Towards new prognostic factors in diffuse large cell non-Hodgkin's lymphoma

PURPOSE Lym-1, a monoclonal antibody that preferentially targets malignant lymphocytes, has induced remissions in patients with non-Hodgkin's lymphoma (NHL) when labeled with iodine 131 ((131)I). Based on the strategy of fractionating the total dose, this study was designed to define the maximum-tolerated dose (MTD) and efficacy of the first two, of a maximum of four, doses of (131)I-Lym-1 given 4 weeks apart. Additionally, toxicity and radiation dosimetry were assessed. MATERIALS AND METHODS Twenty patients with advanced NHL entered the study a total of 21 times. Thirteen (62%) of the 21 entries had diffuse large-cell histologies. All patients had disease resistant to standard therapy and had received a mean of four chemotherapy regimens. (131)I-Lym-1 was given after Lym-1 and (131)I was escalated in cohorts of patients from 40 to 100 mCi (1.5 to 3.7 GBq)/m2 body surface area. RESULTS Mean radiation dose to the bone marrow from body and blood (131)I was 0.34 (range, 0. 1 6 to 0.63) rad/mCi (0.09 mGy/MBq; range, 0.04 to 0.17 mGy/ MBq). Dose-limiting toxicity was grade 3 to 4 thrombocytopenia with an MTD of 100 mCi/m2 (3.7 GBq/m2) for each of the first two doses of (131)I-Lym-1 given 4 weeks apart. Nonhematologic toxicities did not exceed grade 2 except for one instance of grade 3 hypotension. Ten (71 %) of 14 entries who received at least two doses of (131)I-Lym-1 therapy and 11 (52%) of 21 total entries responded. Seven of the responses were complete, with a mean duration of 14 months. All three entries in the 100 mCi/m2 (3.7 MBq/m2) cohort had complete remissions (CRs). All responders had at least a partial remission (PR) after the first therapy dose of (131)I-Lym-1. CONCLUSION (131)I-Lym-1 induced durable remissions in patients with NHL resistant to chemotherapy and was associated with acceptable toxicity. The nonmyeloablative MTD for each of the first two doses of (131)I-Lym-1 was 100 mCi/m2 (total, 200 mCi/m2) (3.7 GBq/m2; total, 7.4 GBq/m2).

Download Full-text

Chemotherapy with MECOP-B for Intermediate-Grade and High-Grade Non-Hodgkin’s Lymphoma in Saudi Arabia: Clinical Results and Analysis of Prognostic Factors

Acta Haematologica ◽

10.1159/000203743 ◽

1996 ◽

Vol 96 (3) ◽

pp. 126-134

Author(s):

Ezzeldin M. Ibrahim ◽

Reem F. Bunyan ◽

Fatma A. Al-Mulhim ◽

Arwa A. Al-Nabhan ◽

Rania E. Ibrahimá

Keyword(s):

Saudi Arabia ◽

Prognostic Factors ◽

Hodgkin’S Lymphoma ◽

Clinical Results ◽

Hodgkin's Lymphoma ◽

High Grade ◽

Intermediate Grade ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma

Download Full-text

Coherent view of non-Hodgkin's lymphoma.

Journal of Clinical Oncology ◽

10.1200/jco.1995.13.10.2656 ◽

1995 ◽

Vol 13 (10) ◽

pp. 2656-2675 ◽

Cited By ~ 73

Author(s):

A C Aisenberg

Keyword(s):

Hodgkin’S Lymphoma ◽

Large Cell ◽

Hodgkin's Lymphoma ◽

Malignant Neoplasms ◽

Low Grade ◽

Cell Leukemia Virus Type ◽

Microscopic Appearance ◽

Non Hodgkin’S Lymphoma ◽

Incidence And Mortality ◽

Non Hodgkin's Lymphoma

PURPOSE Even though non-Hodgkin's lymphoma is already sixth in incidence and mortality among malignant neoplasms (and the incidence was increasing at a rate of 3% to 4% per year before the advent of AIDS epidemic-associated lymphomas), most physicians and many oncologists find the disorder arcane. The problem lies in the complexity of human lymphoma, which encompasses more than a dozen neoplasms of the lymphoid system. The goal of this review is to provide user-friendly access to the condition. METHODS The variety of inputs required for a subdivision of non-Hodgkin's lymphoma that is useful to clinicians includes lymphocyte lineage and sublineage based on microscopic appearance and immunophenotype, clinical behavior manifest in survival and early dissemination, and analysis of molecular genetic and cytogenetic abnormalities, which reflect pathogenic oncogene derangements. Epstein-Barr virus (EBV) and human T-cell leukemia virus type 1 (HTLV-1) are important in certain uncommon lymphomas. RESULTS AND CONCLUSION The subtypes of primary B-lineage nodal lymphoma include low-grade (small lymphocytic, lymphoplasmacytic-lymphoplasmacytoid, follicular small cleaved cell, and follicular mixed small cleaved and large cell), intermediate-grade (follicular large cell, diffuse small cleaved or mixed, and intermediate lymphocytic), and high-grade (diffuse large cell, immunoblastic, and small noncleaved cell) neoplasms. The less common lymphomas of T lineage and lymphomas that arise in extranodal sites are placed in separate subdivisions. This subdivision serves as a guide to prognosis and treatment.

Download Full-text