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NCI CANCERLIT® Search: Therapy of Non-Hodgkin's Lymphoma - April 2002
National Cancer Institute®
Ultima Vez Modificado: 1 de abril del 2002
Table of Contents
1
UI - 11854211
AU - Marcato P; Mulvey G; Armstrong GD
TI -
Cloned Shiga toxin 2 B subunit induces apoptosis in Ramos Burkitt's
lymphoma B cells.
SO - Infect Immun 2002 Mar;70(3):1279-86
AD - Department of Medical Microbiology and Immunology, University of
Alberta, Edmonton, Alberta T6G 2H7, Canada.
The Shiga toxins (Stx1 and Stx2), produced by Shigella dysenteriae type
1 and enterohemorrhagic Escherichia coli, consist of one A subunit and
five B subunits. The Stx1 and Stx2 B subunits form a pentameric
structure that binds to globotriaosylceramide (Gb3-Cer) receptors on
eukaryotic cells and promotes endocytosis. The A subunit then inhibits
protein biosynthesis, which triggers apoptosis in the affected cell. In
addition to its Gb3-Cer binding activity, the data in the following
report demonstrate that the Stx2 B pentamer induces apoptosis in Ramos
Burkitt's lymphoma B cells independently of A subunit activity.
Apoptosis was not observed in A subunit-free preparations of the Stx1 B
pentamer which competitively inhibited Stx2 B pentamer-mediated
apoptosis. The pancaspase inhibitor, Z-VAD-fmk, prevented apoptosis in
Ramos cells exposed to the Stx2 B subunit, Stx1 or Stx2. Brefeldin A, an
inhibitor of the Golgi transport system, also prevented Stx2 B
subunit-mediated apoptosis. These observations suggest that the Stx2 B
subunit must be internalized, via Gb3-Cer receptors, to induce Ramos
cell apoptosis. Moreover, unlike the two holotoxins, Stx2 B
subunit-mediated apoptosis does not involve inhibition of protein
biosynthesis. This study provides further insight into the pathogenic
potential of this family of potent bacterial exotoxins.
2
UI - 11788819
AU - Spaepen K; Mortelmans L
TI -
Evaluation of treatment response in patients with lymphoma using
[18F]FDG-PET: differences between non-Hodgkin's lymphoma and Hodgkin's
disease.
SO - Q J Nucl Med 2001 Sep;45(3):269-73
AD - Department of Nuclear Medicine, University Hospital Gasthuisberg,
Leuven, Belgium.
Fluorine-18fluorodeoxyglucose positron emission tomography
([18F]FDG-PET) has become a very useful technique for the therapy
monitoring of patients with lymphoma. It provides unique information
about the metabolic behavior of the disease independent of morphological
criteria. In recent years, [18F]FDG-PET has proven to be a technique
with high sensitivity for the detection of residual tumor. Therefore,
[18F]FDG-PET seems to be the ideal tool for the evaluation of treatment
response. However, most recent published studies included both HD and
NHL, although [18F]FDG-PET scan results in Hodgkin's disease (HD) has a
different impact than in Non Hodgkin's Lymphoma (NHL). In this paper, we
summarize our findings on the role of [18F]FDG-PET in the therapy
evaluation of lymphoma patients in a large group of patients and
highlight the differences between the interpretations of the results of
HD and NHL patients. Finally, a strategy for the implementation of
[18F]FDG-PET in the management of lymphoma patients is proposed.
3
UI - 11862427
AU - Hempel G; Flege S; Wurthwein G; Boos J
TI -
Peak plasma concentrations of doxorubicin in children with acute
lymphoblastic leukemia or non-Hodgkin lymphoma.
SO - Cancer Chemother Pharmacol 2002 Feb;49(2):133-41
AD - Institut fur Pharmazeutische Chemie, Westfalische Wilhems-Universitat,
Munster, Germany. hempege@uni-muenster.de
PURPOSE: The peak plasma concentrations seem to play an important role
in the toxicity of the anthracyclines. As there are only limited data in
the literature about the distribution of doxorubicin in children, we
assessed the peak plasma concentrations of doxorubicin in pediatric
patients. PATIENTS AND METHODS: We collected 87 plasma samples at the
end of infusion from 27 children with acute lymphoblastic leukemia (ALL)
or non-Hodgkin lymphoma (NHL) treated with 30 mg/m(2) doxorubicin as a
1- or 2-h infusion once weekly for four weeks in the ALL-BFM 95 or
NHL-BFM 95 protocol. Plasma concentrations of doxorubicin were
quantified by capillary electrophoresis, and the peak plasma levels for
a uniform 2-h infusion were calculated. RESULTS: The geometric mean of
all samples was 273 microg/l with a geometric coefficient of variation
of 46.0%. This is in accordance with the peak plasma concentrations
expected from simulations based on literature data from adults. High
inter-individual as well as substantial intra-individual variability was
observed. Girls had slightly higher peak plasma levels than boys. Age,
weight, and body mass index as well as laboratory parameters had no
influence on the peak plasma concentrations. No cumulation of
doxorubicin during therapy was observed. CONCLUSION: The peak plasma
concentrations are similar in adults and children for both the absolute
values as well as the variability; this indicates that there are no
major differences in the distribution of doxorubicin in children and
adults.
4
UI - 11862429
AU - Muller HJ; Beier R; da Palma JC; Lanvers C; Ahlke E; von Schutz V;
TI -
Gunkel M; Horn A; Schrappe M; Henze G; Kranz K; Boos J
PEG-asparaginase (Oncaspar) 2500 U/m(2) BSA in reinduction and relapse
treatment in the ALL/NHL-BFM protocols.
