scholarly journals Role of diffusion MRI in diagnosis of mediastinal lymphoma: initial assessment and response to therapy

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Youssriah Yahia Sabri ◽  
Nourhan Mohamed Ewis ◽  
Hussam Eldin Hamdy Zawam ◽  
Mostafa Ahmed Khairy
Keyword(s):  
Diffusion Mri ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Resonance Imaging ◽  
Non Hodgkin’S Lymphoma ◽  
Mediastinal Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Significant Difference ◽  
Adc Values ◽  
Weighted Magnetic Resonance Imaging

Abstract Background Malignant lymphoma accounts for nearly 20% of all mediastinal neoplasms in adults and 50% in children. Hodgkin’s disease is the most common primary mediastinal lymphoma. In non-Hodgkin’s lymphoma, the two most common forms of primary mediastinal lymphoma are lymphoblastic lymphoma and diffuse large B-cell lymphoma. The aim of this study is to implement diffusion MRI in the algorithm of diagnosis of mediastinal lymphoma, differentiating Hodgkin's from non-Hodgkin's lymphoma and assessment of post therapeutic response. Results Using Diffusion weighted magnetic resonance imaging DWI-MRI, there were statistic significant difference between ADC values in lymph nodes and mediastinal masses in Hodgkin and non-Hodgkin lymphomas. ADC range in non-treated Hodgkin lymphoma cases was 0.774 to 1.4, while ADC range in in non-treated non-Hodgkin lymphoma was 0.476 to 0.668. In this study, there was statistically significant difference of ADC values in lymphoma cases presented by mediastinal masses with and without chemotherapy. Conclusions Diffusion weighted magnetic resonance imaging DWI-MRI is a promising functional technique in diagnosis of Hodgkin's and non-Hodgkin's lymphoma and assessment of response to treatment with no need for special preparation, contrast injection or radiation exposure.

Non-Hodgkin's Lymphoma in the Elderly: A Retrospective Evaluation of Toxicity Related to Aggressive vs. Conservative Treatments

1988 ◽  
Vol 74 (4) ◽  
pp. 433-438 ◽  
Author(s):  
Umberto Tirelli ◽  
Vittorina Zagonel ◽  
Rachele Volpe ◽  
Mauro G. Trovo ◽  
Antonino Carbone
Keyword(s):  
Elderly Patients ◽  
Hodgkin’S Lymphoma ◽  
Randomized Trials ◽  
Survival Rates ◽  
The Elderly ◽  
Hodgkin's Lymphoma ◽  
Severe Toxicity ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Significant Difference

The outcome of 70 elderly patients aged 65 years or more (median, 71 years) with non-Hodgkin's lymphoma (NHL) treated between 1973 and 1981 with aggressive (AM) or conservative modalities (CM) was retrospectively evaluated. A significantly higher incidence of lethal and severe toxicity was observed in patients treated with AM than in those treated with CM (32 % vs 3 %, p < 0.01), with 10 % treatment related deaths in the AM group. Only 56 % of the deaths were attributed to NHL; other major causes were treatment-related deaths, infection and cardiac diseases. No significant difference in response and survival was found between AM and CM groups (complete remission rates were 35 % vs 42 %, and 10 year survival rates were 31 % vs 19 %, respectively), but the prevalence of stages III-IV in patients treated with AM makes these results meaningless. Prospective randomized trials with AM vs CM are clearly needed in elderly patients with advanced unfavorable NHL.

scholarly journals PROGNOSTIC SIGNIFICANCE OF PLATELET- NEUTROPHIL COMPLEXES IN NON-HODGKIN’S LYMPHOMA PATIENTS

ASJ. ◽  
2021 ◽  
Vol 1 (54) ◽  
pp. 14-17
Author(s):  
Yu. Sheniz ◽  
Sh. Bozhidara ◽  
M. Ilina ◽  
G. Liana
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Therapeutic Response ◽  
Prognostic Significance ◽  
Complete Response ◽  
Hodgkin's Lymphoma ◽  
Aggressive Lymphoma ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Significant Difference ◽  
Hodgkin's Lymphomas

