Rituximab Combined with M/VACOP-B and Radiotherapy in Primary Mediastinal Large B-Cell Lymphoma (PMLBCL): A Prospective Italian Phase II IIL Study.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4697-4697 ◽  
Author(s):  
Maurizio Martelli ◽  
Vittorio Stefoni ◽  
Giuseppina Cabras ◽  
Sergio Cortellazzo ◽  
Ercole Brusamolino ◽  
...  
Keyword(s):  
Superior Vena ◽  
Vena Cava ◽  
Stage Iv ◽  
B Cell Lymphoma ◽  
Severe Toxicity ◽  
Bulky Disease ◽  
Free Survival ◽  
Number Of Patients ◽  
Vena Cava Syndrome ◽  
Involved Field

Abstract Background: Third generation regimens such as MACOP-B or VACOP-B (M/VACOP-B) in combination with involved-field radiotherapy (IFRT) seem to improve lymphoma-free survival of PMLBCL. The superiority of R-CHOP over CHOP-like regimens has been recently demonstrated in younger low risk DLBCL. Recently, the addition of Rituximab to CHOP has also improved survival in PMBLCL. Aims: To evaluate the effectiveness and safety of Rituximab added to the standard M/VACOP-B regimens (R-M/VACOP-B) +/− IFRT in PMLBCL. Patients and Methods: A total of 40 patients with PMLBCL has so far been treated in the six participating centers between February 2002 and July 2005. The median age was 38 years (range 17–54); 21/19 (53%) were females; 30 patients had stage II and 10 stage IV; 38 (95%) presented a bulky disease; LDH was increased in 26 (65%) and 21(53%) had a superior vena cava syndrome. According to the age-adjusted IPI score, 24 patients had an IPI = 0–1 and 16 an IPI = 2–3. All patients were treated with standard MACOP-B (30 patients) or VACOP-B (10 patients) regimens plus six cycles of Rituximab (375mg/m2) given at weeks 3, 5, 7, 9, 11 and 13. Twenty-six patients (65%) received mediastinal IFRT at a median dose of 36 Gy. The response was evaluated in all patients after six cycles of chemo-immunotherapy, at the end of the planned chemotherapy and after IFRT. Results: The response rate after six cycles of the scheduled R-M/VACOP-B regimen was CR/CRu = 20 (50%), PR = 19 (47%) and NR = 1 (3%). Eight of the 40 patients received a second line therapy followed by HDT-ASCT (6/8 patients) because considered as low responders (PR = 7 and NR = 1). At the end of the chemo-immunotherapy program, 28 patients witnessed a CR/CRu (70%) and 12 a PR (30%). Seven of the 12 PR patients obtained a CR/CRu following IFRT for an overall CR/CRu rate of 87% (35/40). After a median follow-up of 13 months, the 2-year OS and PFS are 75% and 78%, respectively. No additional toxicities other than those related to chemotherapy were observed during and after Rituximab infusion. Conclusions: R-M/VACOP-B are active therapeutic regimens devoid of severe toxicity for the management of patients with PMLBCL. The addition of Rituximab to M/VACOP-B regimens does not seem to improve the lymphoma-free survival of this group of patients. An update of these results on a broader number of patients will be presented at the meeting.

scholarly journals Primary cardiac diffuse large B cell lymphoma presenting with superior vena cava syndrome

2009 ◽  
Vol 25 (6) ◽  
pp. e210-e212 ◽  
Author(s):  
Amer Johri ◽  
Tara Baetz ◽  
Phillip A. Isotalo ◽  
Robert L. Nolan ◽  
Anthony J. Sanfilippo ◽  
...  
Keyword(s):  
B Cell ◽  
Superior Vena Cava ◽  
Superior Vena Cava Syndrome ◽  
Cell Lymphoma ◽  
Superior Vena ◽  
Vena Cava ◽  
B Cell Lymphoma ◽  
Large B Cell Lymphoma ◽  
Vena Cava Syndrome ◽  
Large B Cell

Clinical features and results of management of superior vena cava syndrome secondary to lymphoma.

