National Cancer Institute®
Last Modified: August 1, 2002
UI - 12134704
AU - Kondo T; Wada H; Yata K; Mikami M; Tsujioka T; Suemori S; Suetsugu Y;
TI - Nakanishi H; Otsuki T; Yamada O; Yawata Y; Morioka M; Tanaka H; Sadahira Y; Sugihara T [Seven patients with stage I and II primary testicular lymphoma]
SO - Rinsho Ketsueki 2002 Jun;43(6):473-6
AD - Division of Hematology, Department of Medicine, Kawasaki Medical School.
Seven patients with stage I and II primary testicular lymphoma (PTL) have been treated since 1990 to the present at Kawasaki Medical School. All patients, whose median age was 56 yrs, had initially complained of swelling of the scrotal contents. The lesions were on the right in two patients, on the left in five, and no patient had bilateral lesions. The histological diagnosis was diffuse large B-cell type in all patients. Five patients were classified as Ann Arbor stage I, and two at stage II. After high-orchiectomy for resection of tumor, two patients received chemotherapy alone, with a combination of chemotherapy and irradiation of the contralateral testis in the remaining five. Complete remission was achieved in all seven patients, but relapse occurred later in one. As it is recognized that, even in localized stage or low risk group PTL patients, the relapse rate in the central nervous system (CNS) and contralateral testis is quite high, chemotherapy, prophylactic CNS treatment and radiation of the contralateral testis after tumor resection should be included in the management of PTL.
UI - 12134706
AU - Fujii H; Iwai T; Ueda Y; Nakagawa H
TI - [Therapy-related acute myeloid leukemia following double autologous peripheral blood stem cell transplantation for non-Hodgkin's lymphoma]
SO - Rinsho Ketsueki 2002 Jun;43(6):482-7
AD - Department of Hematology, Kyoto First Red Cross Hospital.
A 29-year-old male was diagnosed as having non-Hodgkin's lymphoma (NHL, courses of chemotherapy and double autologous peripheral stem cell transplantation (total dose: CPA 13,000 mg, BUS 892 mg, L-PAM 150 mg, MCNU 870 mg, MTX 60 mg, Ara-C 160 mg, DXR 350 mg, VP-16 11,190 mg, VCR 8 mg, CBDCA 700 mg, and MIT 22 mg) for NHL and obtained complete remission malaise. Laboratory findings showed marked leukocytosis with 85% leukemia cells, which were positive for alpha-naphthyl butyrate esterase. Surface-marker analysis of the leukemia cells showed positive results for CD11b, CD11c, CD13, CD15, CD33, CD56, CD64, CD65, CD71 and HLA-DR, and chromosomal analysis revealed add(8) (p11), add(9) (p13). He was diagnosed as having AML (M5a) and was still in complete remission believed to be from therapy-related leukemia induced by the VP-16 used for treating NHL, judging by the patient's short clinical course and monocytic type of leukemia.
UI - 12134707
AU - Yamamoto K; Nagata K; Morita Y; Hamaguchi H
TI - [Successful treatment with G-CSF and continuous infusion of low-dose cytarabine and etoposide for therapy-related acute myeloid leukemia developed during chemotherapy for malignant lymphoma]
SO - Rinsho Ketsueki 2002 Jun;43(6):488-92
AD - Department of Hematology, Musashino Red Cross Hospital. having non-Hodgkin's lymphoma because of right cervical lymphadenopathy. He had received 8 cycles of chemotherapy including doxorubicin in China. leukopenia and thrombocytopenia. Peripheral blood showed hemoglobin 12.7 g/dl, platelets 4.1 x 10(4)/microliter and white blood cells 2300/microliter with 15% blasts. Bone marrow was hypocellular with 48% blasts, which were positive for myeloperoxidase, CD13 and CD33. Chromosome analysis showed 46,XY, t(9;11) (p21;q23) in all 20 metaphase spreads. He was diagnosed as having therapy-related acute myeloblastic leukemia (AML). Because of hypoplastic bone marrow, induction therapy with the CAG regimen including cytarabine, aclarubicin and granulocyte-colony stimulating factor (G-CSF) was started, but no apparent effect was observed. The patient was then treated with the AVG regimen comprising 250 micrograms of G-CSF and continuous infusion with 20 mg of cytarabine and 50 mg of etoposide for 14 days. Complete hematological and cytogenetic remission was achieved after two courses of the AVG regimen. Although it has been shown that the CAG regimen is effective for refractory and/or secondary AML, our results indicate that the AVG regimen should be tried for cases of AML resistant to the CAG regimen.
UI - 12113132
AU - Lionberger JM; Armitage JO
TI - Advances in the management of patients with non-Hodgkin's lymphoma.
SO - Expert Rev Anticancer Ther 2001 Jun;1(1):43-52
AD - University of Nebraska Medical Center, 986545 Nebraska Medical Center, Omaha, NE 68198-6545, USA.
Non-Hodgkin's lymphoma is the fifth most common cause of death due to cancer and has been rising at a rate of 4% per year for the last four decades. Although 'traditional' chemotherapy and radiotherapy have had important contributions to improving outcomes, new tools in the treatment of non-Hodgkin's lymphoma are needed. This review describes therapeutic modalities that are currently being used or are in the process of being developed and which are based on concepts divergent from 'traditional' approaches to managing non-Hodgkin's lymphoma.
UI - 12113133
AU - Raderer M; Isaacson PG
TI - Extranodal lymphoma of MALT-type: perspective at the beginning of the 21st century.
