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Abramson Cancer CenterNCI CANCERLIT® Search: Therapy of Non-Hodgkin's Lymphoma - October 2001
National Cancer Institute®
Last Modified: November 21, 2001
Table of Contents
1
UI - 20277954
AU - Fong IW; Ho J; Toy C; Lo B; Fong MW
TI -
Value of long-term administration of acyclovir and similar agents for
protecting against AIDS-related lymphoma: case-control and historical
cohort studies.
SO - Clin Infect Dis 2000 May;30(5):757-61
AD - Department of Medicine, St. Michael's Hospital, University of Toronto,
Ontario, Canada. fongi@smh.toronto.on.ca
Acyclovir or similar agents with activity against Epstein-Barr virus
(EBV) theoretically may prevent non-Hodgkin's lymphoma (NHL) in AIDS. A
case-control study of 29 patients with AIDS-related NHL and 58 matched
control subjects assessed the frequency with which daily acyclovir
(>/=800 mg/d) or similar agents were used for > or =1 year. In a
historical cohort of 304 patients with AIDS for > or =2 years, the
prevalence of NHL was assessed among 3 groups of patients: those who
received long-term treatment with high-dose acyclovir (or similar
agents) or low-dose or intermittent acyclovir; those treated with
ganciclovir/foscarnet for <1 year; and those who had not previously been
treated with acyclovir, ganciclovir, or foscarnet. In the case-control
study, 22 patients (72.4%) with NHL never received acyclovir or similar
drugs versus 19 control subjects (32.8%; P=. 002); 2 patients (6.9%)
with NHL received acyclovir (> or =800 mg/d) for > or =1 year versus 27
(46.6%) of control subjects (P=.0001). In the cohort study, 6 (6.8%) of
88 patients who received acyclovir (> or =800 mg/d) for > or =1 year
developed NHL versus 15 (15.5%) of 97 patients who received intermittent
or lower-dose acyclovir and 30 (25.2%) of 119 patients who never
received these agents (P=.002). Long-term administration (>1 year) of
high-dose acyclovir or similar agents with anti-EBV activity may prevent
NHL in patients with AIDS. A prospective, randomized study is warranted
to confirm these results.
2
UI - 20368514
AU - Railan D; Fivenson DP; Wittenberg G
TI -
Capillary leak syndrome in a patient treated with interleukin 2 fusion
toxin for cutaneous T-cell lymphoma.
SO - J Am Acad Dermatol 2000 Aug;43(2 Pt 1):323-4
3
UI - 21102696
AU - Acosta M; Teitelbaum A
TI -
Capillary leak syndrome in a patient treated with interleukin 2 fusion
toxin for cutaneous T-cell lymphoma.
SO - J Am Acad Dermatol 2001 Feb;44(2):312-3
4
UI - 21240453
AU - Grigg A; Clarke K; Szer J
TI -
Prolonged disease-free survival after autografting for chemosensitive
non-bulky low grade non-Hodgkin's Lymphoma.
SO - Leuk Lymphoma 2000 Oct;39(3-4):283-90
AD - Bone Marrow Transplant Service and Department of Clinical Haematology
and Medical Oncology, The Royal Melbourne Hospital, Grattan Street,
Parkville VIC 3050, Australia. andrew.grigg@nwhcn.org.au
The results of autografting in patients with relapsed low grade
non-Hodgkin's Lymphoma (NHL) have generally been disappointing due to
the failure to maintain remission and the late development of
myelodysplasia. Most series have used regimens that include total body
irradiation and purged stem cells. We evaluated the outcome in 32
patients with low grade NHL autografted using chemotherapy-only
busulfan-based conditioning and unpurged stem cells. Seven of 10
patients with poor prognostic features at diagnosis remain alive in CR a
median of 78 months (range 14-129) post-transplant. Twenty two patients
with relapsed, chemosensitive, low bulk disease, most of whom did not
have marrow involvement or an elevated LDH, were transplanted. Only five
of the 22 have relapsed, with an 86 +/- 8% overall survival and 72 +/-
10% event free survival (EFS) after a median follow-up of 56.5 months.
All but one patient has an EFS period longer, often substantially so,
than their previous longest remission. No patient has developed
myelodysplasia. These data suggest that in selected patients with poor
prognosis or relapsed low grade NHL autografting has a favourable impact
on the natural history of their disease and may result in long-term
disease control.
5
UI - 21240455
AU - Dazzi C; Cariello A; Rosti G; Argnani M; Sebastiani L; Ferrari E;
TI -
Zornetta L; Monti G; Nicoletti P; Baioni M; Salvucci M; Scarpi E;
Marangolo M
Is there any difference in PBPC mobilization between cyclophosphamide
plus G-CSF and G-CSF alone in patients with non-Hodgkin's Lymphoma?
