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Abramson Cancer CenterNCI CANCERLIT® Search: Therapy of Non-Hodgkin's Lymphoma - May 2002
National Cancer Institute®
Last Modified: May 1, 2002
Table of Contents
1
UI - 11953804
AU - Anonymous
TI -
Minimum standard of care defined for HIV patients with cancer.
SO - Bull World Health Organ 2002;80(2):176
2
UI - 11935301
AU - Sayer HG; Will U; Schilling K; Vogt T; Wollina K; Hoffken K
TI -
Hepatic veno-occlusive disease (VOD) with complete occlusion of liver
venules after tandem autologous stem cell transplantation-- successful
treatment with high-dose methylprednisolone and defibrotide.
SO - J Cancer Res Clin Oncol 2002 Mar;128(3):148-52
AD - Klinik und Poliklinik fur Innere Medizin II (Hamatologie, Onkologie,
Endokrinologie und Stoffwechselerkrankungen) der
Friedrich-Schiller-Universitat Jena, Erlanger Allee 101, 07740 Jena,
Germany. Herbert.Sayer@med.uni-jena.de
Veno-occlusive disease (VOD) is a life-threatening complication
following allogeneic or autologous stem cell transplantation. We report
on a patient with a high grade B-cell lymphoma who presented 28 days
after the second autologous stem cell transplantation with weight gain,
ascites, hyperbilirubinemia, and liver venules occlusion as demonstrated
by sonography. Starting with high-dose methylprednisolone treatment
followed by defibrotide maintenance therapy the patient showed dramatic
complete response of VOD, resulting in a normal sonography of the liver
and normalization of laboratory values. The response of the occlusion of
nearly all liver venules underlines the value of anti-inflammatory
treatment combined with new thrombolytic medication such as defibrotide
for the treatment of severe VOD.
3
UI - 11935303
AU - Bonnekoh B; Schulz M; Franke I; Gollnick H
TI -
Complete remission of a primary cutaneous B-cell lymphoma of the lower
leg by first-line monotherapy with the CD20-antibody rituximab.
SO - J Cancer Res Clin Oncol 2002 Mar;128(3):161-6
AD - Department of Dermatology and Venereology, Otto-von-Guericke-University,
Leipziger Strasse 44, 39120 Magdeburg, Germany.
bernd.bonnekoh@medizin.uni-magdeburg.de
BACKGROUND: Rituximab is a genetically engineered antibody recognizing
the CD20 antigen known to be expressed by more than 95% of B-cell
lymphomas. Recently the antibody has been approved for routine
administration in primary extracutaneous, treatment-refractory or
relapsed low-grade, follicular non-Hodgkin B-cell lymphomas. With regard
to the pathogenetically related primary cutaneous lymphomas, the
so-called large B-cell lymphoma of the leg represents a distinct, but
rare subentity. In an 89-year-old, multimorbid patient who was affected
by such a non-resectable CD20+ large B-cell lymphoma limited to the skin
of both lower legs, rituximab was used as a first-line monotherapy in
order to avoid local or systemic toxicities inevitably linked to
conventional treatment modalities, i.e., radio- or chemotherapy.
METHODS: Rituximab was administered at a dosage of 375 mg/m(2) i.v.
eight times in weekly intervals. As a premedication we used prednisolone
150 mg i.v. as well as loratadine 10 mg p.o. 1 h before each rituximab
infusion. RESULTS: The treatment was well tolerated without any adverse
reactions, but was accompanied by a mild transient blood eosinophilia.
The histologically proven, exophytic, multi-nodular lymphoma showed a
substantial regression already at 2 weeks after the onset of the
rituximab treatment. At 8 weeks we observed a complete clinical
remission which is now stabile for a follow-up period of 6 months
without any maintenance therapy. CONCLUSIONS: Our case observation
demonstrates that an intensified, i.e. eightfold, rituximab application
in weekly intervals may be a highly effective, tumor target
cell-specific first-line monotherapy in the management of primary
cutaneous large B-cell lymphoma of the leg. Given the rareness of the
disease, the result as well as the possible contribution of the
prednisolone premedication will have to be evaluated in a future,
controlled, multi-centre study.
4
UI - 11960338
AU - Cairo MS; Krailo MD; Morse M; Hutchinson RJ; Harris RE; Kjeldsberg CR;
TI -
Kadin ME; Radel E; Steinherz LJ; Morris E; Finlay JL; Meadows AT
Long-term follow-up of short intensive multiagent chemotherapy without
high-dose methotrexate ('Orange') in children with advanced
non-lymphoblastic non-Hodgkin's lymphoma: a children's cancer group
report.
SO - Leukemia 2002 Apr;16(4):594-600
AD - Children's Hospital of New York, Columbia University, New York, NY, USA.
Despite prolonged therapy (18 months), children with advanced
non-lymphoblastic, non-Hodgkin's lymphoma (NHL) treated on previous
Children's Cancer Group (CCG) trials achieved less than a 60% 5-year
event-free survival (EFS). In this study we piloted a shorter but more
intensive protocol ('Orange') to determine the feasibility, safety, and
efficacy of this alternative treatment approach. Thirty-nine children
received a CHOP-based induction, etoposide/ifosfamide consolidation,
DECAL (dexamethasone, etoposide, cisplatin, cytosine arabinoside (Ara-C)
and L-asparaginase) intensification, and either one or two similar but
less intense maintenance courses. Patients were stratified to
standard-risk (5 months) vs high-risk (7 months) treatment. High risk
was defined as either bone marrow disease, CNS disease, mediastinal mass
> or = one-third thoracic diameter at T5 and/or LDH > or =2 times
institutional upper limits of normal. All other patients were considered
to be standard risk. Results were compared with the previous CCG NHL
study (CCG-503). Sixteen and 23 patients were considered standard- vs.
high-risk, respectively. The 5-year EFS and overall survival (OS) were
77 +/- 7% and 80 +/- 7%, respectively. The 5-year EFS and OS were
significantly better in the standard- vs. high-risk subgroups (100% vs.