Abstract. Non-Hodgkin's lymphomas (NHL) are a group of lymphoproliferative diseases with a heterogeneous spectrum of clinical, morphological, and immunophenotypic characteristics. Non-Hodgkin’s lymphoma is characterized by abnormal proliferation or accumulation of B or T lymphocytes. Circulating neutrophils and platelets have a proven role in both the pathogenesis of inflammatory processes and thrombosis and in the processes of tumorigenesis.The formation of complexes between neutrophils and circulating platelets (PNC) is a fundamental mechanism that is known but poorly studied in non-Hodgkin's lymphomas. Aim: To investigate the levels of circulating neutrophil-platelet complexes in newly diagnosed patients with aggressive and indolent NHL and the relationship of those levels with prognostic risk, prognosis, overall survival, and therapeutic response. Methods: PNC levels were analyzed by flow cytometry of peripheral blood from 88 patients with histologically verified NHL before chemotherapy. The results were statistically analyzed using dispersion, variable, comparison, correlation, and regression methods. Results: The mean age of the studied patients was 60.6 years ± 11.8 years (range 28–88 years), with men and patients with aggressive lymphoma accounting for just over half the population (52.3% each). A significant difference (p = 0.005) and an inversely weak dependence was found between IPI risk and survival (r = -0.277; p = 0.009) in aggressive lymphomas. A significant difference was found between the type of lymphoma and the therapeutic response (p = 0.030). A complete response was achieved in 42 (47.7%) patients with NHL, while progression was observed in 17 (19.3%) and relapse in 2 (2.3%) There was a strong significant correlation between PNC and IPI (р=0.021), PNC and therapeutic response (р=0.044). Conclusion: PNC measurement could be a useful diagnostic and prognostic marker in many diseases. 

Prognostic Value of P-Glycoprotein (Pgp) in Non-Hodgkin’s Lymphoma

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 5302-5302
Author(s):  
Lilian M Pilleux ◽  
Cristian S Carrasco ◽  
Claudia V Pisón ◽  
Yenny O Valencia ◽  
Mauricio G Lopez ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Hodgkin’S Lymphoma ◽  
Statistical Tests ◽  
Descriptive Analysis ◽  
Disease Free Survival ◽  
Hodgkin's Lymphoma ◽  
Actuarial Survival ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Significant Difference

Abstract Multidrug resistance (MDR) is one of the greatests obstacles of cancer therapy. One of the most studied mechanisms of resistance is mediated by Pgp encoded by gene MDR-1. Studies in patients with Human Immunodeficiency Virus associated non-Hodgkin’s lymphoma (NHL) show that those MDR positive achieve lower rate of complete remission than those MDR negative. Reports in refractory or relapsed NHL have failed to reproduce this finding. In an attempt to confirm the relationship between Pgp and poor outcome in NHL we analyzed the expression of Pgp in patients treated in our cancer reference hospital. Patients and Methods: We retrospectively analyzed a cohort of patients 15 years or older diagnosed with NHL in 1998–2002 quinquennium in Valdivia Public Hospital (VPH) treated in accordance with the protocols of the National Adults’ Antineoplastic Drugs Program (NAADP) with an emphasis on clinical response and histological features. An immunohistochemical staining (IH) with Pgp Clone C494 considering negative that one without positivity or &lt;5% of the cells, + positive: 5–25%, + + positivity 25–50% and + + + positivity 50–100%. We performed a descriptive analysis and Kaplan-Meier actuarial survival analysis using log-rank and Wilcoxon statistical tests for comparing curves. It was considered statistically significant value of p &lt;0.05. Results: During the study period 96 patients were admitted to NAADP at VPH corresponding 82 to newly diagnosed cases confirmed histologically, 14 were excluded (6 relapses, 4 histology not NHL, 2 without biopsy, 2 not evaluable). At the time of analysis there were 49 cases of with Pgp IH. 63% of the cases were positive and 37% negative. Among the positive cases Pgp intensity was: + in 34.5%, + + in17.2% and + + + in 48.3%. When analizing survival curves according to Pgp positivity at 2 and 5 years, respectively, we observed that: The overall survival (OS) showed a trend towards increased survival in the Pgp negative group, but without significant difference (log-rank p = 0.07; Wilcoxon p = 0.05). Disease-free survival (DFS) showed no differences (log-rank p = 0.49; Wilcoxon p = 0.65). The OS according to intensity of Pgp positivity again showed no differences (log-rank p = 0.07; Wilcoxon p = 0.11). When analizing OS in Pgp positive cases according to localized (I and II) or advanced (III and IV) stages we observed it was higher in the first group (log-rank p = 0.01; Wilcoxon p = 0.03). Conclusions: In our study the expression of Pgp or its intensity at the time of diagnosis in patients with NHL did not have prognostic value. We have to consider the limited number of cases analized and the low percentage of localized stages in it. Additionally histological subtypes Pgp negative cases were mostly aggressive. Further studies are needed to discard Pgp expression as another prognostic factor in NHL. (DID S-200725 Proyect)