SO - Leuk Lymphoma 2000 Oct;39(3-4):301-10
AD - Oncology and Hematology Department, Ospedale Santa Maria delle Croci,
Ravenna, Italy. c.dazzi@ra.nettuno.it
We attempted to analyze whether the use of high-dose cyclophosphamide
(CTX 7g/m2, group A) plus hematopoietic growth factor (G-CSF) or G-CSF
alone (10 microg/Kg, group B) as a mobilizing regimen, could result in
harvesting different numbers of CD34+ cells, committed progenitors and
CD34+ cells subsets. The number of CD34+ cells considered as the target
for each high-dose chemotherapy was > or = 2 x 10(6) /Kg/bw. Fifteen
leukaphereses procedures were necessary in group A, while 16 procedures
were performed in group B. We did not observe any difference between the
two groups in terms of CD34+ cells/microl in the peripheral blood (117
vs 78; p = NS), whereas in the aphereses product we found a significant
difference between the two groups of patients in terms of CD34+ cells
(6.41 vs 2.89 x 10(6) /Kg/bw; p = .009), CFU-GM (82.5 vs 52.3 x 10(4)
/Kg/bw; p = .04). Interestingly, we noted a different distribution of
CD34+/33- cells between the 2 groups (mean value 39% vs 65%; p < .05),
whereas we did not find any differences regarding CD34+/38-,
CD34+/Thy1+, CD34+/HLADR-. The higher number of CFU-GM/Kg/bw collected
in the former group did not translate into a superior plating efficiency
(27.75 vs 30.29). Furthermore, we observed a strong correlation between
CD34+ cells/&mgr;l in the peripheral blood and the total number of CD34+
cells in the leukaphereses product (r = 0.97), whereas this correlation
was not found in group B (r = 0.15). In both groups of patients the
number of CD34+ cells collected correlated well with CFU-GM (r = 0.93; r
= 0.94), but definitely we did not observe any correlation between CD34+
cells/microl and CFU-GM in patients mobilized with G-CSF alone and this
did not allow us to predict the harvest accurately. Finally, we
evaluated the engraftment kinetics and we did not observe any
statistically significant difference between the two groups of patients.
6
UI - 21240490
AU - Huerta-Zepeda A; Talavera A; Aviles A; Neri N; Mayani H
TI -
In vitro hematopoiesis in patients with malignant lymphoma during active
disease and at complete clinical remission after chemotherapy.
SO - Leuk Lymphoma 2000 Nov;39(5-6):613-24
AD - Oncological Research Unit; Oncology Hospital, National Medical Center,
IMSS, Mexico City.
Malignant lymphomas are neoplastic diseases of lymphoid cells, which
usually originate in the lymph nodes. During the last two decades,
significant progress has been made in the characterization of
chromosomal and molecular alterations in these malignancies. To date,
however, the composition and function of the hematopoietic system in
this group of hematological disorders is still not fully understood. In
the present study, we have determined the progenitor cell content in 10
patients with diffuse large-cell lymphoma (DLCL) and characterized the
proliferation of these cells in long-term marrow cultures. We have also
addressed some issues regarding the composition and function of the
hematopoietic microenvironment in this malignancy. All the patients
included in this study showed normal hematological parameters in
peripheral blood, both before and after chemotherapy, however,
significant hematopoietic alterations were consistently observed. As
compared to normal subjects, lymphoma patients showed a 35% reduction in
progenitor cell numbers, including myeloid, erythroid and multipotent
progenitors. The in vitro proliferation of these cells was also
deficient, since their levels in long-term marrow cultures were
significantly lower than those observed in normal bone marrow cultures.
Fibroblastic progenitors were reduced by >50% and this correlated with a
deficient adherent cell layer development in culture. A reduction was
also seen in the levels in culture supernatant of the stimulatory
cytokines Stem Cell Factor and Interleukin-6. Interestingly, all the
hematopoietic alterations mentioned above were still present in patients
at complete clinical remission after chemotherapy. Thus, in the present
study we have demonstrated significant in vitro deficiencies in the
composition and function of the hematopoietic system in patients with
diffuse large-cell lymphoma, both during active disease and at the time
of complete clinical remission.
7
UI - 21215925
AU - Doll C; Wulff B; Rossler J; Schaper J; Havers W
TI -
Primary B-cell lymphoma of bone in children.
SO - Eur J Pediatr 2001 Apr;160(4):239-42
AD - Department of Paediatric Haematology, Oncology and Endocrinology,
Universitatsklinikum GH Essen, Zentrum fur Kinderheilkunde,
Hufelandstrasse 55, 45122 Essen, Germany. carsten.doell@uni-essen.de
Primary lymphoma of bone (PLB) is a rare entity of extranodal
non-Hodgkin lymphoma (NHL). We report on two children with PLB focussing
on diagnostic evaluation and treatment strategy. Clinical and
radiographic presentation in both children suggested a primary bone
tumour such as Ewing sarcoma. A 13-year-old girl showed osteolytic
tumours in the right 7th rib and right iliac crest. Additional skeletal
lesions were found by whole-body positron emission tomography. A
6-year-old boy presented with an isolated, osteolytic lesion of the left
distal femur. In both patients staging procedures excluded any organ
involvement besides the skeletal tumours. Tumour biopsy and
immunohistological studies revealed lymphoblastic non-Hodgkin lymphoma
of B-cell lineage in both children. They received a polychemotherapy for
B-cell lymphoma according to the NHL-BFM 95 protocol and are in complete
remission with a follow up of 24 and 18 months respectively. CONCLUSION:
Isolated, primary lymphoma of bone in children may clinically and
radiographically impose as primary bone tumour. Multiple therapeutic
strategies have been applied in the treatment of this malignancy,
however, treatment modalities are not well focussed on immunological
patterns in the case of primary lymphoma of bone. Staging techniques
should include immunophenotyping to initiate specific cell lineage
treatment.
8
UI - 21245393
AU - Anonymous
TI -
Are older lymphoma and breast cancer patients undertreated?
SO - Oncology (Huntingt) 2001 Apr;15(4):406, 436
9
UI - 21340686
AU - Weidmann E; Boehrer S; Chow KU; Engels K; Harder L; Hinz T; Janssen O;
TI -
Kriener S; Rummel MJ; Siebert R; Kabelitz D; Hansmann ML; Hoelzer D;
Mitrou PS; The Study Group Peripheral T- and NK-Cell Neoplasias
Treatment of aggressive, or progressing indolent peripheral T- and
NK-cell neoplasias by combination of fludarabine, cyclophosphamide and
doxorubicine.