61 +/- 11%) (P < 0.003) and (100% vs. 65 +/- 11%) (P < 0.01),
respectively. Lactate dehydrogenase (LDH) > or =2 x normal (NL) was
associated with significantly poorer outcomes (LDH > or =2 x NL vs. <2 x
NL) (5-year EFS: 55 +/- 12% vs. 100%) (P < 0.0004). This CCG hybrid
regimen, 'Orange', of short and more intensive therapy resulted in a
significant improvement in outcomes compared with the previous CCG trial
of more prolonged but less intense therapy. This regimen that deletes
high-dose methotrexate, if confirmed in a larger trial, could be
considered as an alternative treatment approach in children without high
tumor burdens (LDH <2 x NL) and Murphy stage III disease.
5
UI - 11520778
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.
6
UI - 11858975
AU - Raemaekers J; Kluin-Nelemans H; Teodorovic I; Meerwaldt C; Noordijk E;
TI -
Thomas J; Glabbeke M; Henry-Amar M; Carde P
The achievements of the EORTC Lymphoma Group. European Organisation for
Research and Treatment of Cancer.
SO - Eur J Cancer 2002 Mar;38 Suppl 4():S107-13
AD - Deptartment of Hematology, University Medical Centre Nijmegen, PO Box
9101, 6500 HB, Nijmegen, The Netherlands. j.raemaekers@hemat.azn.nl
From 1964 onwards, the EORTC Lymphoma Group has conducted seven
consecutive randomised phase 3 trials on early stage Hodgkin's lymphoma
aiming at increasing efficacy, while decreasing short- and long-term
toxicity. Staging laparotomy is definitely abandoned and replaced by
identification of prognostic subgroups based on pretreatment clinical
characteristics. Event-free and overall survival significantly improved
from about 50 and then 70%, in the early years, to over 80 and then 90%
more recently. Radiotherapy fields have become more restricted, whereas
chemotherapy has become standard. Longitudinal quality-of-life
assessment has become an integral part of our studies. In advanced
stages, overall outcome has improved as well with 6-year survival rates
of over 80%. In aggressive types of NHL, the second generation
chemotherapy schedule CHVmP-BV was superior to CHVmP. We could not show
any advantage for intensification of upfront treatment with autologous
stem cell transplantation.
7
UI - 11979748
AU - Ohno H; Ishikawa T; Kitajima H; Nomura S; Suzuki T; Konishi H; Ohno Y;
TI -
Onishi R; Konaka Y; Arima N; Doi S; Nasu K; Takahashi T; Tsudo M;
Fukuhara S; Uchiyama T
[Significance of soluble interleukin-2 receptor alpha chain in the
management of patients with malignant lymphoma: a multi-center study]
SO - Rinsho Ketsueki 2002 Mar;43(3):170-5
AD - First Division, Department of Internal Medicine, Faculty of Medicine,
Kyoto University, Kyoto.
A multi-center series of 117 patients with malignant lymphoma were
analyzed to evaluate the clinical significance of soluble interleukin-2
receptor alpha chain (sIL-2R alpha). The initial levels of sIL-2R alpha
ranged from 277 U/ml to 22,800 U/ml with a mean level of 3,451 +/- 4,268
U/ml and a median level of 1,600 U/ml. The sIL-2R alpha levels of the
diffuse lymphoma/intermediate-grade subtypes defined by the LSG
classification/Working Formulation were higher than those of the
follicular lymphoma/low-grade subtypes. There was a tendency for B-cell
lymphomas to show higher sIL-2R alpha levels than T-cell lymphomas. The
sIL-2R alpha level was correlated with the Ann Arbor clinical stage (I,
II versus III, IV), presence or absence of B symptoms, and performance
status (0, 1 versus 2, 3, 4) of the patients. The sIL-2R alpha levels
were in good accordance with the four risk groups defined by the
International Prognostic Indices. Of 21 patients whose tumor burden was
serially measured, the coefficients of correlation between sIL-2R alpha
and tumor mass were > 0.6 in 18 cases. Sixty-two patients achieved
complete remission (CR) during the study; the initial and minimum sIL-2R
alpha levels were lower than those of the non-CR patients. This study
confirmed that sIL-2R alpha is a convenient and useful marker in the
management of malignant lymphoma.
8
UI - 11792410
AU - Murohashi I; Kashimura T; Tominaga K; Wakao D; Takahashi T; Akiba M;
TI -
Kishimoto K; Yoshida K; Yagasaki F; Itoh Y; Sakata T; Kawai N; Itoh K;
Suzuki T; Matsuda A; Hirashima K; Bessho M
Efficacy of carboplatin with an MEP (mitoxantrone, etoposide and
prednisone) regimen for relapsed and CHOP-resistant diffuse large B-cell
lymphomas.
SO - Leuk Res 2002 Mar;26(3):229-34
AD - First Department of Internal Medicine, Saitama Medical School, Morohongo
38, Moroyama-machi, Iruma-gun, Saitama 350-0451, Japan.
murohashi-ikuo@spu.ac.jp
Mitoxantrone, etoposide and prednisone (MEP)-based regimens using
granulocyte colony-stimulating factor (G-CSF) were designed for relapsed
and CHOP-resistant diffuse large B-cell lymphomas in a single
institution, and the therapeutic effects and adverse reactions were
studied. In a total of 49 patients, the MEP regimen had a 41% (9/22)
overall response rate compared with 48% (13/27) for the MEP plus
carboplatin (C-MEP) regimen (Chi-squared test, P=0.602). Among 38
CHOP-resistant patients, however, the overall response rate to C-MEP
[42% (10/24)] was significantly superior compared with MEP [7% (1/14)]
(P=0.023), and the overall survival to C-MEP was superior compared with
MEP (P=0.088). Taken together, our results, although non-randomized,
suggest that a combination of MEP with carboplatin is better than MEP
alone in CHOP-resistant diffuse large B-cell lymphomas.
