scholarly journals Use of pembrolizumab with or without pomalidomide in HIV-associated non-Hodgkin’s lymphoma

2021 ◽  
Vol 9 (2) ◽  
pp. e002097
Author(s):  
Kathryn Lurain ◽  
Ramya Ramaswami ◽  
Ralph Mangusan ◽  
Anaida Widell ◽  
Irene Ekwede ◽  
...  
Keyword(s):  
B Cell ◽  
Hodgkin’S Lymphoma ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Hiv And Aids ◽  
Hodgkin's Lymphoma ◽  
People Living With Hiv ◽  
Oncogenic Viruses ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

BackgroundNon-Hodgkin’s lymphoma (NHL) is currently the most common malignancy among people living with HIV (PLWH) in the USA. NHL in PLWH is more frequently associated with oncogenic viruses than NHL in immunocompetent individuals and is generally associated with increased PD-1 expression and T cell exhaustion. An effective immune-based second-line approach that is less immunosuppressive than chemotherapy may decrease infection risk, improve immune control of oncogenic viruses, and ultimately allow for better lymphoma control.MethodsWe conducted a retrospective study of patients with HIV-associated lymphomas treated with pembrolizumab±pomalidomide in the HIV and AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute.ResultsWe identified 10 patients with stage IV relapsed and/or primary refractory HIV-associated NHL who were treated with pembrolizumab, an immune checkpoint inihibitor, with or without pomalidomide. Five patients had primary effusion lymphoma (PEL): one had germinal center B cell-like (GCB) diffuse large B cell lymphoma (DLBCL); two had non-GCB DLBCL; one had aggressive B cell lymphoma, not otherwise specified; and one had plasmablastic lymphoma. Six patients received pembrolizumab alone at 200 mg intravenously every 3 weeks, three received pembrolizumab 200 mg intravenously every 4 weeks plus pomalidomide 4 mg orally every day for days 1–21 of a 28-day cycle; and one sequentially received pembrolizumab alone and then pomalidomide alone. The response rate was 50% with particular benefit in gammaherpesvirus-associated tumors. The progression-free survival was 4.1 months (95% CI: 1.3 to 12.4) and overall survival was 14.7 months (95% CI: 2.96 to not reached). Three patients with PEL had leptomeningeal disease: one had a complete response and the other two had long-term disease control. There were four immune-related adverse events (irAEs), all CTCAEv5 grade 2–3; three of the four patients were able to continue receiving pembrolizumab. No irAEs occurred in patients receiving the combination of pembrolizumab and pomalidomide.ConclusionsTreatment of HIV-associated NHL with pembrolizumab with or without pomalidomide elicited responses in several subtypes of HIV-associated NHL. This approach is worth further study in PLWH and NHL.

Clinical Features and Prognostic Relevance of Ovarian Involvement in Non-Hodgkin's Lymphoma: a Consortium for Improving Survival of Lymphoma (CISL) Report.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4999-4999
Author(s):  
Jina Yoon ◽  
Seok Jin Kim ◽  
Jong Ho Won ◽  
Chul Won Choi ◽  
Hyeon-Seok Eom ◽  
...  
Keyword(s):  
B Cell ◽  
Hodgkin’S Lymphoma ◽  
Cell Lymphoma ◽  
Performance Status ◽  
B Cell Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Disseminated Disease ◽  
Ovarian Involvement

