More Than 4 Cycles of ABVD for the Treatment of Stage I–II Hodgkin’s Lymphoma?.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4719-4719
Author(s):  
Norma Tartas ◽  
Marta Zerga ◽  
Graciela Alfonso ◽  
María P. Amoroso Copello ◽  
Isabel Santos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Hodgkin’S Lymphoma ◽  
Residual Disease ◽  
Negative Impact ◽  
Patient Characteristics ◽  
Marrow Transplant ◽  
Stage I ◽  
Hodgkin's Lymphoma ◽  
Bulky Disease

Abstract Patients with stage I-II A non bulky Hodgkin’s lymphoma (HL) are successfully treated with 2–4 cycles of ABVD plus IF radiotherapy (RT). Although the negative impact in DFS and OS of B symptoms and bulky disease(X) is widely accepted, other risk factors such as number of lymph node regions involved or extensive spleen involvement have also been reported. What is the best treatment for such patients? Is radiotherapy necessary? We report here our experience with protocol HD 98 in 62 patients, with stage I–II HL. Since January 98 we have included 30 individuals without risk factors and 32 with one of the following risk factors: B symptoms (n:11), X (n:9), extensive spleen involvement (n:1) and involvement of more than two lymph node regions (n:11). Other patient characteristics were: age: x 31yrs (15–69), sex: females 31, males :31. Ann Arbor stage IA :11, IB :1, IIA: 36, IIB :14. Histologic subtypes were: LP: 4, NS: 42, MC: 15, lymphocyte rich :1. Patients with favourable features received 4 cycles of ABVD plus IFRT, those with unfavourable factors received 6–8 cycles of ABVD plus RT in areas of bulky or residual disease. Results: 59/61 evaluable patients obtained CR or CRu. Two patients were considered primary resistant. Three patients relapsed at 7, 13 and 30 months after completion of treatment. Autologus bone marrow transplant was performed in four patients. The two primary resistant patients relapsed after the transplant and died with proggressive disease. Those patients transplanted in a chemosensitive relapse are currently in CR. With a median follow up of 46m (13–84) 96.7% of the patients are alive, in CR. Conclusions: In our experience patients with unfavourable stages I–II HL are succesfully treated with 6–8 cycles of ABVD. In such patients RT might only be necessary in areas of bulky or residual disease.

scholarly journals Translocation (14;18)-positive cells are present in the circulation of the majority of patients with localized (stage I and II) follicular non- Hodgkin's lymphoma

Blood ◽  
1993 ◽  
Vol 82 (8) ◽  
pp. 2510-2516 ◽  
Author(s):  
AC Lambrechts ◽  
PE Hupkes ◽  
LC Dorssers ◽  
MB van't Veer
Keyword(s):  
Bone Marrow ◽  
Lymph Node ◽  
Peripheral Blood ◽  
Hodgkin’S Lymphoma ◽  
Lymph Node Biopsy ◽  
Stage I ◽  
Hodgkin's Lymphoma ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Sensitive Polymerase Chain Reaction

Abstract Stage I and II follicular non-Hodgkin's lymphoma (NHL) is clinically defined as a localized disease. To study the possibility that this disease is in fact disseminated, we used the sensitive polymerase chain reaction (PCR) method using translocation (14;18) as marker. Samples from 21 patients who were clinically diagnosed with stage I or II follicular NHL were analyzed for the presence of t(14;18)-positive cells using PCR. We analyzed (1) the diagnostic lymph node biopsy and (2) the peripheral blood or bone marrow samples from these patients. Translocation (14;18) cells were detected in the diagnostic lymph node biopsies of 12 patients. In 9 of these patients, t(14;18)-positive cells were detected in peripheral blood and/or bone marrow samples at diagnosis and/or after therapy. Thus, in 75% of the follicular NHL patients carrying the t(14;18) as a marker for lymphoma cells, t(14;18)- positive cells were detected in peripheral blood and bone marrow at diagnosis and after therapy. Our results show that t(14;18)-positive cells can be detected in the circulation of patients with stage I and II follicular NHL, indicating that, although diagnosed as localized, the disease is disseminated.

