Postchemotherapy Histiocyte-rich Pseudotumor Mimicking Residual Lymphoma

Abstract Polymerase chain reaction (PCR) amplification of the t(14;18) has been shown to be a highly sensitive method to detect minimal residual disease in patients with non-Hodgkin's lymphoma (NHL) whose tumors bear this translocation. The ideal tissue source to detect residual lymphoma would be from a previously involved lymph node. However, lymphoid tissue is rarely available once patients achieve complete remission. Although PCR amplification has been used to detect residual lymphoma cells in both bone marrow (BM) and peripheral blood (PB) of patients in complete remission, it is presently unknown whether BM and PB are equivalent tissue sources to detect residual disease. In the present study, we compared the clinical utility of the detection of residual lymphoma in both the BM and the PB of patients with advanced-stage non- Hodgkin's lymphoma before, at the time of, and after high-dose therapy and autologous BM transplantation (ABMT). The detection of residual lymphoma in either the BM or PB was associated with decreased disease- free survival. However, in the present study, 44% of patients who relapsed had no evidence of circulating lymphoma cells in their PB. At the time of BM harvest, PCR-detectable residual lymphoma cells were detected in 211 of 212 patients; although, in a subset of these patients analyzed, lymphoma cells were detected in the peripheral blood of only 49% of patients. When residual lymphoma cells within the autologous BM are infused into the patient these cells are rapidly detectable circulating in the PB in the patient. These cells continue to circulate during the immediate posttransplant period and be detectable in the PB in the majority of patients who are infused with marrow containing residual lymphoma. We conclude that BM is a more informative tissue source than PB in detecting minimal residual disease at the time of and after ABMT, and that contamination of PB early after ABMT appears to be the consequence of reinfusion of lymphoma cells within autologous marrow.

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Residual lymphoma detected by methionine positron emission tomography imaging

Inpharma Weekly ◽

10.2165/00128413-199007640-00058 ◽

1990 ◽

Vol &NA; (764) ◽

pp. 19-20

Author(s):

&NA;

Keyword(s):

Positron Emission Tomography ◽

Positron Emission Tomography Imaging ◽

Emission Tomography ◽

Tomography Imaging ◽

Positron Emission ◽

Residual Lymphoma

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Detection by polymerase chain reaction of residual cells with the bcl-2 translocation is associated with increased risk of relapse after autologous bone marrow transplantation for B-cell lymphoma

Blood ◽

10.1182/blood.v81.12.3449.bloodjournal81123449 ◽

1993 ◽

Vol 81 (12) ◽

pp. 3449-3457 ◽

Cited By ~ 6

Author(s):

JG Gribben ◽

D Neuberg ◽

AS Freedman ◽

CD Gimmi ◽

KW Pesek ◽

...

Keyword(s):

B Cell ◽

Minimal Residual Disease ◽

Residual Disease ◽

Pcr Amplification ◽

B Cell Lymphoma ◽

Lymphoma Cells ◽

Minimal Disease ◽

Residual Lymphoma ◽

Minimal Residual ◽

Risk Of Relapse

Although molecular biologic techniques can now detect minimal numbers of residual cancer cells in patients in complete clinical remission, the clinical significance of minimal residual disease has never been conclusively established. If the detection of minimal residual disease predicts which patients will relapse, then therapy could be altered based upon the detection of these cells. The t(14;18) can be detected by polymerase chain reaction (PCR) amplification in 50% of patients with B-cell non-Hodgkin's lymphoma and allows detection of one lymphoma cell in up to 1 million normal cells. To determine the clinical significance of the detection of minimal residual lymphoma cells in the bone marrow (BM) PCR amplification was used to detect the presence of residual lymphoma cells after autologous BM transplantation (ABMT) in serial BM samples from 134 patients with B-cell lymphoma in whom a bcl- 2 translocation could be detected. PCR analysis was performed on a total of 542 BM samples obtained while these patients were in complete remission. Disease-free survival was markedly increased in patients with no PCR-detectable lymphoma cells in the marrow compared with those in whom residual lymphoma cells were detected (P < .00001), and the presence of detectable lymphoma cells was associated with a 48-fold increase in the risk of relapse. Of the 77 patients (57%) with no PCR- detectable lymphoma cells in their most recent BM sample, none have relapsed. In contrast, all 33 patients (25%) who have relapsed had PCR- detectable lymphoma cells detected in their BM before clinical relapse occurred. In 19 patients (14%), residual lymphoma cells in the BM were detected early following transplantation and subsequently were no longer detectable, although these patients received no further therapy. In these patients, residual lymphoma cells may already have been irreversibly damaged by the high-dose therapy or an endogenous immune mechanism may be capable of eliminating residual lymphoma cells in some patients. Therefore, although the detection of minimal residual disease by PCR following ABMT in patients with lymphoma identifies those patients at high risk of relapse, the presence of residual minimal disease early after transplantation may not be associated with poor prognosis in a small subset of patients. Confirmatory studies will be required to determine more definitively the role of minimal disease detection to identify which patients require additional therapy.