9
UI - 11798962
AU - Yong W; Zheng W; Zhang Y
TI -
[Clinical characteristics and treatment of midline nasal and nasal type
NK/T cell lymphoma]
SO - Zhonghua Yi Xue Za Zhi 2001 Jul 10;81(13):773-5
AD - Clinical Oncology School, Peking University, Beijing 100036, China.
OBJECTIVE: To study the clinical characteristics and treatment of
midline nasal and nasal type T/Nk cell non-Hodgkin lymphoma. METHODS: A
retrospective study was made on the clinical characteristics, treatment,
short-term effect, and two-year survival rate of 37 patients with
midline nasal and nasal type T/NK non-Hodgkin lymphoma. RESULTS: All of
the patients were primarily treated with 2 cycles of CHOP chemotherapy.
Ten of them were with good effect (common group). Then they were given 6
cycles of chemotherapy followed by focal radiotherapy and reached
complete remission (CM). The other 27 patients failed to reach partial
remission (PM) or even with their condition worsened after 2 cycles of
CHOP regimen and were included into the refractory group. Fourteen of
them received L-asparaginase-based salvage chemotherapy followed by
focal radiotherapy (L-ASP group), and salvage therapy without L-ASP and
followed by focal radiotherapy was given to the other 13 patients
(non-L-ASP group). Continuous fever, angioinvasive growth and necrotic
lesion could not be found among the patients in the common group. Their
international prognostic indexes (IPI) were 0 approximately 1. Seventy
percent of them were at the stages I or II. Continuous fever,
angioinvasive growth and necrotic lesion could be found in the patients
in refractory group. The IPIs among 85% of them were > 2, and 82% of
them were at the stages III and IV. The CR rate was 46% for all patients
as a whole, 100% for the common group, 26% for the refractory group (P <
0.005); and was 50% for the L-ASP group and 0% for the non-L-ASP group
(P < 0.005). The 2-year survival rate was 43% for all patients as a
whole, 100% for the common group, 20% for the refractory group (P <
0.005); and was 50.8% for the L-ASP group and 0% for the non-L-ASP group
(P < 0.005). CONCLUSION: Patients with midline nasal and nasal type T/NK
non-Hodgkin lymphoma can be treated primarily by CHOP regimen and local
radiotherapy. Refractory patients can be treated by salvage therapy
based on L-ASP chemotherapy with a rather good effect. The clinical
characteristics of most of the refractory patients include continuous
fever, angioinvasive growth, necrotic lesion, being at stage III and IV,
and with an IPI > 2.
10
UI - 11762412
AU - Grillo-Lopez AJ; Dallaire BK; McClure A; Weaver R; Varns C; Wei A; Allen
TI -
R; Lee D; Shen D; Leonard J; Multani P; White CA
Monoclonal antibodies: a new era in the treatment of non-Hodgkin's
lymphoma.
SO - Curr Pharm Biotechnol 2001 Dec;2(4):301-11
AD - IDEC Pharmaceuticals Corporation, San Diego, California, USA.
agrillo@aol.com
Monoclonal antibodies (MAbs) have been used as therapeutic agents for
many years. In 1997, Rituxan (IDEC-C2B8, rituximab, MabThera) became the
first MAb to be approved by the FDA for a cancer indication. Rituxan
served to heighten interest in the therapeutic applications of MAbs.
Herceptin (for patients with breast cancer) and Mylotarg (for patients
with acute myeloid leukemia) were approved shortly thereafter. Literally
dozens of antibodies are currently under investigation for a variety of
malignant and non-neoplastic indications. Rituxan is effective in
patients with low-grade or follicular, relapsed or refractory
non-Hodgkin's lymphoma (NHL). The response rate and time to progression
(responders) are in the 50% and 13 months range, respectively. It is
also active in intermediate-grade NHL where a large randomized study, in
combination with CHOP chemotherapy, has shown a statistically
significant increase in complete response (CR) rate (75% vs. 60%),
prolongation of 1 year event-free survival (69% vs. 49%) and of overall
survival (83% vs. 68%) as compared to CHOP alone. This marks the first
time that any agent has shown results superior to CHOP, the curative
gold standard for this type of NHL. Other promising antibodies under
clinical investigation include: Hu1D10; Anti CD19, 22, 52, and anti-Id
antibodies. The safety profile, clinical activity, and mechanism of
action of these MAbs make them ideal candidates for combination with
chemotherapy or biologicals. Over the next few years, we will see very
significant therapeutic advances emerge as this important research
yields additional clinical results.
11
UI - 11915614
AU - Ses E; N'dri Oka D; Varlet G; Koffi K; Boni NR; Ba Zeze V
TI -
[Medullary compression by Burkitt lymphoma. Analysis of 7 cases]
SO - Neurochirurgie 2001 Dec;47(6):552-6
AD - Service de Reeducation Fonctionnelle, CHU de Yopougon, 21 BP 632,
Abidjan 21, Republique de Cote d'Ivoire.
OBJECTIVES: Burkitt's lymphoma is one of the possible cause of spinal
cord compression. We defined the surgical approach in this rare
localization of Burkitt's lymphoma. PATIENTS AND METHODS: We report 7
cases of spinal cord compression secondary to Burkitt's lymphoma treated
RESULTS: Mean age of the patients was 15.4 years, range 8 to 28 years.
Five of the 7 patients were children. Surgery was both a diagnostic and
therapeutic emergency in this rare but serious localization of Burkitt's
disease, which remains highly chemosensitive. CONCLUSION: Surgical
management is warranted if Burkitt's lymphoma is revealed by spinal cord
compression or if there is a primary spinal epidural localization.
