwise specified (NOS). Methods: This is a retrospective study conducted on 16 cases of relapsed DLBCL (relapsed group). Meanwhile, 27 cases with DLBCL who capable of attaining complete remission (CR) for 36 months were used as control (CR group). Results: clinically, most patients in the relapsed group were male (62.5%). The relapsed group had a significant difference in comparison to the CR group as regard bone marrow involvement (P = 0.003), serum lactate dehydrogenase (LDH) level (P = 0.005), B symptoms (P = 0.007), performance status (PS) (P = 0.008), international prognostic index (IPI) (P = 0.000) and age-adjusted IPI (P = 0.017). Pathologically, relapsed DLBCL was associated with negative CD10 expression (P = 0.001), negative BCL6 expression (P = 0.047), and nongerminal center B-cell (non-GCB) phenotype (P = 0.018). Conclusions: patients with bone marrow involvement, abnormal serum LDH level, B symptoms, poor PS, intermediate to high IPI & AA-IPI, non-GCB phenotype, lower CD10, and BCL6 expression are more likely to relapse.

Background: Diffuse large B-cell lymphoma (DLBCL) is considered the commonest subtype of non-Hodgkin lymphoma (NHL) in the world. It is a refractory disease with a high mortality rate due to frequent relapses. Several prognostic parameters are now widely studied for risk stratification and achieving a better outcome. Objectives: In this study, we aim to assess the prognostic value of immunohistochemical expression of CD10, BCL6, and MUM1 independently as surrogate markers for cell of origin (COO) classification of DLBCL and their correlation with clinicopathological characters and survival. Patients and methods: This is a retrospective study conducted on 63 cases of DLBCL, NOS. Full-faced sections were constructed and immunostained for CD10, BCL6, and MUM1. Results: CD10 expression was associated with early-stage (P=0.003), normal serum LDH level (P=0.022), absence of B symptoms (P=0.019), low international prognostic index (IPI) and age-adjusted-IPI (P=0.001) and also associated with longer progression free survival (PFS) (P=0.006). BCL6 expression was associated with centroblastic variant (P=0.005), good ECOG performance status (P=0.038) and low IPI (P=0.004) and also associated with better overall survival (OS) (P=0.028) and PFS (P=0.018). MUM1 expression was associated with advanced-stage (P=0.002) while no significant association was detected with other clinicopathological parameters or survival. Conclusion CD10, BCL6, and MUM1 can be used independently as prognostic immunohistochemical markers for DLBCL that may denote the clinical behavior of the disease and further patients' outcomes.

Background: Diffuse large B-cell lymphoma (DLBCL) is considered the commonest subtype of non-Hodgkin lymphoma (NHL) in the world. It is a refractory disease with a high mortality rate due to frequent relapses. Several prognostic parameters are now widely studied for risk stratification and achieving a better outcome. Objectives: In this study, we aim to assess the prognostic value of immunohistochemical expression of CD10, BCL6, and MUM1 independently as surrogate markers for cell of origin (COO) classification of DLBCL and their correlation with clinicopathological characters and survival. Patients and methods: This is a retrospective study conducted on 63 cases of DLBCL, NOS. Full-faced sections were constructed and immunostained for CD10, BCL6, and MUM1. Results: CD10 expression was associated with early-stage (P=0.003), normal serum LDH level (P=0.022), absence of B symptoms (P=0.019), low international prognostic index (IPI) and age-adjusted-IPI (P=0.001) and also associated with longer progression free survival (PFS) (P=0.006). BCL6 expression was associated with centroblastic variant (P=0.005), good ECOG performance status (P=0.038) and low IPI (P=0.004) and also associated with better overall survival (OS) (P=0.028) and PFS (P=0.018). MUM1 expression was associated with advanced-stage (P=0.002) while no significant association was detected with other clinicopathological parameters or survival. Conclusion CD10, BCL6, and MUM1 can be used independently as prognostic immunohistochemical markers for DLBCL that may denote the clinical behavior of the disease and further patients' outcomes.