SO - Cancer Chemother Pharmacol 2002 Feb;49(2):149-54
AD - Department of Pediatric Hematology/Oncology, University of Munster,
Germany. muellerb@mailer.uni-marburg.de
PURPOSE: As previous data had shown that only two-thirds of patients had
the predicted activity time courses when PEG-asparaginase 1000 U/m(2)
was used in reinduction after native E. coli asparaginase in induction
treatment of acute lymphoblastic leukaemia (ALL), drug monitoring was
performed with the use of a higher dose. METHODS: Because one-third of
patients had insufficient serum asparaginase activity time courses after
a single dose of 1000 U/m(2) PEG-asparaginase during reinduction
treatment, a dose of 2500 U/m(2) PEG-asparaginase, which is the approved
dosage in Germany, was used in 39 reinduction and 20 relapse patients to
determine whether prolongation of the activity time course may be
possible with this higher dose, and to look for significant differences
between reinduction and relapse patients. RESULTS: After 1, 2 and 3
weeks, the mean activities were 1113 +/- 699 U/l, 231 +/- 259 U/l, and
13 +/- 35 U/l in the reinduction patients, and 1078 +/- 649 U/l, 165 +/-
195 U/l and 19 +/- 28 U/l in the relapse patients, respectively. There
were a considerable number of patients with a substantially shortened
activity time course in both groups. In 10 of 39 reinduction patients
and in 7 of 24 doses during relapse treatment, only activities <100 U/l
were found after 1 week with a further fast decline. No statistically
significant differences between the two patient groups could be shown at
any time-point. CONCLUSIONS: Comparison of these data with activities
after 1000 U/m(2) PEG-asparaginase showed no prolongation of the time
with activity in the therapeutic range with the higher dose. Therefore,
for a longer duration of therapeutic activity, administration of further
doses is mandatory.
5
UI - 11889454
AU - Kollmar O; Becker S; Schilling MK; Maurer CA
TI -
Intestinal lymphoma perforations as a consequence of highly effective
anti-CD20 antibody therapy.
SO - Transplantation 2002 Feb 27;73(4):669-70
6
UI - 11899688
AU - el Mrabet F; Ferhati D; Berkhli S; el Hanchi Z; Rhrab B; Lakhdar A;
TI -
Baidada A; Kettani F; Kharbach A; Chaoui A
[Primary malignant non-Hodgkin's lymphoma of the cervix uteri]
SO - Presse Med 2002 Feb 23;31(7):318
7
UI - 11899679
AU - el Omari-Alaoui H; Kebdani T; Benjaafar N; el Ghazi E; Erriahni H; el
TI -
Gueddari BK
[Non-Hodgkin's lymphoma of the uterus: apropos of 4 cases and review of
the literature]
SO - Cancer Radiother 2002 Feb;6(1):39-45
AD - Service de radiotherapie, Institut national d'oncologie, Rabat, Maroc.
The primary non hodgkin's lymphoma of the uterus is rare. This rarity
explains of one part certain difficulties of the histological diagnosis
and on the other hand the absence of a therapeutic strategy clearly
established. We report 4 cases of primary non-hodgkin lymphoma of the
uterus. Two patients had a cervical location, the two other had corpus
location. The average age of our patients is of 59 years (extremes:
54-68). Histological diagnosis was confirmed by biopsy for the cervical
location. For the corpus location, it is study of the uterus after
hysterectomy which retained the diagnosis of lymphoma. The type of the
lymphoma was low grade in two cases and high grade in the two other
cases. The disease was limited to the pelvis for all our patients (stage
IE according to Ann-Arbor's classification). The treatment consisted of
an association of chemotherapy and radiotherapy in both cases of
lymphoma of the cervix and in a radical hysterectomy followed by
chemotherapy for the two cases of lymphoma of the corpus. Our patients
are regularly followed, with an average follow-up of 56 months. Two
patients are in disease free, the third patient presented a
dissemination of the disease and the fourth patient presented a squamous
cell carcinoma of the lung.
8
UI - 11915743
AU - Tobinai K
TI -
[Rituximab, a chimeric anti-CD20 monoclonal antibody, in the treatment
of B-cell lymphoma]
SO - Gan To Kagaku Ryoho 2002 Mar;29(3):473-80
AD - Hematology Division, National Cancer Center Hospital, 5-1-1 Tsukiji,
Chuo-ku, Tokyo 104-0045, Japan.
monoclonal antibody, was approved for the treatment of B-cell lymphoma
by the Japanese government. Rituximab is the first monoclonal antibody
that was approved for the treatment of malignant neoplasms by the U.S.
Food and Drug Administration (FDA). Several clinical trials of rituximab
conducted in USA, Europe and Japan revealed its promising therapeutic
efficacy for B-cell lymphoma. Its minimal myelotoxicity allows rituximab
to be combined with full doses of anticancer agents. Ongoing clinical
trials will define the future role of rituximab in the treatment of
B-cell lymphoma.
9
UI - 11760551
AU - Zelenetz AD; Hoppe RT; NCCN Non-Hodgkin's Lymphoma Practice Guidelines
TI -
Panel
NCCN: Non-Hodgkin's lymphoma.
SO - Cancer Control 2001 Nov-Dec;8(6 Suppl 2):102-13
AD - Stanford University Medical Center.
10
UI - 11868363
AU - Yanagiya N; Takahashi N; Nakae H; Kume M; Chubachi A; Miura I
TI -
[Plasma exchange and continuous hemodiafiltration as an initial
treatment for diffuse large B-cell lymphoma-associated hemophagocytic
syndrome]
SO - Rinsho Ketsueki 2002 Jan;43(1):35-40
AD - Third Department of Internal Medicine, Akita University School of
Medicine.
