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Relapsed diffuse large b cell lymphoma

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https://www.readbyqxmd.com/read/27913503/diffuse-large-b-cell-lymphoma-r-chop-failure-what-to-do
#1
Bertrand Coiffier, Clémentine Sarkozy
Although rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is the standard treatment for patients with diffuse large B-cell lymphoma (DLBCL), ∼30% to 50% of patients are not cured by this treatment, depending on disease stage or prognostic index. Among patients for whom R-CHOP therapy fails, 20% suffer from primary refractory disease (progress during or right after treatment) whereas 30% relapse after achieving complete remission (CR). Currently, there is no good definition enabling us to identify these 2 groups upon diagnosis...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27904766/the-role-of-pim1-in-the-ibrutinib-resistant-abc-subtype-of-diffuse-large-b-cell-lymphoma
#2
Hsu-Ping Kuo, Scott A Ezell, Sidney Hsieh, Karl J Schweighofer, Leo Wk Cheung, Shiquan Wu, Mutiah Apatira, Mint Sirisawad, Karl Eckert, Yu Liang, Jeff Hsu, Chun-Te Chen, Darrin Beaupre, Betty Y Chang
Diffuse large B cell lymphoma (DLBCL) is a heterogeneous lymphoma and the most common subtype of non-Hodgkin lymphoma, accounting for roughly 30% of newly diagnosed cases in the United States. DLBCL can be separated into the activated B cell-like (ABC) and germinal center B cell-like (GCB) subtypes, with distinct gene expression profiles, oncogenic aberrations, and clinical outcomes. ABC-DLBCL is characterized by chronically active B-cell receptor (BCR) signaling that can be modulated by Bruton's tyrosine kinase (BTK) activity...
2016: American Journal of Cancer Research
https://www.readbyqxmd.com/read/27900097/post-transplant-lymphoproliferative-disorder-presenting-with-skin-ulceration-in-a-renal-transplant-recipient-who-achieved-sustained-remission-with-rituximab-therapy-a-case-report
#3
Man Fai Law, Hay Nun Chan, Ho Kei Lai, Chung Yin Ha, Celia Ng, Yiu Ming Yeung, Sze Fai Yip
Post-transplant lymphoproliferative disorder (PTLD) is associated with a variety of clinical presentations, but rarely involves the skin. We herein report a case of PTLD presenting with skin ulceration in a renal transplant recipient. A biopsy of the ulcer confirmed the diagnosis of diffuse large B-cell lymphoma. The patient was initially treated with immunosuppression reduction, but the skin ulcer persisted. He was then treated with two courses of chemotherapy, but his condition was complicated with cryptococcal infection...
November 2016: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/27888879/gray-zone-lymphoma-current-diagnosis-and-treatment-options
#4
REVIEW
Monika Pilichowska, Athena Kritharis, Andrew M Evens
The morphology of gray zone lymphoma (GZL) is variable with tumor cells spanning the spectrum of diffuse large B-cell lymphoma (DLBCL) and classical Hodgkin lymphoma. The immunophenotype is frequently discordant. Clinically, the initial case descriptions of GZL were primarily with mediastinal presentation; however, a nonmediastinal (systemic) clinical subtype is now recognized. Patients with GZL have high relapse rates. Recommended treatment of GZL is with a DLBCL-directed regimen with consideration for consolidative radiotherapy for bulk disease...
December 2016: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27888875/management-of-relapsed-diffuse-large-b-cell-lymphoma
#5
REVIEW
Michael Crump
Second-line therapy options for patients with diffuse large B-cell lymphoma (DLBCL) that is refractory to, or relapses after, current rituximab-containing primary therapy continue to evolve. For younger patients, salvage therapy followed by intensive therapy and autologous stem cell transplant (ASCT) remains the treatment of choice for those with chemotherapy-sensitive disease. Combination therapy may be used for those who are not candidates for ASCT. In contrast, patients with DLBCL refractory to 2 lines of therapy have a very poor prognosis and generally short survival, and should be carefully considered for participation in clinical trials of novel approaches...
December 2016: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27888874/diffuse-large-b-cell-lymphoma-should-limited-stage-patients-be-treated-differently
#6
REVIEW
Eva Giné, Laurie H Sehn
Diffuse large B-cell lymphoma presents as limited-stage disease in approximately 30% of cases. Historically, therapy relied on a combined modality of abbreviated chemotherapy followed by involved-field radiotherapy (IFRT). Due to the apparent lack of long-term survival and the concern for delayed toxicity, chemotherapy-only strategies are used more frequently. Treatment should take into account patient performance, clinical risks, and involvement sites. PET-guided approaches are being investigated. The risk of late relapse has been recognized, highlighting the importance of long-term follow-up...
