Bone and soft tissue malignancies

2015 ◽  
Author(s):  
Jim Cassidy ◽  
Donald Bissett ◽  
Roy A. J. Spence OBE ◽  
Miranda Payne ◽  
Gareth Morris-Stiff
Keyword(s):  
Myeloid Leukaemia ◽  
Hodgkin Lymphoma ◽  
Kinase Inhibitors ◽  
Treatment Options ◽  
B Cell Lymphoma ◽  
Current Treatment ◽  
Bisphosphonate Therapy ◽  
Heterogeneous Group ◽  
Low Grade ◽  
Quality Life

Haematological malignancies examines the epidemiology, genetics, clinical presentation and classification of these diseases, and presents current treatment approaches for each. First are the acute leukaemias, and the management of acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML). Chronic myeloid leukaemia, its genetics and sensitivity to tyrosine kinase inhibitors, is described. Myelodysplastic syndromes and their management, are followed by chronic lymphoid leukaemias, a large heterogeneous group of diseases, and their treatment. Hodgkin lymphoma, its pathology and presentation, staging and role of PET scanning, is described along with current treatment with chemotherapy and limited radiotherapy. Non-Hodgkin lymphoma is another heterogeneous group of diseases, divided into low-grade and high-grade pathology, and varying in their genetics, presentation, and management. Rituximab is a key component of chemotherapy regimens against B-cell lymphoma. Myeloma and other plasma cell dyscrasias are described, and treatment options reviewed. Myeloma remains incurable, but with appropriate management consistent with prolonged good quality life. Treatment includes chemotherapy, bisphosphonate therapy, analgesics and radiotherapy, Throughout this chapter is emphasised the importance of clinical trials in driving the rapid improvements in treatment of these diseases.

Haematological cancers

2019 ◽  
pp. 397-416
Author(s):  
Toby Eyre
Keyword(s):  
Myeloid Leukaemia ◽  
Hodgkin’S Lymphoma ◽  
Treatment Options ◽  
Current Treatment ◽  
Bisphosphonate Therapy ◽  
Hodgkin's Lymphoma ◽  
Low Grade ◽  
Specific Section ◽  
Acute Myeloid

This chapter examines the epidemiology, genetics, clinical presentation, and classification of these diseases and presents current treatment approaches for each. First are the acute leukaemias: acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML). Chronic myeloid leukaemia and chronic lymphoid leukaemias follow. Hodgkin's lymphoma is described, along with current treatment with chemotherapy and limited radiotherapy. Non-Hodgkin's lymphoma is divided into low-grade and high-grade pathology. Treatments, including chemotherapy and rituximab, are covered. Myeloma and its treatment options are reviewed, including chemotherapy, bisphosphonate therapy, and radiotherapy. Throughout this chapter is emphasized the importance of clinical trials in driving the rapid improvements in treatment of these diseases. Nursing issues related to each disease are covered within each of their specific section.

scholarly journals Tumor Reduction with Pazopanib in a Patient with Recurrent Lumbar Chordoma

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Maurício Fernando Silva Almeida Ribeiro ◽  
Micelange Carvalho de Sousa ◽  
Samir Abdallah Hanna ◽  
Marcos Vinicius Calfat Maldaun ◽  
Ceci Obara Kurimori ◽  
...  
Keyword(s):  
Kinase Inhibitors ◽  
Systemic Treatment ◽  
Treatment Options ◽  
Axial Skeleton ◽  
Low Grade ◽  
Complete Excision ◽  
Systemic Treatments ◽  
Tumor Reduction ◽  
Comprehensive Genomic Profiling ◽  
Multifocal Recurrence

Introduction. Chordomas are rare malignancies of bone origin that occur in the axial skeleton, typically the skull base and lumbar/sacral regions. Although often classified as low-grade neoplasms, its locally infiltrative behavior may result in significant morbidity and mortality. Optimal surgical resection may be curative, but up to 50% of the cases relapse within 5 years, and currently there are no systemic treatments approved in this setting. A large proportion of these tumors express stem-cell factor receptor (c-KIT) and platelet-derived growth factor receptors (PDGFRs), providing a rationale for the use of tyrosine-kinase inhibitors (TKIs). Case report. A 27-year-old male presented with recurrent chordoma of the lumbar spine 4 years after initial diagnosis. Salvage therapies in the interval included repeat resections and radiation therapy. He ultimately developed multifocal recurrence not amenable to complete excision or reirradiation. A comprehensive genomic profiling assay was performed and revealed nondrugable alterations. Decision was made to proceed with systemic treatment with pazopanib 800 mg/day, resulting in tumor reduction (−23.1% reduction in size) and prolonged disease control. Conclusion. For this patient with a multiple recurrent chordoma and limited treatment options, pazopanib resulted in sustained clinical benefit following initial tumor reduction.