TARC Is Useful as Additional Prognostic Factor for Hodgkin's Lymphoma Outcome.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1557-1557
Author(s):  
Simonetta Viviani ◽  
Arabella Mazzocchi ◽  
Valeria Bonfante ◽  
Rosalba Miceli ◽  
Davide Dalu ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Hodgkin’S Lymphoma ◽  
Conflicts Of Interest ◽  
Progression Free Survival ◽  
Serum Levels ◽  
Stage I ◽  
Hodgkin's Lymphoma ◽  
Bulky Disease ◽  
T Distribution

Abstract Abstract 1557 Poster Board I-580 Introduction The CC thymus and activation related chemokine TARC, a protein highly expressed by Reed-Sternberg cells and in the microenvironment of Hodgkin's lymphoma (HL) involved lymph nodes, as well as detectable in the serum of HL patients (pts), has been reported to have prognostic value in retrospective analysis. The aim of our study was to prospectively investigate the association among PET-2 results and TARC serum levels (T) in HL and the prognostic role of T in disease relapse or progression. Patients and Methods Between November 2006 and June 2009, T was measured by ELISA in 73 pts: 50 newly diagnosed untreated pts (Group U) and 23 pts relapsing or progressing after first line CT±RT (Group S). Group U pts received stage-directed therapy consisting in 4 ABVD cycles followed by IFRT for stage I-II A, and 6-8 ABVD cycles ± RT on bulky sites of disease for stage II B, III-IV. Group S pts received cytoreductive CT with Ifosfamide-containing regimens followed by HDBEAM+ASCT. T evaluation was repeated after each CT cycle, at the end of treatment and during follow-up. Results Main pts characteristics were as follows: males/females: 32/41; age<45/≥45yrs: 59/16; Nodular Sclerosis (NS) histology/other: 54/73; stage I+II/III+IV: 46/27; B symptoms: 37; bulky disease: 35; nodal/extra±nodal involvement: 49/24; >3/≤3 involved sites: 34/39; IPS>2/≤2: 8/65. Basal T (T0) (median, IQ range) was significantly higher in Group U vs S (23540, 6528-50710 vs 1448, 735-8278; Mann-Whitney test P=0.002); T0 values >536 were observed in 43 (86%) Group U pts and 18 (78%) Group S pts (536 was the 95th centile of T distribution in a group of 40 independent healthy subjects). Pts with NS, bulky disease and extranodal involvement had significantly higher T0 levels than their counterparts. After 2 CT cycles, T (T2) was significantly lower than T0 in Group U (Wilcoxon paired sample test P<0.001), but not in Group S pts (p=0.090); T2 values >536 were observed in 18 (36%) Group U pts and 14 (61%) Group S pts. PET-2 scan was positive in 20 pts (27%) (Group U: 18%, Group S: 48%); PET- 2 was positive in 19/61 pts (31%) with T0 >536 and in 1/12 pts (8%) with T0 ≤ 536; in 17/32 (53%) pts with T2 >536 and in 2/35 (6%) pts with T2 ≤ 536. The chance of having a positive PET-2 was similar in pts with T0 >536 and T2 ≤ 536 compared with pts with T0 ≤ 536 (OR: 1.1; 95% CI: 0.9-13.5), whereas it was 13-fold greater in pts with both T0 and T2 >536 (OR: 12.6; 95% CI 1.4-110). Median follow-up was 18 months (interquartile range: 13-25 months); 13 (18%) pts had relapse or progression (7 Group U, 6 Group S), 24-months progression-free survival (PFS) was 83.4% in Group U and 60.6% in Group S. PFS was 100% vs 78.6% vs 59.4% in pts with T0 ≤ 536, T0 >536 and T2 ≤ 563, and both T0 and T2 >536, respectively. Conclusions Our study confirms that HL pts have increased serum TARC values at baseline compared with healthy subjects; moreover T0 combined with values observed after 2 cycles of CT may have a role in predicting PET-2 results and disease outcome. Disclosures No relevant conflicts of interest to declare.

Lymphocyte-Predominant Hodgkin’s Lymphoma in Children: Therapeutic Abstention After Initial Lymph Node Resection—A Study of the French Society of Pediatric Oncology

2003 ◽  
Vol 21 (15) ◽  
pp. 2948-2952 ◽  
Author(s):  
B. Pellegrino ◽  
M.J. Terrier-Lacombe ◽  
O. Oberlin ◽  
T. Leblanc ◽  
Y. Perel ◽  
...  
Keyword(s):  
Lymph Node ◽  
Pediatric Oncology ◽  
Hodgkin’S Lymphoma ◽  
Stage I ◽  
Hodgkin's Lymphoma ◽  
French Society ◽  
Complementary Treatment ◽  
Lymph Node Resection ◽  
Initial Surgery