Abstract Abstract 4999 Introduction Ovary can be involved as a primary ovarian lymphoma or secondarily involved by disseminated disease of non-Hodgkin's lymphoma. However, ovarian involvement is an extremely rare event in non-Hodgkin's lymphoma. Thus, it clinical features and prognostic relevance has rarely been addressed, and most publications refer to a single or a few cases. Thus, we retrospectively analyzed patients with ovarian involvement Patients and methods 32 patients with ovarian involvement were assembled from 8 hospitals affiliated with the CISL (Consortium for Improving Survival of Lymphoma), a Korean lymphoma study group. Primary ovarian involvement was defined as a lymphoma confined to ovary with or without involvement of adjacent lymph nodes and contiguous organs. Secondary ovarian lymphoma was defined as a secondary involvement of ovary in disseminated disease of lymphoma at initial diagnosis. Results Twelve patients had primary ovarian lymphoma (37.5%) while twenty patients (62.5%) had secondary ovarian involvement by systemic disease. The clinical manifestations of ovarian involvement were similar to that of other ovarian tumors, namely an abdominal pain (31%), abdominal distension (19%) or lower abdominal palpable mass (16%). Pathological review according to the WHO classification showed that the most common histological subtype was diffuse large B-cell lymphoma (DLBCL, 75.0%, 24/32), and the frequency of other subtypes was as follows: Burkitt lymphoma (BL, 12.5%, 4/32), lymphoblastic lymphoma (6.3%, 2/32), marginal zone B-cell lymphoma (MZL, 3.1%, 1/32), peripheral T-cell lymphoma, unspecified (PTCL-U, 3.1%, 1/32). The median age (43 years, range 18-80) was younger than that of previously reported other organs such as uterus or prostate. The presence of B symptoms was only observed in 31.3%, and the performance status was good (84.4% of patients had less than grade II of ECOG performance status). The cases involving two or more than two extranodal sites were 68.8% while cases with elevated level of serum LDH were 59.4%. Thus, 59.4% of patients had the low or low-intermediate score of IPI score. Bilateral ovarian involvement was found in 12/32 (38%) while unilateral involvement was 20/32 (63%, 9 right and 11 left side. Three patients showed the involvement of central nervous system (CNS) at diagnosis (3/32, 9.4%). These three patients had DLBCL histology and unfavorable parameters including stage IV, high IPI score and bone marrow BM involvement. Thus, the initial CNS involvement might be associated with advanced stage of lymphoma not with ovarian involvement itself. Surgical removal of involved ovary was performed in 20 patients (62%), and then they were treated with systemic chemotherapy. Twelve patients (38%) were treated with chemotherapy alone. The comparison of outcomes according to the treatment modalities showed the outcomes of chemotherapy-based treatment versus surgery-based treatment were not significantly different (2 year overall survival; 66% vs. 68%). With a median follow-up of 25 months (range 3-185), 13 patients (40.6%) relapsed. Two patients were relapsed in single lesion and 11 were relapsed in multiple lesions. The majority relapsed at various extranodal sites (11/13, 84.6%) and only 2 cases relapsed at nodal sites. Most common relapse site was CNS (4 cases among 13 cases of relapse, 31%). All CNS relapsed patients had DLBCL histology. Ovarian relapse observed in one case that had been involved both ovary at the time of diagnosis. The 2 year overall survivals (OS) were 67% (95% CI: 50 to 83%) and the 2 year progression free survivals (PFS) were 61% (95% CI: 44 to 78%). In univariate analysis, high IPI score, 2 or more extranodal sites involvement and elevated LDH level were statistically significant parameters for lower PFS; moreover, 2 or more extranodal sites involvement and elevated LDH level associated with poor OS. Conclusion Ovarian involvement of non-Hodgkin's lymphoma showed a dismal prognosis despite active treatment. Therefore, more optimal treatment strategy should be warranted. Disclosures No relevant conflicts of interest to declare.

scholarly journals Cauda Equina Syndrome as A Clinical Presentation of Extradural Diffuse B-Cell Non-Hodgkin’s Lymphoma: Case Report and Literature Review

2020 ◽  
Vol 3 (4) ◽  
Keyword(s):  
B Cell ◽  
Hodgkin’S Lymphoma ◽  
Clinical Presentation ◽  
Cell Lymphoma ◽  
Cauda Equina ◽  
B Cell Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Diffuse B Cell Lymphoma

Diffuse B-Cell Lymphoma corresponds to the most frequent pathological entity within the spectrum of Non-Hodgkin’s Lymphoma, with reported annual incidence of 24% in the U.S. literature.

scholarly journals Pattern of Immunophenotype Among the Cases of Lymphoma Attending in A Tertiary Level Hospital

2019 ◽  
Vol 17 (2) ◽  
pp. 21-25
Author(s):  
Shirajam Munira ◽  
Salama Afroze ◽  
Akhil Ranjon Biswas ◽  
MA Khan
Keyword(s):  
T Cell ◽  
B Cell ◽  
Hodgkin’S Lymphoma ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
T Cell Lymphoma ◽  
Hodgkin's Lymphoma ◽  
College Hospital ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