Low-Grade Lymphoma

Hematology ◽  
2004 ◽  
Vol 2004 (1) ◽  
pp. 203-220 ◽  
Author(s):  
Jane N. Winter ◽  
Randy D. Gascoyne ◽  
Koen Van Besien
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Treatment Options ◽  
B Cell Lymphoma ◽  
Allogeneic Transplantation ◽  
Low Grade ◽  
Non Hodgkin Lymphoma ◽  
Treatment Paradigm ◽  
Optimal Approach

Abstract Folicular lymphoma (FL), the second most common subtype of non-Hodgkin lymphoma, shows considerable heterogeneity in its clinical behavior, representative of a biology that appears increasingly complex and diverse. As our knowledge of the molecular basis of FL increases, we strive for an integration between the bench and clinic that yields treatments based on our scientific understanding and biomarkers that allow us to prescribe treatment rationally. In Section I, Dr. Randy Gascoyne describes the histologic, cytogenetic and biologic features of FL that underlie its clinical variability. Key aspects of the pathologic diagnosis of FL that have particular relevance to the clinician are highlighted. A proposed model for follicular lymphomagenesis and diffuse large B cell lymphoma transformation has emerged and continues to evolve as the molecular story unfolds. A biologic basis for clinical outcome in FL also appears to be forthcoming. In Section II, Dr. Jane Winter addresses the complex process of selecting among the many treatment options for patients with FL. Previously a simple matter of deciding between oral or intravenous alkylators, clinicians and patients must now struggle to choose among vastly different approaches ranging from “watch and wait” to stem cell transplantation. The introduction of rituximab and radioimmunoconjugates is changing the treatment paradigm, but the optimal approach to integrating these and other new agents remains to be determined. At every decision point, the best approach is always a clinical trial. In Section III, Dr. Koen Van Besien provides a well-documented update on outcomes associated with autologous and allogeneic stem cell transplantation for FL. The results of trials of autologous stem cell transplantation in first remission and recent data supporting a role for graft purging are discussed. Based on the premise that a graft-versus-lymphoma effect is operative in FL, reduced-intensity allogeneic transplantation is the preferred approach in many cases, and recently reported results are summarized. Criteria for patient selection and the optimal role of transplantation in the overall therapeutic plan for the patient with FL are presented.

scholarly journals Lenalidomide in Diffuse Large B-Cell Lymphoma

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Catherine Thieblemont ◽  
Marie-Hélène Delfau-Larue ◽  
Bertrand Coiffier
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Treatment Options ◽  
B Cell Lymphoma ◽  
Current Treatment ◽  
New Agents ◽  
Large B Cell Lymphoma ◽  
History Of ◽  
Immunomodulatory Drug ◽  
Large B Cell

Diffuse large B-cell lymphoma (DLBCL) is the most common form of non-Hodgkin's lymphoma (NHL) in adults. Even if the natural history of DLBCL has been improved with the advent of immunochemotherapy, the survival results obtained with current treatment options clearly indicate that new agents or novel approaches are needed. Lenalidomide (Revlimid, Celgene Corporation, Summit, NJ, USA), an analogue of thalidomide, is an immunomodulatory drug with pleiotropic mechanisms of action potentially adding to immunochemotherapy. We present here the biological rational for the use of lenalidomide in DLBCL in light of recent advances in the pathophysiology of the disease and the therapeutic results of the most recent trials published in literature or reported in meetings in relapsed/refractory situations as well as in first-line treatment.

scholarly journals A Rare Case of Grey Zone Lymphoma Successfully Treated with Brentuximab Vedotin and R-CHP Chemotherapy

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Rajiv M. Mallipudi ◽  
Lance Alquran ◽  
Vishnu A. Shenoy ◽  
Lori A. Leslie ◽  
John A. Conti
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Treatment Options ◽  
B Cell Lymphoma ◽  
Complete Response ◽  
Current Treatment ◽  
Brentuximab Vedotin ◽  
Grey Zone ◽  
Antibody Drug Conjugate ◽  
Wide Range