SO - Expert Rev Anticancer Ther 2001 Jun;1(1):53-64
AD - Department of Internal Medicine I, Division of Oncology, University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria. email@example.com
Extranodal lymphomas arising from mucosa associated lymphoid tissue (MALT) have become a focus of interest in recent years due to their unique pathological and clinical properties. The link between Helicobacter pylori and the development of gastric MALT-type lymphoma has revolutionized treatment options as up to 80% of patients with early gastric MALT-type lymphoma achieve complete remission of the tumor following eradication of H. pylori. As opposed to surgical intervention, which has been the preferred form of treatment in the past, organ conserving approaches are increasingly being applied, as both irradiation and chemotherapy have given excellent results. However, mature data from prospective, randomized studies taking into account the concept of MALT lymphoma as a distinct entity are still lacking in order to define the optimal approach to the management of MALT-type lymphoma.
UI - 12113135
AU - Bendandi M
TI - Role of anti-idiotype vaccines in the modern treatment of human follicular lymphoma.
SO - Expert Rev Anticancer Ther 2001 Jun;1(1):65-72
AD - Clinica Universitaria, University of Navarra, Department of Hematology, Avda. Pio XII, 36 31008 Pamplona, Navarra, Spain. firstname.lastname@example.org
Cancer vaccines are currently conceived as therapeutic tools, in contrast to the prophylactic vaccines that have resolved the problem of a number of infectious diseases. Among the former, anti-idiotype vaccines for human follicular lymphoma have begun to produce tangible clinical results. Just 10 years ago it was not even known whether patients could be immunized against their own tumor antigens and now as many as two independent Phase III clinical trials based on this finding are underway. The rapidity of this development encourages the hope that active immunotherapy may soon become decisive in oncology. For the time being, many important results have already been achieved: the evidence of vaccine-induced, tumor-specific humoral/cellular responses and the first documented molecular remissions following vaccination.
UI - 11843254
AU - Haioun C; Mounier N; Quesnel B; Morel P; Rieux C; Beaujean F; Marolleau
TI - JP; Belhadj K; Simon D; Gaulard PH; Lepage E; Gisselbrecht CH; Reyes F Tandem autotransplant as first-line consolidative treatment in poor-risk aggressive lymphoma: a pilot study of 36 patients.
SO - Ann Oncol 2001 Dec;12(12):1749-55
AD - Service d' Hematologie Clinique, Hjpital Henri Mondor, Creteil, France. email@example.com
PURPOSE: In the previous LNH87-2 study, consolidative high-dose therapy followed by stem cell transplantation (HDT) improved disease-free survival, as well as survival for patients (pts) presenting with two or three factors of the age-adjusted international prognostic index (Aa-IPI) in first complete remission (CR). In order to improve further the outcome of such patients, we conducted a pilot study of consolidative tandem autotranplant. PATIENTS AND METHODS: Thirty-six patients (pts) under 60 years of age with two or three factors of the Aa-IPI were enrolled. Their main characteristics were: diffuse large B-cell lymphoma (83%), Aa-IPI three factors (50%), and marrow involved (36)%. The procedure consisted of 1) induction with four cycles of ACVBP (doxorubicin, cyclophosphamide, vindesine, bleomycin, prednisone) 2) in responding pts, peripheral blood stem cell (PBSC) collection after the fourth cycle of ACVBP (11 pts) or after an additional mobilization regimen (Cyclophosphamide-VP16) (17 pts) 3) a first HDT (mitoxantrone, cyclophosphamide, VP16 and carmustine) followed by PBSC infusion 4) a second HDT (busulfan, carboplatin and melphalan) followed by PBSC infusion. Among the 29 patients responding to induction, 28 received the first HDTand 24 the second. RESULTS: The rates of three-year-event free survival and survival are 47% (95% confidence interval (95% CI: 31%-63%) and 50% (95% CI: 37%-69%), respectively. Eighteen patients remained free of evolutive disease and 18 patients have died, 15 from disease progression and three from treatment-related toxicity after tandem transplant (two veno-occlusive disease and one cerebral toxoplasmosis). CONCLUSION: We conclude that tandem transplant did not improve the results of the LNH87-2 study in which patients received a single consolidative HDT.
UI - 11911406
AU - Lichtman SM; Petroni G; Schilsky RL; Johnson JL; Perri RT; Niedzwiecki
TI - D; Sklar J; Barcos M; Peterson BA High dose cyclophosphamide plus recombinant human granulocyte-colony stimulating factor (rhG-CSF) in the treatment of follicular, low grade non-Hodgkin's lymphoma: CALGB 9150.
