scholarly journals Intrathecal Rituximab for Treatment of Leptomeningeal NonHodgkin’s Lymphoma: A Case Report

2021 ◽  
Vol 3 (1) ◽  
pp. 1-8
Author(s):  
Vikas Kumar ◽  
◽  
Shaha Nabeel ◽  
Thuy-Hong Le ◽  
◽  
...  
Keyword(s):  
B Cell ◽  
Leptomeningeal Metastasis ◽  
Standard Of Care ◽  
Low Grade ◽  
Whole Brain Radiation ◽  
Prospective Trials ◽  
Parenchymal Disease ◽  
Role Of It ◽  
Brain Radiation

Introduction: Standard therapy for central nervous system (CNS) Non-Hodgkin’s lymphoma (NHL) is still to be determined and varies in clinical practice. Leptomeningeal metastasis (LM) is more common as compared to parenchymal disease in CNS NHL. We present a case of Leptomeningeal NHL which was found to be resistant to treatment with intrathecal (IT) Methotrexate, Cytarabine and whole brain radiation therapy (WBRT). Our patient achieved a complete remission only after treatment with IT Rituximab. Case Presentation: 74-year-old male presented to us with cough with purulent sputum. Upon thorough investigation including biopsy of axillary lymphadenopathy and a staging MRI, the patient was found to have low grade I/III B cell follicular lymphoma with LM. The patient was refractory to treatment with intrathecally administered Methotrexate, intrathecal (IT) Cytarabine and WBRT. After administration of IT Rituximab, patient showed clinical improvement and subsequent cerebrospinal fluid (CSF) cytology revealed complete elimination of clonal B-cell population. Conclusions: In LM where cure is generally not expected, administration of IT Rituximab showed a favorable efficacy and safety profile. Prospective trials are needed to establish the role of IT Rituximab as a standard of care for treatment of LM involvement in B-cell lymphomas.

scholarly journals The Current Role of Whole Brain Radiation Therapy in Non–Small Cell Lung Cancer Patients

2017 ◽  
Vol 12 (10) ◽  
pp. 1467-1477 ◽  
Author(s):  
Gokoulakrichenane Loganadane ◽  
Lizza Hendriks ◽  
Cécile Le Péchoux ◽  
Antonin Levy
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Cancer Patients ◽  
Small Cell ◽  
Small Cell Lung ◽  
Current Role ◽  
Lung Cancer Patients ◽  
Whole Brain Radiation ◽  
Brain Radiation

The role of pre-treatment white matter abnormalities in developing white matter changes following whole brain radiation: a volumetric study

2013 ◽  
Vol 114 (3) ◽  
pp. 291-297 ◽  
Author(s):  
David S. Sabsevitz ◽  
Joseph A. Bovi ◽  
Peter D. Leo ◽  
Peter S. LaViolette ◽  
Scott D. Rand ◽  
...  
Keyword(s):  
White Matter ◽  
White Matter Changes ◽  
Whole Brain ◽  
White Matter Abnormalities ◽  
Whole Brain Radiation ◽  
Volumetric Study ◽  
Pre Treatment ◽  
Brain Radiation

Lack of Hcv Infection in Malignant, Cells Refutes the Hypothesis of a Direct Transforming Action of the Virus in the Pathogenesis of Hcv-Associated B-Cell Nhls

2002 ◽  
Vol 88 (5) ◽  
pp. 400-406 ◽  
Author(s):  
Salvatore De Vita ◽  
Valli De Re ◽  
Domenico Sansonno ◽  
Annunziata Gloghini ◽  
Daniela Gasparotto ◽  
...  
Keyword(s):  
B Cells ◽  
B Cell ◽  
Hcv Infection ◽  
Low Grade ◽  
Immunoglobulin Gene ◽  
Pathogenetic Role ◽  
Exogenous Trigger ◽  
Grade One ◽  
Hodgkin's Lymphomas

Aims and background Preliminary evidence suggests that hepatitis C virus (HCV) might play a pathogenetic role in autoimmune-related, non-malignant B-cell lymphoproliferation, as well as in a subset of B-cell non-Hodgkin's lymphomas (NHLs). With regard to the mechanism(s) by which HCV might favor B-cell expansion and malignant transformation, most data support an indirect pathogenetic role of the virus as an exogenous trigger. A direct oncogenetic role of HCV by direct cell infection and deregulation has only been hypothesized on the basis of the lymphotropism of the virus. Methods In this study we investigated the possible HCV infection of NHL B cells by means of sensitive and quantitative polymerase chain reaction (PCR) on affinity-purified neoplastic cells, and by HCV-specific immunohistochemistry and in situ hybridization. Results HCV infection of neoplastic B cells was documented in only three cases, namely the low-grade B-cell NHLs that arose in the course of mixed cryoglobulinemia syndrome (MC). HCV infection, below one viral genome per cell, was detectable only by PCR. All the remaining low-grade (one case) and high-grade B-cell NHLs (two cases) were HCV uninfected. Previous immunoglobulin gene analyses were consistent with an antigen-driven B-cell lymphoproliferation in the studied cases. Conclusions Overall, our data are consistent with an indirect oncogenetic role of HCV in B-cell lymphomagenesis as an exogenous trigger. Infection of B cells by HCV appears possible in some NHL subsets, but the implications remain unknown.