scholarly journals Angiogenesis in Non-Hodgkin's Lymphoma: An Intercategory Comparison of Microvessel Density

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Deepti Aggarwal ◽  
Gunjan Srivastava ◽  
Ruchika Gupta ◽  
Leela Pant ◽  
Gopal Krishan ◽  
...  
Keyword(s):  
Microvessel Density ◽  
Hodgkin’S Lymphoma ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Significant Difference ◽  
Well Differentiated ◽  
Reactive Hyperplasia

Background. This study was aimed at comparing angiogenesis, seen as microvessel density (MVD) in subtypes of non-Hodgkin’s lymphoma (NHL). Methods. In this study, 64 cases of NHL diagnosed over a three-year period were included along with 15 lymph node biopsies of reactive hyperplasia. NHLs were classified using REAL classification, and immunohistochemistry was performed for CD34 in all cases. CD34-stained sections were evaluated for “hot spots,” where MVD was assessed and expressed as per mm2. Appropriate statistical methods were applied. Results. There were 6 cases of well-differentiated lymphocytic lymphoma (SLL), 21 diffuse large B-cell lymphoma (DLBCL), 15 follicular lymphoma, 10 lymphoblastic lymphoma, 7 MALToma, and 5 peripheral T-cell lymphoma (PTCL). Mean MVD was highest in reactive hyperplasia (191.92±12.16 per mm2) compared to all NHLs. Among NHLs, PTCL demonstrated the highest MVD (183.42±8.24) followed by DLBCL (149.91±13.68). A significant difference was found in MVD between reactive and individual lymphoma groups. SLL had significantly lower MVD than other lymphoma subtypes. Conclusion. Angiogenesis, assessed by MVD, showed significant differences among subtypes of NHL, especially the indolent types like SLL. The higher MVD in aggressive lymphomas like PTCL and DLBCL can potentially be utilized in targeted therapy with antiangiogenic drugs.

Randomized comparison of MACOP-B with CHOP in patients with intermediate-grade non-Hodgkin's lymphoma. The Australian and New Zealand Lymphoma Group.