SO - Onkologie 2001 Apr;24(2):162-4
AD - Medizinische Klinik III, Universitatsklinik,
Johann-Wolfgang-Goethe-Universitat, Frankfurt/M.
E.Wiedmann@em.uni-frankfurt.de
BACKGROUND: Regarding standardization of treatment, classification, and
pathophysiology of peripheral T- and NK-cell neoplasias the current
knowledge is markedly behind that of B-cell lymphomas, which are
'Peripheral T- and NK-cell Neoplasias' was founded in Frankfurt/M. This
group decided on a clinical protocol and a scientific program for
research on the pathophysiology of these entities. Rationales for the
therapeutic regimen are the efficacy of cyclophosphamide and
doxorubicine as shown in protocols for treatment of high grade lymphoma,
the synergism of cyclophosphamide and fludarabine, and reports
demonstrating the efficacy of fludarabine in T-cell neoplasias. PATIENTS
AND METHODS: Patients will be treated with a combination of fludarabine
(30 mg/m(2) days 1-3), cyclophosphamide (1000 mg/m(2) day 1)
doxorubicine (25 mg/m(2) day 2+3) (FCD). For patients > or =65 years a
dose-reduced FCD regimen will be administered. In patients included in
the treatment study and additionally in patients with indolent disease
not requiring therapy, scientific projects on the biology of peripheral
T- and NK-cell neoplasias will be performed. CONCLUSIONS: Expected
conclusions of the projected study are the establishment of treatment
and diagnostic standards, and improvement of classification of these
entities by clinical, morphologic and biologic parameters. Copyright
2001 S. Karger GmbH, Freiburg
10
UI - 21411445
AU - Huhn D; von Schilling C; Wilhelm M; Ho AD; Hallek M; Kuse R; Knauf W;
TI -
Riedel U; Hinke A; Srock S; Serke S; Peschel C; Emmerich B; German
Chronic Lymphocytic Leukemia Study Group
Rituximab therapy of patients with B-cell chronic lymphocytic leukemia.
SO - Blood 2001 Sep 1;98(5):1326-31
AD - Department of Medicine/Hematology and Oncology, Charite Campus
Virchow-Klinikum, Humboldt Universitat Berlin, Germany.
dieter.parczany@charite.de
Rituximab (IDEC-C2B8) is a chimeric antibody that binds to the B-cell
surface antigen CD20. Rituximab has significant activity in follicular
non-Hodgkin lymphomas. Much less is known about the effects in chronic
lymphocytic leukemia (CLL). We have initiated a phase II trial to
evaluate the efficacy and safety of rituximab in patients with CD20+
pretreated CLL. To avoid the rituximab-associated toxicity, we
restricted the tumor cell load, as measured by the number of circulating
lymphocytes and the spleen size, in the first 2 cohorts of patients
included in the study. Patients received 4 intravenous infusions of 375
mg/m2 once a week over a period of 1 month. Of the 28 patients evaluable
for response, 7 patients showed a partial remission (National Cancer
Institute criteria) lasting for a median of 20 weeks, with 1 patient
still in remission after 71 weeks. Based on lymphocyte counts only, we
found at least a 50% reduction of lymphocyte counts lasting for at least
4 weeks in 13 (45%) of 29 patients. Fifteen patients from 3 institutions
were monitored for the immunophenotype profile of lymphocyte subsets.
The number of CD5+CD20+ cells decreased significantly and remained low
until day 28 after therapy. T-cell counts were not affected. With the
exception of one rituximab-related death, adverse events in the
remaining patients were mild. The results suggest that rituximab has
clinical activity in pretreated patients with B-CLL. Toxicity is
tolerable. Response duration after withdrawal of rituximab is rather
short. Therefore, other modes of application and the combination with
other agents need to be tested.
11
UI - 21411449
AU - Weng WK; Levy R
TI -
Expression of complement inhibitors CD46, CD55, and CD59 on tumor cells
does not predict clinical outcome after rituximab treatment in
follicular non-Hodgkin lymphoma.
SO - Blood 2001 Sep 1;98(5):1352-7
AD - Division of Medical Oncology, Department of Internal Medicine, Stanford
University School of Medicine, CA 94305-5306, USA.
Rituximab is a chimeric monoclonal antibody that targets B-cell-specific
antigen CD20 and an effective treatment for B-cell non-Hodgkin lymphoma.
Although it is readily used in clinical practice, the exact mechanism of
its antitumor effect is unclear. One potential mechanism involves
complement-mediated cytotoxicity. It has been shown that rituximab
induces complement-mediated cytotoxicity in follicular lymphoma cells in
vitro, and complement inhibitors CD55 and CD59 may regulate this
process. To determine whether complement inhibitors play a role in
regulating the antitumor effect of rituximab, the expression of
complement inhibitors CD46, CD55, and CD59 was analyzed in pretreatment
tumor cells from 29 rituximab-treated follicular lymphoma patients.
Among them, 8 patients achieved complete responses, 11 patients achieved
partial responses, and 10 patients showed no or minimal responses to
rituximab treatment. Expression of surface CD20, CD46, CD55, and CD59
was determined by 2-color flow cytometry. Although the CD59 level was
slightly lower in the complete response group, there was no
statistically significant difference in the expression of individual
complement inhibitor CD46 (mean channel fluorescence [MCF]: NR, 26.4;
PR, 21.9; CR, 29.9), CD55 (MCF: NR, 16.4; PR, 14.9; CR, 23.2), or CD59
(MCF: NR, 41.6; PR, 40.6; CR, 30.6), the combination of any 2
inhibitors, or all 3 on tumor cells from 3 response groups. In addition,
there was no difference in the rituximab-induced complement-mediated
cytotoxicity in an in vitro assay using tumor cells from 3 response
groups. Thus, CD46, CD55, and CD59 expression on pretreatment tumor
cells, or their susceptibility to in vitro complement-mediated killing,
does not predict clinical outcome after rituximab treatment.
