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Relapsed diffuse large b cell lymphoma

Sigal Grisariu, Michael Y Shapira, Reuven Or, Batia Avni
BACKGROUND: High-dose chemotherapy and autologous stem cell transplantation (ASCT) is the current standard of care for relapsed non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL). Conditioning regimens with high-dose carmustine have been associated with idiopathic pneumonitis syndrome. We, therefore, created a modified alternative TECAM conditioning regimen, consisting of etoposide, thiotepa, cytarabine, cyclophosphamide, and melphalan. PATIENTS AND METHODS: We retrospectively analyzed our cohort of 212 NHL and HL patients, who had undergone ASCT with the TECAM conditioning regimen from 2000 to 2013...
February 15, 2018: Clinical Lymphoma, Myeloma & Leukemia
Adil Nazir, Fawad, Neelam Siddique, Abdul Hameed
Background and Objective: Central nervous system (CNS) relapse of diffuse large B cell lymphoma (DLBCL) is relatively uncommon and nearly fatal. Two years CNS relapse risk is 0.8% in low, 3.9% in intermediate and 12% in high risk patients. Our aim was to study, the baseline characteristics and outcome in term of median survival of DLBCL patients with CNS relapse. Methods: This is a retrospective analysis. All patients of DLBCL with CNS relapse from 2006 to 2014 were included...
November 2017: Pakistan Journal of Medical Sciences Quarterly
Rodrigo Quera, Lilian Flores, Daniela Simian, Udo Kronberg, María Teresa Vial, David Ladrón de Guevara, María José García-Rodríguez
Primary colorectal lymphoma is a rare form of presentation of gastrointestinal tract lymphomas. Inflammatory bowel disease and its treatment are risk factors for its development. We report a 47-year-old male patient with Ulcerative Colitis of two years of evolution, treated initially with azathioprine and later on with infliximab. Due to a relapse in symptoms after the second dose of infliximab, a new coloncoscopy was performed showing a rectal ulcerative lesion, corresponding to a large cell Non-Hodgkin's Lymphoma...
October 2017: Revista Médica de Chile
Idanna Innocenti, Davide Rossi, Giulio Trapè, Francesco Autore, Luigi Maria Larocca, Vincenzo Gomes, Michaela Cerri, Paolo Falcucci, Simona Sica, Gianluca Gaidano, Luca Laurenti
Richter syndrome, a transformation of chronic lymphocytic leukemia (CLL) into a diffuse large B-cell lymphoma, is a rare complication of patients treated with chemo-immunotherapy. Richter syndrome might be both clonally related or unrelated to the underlying CLL and often showed mutations of the TP53 and NOTCH1 genes. Recently, ibrutinib was approved for patients with relapsed/refractory CLL or for untreated CLL patients with del 17p or TP53 mutation. The clinical picture, pathology, and genetics of Richter transformation after IBR treatment are largely unknown...
February 27, 2018: Hematological Oncology
Afshan Asghar Rasheed, Adeel Samad, Ahmed Raheem, Samina Ismail Hirani, Munira Shabbir- Moosajee
Introduction: Down regulation of CD20 expression has been reported in diffuse large B cell lymphoma (DLBCL)). Therefore, it is important to determine whether chemotherapy with rituximab induces CD20 down regulation and effects survival. Objectives: To determine the incidence of down regulation of CD20 expression in relapsed DLBCL after treatment with rituximab and to compare outcomes and assess pattern of relapse between CD20 negative and CD20 positive cases. Methodology: We retrospectively reviewed patients with relapsed DLBCL who received rituximab in the first line setting at Aga Khan University Hospital between January 2007 and December 2014...
February 26, 2018: Asian Pacific Journal of Cancer Prevention: APJCP
Tarec Christoffer El-Galaly, Chan Yoon Cheah, Mette Dahl Bendtsen, Grzegorz S Nowakowski, Roopesh Kansara, Kerry J Savage, Joseph M Connors, Laurie H Sehn, Neta Goldschmidt, Adir Shaulov, Umar Farooq, Brian K Link, Andrés J M Ferreri, Teresa Calimeri, Caterina Cecchetti, Eldad J Dann, Carrie A Thompson, Tsofia Inbar, Matthew J Maurer, Inger Lise Gade, Maja Bech Juul, Jakob W Hansen, Staffan Holmberg, Thomas S Larsen, Sabrina Cordua, N George Mikhaeel, Martin Hutchings, John F Seymour, Michael Roost Clausen, Daniel Smith, Stephen Opat, Michael Gilbertson, Gita Thanarajasingam, Diego Villa
PURPOSE: Secondary CNS involvement (SCNS) is a profoundly adverse complication of diffuse large B-cell lymphoma. Evidence from older series indicated a median overall survival (OS) < 6 months; however, data from the immunochemotherapy era are limited. METHODS: Patients diagnosed with SCNS during or after first-line immunochemotherapy were identified from databases and/or regional/national registries from three continents. Clinical information was retrospectively collected from medical records...