Purpose: To clarify treatment strategy for lymphocyte-predominant Hodgkin’s lymphoma (LPHL), the French Society of Pediatric Oncology initiated a prospective, nonrandomized study in 1988. Patients received either standard treatment for Hodgkin’s lymphoma or were not treated beyond initial adenectomy. Patients and Methods: From 1988 to 1998, 27 patients were available for study. Twenty-four patients were male, and median age was 10 years (range, 4 to 16 years). Twenty-two, two, and three patients had stage I, II, and III disease, respectively. Thirteen patients (stage I, n = 11; stage III, n = 2) received no further treatment after initial surgical adenectomy (SA). Fourteen patients received combined treatment (CT; n = 10), involved-field radiotherapy alone (n = 1), or chemotherapy alone (n = 3). The two groups were comparable for clinical status, treatment, and follow-up. Results: Twenty-three of 27 patients achieved complete remission (CR). With a median follow-up time of 70 months (range, 32 to 214 months), overall survival to date is 100%, and overall event-free survival (EFS) is 69% ± 10% (SA, 42% ± 16%; CT, 90% ± 8.6%; P < .04). If we considered only the patients in CR after initial surgery (n = 12), EFS was no longer significantly different between the two groups. Patients with residual mass after initial surgery (n = 15) had worse EFS if they did not receive complementary treatment (P < .05). Conclusion: Although based on a small number of patients, our study showed that (1) no further therapy is a valid therapeutic approach in LPHL patient in CR after initial lymph node resection, and (2) complementary treatment diminishes relapse frequency but has no impact on survival.

Primary non-Hodgkin’s lymphoma of the orbit: treatment outcomes from India

2022 ◽  
pp. 1-5
Author(s):  
Budhi Singh Yadav ◽  
Vjai Simha
Keyword(s):  
Treatment Outcomes ◽  
Hodgkin’S Lymphoma ◽  
Residual Disease ◽  
Tumour Size ◽  
Primary Treatment ◽  
Stage I ◽  
Hodgkin's Lymphoma ◽  
Chop Regimen ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

Abstract Background: Primary non-Hodgkin’s lymphoma (NHL) of the orbit is rare. Orbital NHLs show good response to both radiotherapy (RT) and chemotherapy, and hence, the emphasis should be to ensure maximum cure rate with minimum morbidity. In this study, we present the clinical profile and treatment outcomes of patients with NHL who had initial presentation in the orbit. Materials and methods: In this retrospective analysis, case records of patients with a diagnosis of NHL of the orbit were analysed from January 2005 to January 2015. Patients were worked up and staged according to the Ann Arbor system. Patients with large tumours were initially given chemotherapy with CHOP regimen (cyclophosphamide, vincristine, adriamycin and prednisolone) three weekly for 4–6 cycles. Patients with residual disease were given RT 20–30 Gy at 2 Gy per fraction. RT when given as a primary treatment consisted of 36–45 Gy at 1·8–2 Gy per fraction on either Cobalt 60 machine or linear accelerator. Results: A total of 52 patients with diagnosis of orbital NHL were included in this study. Median age at presentation was 57 years (range 13–71). Left, right and bilateral orbit was involved in 21 (40%), 28(54%) and 3(6%) patients, respectively. Low- and high-grade pathology was seen in 39(75%) and 13(25%) patients, respectively. On immunohistochemistry, 23(44%) tumors were CD 20 positive. After staging, 33 (63%) patients had stage I disease. Median tumour size was 4·0 × 3·2 × 1·5 cm (1·7 × 1·7 × 1·4 cm to 5·8 × 4·0 × 4·7 cm). Primary RT was given to 7(13%) patients. Upfront chemotherapy was given in 45(86·5%) patients, out of which 24 had stage I disease. RT consolidation was done in 26 (50%) patients for residual disease after chemotherapy. Median follow-up was 88 months (range 29–183 months). Relapse occurred in 6(9·6%) patients; 2 local; 2 local + distant and in 2 distant alone. These patients were successfully salvaged with systemic chemotherapy and local RT. One patient died due to neutropenia. Overall survival in this series was 96%. Conclusions: Excellent local control was achieved with initial chemotherapy followed by RT for primary orbital NHL with minimal toxicity. We recommend a dose of 36–40 Gy for definitive RT and 30 Gy for lymphoma following chemotherapy using 2 Gy/fraction for Indian patients who present with bulky tumours. RT should be incorporated in treatment of orbital NHL whenever possible as it is safe, effective and is associated with minimal complications.

Chemotherapy following surgery for stages IE and IIE non-Hodgkin's lymphoma of the gastrointestinal tract.