12
UI - 21427230
AU - DeNardo GL; DeNardo SJ; Kukis DL; O'Donnell RT; Shen S; Mirick GR;
TI -
Meares CF
Metabolite production in patients with lymphoma after radiometal-labeled
antibody administration.
SO - J Nucl Med 2001 Sep;42(9):1324-33
AD - Department of Internal Medicine, University of California Davis Medical
Center, Sacramento, USA.
Radiometal-labeled monoclonal antibodies are retained longer in tumors
than iodinated antibodies, leading to their increased use for
radioimmunotherapy. Dissociation of radioiodine from the antibody during
metabolism has been documented. We now report metabolites in the plasma
of lymphoma patients given 111In- and
90Y-2-iminothiolane-2-[p-(bromoacetamido)benzyl]-1,4,7,10-tetraazacyclod
odecane-N,N',N",N"'-tetraacetic acid-Lym-1 (111In/90Y-2IT-BAD-Lym-1).
METHODS: Nineteen patients with non-Hodgkin's lymphoma (NHL) received
111In- and 90Y-2IT-BAD-Lym-1; 111In was used as a surrogate tracer for
90Y, which emits no gamma-photon. Plasma was obtained up to 7 d and
analyzed by high-performance liquid chromatography to determine the
fraction of radiolabel associated with monomeric antibody, metabolites,
and complexed antibody. Planar images of conjugate views were acquired
up to 7 d and used to quantitate 111In in organs and tumors. RESULTS:
Metabolites and complexes were observed in the plasma of every patient
who received 111In-2IT-BAD-Lym-1. At 3 d, the mean percentages of 111In
in the patients' plasma in monomeric, metabolite, and complexed forms
were 54%, 36%, and 10%, respectively. Metabolites of 90Y-2IT-BAD-Lym-1
were formed to a similar extent. In comparison, in groups of breast and
prostate cancer patients who received the radioimmunoconjugate
111In-2IT-BAD-m170, 91% and 94% of 111In in the patients' plasma were in
monomeric form, respectively. Metabolites and complexes of
111In-2IT-BAD-Lym-1 contributed a mean 10% of the total area under the
time-activity curve (AUC) for blood. Little formation of metabolites and
complexes occurred in vitro in NHL patient or volunteer plasma or in
Raji cell culture. The clinical and in vitro data supported the
processing of 111In/90Y-2IT-BAD-Lym-1 in the hepatocytes as the dominant
mechanism for the production of metabolites. CONCLUSION: Metabolites of
111In/90Y-2IT-BAD-Lym-1 accounted for 10% of blood AUC in patients. The
therapeutic index was adversely affected by metabolism of
111In/90Y-2IT-BAD-Lym-1 to the extent that the tumor specificity of the
radioactive metabolites was lost.
13
UI - 21447302
AU - Ferrer A; Lopez-Guillermo A; Montoto S; Estrach T; Colomo L; Montserrat
TI -
E
Successful treatment of isolated cutaneous relapse of follicular
lymphoma with rituximab.
SO - Ann Hematol 2001 Aug;80(8):479-81
AD - Department of Hematology, Institut d'Investigacions Biomediques August
Pi i Sunyer, Hospital Clinic, Barcelona, Spain. alopezg@clinic.ub.es
Patients with follicular lymphoma (FL) usually present with advanced
disease, with lymph nodes and bone marrow involvement. Extranodal
infiltration is infrequent. In FL isolated cutaneous relapse is a very
rare event that, to the best of our knowledge, has not been previously
reported. We report on a 55-year-old woman with FL who presented with an
isolated skin relapse 5 years after the diagnosis. The patient, who had
relapsed after three lines of chemotherapy, was treated with the
chimeric anti-CD20 antibody, rituximab, achieving a complete response,
which has now persisted for more than 24 months.
14
UI - 21447303
AU - Kawai Y; Ikegaya S; Hata M; Kawahito M; Imamura S; Yoshida A; Tsutani H;
TI -
Ueda T
Successful lamivudine therapy for post-chemotherapeutic fulminant
hepatitis B in a hepatitis B virus carrier with non-Hodgkin's lymphoma:
case report and review of the literature.
SO - Ann Hematol 2001 Aug;80(8):482-4
AD - First Department of Internal Medicine, Fukui Medical University, Japan.
ykawai@fmsrsa.fukui-med.ac.jp
Reactivation of hepatitis B virus (HBV), especially after withdrawal of
corticosteroids is a well-known complication during chemotherapy for
lymphoma. The high mortality makes this complication one of the major
obstacles to completing the standard treatment for lymphoma in HBV
carriers. We report a 58-year-old Japanese male HBV carrier who
developed fulminant hepatitis after chemotherapy with cyclophosphamide
and doxorubicin. Lamivudine was introduced since his hepatitis was
progressive under supportive treatment and showed an elevated level of
HBV DNA. After initiation of lamivudine, HBV DNA decreased to be below
the limit of detection within 3 weeks, and all chemical tests for liver
function recovered to the normal level within 4 weeks, except for a
slight elevation of total-bilirubin. There were no remarkable adverse
effects observed. To the best of our knowledge, six cases of
post-chemotherapeutic fulminant hepatitis including ours have been
treated with lamivudine. A review of these cases indicated that
lamivudine induced a prompt antiviral, biochemical, and clinical
response. Lamivudine is highly recommended for post-chemotherapeutic
fulminant hepatitis caused by reactivation of HBV.
15
UI - 21444016
AU - McCune SL; Gockerman JP; Rizzieri DA
TI -
Monoclonal antibody therapy in the treatment of non-Hodgkin lymphoma.