SO - Leuk Lymphoma 2001 Nov-Dec;42(6):1255-64
AD - Don Monti Division of Oncology, North Shore University Hospital, New York University School of Medicine, Manhasset, USA. firstname.lastname@example.org
The main objectives of this study were to determine the feasibility of administering high doses of cyclophosphamide plus recombinant human granulocyte-colony stimulating factor (rhG-CSF) every 14-21 days to patients with follicular small cleaved cell lymphoma. For each patient, the treatment was not considered feasible if fewer than four cycles of cyclophosphamide chemotherapy could be administered on schedule (i.e. at least every 29 days) or (1) hospitalization of the patient for longer than three days was necessary for neutropenic fever (38 degrees C) or bacteriologically documented infection in > 50% of the cycles, or (2) grade > or = 2 hemorrhage in association with thrombocytopenia of grade > or = 3 severity occurred in > 50% of the cycles or (3) non-hematologic toxicity (excluding nausea/vomiting and alopecia) of grade > or = 3 occurred in > 50% of cycles. The goal was to have a treatment program feasible in 75% or more of the treated patients. The secondary objectives were to determine the toxicities, the complete and partial response rates, and the time to treatment failure (TTF). The trial also attempted to assess the effectiveness of this treatment program in eradicating Bcl-2 rearrangements by PCR, and to assess complete remission duration in relationship to PCR results in patients who respond to this chemotherapy program. Patients were required to have histologically documented non-Hodgkin's lymphoma of the subtypes follicular, predominantly small cleaved cell (IWF-B) or follicular mixed, (IWF-C). Patients were required to have Stage IV disease including histologic evidence of bone marrow involvement. Measurable disease was required and patients were also required to have one of the following risk factors: > or = 2 extranodal sites, node or nodal group > or = 5 cm. Submission of fresh bone marrow for molecular genetic studies for the presence of Bcl-2-Ig fusion DNA was mandatory in previously untreated patients. Patients had to be between 18 and physiologic age 55 years (carefully selected patients over age 55 years were also eligible), expected survival > 2 years, performance status 0-1, and have adequate renal, hepatic and bone marrow function, and a cardiac ejection fraction > or = 50%. Cyclophosphamide 4.5 g/m2 i.v. was given with mesna every 14 days with rhG-CSF support. Twenty-nine patients were accrued to this trial. The median follow-up time is 5.0 years, with a range of 2.5-6.7 years. The overall response rate was 75% (9 CRs 37.5%, 9PRs 37.5%). The median duration of survival is 5.53 years. The 1-year estimated probability of freedom from treatment failure was 50% and of survival at 1 year was 92%. No strong association was observed between TTF and age, symptomatic stage, histology performance status, number of extranodal sites or baseline Bcl-2 status. At 3 years the survival of all patients was 78% and failure free survival was 17%. 15 (62%) of the 24 eligible previously untreated patients met the criteria for feasibility specified in the protocol. The 95% CI for the feasibility rate is (44 and 82%). Twenty-two of the 24 (92%) previously untreated patients had specimens submitted for testing for Bcl-2 rearrangements. Thirteen of the 22 (59%) were found to have rearrangements at baseline. Post-treatment specimens were submitted for seven of the 13 patients. Four of the seven converted to Bcl-2 negative following treatment. Eight of 13 Bcl-2 positive patients (62%) had a clinical response to treatment. The 95% exact binomial CI for the total response rate in this subgroup is (28 and 88%). This study demonstrates that repetitive doses of cyclophosphamide at 4.5 g/m2 every two weeks with rhG-CSF support can be administered to selected younger patients with advanced follicular lymphoma with morphologic involvement of the bone marrow with acceptable non-hematologic toxicity.
UI - 11911411
AU - Takenaka K; Shinagawa K; Maeda Y; Makita M; Kozuka T; Ashiba A; Yamamoto
TI - K; Fujii N; Nawa Y; Hiramatsu Y; Sunami K; Ishimaru F; Yoshimo T; Kiura K; Harada M High-dose chemotherapy with hematopoietic stem cell transplantation is effective for nasal and nasal-type CD56+ natural killer cell lymphomas.
SO - Leuk Lymphoma 2001 Nov-Dec;42(6):1297-303
AD - Second Department of Internal Medicine, Okayama University Medical School, Japan. email@example.com
CD56+ natural killer (NK) cell lymphomas occur frequently in the nasal and nasopharyngeal regions and carry a poor prognosis. We have studied seven cases with NK-cell lymphomas. These lymphomas showed the following immunophenotype: CD56+, CD2+, sCD3- and Epstein-Barr virus-encoded small RNAs (EBERs)+. Six patients had localized (stage I or II) disease involving the nasopharyngeal region, while one had stage III disease. One patient with stage I disease achieved a complete remission (CR) after treatment with involved-field irradiation, but subsequently relapsed and died. The remaining six patients received combination chemotherapy as primary treatment: five patients with localized stage I or II disease and one patient with advanced stage III disease. Responses to initial chemotherapy were generally poor. These six patients received a variety of salvage chemotherapy regimens, but never achieved a CR. Subsequently, four of six patients showed a highly aggressive clinical course and died of disseminated disease within 1 year from the diagnosis. Three of six patients received high-dose chemotherapy supported by syngeneic, autologous or allogeneic peripheral blood stem cell transplantation. Two of the three transplant patients achieved a CR and are now surviving in continuous CR. Our clinical experience suggests that myeloablative high-dose chemotherapy and bone marrow rescue by hematopoietic stem cell transplantation may be an effective salvage treatment modality for refractory NK-cell lymphomas and could be considered as a part of the initial therapy for these patients.
UI - 12113023
AU - King KM; Younes A
TI - Rituximab: review and clinical applications focusing on non-Hodgkin's lymphoma.
SO - Expert Rev Anticancer Ther 2001 Aug;1(2):177-86
AD - Division of Pharmacy, University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA.
Rituximab (Rituxan) was the first monoclonal antibody approved for cancer therapy and the first single-agent approved for therapy of lymphoma. When combined with CHOP, rituximab is the only drug that has been shown to improve survival of a subpopulation of patients with diffuse large cell lymphoma during the last three decades. It was approved by the FDA for the treatment of patients with relapsed or refractory low-grade or follicular, CD20-positive, B-cell non-Hodgkin's lymphoma in 1997. Rituximab is also being studied in many other B-cell malignancies alone and in combination with other agents. Furthermore, it is currently being evaluated in several nonmalignant diseases, such as autoimmune disorders. This review will focus on the role of rituximab in patients with non-Hodgkin's lymphoma.
