Primary extranodal non-Hodgkin lymphoma: Clinical characteristics and outcome.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e20027-e20027
Author(s):  
Tara Rajendran ◽  
Krishna Prasad
Keyword(s):  
Complete Remission ◽  
Incidence Rate ◽  
Clinical Characteristics ◽  
B Cell Lymphoma ◽  
The United States ◽  
Lymphoma Patient ◽  
College Hospital ◽  
Hodgkins Lymphoma ◽  
Patient Reported ◽  
Non Hodgkins Lymphoma

e20027 Background: According to the National Cancer Registry Program, the Indian Council of Medical Research reports that the estimated Incidence rate of Non-Hodgkins Lymphoma in India is 2-3 per 100,000 people. The incidence rate of extranodal Non-Hodgkins Lymphoma (NHL) in Asia is higher than that of the United States. We illustrate a single center review of the clinical characteristics of all the primary extranodal NHL. Methods: We retrospectively identified patients diagnosed with primary extranodal NHL out of 269 NHL patients diagnosed at the department of medical oncology, Kasturba Medical College hospital, Mangalore, India from August 1999 and September 2015. Results: A total of 43 patients(15.9%) with primary extranodal NHL were identified out of which 25 patients (58%) were male with a median age of 49 years (5-92). 11patients (25%) had tonsil as the extranodal location and 10 patients (23%) had musculoskeletal involvement. Lung, thyroid, ovary, nasopharynx, gastrointestinal, paranasal sinuses and central nervous system were the other sites. 17 patients (39.5%) were presented at stage 4. The most common subtype was diffuse large B cell Lymphoma (DLBCL)-25 patients (58%). 2 patients had HIV infection. Some CD 20+ patients could not afford the cost of Rituximab and hence resorted to the CHOP regimen for 6 cycles. Rest received RCHOP 6-8 cycles depending on the stage and response. Follicular Lymphoma patient received 6 cycles of RCHOP and Rituximab maintenance for 12 cycles once in 2 months. Burkitts lymphoma patient received MCP 842. 3 patients denied treatment. 6 patients had recurrence who received DHAP +/- Rituximab or ICE +/- Rituximab. 1 patient-reported progression treated with supportive care. 6 patients (14%) died and 22 (55%) patients attained complete remission. Conclusions: In our cohort, DLBCL was the most common subtype and tonsil, the most involved site. The prognosis was impacted by the stage at which the patient was presented, HIV infections and the higher cost of Rituximab. Primary extranodal NHL must be considered in the differential diagnosis as the current treatments can achieve complete remission.

scholarly journals Clinical profile, prognostication and treatment outcomes in non Hodgkins lymphoma

2017 ◽  
Vol 4 (4) ◽  
pp. 1184
Author(s):  
A. P. Dubey ◽  
Rajeshwar Singh ◽  
Abhishek Pathak ◽  
S. Viswanath ◽  
Anvesh Rathore ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Complete Remission ◽  
B Cell ◽  
Age Of Onset ◽  
Tertiary Care ◽  
B Cell Lymphoma ◽  
Clinical Profile ◽  
Hodgkins Lymphoma ◽  
Steep Decline ◽  
Non Hodgkins Lymphoma

Background: Non Hodgkins lymphoma is the most prevalent hematopoietic neoplasm, representing approximately 4% of all cancer diagnoses and ranking seventh in frequency among all cancers. Most of the data that we have is of west and data pertaining to Indian subcontinent is lacking. The aim of this study was to study clinical profile, prognostication, and assess treatment outcome in DLBCL patients in a tertiary care hospital.Methods: 100 patients of DLBCL reporting to a tertiary care hospital between 2013 to 2016 were chosen for the study. All patients were subjected to routine investigation and specialized investigation including bone marrow examination and Positron emission tomography. Patients were treated with standard treatment protocol and their response to treatment were assessed.Results: Study revealed male predominance with median age of onset was 45.6. Anorexia was the most common symptom. Lymphadenopathy was the most common sign. Bone marrow involvement and anemia commensurate each other. Only16% cases presented in IPI score 4 and 5. Complete remission achieved with treatment in stage l and ll disease were beyond 90% and steep decline in complete remission with treatment was noted in stage lll and lV (~70%). 76% patients with DLBCL showed CR, 12.5% showed PR.Conclusions: The present study revealed male preponderance with relatively early age of onset compared to western population. B- cell lymphoma (DLBCL) constituted maximum number of NHL cases (89%). We have found a higher proportion of B cell subtype as compared to other Indian studies, at the same time it corroborated with the findings of western studies. Complete remission achieved with treatment in stage l and ll disease were beyond 90% and steep decline in complete remission with treatment was noted in stage lll and lV (~70%).