1984 ◽  
Vol 2 (4) ◽  
pp. 260-266 ◽  
Author(s):  
R Perez-Soler ◽  
P McLaughlin ◽  
W S Velasquez ◽  
F B Hagemeister ◽  
J Zornoza ◽  
...  
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena Cava Syndrome ◽  
Superior Vena ◽  
Vena Cava ◽  
Large Cell ◽  
Combined Modality Treatment ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Vena Cava Syndrome ◽  
Radiotherapy Alone

Thirty-six of 915 patients with non-Hodgkin's lymphoma presented with superior vena cava syndrome (SVCS). The histologic types associated with SVCS were diffuse large cell in 23 patients, lymphoblastic in 12, and follicular large cell in one patient. Radiotherapy alone appeared equal to chemotherapy alone or in combination with radiotherapy in achieving relief of SVCS symptoms. Chemotherapy alone or in combination with radiotherapy was superior to radiotherapy alone in prolonging relapse-free survival and overall survival. No differences in relapse-free survival and survival were found between the patients treated with chemotherapy alone and those treated with chemotherapy and radiotherapy, but the addition of radiotherapy appeared to prevent local relapses in the group with large-cell lymphoma. The presence of symptoms of involvement of other mediastinal structures such as dysphagia, hoarseness, or stridor (DHS), a higher grade of intensity, and a shorter duration of symptoms (less than or equal to 2 weeks) appeared to adversely influence relapse-free survival and survival. The following conclusions were made: (1) a histologic diagnosis before the onset of treatment is desirable and feasible in patients presenting with SVCS except in those with severe respiratory distress, (2) both chemotherapy and radiotherapy are equally effective in alleviating the symptoms of SVCS, and (3) combined modality treatment with chemotherapy and radiotherapy results in a lower frequency of local relapses compared to chemotherapy alone but survival was similar in both groups.

Superior vena cava syndrome in primary mediastinal B-cell lymphoma

2013 ◽  
Vol 24 ◽  
pp. e176-e177 ◽  
Author(s):  
L. Ruzickova ◽  
C. Canha ◽  
L. Geraldes ◽  
P. César ◽  
J. Carda ◽  
...  
Keyword(s):  
B Cell ◽  
Superior Vena Cava ◽  
Superior Vena Cava Syndrome ◽  
Cell Lymphoma ◽  
Superior Vena ◽  
Vena Cava ◽  
B Cell Lymphoma ◽  
Vena Cava Syndrome

scholarly journals Primary Pericardial Synovial Sarcoma: A Case Report and Literature Review

Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 158
Author(s):  
Simona Manole ◽  
Roxana Pintican ◽  
Emanuel Palade ◽  
Maria Magdalena Duma ◽  
Alexandra Dadarlat-Pop ◽  
...  
Keyword(s):  
Synovial Sarcoma ◽  
Imaging Modality ◽  
Superior Vena ◽  
Vena Cava ◽  
Disease Free Survival ◽  
Immunohistochemical Analysis ◽  
Free Survival ◽  
Vena Cava Syndrome ◽  
Ct And Mri

We report a case of a 52-year-old woman who was referred to our institution with a superior vena cava syndrome and was investigated through echocardiography, CT and MRI revealing a well-defined, encapsulated pericardial mass. The pathology, correlated with the immunohistochemical analysis, concluded it was an extremely rare primary pericardial synovial sarcoma. The patient underwent surgery and chemotherapy with a 16-month disease-free survival and passed away after a contralateral aggressive relapse. Moreover, we discuss the role of each imaging modality together with their pericardial synovial sarcoma reported features.