12
UI - 11915616
AU - Dufour H; Diaz A; Metellus P; Fuentes S; Chinot O; Figarella-Branger D;
TI -
Grisoli F
[Burkitt lymphoma of the cavernous sinus. Apropos of a case]
SO - Neurochirurgie 2001 Dec;47(6):564-7
AD - Service de Neurochirurgie, CHU-Hopital de la Timone Adultes, rue
Saint-Pierre, 13385 Marseille. hdufour@ap-hm.fr
Cavernous sinus lymphoma is a rare occurrence. We report a case of a
37-year-old woman who was admitted for an oculo-motor paresis and
retro-orbital pain. CT scan and MRI disclosed a cavernous sinus tumor. A
surgical biopsy was performed through a pterional approach and the
histological diagnosis was a solitary primary Burkitt's lymphoma.
Aggressive chemotherapy led to a complete and asymptomatic remission
after a follow-up of 9 years. The mechanism of the primary localization
in the cavernous sinus is discussed.
13
UI - 11759074
AU - Dinndorf P; Krailo M; Liu-Mares W; Frierdich S; Sondel P; Reaman G
TI -
Phase I trial of anti-B4-blocked ricin in pediatric patients with
leukemia and lymphoma.
SO - J Immunother 2001 Nov-Dec;24(6):511-6
AD - Children's National Medical Center, Washington DC, USA.
Monoclonal antibodies, specific for antigens expressed on lymphoid
malignancies, which have been conjugated to toxins such as ricin, hold
promise in the therapy of childhood leukemia and lymphoma.
Anti-B4-blocked ricin (anti-B4-bR) is such an agent, and a phase I study
of this agent was conducted in children with relapsed or refractory
B-lineage leukemia and lymphoma. Anti-B4-bR was given as two 7-day
continuous infusions separated by 7 days. Twenty patients were enrolled
and 19 received the drug. Two dosage levels (30 and 40 microg/kg per
day) were evaluated. Forty micrograms per kilogram per day was the
maximally tolerated dose. Dose-limiting toxicity was capillary leak
syndrome. Grade 3 reversible elevation in transaminases was also
encountered. Human antimouse antibodies or human antiricin antibodies
were detected in five patients. No complete remissions or partial
remissions were seen.
14
UI - 11979093
AU - Abruzzo LV; Rosales CM; Medeiros LJ; Vega F; Luthra R; Manning JT;
TI -
Keating MJ; Jones D
Epstein-Barr virus-positive B-cell lymphoproliferative disorders arising
in immunodeficient patients previously treated with fludarabine for
low-grade B-cell neoplasms.
SO - Am J Surg Pathol 2002 May;26(5):630-6
AD - Department of Hematopathology, University of Texas M.D. Anderson Cancer
Center, Houston, Texas 77030, USA. labruzzo@mdanderson.org
We describe five patients with treated low-grade B-cell neoplasms who
subsequently developed Epstein-Barr virus (EBV)-positive B-cell
lymphoproliferative disorders (BLPDs). The low-grade B-cell neoplasms
were B-cell chronic lymphocytic leukemia in four patients and splenic
marginal zone lymphoma in one patient. All patients had received
treatment with fludarabine for the low-grade B-cell neoplasm, and three
had also received Campath-1H. The EBV-BLPDs arose 2-12 months after
completion of fludarabine therapy and morphologically resembled the
EBV-BLPDs that occur in the setting of iatrogenic immunodeficiency.
Molecular genetic studies showed that these lesions were clonally
distinct from the low-grade B-cell neoplasm in three of four cases
assessed. Two patients did not receive therapy for the EBV-BLPD. The
lesions regressed spontaneously in both patients but recurred in one.
One patient underwent surgical excision and remains without evidence of
the EBV-BLPD. One patient received aggressive multiagent chemotherapy
with a complete response initially, but the EBV-BLPD recurred after 12
months. One patient received antiviral therapy and responded completely
but died 2 months later of an opportunistic infection. We conclude that
patients with low-grade B-cell neoplasms treated with fludarabine,
possibly in combination with other immune suppressive agents, may
subsequently develop EBV-BLPDs that morphologically resemble other
iatrogenic immunodeficiency-associated BLPDs. Most are clonally distinct
from the underlying low-grade B-cell neoplasm. A subset of these lesions
may regress without systemic therapy.
15
UI - 11699226
AU - McBride NC; Cavenagh JD; Ward MC; Grant I; Schey S; Gray A; Hughes A;
TI -
Mills MJ; Cervi P; Newland AC; Kelsey SM
Liposomal daunorubicin (DaunoXome) in combination with cyclophosphamide,
vincristine and prednisolone (COP-X) as salvage therapy in
poor-prognosis non-Hodgkins lymphoma.
SO - Leuk Lymphoma 2001 Jun;42(1-2):89-98
AD - Department of Haematology, St Bartholomew's and the Royal London School
of Medicine and Dentistry, UK.
We treated 33 patients with a variant of the standard 3 weekly CHOP
regime, replacing doxorubicin with liposomal daunorubicin (DaunoXome,
NeXstar Pharmaceuticals) 120 mg/m2 (COP-X). Eighteen subjects had
relapsed/refractory aggressive NHL and 15 had indolent NHL/CLL. Median
number of courses received was 4 (1-8). Thirty-two patients were
evaluable for efficacy and 26 (81%) responded. 88% of patients with
aggressive NHL responded; three (18%) patients achieved complete
remission (CR), 12 (70%) achieved partial remission (PR), 1 (6%) patient
had stable disease (SD) and 1 (6%) patient progressed through treatment.