1994 ◽  
Vol 12 (4) ◽  
pp. 769-778 ◽  
Author(s):  
I A Cooper ◽  
M M Wolf ◽  
T I Robertson ◽  
R M Fox ◽  
J P Matthews ◽  
...  
Keyword(s):  
New Zealand ◽  
Hodgkin’S Lymphoma ◽  
Response Rates ◽  
Large Cell ◽  
Complete Response ◽  
Hodgkin's Lymphoma ◽  
Intermediate Grade ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Significant Difference

PURPOSE To compare complete response rates, time to failure, survival, and toxicity for patients with intermediate-grade non-Hodgkin's lymphoma (NHL) treated with cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) versus those treated with a regimen consisting of methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisolone, and bleomycin (MACOP-B), in a multicenter, randomized controlled trial performed by 22 centers of the Australian and New Zealand Lymphoma Group (ANZLG). PATIENTS AND METHODS Between October 1986 and June 1991, 304 patients were randomized, of whom 236 were eligible for analysis. Eligibility criteria included diffuse small cleaved-cell, diffuse mixed small- and large-cell, follicular large-cell, diffuse large-cell, and large-cell immunoblastic, stages I bulky or II to IV. RESULTS There was no significant difference in complete response rates (51% for MACOP-B v 59% for CHOP), failure-free survival, or overall survival in the two treatment arms. The rate of death of MACOP-B patients relative to CHOP patients was estimated to be 0.91 (P = .64) when stratified by prognostic group. There were no significant differences between the two regimens in any of the prognostic subgroups. Toxicity was significantly more severe with MACOP-B, particularly cutaneous toxicity, stomatitis, and gastrointestinal ulceration. The average relative dose-intensity (RDI) of MACOP-B was 0.91 and of CHOP was 0.90, indicating good dose delivery in this multicenter group setting. CONCLUSION CHOP chemotherapy produced results equivalent to those of MACOP-B in patients with intermediate-grade NHL and with significantly fewer toxic complications. Despite relatively poor results in some patient subgroups, CHOP remains the standard chemotherapy for this disease, against which all new regimens should be compared.

The importance of age in survival of patients treated with chemotherapy for aggressive non-Hodgkin's lymphoma.

1988 ◽  
Vol 6 (12) ◽  
pp. 1838-1844 ◽  
Author(s):  
J M Vose ◽  
J O Armitage ◽  
D D Weisenburger ◽  
P J Bierman ◽  
S Sorensen ◽  
...  
Keyword(s):  
Older Patients ◽  
Hodgkin’S Lymphoma ◽  
Causes Of Death ◽  
The Elderly ◽  
Hodgkin's Lymphoma ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Significant Difference ◽  
The Difference

Non-Hodgkin's lymphoma (NHL) is a malignancy that occurs frequently in the elderly with a median age greater than 60 years. However, most chemotherapy trials have included predominantly patients less than 60 years of age. We treated 157 patients with diffuse aggressive NHL between September 1982 and May 1986 with cyclophosphamide, Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH), procarbazine, bleomycin, vincristine, and prednisone (CAP/BOP). There were no treatment exclusions for age. Patients in this study ranged in age from 15 to 91 years (median, 63) with 112 patients greater than or equal to 60 years of age. The overall complete remission (CR) rate was 65% with no significant difference for age less than 60 (76%) v age greater than or equal to 60 (61%) (P = .18). With a median 36-month follow-up (range, 22 to 65 months), the overall 5-year survival was 42%. The patients less than 60 years old had a 62% 5-year survival in contrast to a 34% 5-year survival in those patients greater than or equal to age 60 (P = .01). The deaths attributed to tumor or treatment-related toxicity were similar above and below age 60. The difference in survival was due to other causes of death not obviously related to the lymphoma or its therapy-occurring in 22% of patients greater than or equal to 60 years of age but only 2% of patients less than 60 years (P = .005). Our data supports the position that aggressive NHL in elderly patients is not significantly less responsive than in younger patients; however, the inclusion of older patients in clinical trials will decrease the overall survival secondary to deaths due to apparently unrelated causes.