Background : To explore the relative frequency and different forms of lymphoma in tertiary level hospital. Methods: This descriptive observational study was carried out in the Department of Hematology at Dhaka Medical College Hospital, Dhaka. Patients attended with solid tissue lymphoma in Outpatient, Inpatient and Lymphoma Clinic services of Department of Hematology and Bone Marrow Transplant, Dhaka Medical College Hospital, Dhaka were taken as study population as per inclusion criteria. A total of 63 patients with lymphoma diagnosed by histopathologically were selected initially, among them 53 were confirmed by immunohistochemistry taken as study population finally. Results: Mean age was 39.2 ± 15.5 years, median age was 36 years within the range of 14 – 75 years. Males were predominant. Male female ratio was 4.3:1. Most of the samples were collected from cervical lymph node (84.1%). Most of the patients came with fatigue and significant weight loss. Maximum 42 (79.24%) cases were Non-Hodgkin’s lymphoma and 11 (20.75%) cases were Hodgkin’s lymphoma. Out of 42 non-Hodgkin’s lymphoma, 27 (64.3%) were B-cell lymphoma and 15 (35.7%) were T-cell lymphoma. Among B-cell lymphoma, 19 (45.2%) were diffuse large B cell lymphoma, three (7.1%) were follicular lymphoma, three (7.1%) were mantle cell lymphoma, one (2.4%) was spleenic marginal zone lymphoma and one (2.4%) was Burkitt lymphoma. Among T-cell lymphoma, nine (21.4%) were peripheral T-cell lymphoma and six (14.3%) were adult T lymphoblastic lymphoma. Out of 11 Hodgkin’s lymphoma, 10 (90.9%) were classical Hodgkin’s lymphoma and one (9.1%) nodular lymphocyte predominant. Among classical Hodgkin’s lymphoma, five (45.5%) were mixed cellularity, three (27.3%) were lymphocyte predominant and two (18.2%) were Nodular sclerosis. Out of 42 non-Hodgkin’s lymphoma, 13 (30.95%) were indolent, 21 (50.00%) were aggressive and eight (19.05%) were very aggressive. Conclusion: In our study, it was found that 79.3% were non-Hodgkin lymphoma of which 64.3% were B-cell lymphoma & 35.7% were T-cell lymphoma and 20.7% cases were Hodgkin lymphoma of which 90.9% were classical Hodgkin’s lymphoma, 9.1% nodular lymphocyte predominant Hodgkin’s lymphoma. Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 21-25

Diffuse Large B-Cell Lymphoma of the Ankle

2010 ◽  
Vol 100 (6) ◽  
pp. 505-510 ◽  
Author(s):  
Mark J. Mendeszoon ◽  
Kyle R. Wire
Keyword(s):  
B Cell ◽  
Hodgkin’S Lymphoma ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Surgical Excision ◽  
Hodgkin's Lymphoma ◽  
Large B Cell Lymphoma ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Large B Cell

The most common type of non-Hodgkin’s lymphoma is the B-cell type. We report herein a type of B-cell lymphoma in an adult ankle. A 63-year-old woman presented with a painful growth on the anteromedial aspect of her right ankle that was later diagnosed as a form of non-Hodgkin’s lymphoma. Clinically, the single mass appeared bluish in color, painful on palpation, and warm to the touch. The overlying skin was friable, and the lesion did not transilluminate. Histopathologic examination revealed a diffuse large B-cell lymphoma of germinal center origin on surgical excision. This case report focuses on the clinical presentation, surgical intervention, and overall outcome of a rare case of lymphoma of the ankle. (J Am Podiatr Med Assoc 100(6): 505–510, 2010)

Incidence patterns and survival outcomes in primary small intestine B-cell lymphoma (PSIBCL) and the effect of Rituximab.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e20025-e20025
Author(s):  
Apoorva Jayarangaiah ◽  
Shuai Wang ◽  
Mariuxi Alexandra Viteri Malone ◽  
Tarek N. Elrafei ◽  
Lewis Steinberg ◽  
...  
Keyword(s):  
B Cell ◽  
Hodgkin’S Lymphoma ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Disease Stage ◽  
Early Stage Disease ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Adjusted Incidence

e20025 Background: PSIBCL is a rare manifestation of primary extra-nodal B-cell Non-Hodgkin’s lymphoma and is underreported in literature. We assessed the incidence patterns, and clinicopathologic features and their impact on survival in this population. Methods: Using the SEER database, we identified patients with PSIBCL who were ≥ 18 years old from 1975-2016. Patients were identified using ICD-O-3 and histology codes. Age-adjusted incidence rates were calculated using SEER*Stat 8.36. Using SPSS 26, overall survival (OS) was analyzed using the Kaplan-Meier method and multivariate Cox proportional hazards model was used to determine the prognostic factors. Results: We identified 4810 patients with PSIBCL. PSIBCL accounts for 0.8% of all B-cell Non-Hodgkin’s lymphoma. Age adjusted incidence rose from 0.2 to 0.4 per 100,000 during the study period. Annual percentage change of age adjusted incidence was +2.0 (95% CI 1.4-2.6). Incidence was highest among males, age > 80 years, white & Asian race. The median age of diagnosis was 63 yrs (51-75). 83% presented with either Diffuse large B-cell lymphoma (54%) or Follicular lymphoma (29%). The site of disease was specified in 65%; of those, duodenum (24%), jejunum (15%) and ileum (23%). Staging was reported in 88%; early stage disease (stage I/II) was found in 67%. Median OS for the entire cohort was 27 years (95% CI 23-32) and 5-year OS was 72.6%. Although the incidence was lower in black patients, the 10 year OS was worse (61% black vs 67.4% white). Survival was improved after 1997 (10-year OS rate 71.3% vs 52.0%). These results may correlate to Rituximab approval in 1997. In the multivariate analysis, age > 65, male sex, black race, late stage (stage III/IV), DLBCL and Burkitt lymphoma subtypes were associated with unfavorable OS. Conclusions: Analysis of four decades of data show an upward trend in incidence. PSIBCL has a favorable outcome with a clear survival advantage in patients diagnosed after 1997; this is likely attributable to Rituximab approval.