Rituximab Maintenenance Therapy in CD20+ B-Cell Non-Hodgkin-Lymphoma - Results of a Multicenter Prospective Randomised Phase II Study.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4704-4704 ◽  
Author(s):  
Mathias Witzens-Harig ◽  
Manfred Hensel ◽  
Johann W. Schmier ◽  
Kai Neben ◽  
Axel Benner ◽  
...  
Keyword(s):  
Maintenance Therapy ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Aggressive Lymphoma ◽  
Pharmacokinetic Data ◽  
Hodgkins Lymphoma ◽  
Rituximab Maintenance ◽  
Mediastinal Lymphoma ◽  
Non Hodgkins Lymphoma

Abstract Clinical and pharmacokinetic data suggest that the effect of rituximab could be improved by prolonged exposure to the drug. To test for this hypothesis we performed a prospective randomized trial of rituximab maintenance therapy in patients with CD20+ B-cell Non-Hodgkins-Lymphoma. After completion of standard treatment patients were randomized to either observation or maintenance therapy with rituximab (375 mg/m2) every 3 months for 2 years. Patients after first line therapy as well as relapse patients were included in the study. Patients with aggressive lymphoma were enrolled if they had achieved a complete response (CR) after initial treatment. Patients with aggressive lymphoma with residual tumor mass were examined with positrone emission tomography (PET) and qualified for randomization if PET showed no signs of tumor activity. Patients with indolent lymphoma qualified for the study if at least a partial response (PR) was achieved. So far 162 patients (pts) with CD20+ B-cell Non-Hodgkins-Lymphoma were enrolled in this trial. Histological subtypes included diffuse large cell lymphoma (69 pts), follicular lymphoma (41 pts), mantle cell lymphoma (18 pts), primary mediastinal lymphoma (15 pts), marginal zone lymphoma (9 pts), Burkitt’s lymphoma (3 pts), immunocytoma (2 pts), primary intestinal lymphoma (1 pt), hairy cell leukemia (1 pt), chronic lymphocytic leukemia (1 pt) and unclassified B-cell lymphoma (2 pts). No severe adverse events were observed during rituximab maintenance therapy. We conclude that rituximab maintenance therapy is feasable, safe and well tolerated in patients with CD20+ B-cell Non-Hodgkins-Lymphoma. Results including event free survival and overall survival for the observation group and for the maintenance therapy group will be presented.

Rituximab maintenenance therapy in CD20+ B-cell non-Hodgkin lymphoma - Interim results of a multicenter prospective randomised phase II study

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 17524-17524 ◽  
Author(s):  
M. Witzens-Harig ◽  
M. Hensel ◽  
J. W. Schmier ◽  
K. Neben ◽  
A. Benner ◽  
...  
Keyword(s):  
Maintenance Therapy ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Aggressive Lymphoma ◽  
Pharmacokinetic Data ◽  
Hodgkins Lymphoma ◽  
Rituximab Maintenance ◽  
Mediastinal Lymphoma ◽  
Non Hodgkins Lymphoma

17524 Background: Clinical and pharmacokinetic data suggest that the effect of rituximab could be improved by prolonged exposure to the drug. Methods: To test for this hypothesis we performed a prospective randomized trial of rituximab maintenance therapy in patients with CD20+ B-cell Non-Hodgkins-Lymphoma. After completion of standard treatment patients were randomized to either observation or maintenance therapy with rituximab (375 mg/m2) every 3 months for 2 years. Patients after first line therapy as well as relapse patients were included in the study. Patients with aggressive lymphoma were enrolled if they had achieved a complete response (CR) after initial treatment. Patients with aggressive lymphoma with residual tumor mass were examined with positrone emission tomography (PET) and qualified for randomization if PET showed no signs of tumor activity. Patients with indolent lymphoma qualified for the study if at least a partial response (PR) was achieved. Results: So far 124 patients (pts) with CD20+ B-cell Non-Hodgkins-Lymphoma were enrolled in this trial. Histological subtypes included diffuse large cell lymphoma (55 pts), follicular lymphoma (24 pts), mantle cell lymphoma (16 pts), primary mediastinal lymphoma (12 pts), marginal zone lymphoma (8 pt), Burkitt’s lymphoma (3 pt), immunocytoma (2 pt), primary intestinal lymphoma (1 pt), hairy cell leukemia (1 pt), chronic lymphocytic leukemia (1 pt) and unclassified B-cell lymphoma (1 pt). No severe adverse events were observed during rituximab maintenance therapy. Results from an interim analysis including event free survival and overall survival for the observation group and for the maintenance therapy group will be presented. Conclusions: We conclude that rituximab maintenance therapy is feasable, effective, safe and well tolerated in patients with CD20+ B-cell Non-Hodgkins-Lymphoma. No significant financial relationships to disclose.

