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Late-onset meningeal lymphomatosis in mantle cell lymphoma controlled with chemotherapy
Linfomatosis meníngea tardía en linfoma del manto controlada con quimioterapia
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(B) Contrast brain CT image at 24<span class="elsevierStyleHsp" style=""></span>hours revealing a hyperdense area in the left temporal lobe, infiltrating the ipsilateral Sylvian fissure with no contrast uptake. Brain MRI: (C) Axial T1-weighted sequence. A hyperintense lesion was observed in the left temporal lobe. (D) Coronal contrast T1-weighted sequence. An irregular lesion with a hypointense centre (ring enhancement) was identified. (E) Axial contrast T1-weighted sequence. The scan revealed an irregular area with low contrast with a cyst-like component and central necrosis exerting a mass effect with left temporal horn effacement. F) Axial T2-weighted sequence. A left temporal hyperintense lesion (oedema) was observed. MRI results: glial tumour in the left temporal lobe expanding into the uncus and hippocampus with a cyst-like appearance and central necrosis with an infiltrative/expansive growth pattern.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "F.J. 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Alonso, A. Cánovas, M.M. Riñón" "autores" => array:3 [ 0 => array:4 [ "nombre" => "J.J." "apellidos" => "Alonso" "email" => array:1 [ 0 => "juanjosealonso@telefonica.net" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "A." "apellidos" => "Cánovas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "M.M." "apellidos" => "Riñón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Universitario de Cruces, Osakidetza, UPV-EHU, Baracaldo, Vizcaya, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Bioquímica, Citometría de flujo, Hospital Universitario de Cruces, Osakidetza, Baracaldo, Vizcaya, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Linfomatosis meníngea tardía en linfoma del manto controlada con quimioterapia" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Mantle cell lymphoma (MCL) is a B-cell lymphoma with poor prognosis (mean survival time below 5 years).<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> The incidence of central nervous system involvement varies (4%-26% of cases)<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,3</span></a>; symptoms appear a mean of 9-25 months from diagnosis.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> The main prognostic variables associated with central nervous system involvement are unfavourable prognostic index (MIPI<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a>) scores,<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> blastoid morphology, and high lactate dehydrogenase levels.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> These cases show poor response to treatment, with a median survival time of 2-9 months from relapse of central nervous system symptoms.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4,6</span></a> Intensive chemotherapy and autologous stem cell transplant achieve complete resolution in only 50% of the patients.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> Progression to systemic lymphoma is the main cause of death.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> We present the case of a patient with a rather unusual progression considering the series reported in the literature.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The patient, a 55-year-old woman, was admitted to our department in October 2012 due to diplopia and a recent diagnosis of brachial neuritis affecting the upper trunk of the brachial plexus, associated with paraesthesia, pain, and left arm weakness. In December 1996, she complained of asthaenia and painful cervical lymphadenopathy and was diagnosed with MCL (low-risk, according to MIPI scores) after a lymph node biopsy revealed diffuse infiltration and nodularity of small, cyclin-D1-positive centrocytes (fewer than 10% of the cells were centroblastic). According to immunohistochemical and flow cytometry results, lymphocytes were CD5+, CD19+, CD20+, CD22+, λ+, FMC7+, CD10−, CD23−, and BLC6−. The bone marrow displayed 70% lymphoid infiltration, with the same markers. A complete blood count and biochemical profile disclosed normal results, with 9000 leucocytes/μL and normal differential test results, except