UI - 12118838
AU - Crovetti G; Carabelli A; Berti E; Guizzardi M; Fossati S; De Filippo C;
TI - Bertani E Photopheresis in cutaneous T-cell lymphoma: five-year experience.
SO - Int J Artif Organs 2000 Jan;23(1):55-62
AD - Photopheresis Department, St. A. Abate Hospital, Gallarate, Italy. firstname.lastname@example.org
BACKGROUND: Cutaneous T-cell lymphoma (CTCL) includes several lymphoproliferative disorders involving mature T-lymphocyte proliferation initially confined to the cutis. These affections, after variable periods, may progress to the blood, limph nodes and visceral organs. Mycosis fungoides (MF) is the most frequent form of CTCL and has an indolent clinical course. The therapy of CTCL depends on the stage of the disease and the patient's general conditions. For advanced cases it includes chemotherapy, retinoids, and interferon-alpha. Since 1987 extracorporeal photochemotherapy (ECP), a novel immunomodulatory approach based on apheresis and photoirradiation of leukocytes, has been successfully introduced for the treatment of advanced CTCL. It can prolong survival of patients with erythrodermic CTCL without significant side effects. OBJECTIVE: To review our five-year experience with ECP in ECP, using two different regimens: two procedures on two consecutive days at four-week intervals for six months, or at two-week intervals for three months with progressive tapering in the second three-month period for the more severe forms. Six patients received ECP with IFN-alpha. ECP was done using the photopheresis UVAR system and UVAR XTS (Therakos, West Chester, Pa) and always with 8-MOP liquid formulation injected directly into the buffy coat bag. Lymphocytes in peripheral blood were immunophenotypically characterized for each patient and every ECP session. RESULTS: All patients tolerated ECP well, without significant side effects. Thirty patients are clinically evaluable (at least three ECP cycles). A favourable clinical response was obtained in 80.9% (16/21) of MF patients (complete response 33%, partial response 47.6%) and in 66% (6/9) of patients in the Sezary's syndrome phase (complete response 33.3%, partial response 33.3%). Five of the six patients given IFN-alpha as adjunctive therapy had a PR and one a CR. Four patients are in CR without therapy at follow-ups of 46, 20, 10 and 8 months. There have been no changes in the peripheral lymphocyte immunophenotype during the follow-up. In 19/30 patients the CD95 antigen, correlated with cellular apoptosis, was expressed and was frequently associated with a good clinical response. CONCLUSIONS: In our experience ECP achieved favourable clinical responses in 73% of patients, in monotherapy or in combination with IFN-alpha, without significant side effects.
UI - 12140464
AU - Gathers RC; Scherschun L; Malick F; Fivenson DP; Lim HW
TI - Narrowband UVB phototherapy for early-stage mycosis fungoides.
SO - J Am Acad Dermatol 2002 Aug;47(2):191-7
AD - Department of Dermatology, Henry Ford Health System, Detroit, MI 48202-2689, USA.
BACKGROUND: Narrowband UVB (NB-UVB) phototherapy has been shown to be effective for the treatment of various dermatoses. OBJECTIVE: We evaluated the effect of NB-UVB in the treatment of early stage mycosis fungoides (MF). METHODS: The response of 24 patients (12 stage IA, 12 stage IB) with patch stage MF to thrice weekly NB-UVB was assessed. Twelve patients had skin phototypes I-III, and 12 had types IV-VI. Seven patients had hypopigmented MF. Mean follow-up period was 29.0 weeks. RESULTS: Thirteen patients (54.2%) had a complete response (CR), 7 (29.2%) had partial response (PR), and 4 (16.7%) had no response. Specimens from a repeat biopsy in 10 patients with CR showed histologic clearing in 9 of them. Upon discontinuation of treatment, 4 patients with CR relapsed, with a mean time to relapse of 12.5 weeks. CONCLUSION: NB-UVB is a viable, comparably safe, and easily administered alternative in the management of early stage MF.
UI - 11866136
AU - Black JB; Feigal EG; Gore-Langton RE
TI - Clinical trials referral resource. Clinical trials and NCI resources for cancer in HIV-positive patients.
SO - Oncology (Huntingt) 2002 Feb;16(2):200-2, 205, 207
AD - National Cancer Institute, USA.
UI - 12080246
AU - Lee SY; Son HJ; Kim JJ; Paik SW; Rhee JC; Choi KW
TI - A case of intraductal papillary mucinous tumor of pancreas combined with early gastric cancer and MALToma of stomach.
SO - J Clin Gastroenterol 2002 Jul;35(1):109-10
UI - 12113055
AU - Grillo-Lopez AJ
TI - AntiCD20 mAbs: modifying therapeutic strategies and outcomes in the treatment of lymphoma patients.