Rituximab Maintenenance Therapy in CD20+ B-Cell Non-Hodgkin-Lymphoma - First Interim Results of a Prospective Randomised Phase II Study.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2454-2454
Author(s):  
Mathias Witzens-Harig ◽  
Manfred Hensel ◽  
Kai Neben ◽  
Axel Benner ◽  
Johann W. Schmier ◽  
...  
Keyword(s):  
Maintenance Therapy ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Aggressive Lymphoma ◽  
Pharmacokinetic Data ◽  
Hodgkins Lymphoma ◽  
Rituximab Maintenance ◽  
Mediastinal Lymphoma ◽  
Non Hodgkins Lymphoma

Abstract Clinical and pharmacokinetic data suggest that the effect of rituximab could be improved by prolonged exposure to the drug. To test for this hypothesis we performed a prospective randomized trial of rituximab maintenance therapy in patients with CD20+ B-cell Non-Hodgkins-Lymphoma. After completion of standard treatment patients were randomized to either observation or maintenance therapy with rituximab (375 mg/m2) every 3 months for 2 years. Patients with aggressive lymphoma were enrolled if they had achieved a complete response (CR) after initial treatment. Patients with aggressive lymphoma with residual tumor mass were examined with positrone emission tomography (PET) and qualified for randomization if PET showed no signs of tumor activity. Patients with indolent lymphoma qualified for the study if at least a partial response (PR) was achieved. So far 87 patients (pts) with CD20+ B-cell Non-Hodgkins-Lymphoma were enrolled in this trial. Histological subtypes included diffuse large cell lymphoma (38 pts), follicular lymphoma (17 pts), mantle cell lymphoma (16 pts), primary mediastinal lymphoma (11 pts), marginal zone lymphoma (1 pt), Burkitt’s lymphoma (2 pt), primary intestinal lymphoma (1pt) and unclassified B-cell lymphoma (1 pt). No severe adverse events were observed during rituximab maintenance therapy. We conclude that rituximab maintenance therapy is feasable, safe and well tolerated in patients with CD20+ B-cell Non-Hodgkins-Lymphoma. First results from an interim analysis including event free survival and overall survival for the observation group and for the maintenance therapy group will be presented.

Quality of Life in Patients with B-Cell Lymphoma during Maintenance Therapy with the Anti-CD20 Antibody Rituximab.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4471-4471
Author(s):  
Mathias Witzens-Harig ◽  
Christiane Heiss ◽  
Axel Benner ◽  
Manfred Hensel ◽  
Kai Neben ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Maintenance Therapy ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Rank Test ◽  
Hodgkins Lymphoma ◽  
Rituximab Maintenance ◽  
Non Hodgkins Lymphoma

Abstract The introduction of rituximab into the treatment of malignant lymphomas of the B-cell lineage has had a major impact on the management of these diseases. In diffuse large B-cell lymphomas (DLBCLs) and follicular lymphomas (FLs) several multicenter prospective randomized trials consistently demonstrated an improved outcome when rituximab was added to chemotherapy. In addition, prolonged exposure to rituximab as maintenance therapy has been benefical in patients with FL and mantle cell lymphoma (MCL). For patients, the effect of any prolonged antitumor therapy on the quality of life (QoL) is a very important question. However, so far the question whether rituximab maintenance therapy may impair QoL in patients with Non-Hodgkins-lymphoma remains unanswered. To investigate this subject, we have performed a prospective randomized trial of rituximab maintenance therapy (8 cycles rituximab 375 mg/m2 every 3 months) versus observation in patients with CD20+ B-cell Non-Hodgkins-Lymphoma in our institution. Between July 2002 and December 2005, 106 patients (pts) were included into the trial. QoL was assessed with the standardized questionnaires EORTC-QLQ-C30 and EuroQol-5D. After statistical analysis with the Wilcoxon signed-rank test, we found no significant differences of the QoL between the rituximab treatment group and the observation group. We conclude that rituximab maintenance therapy is safe and does not impair quality of life in this patient population.

scholarly journals Trends in the profile of non hodgkins lymphoma in North and South India: a study from two tertiary care hospitals in India

