Response to Re-Treatment with Rituximab Plus Salvage-Chemotherapy in Refractory or Relapsed Aggressive Non-Hodgkin’s Lymphoma.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4720-4720 ◽  
Author(s):  
Andrea Borgerding ◽  
Justin Hasenkamp ◽  
Bjoern Chapuy ◽  
Lorenz Truemper ◽  
Gerald Wulf ◽  
...  
Keyword(s):  
Salvage Therapy ◽  
Hodgkin’S Lymphoma ◽  
Progressive Disease ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Salvage Chemotherapy ◽  
Hodgkin's Lymphoma ◽  
Autologous Graft ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

Abstract The efficacy of re-therapy with rituximab immuno-chemotherapy was analysed in 20 consecutive patients with relapsed or progressive aggressive Non Hodgkin’s lymphoma after initial treatment with rituximab plus chemotherapy. Ten patients had a diffuse large B-cell lymphoma, seven had a mantle cell lymphoma and three a grade III follicular lymphoma. At primary diagnosis, the IPI was high-intermediate or high in 75% of the patients and the median age was 55 years (range 36–72 years). The overall response rate of primary immuno-chemotherapy was 75% (15/20 patients) with a complete remission in 8/20 patients (40%). After relapse, 53 % of these patients (8/15) responded again to immunochemotherapy: two patients had a second complete and six a second partial remission. None of the five patients with primary progressive disease responded to a conventional immuno-chemo salvage therapy. After re-therapy with rituximab plus salvage chemotherapy, ten patients received at least one cycle of high dose chemotherapy followed by SCT. One patient did receive HD-chemotherapy and an autologous graft solely, two patients did receive HD-radio-immunotherapy followed by an autologous graft and seven patients finally received HDT and an allogeneic transplant. Allogeneic SCT resulted in a CR in 6 out of 7 patients. One of these ten patients relapsed after HDT consolidation. Six out of ten patients without HDT consolidation after immuno-chemotherapy progressed after secondary treatment, 4 patients are alive without progression (SD, PR) but follow up is short (7, 10, 13 and 16 months). Conclusion: A substantial proportion (53%) of patients with relapse after rituximab immuno-chemotherapy did response to rituximab containing salvage therapy. Patients with progressive disease under immuno-chemotherapy did not respond to such salvage therapy. Without additional consolidation by HDT the risk of progression after successful salvage with rituximab and salvage-chemotherapy is high.

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.

Serum Interleukin-18 Levels Are Associated with Response to Treatment and Survival in Patients with Aggressive Non-Hodgkin’s Lymphoma.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4543-4543 ◽  
Author(s):  
Naoe Goto ◽  
Hisashi Tsurumi ◽  
Masao Takemura ◽  
Takeshi Hara ◽  
Michio Sawada ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Hodgkin’S Lymphoma ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
High Serum ◽  
Hodgkin's Lymphoma ◽  
Interleukin 18 ◽  
Ifn Gamma ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

Abstract Interleukin-18 (IL-18), originally designated as an interferon (IFN)-gamma inducing factor, is a cytokine which induces cytotoxic NK cell activity and stimulates T cells to produce IFN-gamma, IL-2, and GM-CSF. Increased serum IL-18 levels have been found in patients with acute lymphoblastic leukemia, chronic myelocytic leukemia, multiple myeloma and non-Hodgkin’s lymphoma (NHL). The aim of the present study was to assess the prognostic significance of serum IL-18 in aggressive NHL. Consecutive 99 previously untreated patients with aggressive NHL (diffuse large B-cell lymphoma; 84 patients, peripheral T-cell lymphoma; 15 patients) prospectively participated in this study between 1997 and 2003. The patients were treated with 6–8 cycles of CHOP or THP (pirarubicin) -COP regimens. To evaluate serum levels of IL-18, venous blood samples were drawn from patients immediately before the initiation of treatment. In all patients with aggressive NHL, the mean ± SD of serum IL-18 level was 1200.8±151.5 pg/ml (range 96–6603.5) with a median of 556.75 pg/ml. Several poor prognostic features such as poor PS, multiple extranodal sites, advanced disease (clinical stage III/IV), existence of B-symptom, and high soluble interleukin-2 receptor (sIL-2R) were strongly associated with a high serum IL-18 levels. An increased LDH and gender were weakly associated with a high serum IL-18. Histology and age were not associated with serum IL-18 levels. The median serum IL-18 levels of the different IPI risk groups were; 321 pg/ml for the L risk; 442 pg/ml for the LI risk; 557 pg/ml for the HI risk; 1532 pg/ml for the H risk, respectively (P<0.005). The CR rate of patients with an IL-18 level of less than 700 pg/ml was better than that of 700 pg/ml or higher (77% and 50%, P<0.01). Patients with high IL-18 (700 pg/ml and over) at onset had a significantly lower survival rate (5-year: 25%) than those with low IL-18 (below 700 pg/ml) (68 %) ( p<0.0001). Multivariate analysis employing IL-18 and some conventional prognostic factors demonstrated that IL-18, performance status and the number of extranodal sites were significantly poor prognostic factors for both overall survival (OS) and event free survival (EFS). The results suggest that a high serum IL-18 level predicts a poor prognosis in aggressive NHL and may be a useful biomarker for selecting appropriate treatment.