for a slight increase in lactate dehydrogenase levels (299<span class="elsevierStyleHsp" style=""></span>mU/mL). A CT scan revealed supra- and infradiaphragmatic lymphadenopathies measuring up to 2<span class="elsevierStyleHsp" style=""></span>cm, with no visceromegaly. Five cycles of alternating chemotherapy<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> (CHOP-Bleo/OPEN: cyclophosphamide, doxorubicin, vincristine, prednisone, bleomycin; vincristine, prednisone, etoposide, mitoxantrone) achieved only a partial response. We therefore switched to ESHAP<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> (etoposide, methylprednisolone, cytarabine, platinum). After 4 cycles, chemotherapy was intensified and the patient received an autologous stem cell transplant, achieving complete resolution. In July 2003, diffuse infiltration of the bone marrow was observed. Five cycles of rituximab-ESHAP and a second autologous stem cell transplant (none of the patient's relatives was histocompatible) led to complete resolution. In June 2008, the patient further experienced a recurrence, with 60% bone marrow infiltration. The episode resolved fully after 7 cycles of rituximab-bortezomib-dexamethasone. No non-relative donors for stem cell transplant were found. The patient experienced no further recurrences until her latest admission due to diplopia. The clinical examination revealed complete right third nerve palsy and muscle weakness in the proximal segment of the left arm. A body CT scan showed no abnormalities. A histopathological examination of the bone marrow yielded normal results and flow cytometry revealed 0.37% lymphocytes with the same clonality as in the initial flow cytometry. A brain and spinal cord MRI scan showed no abnormalities. A CSF analysis revealed a slight increase in protein levels and a leucocyte count of 44<span class="elsevierStyleHsp" style=""></span>cells/μL (58% lymphocytes), with a small percentage (1.5%) of clonal λ lymphocytes, with the markers reported previously. Chemotherapy with intravenous methotrexate (3.5<span class="elsevierStyleHsp" style=""></span>g/m<span class="elsevierStyleSup">2</span>) and triple intrathecal therapy (methotrexate, cytarabine, hydrocortisone) at 2-week intervals normalised CSF after 3 cycles and led to slow clinical improvement. In March 2013, however, diplopia reappeared due to right sixth nerve palsy, with no changes in imaging or CSF analysis results. We added temozolomide, achieving progressive resolution of the neurological symptoms. We switched to cytarabine (3<span class="elsevierStyleHsp" style=""></span>g/m<span class="elsevierStyleSup">2</span> intravenously), due to poor methotrexate clearance, and increased intervals between cycles, completing intrathecal treatment with liposomal cytarabine. In June 2015, nearly 3 years after the central nervous system relapse, the patient remained asymptomatic and was receiving no treatment; clinical and laboratory findings showed full resolution of systemic and neurological anomalies. The only remarkable finding was 0.4% clonal lymphocytes in the bone marrow according to flow cytometry. In August 2015, the patient received consolidation chemotherapy and haploidentical stem cell transplantation from one of her children. She is currently in clinical remission.</p><p id="par0015" class="elsevierStylePara elsevierViewall">This case is exceptional due to the patient's long survival time; the fact that she experienced a late, isolated neurological relapse, which is a rather infrequent event<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> with no predictive factors; and the patient's response to treatment, which was initially good but was subsequently followed by an early relapse and controlled with chemotherapy (this may be explained by the fact that the relapse was initially only meningeal<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a>). Intrathecal rituximab is useful in these cases if combined with systemic and intrathecal chemotherapy.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> The literature reports 3 cases of patients with MCL associated with neurological involvement who displayed an exceptionally good response to ibrutinib. However, as these patients were followed up for a short time, reassessment would be necessary to confirm the positive results over time.