February 21, 2018: European Journal of Cancer
Jad Chahoud, Dawen Sui, William D Erwin, Alison M Gulbis, Martin Korbling, Mingzhi Zhang, Sairah Ahmed, Gheath Alatrash, Paolo Anderlini, Stefan O Ciurea, Betul Oran, Luis Fayad, Roland L Bassett, Elias Jabbour, L Jeffrey Medeiros, Homer A Macapinlac, Ken H Young, Issa F Khouri
PURPOSE: We evaluated the effect on long-term survival of adding rituximab (R) to BEAM (carmustine, etoposide, cytarabine, and melphalan) conditioning with or without yttrium-90 ibritumomab tiuxetan (90YIT) in patients with relapsed diffuse large B-cell lymphoma (DLBCL) undergoing autologous stem cell transplant (ASCT). EXPERIMENTAL DESIGN: Patients were enrolled on three consecutive phase 2 clinical trials. Patients received two doses of rituximab (375 mg/m2 and 1000 mg/m2) during mobilization of stem cells, followed by 1000 mg/m2 on days +1 and +8 after ASCT with R-BEAM or 90YIT-R-BEAM (90YIT dose of 0...
February 23, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Aurélie Cabannes-Hamy, Frederic Peyrade, Fabrice Jardin, Jean-François Emile, Vincent Delwail, Nicolas Mounier, Corinne Haioun, Aurore Perrot, Olivier Fitoussi, Diane Lara, Richard Delarue, Marc André, Fritz Offner, Hervé Ghesquières, Laurent Pascal, Carole Soussain, Julien Lazarovici, Jean-Marc Schiano, Philippe Gaulard, Hervé Tilly, Catherine Thieblemont
CNS relapse is reported in 2-5% of diffuse large B-cell lymphoma (DLBCL) patients, dramatically decreasing overall survival (OS). Very few studies address incidence and risk factors of CNS relapse in very elderly patients, a challenging population to treat given their commonly associated comorbidities. A retrospective analysis was performed of 270 DLBCL patients >80 years treated between 2004 and 2013 in two multicentre phase II LYSA trials (LNH03-7B, LNH09-7B) evaluating the addition of rituximab or ofatumumab to mini-CHOP as front-line therapy...
February 23, 2018: Cancer Medicine
Sylvain P Chantepie, Sylvain Garciaz, Emmanuelle Tchernonog, Frederic Peyrade, Marie-Virginie Larcher, Momar Diouf, Luc Mathieu Fornecker, Roch Houot, Thomas Gastinne, Carole Soussain, Sandra Malak, Richard Lemal, Caroline Delette, Ahmad Ibrahim, Anne-Claire Gac, E Reboursière, Jean-Pierre Vilque, Mohamed Amine Bekadja, Rene-Olivier Casasnovas, Remy Gressin, Stéphanie Guidez, Diane Coso, Charles Herbaux, Krimo Bouabdallah, Eric Durot, Gandhi Damaj
Carmustine shortage has led to an increase use of alternative conditioning regimens prior to autologous stem cell transplantation for the treatment of lymphoma, including Bendamustine-based (BeEAM). The aim of this study was to evaluate the safety of the BeEAM regimen in a large cohort of patients. A total of 474 patients with a median age of 56 years were analyzed. The majority of patients had diffuse large B-cell lymphoma (43.5%). Bendamustine was administered at a median dose of 197 mg/m2 /day (50-250) on days -7 and -6...
February 23, 2018: American Journal of Hematology
Geffen Kleinstern, Mor Averbuch, Rania Abu Seir, Riki Perlman, Dina Ben Yehuda, Ora Paltiel
Although autoimmune diseases (AIDs) are known to predispose to non-Hodgkin lymphoma (NHL), their association with NHL prognosis has rarely been investigated. We examined associations between autoimmunity and B-cell NHL onset by comparing AID history (determined by self-report and medication review and supplemented by chart review where possible) among 435 adult B-NHL patients in Hadassah-Hebrew University Medical Center, diagnosed 2009-2014, and 414 age-and-sex frequency-matched controls. We examined AIDs as a whole, B- and T-cell-mediated AIDs, and autoimmune thyroid diseases...