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.

Outcome of Young Children with Non-Hodgkin's Lymphoma

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 5106-5106
Author(s):  
Laura Rodriguez ◽  
Mohammed Zolaly ◽  
Sheila Weitzman ◽  
Ahmed Naqvi ◽  
Angela Punnet ◽  
...  
Keyword(s):  
Young Children ◽  
Hodgkin’S Lymphoma ◽  
Conflicts Of Interest ◽  
Cell Lymphoma ◽  
Organ Transplant ◽  
B Cell Lymphoma ◽  
Large Cell ◽  
Hodgkin's Lymphoma ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

Abstract Abstract 5106 Background: The incidence and biology of non-Hodgkin's lymphoma (NHL) vary according to age, and the outcome differs amongst children being less favorable in infants and adolescents. Objectives: To analyze the outcome and toxicity patterns of young children with NHL comparing patients aged < 10 years to those 10–18 years of age. Methods: A retrospective review of children ≤ 18 years of age diagnosed with NHL over a period of 13 years. Patients were treated according to different protocols and treatment subgroups included: Burkitt lymphoma (BL), diffuse large B-cell lymphoma (DLBCL), lymphoblastic lymphoma (LL), anaplastic large cell lymphoma (ALCL), and peripheral T-cell lymphoma (PTCL). Post-organ transplant lymphoproliferative disorder (PTLD) and immunodeficient patients were excluded. Results: From 01/1995 to 12/2008, 173 children with NHL were reviewed. Of these, 81 pts (47%) were <10 years of age, with BL (29 pts), DLBCL (5 pts), PTCL (6 pts), LL (27 pts), and ALCL (14 pts). The 10-year overall survival (OS) was 93. 6+2. 8% in patients aged < 10 years compared to 77. 3+7. 2 in patients 10–18 years of age (P=0. 02). The 10-year event-free survival (EFS) was 89. 4+3. 5% in patients aged < 10 years compared to 70+9. 3% in patients 10–18 years of age (P=0. 03). BL was the most common subtype in patients <10 years, with a 10-year EFS of 96. 4+3. 5% versus 82. 6+7. 9% in patients 10–18 years of age (P=0. 10). The most common subtype in patients 10–18 years of age was ALCL (36%), the 10-year EFS was 78. 5+8. 3 versus 92. 9+6. 9 in patients < 10 years (P=0. 29). Children 10–18 years of age were more likely to develop neurotoxicity (9. 7% vs 0%), gastrointestinal toxicity (30% vs 12%), and treatment-related mortality (4. 3% vs 2. 4%). Conclusions: Children < 10 years with NHL have better outcomes and less treatment-related toxicity than older children. 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

scholarly journals Lemzoparlimab, a Differentiated Anti-CD47 Antibody in Combination with Rituximab in Relapsed and Refractory Non-Hodgkin's Lymphoma: Initial Clinical Results

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 3542-3542
Author(s):  
Amitkumar Mehta ◽  
Wael Harb ◽  
Claire Xu ◽  
Yuan Meng ◽  
Linda Lee ◽  
...  
Keyword(s):  
Targeted Therapies ◽  
Research Funding ◽  
Hodgkin’S Lymphoma ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Target Engagement ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Anti Tumor Activity