PP-126 PRIMARY LARGE CARDIAC B-CELL LYMPHOMA: A VERY RARE CAUSE OF SUPERIOR VENA CAVA SYNDROME

2012 ◽  
Vol 155 ◽  
pp. S141-S142
Author(s):  
O. Turak ◽  
A. Yalçinkaya ◽  
F. Özcan ◽  
I. Taşoğlu ◽  
Kumral çağli ◽  
...  
Keyword(s):  
B Cell ◽  
Superior Vena Cava ◽  
Superior Vena Cava Syndrome ◽  
Cell Lymphoma ◽  
Superior Vena ◽  
Vena Cava ◽  
B Cell Lymphoma ◽  
Vena Cava Syndrome

Comparison CHOP Like Vs Rituximab (R) + CHOP in Non Hodgkin Lymphomas (NHL): Nine Years Uruguayan University Hospital Experience

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4976-4976
Author(s):  
Carolina Oliver ◽  
Paula Martinez ◽  
Cecilia Guillermo ◽  
Lilián Díaz
Keyword(s):  
B Cell Lymphoma ◽  
University Hospital ◽  
Bulky Disease ◽  
Prolymphocytic Leukemia ◽  
Free Survival ◽  
Number Of Patients ◽  
Significant Difference ◽  
Ann Arbor ◽  
Extranodal Disease

Abstract Abstract 4976 Between January 2002 and December 2010, we treated 207 NHL at the Hospital de Clínicas, Uruguayan University Hospital. These are 10 % of the NHL diagnosed in our country. There were 72 Diffuse Large B Cell Lymphoma (DLBCL), 34 Follicular Lymphoma (FL), 33 Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma, 11 Mantle Cell, 10 T Cell, 7 MALT, 7 Anaplasic T, 6 Burkitt, 6 Lymphoblastic Lymphoma, 5 Lymphoplasmocytic, 4 Mycosis Fungoides, 3 Burkitt like, 2 Hairy cell Leukemia, 2 Esplenic Marginal zone, 2 LLGG, 2 angioinmunoblastic, 1 Prolymphocytic Leukemia. The mean of this retrospective study is to analyze the improvement in Overall Survival (OS) with the use of R in DLBCL and FL in HIV negative Uruguayan patients. The DLBCL were 72 patients, we analyze 61 because 5 were HIV positive and 6 were Primary CNS. There were 34 males and 27 females. The median age was 60 years (25-82). At diagnostics, the Ann Arbor Stratification was: 26 I-II, 10 with B symptoms, 35 III – IV, 20 with B symptoms. Nineteen (31 %) had Bulky disease and 18 (30 %) were primary extranodal disease. The International Prognostic Index was: 30%: 0–1; 28,5 %: 2; 28,5 %: 3; 13 %: 4. The delay between the first consult and treatment was 31 days (1-456). The Chemotherapy regimens used were in 35 CHOP-like (CHOP, CAPVE, CEOP, CMVP, CVP, m-BACOD) with a median of cycles of 6 (1-8), and in 22 R-CHOP with a median of cycles of 6 (1-8). Results DLBCL: In DLBCL treated with CHOP-like regimens the Overall Response (OR) (Complete Remission (CR) and Partial Remission (PR)) was 60 % with 37 % of CR and 23 % of PR. With R-CHOP the OR was 100 %, CR: 91 % and PR: 9 %. With a median of follow up of 23 month (0,8-106), the OS in patients treated with CHOP-like is 34,3 months and in R-CHOP it has not been reached yet, but it is not statistically significant: log rank (p=0,121). The OS at 24 months is 52 % in CHOP-like vs 80 % in R-CHOP. These results are very promising for the R- CHOP group. The Disease Free Survival (DFS) was 39,6 month (IC: 0–114,4) in CHOP-like and it has not been reached yet in patients with R-CHOP, but this is not statistically significant, log rank (p= 0,645). At 24 month the DFS was 60 % in CHOP-like and 67 % in R-CHOP. There were 34 patients with FL, we analyze 33 because we exclude HIV +. There were 19 females and 14 males. The median age was 62,5 years (33-79). At diagnostics, the Ann Arbor stratification was: 8 patients I -II, 3 with B symptoms, 25 III – IV, 12 with B symptoms. Twelve percent were bulky and 15 % begun with extranodal disease. Forty four percent had FLIPI 0–1, 36 % FLIPI 2 and 20 % 3 or more. The histological grade was in 3 % G1, 79 % G2 and 18 % G3 (15 % G3a and 3 % G3b). The median delay between the first consult and diagnostic was 24 days (5-765). The Chemotherapy regimens used were: in 18 patients CHOP like (CHOP, CAVPE, m-BACOD), median number of cycles 5 (1-6), in 9 patients R-CHOP with median of cycles of 6 (3-8) and in 3 patients R-CHOP-like (R-CAPVE, FCR, R-CVP), median of cycles 5 (3-6). Results FL: In FL treated with R-CHOP or R-CHOP-like regimens the OR was 92 % with 59 % CR and 33 % PR. With CHOP-like regimens the OR was 55 % with 17 % CR and 38 % PR. With a median follow up of 36 month (3-111), the median OS hasn't been reached. The OS at 24 and 36 month in patients treated with R-CHOP or R-CHOP-like was 82 % and 58 %, and in patients treated with CHOP-like 82 % and 67 % respectively. These are not statistically significant, log rank p=0,923. The median Progression Free Survival (PFS) in patients treated with CHOP-like regimens was 17 month (0-44) and it hasn't been reached in treated with R-Chemotherapy (R-CT). The PFS at 24 and 36 month was 36 % and 18 % in CHOP-like patients and 68 % and 55 % in R-CT patients. These difference also is not statistically significant, log rank p=0,66, but there is a great trend in benefit of R-CT. Discussion and conclusion: the use of the monoclonal antibodies in NHL's treatment has been an important issue and it is now use in first line treatment because it's benefits in OR, CR and OS. R was introduced in Uruguay in 2005 and it is government funded through Fondo Nacional de Recursos. In our series, there is an improvement in CR and a trend towards better results in OS and DFS when R-CHOP is used. In spite of the fact that it was not possible to demonstrate a statistically significant difference in view of the low number of patients, we think that this sample is highly representative of the reality of our country. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Primary Pulmonary Lymphoma Presenting with Superior Vena Cava Syndrome in a Young Female