February 22, 2018: Hematological Oncology
Koung Jin Suh, Ki Hwan Kim, Ryul Kim, Ja Min Byun, Miso Kim, Jin Hyun Park, Bhumsuk Keam, Tae Min Kim, Jin-Soo Kim, In Sil Choi, Dae Seog Heo
Background/Aims: The role of [18F]-f luorodeoxyglucose positron emission tomography-computed tomography (PET/CT) in patients with diffuse large B-cell lymphoma (DLBCL) in first remission is unclear. Methods: Medical costs within the first 3 years of treatment completion and clinical outcomes of 118 patients with DLBCL in first remission with and without surveillance PET/CT (PET/CT [+] group [n = 76] and PET/CT [-] group [n = 42], respectively) were retrospectively analyzed...
February 23, 2018: Korean Journal of Internal Medicine
Cristina Oana Mărginean, Lorena Elena Meliţ, Emoke Horvath, Horea Gozar, Mihaela Ioana Chinceşan
RATIONALE: Non-Hodgkin lymphoma remains an unpredictable condition in pediatric patients. PATIENT CONCERNS: Our first case describes an 8-year-old boy with a history of iron deficiency anemia, admitted in our clinic for recurrent abdominal pain, weight loss, loss of appetite, diarrheic stools, and fever. The second case also describes an 8-year-old boy admitted for abdominal pain and vomiting. The 3rd case refers to a 4 years and 10 months old boy admitted in our clinic with abdominal pain and loss of appetite, who was initially admitted in the Pediatrics Surgery Clinic with the suspicion of appendicitis...
February 2018: Medicine (Baltimore)
Anastasios Stathis, Ian W Flinn, Sumit Madan, Kami Maddocks, Arnold Freedman, Steven Weitman, Emanuele Zucca, Mihaela C Munteanu, M Lia Palomba
Background CD37 is expressed on B-cell lymphoid malignancies, thus making it an attractive candidate for targeted therapy in non-Hodgkin lymphoma (NHL). IMGN529 is an antibody-drug conjugate comprising a CD37-binding antibody linked to the maytansinoid DM1, a potent anti-mitotic agent. Methods This first-in-human, phase 1 trial recruited adult patients with relapsed or refractory B-cell NHL. The primary objective was to determine the maximum tolerated dose (MTD) and recommended phase 2 dose. Secondary objectives were to evaluate safety, pharmacokinetics, and preliminary clinical activity...
February 17, 2018: Investigational New Drugs
Sarah A Milgrom, Chelsea C Pinnix, T Linda Chi, Thinh H Vu, Jillian R Gunther, Tommy Sheu, Nathan Fowler, Jason R Westin, Loretta J Nastoupil, Yasuhiro Oki, Luis E Fayad, Sattva Neelapu, Maria Alma Rodriguez, Frederick B Hagemeister, Michelle A Fanale, Hun J Lee, Chitra Hosing, Sairah Ahmed, Yago Nieto, Elizabeth J Shpall, Bouthaina S Dabaja
PURPOSE: We assessed the efficacy of radiation therapy (RT) in the management of secondary central nervous system (CNS) lymphoma. METHODS AND MATERIALS: The cohort comprised 44 patients with systemic diffuse large B-cell lymphoma (DLBCL) secondarily involving the brain and/or leptomeninges at initial diagnosis or relapse that was treated with RT. RESULTS: Of these patients, 29 (66%) were in systemic remission when CNS disease was diagnosed...
January 6, 2018: International Journal of Radiation Oncology, Biology, Physics
W Jurczak, P L Zinzani, G Gaidano, A Goy, M Provencio, Z Nagy, T Robak, K Maddocks, C Buske, S Ambarkhane, M Winderlich, M Dirnberger-Hertweck, R Korolkiewicz, K A Blum
Background: This two-stage, phase IIa study ( NCT01685008) investigated the antitumor activity and safety of MOR208, an Fc-engineered, humanized, CD19 antibody, in patients with relapsed or refractory (R-R) B-cell non-Hodgkin's lymphoma (NHL). CD19 is broadly expressed across the B-lymphocyte lineage, including in B-cell malignancies, but not by hematological stem cells. Patients and methods: Patients aged ≥18 years, with R-R NHL progressing after ≥1 prior rituximab containing regimen were enrolled into subtype-specific cohorts: diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL), other indolent (i)NHL and mantle cell lymphoma (MCL)...