SO - JAMA 2001 Sep 12;286(10):1149-52
AD - Division of Oncology and Bone Marrow Transplantation, Duke University
Medical Center, 2400 Pratt St, Box 3961 North Pavilion, Durham, NC
27710, USA.
16
UI - 21443828
AU - Koch P; del Valle F; Berdel WE; Willich NA; Reers B; Hiddemann W;
TI -
Grothaus-Pinke B; Reinartz G; Brockmann J; Temmesfeld A; Schmitz R; Rube
C; Probst A; Jaenke G; Bodenstein H; Junker A; Pott C; Schultze J;
Heinecke A; Parwaresch R; Tiemann M; German Multicenter Study Group
Primary gastrointestinal non-Hodgkin's lymphoma: I. Anatomic and
histologic distribution, clinical features, and survival data of 371
patients registered in the German Multicenter Study GIT NHL 01/92.
SO - J Clin Oncol 2001 Sep 15;19(18):3861-73
AD - Department of Medicine, Institute for Medical Informatics and
Biomathematics, Westfalische-Wilhelms-Universitat, Munster, Germany.
prfkoch@aol.com
PURPOSE: The study was initiated to obtain epidemiologic data and
information on anatomic and histologic distribution, clinical features,
and treatment results in patients with primary gastrointestinal
non-Hodgkin's lymphomas (PGI NHL). PATIENTS AND METHODS: Between October
clinical features. Radiotherapy and chemotherapy were stratified
according to histologic grading, stage, and whether surgery had been
carried out or not. RESULTS: A total of 74.8% patients had gastric NHL
(PGL). Within the intestine, the small bowel and the ileocecal region
were involved in 8.6% and 7.0% of the cases, respectively. Multiple GI
involvement (MGI) was 6.5%. Approximately 90% of the GI NHL were in
stages IE/IIE. Aggressive NHL accounted for the majority, with a
distinguishable pattern in several sites. Forty percent of PGL were of
low-grade mucosa-associated lymphatic tissue type. One third of
large-cell lymphomas had low-grade components. Most intestinal NHL were
germinal-center lymphomas. The site of origin was prognostic. In gastric
and ileocecal lymphoma, event-free (EFS) and overall survival (OS) were
significantly higher as compared with the small intestine or MGI (median
time of observation, 51 months). In PGL, localized disease was
prognostic for EFS and OS. Histologic grade influenced only EFS
significantly. Numbers in intestinal lymphomas were too small for
subanalyses. CONCLUSION: PGI NHL are heterogeneous diseases. The number
of localized PGL allowed for detailed analyses. Larger studies are
needed for stages III and IV and for intestinal NHL. A uniform reporting
system for PGI NHL, in terms of definitions and histologic and staging
classifications, is needed to facilitate comparison of treatment
results.
17
UI - 21443829
AU - Koch P; del Valle F; Berdel WE; Willich NA; Reers B; Hiddemann W;
TI -
Grothaus-Pinke B; Reinartz G; Brockmann J; Temmesfeld A; Schmitz R; Rube
C; Probst A; Jaenke G; Bodenstein H; Junker A; Pott C; Schultze J;
Heinecke A; Parwaresch R; Tiemann M; German Multicenter Study Group
Primary gastrointestinal non-Hodgkin's lymphoma: II. Combined surgical
and conservative or conservative management only in localized gastric
lymphoma--results of the prospective German Multicenter Study GIT NHL
01/92.
SO - J Clin Oncol 2001 Sep 15;19(18):3874-83
AD - Department of Medicine, and Institute for Medical Informatics and
Biomathematics, Westfalische-Wilhelms-Universitat, Munster, Germany.
prfkoch@aol.com
PURPOSE: The aim of the study was to obtain data on anatomic and
histologic distribution, clinical features, and treatment results of
patients with primary gastrointestinal non-Hodgkin's lymphomas,
particularly combined surgical and conservative treatment (CSCT) versus
conservative treatment (CT) alone for primary gastric lymphoma (PGL) in
localized stages. PATIENTS AND METHODS: Whether the treatment included
surgery was left to the discretion of each participating center.
Radiotherapy (Rx) and chemotherapy were stratified according to
histologic grading, stage, and the inclusion or omission of surgery as
follows: patients with low-grade PGL were treated with extended-field
(EF) Rx (30 Gy). In case of residual tumor after surgery or in case of
CT only (in stage IIE after six cycles of cyclophosphamide, vincristine,
and prednisone), an additional boost of 10 Gy was given. All patients
with high-grade PGL were treated with four (stage IE) or six (stage IIE)
cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone
followed by EF Rx (stage IE) or involved-field (IF) Rx (stage IIE). Rx
years was 84.4% and was influenced neither by patients' characteristics
nor by stage or histologic grade. Seventy-nine patients had CSCT. Their
SR was 82.0%. Complete resection of the tumor (R0) was prognostic for
the overall survival (P =.0165) as compared with incomplete resection.
CONCLUSION: Although the study was not randomized, a stomach-conserving
approach may be favored.
18
UI - 21455230
AU - Ha CS; Tucker SL; Blanco AI; Wilder RB; McLaughlin P; Cabanillas F; Cox
TI -
JD
Hematologic recovery after central lymphatic irradiation for patients
with stage I-III follicular lymphoma.