Background: Diffuse large B-cell lymphoma (DLBCL) is considered the commonest subtype of non-Hodgkin lymphoma (NHL) in the world. It is a refractory disease with a high mortality rate due to frequent relapses. Several prognostic parameters are now widely studied for risk stratification and achieving a better outcome. Objectives: In this study, we aim to assess the prognostic value of immunohistochemical expression of CD10, BCL6, and MUM1 independently as surrogate markers for cell of origin (COO) classification of DLBCL and their correlation with clinicopathological characters and survival. Patients and methods: This is a retrospective study conducted on 63 cases of DLBCL, NOS. Full-faced sections were constructed and immunostained for CD10, BCL6, and MUM1. Results: CD10 expression was associated with early-stage (P=0.003), normal serum LDH level (P=0.022), absence of B symptoms (P=0.019), low international prognostic index (IPI) and age-adjusted-IPI (P=0.001) and also associated with longer progression free survival (PFS) (P=0.006). BCL6 expression was associated with centroblastic variant (P=0.005), good ECOG performance status (P=0.038) and low IPI (P=0.004) and also associated with better overall survival (OS) (P=0.028) and PFS (P=0.018). MUM1 expression was associated with advanced-stage (P=0.002) while no significant association was detected with other clinicopathological parameters or survival. Conclusion CD10, BCL6, and MUM1 can be used independently as prognostic immunohistochemical markers for DLBCL that may denote the clinical behavior of the disease and further patients' outcomes.

Background: Diffuse large B-cell lymphoma (DLBCL) is considered the commonest subtype of non-Hodgkin lymphoma (NHL) in the world. It is a refractory disease with a high mortality rate due to frequent relapses. Several prognostic parameters are now widely studied for risk stratification and achieving a better outcome. Objectives: In this study, we aim to assess the prognostic value of immunohistochemical expression of CD10, BCL6, and MUM1 independently as surrogate markers for cell of origin (COO) classification of DLBCL and their correlation with clinicopathological characters and survival. Patients and methods: This is a retrospective study conducted on 63 cases of DLBCL, NOS. Full-faced sections were constructed and immunostained for CD10, BCL6, and MUM1. Results: CD10 expression was associated with early-stage (P=0.003), normal serum LDH level (P=0.022), absence of B symptoms (P=0.019), low international prognostic index (IPI) and age-adjusted-IPI (P=0.001) and also associated with longer progression free survival (PFS) (P=0.006). BCL6 expression was associated with centroblastic variant (P=0.005), good ECOG performance status (P=0.038) and low IPI (P=0.004) and also associated with better overall survival (OS) (P=0.028) and PFS (P=0.018). MUM1 expression was associated with advanced-stage (P=0.002) while no significant association was detected with other clinicopathological parameters or survival. Conclusion CD10, BCL6, and MUM1 can be used independently as prognostic immunohistochemical markers for DLBCL that may denote the clinical behavior of the disease and further patients' outcomes.

Background: Diffuse large B-cell lymphoma (DLBCL) is considered the commonest subtype of non-Hodgkin lymphoma (NHL) in the world. It is a refractory disease with a high mortality rate due to frequent relapses. Several prognostic parameters are now widely studied for risk stratification and achieving a better outcome. Objectives: In this study, we aim to assess the prognostic value of immunohistochemical expression of CD10, BCL6, and MUM1 independently as surrogate markers for cell of origin (COO) classification of DLBCL and their correlation with clinicopathological characters and survival. Patients and methods: This is a retrospective study conducted on 63 cases of DLBCL, NOS. Full-faced sections were constructed and immunostained for CD10, BCL6, and MUM1. Results: CD10 expression was associated with early-stage (P=0.003), normal serum LDH level (P=0.022), absence of B symptoms (P=0.019), low international prognostic index (IPI) and age-adjusted-IPI (P=0.001) and also associated with longer progression free survival (PFS) (P=0.006). BCL6 expression was associated with centroblastic variant (P=0.005), good ECOG performance status (P=0.038) and low IPI (P=0.004) and also associated with better overall survival (OS) (P=0.028) and PFS (P=0.018). MUM1 expression was associated with advanced-stage (P=0.002) while no significant association was detected with other clinicopathological parameters or survival. Conclusion CD10, BCL6, and MUM1 can be used independently as prognostic immunohistochemical markers for DLBCL that may denote the clinical behavior of the disease and further patients' outcomes.

Aim: To assess survival outcome of pediatric patients with localized osteosarcoma of the extremities in Upper Egypt, identify factors of prognostic significance for survival, and to determine factors predictive of surgical methods employed in these patients, and developing a clinical model for risk prediction. Patients and Methods: A retrospective analysis of data assembled from medical records of 30 pediatric patients with a histologically verified nonmetastatic osteosarcoma of the extremities treated at South Egypt Cancer Institute with a unified chemotherapy protocol between January 2001 and December 2015 was carried out. Prognostic factors were determined using univariable and multivariable methods. A model for surgical outcomes in these patients based on the baseline clinical factors, and the parameters predictive of their tumor response to chemotherapy, was developed. Results: With a median follow-up of 63 months for the study population, the estimates for event-free survival and overall survival (OS) at 3 and 5 years were 69.5% and 79% and 65.2% and 65.3%, respectively. Age 16 years or above was independently associated with both worse metastasis-free survival (hazard ratio [HR]=6.05, 95% confidence interval [CI]: 1.43-25.6, P=0.015) and OS (HR=7.9, 95% CI: 1.71-36.2, P=0.008). In the multivariable analysis, a proximal location within the limb gained a statistical significance to be independently associated with worse OS (HR=2.4, 95% CI: 1.13-22.1, P=0.003). Poor response to chemotherapy was marginally associated with worse metastasis-free survival (HR=4.9, 95% CI: 1.02-23.8, P=0.047) only in the univariable analysis. The patients found to be more likely to undergo an amputation surgery (odds ratio=14.1, 95% CI: 1.34-149.4, P=0.028) were those in whom a tumor was poorly responding to chemotherapy. Conclusion: In Upper Egypt, despite the reasonable survival outcomes in nonmetastatic osteosarcoma, a relatively high limb amputation rate has been encountered. The development of a clinical prediction model for future planning of possible outcome improvement in these patients, however, is still feasible.

