Anti-retroviral treatment regimens and immune parameters in the prevention of systemic HIV-related non-Hodgkin's lymphoma

Abstract We describe the chromosomal abnormalities found in 104 previously untreated patients with non-Hodgkin's lymphoma (NHL) and the correlations of these abnormalities with disease characteristics. The cytogenetic method used was a 24- to 48-hour culture, followed by G- banding. Several significant associations were discovered. A trisomy 3 was correlated with high-grade NHL. In the patients with an immunoblastic NHL, an abnormal chromosome no. 3 or 6 was found significantly more frequently. As previously described, a t(14;18) was significantly correlated with a follicular growth pattern. Abnormalities on chromosome no. 17 were correlated with a diffuse histology and a shorter survival. A shorter survival was also correlated with a +5, +6, +18, all abnormalities on chromosome no. 5, or involvement of breakpoint 14q11–12. In a multivariate analysis, these chromosomal abnormalities appeared to be independent prognostic factors and correlated with survival more strongly than any traditional prognostic variable. Patients with a t(11;14)(q13;q32) had an elevated lactate dehydrogenase (LDH). Skin infiltration was correlated with abnormalities on 2p. Abnormalities involving breakpoints 6q11–16 were correlated with B symptoms. Patients with abnormalities involving breakpoints 3q21–25 and 13q21–24 had more frequent bulky disease. The correlations of certain clinical findings with specific chromosomal abnormalities might help unveil the pathogenetic mechanisms of NHL and tailor treatment regimens.

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Preliminary Results from a Phase II Study of Lenalidomide Monotherapy in Relapsed/Refractory Aggressive Non-Hodgkin’s Lymphoma.

Blood ◽

10.1182/blood.v108.11.531.531 ◽

2006 ◽

Vol 108 (11) ◽

pp. 531-531 ◽

Cited By ~ 9

Author(s):

Peter H. Wiernik ◽

Izidore Lossos ◽

Joseph Tuscano ◽

Glen Justice ◽

Julie M. Vose ◽

...

Keyword(s):

Median Time ◽

Hodgkin’S Lymphoma ◽

Cell Lymphoma ◽

Objective Response ◽

Prior Treatment ◽

Hodgkin's Lymphoma ◽

Treatment Regimens ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma ◽

Grade 3

Abstract Background: Lenalidomide (Revlimid®), an immunomodulatory drug (IMiD®), was recently approved in the US for treatment of relapsed/refractory multiple myeloma and myelodysplastic syndromes associated with a deletion 5q[31] cytogenetic abnormality. Lenalidomide also has demonstrated activity in chronic lymphocytic leukemia and cutaneous T-cell lymphoma while thalidomide, a less potent IMiD®, has activity in non-Hodgkin’s lymphoma as both monotherapy and in combination with rituximab. Aim: To assess the safety and activity of lenalidomide monotherapy in subjects with relapsed/refractory aggressive non-Hodgkin’s lymphoma (NHL). Methods: Subjects with relapsed/refractory aggressive NHL following at least 1 prior treatment regimen with measurable disease are eligible. Subjects receive 25 mg lenalidomide orally once daily on Days 1–21 every 28 days and continue therapy for 52 weeks as tolerated or until disease progression. Response and progression are evaluated using the IWLRC methodology. Results: As of July 25, 2006, 32 subjects of a planned 40 have enrolled and 31 have received drug. Twenty-two subjects are currently evaluable for tumor response. The median age of the 22 response-evaluable subjects is 65 (46–83) and 13 are female. Histology is diffuse large B-cell lymphoma [DLBCL] (n=12), follicular center lymphoma grade 3 [FL] (n=3), mantle cell lymphoma [MCL] (n=5) and transformed [TSF] (n=2). Median time from diagnosis to lenalidomide monotherapy is 2.3 (0.7–7) years and median number of prior treatment regimens per subject is 2 (1–6). Seven subjects (32%) exhibited an objective response (2 complete responses unconfirmed (CRu) and 5 partial responses (PR)), 6 had stable disease (SD) for a tumor control rate (TCR) of 59% and 9 progressive disease (PD). Responses were produced in each of the aggressive histologic subtypes studied: DLBCL (3/12), FL (1/3), MCL (2/5) and TSF (1/2). Five of 11 subjects (45%) with 1–2 prior treatment regimens had an objective response, as did 2 of 3 subjects (67%) who had received a prior stem cell transplant. Median time-to-response was 2 months. Grade 3 or 4 adverse events occurred in 18 of 31 (58%) subjects receiving drug. These were predominantly Grade 3 hematological events (neutropenia, thrombocytopenia) with only 4 subjects (13%) experiencing a Grade 4 adverse reaction. Conclusion: Preliminary results indicate that lenalidomide monotherapy is active with manageable side effects in relapsed/refractory aggressive NHL.