SO - Expert Rev Anticancer Ther 2002 Jun;2(3):323-9
AD - Neoplastic and Autoimmune Diseases Research Institute, P.O. Box 3797, Rancho Santa Fe, CA 92067, USA. email@example.com
The first monoclonal antibody for the treatment of cancer, rituximab, was approved 5 years ago and has had a remarkable impact on the treatment of non-Hodgkin's lymphomas. Additionally, it sparked a renewed interest in antibodies in general that has revitalized this field of research. Multiple antibodies for a variety of malignant and nonmalignant indications are being evaluated. Some are now approved for anticancer indications (rituximab, ibritumomab, trastuzumab, gemtuzumab, alemtuzumab) and others are completing the review process at US (FDA) and European (EMEA) regulatory agencies. The impact of antiCD20 antibodies, particularly rituximab and ibritumomab, is evident in the way treatment strategies and outcomes have changed for the lymphoma patient. Other unconjugated antibodies (including Hu1D10, epratuzumab and alemtuzumab) and conjugated antibodies (including radiolabeled tositumomab) are under evaluation.
UI - 12029566
AU - Liao SL; Kao SC; Hou PK; Chen MS
TI - Results of radiotherapy for orbital and adnexal lymphoma.
SO - Orbit 2002 Jun;21(2):117-23
AD - Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan. firstname.lastname@example.org
Twenty-five patients presenting with stage I primary orbital and/or retrospectively reviewed at National Taiwan University Hospital. Staging workups included physical examination, chest radiography, blood analysis, whole-body CT scan, CSF examination and bone marrow biopsy. The histological types, based on the National Cancer Institute working formulation, were 17 cases of low-grade and 8 of intermediate lymphoma. Twenty patients received radiotherapy, while five cases refused. All patients except two received a radiation dose of 40 Gy, the other two received 30 Gy. The mean follow-up period was 4.7 +/- 1.6 years (2-8 years). Local control of disease was achieved in all 20 patients, but one patient with low-grade lymphoma developed disseminated disease with parotid gland, bone marrow and lung involvement 43 months after radiotherapy. Two out of five patients who refused treatment with radiotherapy developed systemic involvement 24 months and 18 months after diagnosis. Dry eye (45%) and cataract formation (35%) were among the most frequent complications in this study. One patient developed a recalcitrant trophic corneal ulcer and ultimately required corneal transplantation. In conclusion, radiotherapy is a safe and effective local treatment in the management of primary orbital or adnexal lymphoma.
UI - 12173380
AU - Aviles A; Neri N; Huerta-Guzman J
TI - Large bowel lymphoma: an analysis of prognostic factors and therapy in 53 patients.
SO - J Surg Oncol 2002 Jun;80(2):111-5
AD - Department of Hematology, Oncology Hospital, National Medical Center, I.M.S.S., Mexico D.F., Mexico. email@example.com
BACKGROUND AND OBJECTIVES: We performed a retrospective analysis to assess the influence of different prognostic factors, including the International Prognostic Index (IPI), that can predict the outcome in patients with primary large bowel lymphoma (Stage IE) treated with combined therapy (surgery followed by chemotherapy). METHODS: All patients were treated with radical surgery followed by six cycles of combined chemotherapy: CHOP-Bleo (cyclophosphamide, doxorubicine, vincristine, prednisone, and bleomycin) or variants (epirubicin instead of doxorubicin). In all cases, an multivariate analysis was performed to identify prognostic factors (if any), including IPI, that can influence outcome. RESULTS: According to the IPI, event-free survival (EFS) and overall survival were 85% and 87%, respectively, in patients with low and low-intermediate clinical risk that was not statistically significant when compared to patients at high and high-intermediate clinical risk: 69% and 76% (P = 2). Multivariate analysis failed to demonstrate the influence of multiple prognostic factors that were analyzed. CONCLUSIONS: Combined therapy appears to be an excellent therapeutic approach in this group of patients with prolonged EFS and survival, and without late toxicity. However, no prognostic factors, including IPI, could be identified to define the best therapy, probably because the number of patients, even in large series, is limited. Multicentric studies are necessary to identify prognostic factors to define therapy and outcome in this rare clinical presentation of malignant lymphoma.
UI - 11868976
AU - Knobler E; Warmuth I
TI - Extracorporeal photochemotherapy: a case report and update.
SO - Cutis 2002 Feb;69(2):119-23
AD - Department of Dermatology, Columbia University, New York, New York 10032, USA.
Extracorporeal photochemotherapy (ECP) was developed at Columbia Presbyterian Medical Center in the early 1980s for the treatment of cutaneous T-cell lymphoma (CTCL). ECP is now used primarily in the treatment of that disease at more than 100 centers worldwide. It also has been shown to be potentially effective in treating several autoimmune diseases. Most recently, it has been used in reversing solid-organ transplant rejection and graft-versus-host disease following bone-marrow transplantation. In this article, we present the case of one of the first patients treated with ECP and give an update on the current status of this therapy.
UI - 12077466
AU - Stadler R
TI - Treatment of cutaneous T cell lymphoma.
SO - Skin Pharmacol Appl Skin Physiol 2002 May-Jun;15(3):139-46
AD - Department of Dermatology, Medical Centre Minden, Germany.
Primary cutaneous T cell lymphomas encompass a wide variety of lymphomas that are characterized by a distinct clinical presentation. Advanced biological techniques have allowed a more precise classification in recent years. Stage-adapted therapy is at present the best approach to treat cutaneous T cell lymphoma. Copyright 2002 S. Karger AG, Basel
UI - 12163626
AU - Kostakoglu L; Coleman M; Leonard JP; Kuji I; Zoe H; Goldsmith SJ
TI - PET predicts prognosis after 1 cycle of chemotherapy in aggressive lymphoma and Hodgkin's disease.