Abstract Introduction Lemzoparlimab (also known as TJ011133 or TJC4) is a differentiated CD47 IgG4 antibody targeting a distinct CD47 epitope to enable a unique red blood cell sparing property, while retaining strong anti-tumor activity as demonstrated previously in patients with solid tumors. Lemzoparlimab does not induce significant hematologic toxicity without the need of priming dosing commonly required for other CD47 antibodies. Lemzoparlimab exhibits an enhanced treatment effect when combined with rituximab in lymphoma animal models. Methods This ongoing Phase 1b study (NCT03934814) enrolled relapsed and refractory (R/R) patients with CD20 positive Non-Hodgkin's Lymphoma (NHL) who had at least two prior lines of therapy in a 3+3 dose escalation design followed by a dose expansion. Lemzoparlimab was administered intravenously at doses of 20 or 30 mg/kg weekly with rituximab (375 mg/m2 QW for 5 doses followed by once monthly for 3 doses). Safety, tolerability, pharmacokinetics (PK), pharmacodynamics (PD) and anti-tumor activity based on Lugano criteria were assessed. Preliminary data as of 2 July 2021 are reported here with the updated data set to be presented at the 2021 ASH meeting. Results Eight heavily pre-treated patients with R/R NHL who had progressed on prior CD20 targeted therapies were enrolled to the dose cohorts of 20 mg/kg (n=6) and 30 mg/kg (n=2) of lemzoparlimab in combination with rituximab. The diagnoses included diffuse large B-cell lymphoma (DLBCL) [n=2], mantle cell lymphoma (MCL) [n=1], and follicular lymphoma (FL) [n=5]. Patients had a median age of 63 years (range: 43-83) and a median of 4 prior therapies (range: 2-10). Safety and tolerability: The most common treatment-related adverse events (TRAEs) were infusion-related reactions (n=4), pruritus (n=3), fatigue (n=3), rash (n=2), constipation (n=2), and dyspnea (n=2). All TRAEs were Grade 1 or 2, with one exception who reported Grade 3 TRAEs including pleural effusion, tachycardia, cough, pruritis, fatigue, rash and dyspnea, at 20 mg/kg dose level. Mild hematologic AEs were observed as one isolated episode of anemia and thrombocytopenia, respectively, and no treatment was required. PK and PD: Co-administration of rituximab did not affect the PK or immunogenicity of lemzoparlimab. On average, 80% and 90% CD47 receptor occupancy was detected in biopsied lymph nodes from the patients dosed at 20 and 30 mg/kg, respectively, indicating significant tumor target engagement. Anti-tumor activity: Among 7 efficacy-evaluable patients, 3 complete responses (CR) [1 transformed FL-DLBCL + 2 FL] and 1 partial response (PR) of FL were observed (ORR=57%), together with 3 stable disease (SD duration between 3-6 months). The overall DCR was 100%. Tumor shrinkage was observed in all evaluable patients. One patient was not efficacy evaluable due to clinical disease progression after withdrawal from the study at the first cycle. The median time to an initial response to the treatment was 2 months and all responders remained in clinical response at time of data cutoff. During continued treatment, two patients developed improved responses. One patient with transformed FL-DLBCL improved from PR at 2 nd month to CR at 8 th month and another patient with FL improved from SD at 2 nd month to PR at 4 th month. Conclusion Consistent with the previously reported monotherapy results, lemzoparlimab given at 20 - 30 mg/kg with rituximab is safe and well tolerated in patients with R/R NHL without the need for a priming dose. A high level of intra-tumoral target engagement was reached at both dose levels. The combination therapy exhibited evidence of clinical activity in heavily pre-treated R/R NHL patients who had progressed on prior CD20 targeted therapies. The results provide the basis for RP2D and impetus for accelerated clinical development for NHL. Disclosures Mehta: Seattle Genetics; Incyte; TG Therapeutics: Consultancy; Seattle Genetics; Incyte; TG Therapeutics: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Affirmed; Kite/Gilead; Roche-Genetech; Celgene/BMS; Oncotartis; Innate Pharmaceuticals; Seattle Genetics; Incyte; Takeda; Fortyseven Inc/Gilead; TG Therapeutics; Merck; Juno Pharmaceuticals/Bristol Myers Squibb: Research Funding. Xu: I-Mab Biopharma: Current Employment. Meng: I-Mab Biopharma: Current Employment. Lee: I-Mab Biopharma: Current Employment. Yuan: I-Mab Biopharma: Current Employment. Wang: I-Mab Biopharma: Current Employment. Song: I-Mab Biopharma: Current Employment. Shen: I-Mab Biopharma: Current Employment. Gopal: Genetech: Consultancy, Honoraria, Research Funding; Gilead: Consultancy, Honoraria, Research Funding; Teva: Research Funding; I-Mab bio: Consultancy, Honoraria, Research Funding; Janssen: Consultancy, Honoraria, Research Funding; Nurix Inc: Consultancy, Honoraria; Agios: Research Funding; Servier: Consultancy, Honoraria; ADC Therapeutics: Consultancy, Honoraria; Cellectar: Consultancy, Honoraria; Acrotech: Consultancy, Honoraria; Merck: Consultancy, Honoraria, Research Funding; Karyopharm: Consultancy, Honoraria; Takeda: Research Funding; MorphoSys: Honoraria; Kite: Consultancy, Honoraria; Beigene: Consultancy, Honoraria; Epizyme: Consultancy, Honoraria; Bristol Meyers Squibb: Research Funding; Astra-Zeneca: Research Funding; IGM Biosciences: Research Funding; Incyte: Honoraria; SeaGen: Consultancy, Honoraria, Research Funding.