Introduction. The diagnosis of B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma (DLBCL) and classical Hodgkin’s lymphoma (cHL), also referred to as grey zone lymphoma (GZL), is a challenging diagnosis. There are no standardized guidelines; however, evidence strongly suggests that DLBCL-based regimens are effective in the treatment of GZL. Brentuximab vedotin (BV) is an anti-CD30 antibody drug conjugate that has established efficacy in relapsed/refractory Hodgkin and some T-cell lymphomas. There is some evidence that BV has a positive response in non-Hodgkin lymphoma (NHL) with a wide range of CD30 expressions—including GZL.Case. We present a case of a patient initially diagnosed with cHL who underwent repeat biopsy which was revealed to be GZL. Based on PET scanning and immunohistochemical studies, she was classified as a stage IIIA CD20+/CD30+ GZL patient. Given her strong CD30 expression, she underwent 6 cycles of R-BV-CHP (rituximab, brentuximab vedotin, cyclophosphamide, doxorubicin, and prednisone) chemotherapy and achieved complete response (CR) both clinically and radiographically.Discussion. Given the rarity of GZL, this case illustrates the immense challenges in making the diagnosis, discusses the current treatment options, and suggests that BV may be a viable therapeutic candidate in the treatment of GZL.

Utilization of ‘Rainy Day’ Autologous Peripheral Blood Stem Cells.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4913-4913
Author(s):  
Dominic Wall ◽  
Alexander Yallouridis ◽  
Peter Gambell ◽  
Ritchie David ◽  
Prince Miles
Keyword(s):  
Myeloid Leukaemia ◽  
Hodgkin Lymphoma ◽  
Peripheral Blood ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Common Disease ◽  
High Dose ◽  
Peripheral Blood Stem Cells ◽  
Non Hodgkin Lymphoma ◽  
L 14

Abstract High-Dose myeloablative therapy in conjunction with Autologous Peripheral Blood Stem Cell (APBSC) transplantation is an effective first line treatment in patients with haematological malignancies including Multiple Myeloma (MM) and Non-Hodgkin Lymphoma (NHL). With sufficient resources, APBSC’s can be harvested in patients during remission or consolidation treatment for subsequent transplantation if required (‘Rainy Day’ Collection). We investigated the eventual transplantation of ‘Rainy Day’ collections at our centre to assess the utilization of this strategy. We defined ‘Rainy Day’ collections as those that were not intended to be used as part of initial therapy and in general, patients were not planned to be transplanted within the 12 months following harvest. For collections that were transplanted within 12 months following harvest, ‘Rainy Day’ collections were differentiated based on the utilization intent at time of collection. Any collections infused within 3 months following harvest were excluded from the analysis. Over a 6 year period, we collected APBSC’s from 365 patients with the intent of ‘Rainy Day’ storage. Primary disease indications included NHL (45%, n=166), MM (12%, n=44), Acute Myeloid Leukaemia (AML) (8%, n=29) and Chronic Myeloid Leukaemia (CML) (7%, n=25). To date, 23% (n=84) of these ‘Rainy Day’ collections have been subsequently infused. NHL has been the most common disease requiring Rainy Day collections and has resulted in 41 subsequent transplants (24% utilization) with a median time between collection and infusion of 1.74 years (SD =1.60). Mean days until platelets > 20x109/L=15 (SD=7.0) and days until ANC > 0.5x106/L=10 (SD=1.7). Follicular Non-Hodgkin Lymphoma (fNHL) has accounted for the majority of NHL transplants (37%, 5/15), with 5 of 15 patients exhibiting transformation of fNHL into Diffuse Large B-Cell Lymphoma and an average time between collection and infusion of 2.07 years (SD 2.01). Peripheral T-Cell Lymphoma (T-NHL) has contributed to 15% (n=6/41) of transplanted NHL ‘Rainy Day’ collections with a mean time between collection and infusion being shorter at 1.53 years (SD=0.97). 23% of MM patients (n=44/202) have had APBSC’s collected for potential ‘Rainy Day’ utilization compared with 53% of NHL (n=166/309), 86% of AML (n=29/34) and 100% of CML (25/25). MM has shown to have the highest ‘Rainy Day’ APBSC utilisation with 55% (n=23/44) of patients resulting in transplantation. The average time between collection and infusion has been 2.79 years (SD=1.65) with mean days until platelets > 20x109/L=14 (SD =6.9) and days until ANC > 0.5x106/L=10 (SD=1.7). We conclude that it is clinically feasible and safe to perform ‘Rainy Day’ collections although more stringent criteria would result in a more efficient use of this resource intensive strategy.