1988 ◽  
Vol 6 (2) ◽  
pp. 253-260 ◽  
Author(s):  
F A Shepherd ◽  
W K Evans ◽  
G Kutas ◽  
J C Yau ◽  
P Dang ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Hodgkin’S Lymphoma ◽  
Residual Disease ◽  
Systemic Disease ◽  
Stage I ◽  
Stage Ii ◽  
Hodgkin's Lymphoma ◽  
Non Hodgkin’S Lymphoma ◽  
Complete Surgical Resection ◽  
Non Hodgkin's Lymphoma

Twenty-six patients were treated with chemotherapy following surgery for gastrointestinal non-Hodgkin's lymphoma (GI-NHL). The median age was 50 years (range, 20 to 76). The primary site included stomach (16 patients), small bowel (seven), large bowel (two), and mesenteric nodes (one). Following surgery, nine patients had macroscopic and four patients had microscopic residual disease, and 13 were felt to have had complete surgical resection. Thirteen patients were stage I and 13 were stage II. Sixteen patients were treated with COPP (cyclophosphamide, vincristine, procarbazine, prednisone), nine with CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone), and one with CVP (cyclophosphamide, vincristine, prednisone). At a median follow-up of 50 months (8+ to 178+ months) ten of 12 stage I patients and nine of 14 stage II patients remain alive. Of the nine patients with macroscopic residual disease, four died of disease 6.5 to 11.0 months after diagnosis, and five are alive 8+ to 178+ months from diagnosis. Fourteen of the remaining 17 patients who had complete surgical resection are alive without disease. Death in the other three patients was due to multiple abdominal abscesses at 12 months, adenocarcinoma of the colon at 57 months, and dementia and progressive neurologic dysfunction at 65 months. No patient who had complete resection has relapsed or developed systemic disease after chemotherapy. These results suggest that complete surgical resection is an important prognostic factor and that chemotherapy without irradiation in completely resected localized GI-NHL can prevent local and systemic relapse resulting in long-term disease-free survival.

scholarly journals Translocation (14;18)-positive cells are present in the circulation of the majority of patients with localized (stage I and II) follicular non- Hodgkin's lymphoma

Blood ◽  
1993 ◽  
Vol 82 (8) ◽  
pp. 2510-2516
Author(s):  
AC Lambrechts ◽  
PE Hupkes ◽  
LC Dorssers ◽  
MB van't Veer
Keyword(s):  
Bone Marrow ◽  
Lymph Node ◽  
Peripheral Blood ◽  
Hodgkin’S Lymphoma ◽  
Lymph Node Biopsy ◽  
Stage I ◽  
Hodgkin's Lymphoma ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Sensitive Polymerase Chain Reaction

Stage I and II follicular non-Hodgkin's lymphoma (NHL) is clinically defined as a localized disease. To study the possibility that this disease is in fact disseminated, we used the sensitive polymerase chain reaction (PCR) method using translocation (14;18) as marker. Samples from 21 patients who were clinically diagnosed with stage I or II follicular NHL were analyzed for the presence of t(14;18)-positive cells using PCR. We analyzed (1) the diagnostic lymph node biopsy and (2) the peripheral blood or bone marrow samples from these patients. Translocation (14;18) cells were detected in the diagnostic lymph node biopsies of 12 patients. In 9 of these patients, t(14;18)-positive cells were detected in peripheral blood and/or bone marrow samples at diagnosis and/or after therapy. Thus, in 75% of the follicular NHL patients carrying the t(14;18) as a marker for lymphoma cells, t(14;18)- positive cells were detected in peripheral blood and bone marrow at diagnosis and after therapy. Our results show that t(14;18)-positive cells can be detected in the circulation of patients with stage I and II follicular NHL, indicating that, although diagnosed as localized, the disease is disseminated.

Six cycles of ABVD in the treatment of stage I and II Hodgkin's lymphoma: a pilot study.

1997 ◽  
Vol 15 (3) ◽  
pp. 1118-1122 ◽  
Author(s):  
A Rueda ◽  
E Alba ◽  
N Ribelles ◽  
I Sevilla ◽  
I Ruiz ◽  
...  
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Clinical Stage ◽  
Survival Rates ◽  
Progression Free Survival ◽  
Stage I ◽  
Hodgkin's Lymphoma ◽  
Observation Data ◽  
Bulky Disease ◽  
Early Stages ◽  
Long Term Observation