2020 ◽  
Vol 8 (4) ◽  
pp. 1391
Author(s):  
Rahul Sud ◽  
Kishore Kumar ◽  
A. P. Dubey ◽  
Sagar Bhagat
Keyword(s):  
T Cell ◽  
South India ◽  
Cell Lymphoma ◽  
Tertiary Care ◽  
B Cell Lymphoma ◽  
Age Group ◽  
Hodgkins Lymphoma ◽  
Army Hospital ◽  
Non Hodgkins Lymphoma ◽  
Hodgkin's Lymphomas

Background: A number of environmental and chemical factors have been thought to been implicated in the occurrence of Non-Hodgkin’s Lymphomas (NHLs).To fill the knowledge gap in various aspect of the disease, this study was undertaken at this tertiary care centre in Delhi and Bangalore.Methods: This was a prospective observational study conducted in two defenses medical centre in India among patients of Non Hodgkins Lymphoma, registered at Command hospital Airforce Bangalore and Army Hospital (Research and Referral), New Delhi, between March 2016 and March 2019.Results: The disease showed a bimodal onset in both centres with 26 (26%) and 24 (24%) cases occurring in the age group of 31-40 years and 24 (24%) and 25 (25%) cases occurring in the age group of >60 years at CHAF (B) and AH (RR) respectively. B cell Lymphoma was the most common type of NHL seen in 85% and 89% patients, whereas T-cell lymphomas constituted 13% and 11% at CHAF (B) and AH (RR).  32(32%) patients presented with an Ann Arbor Stage 1 or 2 disease whereas 68(68%) patients were with Stage 3 or 4 disease at both the centers. IPI score was ≥3 in 45 % and 43% patients.Conclusions: NHL in India is a homogeneous and uniform disease. But there was increased detection of hepatosplenomegaly and associated hepatitis B/C in the southern part of India. Also, the occurrence of Cutaneous T cell lymphoma was only seen in the south India centre. The early stage NHLs has better survival and increase chance of complete response.

scholarly journals Non–Hodgkin’s Lymphoma of the Appendix

2015 ◽  
Vol 5 (1) ◽  
pp. 1
Author(s):  
G. A. Watson ◽  
J. Gleeson ◽  
D. Kelly ◽  
D. Byrne ◽  
P. De La Harpe-Golden ◽  
...  
Keyword(s):  
Hodgkin’S Lymphoma ◽  
B Cell Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Hodgkins Lymphoma ◽  
Large B Cell Lymphoma ◽  
Non Hodgkin’S Lymphoma ◽  
Pet Ct ◽  
Non Hodgkin's Lymphoma ◽  
History Of ◽  
Non Hodgkins Lymphoma

AbstractInfiltration of the appendix as a manifestation of non-hodgkins lymphoma (NHL) at diagnosis or at relapse is a rare finding. We report the history of a patient with gastrointestinal non-hodgkin's lymphoma treated 8 years earlier who presented with symptoms suggestive of acute appendicitis secondary to relapsed NHL.Keywords: Non Hodgkins Lymphoma, Diffuse Large B Cell Lymphoma, appendix, PET CT

Rituximab Retreatment in B-Cell Non-Hodgkins Lymphoma Patients.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2455-2455
Author(s):  
Osnat Bairey ◽  
Eldad J. Dann ◽  
Yair Herishanu ◽  
Rosa Ruchlemer4 ◽  
Tamar Tadmor5 ◽  
...  
Keyword(s):  
B Cell ◽  
Median Time ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Aggressive Lymphoma ◽  
Indolent Lymphoma ◽  
Treatment Benefit ◽  
Hodgkins Lymphoma ◽  
Significant Difference ◽  
Non Hodgkins Lymphoma