Tolerability of toceranib phosphate (Palladia) when used in conjunction with other therapies in 35 cats with feline oral squamous cell carcinoma: 2009–2013

2016 ◽  
Vol 19 (6) ◽  
pp. 568-575 ◽  
Author(s):  
Gina A Olmsted ◽  
John Farrelly ◽  
Gerald S Post ◽  
Jaclyn Smith
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Treatment Options ◽  
Surgical Excision ◽  
Current Treatment ◽  
Treatment Modalities ◽  
Low Grade ◽  
Treatment Delays ◽  
Gi Toxicity

Objectives Squamous cell carcinoma (SCC) is the most common oral tumor in cats and typically carries a poor prognosis with current treatment options. The objective of this study was to evaluate the toxicity of toceranib phosphate (Palladia; Pfizer) in cats with oral SCC in combination with other treatment modalities. Methods In this study, 35 cats were retrospectively evaluated to determine toxicity when treated with toceranib in combination with other treatment modalities. Cats received toceranib at a median dose of 2.75 mg/kg (range 1.9–4.17 mg/kg) 3 days a week. Cats also underwent additional therapies, including surgical excision, radiation therapy, chemotherapy and/or use of non-steroidal anti-inflammatory drugs. Results Toxicity was seen in six cats, with five cases of grade 1 or 2 gastrointestinal (GI) toxicity and one grade 4 metabolic toxicity. Toceranib was discontinued in one cat and two cats received dose reductions. None of the cats required treatment delays or hospitalization due to toxicity. Median toceranib treatment duration was 77 days (range 7–741 days). Conclusions and relevance This study revealed that toceranib was well tolerated by the majority of cats, with five cases of low-grade GI toxicity and one case of metabolic toxicity. Given the favorable toxicity profile, future studies further evaluating the safety and efficacy of toceranib for cats with oral SCC should be considered.

scholarly journals Avapritinib: novel hope for patients with metastatic gist with PDGFRA exon 18 mutation

2020 ◽  
Vol 9 (7) ◽  
pp. 1175
Author(s):  
Sachin Maggo ◽  
A. P. Dubey ◽  
Pawan Dhull ◽  
Nilabh Kumar Singh
Keyword(s):  
Kinase Inhibitors ◽  
Treatment Options ◽  
Growth Factor Receptor ◽  
Oral Formulation ◽  
Current Treatment ◽  
Activating Mutations ◽  
Metastatic Gist ◽  
Fda Approval ◽  
Effective Option ◽  
Us Fda

Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms of the gastrointestinal tract associated with high rates of malignant transformation. The activating mutations in platelet-derived growth factor receptor A (PDGFRA) have been linked to the development of GISTs, and up to approximately 10% of GIST cases involve mutations of this gene. Current treatment options for metastatic GIST are minimal, mainly trusting on tyrosine kinase inhibitors (TKIs) such as Imatinib, Sunitinib and Regorafenib. However, eventually, most patients develop resistance to TKIs, usually due to the acquisition of secondary mutations. Moreover, 5-6% of patients with unresectable of metastatic GIST have the primary PDGFRA D842V mutation, which makes it resistant to all approved treatment options. Avapritinib, a potent and selective TKI of KIT and PDGFRA activation loop mutants. The drug demonstrates anti-tumor activity by inhibiting the autophosphorylation of KIT D816V and PDGFRA D842V, thereby terminating the downstream signalling. The drug is available in oral formulation with a recommended dosage of 300 mg once daily. The onset of Avapritinib is fast, shows rapid absorption and linear pharmacokinetics. Most common adverse reactions seen are edema, fatigue, abdominal pain, and neurocognitive defects. Clinical trials for Avapritinib have been positive, and results suggest that the drug may be a new safe and effective option for metastatic GIST treatment. With Blueprint Medicines having already received US FDA approval in January 2020, Avapritinib may soon be an addition to the mounting armoury of drugs against metastatic GIST harbouring PDGFRA exon 18 mutation.