Consolidative or palliative whole brain radiation for secondary CNS diffuse large B-Cell lymphoma

2020 ◽  
pp. 1-8 ◽  
Author(s):  
Tyler Walburn ◽  
Natalie S. Grover ◽  
Colette J. Shen ◽  
Raghuveer Ranganathan ◽  
Christopher Dittus ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Whole Brain ◽  
Whole Brain Radiation ◽  
Large B Cell Lymphoma ◽  
Brain Radiation ◽  
Large B Cell

Is there a role for neoadjuvant chemotherapy in the management of non-carcinoid epithelial neoplasms of the appendix?

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15115-15115
Author(s):  
M. H. Katz ◽  
P. F. Mansfield ◽  
C. Eng ◽  
R. A. Wolff ◽  
P. Diaz ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Standard Of Care ◽  
Low Grade ◽  
High Grade ◽  
Appendiceal Neoplasms ◽  
Tertiary Center ◽  
Standardized Treatment ◽  
Crs And Hipec ◽  
Epithelial Neoplasms

15115 Background: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS and HIPEC) are considered the standard of care for patients with pseudomyxoma peritonei (PMP) and carcinomatosis of appendiceal origin. The role of neoadjuvant chemotherapy (CTX) in the management of these patients is unknown. Methods: Retrospective analysis of all patients evaluated for the treatment of appendiceal epithelial neoplasms at a tertiary center between 1992 and August 2006. All diagnoses were confirmed pathologically and classified by a single group of pathologists. Patients with carcinoid tumors or metastases to the appendix were excluded. Tumor histology, stage, peritoneal-based disease, and the potential for complete cytoreduction dictated treatment. Results: 250 consecutive patients were evaluated, 140 of whom had low grade disease. 114 underwent CRS and HIPEC. Median follow-up was 24 mos from referral. Average time to referral was 13 mos after diagnosis (range 0–243); 85% had undergone prior surgical therapy (median 1.3 operations, range 1–4); 22% had previous CTX consisting of many different regimens. 5- and 10-year survival for patients with low grade tumors treated with CRS and HIPEC alone (n=80) were 84% and 68%, respectively. 21 patients with low grade tumors had CTX prior to CRS and HIPEC. There was no effect on overall survival (p = 0.61). 5-and 10-year survival of 39 patients with low grade histology who did not receive CRS and HIPEC was 55% and 30%, respectively (p = 0.009). 83 patients with intermediate and high-grade disease who received CTX but not CRS and HIPEC had a 5- year survival of 27%. 5-year survival for patients with intermediate or high grade disease who underwent CRS and HIPEC (n=13) was 67%. Conclusions: Patients with peritoneal-based disease from non-carcinoid epithelial neoplasms of the appendix who undergo CRS and HIPEC have a more favorable survival. Currently there is no survival advantage to the use of CTX before CRS and HIPEC for low grade appendiceal neoplasms. The role of neoadjuvant CTX and biologic agents for patients with high grade neoplasms needs to be determined. Early referral to a peritoneal malignancy center will help standardized treatment for these patients. No significant financial relationships to disclose.

Role of Anti-Hepatitis C Virus (HCV) Treatment in HCV-Related, Low-Grade, B-Cell, Non-Hodgkin's Lymphoma: A Multicenter Italian Experience

2005 ◽  
Vol 23 (3) ◽  
pp. 468-473 ◽  
Author(s):  
Daniele Vallisa ◽  
Patrizia Bernuzzi ◽  
Luca Arcaini ◽  
Stefano Sacchi ◽  
Vittorio Callea ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
B Cell ◽  
Antiviral Treatment ◽  
Complete Response ◽  
Hcv Infection ◽  
Low Grade ◽  
Hcv Treatment ◽  
Hematologic Response

Purpose Hepatitis C virus (HCV) is endemic in some areas of Northwestern Europe and the United States. HCV has been shown to play a role in the development of both hepatocellular carcinoma and B-cell non-Hodgkin's lymphoma (B-NHL). The biologic mechanisms underlying the lymphomagenic activity of the virus so far are under investigation. In this study, the role of antiviral (anti-HCV) treatment in B-NHL associated with HCV infection is evaluated. Patients and Methods Thirteen patients with histologically proven low-grade B-NHL characterized by an indolent course (ie, doubling time no less than 1 year, no bulky disease) and carrying HCV infection were enrolled on the study. All patients underwent antiviral treatment alone with pegilated interferon and ribavirin. Response assessment took place at 6 and 12 months. Results Of the twelve assessable patients, seven (58%) achieved complete response and two (16%) partial hematologic response at 14.1 ± 9.7 months (range, 2 to 24 months, median follow-up, 14 months), while two had stable disease with only one patient experiencing progression of disease. Hematologic responses (complete and partial, 75%) were highly significantly associated to clearance or decrease in serum HCV viral load following treatment (P = .005). Virologic response was more likely to be seen in HCV genotype 2 (P = .035), while hematologic response did not correlate with the viral genotype. Treatment-related toxicity did not cause discontinuation of therapy in all but two patients, one of whom, however, achieved complete response. Conclusion This experience strongly provides a role for antiviral treatment in patients affected by HCV-related, low-grade, B-cell NHL.

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