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> In any case, these findings represent a huge step forward in the field.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare and have received no funding for this study.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Alonso JJ, Cánovas A, Riñón MM. Linfomatosis meníngea tardía en linfoma del manto controlada con quimioterapia. Neurología. 2018;33:201–202.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mantle cell lymphoma: 2013 Update on diagnosis, risk-stratification, and clinical management" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.M. Vose" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ajh.23615" "Revista" => array:6 [ "tituloSerie" => "Am J Hematol" "fecha" => "2013" "volumen" => "88" "paginaInicial" => "1082" "paginaFinal" => "1088" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24273091" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Central nervous system involvement in mantle cell lymphoma: clinical features, prognostic factors and outcomes from the European Mantle Cell Lymphoma Network" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.Y. Cheah" 1 => "A. George" 2 => "E. Giné" 3 => "A. Chiappella" 4 => "H.C. Kluin-Nelemans" 5 => "W. Jurczak" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/annonc/mdt139" "Revista" => array:6 [ "tituloSerie" => "Ann Oncol" "fecha" => "2013" "volumen" => "24" "paginaInicial" => "2119" "paginaFinal" => "2123" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23616279" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Central nervous system involvement in mantle cell lymphoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Ferrer" 1 => "F. Bosch" 2 => "N. Villamor" 3 => "M. Rozman" 4 => "F. Graus" 5 => "G. Gutiérrez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/annonc/mdm447" "Revista" => array:6 [ "tituloSerie" => "Ann Oncol" "fecha" => "2008" "volumen" => "19" "paginaInicial" => "135" "paginaFinal" => "234" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17962207" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mantle cell lymphoma with central nervous system involvement: frequency and clinical features" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Gill" 1 => "K.E. Herbert" 2 => "H.M. Prince" 3 => "M.M. Wolf" 4 => "A. Wirth" 5 => "G. Ryan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2141.2009.07835.x" "Revista" => array:6 [ "tituloSerie" => "Br J Haematol" "fecha" => "2009" "volumen" => "147" "paginaInicial" => "83" "paginaFinal" => "88" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19694718" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A new prognostic index (MIPI) for patients with advanced-stage mantle cell lymphoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Hoster" 1 => "M. Dreyling" 2 => "W. Klapper" 3 => "C. Gisselbrecht" 4 => "A. van Hoof" 5 => "C. Hanneke" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1182/blood-2007-06-095331" "Revista" => array:6 [ "tituloSerie" => "Blood" "fecha" => "2008" "volumen" => "111" "paginaInicial" => "558" "paginaFinal" => "565" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17962512" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk factors of central nervous system relapse in mantle cell lymphoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Conconi" 1 => "S. Franceschetti" 2 => "C. Lobetti-Bodoni" 3 => "A. Stathis" 4 => "G. Margiotta-Casaluci" 5 => "A. Ramponi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3109/10428194.2013.767454" "Revista" => array:6 [ "tituloSerie" => "Leuk Lymphoma" "fecha" => "2013" "volumen" => "54" "paginaInicial" => "1908" "paginaFinal" => "1914" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23339449" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recent trends in the management of lymphomas at M.D. Anderson Cancer Center" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F. Cabanillas" 1 => "M.A. Rodríguez" 2 => "F. Swan Jr." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Semin Oncol" "fecha" => "1990" "volumen" => "17" "paginaInicial" => "28" "paginaFinal" => "34" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2259921" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Central nervous system relapse in a patient with mantle cell lymphoma in continuous clinical and molecular remission at six years since autografting" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Ladetto" 1 => "S. Sametti" 2 => "M. Astolfi" 3 => "P. Corradini" 4 => "I. Ricca" 5 => "D. Drandi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3109/10428190109097668" "Revista" => array:6 [ "tituloSerie" => "Leuk Lymphoma" "fecha" => "2001" "volumen" => "40" "paginaInicial" => "679" "paginaFinal" => "682" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11426542" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rapid complete response using intrathecal rituximab in a patient with leptomeningeal lymphomatosis due to mantle cell lymphoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L. Villela" 1 => "M. García" 2 => "R. Caballero" 3 => "J.R. Borbolla-Escoboza" 4 => "J. Bolaños-Meade" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/CAD.0b013e32830cebc1" "Revista" => array:6 [ "tituloSerie" => "Anticancer Drugs" "fecha" => "2008" "volumen" => "19" "paginaInicial" => "917" "paginaFinal" => "920" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18766006" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "pii:blood-2015-05-64783" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Activity with ibrutinib in mantle cell lymphoma patients with central nervous system relapse" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Bernard" 1 => "L. Goldwirt" 2 => "S. Amorim" 3 => "P. Brice" 4 => "J. Brière" 5 => "E. de Kerviler" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Blood" "fecha" => "2015" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7949091" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735808/0000003300000003/v1_201804060407/S2173580818300099/v1_201804060407/en/main.assets" "Apartado" => array:4 [ "identificador" => "9409" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735808/0000003300000003/v1_201804060407/S2173580818300099/v1_201804060407/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173580818300099?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 9 | 0 | 9 |
| 2024 October | 15 | 3 | 18 |
| 2024 September | 16 | 4 | 20 |
| 2024 August | 26 | 4 | 30 |
| 2024 July | 19 | 5 | 24 |
| 2024 June | 11 | 3 | 14 |
| 2024 May | 26 | 6 | 32 |
| 2024 April | 15 | 5 | 20 |
| 2024 March | 30 | 9 | 39 |
| 2024 February | 9 | 3 | 12 |
| 2024 January | 18 | 4 | 22 |
| 2023 December | 40 | 9 | 49 |
| 2023 November | 31 | 5 | 36 |
| 2023 October | 31 | 7 | 38 |
| 2023 September | 17 | 7 | 24 |
| 2023 August | 17 | 8 | 25 |
| 2023 July | 11 | 6 | 17 |
| 2023 June | 18 | 1 | 19 |
| 2023 May | 30 | 4 | 34 |
| 2023 April | 43 | 2 | 45 |
| 2023 March | 33 | 2 | 35 |
| 2023 February | 18 | 0 | 18 |
| 2023 January | 20 | 5 | 25 |
| 2022 December | 37 | 6 | 43 |
| 2022 November | 30 | 8 | 38 |
| 2022 October | 18 | 5 | 23 |
| 2022 September | 15 | 15 | 30 |
| 2022 August | 17 | 7 | 24 |
| 2022 July | 26 | 9 | 35 |
| 2022 June | 16 | 8 | 24 |
| 2022 May | 14 | 7 | 21 |
| 2022 April | 13 | 12 | 25 |
| 2022 March | 20 | 7 | 27 |
| 2022 February | 8 | 6 | 14 |
| 2022 January | 17 | 7 | 24 |
| 2021 December | 12 | 11 | 23 |
| 2021 November | 17 | 9 | 26 |
| 2021 October | 19 | 12 | 31 |
| 2021 September | 15 | 10 | 25 |
| 2021 August | 24 | 8 | 32 |
| 2021 July | 17 | 9 | 26 |
| 2021 June | 14 | 10 | 24 |
| 2021 May | 20 | 7 | 27 |
| 2021 April | 65 | 16 | 81 |
| 2021 March | 25 | 4 | 29 |
| 2021 February | 14 | 6 | 20 |
| 2021 January | 22 | 12 | 34 |
| 2020 December | 19 | 10 | 29 |
| 2020 November | 18 | 11 | 29 |
| 2020 October | 25 | 4 | 29 |
| 2020 September | 17 | 20 | 37 |
| 2020 August | 16 | 5 | 21 |
| 2020 July | 10 | 9 | 19 |
| 2020 June | 11 | 8 | 19 |
| 2020 May | 21 | 10 | 31 |
| 2020 April | 15 | 9 | 24 |
| 2020 March | 21 | 6 | 27 |
| 2020 February | 14 | 10 | 24 |
| 2020 January | 21 | 6 | 27 |
| 2019 December | 20 | 8 | 28 |
| 2019 November | 20 | 7 | 27 |
| 2019 October | 22 | 5 | 27 |
| 2019 September | 8 | 3 | 11 |
| 2019 August | 5 | 8 | 13 |
| 2019 July | 13 | 19 | 32 |
| 2019 June | 40 | 10 | 50 |
| 2019 May | 105 | 7 | 112 |
| 2019 April | 24 | 42 | 66 |
| 2019 March | 5 | 1 | 6 |
| 2019 February | 8 | 6 | 14 |
| 2019 January | 9 | 2 | 11 |
| 2018 December | 5 | 7 | 12 |
| 2018 November | 8 | 2 | 10 |
| 2018 October | 14 | 13 | 27 |
| 2018 September | 5 | 5 | 10 |
| 2018 August | 2 | 4 | 6 |
| 2018 July | 6 | 4 | 10 |
| 2018 June | 6 | 3 | 9 |
| 2018 May | 11 | 4 | 15 |
| 2018 April | 9 | 2 | 11 |
| 2018 March | 2 | 1 | 3 |
| 2018 February | 0 | 1 | 1 |
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