December 2016: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27884973/the-emerging-role-of-immune-checkpoint-inhibition-in-malignant-lymphoma
#7
Ida Hude, Stephanie Sasse, Andreas Engert, Paul J Bröckelmann
To evade elimination by the host immune system, tumor cells commonly exploit physiological immune checkpoint pathways, restraining efficient anti-tumor immune cell function. Growing understanding of the complex dialog between tumor cells and their microenvironment contributed to the development of immune checkpoint inhibitors. This innovative strategy has demonstrated paradigm-shifting clinical activity in various malignancies. Antibodies targeting programmed death 1 and cytotoxic T-lymphocyte-associated protein-4 are also being investigated in lymphoid malignancies with varying levels of activity and a favorable toxicity profile...
November 24, 2016: Haematologica
https://www.readbyqxmd.com/read/27880984/diffuse-large-b-cell-lymphoma-with-primary-treatment-failure-ultra-high-risk-features-and-benchmarking-for-experimental-therapies
#8
Luciano J Costa, Kami Maddocks, Narendranath Epperla, Nishitha M Reddy, Reem Karmali, Elvira Umyarova, Veronika Bachanova, Christiana Costa, Martha Glenn, Julio Chavez, Oscar Calzada, Frederick Lansigan, Hossain Nasheed, Stefan Barta, Zheng Zhou, Michael Jaglal, Saurabh Chhabra, Francisco Hernandez-Ilizaliturri, Ana C Xavier, Amitkumar Mehta, Deniz Peker, Andreas Forero-Torres, Zeina Al-Mansour, Andrew M Evens, Jonathon B Cohen, Christopher R Flowers, Timothy S Fenske, Mehdi Hamadani
While a subset of patients with DLBCL relapsing after upfront chemoimmunotherapy can be cured with salvage therapy and autologous hematopoietic cell transplantation (auto-HCT), the outcome of patients with primary treatment failure (PTF) is less clear. For this study we analyzed 331 patients from 15 US institutions with DLBCL and PTF, defined as primary progression while on upfront chemoimmunotherapy (PP), residual disease at the end of upfront therapy (RD) or relapse < 6 months from end of therapy (early relapse; ER)...
November 23, 2016: American Journal of Hematology
https://www.readbyqxmd.com/read/27869811/diffuse-large-b-cell-lymphoma-the-challenge-of-relapse-after-an-autologous-stem-cell-transplant
#9
S P Robinson
No abstract text is available yet for this article.
November 21, 2016: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/27867670/lymphoma-heterogeneity-three-different-histological-pictures-and-one-unique-clone
#10
Sara Alonso-Alvarez, Alba Redondo-Guijo, Óscar Blanco, Miguel Alcoceba, Ana Balanzategui, Juan C Caballero, Julio Dávila, Marcos González, María D Caballero, Alejandro Martín, Ramón García-Sanz
We report a patient who developed up to three different lymphomas with the same clonal IGH rearrangement. She was first diagnosed of splenic zone marginal lymphoma and relapsed for the first time with Hodgkin lymphoma histology and later with diffuse large B-cell lymphoma histology. Subsequent biopsies and analysis of clonally rearranged IGH genes helped to elucidate the clonal relationship between the three histologies and to confirm a common origin from the three tissue histologies. An integrated diagnosis should always be performed in order to achieve the most accurate diagnosis and be able to choose the best therapeutic options for our patients...
2016: Case Reports in Hematology
https://www.readbyqxmd.com/read/27861596/pd-l1-status-in-refractory-lymphomas
#11
Semir Vranic, Nilanjan Ghosh, Jeffery Kimbrough, Nurija Bilalovic, Ryan Bender, David Arguello, Yvonne Veloso, Aida Dizdarevic, Zoran Gatalica
Targeted immunotherapy based on PD-1/PD-L1 suppression has revolutionized the treatment of various solid tumors. A remarkable improvement has also been observed in the treatment of patients with refractory/relapsing classical Hodgkin lymphoma (cHL). We investigated PD-L1 status in a variety of treatment resistant lymphomas. Tumor samples from 78 patients with therapy resistant lymphomas were immunohistochemically (IHC) investigated for the expression of PD-L1 using two antibody clones (SP142 and SP263, Ventana)...