A 68-year-old man was admitted to our hospital because of fever,
jaundice and hepatosplenomegaly. A diagnosis of diffuse large cell,
B-cell type malignant lymphoma, associated with hemophagocytic syndrome
(LAHS), was made. CT scan revealed lymphadenopathy in the abdominal
cavity and multiple tumors in the spleen. Performance status and hepatic
coma grade were 4 and II, respectively. Laboratory findings showed
bicytopenia (Hb 9.9 g/dl, platelet 35 x 10(3)/microliter), severe liver
dysfunction (ALP 1,115 U/l, gamma-GTP 437 U/l, T.Bil 15.4 mg/dl, D.Bil
12.8 mg/dl) and elevated levels of beta 2 microglobulin (12.9 mg/dl),
ferritin (2,300 ng/ml) and sIL-2 receptor (36,900 U/ml). Plasma exchange
(PE) and continuous hemodiafiltration (CHDF) enabled the patient to
undergo diagnostic procedures, irradiation (total 34 Gy) and
chemotherapy. Biopsy specimens revealed infiltration of lymphoma cells
into the liver and bone marrow. We measured the blood concentrations of
TNF-alpha, IL-6, and IL-8 before and after PE and CHDF by the ELISA
method, and found normalization of hypercytokinemia after the procedure.
It was suggested that initial treatment with PE and CHDF was effective
for control of HPS, enabling us to perform chemotherapy for the
lymphoma.
11
UI - 11790067
AU - Kouroukis CT; Browman GP; Esmail R; Meyer RM
TI -
Chemotherapy for older patients with newly diagnosed, advanced-stage,
aggressive-histology non-Hodgkin lymphoma: a systematic review.
SO - Ann Intern Med 2002 Jan 15;136(2):136-43
AD - Hamilton Regional Cancer Centre, 699 Concession Street, Hamilton,
Ontario L8V 5C2, Canada.
PURPOSE: To conduct a systematic review assessing chemotherapeutic
regimens in patients at least 60 years of age with previously untreated,
advanced-stage, aggressive-histology non-Hodgkin lymphoma. DATA SOURCES:
Computerized databases were searched for reports from 1966 to April
2000. Relevant journals, textbooks, and reference lists of published
articles were hand searched. Abstract reports were not considered. STUDY
SELECTION: Randomized trials comparing different chemotherapy regimens
were selected. Two independent assessors, who were blinded to authors,
institution, and results of the report, reviewed the retrieved
citations. DATA EXTRACTION: One author abstracted data on patient
characteristics, study quality score, survival, disease response and
control, toxicity, and quality of life; pooling was not done because of
study heterogeneity. DATA SYNTHESIS: 12 randomized trials that compared
chemotherapeutic regimens were reviewed. Progression-free and overall
survival were improved when anthracycline-containing regimens, such as
CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) or
CTVP (cyclophosphamide, pirarubicin, vincristine, and prednisone), were
compared with other regimens. CONCLUSIONS: For treatment of older
patients with advanced-stage, aggressive-histology lymphoma who do not
have significant comorbid illnesses, an anthracycline-containing
regimen, such as CHOP, given in standard doses and schedule, provides
for superior outcomes compared with other regimens.
12
UI - 11779292
AU - Godwin JE; Fisher RI
TI -
Diffuse large-cell lymphomas: a review of therapy.
SO - Clin Lymphoma 2001 Dec;2(3):155-63
AD - Department of Medicine and Pathology, Cardinal Bernardin Cancer Center,
Loyola University Chicago, Maywood, IL 60153, USA. jgodwin@lumc.edu
In this review, the historical and modern classification schemes of
non-Hodgkin's lymphoma (NHL) will be briefly summarized, with a critical
review of the evolution and current state of treatment strategies for
diffuse large-cell lymphoma (DLCL). We provide current treatment
recommendations for newly diagnosed disease and indicate the areas of
active clinical investigation. In the past, many of the promising phase
II studies in DLCL have appeared beneficial based on patient selection
criteria and not the therapeutic result. Lessons learned in clinical
trials in NHL may serve as a paradigm for other cancer investigations.
13
UI - 11779293
AU - Rutar FJ; Augustine SC; Kaminski MS; Wahl RL; Siegel JA; Colcher D
TI -
Feasibility and safety of outpatient Bexxar therapy (tositumomab and
iodine I 131 tositumomab) for non-Hodgkin's lymphoma based on radiation
doses to family members.
SO - Clin Lymphoma 2001 Dec;2(3):164-72
AD - University of Nebraska Medical Center, Omaha 68198-5480, USA.
frutar@unmc.edu
Radioimmunotherapy with anti-CD20 antibodies is a promising treatment
approach for relapsed low-grade non-Hodgkin's lymphoma. Under revised
released following treatment provided the maximum dose to any individual
is not likely to exceed 500 mrem. Non-Hodgkin's lymphoma patients have
been studied to evaluate radiation exposure to caregivers/family members
after outpatient treatment with tositumomab and iodine I 131 tositumomab
(Bexxar therapy). Estimates of total radiation doses to individuals
expected to be maximally exposed to patients posttreatment have revealed
that the doses should be within revised guidelines. In a University of
Nebraska Medical Center study, the predicted total radiation doses
(based on patient dose rate at 1 meter) ranged from 95-423 mrem. Family
members were provided radiation-monitoring devices to directly monitor
radiation exposure. Measured doses ranged from 10-409 mrem. In this and
other studies, estimated and measured dose equivalents to maximally
exposed individuals were below 500 mrem. Measured doses were, in most
instances, lower than those predicted by patient-specific calculations,
thus confirming the validity of the calculated dose predictions.