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Detection by polymerase chain reaction of residual cells with the bcl-2 translocation is associated with increased risk of relapse after autologous bone marrow transplantation for B-cell lymphoma

Blood ◽

10.1182/blood.v81.12.3449.3449 ◽

1993 ◽

Vol 81 (12) ◽

pp. 3449-3457 ◽

Cited By ~ 239

Author(s):

JG Gribben ◽

D Neuberg ◽

AS Freedman ◽

CD Gimmi ◽

KW Pesek ◽

...

Keyword(s):

B Cell ◽

Minimal Residual Disease ◽

Residual Disease ◽

Pcr Amplification ◽

B Cell Lymphoma ◽

Lymphoma Cells ◽

Minimal Disease ◽

Residual Lymphoma ◽

Minimal Residual ◽

Risk Of Relapse

Abstract Although molecular biologic techniques can now detect minimal numbers of residual cancer cells in patients in complete clinical remission, the clinical significance of minimal residual disease has never been conclusively established. If the detection of minimal residual disease predicts which patients will relapse, then therapy could be altered based upon the detection of these cells. The t(14;18) can be detected by polymerase chain reaction (PCR) amplification in 50% of patients with B-cell non-Hodgkin's lymphoma and allows detection of one lymphoma cell in up to 1 million normal cells. To determine the clinical significance of the detection of minimal residual lymphoma cells in the bone marrow (BM) PCR amplification was used to detect the presence of residual lymphoma cells after autologous BM transplantation (ABMT) in serial BM samples from 134 patients with B-cell lymphoma in whom a bcl- 2 translocation could be detected. PCR analysis was performed on a total of 542 BM samples obtained while these patients were in complete remission. Disease-free survival was markedly increased in patients with no PCR-detectable lymphoma cells in the marrow compared with those in whom residual lymphoma cells were detected (P < .00001), and the presence of detectable lymphoma cells was associated with a 48-fold increase in the risk of relapse. Of the 77 patients (57%) with no PCR- detectable lymphoma cells in their most recent BM sample, none have relapsed. In contrast, all 33 patients (25%) who have relapsed had PCR- detectable lymphoma cells detected in their BM before clinical relapse occurred. In 19 patients (14%), residual lymphoma cells in the BM were detected early following transplantation and subsequently were no longer detectable, although these patients received no further therapy. In these patients, residual lymphoma cells may already have been irreversibly damaged by the high-dose therapy or an endogenous immune mechanism may be capable of eliminating residual lymphoma cells in some patients. Therefore, although the detection of minimal residual disease by PCR following ABMT in patients with lymphoma identifies those patients at high risk of relapse, the presence of residual minimal disease early after transplantation may not be associated with poor prognosis in a small subset of patients. Confirmatory studies will be required to determine more definitively the role of minimal disease detection to identify which patients require additional therapy.

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Nonossifying Fibroma can Mimic Residual Lymphoma in FDG PET: Additional Value of Combined PET/CT

Clinical Nuclear Medicine ◽

10.1097/rlu.0b013e3180a1ad09 ◽

2007 ◽

Vol 32 (8) ◽

pp. 640-642 ◽

Cited By ~ 6

Author(s):

Christian von Falck ◽

Herbert Rosenthal ◽

Klaus F. Gratz ◽

Michael Galanski

Keyword(s):

Fdg Pet ◽

Pet Ct ◽

Nonossifying Fibroma ◽

Additional Value ◽

Residual Lymphoma

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Secondary membranous glomerulonephritis associated with recipient residual lymphoma cells after allogeneic bone marrow transplantation

Clinical and Experimental Nephrology ◽

10.1007/s10157-008-0120-z ◽

2009 ◽

Vol 13 (2) ◽

pp. 174-178 ◽

Cited By ~ 3

Author(s):

Kentaro Sakai ◽

Joichi Usui ◽

Hirayasu Kai ◽

Masahiro Hagiwara ◽

Naoki Morito ◽

...