2016: PloS One
https://www.readbyqxmd.com/read/27846613/guidelines-for-diagnosis-prevention-and-management-of-central-nervous-system-involvement-in-diffuse-large-b-cell-lymphoma-patients-by-the-spanish-lymphoma-group-geltamo
#12
Francisco-Javier Peñalver, Juan-Manuel Sancho, Adolfo de la Fuente, Maria-Teresa Olave, Alejandro Martin, Carlos Panizo, Elena Pérez, Antonio Salar, Alberto Orfao
: Diffuse large B-cell lymphoma patients have a 5% overall risk of central nervous system events (relapse or progression), which account for high morbidity and frequently fatal outcomes(1) and shortened overall survival of <6 months.(2) Early diagnosis of central nervous system events is critical for successful treatment and improved prognosis. Identification of patients at risk of central nervous system disease is critical to accurately identify candidates for central nervous system- prophylaxis vs...
October 20, 2016: Haematologica
https://www.readbyqxmd.com/read/27835875/prognostic-value-of-total-lesion-glycolysis-of-baseline-18f-fluorodeoxyglucose-positron-emission-tomography-computed-tomography-in-diffuse-large-b-cell-lymphoma
#13
Mingge Zhou, Yumei Chen, Honghui Huang, Xiang Zhou, Jianjun Liu, Gang Huang
PURPOSE: We evaluated the prognostic value of total lesion glycolysis (TLG) measured in baseline 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in diffuse large B-cell lymphoma (DLBCL) treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). METHODS: A total of 91 patients with newly diagnosed DLBCL underwent 18F-FDG PET/CT scans before R-CHOP therapy. Metabolic tumor volume (MTV) was measured with the marginal threshold of normal liver mean standard uptake value (SUVmean) plus 3 standard deviations (SD)...
November 7, 2016: Oncotarget
https://www.readbyqxmd.com/read/27813622/18f-fdg-pet-ct-in-the-diagnosis-of-an-extranodal-relapse-of-diffuse-large-b-cell-lymphoma-dlbcl-a-clinical-case-with-a-literature-review
#14
Borislav Chaushev, Ilina Micheva, Merilin Mechmed, Boyan Balev, Yana Bocheva, Darina Ivanova, Ivan Krasnaliev, Rumena Lozanova, Anelia Klisarova, Pavel Bochev, Jivka Dancheva
Extranodal lymphoma, secondary to or accompanying nodal disease is uncommon, but not unusual finding. 18-Fluorodeoxyglucose positron emission tomography (18F-FDG PET/CT) imaging has an essential role in the staging of lymphoma, in treatment response monitoring, and in detection of recurrence. We present a case of a 52-year-old man with generalized diffuse large B-cell lymphoma (DLBCL) with multiple extranodal sites involvement detected by 18F-FDG PET/CT. With this clinical case we demonstrate that 18F-FDG PET-CT is a more effective technique than CE-CT for the evaluation of viable extranodal involvement of the diffuse large B-cell lymphoma (DLBCL) and should be combined in the monitoring of DLBCL...
2016: Nuclear Medicine Review. Central & Eastern Europe
https://www.readbyqxmd.com/read/27807649/peripheral-blood-lymphocyte-monocyte-ratio-following-completion-of-first-line-therapy-predicts-early-relapse-in-patients-with-diffuse-large-b-cell-lymphoma
#15
Shu-Juan Zhou, Yong-Yong Ma, Yu Zhang, Sheng Luo, Li-Yuan Tang, Yi Chen, Lan Sun, Kang Yu
To investigate whether the post-therapy lymphocyte/monocyte ratio (ALC/AMC ratio or LMR) predicts early relapse in patients with diffuse large B cell lymphoma (DLBCL), we enrolled 125 consecutive patients with DLBCL and followed up from 2005 to 2015 in our hospital. The LMR was measured following completion of first-line therapy. We found that the LMR following completion therapy was a strong predictor of early relapse, which is less than 12 months after diagnosis. A low LMR was significantly associated with early relapse in both univariate [odds ratio (OR) = 8...
November 2, 2016: Annals of Hematology
https://www.readbyqxmd.com/read/27791447/managing-early-failures-with-r-chop-in-patients-with-diffuse-large-b-cell-lymphoma
#16
Vincent Camus, Hervé Tilly
Patients with refractory or relapsing diffuse large B-cell lymphoma (DLBCL) represent a major challenge for physicians, and the tools necessary to manage these situations remain limited and better options are needed. Despite the overall improvement in the outcome of patients with DLBCL since the introduction of front-line immunochemotherapy (R-CHOP), 20% of patients are primarily refractory or experience short-term relapse and have an extremely poor prognosis. Areas covered: This article reviews the current landscape of refractory/relapsed DLBCL management solutions, including chemotherapy and targeted therapies, with a special focus on primary refractory patients...