Therefore, radioimmunotherapy with tositumomab and iodine I 131
tositumomab can be safely conducted on an outpatient basis.
14
UI - 11779297
AU - Natkunam Y; Stanton TS; Warnke RA; Horning SJ
TI -
Durable remission in recurrent T-cell-rich B-cell lymphoma with the
anti-CD20 antibody rituximab.
SO - Clin Lymphoma 2001 Dec;2(3):185-7
AD - Department of Pathology, Stanford University Medical Center, Stanford,
CA 94305, USA. yaso@stanford.edu
A diagnostic continuum exists between lymphocyte-predominant Hodgkin's
disease, T-cell-rich B-cell lymphoma (TCRBCL), and diffuse large B-cell
lymphoma. While TCRBCLs are uncommon, their clinical and morphologic
presentation can mimic other Hodgkin's and non-Hodgkin's lymphomas from
which they must be distinguished for diagnosis and treatment. We present
an unusual case of a 30-year-old man with recurrent TCRBCL arising from
lymphocyte-predominant Hodgkin's disease with remarkable response to
treatment with the anti-CD20 antibody, rituximab.
15
UI - 11779298
AU - Brown KS; Levitt DJ; Shannon M; Link BK
TI -
Phase II trial of Remitogen (humanized 1D10) monoclonal antibody
targeting class II in patients with relapsed low-grade or follicular
lymphoma.
SO - Clin Lymphoma 2001 Dec;2(3):188-90
AD - Division of Hematology, Oncology, and Blood and Marrow Transplant,
Department of Internal Medicine and Holden Comprehensive Cancer Center,
University of Iowa, Iowa City, 52242, USA.
16
UI - 11902529
AU - Du MQ; Isaccson PG
TI -
Gastric MALT lymphoma: from aetiology to treatment.
SO - Lancet Oncol 2002 Feb;3(2):97-104
AD - Department of Histopathology, Royal Free and University College Medical
School, University College London, UK. m.du@ucl.ac.uk
The development of gastric mucosa-associated lymphoid tissue (MALT)
lymphoma is dependent on Helicobacter pylori infection. Bacterial
colonisation of the gastric mucosa triggers lymphoid infiltration and
the formation of acquired MALT. The bacterial infection induces and
sustains an actively proliferating B-cell population through direct
(autoantigen) and indirect (intratumoral T cells specific for H. pylori)
immunological stimulation. Moreover, the bacterial infection provokes a
neutrophilic response, which causes the release of oxygen free radicals.
These reactive species may promote the acquisition of genetic
abnormalities and malignant transformation of reactive B cells. A
transformed clone carrying the translocation t(1;18)(q21;q21) forms a
MALT lymphoma, the growth of which is independent of H. pylori and will
not respond to bacterial eradication. Malignant clones without
t(11;18)(q21;q21), but with other genetic abnormalities, such as trisomy
3 or microsatellite instability, depend critically on immune stimulation
mediated by H. pylori for their clonal expansion. In the early stages,
the tumour can be successfully treated by eradication of the bacterium,
whereas at later stages the tumour may escape its growth dependency
through acquisition of additional genetic abnormalities such as
t(1;14)(p22;q32) and t(1;2)(p22,p12) involving the BCL-10 gene. Finally,
further genetic abnormalities, such as inactivation of the tumour
suppressor genes, p53 and p16, can lead to high-grade transformation.
Detection of these abnormalities may help with the clinical management
of patients with gastric MALT lymphoma.
17
UI - 11533100
AU - Rodriguez J; Munsell M; Yazji S; Hagemeister FB; Younes A; Andersson B;
TI -
Giralt S; Gajewski J; de Lima M; Couriel D; Romaguera J; Cabanillas FF;
Champlin RE; Khouri IF
Impact of high-dose chemotherapy on peripheral T-cell lymphomas.
SO - J Clin Oncol 2001 Sep 1;19(17):3766-70
AD - Department of Blood and Marrow Transplantation, University of Texas M.D.
Anderson Cancer Center, Houston, TX 77030, USA.
PURPOSE: To evaluate the outcome of high-dose chemotherapy (HDCT) and
autologous or allogeneic hematopoietic transplantation in patients with
peripheral T-cell lymphoma (PTCL) who experienced disease recurrence
after prior conventional chemotherapy. PATIENTS AND METHODS: We
performed a retrospective analysis of 36 PTCL patients from the
University of Texas M.D. Anderson Cancer Center treated between 1989 and
1998 with HDCT and autologous or allogeneic hematopoietic
transplantation. RESULTS: A total of 36 patients were studied (29
received autologous transplantation, and seven received allogeneic
transplantation). The overall survival rate at 3 years was 36% (95%
confidence interval [CI], 23% to 59%), and the progression-free survival
(PFS) rate was 28% (95% CI, 16% to 49%). The pretransplant serum lactate
dehydrogenase level was the most important prognostic factor for both
survival and PFS rates (P < .001). A Pretransplant International
Prognostic Index score of < or = 1 indicated a superior survival rate (P
= .036) but not an improved PFS rate. A median follow-up of 43 months
(range, 13 to 126 months) showed 13 patients (36%) were still alive with
no evidence of disease. CONCLUSION: Our results are comparable to the
published data on HDCT in B-cell non-Hodgkin's lymphoma (NHL) patients
despite the fact that patients with PTCL are known to have a worse
outcome compared with B-cell NHL patients. Considering the dismal
outcome of conventional chemotherapy in PTCL patients, these data
suggest the hypothesis that the poor prognostic implication of T-cell
phenotyping in NHL might be overcome by frontline HDCT and
transplantation.