SO - J Nucl Med 2002 Aug;43(8):1018-27
AD - Division of Nuclear Medicine, Department of Radiology, Weill Medical College of Cornell University and New York Presbyterian Hospital, New York, New York 10021, USA. firstname.lastname@example.org
Early identification of chemotherapy-refractory lymphoma patients provides a basis for alternative treatment strategies. Metabolic imaging with (18)F-FDG PET offers functional tissue characterization that is useful for assessing response to therapy. Our objective was to determine the predictive value of (18)F-FDG PET early during chemotherapy (after 1 cycle) and at the completion of chemotherapy for subsequent progression-free survival (PFS) in patients with aggressive non-Hodgkin's lymphoma (NHL) or Hodgkin's disease (HD). METHODS: (18)F-FDG PET (dual-head coincidence camera with attenuation correction) was performed before and after 1 cycle of chemotherapy on 30 patients (17 NHL, 13 HD; mean age, 52.3 +/- 16.0 y). For 23 of the 30 patients, (18)F-FDG PET data were also obtained after the completion of chemotherapy. The patients had a median follow-up of 19 mo (range, 18-24 mo). Follow-up of PFS was compared between patients with positive and negative (18)F-FDG PET results obtained after the first cycle of chemotherapy and at the completion of chemotherapy. RESULTS: Positive (18)F-FDG PET results obtained both after the first cycle and at the completion of therapy were associated with a shorter PFS (median, 5 and 0 mo, respectively) than were negative (18)F-FDG PET results (PFS medians not reached). A statistically significant difference in PFS between positive and negative (18)F-FDG PET results was obtained both after the first cycle and at the completion of chemotherapy (P < or = 0.001). The PFS and (18)F-FDG PET results obtained after the first cycle correlated better than those obtained after the completion of chemotherapy (r(2) = 0.45 vs. 0.17). (18)F-FDG PET had more false-negative results after the last cycle (6/17 cases, or 35%) than after the first cycle (2/13 cases, or 15%). Thus, (18)F-FDG PET had greater sensitivity and positive predictive values after the first cycle (82% vs. 45.5% and 90% vs. 83%, respectively) than after the last cycle. CONCLUSION: (18)F-FDG PET after 1 cycle of chemotherapy is predictive of 18-mo outcome in patients with aggressive NHL and HD and may earlier identify patients who would benefit from more intensive treatment programs.
UI - 11697438
AU - Kamaluddin M; McNally P; Breatnach F; O'Marcaigh A; Webb D; O'Dell E;
TI - Scanlon P; Butler K; O'Meara A Potentiation of vincristine toxicity by itraconazole in children with lymphoid malignancies.
SO - Acta Paediatr 2001 Oct;90(10):1204-7
AD - Department of Haematology Oncology, Our Lady's Hospital for Sick Children, Crumlin, Dublin, Ireland.
Eight consecutive paediatric patients with acute lymphoblastic leukaemia (ALL) (n = 7) and T-cell non-Hodgkin's lymphoma (NHL) (n = 1) presenting within a 5-wk interval were started on a standard induction protocol which included weekly treatment with vincristine for 4 wk. Itraconazole was commenced as antifungal prophylaxis, 1-21 d after the first injection of vincristine. Within 2 to 4 wk, enhanced vincristine neurotoxicity was noted in all patients, abdominal cramps and constipation occurred most frequently, and one patient developed a bowel perforation associated with paralytic ileus. Hyponatraemia associated with SIADH was observed in three patients and four patients developed seizures. An additional patient with B cell NHL developed seizures 5 d after an injection of vincristine. Recovery was complete in all patients and ranged from 2 d to 15 wk. CONCLUSION: The extent and consistency of adverse effects documented in this study support the recommendation that concurrent administration of vincristine and itraconazole should be avoided.
UI - 12163627
AU - Lowe VJ; Wiseman GA
TI - Assessment of Lymphoma Therapy Using (18)F-FDG PET.
SO - J Nucl Med 2002 Aug;43(8):1028-30
AD - PET Imaging, Department of Radiology, Mayo Clinic Rochester, Minnesota 55905, USA. email@example.com
UI - 12151972
AU - Lynch JW; Hei DL; Braylan RC; Rimzsa LM; Staab EV; Bewsher CJ;
TI - Mendenhall NP; Hudson JK Phase II study of fludarabine combined with interferon-alpha-2a followed by maintenance therapy with interferon-alpha-2a in patients with low-grade non-hodgkin's lymphoma.
SO - Am J Clin Oncol 2002 Aug;25(4):391-7
AD - Division of Hematology and Oncology, University of Florida College of Medicine, Gainesville, Florida 32610, U.S.A.
Randomized trials suggest improved disease-free survival in low-grade non-Hodgkin's lymphoma (LGNHL) when interferon is combined with multiagent chemotherapy. This phase II trial was conducted to investigate the feasibility of combining fludarabine monophosphate (fludarabine) and IFN in a regimen for treatment of LGNHL. Twenty-one patients were evaluable. Median age was 55 years, and patients had been treated with an average of 1.7 chemotherapy regimens before enrollment. Patients received 25 mg/m2 of fludarabine intravenously on days 1 through 5 followed by 2 x 10(6) U/m2 of interferon-alpha-2a subcutaneously on days 22 through 26. Cycles were repeated every 4 weeks with delays and dose modifications for significant cytopenias. Patients were restaged after cycles 4 and 8, and those with at least a partial response to therapy were given maintenance therapy consisting of 2 x 10(6) U/m2 interferon-alpha-2a subcutaneously three times per week for 6 months. The overall response rate was 76% with a 25% complete response (CR) rate. Overall response rates were 75% (3/4 with 2 CR's) for chemotherapy-naive patients and 76% (13/17 with 3 CR's) for previously treated patients. Median time to progression was 12 months, and currently two patients are without evidence of progression at a median follow-up of 55 months. Grade III or greater toxicities included neutropenia (39%), anemia (17%), thrombocytopenia (5%), fevers/chills (5%), and fatigue (5%). Fludarabine and interferon can be effectively and safely combined in a regimen with significant activity against LGNHL. A modification of this regimen may be suitable for further study.