scholarly journals Primary B-Cell Lymphoma of Caecum Presenting as an Ulcerative Lesion in a Young Male

2020 ◽  
Vol 11 (02) ◽  
pp. 159-162
Author(s):  
Arvind Bamanikar ◽  
Swapnil Patil ◽  
Shivam Sharma
Keyword(s):  
B Cell ◽  
Hodgkin’S Lymphoma ◽  
Cell Lymphoma ◽  
Young Male ◽  
B Cell Lymphoma ◽  
Hodgkin's Lymphoma ◽  
World Health ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Health Organization

AbstractExtra nodal site of non–Hodgkin’s lymphoma is mostly in the gastrointestinal tract. Large intestine is rarely affected compared with stomach or small bowel. The colon is affected in 0.4% of cases approximately. High index of suspicion is required to establish the diagnosis, since there may be no specific signs. Here we report a case of a 28-year-old male, who presented with diarrhea , abdominal pain and weight loss of 2-month duration and diagnosed as non-Hodgkin’s lymphoma (NHL) of the cecum as B-cell lymphoma, unclassified (BCLU) according to World Health Organization (WHO) guidelines.

Tumor Necrosis Factor and Lymphotoxin Alfa Genetic Polymorphisms and Outcome in Pediatric Patients With Non-Hodgkin’s Lymphoma: Results From Berlin-Frankfurt-Münster Trial NHL-BFM 95

2005 ◽  
Vol 23 (33) ◽  
pp. 8414-8421 ◽  
Author(s):  
Kathrin Seidemann ◽  
Martin Zimmermann ◽  
Marion Book ◽  
Ulrike Meyer ◽  
Birgit Burkhardt ◽  
...  
Keyword(s):  
Tumor Necrosis Factor ◽  
B Cell ◽  
Hodgkin’S Lymphoma ◽  
Tumor Necrosis ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Necrosis Factor

Purpose To analyze the association of genetic variation within the tumor necrosis factor (TNF −308 [G→A]) and lymphotoxin alfa (LT-a +252 [A→G]) genes with outcome in non-Hodgkin's lymphoma of childhood and adolescence. Patients and Methods Genotyping of the TNF −308 (G→A) and LT-a +252 (A→G) polymorphisms in patients (n = 488) enrolled onto the German-Austrian-Swiss multicenter trial NHL-BFM 95 from April 1996 to January 2000 was performed by polymerase chain reaction with subsequent restriction fragment length polymorphism analysis on DNA from tumor-free specimen. Results In patients with Burkitt's lymphoma (BL) and B-cell acute lymphoblastic leukemia (B-ALL; n = 219, 211 eligible patients), patients carrying at least two variant alleles (high-producer haplotypes) had an increased risk of events: probability of event-free survival (pEFS) at 3 years was 81% (SE = 5%), compared with 91% (SE = 2%) in low-producer haplotypes (P = .018). In BL/B-ALL with high tumor load (lactate dehydrogenase [LDH] ≥ 500 U/L; n = 104), pEFS was 69% (SE = 8%) in high-producer versus 85% (SE = 4%) in low-producer haplotypes (P = .05). In multivariate analysis including risk factors for events (LDH ≥ 500 U/L, CNS involvement, methotrexate infusion regimen), TNF −308/LT-α +252 haplotype kept prognostic relevance: patients with high-producer haplotypes had a 2.34-fold increase in risk of events (P = .048). The TNF −308 (G→A) and LT-α +252 (A→G) polymorphisms were not associated with pEFS in lymphoblastic lymphoma (n = 101), anaplastic large-cell lymphoma (n = 67), or diffuse large B-cell lymphoma (n = 65), nor with therapy-related toxicity. Conclusion The TNF −308 (G→A) and LT-a +252 (A→G) polymorphisms were negative prognostic factors in pediatric BL/B-ALL. Among patients with serum LDH ≥ 500 U/L, haplotype analysis further determined patients at risk for events.

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