18
UI - 11866264
AU - Levy M; Copie-Bergman C; Traulle C; Lavergne-Slove A; Brousse N; Flejou
TI -
JF; de Mascarel A; Hemery F; Gaulard P; Delchier JC; Groupe d'Etude des
Lymphomes de l'Adulte (GELA)
Conservative treatment of primary gastric low-grade B-cell lymphoma of
mucosa-associated lymphoid tissue: predictive factors of response and
outcome.
SO - Am J Gastroenterol 2002 Feb;97(2):292-7
AD - Service d'Hepatologie et de Gastroenterologie, Departement de Pathologie
et EA 2348, and Service de Biostatistiques et d'Informatique, Hjpital
Henri Mondor, Creteil, France.
OBJECTIVES: Primary gastric low-grade B-cell lymphoma of
mucosa-associated lymphoid tissue may regress with conservative
treatment such as anti-Helicobacterpylori therapy or monochemotherapy.
The aims of the present study were to analyze the predictive factors of
response to anti-H. pylori treatment, to assess the effects of an
adjuvant therapy in responding patients, and to evaluate an alternative
therapy in nonresponding patients. METHODS: From 1995 to 2000, 48 H.
pylori-infected patients with localized primary gastric low-grade B-cell
lymphoma of mucosa-associated lymphoid tissue were treated with anti-H.
pylori therapy. Endoscopic and endoscopic ultrasonography features and
histological grading of large cells' proportion were analyzed.
Eradication of H. pylori and tumoral response were assessed at 2 and 6
months, respectively. From 1996, patients in remission at 6 months were
randomized to receive either chlorambucil p.o. for 6 months or no
treatment. Patients who did not respond to H. pylori eradication
received chlorambucil p.o. for 1 yr. RESULTS: Among the 48 treated
patients, 33 (69%) were in complete (n = 28) or in partial (n = 5)
remission, and 15 (31%) were in treatment failure at 6 months. H. pylori
was eradicated in 47 patients. The response was not correlated with the
endoscopic features or with the histological grade. In contrast, it was
related to ultrasonographic features: remission was achieved in 76% of
patients when no perigastric lymph node was detected versus only 33%
when endoscopic ultrasonography showed presence of lymph nodes (p =
0.025). All responding patients remained in remission (median 34 months)
whatever the treatment they received (no treatment or chlorambucil).
Remission could be achieved with chlorambucil in 58% of the
nonresponding patients to anti-H. pylori treatment. CONCLUSIONS: The
major negative predictive factor of the tumoral response to anti-H.
pylori treatment in patients with primary gastric low-grade B-cell
lymphoma of mucosaassociated lymphoid tissue was the presence of
perigastric lymph nodes on endoscopic ultrasonography. In responding
patients, remission remained stable, suggesting that adjuvant
chemotherapy was not useful. In patients who failed to respond to H.
pylori eradication, monochemotherapy with chlorambucil proved to be
efficient, but new therapeutic modalities should be evaluated to improve
the control of the tumoral process.
19
UI - 11870175
AU - Wang XS; Giralt SA; Mendoza TR; Engstrom MC; Johnson BA; Peterson N;
TI -
Broemeling LD; Cleeland CS
Clinical factors associated with cancer-related fatigue in patients
being treated for leukemia and non-Hodgkin's lymphoma.
SO - J Clin Oncol 2002 Mar 1;20(5):1319-28
AD - Department of Symptom Research, Division of Anesthesiology and Critical
Care, The University of Texas M.D. Anderson Cancer Center, Houston, TX
77030, USA. swong@mdanderson.org
PURPOSE: To describe fatigue severity, fatigue interference, and
associated factors in hematologic malignancies. PATIENTS AND METHODS:
Patients being treated for leukemia and non-Hodgkin's lymphoma (n = 228)
completed the Brief Fatigue Inventory to rate fatigue severity and
functional interference caused by fatigue. Data on patient demographics,
Eastern Cooperative Oncology Group performance status, other physical
symptoms, current treatments, and laboratory values were also collected.
Descriptive statistics, bivariate correlation, and logistic regression
were used for data analysis. RESULTS: Fifty percent of the sample
reported severe fatigue, which was defined as a "fatigue worst" rating
of 7 or greater. More patients with acute leukemia (61%) reported severe
fatigue compared with those with chronic leukemia (47%) and
non-Hodgkin's lymphoma (46%). Increased fatigue severity significantly
compromised patients' general activity, work, enjoyment of life, mood,
walking, and relationships with others. Fatigue severity was strongly
associated with performance status, use of opioids, blood transfusions,
gastrointestinal symptoms, and sleep disturbance items, as well as with
low serum hemoglobin and albumin levels. Regression analysis indicated
that nausea was the significant clinical predictor of severe fatigue
(odds ratio, 13), and low serum albumin was the significant laboratory
value predictor (odds ratio, 3.8). CONCLUSION: Disabling fatigue occurs
with high frequency in hematologic malignancy, supporting a need to
develop better methods of fatigue management. Better control of
gastrointestinal and other symptoms may be of benefit. The mechanism and
relationship between low albumin and severe fatigue needs to be
investigated further, and longitudinal studies of the effects of
treatment, host factors, and other symptoms are needed.
20
UI - 11870192
AU - Mounier N; Simon D; Haioun C; Gaulard P; Gisselbrecht C
TI -
Impact of high-dose chemotherapy on peripheral T-cell lymphomas.