Activation of Phospholipase C γ 2 in Lymphoma Cells.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 1220-1220
Author(s):  
Minh Q. Huynh ◽  
Thomas Wuendisch ◽  
Annette Ramaswamy ◽  
Andreas Neubauer
Keyword(s):  
B Cell ◽  
Hodgkin Lymphoma ◽  
Signaling Pathway ◽  
B Cell Lymphoma ◽  
Cell Receptor ◽  
Gastric Malt Lymphoma ◽  
Low Grade ◽  
Lymphoma Cells ◽  
Functional Studies ◽  
Molecule Inhibitor

Abstract The Nf-κB signaling pathway is important for lymphoma survival and cell proliferation. In recent immunohistological studies, the B-cell receptor (BCR), Src kinases and PLC γ 2 were shown to be highly expressed in primary mediastinal B-cell lymphoma and lymphocyte predominant Hodgkin lymphoma, but not in classical Hodgkin lymphoma. Activation of PLC γ 2 is a crucial step in regulating Nf-κB through protein kinase C (PKC). The PLC-PKC cascade also activates the Ras-Raf-Erk signaling pathway by recruiting GRP3 to the cell membrane. These signaling cascades are well studied in physiological B-cells, but there is little data about the role of PLC γ 2 in lymphomas. Our study compared the PLC γ 2 expression in low-grade gastric MALT lymphoma tissue and chronic gastritis tissue from the same patient by quantitative PCR. In 8 out of 10 cases PLC γ 2 was overexpressed in MALT lymphomas, but not in gastritis. We performed functional studies with the PLC-inhibitor U73122 and PLC γ 2 specific siRNA in two lymphoma cell lines (SSK41, Raji). Proliferation of lymphoma cells was significantly reduced by inhibition of PLC γ 2 on protein level and by knocking down PLC γ 2 mRNA by transfection with a specific siRNA. Our results indicate that proliferation and survival of lymphoma cells depend, at least in part, on the activated PLC-PKC signaling cascade and that it is possible to reduce lymphoma survival by the “small molecule inhibitor” U73122. PLC γ 2 could be a new target for lymphoma treatment.

Hepatitis B and C Virus in Patients with Non-Hodgkin Lymphoma.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2627-2627
Author(s):  
Lesley A. Anderson ◽  
Ruth Pfeiffer ◽  
Joan Warren ◽  
Ola Landgren ◽  
Sonja Berndt ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Hodgkin Lymphoma ◽  
B Cell Lymphoma ◽  
Population Based ◽  
Hcv Infection ◽  
Hbv Infection ◽  
Low Grade ◽  
Physician Visits ◽  
Non Hodgkin Lymphoma ◽  
Medicare Database

Abstract Background: Hepatitis C virus (HCV) infection has been implicated in the development of Non-Hodgkin lymphoma (NHL), but subtype specific analyses are limited. Although some studies have reported a higher prevalence of hepatitis B virus (HBV) infection in patients with NHL, results are conflicting. Methods: From the U.S. SEER-Medicare database, we selected 59,824 patients with NHL (aged 65+ years) and 166,057 population-based controls. Participants were classified as having HCV or HBV infection if they had any Medicare record of infection >1 year prior to diagnosis/selection. Polytomous logistic regression analyses were used to compare HCV and HBV infection in cases and controls with adjustment for gender, age (5-year age bands), calendar year of diagnosis/selection (in tertiles), race (white versus non-white) and the number of physician visits (in quartiles). Results: Overall, 137 (0.23%) NHL cases and 270 (0.16%) controls had HCV infection and 82 (0.14%) cases and 249 (0.15%) controls had HBV infection. HCV infection was significantly associated with NHL overall (OR 1.3, 95% CI 1.1–1.7) and with diffuse large B-cell lymphoma (n=13,330; OR 1.5, 95% CI 1.1–2.2), Burkitt’s lymphoma (n=221; OR 5.7, 95% CI 1.8–17.9), follicular lymphoma (n=6,142; OR 1.9, 95% CI 1.2–3.0) and marginal zone lymphoma (n=1,989; OR 2.3, 95% CI 1.3–4.1). HCV infection was not associated with T-NHL (n=2,362; OR 0.4, 95% CI 0.1–1.6) or NHL not otherwise specified (n=3330; OR0.9, 95% CI 0.3–2.9). HBV infection was not significantly associated with NHL or NHL subtypes. Conclusions: HCV, but not HBV, infection was associated with elevated risk of high- and low-grade NHLs. HCV may induce NHL development through chronic immune stimulation or other mechanisms.

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