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Pediatric non-hodgkin's lymphoma abdominal presentations: A comparative study between two treatment regimens at the national cancer institute cairo

Hematological Oncology ◽

10.1002/hon.2900090414 ◽

2006 ◽

Vol 9 (4-5) ◽

pp. 275-279

Author(s):

Salah S. Abdel Hadi ◽

Omar M. El Taneer ◽

Mohamed H. Hussein ◽

Alaa El Haddad ◽

Sami El Badawi ◽

...

Keyword(s):

Comparative Study ◽

National Cancer Institute ◽

Hodgkin’S Lymphoma ◽

Hodgkin's Lymphoma ◽

Treatment Regimens ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma

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Increased risk of lung cancer, non-Hodgkin's lymphoma, and leukemia following Hodgkin's disease.

Journal of Clinical Oncology ◽

10.1200/jco.1989.7.8.1046 ◽

1989 ◽

Vol 7 (8) ◽

pp. 1046-1058 ◽

Cited By ~ 99

Author(s):

F E van Leeuwen ◽

R Somers ◽

B G Taal ◽

P van Heerde ◽

B Coster ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Risk ◽

Hodgkin's Disease ◽

Hodgkin’S Lymphoma ◽

Lung Cancer Risk ◽

Hodgkin’S Disease ◽

Hodgkin's Lymphoma ◽

Treatment Regimens ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma

The risk of second cancers (SCs) was assessed in 744 patients with Hodgkin's disease (HD) admitted to The Netherlands Cancer Institute from 1966 to 1983. Sixty-nine SCs were observed one month or more after start of first treatment. These included 14 cases of lung cancer, nine cases of non-Hodgkin's lymphoma (NHL), 16 cases of leukemia, and six cases of the myelodysplastic syndrome (MDS). The median interval between the diagnosis of HD and that of second lung cancer, NHL, and leukemia was 8.1, 13.3, and 5.7 years, respectively. The overall relative risks (RR) (observed/expected [O/E] ratios) of developing lung cancer, NHL, and leukemia were 4.9 (95% confidence limit [CL], 2.7 to 8.2), 31.0 (95% CL, 14.2 to 58.9) and 45.7 (95% CL, 26.1 to 74.2), respectively. At 15 years the cumulative risk of developing an SC amounted to 20.6% +/- 2.9%. The 15-year estimates of lung cancer, NHL, and leukemia were 6.2% +/- 1.9%, 5.9% +/- 2.1% and 6.3% +/- 1.7%, respectively. Increased lung cancer risk following HD has not frequently been clearly demonstrated before; that we were able to demonstrate such risk may be due to the completeness of follow-up over long periods that could be achieved in this study. Excess lung cancer risk was only noted in treatment regimens with radiotherapy (RT); also, all lung cancers arose in irradiation fields. Excess risk of leukemia was only found in treatment regimens involving chemotherapy (CT). For NHL, combined modality treatment was shown to be the most important risk factor. Risk of lung cancer and NHL increased with time since diagnosis. A time-dependent covariate analysis (Cox model) performed on leukemia and MDS showed an increasing risk with intensity of CT, age (greater than 40 years), and a splenectomy.