SO - J Clin Oncol 2002 Mar 1;20(5):1426-7
21
UI - 11884495
AU - Siegel JA; Kroll S; Regan D; Kaminski MS; Wahl RL
TI -
A practical methodology for patient release after tositumomab and
(131)I-tositumomab therapy.
SO - J Nucl Med 2002 Mar;43(3):354-63
AD - Nuclear Physics Enterprises, Cherry Hill, New Jersey 08003, USA.
siegelja@aol.com
A methodology was developed determining patient releasability after
radioimmunotherapy with tositumomab and (131)I-tositumomab for the
treatment of non-Hodgkin's lymphoma. METHODS: Dosimetry data were
obtained and analyzed after 157 administrations of (131)I-tositumomab to
139 patients with relapsed or refractory non-Hodgkin's lymphoma.
Tositumomab and (131)I-tositumomab therapy included dosimetric (low
activity) and therapeutic (high activity) administrations. For each
patient, the total-body residence time was calculated after the
dosimetric administration from total-body counts obtained over 6 or 7 d
and was then used to determine the appropriate therapeutic activity to
deliver a specific total-body radiation dose. Patient dose rates at 1 m
were measured immediately after the therapeutic infusion.
Patient-specific calculations based on the measured total-body residence
time and dose rate for (131)I-tositumomab were derived to determine the
patient's maximum releasable dose rate at 1 m, estimated radiation dose
to maximally exposed individuals, and the amount of time necessary to
avoid close contact with others. RESULTS: The mean administered activity
(+/-SD), determined by dosimetry studies for each patient before
therapy, was 3,108 +/- 1,073 MBq (84 +/- 29 mCi) (range, 1,221 +/- 5,957
MBq [33--161 mCi]). Immediately after treatment, the mean measured dose
rate (+/- SD) at 1 m was 0.109 +/- 0.032 mSv/h (10.9 +/- 3.2 mrem/h;
range, 0.04--0.24 mSv/h [4--24 mrem/h]). The measured dose rates were
60% (range, 37%--90%; P < 0.0001) of the theoretic dose rates from a
point source in air predicted using the dose equivalent rate per unit
activity of (131)I (5.95 x 10(-5) mSv/MBq h [0.22 mrem/mCi h] at 1 m).
The mean estimated radiation dose to the maximally exposed individual
was 3.06 mSv (306 mrem) (range, 1.95--4.96 mSv [195--496 mrem]). On the
basis of current regulatory patient-release criteria, all
(131)I-tositumomab--treated patients were determined to be releasable by
comparing the dose rate at 1 m with a predetermined maximum releasable
dose rate. Detailed instructions were provided to limit family members'
exposure. CONCLUSION: A methodology has been developed for the release
of patients administered radioactive materials based on the new Nuclear
Regulatory Commission regulations. This approach uses a patient-specific
dose calculation based on the measured total-body residence time and
dose rate. This analysis shows the feasibility of outpatient
radioimmunotherapy with tositumomab and (131)I-tositumomab.
22
UI - 11801488
AU - Cohen Y; Amir G; Rachmilewitz EA; Polliack A
TI -
Sustained complete remission following a combination of very low
intensity chemotherapy with rituximab in an elderly patient with
Burkitt's lymphoma.
SO - Haematologica 2002 Jan;87(1):ELT04
AD - Department of Hematology, Hadassah University Hospital, Jerusalem,
Israel 91120.
23
UI - 11849235
AU - Straka C; Oduncu F; Drexler E; Mitterer M; Schnabel B; Konig A; Brack N;
TI -
Nerl C; Emmerich B
The CD19+ B-cell counts at peripheral blood stem cell mobilization
determine different levels of tumour contamination and autograft
purgability in low-grade lymphoma.
SO - Br J Haematol 2002 Mar;116(3):695-701
AD - Medizinische Klinik-Innenstadt, University of Munich, Munich, Germany.
cstraka@medinn.med.uni-muenchen.de
The tumour load of peripheral blood stem cell (PBSC) harvests and the
outcome of ex vivo immunomagnetic B-cell purging was investigated in 19
patients with low-grade lymphoma. To quantify the tumour load, we
combined fluorescence-activated cell sorting measurement of CD19+
B-cells and determination of the B-cell light chain ratio (LCR) with
consensus complementarity-determining region III-polymerase chain
reaction (CDRIII-PCR) and gene scan analysis. The number of tumour cells
was calculated using B-cell extracts from the PBSCs. Two different
patterns were distinguished. In eight patients (42%) with CD19+ B cells
>1% in the apheresis product, a high tumour load was found,
characterized by a monoclonal LCR, positive PCR in seven out of eight
cases, >5 x 10(7) extracted lymphoma cells in six out of seven
PCR-assessable cases, and the presence of residual lymphoma after
purging in six of seven cases. In 11 patients (58%) with <1% CD19+
B-cells in the product, a low tumour load was indicated by a polyclonal
LCR, positive PCR in only 4 out of 11 cases, >5 x 10(7) extracted
lymphoma cells in zero out of four PCR-assessable cases, and the
presence of residual lymphoma after purging in zero out of four of these
cases. The level of residual lymphoma following purging largely depended
on the level of tumour contamination. CD19+ B-cells >50/microl in the
peripheral blood at mobilization predicted a high tumour load in the
apheresis product.