Median duration of response for patients with aggressive NHL was 3
months. The response rate in indolent NHL/CLL was 73%. Four (27%)
patients achieved CR, 7 (46%) PR and 4 (27%) SD. At two years post
treatment, 55% of the patients with indolent NHL/CLL remain
progression-free, although 4 patients have proceeded to consolidation
therapy. Twenty-seven out of 28 (96%) patients developed neutropenia of
short duration following one or more of their treatments. Twenty-three
patients developed an infection at some stage during therapy (all
associated with neutropenia) and required hospitalisation. There were
two toxic deaths (infection) both of which occurred in patients who were
neutropenic before starting COP-X. Platelet toxicity was mild in
patients with normal platelet counts at the commencement of therapy.
Alopecia and mucositis were mild. No clinical evidence of myocardial
failure was observed. We conclude that the substitution of DaunoXome for
doxorubicin in the CHOP regimen to form COP-X provides excellent
efficacy against non-Hodgkin's lymphoma. Response durations were short
but comparable to those reported with other regimens. COP-X was well
tolerated with some suggestion of reduced non-haematological toxicity.
The regimen should be considered as an alternative to CHOP with
potentially less non-haematological toxicity, particularly cardiac;
further studies are required to evaluate the regimen in this context.
16
UI - 11861263
AU - Timmerman JM; Czerwinski DK; Davis TA; Hsu FJ; Benike C; Hao ZM; Taidi
TI -
B; Rajapaksa R; Caspar CB; Okada CY; van Beckhoven A; Liles TM; Engleman
EG; Levy R
Idiotype-pulsed dendritic cell vaccination for B-cell lymphoma: clinical
and immune responses in 35 patients.
SO - Blood 2002 Mar 1;99(5):1517-26
AD - Division of Oncology, Department of Medicine, Stanford University School
of Medicine, CA, USA.
Tumor-specific clonal immunoglobulin expressed by B-cell lymphomas
(idiotype [Id]) can serve as a target for active immunotherapy. We have
previously described the vaccination of 4 patients with follicular
lymphoma using dendritic cells (DCs) pulsed with tumor-derived Id
protein and now report on 35 patients treated using this approach. Among
10 initial patients with measurable lymphoma, 8 mounted T-cell
proliferative anti-Id responses, and 4 had clinical responses--2
complete responses (CRs) (progression-free [PF] for 44 and 57 months
after vaccination), 1 partial response (PR) (PF for 12 months), and 1
molecular response (PF for 75+ months). Subsequently, 25 additional
patients were vaccinated after first chemotherapy, and 15 of 23 (65%)
who completed the vaccination schedule mounted T-cell or humoral anti-Id
responses. Induction of high-titer immunoglobulin G anti-Id antibodies
required coupling of Id to the immunogenic carrier protein keyhole
limpet hemocyanin (Id-KLH). These antibodies could bind to and induce
tyrosine phosphorylation in autologous tumor cells. Among 18 patients
with residual tumor at the time of vaccination, 4 (22%) had tumor
regression, and 16 of 23 patients (70%) remain without tumor progression
at a median of 43 months after chemotherapy. Six patients with disease
progression after primary DC vaccination received booster injections of
Id-KLH protein, and tumor regression was observed in 3 of them (2 CRs
and 1 PR). We conclude that Id-pulsed DC vaccination can induce T-cell
and humoral anti-Id immune responses and durable tumor regression.
Subsequent boosting with Id-KLH can lead to tumor regression despite
apparent resistance to the primary DC vaccine.
17
UI - 11989907
AU - Bernardi D
TI -
Is it possible to use anthracyclines in patients older than 70 years?
Pro.
SO - Tumori 2002 Jan-Feb;88(1 Suppl 1):S133-5
AD - Centro di Riferimento Oncologico, Divisione di Oncologia Medica A,
Aviano (PN).
18
UI - 11989914
AU - Tirelli U; Bernardi D
TI -
Non Hodgkin's lymphoma in the elderly.
SO - Tumori 2002 Jan-Feb;88(1 Suppl 1):S17-9
AD - Centro di Riferimento Oncologico, Divisione di Oncologia Medica A,
Aviano (PN).
19
UI - 11989915
AU - Salvagno L; Errante D; Bianco A; Palmisano V; Ballerini F; Boccalon M;
TI -
Aversa S; Monfardini S
Treatment of non-Hodgkin's lymphoma in the elderly. The Italian studies.
SO - Tumori 2002 Jan-Feb;88(1 Suppl 1):S20-5
AD - Unit of Medical Oncology, General Hospital of Vittorio Veneto.
20
UI - 11989916
AU - Coiffier B
TI -
Rituximab in combination with CHOP improves survival in elderly patients
with aggressive non-Hodgkin's lymphoma.
SO - Tumori 2002 Jan-Feb;88(1 Suppl 1):S26-8
AD - Service d'Hematologie, Centre Hospitalier Lyon-Sud, France.
21
UI - 11989917
AU - Levis A; Pietrasanta D; Anselmo AP; Ambrosetti A; Bertini M
TI -
Treatment of elderly Hodgkin's lymphoma patients. The experience of the
Italian Lymphoma Intergroup.
SO - Tumori 2002 Jan-Feb;88(1 Suppl 1):S29-31
AD - Haematology Department, Ospedale SS Antonio e Biagio, Alessandria.
22
UI - 11926139
AU - Kowalczuk A; Wiecek A; Franek E; Kokot F
TI -
[Plasma concentration of leptin, neuropeptide Y and tumor necrosis
factor alpha in patients with cancers, before and after radio- and
chemotherapy]
SO - Pol Arch Med Wewn 2001 Aug;106(2):657-68
AD - Katedra i Klinika Nefrologii, Endokrynologii i Chorob Przemiany Materii
Sl. AM w Katowicach.