PURPOSE Chemotherapy is the standard treatment in advanced Hodgkin's lymphoma and a therapeutic alternative for early stages. Although polychemotherapy with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) is equivalent or superior to mechloretamine, vincristine, procarbazine, and prednisone (MOPP) in advanced disease, no series have been published using ABVD without associated radiotherapy in early stages. We report the results obtained with the administration of six cycles of ABVD alone in clinical stage I and II disease. PATIENTS AND METHODS From January 1990 to October 1994, 23 patients with stage I or II Hodgkin's lymphoma were treated with six cycles of ABVD; six patients who met the criteria for mediastinal bulky disease also received radiotherapy to the mediastinum. RESULTS After six cycles, 20 complete responses (CRs) and three partial responses (PRs), which became CRs after radiotherapy, were obtained. Toxicity was moderate and manageable. With a median follow-up duration of 37 months (range, 12 to 75), three patients have relapsed and one has died. Overall and progression-free survival rates at 42 months are 95% and 84%, respectively. CONCLUSION Six cycles of ABVD are effective and safe in the treatment of stage I and II Hodgkin's lymphoma, at least in the short term, but long-term observation data are not yet available.

Agricultural risk factors for t(14;18) subtypes of non-Hodgkin’s lymphoma

Epidemiology ◽  
2001 ◽  
Vol 12 (6) ◽  
pp. 701-709 ◽  
Author(s):  
Jane C. Schroeder ◽  
Andrew F. Olshan ◽  
Ralph Baric ◽  
Georgette A. Dent ◽  
Clarice R. Weinberg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Agricultural Risk ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

Impact of chest wall and lung invasion on outcome of stage I–II Hodgkin's lymphoma after combined modality therapy

2003 ◽  
Vol 57 (5) ◽  
pp. 1374-1381 ◽  
Author(s):  
David C Hodgson ◽  
Richard W Tsang ◽  
Melania Pintilie ◽  
Alex Sun ◽  
Woodrow Wells ◽  
...  
Keyword(s):  
Chest Wall ◽  
Hodgkin’S Lymphoma ◽  
Combined Modality Therapy ◽  
Stage I ◽  
Hodgkin's Lymphoma ◽  
Combined Modality

Prognostic and predictive factors in early stages of classic Hodgkin’s lymphoma

2022 ◽  
pp. 7-15
Author(s):  
T. I. Bogatyreva ◽  
A. O. Afanasov ◽  
A. Yu. Terekhova ◽  
N. A. Falaleeva
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Hodgkin’S Lymphoma ◽  
Early Stage ◽  
Hodgkin's Lymphoma ◽  
Cure Rate ◽  
First Line ◽  
Bulky Disease ◽  
Cox Regression Analysis ◽  
Early Stages

Rationale. In the early stages of classical Hodgkin’s lymphoma (cHL), the cure rate reaches 85–95 %, but the long-term effects of therapy can worsen overall survival. Current trials for early stages of Hodgkin’s lymphoma with favorable prognosis address the task of maintaining cure rates while reducing sequelae. For early unfavorable stages, the challenge is to improve cure rate without increasing toxicity.Purpose. To assess the potential significance of individual risk factors for optimal choice of the first line chemotherapy in early-stage Hodgkin lymphoma.Materials and methods. This single-center retrospective study included 290 patients with early stage cHL who had received ABVD – based (n = 249; 86 %) or BEACOPP‑21 – based (n = 41; 14 %) combined modality therapy from 2000 to 2017. Progression-free survival (PFS) and overall survival (OS) were assessed in Cox regression analysis including 12 clinical parameters.Main results. At a median follow up of 60 months for the entire group, OS was 95 % and PFS was 89 %. In a multivariate analysis PFS, at 5 years, was significantly inferior in patients with mediastinal bulk, baseline lymphocytopenia (≤ 0.6 × 109/L, р = 0.002; < 1.0 × 109/L, р = 0.000) and male gender; OS was inferior only in patients with an absolute lymphocytopenia (AL). In patients with AL, PFS after ABVD-based regimen was, respectively, 12 % in the high-risk group with mediastinal bulk and 56 % without it. PFS of patients without AL when treated with ABVD did not differ compared to BEACOPP‑21 within the same prognostic group: 95.2 % vs. 92.3 % for non-bulky and 86.4 % vs. 84.2 % for bulky disease. In the absence of AL, mediastinal bulk remained the main and only risk factor in multivariate analysis.Conclusions. The ABVD regimen is highly effective in the first line of chemotherapy for cHL, except for cases with baseline lymphocytopenia, in which the early usage of the BEACOPP regimen in the escalated or 14-day variants might be justified. In patients with mediastinal bulk, standard chemotherapy is not effective enough even in the absence of AL; therefore, if an intermediate PET/CT scan is available, it seems more appropriate to use a milder ABVD regimen on the first line and leave intensive therapy for patients with proven refractory disease. Prospects for improving the efficiency are opened with the new N-AVD and A-AVD schemes, the benefits of which should be evaluated, first of all, in patients with AL and mediastinal bulk.

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