SO - Cancer 2001 Sep 1;92(5):1074-9
AD - Department of Radiation Oncology, The University of Texas M. D. Anderson
Cancer Center, Houston, Texas 77030, USA. chulha@mdanderson.org
BACKGROUND: The authors previously reported that central lymphatic
irradiation (CLI) can induce molecular remission in patients with Stage
I-III follicular lymphoma, as measured by polymerase chain reaction
analysis for t(14;18) (q32;q21). Hematologic toxicity has been
considered a major consequence of CLI. This study was undertaken to
analyze the patterns of hematologic recovery after CLI. METHODS:
Thirty-three patients with Stage I-III follicular lymphoma were treated
irradiation to mantle, upper two-thirds of abdomen, and pelvic fields.
Each field was treated to 30.0-30.6 grays (Gy) at 1.5-1.8 Gy per
fraction, with a boost to 36.0-39.6 Gy at the same rate to the sites of
macroscopic disease. A break of approximately 4 weeks was given after
treatment of each field. Twenty-four patients who were followed for a
minimum of 1 year from the end of CLI form the basis of this analysis.
Fourteen patients were male. Three patients had Stage I disease, 6
patients had Stage II disease, and 15 patients had Stage III disease.
The International Prognostic Index (IPI) for malignant lymphoma was 0
for 5 patients, 1 for 13 patients, and 2 for 6 patients. The Eastern
Cooperative Oncology Group performance status was 0 for 21 patients and
1 for 3 patients. The median values for their pretreatment
characteristics were as follows: age, 60 years (range, 34-73 years);
height, 173 cm (range, 155-193 cm); weight, 79 kg (range, 57-107 kg);
body surface area (BSA), 1.95 m(2) (range, 1.61-2.31 m(2)); bone marrow
cellularity, 27%(range, 2-75%), platelet count, 233,000/mm(3) (range,
139,000-339,000/mm(3)), white blood cell (WBC) counts, 6400/mm(3)
(range, 4200-10,900/mm(3)); and hemoglobin, 14.5 mg/dL (range, 11.8
-16.6 mg/dL). The median duration of CLI was 159 days (range, 137-345
days). Ten patients had cardiovascular disease. The number of sites
receiving a boost dose of > or = 36.0 Gy was 0 sites in 1 patient, 1
site in 6 patients, 2 sites in 11 patients, 3 sites in 5 patients, and 4
sites in 1 patient. The platelet, hemoglobin, and WBC counts were
followed every 3 months after completion of CLI. These counts were
normalized to the pretreatment counts for statistical analyses.
Univariate and multivariate analyses were performed to investigate the
correlations between patient factors and hematologic status at 1 year
posttreatment. Pearson correlation analysis was used for the continuous
factors (patient age, height, weight, BSA, bone marrow cellularity, and
duration of CLI), and the Mann-Whitney test was used for categoric
factors (IPI, gender, performance status, stage, number of sites
receiving > or = 36.0 Gy, and presence or absence of cardiovascular
disease). RESULTS: There was continued recovery, essentially approaching
the pretreatment levels, over 3 years for platelet, WBC, and hemoglobin
counts. Factors that were associated significantly with normalized
platelet counts at 1 year by univariate analyses were age (P = 0.015)
and cardiovascular disease (P = 0.041). Age was the only significant
factor by multivariate analyses, with older patients having lower
platelet counts at 1 year posttreatment. No factors were found that were
associated significantly with 1-year normalized WBC or hemoglobin levels
by either univariate or multivariate analyses. CONCLUSIONS: All three of
the hematologic components (platelets, WBC, and hemoglobin) essentially
recover after patients undergo CLI over a 3-year period. Older age was
the only significant adverse factor that affected the platelet recovery,
as detected by multivariate analysis. (c) 2001 American Cancer Society.
19
UI - 21468607
AU - Limat S; Woronoff-Lemsi MC; Milpied N; Chartrin I; Ifrah N; Deconinck E;
TI -
Gressin R; Colombat P; Cahn JY; Arveux P; The Groupe Ouest Est d'etude
des Leucemies et Autres Maladies du Sang (GOELAMS)
Effect of cell determinant (CD)34+ cell dose on the cost and
consequences of peripheral blood stem cell transplantation for
non-Hodgkin's lymphoma patients in front-line therapy.
SO - Eur J Cancer 2000 Dec;36(18):2360-7
AD - Department of Pharmacy, Besancon University Hospital, France.
The aim of this study was to assess the effect of cell determinant
(CD)34+ cell dose on the cost and consequences of peripheral blood stem
cell transplantation for non-Hodgkin's lymphoma (NHL) patients in
front-line therapy. Resource utilisation, length of aplasia, overall
(OS) and event-free survival (EFS) were assessed for 63 patients.
Economic data were calculated taking into account harvest,
hospitalisation, blood product requirements and drugs required until
discharge. The point of view of the Hospital Institution was chosen. A
significantly earlier haematopoietic engraftment was achieved in
patients with a count of more than 5 x 10(6) CD34+/kg. There were no
differences for OS and EFS. A high CD34+ cell content resulted in a
total cost saving of $4210. This was principally related to a
significant reduction in the length of hospitalisation (-$3010) and
platelet and red blood cell transfusions (-$815), although the latter
was not significant. Several sensitivity analyses showed the robustness
of our results. A CD34+ cell dose higher than 5 x 10(6)/kg appeared to
be optimal for clinical and economic considerations in NHL patients
undergoing transplantation in front-line therapy.
20
UI - 21170449
AU - Bell TJ
TI -
T-cell lymphoma products.
SO - Nurse Pract 2001 Mar;26(3):19
21
UI - 21259468
AU - Blystad AK; Enblad G; Kvaloy S; Berglund A; Delabie J; Holte H; Carlson
TI -
K; Kvalheim G; Bengtsson M; Hagberg H
High-dose therapy with autologous stem cell transplantation in patients
with peripheral T cell lymphomas.