Abstract Rituximab has revolutionized the treatment outcome of non-Hodgkins lymphoma (NHL) patients but its role in retreatment in all NHL patients is not yet established. Therefore, the Israel Rituximab Retreatment Study Group was organized in order to summarize retrospectively the treatment results of B-cell NHL patients who received ≥ 2 rituximab treatments. Eighty-eight NHL patients from 13 medical centers were enrolled, 39 males, 49 females with a mean age of 57.3 years (range 26–88). Sixty-four patients (73%) had indolent lymphoma (21- follicular grade I, 17 follicular grade II, 10-follicular grade III, 9-small lymphocytic, 6- MALT, 2- marginal zone, 1-lymphoplasmacytic). Eighteen patients (20%) had aggressive lymphoma [diffuse large B-cell lymphoma (DLBCL)] and 6 patients had mantle cell lymphoma. Fifty-nine patients received one regimen of chemotherapy and 23 patients received 2 chemotherapy regimens before the first treatment with rituximab. There was no significant difference in the median time to progression (TTP) after the first rituximab treatment whether the patient received no previous chemotherapy or 1 or 2 previous chemotherapy regimens (12 vs 12 vs 14 months, respectively). All patients received 2 courses of rituximab, 33 patients-3 courses, 6 patients -4 courses and 2 patients-5 courses, with a mean of 4.4 doses in each course (range 1–8). Only 45 patients received any treatment after the second course of rituximab. The first course of rituximab was administered alone in 46 patients and with chemotherapy in 42 (24 CHOP, 6 COP, 6 FC, 2 chlorambucil, 1 LMP, 1 DVIP, 1 ESHAP, 1 MACOP-B). There was no difference in the median time to next treatment (TTNT) whether the rituximab was given alone or with chemotherapy (16 and 14 months, respectively). The second course of rituximab was administered alone in 46 patients and with chemotherapy in 42 patients (13 CHOP, 11 FC, 6 COP, 5 ICE, 3 ESHAP, 2 HyperCVAD, 1 CNOP 1 VEEP). The addition of chemotherapy did not change the overall response (CR and PR) to the second rituximab treatment (72% in rituximab alone vs. 69% in rituximab with chemotherapy, in indolent lymphoma patients 76% vs. 72%, in aggressive lymphoma patients 70% vs. 62.5%, respectively). TTP after the second rituximab treatment was similar or possibly longer than after the first treatment (median 14 and 12 months, mean 23.4 and 16.2 months respectively). Conclusions: The response to a second rituximab treatment is the same whether the rituximab is given alone or combined with chemotherapy. TTP after retreatment with rituximab is as good as after the first treatment. Prospective studies should examine the treatment benefit of adding chemotherapy to a second treatment with rituximab.

Safety of Intrathecal Rituximab as Prophylaxis or Treatment in CD20+ Acute Lymphoblastic and Aggressive Lymphoma: Report from a Mexican Pilot Study.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4713-4713
Author(s):  
Luis Villela ◽  
Rocio Caballero-Caballero ◽  
Josefa Piedras-Ross ◽  
Hetor Garcia-Herrera ◽  
Dolores Mejia ◽  
...  
Keyword(s):  
Side Effects ◽  
Complete Remission ◽  
B Cell ◽  
Mantle Cell Lymphoma ◽  
Cell Lymphoma ◽  
Lymphoblastic Leukemia ◽  
B Cell Lymphoma ◽  
Lymphoma Patient ◽  
Anaplastic Lymphoma ◽  
Mantle Cell

Abstract CNS infiltration of neoplastic B-cell lymphocytes both in acute leukemia as well as in lymphoma, carry very bad prognosis. There are no universal guidelines for the prophylaxis of such CNS relapse in these patients. Current prophylactic regimes have early and late side effects, sometimes with severe toxicities. Although rituximab has improved treatment results in lymphoproliferative diseases, it cannot reach the CNS when administered systemically (Feugier, Ann Oncol 2004, Rubenstein, Blood 2004). Schulz (Haematologica 2004) used this drug in the treatment of relapse of primary brain lymphomas with positive results using a dose of 10 to 40mg, and estimated 25mg to be a good standardized dose. After approval from our ethics committee and obtaining the informed consent signature, patients received 25 mg of intrathecal rituximab (IT-R) according to the standard intrathecal regimen, plus the standard systemic chemotherapy protocol in our department. Side effects were evaluated according to the NIC toxicity scale. Nine patients have been enrolled in the protocol so far: 8 were male and 1 female, median of age was 49 years (range 14–72). A total of 57 IT-R were administered to our patients (median: 6, range 3–15). They had the following diagnosis: Two with large diffuse B cell lymphoma (LDBCL); two with mantle cell lymphoma (one of them blastic type), three with acute lymphoblastic leukemia; one with Burkitt’s lymphoma (BL) and one with anaplastic lymphoma. Two patents had initial CNS infiltration; the blastic type Mantle Cell Lymphoma (patient 2) and the anaplastic Lymphoma (patient 9); these patients received IT-R three times per week, plus two extra doses after complete remission in CNS. Median follow-up was 9 months (range: 3–15 months). All patients had risk factors that warranted prophylaxis (see table). Toxicity included headache in 35% of administrations (Grade I/II), temporal paresthesias in 24.5% of administrations (lasting a median of 5 minutes, range 2–15), neuropathic pain and vomit in 12.3% of administrations (grade I/II), fever and chills in 7% of administrations (Grade I/II). All side effects were temporary and no patient has shown neurological or other late toxicities. The patient with mantle cell lymphoma infiltrated to CNS achieved complete remission after 5 doses of IT-R which continues after autologous stem cell transplantation. The use of rituximab as IT-R is safe and effective. We are starting a phase II study using IT rituximab as prophylaxis and treatment, in a larger group of patients.

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