Aim: To assess survival outcome of pediatric patients with localized osteosarcoma of the extremities in Upper Egypt, identify factors of prognostic significance for survival, and to determine factors predictive of surgical methods employed in these patients, and developing a clinical model for risk prediction. Patients and Methods: A retrospective analysis of data assembled from medical records of 30 pediatric patients with a histologically verified nonmetastatic osteosarcoma of the extremities treated at South Egypt Cancer Institute with a unified chemotherapy protocol between January 2001 and December 2015 was carried out. Prognostic factors were determined using univariable and multivariable methods. A model for surgical outcomes in these patients based on the baseline clinical factors, and the parameters predictive of their tumor response to chemotherapy, was developed. Results: With a median follow-up of 63 months for the study population, the estimates for event-free survival and overall survival (OS) at 3 and 5 years were 69.5% and 79% and 65.2% and 65.3%, respectively. Age 16 years or above was independently associated with both worse metastasis-free survival (hazard ratio [HR]=6.05, 95% confidence interval [CI]: 1.43-25.6, P=0.015) and OS (HR=7.9, 95% CI: 1.71-36.2, P=0.008). In the multivariable analysis, a proximal location within the limb gained a statistical significance to be independently associated with worse OS (HR=2.4, 95% CI: 1.13-22.1, P=0.003). Poor response to chemotherapy was marginally associated with worse metastasis-free survival (HR=4.9, 95% CI: 1.02-23.8, P=0.047) only in the univariable analysis. The patients found to be more likely to undergo an amputation surgery (odds ratio=14.1, 95% CI: 1.34-149.4, P=0.028) were those in whom a tumor was poorly responding to chemotherapy. Conclusion: In Upper Egypt, despite the reasonable survival outcomes in nonmetastatic osteosarcoma, a relatively high limb amputation rate has been encountered. The development of a clinical prediction model for future planning of possible outcome improvement in these patients, however, is still feasible.

Aim: To assess survival outcome of pediatric patients with localized osteosarcoma of the extremities in Upper Egypt, identify factors of prognostic significance for survival, and to determine factors predictive of surgical methods employed in these patients, and developing a clinical model for risk prediction. Patients and Methods: A retrospective analysis of data assembled from medical records of 30 pediatric patients with a histologically verified nonmetastatic osteosarcoma of the extremities treated at South Egypt Cancer Institute with a unified chemotherapy protocol between January 2001 and December 2015 was carried out. Prognostic factors were determined using univariable and multivariable methods. A model for surgical outcomes in these patients based on the baseline clinical factors, and the parameters predictive of their tumor response to chemotherapy, was developed. Results: With a median follow-up of 63 months for the study population, the estimates for event-free survival and overall survival (OS) at 3 and 5 years were 69.5% and 79% and 65.2% and 65.3%, respectively. Age 16 years or above was independently associated with both worse metastasis-free survival (hazard ratio [HR]=6.05, 95% confidence interval [CI]: 1.43-25.6, P=0.015) and OS (HR=7.9, 95% CI: 1.71-36.2, P=0.008). In the multivariable analysis, a proximal location within the limb gained a statistical significance to be independently associated with worse OS (HR=2.4, 95% CI: 1.13-22.1, P=0.003). Poor response to chemotherapy was marginally associated with worse metastasis-free survival (HR=4.9, 95% CI: 1.02-23.8, P=0.047) only in the univariable analysis. The patients found to be more likely to undergo an amputation surgery (odds ratio=14.1, 95% CI: 1.34-149.4, P=0.028) were those in whom a tumor was poorly responding to chemotherapy. Conclusion: In Upper Egypt, despite the reasonable survival outcomes in nonmetastatic osteosarcoma, a relatively high limb amputation rate has been encountered. The development of a clinical prediction model for future planning of possible outcome improvement in these patients, however, is still feasible.