SO - Bone Marrow Transplant 2001 Apr;27(7):711-6
AD - Department of Oncology and Pathology, The Norwegian Radium Hospital,
0310 Oslo, Norway.
Peripheral T cell lymphomas (PTCL) have a poorer prognosis after
conventional treatment than do high-grade B cell lymphomas. The place
for high-dose therapy (HDT) with autologous stem cell support in these
patients is still not clear. Forty patients, 10 women and 30 men, median
age 41.5 years (range 16-61) with PTCL were treated with HDT and
autologous stem cell support at The Norwegian Radium Hospital, Oslo,
Norway and The University Hospital, Uppsala, Sweden, between February
20 patients; intestinal, two patients; angioimmunoblastic (AILD), two
patients; angiocentric, two patients and anaplastic large cell lymphoma
(ALCL), 14 patients. All patients had chemosensitive disease and had
received anthracycline-containing regimens prior to transplantation. At
the time of HDT, 17 patients were in first PR or CR and 23 were in
second or third PR or CR. Conditioning regimens were BEAM in 15
patients, BEAC in 14 patients, cyclophosphamide and total body
irradiation (TBI) in eight patients, BEAC, without etoposide and TBI in
one patient and mitoxantrone and melphalan in two patients. There were
three (7.5%) treatment-related deaths. The estimated overall survival
(OS) at 3 years was 58%, the event-free survival (EFS) 48% and the
relapse-free survival (RFS) 56%, with a median follow-up of 36 months
(range 7-100) for surviving patients. The patients with ALCL tended to
have a better prognosis compared to those with other PTCL subtypes, OS
79% vs 44%, respectively. In conclusion, patients with chemosensitive
PTCL who are failing to achieve CR with first-line chemotherapy or are
in relapse can successfully be treated with HDT and autologous stem cell
support.
22
UI - 21381292
AU - Feldman RA
TI -
Review article: would eradication of Helicobacter pylori infection
reduce the risk of gastric cancer?
SO - Aliment Pharmacol Ther 2001 Jun;15 Suppl 1():2-5
AD - The Royal London Hospital, Whitechapel Road, London E1 1BB, UK.
feldman@qmw.ac.uk
This article reviews the data on the epidemiology of gastric cancer, to
determine if treatment of an asymptomatic individual can be justified.
It reviews retrospective and prospective case-control studies of gastric
cancer in Italy and other countries. Mucosa-associated lymphoid tissue
lymphoma is associated with Helicobacter pylori infection. The risk of
noncardia gastric cancer is higher (4-fold or greater) in those with H.
pylori infection. Although no studies have shown prevention following
treatment, eradication of asymptomatic H. pylori infection in an
individual in the age group 40 or lower may be expected to reduce the
risk of gastric cancer.
23
UI - 21400390
AU - Demirkazik A; Kessinger A; Armitage JO; Bierman PJ; Lynch J; Vose J;
TI -
Chan W; Sharp JG
Progenitor and lymphoma cells in blood stem cell harvests: impact on
survival following transplantation.
SO - Bone Marrow Transplant 2001 Jul;28(2):207-12
AD - Medical Oncology Section, Department of Internal Medicine, School of
Medicine, University of Ankara, Ankara, Turkey.
This study evaluated whether cytokine-induced blood stem cell
mobilization also mobilized lymphoma cells and whether lymphoma cell
mobilization affected outcome post autologous blood stem cell
transplant. Blood stem cell collections from 26 non-Hodgkin's lymphoma
(NHL) patients harvested during steady-state (non-mobilized) and from 35
NHL patients harvested after cytokine administration (mobilized) were
studied. The harvests were cultured and molecularly evaluated for clonal
markers of the primary lymphoma. All patients underwent high-dose
chemotherapy and autologous transplantation. Graft products from
mobilized patients were more likely to contain lymphoma than graft
products from non-mobilized patients (37% vs 19%) but this difference
was not significant (P = 0.16). In a multivariate analysis, lymphoma
contamination was not associated with patient age, gender, tumor grade,
prior radiotherapy, duration of prior chemotherapy, mononuclear cell
count, or the number of aphereses performed to obtain the product.
Heavily pre-treated patients were less likely to have
lymphoma-contaminated harvests (P = 0.064). Lymphoma contamination was
positively associated with the number of progenitor cells collected (P =
0.047). In multivariate analyses, the only significant independent
predictor of lymphoma contamination was the number of mononuclear cells
collected (P = 0.031). Lymphoma contamination of transplanted apheresis
products had no apparent impact on event-free and overall survival.
24
UI - 21437196
AU - Olavarria E; Child F; Woolford A; Whittaker SJ; Davis JG; McDonald C;
TI -
Chilcott S; Spittle M; Grieve RJ; Stewart S; Apperley JF; Russell-Jones
R
T-cell depletion and autologous stem cell transplantation in the
management of tumour stage mycosis fungoides with peripheral blood
involvement.
SO - Br J Haematol 2001 Sep;114(3):624-31
AD - Department of Haematology, Hammersmith Hospital, ICSM, London, UK.
e.olavarria@ic.ac.uk
Nine patients with tumour stage mycosis fungoides (MF) have been entered
into a pilot study of T-cell depletion and autologous stem cell
transplantation (SCT). Eight patients had detectable rearrangements of
the T-cell receptor (TCR) gamma-gene demonstrated by polymerase chain
reaction (PCR)/single-stranded conformation polymorphism (SSCP) in the
peripheral blood. The median age was 47 years and the median duration of
disease before SCT was 61 months; Peripheral blood progenitor cells were
mobilized using high-dose etoposide (1.6 g/m2) and granulocyte
colony-stimulating factor (G-CSF). The apheresis products underwent
rigorous T-cell depletion with immunomagnetic methods. Double
CD34-positive and CD4/CD8-negative selection achieved a median reduction
of 3.89 log of T cells. All nine patients have been transplanted.