Keyword(s):

Bone Marrow ◽

Bone Marrow Transplantation ◽

Marrow Transplantation ◽

Allogeneic Bone Marrow Transplantation ◽

Membranous Glomerulonephritis ◽

Allogeneic Bone Marrow ◽

Allogeneic Bone ◽

Lymphoma Cells ◽

Residual Lymphoma

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Anti-Idiotype Antibodies Can Induce Long-Term Complete Remissions in Non-Hodgkin’s Lymphoma Without Eradicating the Malignant Clone

Blood ◽

10.1182/blood.v92.4.1184.416k05_1184_1190 ◽

1998 ◽

Vol 92 (4) ◽

pp. 1184-1190 ◽

Cited By ~ 1

Author(s):

Thomas A. Davis ◽

David G. Maloney ◽

Debra K. Czerwinski ◽

Tina-Marie Liles ◽

Ronald Levy

Keyword(s):

B Cell ◽

Interleukin 2 ◽

B Cell Lymphoma ◽

Complete Response ◽

Inactive Disease ◽

Enzyme Linked Immunosorbent Assay ◽

Low Grade ◽

Custom Made ◽

Residual Lymphoma

The immunoglobulin on the surface of B-cell lymphomas can be a tumor-specific target for monoclonal antibody therapy. Between 1981 and 1993, 45 individuals with low grade B-cell lymphoma were treated with 52 courses of custom-made anti-idiotype antibodies. The antibodies were used either alone or in combination with -interferon, chlorambucil, or interleukin-2 (IL-2). The majority of these patients responded to treatment, with a 66% overall and 18% complete response rate. Six patients (13%) experienced prolonged complete remissions, five of which are ongoing from 4 to 10 years after therapy and are the subject of this report. We asked whether residual lymphoma could be found in these patients with prolonged remissions. We performed enzyme-linked immunosorbent assay (ELISA) assays for idiotype protein or anti-idiotype antibodies in serum. Blood and bone marrow samples were examined by flow cytometry for idiotype positive cells, and by polymerase chain reaction (PCR) for clonal gene rearrangements of immunoglobulin CDR3 sequences or t(14;18) translocations. Using these sensitive and specific tests it was possible to detect very low levels of residual lymphoma in five of these patients who had been in clinical remission for 3 to 8 years before this evaluation. These five have continued without recurrence for up to 3 years since. Thus, we have found a pattern of residual inactive disease in patients treated with anti-idiotype antibodies. The biology of follicular lymphoma evidently includes the potential for tumor dormancy after therapies with varied mechanisms of action, resulting in clinical inactivity for many years. Thus, long-term control of the disease is possible at a clinical level despite persistence of the malignant clone. © 1998 by The American Society of Hematology.

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Anti-Idiotype Antibodies Can Induce Long-Term Complete Remissions in Non-Hodgkin’s Lymphoma Without Eradicating the Malignant Clone

Blood ◽

10.1182/blood.v92.4.1184 ◽

1998 ◽

Vol 92 (4) ◽

pp. 1184-1190 ◽

Cited By ~ 128

Author(s):

Thomas A. Davis ◽

David G. Maloney ◽

Debra K. Czerwinski ◽

Tina-Marie Liles ◽

Ronald Levy

Keyword(s):

B Cell ◽

Interleukin 2 ◽

B Cell Lymphoma ◽

Complete Response ◽

Inactive Disease ◽

Enzyme Linked Immunosorbent Assay ◽

Low Grade ◽

Custom Made ◽

Residual Lymphoma

Abstract The immunoglobulin on the surface of B-cell lymphomas can be a tumor-specific target for monoclonal antibody therapy. Between 1981 and 1993, 45 individuals with low grade B-cell lymphoma were treated with 52 courses of custom-made anti-idiotype antibodies. The antibodies were used either alone or in combination with -interferon, chlorambucil, or interleukin-2 (IL-2). The majority of these patients responded to treatment, with a 66% overall and 18% complete response rate. Six patients (13%) experienced prolonged complete remissions, five of which are ongoing from 4 to 10 years after therapy and are the subject of this report. We asked whether residual lymphoma could be found in these patients with prolonged remissions. We performed enzyme-linked immunosorbent assay (ELISA) assays for idiotype protein or anti-idiotype antibodies in serum. Blood and bone marrow samples were examined by flow cytometry for idiotype positive cells, and by polymerase chain reaction (PCR) for clonal gene rearrangements of immunoglobulin CDR3 sequences or t(14;18) translocations. Using these sensitive and specific tests it was possible to detect very low levels of residual lymphoma in five of these patients who had been in clinical remission for 3 to 8 years before this evaluation. These five have continued without recurrence for up to 3 years since. Thus, we have found a pattern of residual inactive disease in patients treated with anti-idiotype antibodies. The biology of follicular lymphoma evidently includes the potential for tumor dormancy after therapies with varied mechanisms of action, resulting in clinical inactivity for many years. Thus, long-term control of the disease is possible at a clinical level despite persistence of the malignant clone. © 1998 by The American Society of Hematology.

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