24
UI - 11054376
AU - Fischbach W; Dragosics B; Kolve-Goebeler ME; Ohmann C; Greiner A; Yang
TI -
Q; Bohm S; Verreet P; Horstmann O; Busch M; Duhmke E; Muller-Hermelink
HK; Wilms K; Allinger S; Bauer P; Bauer S; Bender A; Brandstatter G;
Chott A; Dittrich C; Erhart K; Eysselt D; Ellersdorfer H; Ferlitsch A;
Fridrik MA; Gartner A; Hausmaninger M; Hinterberger W; Hugel K; Ilsinger
P; Jonaus K; Judmaier G; Karner J; Kerstan E; Knoflach P; Lenz K;
Kandutsch A; Lobmeyer M; Michlmeier H; Mach H; Marosi C; Ohlinger W;
Oprean H; Pointer H; Pont J; Salabon H; Samec HJ; Ulsperger A; Wimmer A;
Wewalka F
Primary gastric B-cell lymphoma: results of a prospective multicenter
study. The German-Austrian Gastrointestinal Lymphoma Study Group.
SO - Gastroenterology 2000 Nov;119(5):1191-202
AD - Medizinische Klinik II, Klinikum Aschaffenburg, Aschaffenburg, Germany.
BACKGROUND & AIMS: Appropriate management of primary gastric lymphoma is
controversial. This prospective, multicenter study aimed to evaluate the
accuracy of endoscopic biopsy diagnosis and clinical staging procedures
and assess a treatment strategy based on Helicobacter pylori status and
tumor stage and grade. METHODS: Of 266 patients with primary gastric
B-cell lymphoma, 236 with stages EI (n = 151) or EII (n = 85) were
included in an intention-to-treat analysis. Patients with H.
pylori-positive stage EI low-grade lymphoma underwent eradication
therapy. Nonresponders and patients with stage EII low-grade lymphoma
underwent gastric surgery. Depending on the residual tumor status and
predefined risk factors, patients received either radiotherapy or no
further treatment. Patients with high-grade lymphoma underwent surgery
and chemotherapy at stages EI/EII, complemented by radiation in case of
incomplete resection. RESULTS: Endoscopic-bioptic typing and grading and
clinical staging were accurate to 73% and 70%, respectively, based on
the histopathology of resected specimens. The overall 2-year survival
rates for low-grade lymphoma did not differ in the risk-adjusted
treatment groups, ranging from 89% to 96%. In high-grade lymphoma,
patients with complete resection or microscopic tumor residuals had
significantly better survival rates (88% for EI and 83% for EII) than
those with macroscopic tumor residues (53%; P < 0.001). CONCLUSIONS:
There is a considerable need for improvement in clinical diagnostic and
staging procedures, especially with a view toward nonsurgical treatment.
With the exception of eradication therapy in H. pylori-positive
low-grade lymphoma of stage EI and the subgroup of locally advanced
high-grade lymphoma, resection remains the treatment of choice. However,
because there is an increasing trend toward stomach-conserving therapy,
a randomized trial comparing cure of disease and quality of life with
surgical and conservative treatment is needed.
25
UI - 11163492
AU - Murtha AD; Rupnow BA; Hansosn J; Knox SJ; Hoppe R
TI -
Long-term follow-up of patients with Stage III follicular lymphoma
treated with primary radiotherapy at Stanford University.
SO - Int J Radiat Oncol Biol Phys 2001 Jan 1;49(1):3-15
AD - Department of Radiation Oncology, Stanford University Medical Center,
Stanford, CA, USA. albertmu@cancerboard.ab.ca
PURPOSE: To report the long-term survival and late toxicity data of
Stage III follicular lymphoma patients treated with primary
radiotherapy.METHODS AND MATERIALS: Sixty-six patients with Stage III
follicular small cleaved (FSC) or follicular mixed (FM) non-Hodgkin's
lymphoma were treated with total lymphoid irradiation (61 patients) or
whole body irradiation (5 patients) as their primary treatment modality
from 1963 to 1982 at Stanford University. Adjuvant chemotherapy was
given to 13 patients. RESULTS: Median follow-up was 9.5 years with a
range of 0.5-24.3 years. Median overall survival, cause-specific
survival, freedom from relapse, and event-free survival were 9.5, 18.9,
7.1, and 5.1 years, respectively. Few initial relapses or
lymphoma-related deaths were seen beyond the first decade of follow-up.
Patient age and number of disease sites were the two strongest
predictors of overall survival. The cohort of patients with limited
Stage III disease demonstrated an 88% freedom from relapse and a 100%
cause-specific survival with up to 23.5 years follow-up. CONCLUSION: The
long-term survival data for Stage III FSC or FM non-Hodgkin's lymphoma
treated with primary radiotherapy are at least comparable and possibly
better than results achieved with other therapeutic approaches. Patients
with limited Stage III disease do particularly well. Whether these
results are superior to an initial approach of deferred therapy until
clinically indicated is currently unknown.
26
UI - 11762817
AU - Machover D; Delmas-Marsalet B; Misra SC; Gumus Y; Goldschmidt E; Schilf
TI -
A; Frenoy N; Emile JF; Debuire B; Guettier C; Farrokhi P; Boulefdaoui B;
Norol F; Parquet N; Ulusakarya A; Jasmin C
Dexamethasone, high-dose cytarabine, and oxaliplatin (DHAOx) as salvage
treatment for patients with initially refractory or relapsed
non-Hodgkin's lymphoma.
SO - Ann Oncol 2001 Oct;12(10):1439-43
AD - Department of Hematology and Oncology and the Institut du Cancer et
d'Immunogenetique (ICIG), Hospital Paul Brousse, Villejuif, France.
david.machover@pbr.ap-hop-paris.fr
BACKGROUND: Dexamethasone. cytarabine (ara-C), and cisplatin (DHAP) can
be used effectively to treat patients with non-Hodgkin's lymphoma (NHL).