Conditioning included carmustine (BCNU), etoposide and melphalan (BEM)
in seven patients and total body irradiation plus etoposide or melphalan
in two. Eight patients engrafted promptly and one patient died of
septicaemia. All survivors entered complete remission. Seven patients
have relapsed at a median of 7 months (2-14) post SCT. However, most
patients have relapsed into a less aggressive stage, which has responded
to conventional therapy. Four out of seven evaluable patients had
detectable TCR rearrangements in the T-cell depleted graft. A T-cell
clone was also detected in the peripheral blood before relapse in four
cases. Autologous SCT is feasible, safe and can result in complete
remission in a significant proportion of patients with tumour stage
mycosis fungoides. Despite a short relapse-free survival, most patients
achieved good disease control at the time of relapse.
25
UI - 21463145
AU - Cheson BD
TI -
Some like it hot!
SO - J Clin Oncol 2001 Oct 1;19(19):3908-11
26
UI - 21463147
AU - Kaminski MS; Zelenetz AD; Press OW; Saleh M; Leonard J; Fehrenbacher L;
TI -
Lister TA; Stagg RJ; Tidmarsh GF; Kroll S; Wahl RL; Knox SJ; Vose JM
Pivotal study of iodine I 131 tositumomab for chemotherapy-refractory
low-grade or transformed low-grade B-cell non-Hodgkin's lymphomas.
SO - J Clin Oncol 2001 Oct 1;19(19):3918-28
AD - University of Michigan Medical Center, Ann Arbor, MI 48109-0936, USA.
mkaminsk@umich.edu
PURPOSE: To evaluate the efficacy and safety of tositumomab and iodine I
131 tositumomab (Bexxar; Corixa Corp, Seattle, WA, and GlaxoSmithKline,
Philadelphia, PA) in patients with chemotherapy-refractory low-grade or
transformed low-grade non-Hodgkin's lymphoma (NHL) and to compare its
efficacy to the patients' last qualifying chemotherapy (LQC) regimens.
PATIENTS AND METHODS: Sixty patients who had been treated with at least
two protocol-specified qualifying chemotherapy regimens and had not
responded or progressed within 6 months after their LQC were treated
with a single course of iodine I 131 tositumomab. RESULTS: Patients had
received a median of four prior chemotherapy regimens. A partial or
complete response (CR) was observed in 39 patients (65%) after iodine I
131 tositumomab, compared with 17 patients (28%) after their LQC (P
<.001). The median duration of response (MDR) was 6.5 months after
iodine I 131 tositumomab, compared with 3.4 months after the LQC (P
<.001). Two patients (3%) had a CR after their LQC, compared with 12
(20%) after iodine I 131 tositumomab (P <.001). The MDR for CR was 6.1
months after the LQC and had not been reached with follow-up of more
than 47 months after iodine I 131 tositumomab. An independent review
panel verified that 32 (74%) of the 43 patients with nonequivalent
durations of response (> 30 days difference) had a longer duration of
response after iodine I 131 tositumomab (P <.001). Only one patient was
hospitalized for neutropenic fever. Five patients (8%) developed human
antimurine antibodies, and one (2%) developed an elevated TSH level
after treatment. Myelodysplasia was diagnosed in four patients in
follow-up. CONCLUSION: A single course of iodine I 131 tositumomab was
significantly more efficacious than the LQC received by extensively
pretreated patients with chemotherapy-refractory, low-grade, or
transformed low-grade NHL and had an acceptable safety profile.
27
UI - 21471005
AU - Tobinai K
TI -
Clinical trials of a mouse-human chimeric anti-CD20 monoclonal antibody
(rituximab) for B cell non-Hodgkin's lymphoma in Japan.
SO - Cancer Chemother Pharmacol 2001 Aug;48 Suppl 1():S85-90
AD - Hematology Division, National Cancer Center Hospital, Tokyo, Japan.
ktobinai@ncc.go.jp
Rituximab, a mouse-human chimeric anti-CD20 monoclonal antibody, induces
apoptosis in B cell non-Hodgkin's lymphoma (B-NHL) cells, in addition to
lysis by complement-dependent cytotoxicity and antibody-dependent
cell-mediated cytotoxicity. A group of 12 patients with relapsed CD20+
B-NHL were enrolled in a phase I study; 4 received rituximab 250 mg/m2
and 8 375 mg/m2 once weekly for 4 weeks. Grade 1 or 2 infusion-related
toxicity such as 'flu-like symptoms and skin reactions were observed. Of
the 11 patients eligible for study enrollment, 2 achieved a complete
response (CR) and 5 a partial response (PR). The T 1/2 of rituximab was
445+/-361 h, and serum rituximab levels were measurable at 3 months.
Thereafter, 90 relapsed patients with indolent B-NHL or mantle cell
lymphoma (MCL) were enrolled in a phase II study and received rituximab
375 mg/m2x4 weekly infusions. A central pathology review and an
extramural review disclosed that 13 patients were ineligible for final
analysis. Factors affecting response and progression-free survival (PFS)
were analyzed in the remaining 77 patients. The overall response rate
(ORR) in indolent B-NHL and MCL was 61% (37/ 61, 95% CI 47-73%) and 46%
(6/13, 95% CI 19-75%), respectively. The median PFS time was 245 days in
indolent B-NHL and 111 days in MCL patients. Multivariate analysis
revealed that the ORR was affected by the number of prior regimens
(P=0.018) and that the PFS was affected by the following three factors:
disease type (P = 0.000), presence of extranodal lesions (P=0.001). and
number of prior regimens (P=0.007). The PFS times of patients with
higher serum rituximab concentrations at day 14 (> or =70
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