February 9, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Anita J Kumar, Tobi Henzer, Angie Mae Rodday, Susan K Parsons
BACKGROUND: While treatment of DLBCL is largely outpatient, some patients require planned or unplanned admissions for chemotherapy, new diagnosis, relapse, or toxicity. We examined risk factors for receipt of inpatient chemotherapy and death during hospitalization. METHODS: We analyzed data from the 2012-2013 HCUP-NIS. We identified patient and hospital characteristics that were associated with chemotherapy administration and death. RESULTS: Chemotherapy was given in 3260/11,150 (29...
February 10, 2018: Cancer Epidemiology
Wei Jiang, Xiaoyan Zhou, Zengxia Li, Kaiyu Liu, Weige Wang, Renke Tan, Xiaoji Cong, Jiaoyu Shan, Yanxia Zhan, Zhaomeng Cui, Lizhi Jiang, Quanfu Li, Suqin Shen, Meirong Bai, Yunfeng Cheng, Bin Li, Minjia Tan, Dengke K Ma, Jun O Liu, Yongjun Dang
B-cell lymphomas are heterogeneous blood disorders with limited therapeutic options, largely because of its propensity to relapse and become refractory to treatments. Carabin, a key suppressor of B cell receptor signaling and proliferation, is inactivated in B-cell lymphoma by unknown mechanisms. Here we identify P4HA2 (Prolyl 4-Hydroxylase 2) as a specific proline hydroxylase of Carabin. Carabin hydroxylation leads to its proteasomal degradation, thereby activating the Ras/ERK pathway and increasing B-cell lymphoma proliferation...
February 1, 2018: Blood
Hongfei Ji, Xingjian Niu, Lei Yin, Yiran Wang, Lan Huang, Qijia Xuan, Liru Li, Han Zhang, Jingtong Li, Yue Yang, Weiwei An, Qingyuan Zhang
BACKGROUND/AIMS: Diffuse large B-cell lymphoma (DLBCL) is an aggressive disease, and is the most common type of lymphoma in adults. Although significant progress in treatment has been made using chemotherapy combinations, there exist a large amount of relapse or refractory cases. Thus, effective clinical biomarkers for DLBCL are urgently needed. Our study aims to explore the predictive significance of using the immune response to tumor burden ratio [defined as the lymphocyte to monocyte ratio (LMR)/lactate dehydrogenase (LDH) levels] in 184 DLBCL patients and the potential mechanism underlying the use of the LMR to tumor burden ratio in predicting patient survival...
February 2, 2018: Cellular Physiology and Biochemistry
Dongfeng Zeng, Aakash Desai, Fangfang Yan, Tiejun Gong, Haige Ye, Makhdum Ahmed, Krystle Nomie, Jorge Romaguera, Richard Champlin, Shaoying Li, Michael Wang
The most common subtype of non-Hodgkin lymphoma, diffuse large B-cell lymphoma, is cured in approximately two thirds of patients after initial therapy. The remaining one-third of patients who suffer relapse or become refractory have very poor survival outcomes despite salvage chemotherapy with or without stem cell transplantation. A considerable proportion of relapsed or refractory large B cells belong to the WHO subtype known as high-grade B-cell lymphoma with rearrangement of MYC and BCL2 and/or BCL6, also known as double-hit lymphoma (DHL)...
February 6, 2018: American Journal of Clinical Oncology
Haneen Shalabi, Ira L Kraft, Hao-Wei Wang, Constance M Yuan, Bonnie Yates, Cindy Delbrook, Julie D Zimbelman, Roger Giller, Maryalice Stetler-Stevenson, Elaine S Jaffe, Daniel W Lee, Jack F Shern, Terry J Fry, Nirali N Shah
Chimeric antigen receptor (CAR) T cell therapy using an anti-CD19 binding domain has been shown to be effective in adults with lymphoma and may represent an alternative treatment strategy in pediatric lymphoma, although experience in this younger age group is limited. Loss of the target antigen, as a mechanism of tumor escape following immunotherapy, is an increasingly recognized phenomena which has limited the efficacy of immunotherapy in leukemia, however little is known about antigen loss in lymphoma. We present a case of a pediatric patient with multiply relapsed advanced stage DLBCL who developed sequential antigen loss disease following sequential CAR immunotherapy...
February 1, 2018: Haematologica
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