In patients with cancers progressive reduction of body mass is
frequently recent. Pathogenesis of cachexia in patients with cancer is
multifactorial. Such factors as cytokines, peptides relieved by tumor
mass and different forms of treatment as radio or chemotherapy may play
a major role in the pathogenesis of cachexia in patients with cancer.
The aim of this study was to assess the relationship between body fat
and lean mass and plasma leptin, NPY and TNF concentrations in patients
with cancer of oral cavity and pharynx, cancer of larynx and non-Hodgkin
lymphoma (NIL). 30 patients (10 with cancer of oral cavity and pharynx,
10 with cancer of larynx and 10 with non-Hodgkin lymphoma) were enrolled
into this study. Mean age of all cancer patients was 50 +/- 2.9 years
(from 18 to 76 years). The control group consisted of 29 healthy
subjects with a means age 48 +/- 3.5 years (from 18 to 75 years),
properly chosen according to the body weight, BMI, gender and age as
above mentioned groups of patients with cancer. In control and study
groups body fat and not-fat mass was assessed before and after treatment
using the bioelectrical impedance method. Before oncological therapy
patients with cancer did not differ from healthy subject with regard to
body weight and body mass index. After treatment significant: decrease
of body weight, body fat mass and BMI was observed. Serum leptin, NPY
and TNF concentrations were analysed in healthy subjects and patients
with cancer before and after treatment. Before oncological treatment
significantly lower serum leptin concentration in comparison to
leptinaemia in control group was found. In contrast to serum leptin, NPY
serum concentration was similar in patients with cancer and in control
subjects. Serum concentration of TNF was significantly higher in
patients with cancer in comparison to subjects of control group. After
oncological treatment, serum leptin and NPY concentration did not change
significantly. In contrast, serum TNF concentration decreased
significantly after oncological therapy. From the results obtained in
this study we can conclude, that in patients with cancer secretion of
leptin is decreased in relation to body fat mass. However, contribution
of this hormone to pathogenesis of cancer induced anorexia seems not to
proven. From the other side, the role of TNF in pathogenesis of
disregulation of leptin secretion seems to be very likely. After chemo
or radiotherapy, serum NPY concentration did not change significantly.
After this oncological treatment the relationship between serum leptin
concentration and body mass is no longer significant.
23
UI - 11935660
AU - Schneidewind A
TI -
[A therapeutic approach in Burkitt's lymphoma. 2 case reports from the
Hospital Central da Beira/Mozambique]
SO - Fortschr Med Orig 2001;119(1):5-8
Burkitt's lymphoma is the most common malignant tumor encountered in
children (age peak 3 to 8 years) living in areas with endemic malaria
tropica. In the Hospital Central da Beira/Mozambique, two children with
Burkitt's lymphoma were treated with cyclophosphamide. During the period
covered by this report--August 1 to September 30, 2000--two of the
required four treatment cycles were carried out, and both children
experienced a remission.
24
UI - 11869953
AU - Le Gouill S; Moreau P; Morineau N; Harousseau JL; Milpied N
TI -
Tandem high-dose therapy followed by autologous stem-cell
transplantation for refractory or relapsed high grade non-Hodgkin's
lymphoma with poor prognosis factors: a prospective pilot study.
SO - Haematologica 2002 Mar;87(3):333-4
AD - Service d Hematologie, Hotel-Dieu, CHU de Nantes, France.
We conducted a tandem autologous stem cell transplantation procedure for
patients with relapsed or refractory high-grade non-Hodgkin's lymphoma
(HGNHL) or with transformation of indolent lymphoma (n=15). These
patients had poor prognosis factors. The procedure was well tolerated,
ten patients were in complete remission. Overall survival rate is 67%.
25
UI - 11998885
AU - Gomez-Ulla F; Rodriguez-Cid MJ; Gomez-Torreiro M; Abelenda D
TI -
Bone marrow transplantation retinopathy.
SO - Int Ophthalmol 2001;24(1):33-5
AD - Department of Ophthalmology, Complexo Hospitalario Universitario de
Santiago, Santiago de Compostela, Spain. ciulla@usc.es
BACKGROUND: Bone marrow transplantion (BMT) is the treatment of choice
for both malignant and nonmalignant disorders of the bone marrow. BMT
retinopathy occurs after a latent period of 6 months and usually
recovers after a few weeks. METHODS: We present a case of BMT
retinopathy (BMT) in a patient with a high-degree of non-Hodgkin
lymphoma. We analysed the funduscopic and angiographic findings, and the
evolution of the case. RESULTS: AND CONCLUSIONS: After a period of two
and a half years we observed the spontaneous complete resolution of the
fundus lesions and the recovery of visual acuity All of this confirm the
theory that BMT retinopathy does not progress beyond the ischemic
microvascular stage.
26
UI - 12002116
AU - Kotila TR; Aken'ova YA; Shokunbi WA; Akingbola TS; Fasola FA
TI -
Hodgkin's disease after treatment for Burkitt's lymphoma: case report.
SO - East Afr Med J 2001 Jun;78(6):334-6
AD - Department of Haematology, College of Medicine, University of Ibadan,
Nigeria.
Hodgkin's disease and non-Hodgkin's lymphomas are interrelated disorders
which have been reported to occur either simultaneously or sequentially
in the same patient. We report here the development of nodular
sclerosing type Hodgkin's disease in a patient two decades after
successful treatment for Burkitt's lymphoma with cyclophosphomide and
abdominal resection (AR). While the onset of symptoms after treatment
for Burkitt's lymphoma was seven years definitive diagnosis of Hodgkin's
disease was only made 22 years after the initial diagnosis of Burkitt's
lymphoma. The recurrent and solitary nature ofthe lymphadenopathy and
the fact that it was initially reported as reactive hyperplasia is
typical of nodular lymphocyte predominant Hodgkin's disease. We believe
that there was a transitory period of the malignancy as nodular
lymphocyte predominant Hodgkin's disease.