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Divya Salhan ◽  
Prakash Verma ◽  
Tun Win Naing ◽  
Ebad Ur Rehman ◽  
Saroj Kandel ◽  
...  
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
B Cell Lymphoma ◽  
Young Female ◽  
Large B Cell Lymphoma ◽  
Primary Pulmonary Lymphoma ◽  
Pulmonary Lymphoma ◽  
Vena Cava Syndrome ◽  
The Right

Primary Pulmonary Diffuse Large B Cell Lymphoma (PPDLBCL) is an extremely rare entity, which exhibits an aggressive behavior by compressing local blood vessels. It represents only 0.04% of all lymphoma cases and is extremely rare in young age. We present a case of a primary pulmonary lymphoma with superior vena cava syndrome (SVCS) in a young female. 27-year-old African American female presented with fever, cough, and facial puffiness for 2 weeks and unintentional weight loss. Chest examination showed decreased breath sounds and dullness on percussion on right side. Labs were normal except for mild leukocytosis, high lactate, and lactate dehydrogenase. Chest X-ray showed a large right side infiltrate with pleural effusion but chest CT showed 10 × 14 × 16 cm mass in the right lung without hilar and mediastinal lymphadenopathy. CT guided biopsy of the right lung mass was done and large B cell lymphoma was diagnosed. She received “involved field radiation” because of the bulky tumor size and superior vena cava involvement prior to R-CHOP to which she responded well. PPDLBCL should be considered as one of the differentials in a young patient with a large lung mass, which needs timely diagnosis and management.

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