November 16, 2016: Expert Review of Hematology
https://www.readbyqxmd.com/read/27771712/prognostic-significance-of-mirna-in-patients-with-diffuse-large-b-cell-lymphoma-a-meta-analysis
#17
Zhuojun Zheng, Xiaodong Li, Yuandong Zhu, Weiying Gu, Xiaobao Xie, Jingting Jiang
INTRODUCTION: This pooled analysis study aimed to reveal the prognostic relevance of microRNAs (miRNAs) in patients with diffuse large B-cell lymphoma (DLBCL). MATERIALS AND METHODS: We examined the impact of miRNAs on clinical outcome. Eligible studies were identified and quality assessed using multiple search strategies. Data were extracted from included studies which correlated survival with expression of miRNAs (serum or tissue). RESULTS: We pooled proper studies, and combined the hazard ratios with 95% confidence intervals to estimate strength of the correlations...
2016: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/27752821/secondary-central-nervous-system-relapse-in-diffuse-large-b-cell-lymphoma-in-a-resource-limited-country-result-from-the-thailand-nationwide-multi-institutional-registry
#18
Kitsada Wudhikarn, Udomsak Bunworasate, Jakrawadee Julamanee, Arnuparp Lekhakula, Suporn Chuncharunee, Pimjai Niparuck, Supachai Ekwattanakit, Archrob Khuhapinant, Lalita Norasetthada, Weerasak Nawarawong, Nisa Makruasi, Nonglak Kanitsap, Chittima Sirijerachai, Kanchana Chansung, Peerapon Wong, Tontanai Numbenjapon, Kannadit Prayongratana, Tawatchai Suwanban, Somchai Wongkhantee, Pannee Praditsuktavorn, Tanin Intragumtornchai
Secondary central nervous system (CNS) relapse is a serious and fatal complication of diffuse large B cell lymphoma (DLBCL). Data on secondary CNS (SCNS) relapse were mostly obtained from western countries with limited data from developing countries. We analyzed the data of 2034 newly diagnosed DLBCL patients enrolled into the multi-center registry under Thai Lymphoma Study Group from setting. The incidence, September 2006 to December 2013 to represent outcome from a resource limited pattern, management, and outcome of SCNS relapse were described...
October 18, 2016: Annals of Hematology
https://www.readbyqxmd.com/read/27742770/inhibition-of-demethylase-kdm6b-sensitizes-diffuse-large-b-cell-lymphoma-to-chemotherapeutic-drugs
#19
Rohit Mathur, Lalit Sehgal, Ondrej Havranek, Stefan Köhrer, Tamer Khashab, Neeraj Jain, Jan A Burger, Sattva S Neelapu, R Eric Davis, Felipe Samaniego
Histone methylation and demethylation regulates B-cell development, and their deregulation correlates with tumor chemoresistance in diffuse large B-cell lymphoma, limiting curative rates. Since histone methylation status correlates with disease aggressiveness and relapse, we investigated the therapeutic potential of inhibiting histone 3 Lys27 demethylase KDM6B, in-vitro, using the small molecule inhibitor GSK-J4. KDM6B is overexpressed in the DLBCL germinal center B-cell subtype, and higher KDM6B levels are associated with worse survival in DLBCL patients treated with R-CHOP...
October 14, 2016: Haematologica
https://www.readbyqxmd.com/read/27739058/diffuse-large-b-cell-lymphoma-with-testicular-involvement-outcome-and-risk-of-cns-relapse-in-the-rituximab-era
#20
Robert Kridel, David Telio, Diego Villa, Laurie H Sehn, Alina S Gerrie, Tamara Shenkier, Richard Klasa, Graham W Slack, King Tan, Randy D Gascoyne, Joseph M Connors, Kerry J Savage
The addition of rituximab has improved outcomes in diffuse large B-cell lymphoma (DLBCL), however, there remains limited information on the impact of rituximab in those with testicular involvement. All patients with diffuse large cell lymphoma and testicular involvement treated with curative intent were identified in the British Columbia Cancer Agency Lymphoid Cancer Database. In total, 134 patients diagnosed between 1982 and 2015 with diffuse large cell lymphoma involving the testis were identified: 61 received CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone)-like chemotherapy and 73 received CHOP plus rituximab (R-CHOP)...
October 14, 2016: British Journal of Haematology
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