UI - 12164743
AU - Suchin KR; Cucchiara AJ; Gottleib SL; Wolfe JT; DeNardo BJ; Macey WH;
TI - Bromley PG; Vittorio CC; Rook AH Treatment of cutaneous T-cell lymphoma with combined immunomodulatory therapy: a 14-year experience at a single institution.
SO - Arch Dermatol 2002 Aug;138(8):1054-60
AD - Department of Dermatology and General Clinical Research Center, Hospital of the University of Pennsylvania, Philadelphia, PA 19104-4283, USA.
OBJECTIVE: To determine the efficacy of multimodality biologic response therapy for patients with cutaneous T-cell lymphoma (CTCL). DESIGN: Retrospective cohort study over a 14-year period. SETTING: Tertiary care university hospital. PATIENTS: A consecutive sample of patients was studied, all 47 of whom carried the clinical and laboratory diagnosis of CTCL: 68% of patients had stage III or IV disease, and 89% had circulating malignant T cells. INTERVENTIONS: All 47 patients received photopheresis for 6 or more cycles. Thirty-one patients received treatment with a combination of photopheresis and 1 or more systemic immunostimulatory agents, including interferon alfa, interferon gamma, sargramostim, or systemic retinoids for 3 or more months. MAIN OUTCOME MEASURES: Differences in pretreatment prognostic factors, response rates, and survival between patients receiving multimodality therapy and single-modality therapy or historical controls. RESULTS: A total of 79% of patients responded to therapy: 26% had complete remission, and 53% had a partial remission. Median survival from initiation of therapy was 74 months. Median survival for patients with stages III and IV and peripheral blood involvement was 55 months compared with 31 months for historical controls. Compared with the photopheresis monotherapy group, the patients receiving combination immunomodulatory therapy had a worse prognosis at the time of treatment initiation based on multiple prognostic factors. The positive response rates and median survival times were 84% and 74 months, respectively, compared with 75% and 66 months, respectively, for the combination immunomodulatory and photopheresis monotherapy groups (P =.47 for positive response rates and P =.51 for survival). CONCLUSIONS: Patients with advanced CTCL and multiple poor prognostic factors who receive treatment with combination immunomodulatory therapy experience higher clinical response rates and longer survival than historical controls. Although the group who received combination therapy had worse prognostic factors at baseline, they had better response rates and overall survival compared with those receiving photopheresis monotherapy.
UI - 12164760
AU - Feher O; Sant'Ana RO; Valadares AD; Anelli A
TI - Alopecia universalis completely resolved following autologous bone marrow transplantation.
SO - Arch Dermatol 2002 Aug;138(8):1102-3
UI - 12029594
AU - Braune C; Rittmeister M; Engels K; Kerschbaumer F
TI - [Non-hodgkin-lymphoma of low malignancy (immunocytoma) and arthritis of the glenohumeral joint]
SO - Z Orthop Ihre Grenzgeb 2002 Mar-Apr;140(2):199-202
AD - Abteilung fur Rheumaorthopadie der Johann-Wolfgang-Goethe-Universitat Frankfurt, Germany.
AIM: Oligo- or monarthritis is reported as an uncommon complication of both acute and chronic leukemia. Childhood leukemias are complicated more frequently by leukemic arthritis (LA) than adult cases. LA occurs rather in acute than in chronic leukemia and can present at any stage of the disease. Proposed pathogenic mechanisms of arthritis in leukemia are leukemic infiltration of synovial tissue and resulting periosteal and capsular inflammation. As the primary manifestation of chronic lymphocytic leukemia (CLL) and immunocytoma (IC), LA is extremely rare. In such cases osteoarthritis may then be misdiagnosed as the source of joint disease. METHOD: We report a case of glenohumeral arthritis with complete rotator cuff tear and humeral head migration in an 88-year-old patient. Surgery exposed joint effusion, synovitis and chondromalacia with glenohumeral joint destruction. RESULTS: Histopathological examination revealed an articular chondrocalcinosis and bone marrow infiltration by an immunocytoma (B-cell non-Hodgkin lymphoma of low malignancy). CONCLUSION: Although LA is an uncommon complication in CLL and IC, it may be considered in elderly patients with lymphocytosis and arthritis.
UI - 12135682
AU - Altes A; Sierra J; Esteve J; Martin-Henao G; Marin P; Sureda A; Briones
TI - J; Martino R; Villamor N; Colomer D; Carreras E; Garcia J; Brunet S; Montserrat E CD34+-enriched-CD19+-depleted autologous peripheral blood stem cell transplantation for chronic lymphoproliferative disorders: high purging efficiency but increased risk of severe infections.