27
UI - 11990514
AU - Goldkuhl C; Ekman T; Wiklund T; Telhaug R; Nordic Lymphoma Group
TI -
Age-adjusted chemotherapy for primary central-nervous system lymphoma--a
pilot study.
SO - Acta Oncol 2002;41(1):29-35
AD - Department of Oncology, Sahlgrenska University Hospital, Gothenburg,
Sweden.
Patients with primary central-nervous-system lymphoma (PCNSL) are
treated with chemotherapy and cranial irradiation, which increase the
risk of late neurotoxicity. The aim of this phase II trial was to
investigate whether chemotherapy alone could induce durable remissions.
Thirty non-immunocompromised patients were enrolled in two treatment
groups, according to age. Patients in group A (< 65 years; n = 17)
received carmustine, vincristine, dexamethasone, high-dose methotrexate
and high-dose cytarabine. Patients in group B > 65 years: n = 13) were
treated with carmustine, vincristine, dexamethasone and high-dose
cytarabine. Both groups received intrathecal treatment. Radiotherapy was
reserved for patients with stable or progressive disease. The overall
response rate in group A was 65% (complete response 35%; partial
response 29%) and in group B. 61% (complete response 23%; partial
response 38%), but only 6 remissions were maintained without
irradiation. In all, there were five treatment-related deaths. Responses
were induced, but were mostly of short duration, and the treatment was
associated with profound toxicity.
28
UI - 11990516
AU - Ericsson SM; Larsson RL; Nygren HP; Sundstrom C; Glimelius BL
TI -
Assessment of drug activity and proliferation ex vivo for prediction of
outcome in aggressive non-Hodgkin's lymphomas.
SO - Acta Oncol 2002;41(1):36-43
AD - Department of Oncology, Radiology and Clinical Immunology, University of
Uppsala, Akademiska sjukhuset, Sweden.
suzanne.rehn.ericsson@onkologi.uu.se
The activity of cytotoxic drugs and tumour cell proliferation rate were
assessed ex vivo using the fluorometric microculture cytotoxicity assay
(FMCA) and stainings for Ki67 and mitosis in 40 patients with aggressive
non-Hodgkin's lymphomas (NHL). The findings were correlated to clinical
response and survival. Twenty-three patients had a complete remission
and 10 a partial remission. A drug sensitivity index based on the cell
survival for three major drugs in NHL treatment was derived empirically
and proliferation was expressed as low-, intermediate- or high. In 5 out
of 8 drugs tested, cell survival ex vivo was higher in clinical
non-responders than that in responders. Using the median drug
sensitivity index as a cut-off, the sensitivity and specificity for
tumour response were 58% and 100%, respectively, and was similar for the
proliferation index. Both indices combined increased the sensitivity to
73% at retained specificity. Intermediate/high proliferation was
significantly associated with impaired survival, whereas the drug
sensitivity index was not predictive of survival. Thus, ex vivo
assessments of drug sensitivity and proliferation seem to provide
prognostic information in aggressive NHL.
29
UI - 11847607
AU - Rothenburger M; Semik M; Hoffmeier A; Baba H; Kamanabrou D; Roos N;
TI -
Schmidt C; Scheld HH
Coexistence of non-Hodgkin's lymphoma and non-small cell lung carcinoma:
diagnosis and treatment.
SO - Thorac Cardiovasc Surg 2002 Feb;50(1):59-61
AD - Department of Cardiothoracic Surgery, University of Muenster, Germany.
Abstract.In this communication, we will present a very rare case of the
coexistence of non-Hodgkin's lymphoma (NHL; low malignant lymphocytic
lymphoma of the B-cell type) and a non-small-cell lung carcinoma
(NSCLC). A patient with a 15-year history of NHL developed a generalized
relapse of the lymphoma with an additional tumor mass in the left lower
lobe of the lung. Bronchoscopy showed the evidence of the NHL. Due to
non-responding chemotherapy on the lung tumor, the coexistence of a
second malignancy was histologically proved in a second bronchoscopy.
Resection of the lung tumor with complex lobectomy and lymphadenectomy
was performed. After that, chemotherapy with four cycles of carboplatin
supplemented with taxol was induced. The patient was discharged from the
hospital with a stable remission of both tumor diseases. Restaging after
six months showed no evidence of a tumor relapse. This is a very rare
case of the coexistence of NHL and NSCLC; we will discuss the difficulty
of diagnostic and treatment of both tumor diseases.
30
UI - 11981000
AU - Lones MA; Perkins SL; Sposto R; Tedeschi N; Kadin ME; Kjeldsberg CR;
TI -
Wilson JF; Zwick DL; Cairo MS
Non-Hodgkin's lymphoma arising in bone in children and adolescents is
associated with an excellent outcome: a Children's Cancer Group report.
SO - J Clin Oncol 2002 May 1;20(9):2293-301
AD - Pathology Department, Children's Hospital of Orange County/St Joseph
Hospital, Orange, CA, USA. smason@childrenoncologygroup.org
PURPOSE: Non-Hodgkin's lymphoma (NHL) arising in bone is a heterogeneous
histologic type of NHL that includes large-cell lymphoma, lymphoblastic
lymphoma, and small noncleaved-cell lymphoma. NHL arising in bone is
well recognized in adults but is less well characterized and infrequent
in children and adolescents. PATIENTS AND METHODS: We performed a
retrospective review of Children's Cancer Group (CCG) studies treating
children and adolescents with NHL over a 20-year period (CCG-551,
CCG-501, CCG-502, CCG-503, CCG-552, CCG-5911, and CCG-5941) and
determined the response and event-free survival (EFS) rates in 31
patients with NHL arising in bone. RESULTS: The patients ranged in age
from 3 to 17 years (median, 11 years; mean, 11 years), and 64.5% were
male. All 31 (100%) patients achieved complete response. For 31 patients
with NHL arising in bone, the product-limit estimated 5-year EFS was
83.8% +/- 6.7%. EFS in 17 patients with localized disease (Murphy stages
I and II) was 94.1% +/- 5.7%, and EFS in 14 patients with disseminated
disease (Murphy stage III) was 70.7% +/- 12.4% (log-rank P =.10). EFS in
17 patients treated with chemotherapy and radiation was 70.1% +/- 11.2%,
and EFS in 14 patients treated with chemotherapy without radiation was
100% (P =.03). EFS in 26 patients with histology-directed treatment
(LSA2-L2 or ADCOMP for lymphoblastic, other therapy for
nonlymphoblastic) was 92.2% +/- 5.3%, and in five patients with
nonhistology-directed treatment it was 40.0% +/- 21.9% (P <.001).