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)

R-CHOP Every Two Weeks with Pegylated Filgastrim Support for the Treatment of CD20+ Aggressive Non Hodgkin's Lymphoma: Feasibility of Delivery On Time.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4773-4773
Author(s):  
Shatha Y. Farhan ◽  
Tim Kasunic ◽  
George Divine ◽  
Philip Kuriakose ◽  
Nalini Janakiraman
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Cell Lymphoma ◽  
International Prognostic Index ◽  
B Cell Lymphoma ◽  
Treatment Delay ◽  
Hodgkin's Lymphoma ◽  
Hematologic Toxicity ◽  
Bulky Disease ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

Abstract Abstract 4773 Introduction Several studies have shown that modifying CHOP (cyclophosphamide 750 mg/m2, doxorubicin 50 mg/m2, vincristine 1.4 mg/m2, prednisone 100 mg) by adding rituximab (R) and/or shortening the time between cycles to 14 days improves survival in patients with aggressive non hodgkin's lymphoma (NHL). However, in some of the 14-day trials few patients withdrew from studies because of treatment delay more than 2 weeks. We implemented a two-stage phase II trial to assess the feasibility of delivering R-CHOP on time every two weeks with pegylated filgastrim (Neulasta) support for the treatment of CD20+ aggressive NHL. Patients and Methods Previously untreated patients with intermediate or high grade CD20+ NHL were assigned to receive R-CHOP every 2 weeks with pegylated filgastrim support. Lymphoblastic and mantle cell lymphoma were excluded. After 4 cycles, the patients who achieved complete response (CR) received 2 more cycles. Those who achieved a partial response (PR) were re-evaluated after receiving six cycles. If they were found in CR they got two more cycles (8 total). However, if they were found to be in PR they received radiotherapy or other therapy per treating physician. This interim report of this study reflects 16 patients enrolled so far between 8/4/05 till 8/8/09. Results Fourteen patients received two or more cycles and are considered evaluable. Their mean age was 60 years (range: 47-77). Thirteen patients had Diffuse Large B cell Lymphoma (DLBL) and one patient had DLBL transformed from follicular lymphoma. Ten patients (71.4%) had an International Prognostic Index (IPI) low to low-intermediate and four (28.6%) had high intermediate to high IPI, two had a bulky disease and six had stage IV disease, three had stage III, the rest had stage I and II. Treatment delay was defined as more than two week delay in delivering the scheduled chemotherapy in two or more cycles due to absolute neutrophil count <500/microL or Platelets <75,000/microL. Nine patients received 6 cycles, two received 8, another two patients received 5 and one received 7 cycles (87 cycles total). Therapy was delivered on time without any delay in 8 patients (57% of patients). Only one patient (7.1%) met the defined criteria and had treatment delay >2 weeks for 2 cycles secondary to neutropenic fever (2.73% of 73 cycles, since the first cycle in each patient was not susceptible to delay). The study met the criteria (<=2 delays among the first 10 patient) for progression to the second stage. Five patients (6.84% of 73 cycles) had >1 week delay for non hematologic reasons (stroke, gastritis, ovarian cancer, perforated colon and drug allergy). Eleven patients had grade 3-4 neutropenia, five had grade 3anemia and one had grade 3thrombocytopenia. One patient had grade 2neuropathy. Median follow up time was 21.1 months. Overall response rate (CR+ PR) was 14/14 (100%), however one patient relapsed after 7 months and underwent stem cell transplantation. Conclusions It appears feasible and safe to deliver RCHOP every two weeks with pegylated filgastrim support in patients with CD20+ aggressive NHL. However in this group of 14 patients, there were some delays due to non hematologic toxicities and the delay due to hematologic toxicity was encountered in only one patient. Disclosures: No relevant conflicts of interest to declare.

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