We hypothesized that substitution of cisplatin by oxaliplatin (L-OHP)
could result in less toxicity and greater efficacy. L-OHP is active in
patients with lymphoma. It produces mild myelosuppression and is devoid
of renal toxicity. We report on a phase II study of dexamethasone,
high-dose ara-C, and L-OHP (DHAOx) used to treat patients with NHL who
were previously treated with chemotherapy. PATIENTS AND METHODS: Fifteen
patients were given DHAOx. They had failed to achieve a CR with initial
chemotherapy or had recurrent disease. DHAOx consisted of dexamethasone,
40 mg/day (days 1 to 4): L-OHP, 130 mg/m2 (day 1); and ara-C, 2,000
mg/m2 every 12 h (day 2). Treatment was repeated every 21 days. RESULTS:
Patients received a median of four courses of DHAOx. Myelosuppression
and transient sensory peripheral neuropathy were the most prominent
toxic effects. Serum creatinine levels did not increase in patients with
normal renal function, nor in patients who had renal impairment before
DHAOx. The median follow-up time from the start of DHAOx treatment was
17 months. Eight patients (53%) achieved a CR, and three patients (20%)
had a PR. Responses were achieved by patients with lymphomas of various
histologies that included mainly the follicular subtype, and by patients
with and without resistance to prior chemotherapy. None of the eight
responders have relapsed from CR at 4+. 6+, 14+, 15+, 19+, 20+, 24+, and
24+ months. They had various types of therapy after DHAOx. Disappearance
of molecular markers was observed in all four patients who achieved a CR
and whose tumor cells carried molecular abnormalities. CONCLUSION: DHAOx
possesses characteristics of toxicity which compare favorably to those
reported with DHAP, and it is useful as a salvage treatment for patients
with NHL. Larger studies are required to establish the therapeutic
potential of the regimen.
27
UI - 11762819
AU - Seymour JF; Grigg AP; Szer J; Fox RM
TI -
Fludarabine and mitoxantrone: effective and well-tolerated salvage
therapy in relapsed indolent lymphoproliferative disorders.
SO - Ann Oncol 2001 Oct;12(10):1455-60
AD - Department of Haematology, The Peter MacCallum Cancer Institute, East
Melbourne, Victoria, Australia. jseymour@petermac.unimelb.edu.au
BACKGROUND: Prior studies of the combination of fludarabine,
mitoxantrone and dexamethasone have yielded high response rates but are
associated with a significant risk of opportunistic infections,
predominantly Pneumocystis Carinii pneumonia (PCP) requiring routine
prophylaxis. PATIENTS AND METHODS: We evaluated the combination of
fludarabine (25 mg/m2/day x 3) and mitoxantrone (10 mg/m2 x 1) without
corticosteroids or PCP prophylaxis in 29 patients with relapsed or
refractory indolent lymphoproliferative disorders; median age 56 years,
62% refractory to preceding chemotherapy. RESULTS: A median of four
cycles was administered without cumulative myelosuppression. Neutropenia
<0.5 x 10(9/)l was seen in 16% of cycles. Infections complicated 10.4%
of cycles. with impaired performance status (> or = ECOG 2) and
increased age ( > 56 years) significant risk factors (P < or = 0.01). No
cases of PCP were encountered. The response rate was 90%, median
remission duration 11.9 months and the median survival 57 months.
Peripheral blood progenitor cell mobilization was attempted in 11
patients and yielded > or = 2 x 10(6) CD34+ cells/kg in only 5 cases
(45%). CONCLUSIONS: High response rates can be attained with fludarabine
and mitoxantrone in combination without corticosteroids, and routine PCP
prophylaxis can safely be omitted. Peripheral blood progenitor
collections are problematic in these heavily pretreated patients.
28
UI - 11762825
AU - Saikia TK; Menon H; Advani SH
TI -
Prolonged neutropenia following anti CD20 therapy in a patient with
relapsed follicular non-Hodgkin's lymphoma and corrected with IVIG.
SO - Ann Oncol 2001 Oct;12(10):1493-4
29
UI - 11902983
AU - Breneman D; Duvic M; Kuzel T; Yocum R; Truglia J; Stevens VJ
TI -
Phase 1 and 2 trial of bexarotene gel for skin-directed treatment of
patients with cutaneous T-cell lymphoma.
SO - Arch Dermatol 2002 Mar;138(3):325-32
AD - Department of Dermatology, University of Cincinnati, OH, USA.
OBJECTIVE: To evaluate the safety, dose tolerance, and efficacy of
topical bexarotene gel in patients with early-stage cutaneous T-cell
lymphoma (CTCL). DESIGN: Phase 1 and 2, open-label, dose-escalation
clinical trial of bexarotene gel. SETTING: Three university-based
clinics. PARTICIPANTS: Sixty-seven adults with early-stage (TNM stages
IA-IIA) CTCL. INTERVENTIONS: Bexarotene gel, 0.1%, 0.5%, and 1.0%,
applied in incremental dose adjustments from 0.1% gel every day to 1.0%
gel 4 times daily or the maximal tolerated dose. MAIN OUTCOME MEASURES:
Patients were followed for efficacy and safety, and treatment continued
as long as they benefited. Response (> or =50% improvement) was
evaluated by the Physician's Global Assessment of cutaneous disease and
by an overall severity assessment of cutaneous disease, including signs
of CTCL and area involved. RESULTS: Most patients tolerated topical
bexarotene at 1% gel twice daily for routine use. Adverse events were
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