Información sobre riesgo, prevención, detección, síntomas, diagnosis, tratamiento y apoyo para el cáncer.
Información sobre el tratamiento del cáncer incluyendo quirúrgica, quimioterapia, radioterapia, estudios clínicos, terapia con protón, medicina complementaria avanzadas.
OncoLink se complace en ofrecer una amplia lista de lista completa de los agentes quimioterapéuticos más comúnmente usados??. Esta guía de referencia incluye información sobre la forma en que cada fármaco se administra, cómo funcionan, y los pacientes los efectos secundarios comunes pueden experimentar.
Maneras que los pacientes de cáncer y las personas que le cuidan puedan enfrentar el cáncer, los efectos secundarios, nutrición, cuestiones en general sobre el apoyo para el cáncer, duelo/decisiones sobre el termino de vida, y experiencias compartidas por sobrevivientes.
National Cancer Institute®
Ultima Vez Modificado: 21 de noviembre del 2001
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. firstname.lastname@example.org
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.
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
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
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. email@example.com
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.
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. firstname.lastname@example.org
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.
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.
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. email@example.com
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.
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
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. firstname.lastname@example.org
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.
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.
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.
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. email@example.com
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.
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. firstname.lastname@example.org
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.
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.
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. email@example.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.
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. firstname.lastname@example.org
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.
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. email@example.com
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.
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.
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.
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. firstname.lastname@example.org
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.
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.
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. email@example.com
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.
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. firstname.lastname@example.org
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.
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. email@example.com
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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