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Pharmacotherapy Update: Fludarabine in the Treatment of Non-Hodgkin's Lymphoma

Clinical Medicine Therapeutics ◽

10.4137/cmt.s2553 ◽

2009 ◽

Vol 1 ◽

pp. CMT.S2553

Author(s):

Lev Shvidel ◽

Mirel Cohn ◽

Erica Sigler

Keyword(s):

Hodgkin’S Lymphoma ◽

Current Knowledge ◽

Lymphocytic Leukemia ◽

Hodgkin's Lymphoma ◽

Clinical Activity ◽

Treatment Regimens ◽

Highly Active ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma ◽

Indolent Lymphomas

Fludarabine, a purine nucleoside analogue, is considered as the most active drug in chronic lymphocytic leukemia. This review summarizes current knowledge concerning the mechanism of action, pharmacological properties, clinical activity and toxicity of fludarabine in the treatment of non-Hodgkin's lymphoma. A literature search on fludarabine for lymphomas was undertaken using MEDLINE databases. Clinical data shows that fludarabine alone and as a component of combination chemotherapy is effective in patients with various types of non-Hodgkin's lymphoma, particularly in follicular lymphoma. The most commonly used combinations are with cyclophosphamide and/or mitoxantrone. Fludarabine-based regimens are highly active in both previously untreated and relapsed indolent lymphomas. The results of the chemotherapy are considerably improved with the addition of rituximab. Fludarabine is generally well tolerated. Myelosuppression and infections, including opportunistic varieties, are the most frequent adverse effects. Indications for fludarabine and treatment regimens for lymphoma patients are discussed.

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Chromosomal abnormalities in untreated patients with non-Hodgkin's lymphoma: associations with histology, clinical characteristics, and treatment outcome. The Nebraska Lymphoma Study Group

Blood ◽

10.1182/blood.v75.9.1841.bloodjournal7591841 ◽

1990 ◽

Vol 75 (9) ◽

pp. 1841-1847 ◽

Cited By ~ 1

Author(s):

HC Schouten ◽

WG Sanger ◽

DD Weisenburger ◽

J Anderson ◽

JO Armitage

Keyword(s):

Hodgkin’S Lymphoma ◽

Chromosomal Abnormalities ◽

Clinical Findings ◽

Hodgkin's Lymphoma ◽

Bulky Disease ◽

Treatment Regimens ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma ◽

Skin Infiltration ◽

Lymphoma Study Group

We describe the chromosomal abnormalities found in 104 previously untreated patients with non-Hodgkin's lymphoma (NHL) and the correlations of these abnormalities with disease characteristics. The cytogenetic method used was a 24- to 48-hour culture, followed by G- banding. Several significant associations were discovered. A trisomy 3 was correlated with high-grade NHL. In the patients with an immunoblastic NHL, an abnormal chromosome no. 3 or 6 was found significantly more frequently. As previously described, a t(14;18) was significantly correlated with a follicular growth pattern. Abnormalities on chromosome no. 17 were correlated with a diffuse histology and a shorter survival. A shorter survival was also correlated with a +5, +6, +18, all abnormalities on chromosome no. 5, or involvement of breakpoint 14q11–12. In a multivariate analysis, these chromosomal abnormalities appeared to be independent prognostic factors and correlated with survival more strongly than any traditional prognostic variable. Patients with a t(11;14)(q13;q32) had an elevated lactate dehydrogenase (LDH). Skin infiltration was correlated with abnormalities on 2p. Abnormalities involving breakpoints 6q11–16 were correlated with B symptoms. Patients with abnormalities involving breakpoints 3q21–25 and 13q21–24 had more frequent bulky disease. The correlations of certain clinical findings with specific chromosomal abnormalities might help unveil the pathogenetic mechanisms of NHL and tailor treatment regimens.

Download Full-text