CONCLUSION: NHL arising in bone is a heterogeneous type of NHL that
makes up approximately 2.0% of NHL in children and adolescents on CCG
studies. Response and survival in this young age group seem superb, with
histology-directed treatment protocols without radiation in both
localized and disseminated disease.
31
UI - 11981006
AU - Vose JM; Sharp G; Chan WC; Nichols C; Loh K; Inwards D; Rifkin R;
TI -
Bierman PJ; Lynch JC; Weisenburger DD; Kessinger A; Armitage JO
Autologous transplantation for aggressive non-Hodgkin's lymphoma:
results of a randomized trial evaluating graft source and minimal
residual disease.
SO - J Clin Oncol 2002 May 1;20(9):2344-52
AD - Department of Internal Medicine, University of Nebraska Medical Center,
Omaha, NE 69198, USA. jmvose@unmc.edu
PURPOSE: To determine whether the source of autologous hematopoietic
stem cells altered the clinical outcomes of patients undergoing
high-dose chemotherapy and hematopoietic stem-cell transplantation
(HSCT) for aggressive non-Hodgkin's lymphoma (NHL). PATIENTS AND
METHODS: Of 105 high-risk, persistent, or relapsed NHL patients slated
for an autologous HSCT entered onto this trial, 93 eligible patients
were randomized to receive cytokine-naive autologous bone marrow
transplantation (ABMT) (n = 46) or mobilized peripheral-blood stem-cell
transplantation (PBSCT) (n = 47). All patients received carmustine,
etoposide, cytarabine, and cyclophosphamide as the conditioning regimen.
PBSCT patients also received identical mobilization with granulocyte
colony-stimulating factor (G-CSF) 10 microg/kg/d, and both groups
received G-CSF 5 microg/kg/d after the infusion of the stem-cell product
until neutrophil engraftment. RESULTS: PBSCT patients had significantly
faster engraftment of all cell lineages: median time to absolute
neutrophil count > or = 500/microL, 10 days versus 13 days on the ABMT
arm; median time to platelet count greater than 20,000/microL
untransfused, 11 days versus 15 days on the ABMT arm; and median time to
RBC transfusion independence, 8 days versus 16 days on the ABMT arm. The
complete response rate was 72% for PBSCT and 54% for ABMT. The death
rate before posttransplant day 100 was 2% on the ABMT arm and 6% on
PBSCT arm. Event-free survival was 37% for PBSCT and 37% for ABMT.
However, overall survival for PBSCT was 61% compared with 43% for ABMT.
CONCLUSION: Patients with aggressive NHL receiving HSCT randomized to
PBSCT demonstrated improved neutrophil engraftment and platelet and RBC
transfusion independence. The complete response rate and EFS were not
statistically different by randomization arm. Patients whose harvests
were positive for minimal residual disease by molecular analysis had
poorer EFS.
32
UI - 12007954
AU - McAfee SL; Powell SN; Colby C; Spitzer TR
TI -
Dose-escalated total body irradiation and autologous stem cell
transplantation for refractory hematologic malignancy.
SO - Int J Radiat Oncol Biol Phys 2002 May 1;53(1):151-6
AD - Department of Medicine, Bone Marrow Transplantation Program,
Massachusetts General Hospital and Harvard Medical School, 55 Fruit
Street, Boston, MA 02114, USA.
PURPOSE: To evaluate the feasibility of dose escalation of total body
irradiation (TBI) above the previously reported maximally tolerated
dose, we have undertaken a Phase I-II trial of dose-escalated TBI with
autologous peripheral blood stem cell transplantation (PBSCT) for
chemotherapy-refractory lymphoma. METHODS AND MATERIALS: Nine lymphoma
patients with primary refractory disease (PRD) or in resistant relapse
(RR) received dose-escalated TBI and PBSCT. The three dose levels of
fractionated TBI (200 cGy twice daily) were 1,600 cGy, 1,800 cGy, and
2,000 cGy. Lung blocks were used to reduce the TBI transmission dose by
50%, and the chest wall dose was supplemented to the prescribed dose
using electrons. Shielding of the kidneys was performed to keep the
maximal renal dose at 1,600 cGy. Three patients, two with non-Hodgkin's
lymphoma (NHL) in RR and one with PRD Hodgkin's disease, received 1,600
cGy + PBSCT, three patients (two NHL in RR, one PRD) received 1,800 cGy
+ PBSCT, and three patients with NHL (two in RR, one PRD) received 2,000
cGy + PBSCT. RESULTS: Toxicities associated with this high-dose TBI
regimen included reversible hepatic veno-occlusive disease in 1 patient,
Grade 2 mucositis requiring narcotic analgesics in 8 patients, and
neurologic toxicities consisting of a symmetrical sensory neuropathy (n
= 4) and Lhermitte's syndrome (n = 1). Interstitial pneumonitis
developed in 1 patient who received 1,800 cGy after receiving
recombinant alpha-int
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