Single Agent Metronomic Cyclophosphamide in Refractory,Non-Hodgkin's Lymphoma.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4776-4776
Author(s):  
Caroline Hamm ◽  
Sindu M. Kanjeekal ◽  
John Mathews ◽  
Yasmin Alam ◽  
Sam Yoshida ◽  
...  
Keyword(s):  
Mechanism Of Action ◽  
Hodgkin’S Lymphoma ◽  
Conflicts Of Interest ◽  
Single Agent ◽  
Progression Free Survival ◽  
Hodgkin's Lymphoma ◽  
Free Survival ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Significant Difference

Abstract Abstract 4776 n this retrospective review, we report a case series of eight patients with refractory, heavily pre-treated non-Hodgkin's lymphoma(NHL), treated with low dose cyclophosphamide. Median number of prior treatment regimens was 3. The median disease free survival was 15.5 months with three patients in ongoing CR at the time of reporting with 15 - 36 months of followup. In a comparative group of 6 patients with other malignancies beside NHL (3 chronic lymphocytic leukemia, 2 breast cancer, 1 thymoma, and one small cell carcinoma) the median progression free survival was significantly worse at 3 months. Interestingly the thymoma had a progression free survival of 36 months. Toxicity was minimal. One patient stopped because of thrombocytopenia. One of the patients with ongoing CR at 36 months stopped after 11 months of treatment. One patient died in CR of anal cancer after 15 months of treatment. These results demonstrate an easily tolerable and surprisingly effective treatment option in patients with non-Hodgkin's lymphoma who are not candidates for bone marrow transplantation. The mechanism of action of metronomic chemotherapy has been proposed as anti-angiogenic. We suggest an alternate mechanism of action: that of immunomodulation. We are suggesting this alternate explanation in view of the significant difference in the response rate between those disease that are known to immunogenic and those that may be less so, as well as the well-known immunogenic affect of cyclophosphamide. Further studies are ongoing to investigate this hypothesis. Disclosures: No relevant conflicts of interest to declare.

Antiphospholipid Antibodies Are Not Associated with Clinical Parameters or Prognostic Outcomes in Patients with Non-Hodgkin's Lymphoma

2020 ◽  
Vol 40 (05) ◽  
pp. 662-670
Author(s):  
Rimesh Pal ◽  
Subhash Varma ◽  
Jasmina Ahluwalia ◽  
Gaurav Prakash
Keyword(s):  
Overall Survival ◽  
Treatment Response ◽  
Antiphospholipid Antibodies ◽  
Hodgkin’S Lymphoma ◽  
Univariate Analysis ◽  
International Prognostic Index ◽  
Hodgkin's Lymphoma ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Significant Difference

Abstract Background Antiphospholipid antibodies (APAs) are found quite frequently in patients with non-Hodgkin’s lymphoma (NHL). However, the clinical significance of these antibodies is largely unknown. This study aims to delineate the clinical and prognostic role of APAs in NHL patients. Patients and Methods  Consecutive patients of NHL were screened for lupus anticoagulant (LA), IgG/IgM anticardiolipin antibody, and IgG/IgM anti-β2-glycoprotein I at the time of diagnosis. Baseline investigations, staging, and treatment were done as per institutional protocol. Patients were followed up until the last known outpatient visit or death. All were screened at each visit for any thromboembolic event. The association of APA status with baseline NHL characteristics and treatment response was evaluated by univariate analysis. Kaplan–Meier survival analysis was used to compare the final outcome in patients with or without APAs. Patients who were initially APA positive were retested for the corresponding antibody at the end of chemotherapy. Results Twenty-four out of 105 patients (22.8%) were APA positive at diagnosis. The presence of APA was not significantly associated with NHL stage, histology, International Prognostic Index score, activated partial thromboplastin time, or treatment response. The median duration of follow-up was 15 months. Only four patients developed venous thrombosis; none was APA positive. There was no statistically significant difference in overall survival between the two groups (p = 0.471). Patients, who were APA positive initially, tested negative at the end of treatment, irrespective of treatment response. Conclusion APAs are encountered more frequently in NHL patients than in the general population. However, APAs do not correlate with disease severity, thrombosis risk, treatment outcome, or overall survival.

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