SO - Exp Hematol 2002 Jul;30(7):824-30
AD - Clinical Hematology Division, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain. firstname.lastname@example.org
OBJECTIVE: The main objective of this work was to decrease the incidence of relapse after autologous stem cell transplantation with a "double purging" procedure. METHODS: We used a "positive" (CD34) and "negative" (CD19) double selection method to improve the efficacy of "single purging" of hematopoietic harvests in poor-prognosis lymphoproliferative disorders. All patients included in the study had a positive molecular marker of their disease. Minimal residual disease (MRD) was studied by flow cytometry and PCR techniques during the purging procedure and after transplantation. RESULTS: Twenty-six patients fulfilled entry criteria. Median age of patients was 50 years (range: 33-66); 17 were male and 9 female. Thirteen (50%) of the patients mobilized an adequate number of CD34+ cells (>or=3 x 10(6)/kg) to proceed with the double-selection protocol. Twelve of the 13 harvests became PCR negative after purging. Ten patients were grafted with the selected products and all but one engrafted without delay. After a median follow-up of 30 months, 2 of 10 patients suffered a molecular relapse at 7 and 19 months respectively. The earlier relapse was observed in the patient who received a MRD+ product. Only one patient experienced a clinical relapse. Three patients died due to obliterans bronchiolitis, pneumococcal sepsis, and septic shock of unknown origin, respectively, and three others presented life-threatening infections. CONCLUSION: Therefore, CD34+/CD19+ positive/negative selection is an effective purging approach in patients with chronic lymphoproliferative disorders. This favorable effect is, however, counterbalanced by the high frequency of life-threatening infections.
UI - 11942381
AU - Warscotte L; Duprez T; Lonneux M; Michaux L; Renard L; Sindic CJ;
TI - Lecouvet FE Concurrent spinal cord and vertebral bone marrow radionecrosis 8 years after therapeutic irradiation.
SO - Neuroradiology 2002 Mar;44(3):245-8
AD - Department of Neurology, Universite catholique de Louvain, Cliniques universitaires Saint-Luc, Brussels, Belgium.
Concurrent radionecrosis within the spinal cord and the bone marrow at the same thoracic level was observed 8 years after localized therapeutic irradiation in a patient who had undergone repeated cycles of radiotherapy, glucocorticoid treatment, and chemotherapy for a non-Hodgkin's lymphoma. Mechanisms combining radiotoxic potentialization by glucocorticoids/alkylating agents and delayed radiation-induced vasculitis involving the common arterial pathways to the spinal cord and to the vertebrae were speculated to have acted in a synergistic way.
UI - 12173345
AU - Dabaja BS; Ha CS; Thomas DA; Wilder RB; Gopal R; Cortes J; Bueso-Ramos
TI - C; Hess MA; Cox JD; Kantarjian HM The role of local radiation therapy for mediastinal disease in adults with T-cell lymphoblastic lymphoma.
SO - Cancer 2002 May 15;94(10):2738-44
AD - Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Box 97, 1515 Holcombe Boulevard, Houston, TX 77030, USA. email@example.com
BACKGROUND: Mediastinal recurrence remains the most common cause of failure in patients with mediastinal T-cell lymphoblastic lymphoma (LBL). The role of mediastinal radiation therapy in improving local disease control and overall prognosis is not well-known with modern intensive chemotherapy. The objective of this study was to investigate the role of mediastinal radiation therapy in patients who achieve a complete response (CR) to chemotherapy. METHODS: The authors reviewed 47 patients with mediastinal T-cell LBL with or without bone marrow (BM) involvement who presented between 1980 and 1998. The median patient age was 25 years, and 33 patients (70%) were males. BM involvement was present in 16 patients (34%), 5 patients (11%) were in leukemic phase, lymph node involvement in was present 23 patients (49%), hepatosplenomegaly was present in 4 patients (9%), and pleural effusions were present in 22 patients (45%). The initial chemotherapy regimens were fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (hyper-CVAD) in 23 patients; cyclophosphamide, vincristine, doxorubicin, and dexamethasone in 9 patients; vincristine, doxorubicin, and dexamethasone in 4 patients; cyclophosphamide, doxorubicin, vincristine, and prednisone in 4 patients; and other in 7 patients. Forty-three patients achieved a CR to chemotherapy and were the subject of this analysis. Nineteen of those patients received adjuvant mediastinal radiation therapy at a dose ranging from 26 grays (Gy) to 39 Gy. RESULTS: There was no difference in patient characteristics between the 19 patients who were treated with mediastinal radiation therapy and the 24 patients who did not receive mediastinal radiation therapy. The median follow-up for all 43 patients was 43 months. The 5-year overall survival (OS) rate was 66%, and the freedom from progression (FFP) rate was 64%. None of 19 patients who received radiation therapy experienced a mediastinal recurrence compared with 8 of 24 patients who did not receive radiation therapy and experienced a mediastinal recurrence. Patients who were treated with mediastinal radiation therapy had a significantly better mediastinal FFP rate (P = 0.01), but the differences in overall FFP and OS rates were not significant (P = 0.14 and P = 0.25, respectively). The effectiveness of the hyper-CVAD regimen seemed to underscore the role of mediastinal radiation therapy; only 2 patients experienced a recurrence among 16 patients who received mediastinal radiation therapy, both outside the mediastinum. This compared with two patients who experienced a recurrence among six patients who did not receive mediastinal radiation therapy, both in the mediastinum. CONCLUSIONS: Local radiation therapy significantly decreased the risk of mediastinal recurrence in adult patients with mediastinal T-cell lymphoblastic lymphoma. The benefit of adjuvant radiation therapy was particularly evident in patients treated with more intensive chemotherapy regimens.