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rituximab and lymphoma relapse

Monica Cabrero, Alejandro Martin, Javier Briones, Jorge Gayoso, Isidro Jarque, Javier López, Carlos Grande, Inmaculada Heras, Reyes Arranz, Teresa Bernal, Estefania Perez-Lopez, Oriana López-Godino, Eulogio Conde, Dolores Caballero
We designed a phase-II clinical trial including Y-90-ibritumomab-tiuxetan as part of a reduced-intensity conditioning (RIC) allogeneic stem cell transplant (AlloSCT) in high-risk NHL (Clinical Trials Identifier: NCT00644371). Eligible patients were high-risk relapsed/refractory aggressive lymphoma. Conditioning regimen consisted of rituximab 250 mg (days -21 and -14), Y-90 ibritumomab IV (0.4 mCi/kg, day -14), fludarabine 30 mg/m(2) IV (days -3 and -2) plus melphalan 70 mg/m(2) IV (days -3 and -2) or one dose of melphalan and thiotepa 5 mg/kg (day -8)...
October 19, 2016: Biology of Blood and Marrow Transplantation
Clémentine Sarkozy, Thierry Molina, Hervé Ghesquières, Anne-Sophie Michallet, Jehan Dupuis, Diane Damotte, Franck Morsschauser, Marie Parrens, Laurent Martin, Peggy Dartigues, Aspasia Stamatoullas, Pierre Hirsch, Betina Fabiani, Krimo Bouabdallah, Maria Gomes da Silva, Marie Maerevoet, Camille Laurent, Bertrand Coiffier, Gilles Salles, Alexandra Traverse-Glehen
Mediastinal grey zone lymphoma, B cell lymphomas with intermediate features between classical Hodgkin lymphoma and primary mediastinal B cell lymphoma, are not well described in the literature. We report the clinical characteristics and outcomes of a large retrospective series of 99 cases centrally reviewed by a panel of hematopathologists, with a consensus established for the diagnosis. Cases were defined as classical Hodgkin lymphoma-like morphology (64.6%) with primary mediastinal B cell lymphoma immunophenotype, primary mediastinal B cell lymphoma-like morphology (30...
October 6, 2016: Haematologica
Gillian M Keating
Pixantrone (Pixuvri(®)) is an aza-anthracenedione with a novel mode of action that is conditionally approved in the EU for use as monotherapy in adult patients with multiply relapsed or refractory aggressive B-cell non-Hodgkin's lymphoma (NHL). In the randomized, open-label, multinational, phase 3 PIX301 trial in patients with multiply relapsed or refractory aggressive NHL, the complete response (CR) plus unconfirmed CR (uCR) rate at the end of treatment (primary endpoint) was significantly higher with intravenous pixantrone monotherapy than with a single-agent comparator (vinorelbine, oxaliplatin, ifosfamide, etoposide, mitoxantrone or gemcitabine)...
October 18, 2016: Drugs
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
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
Ipek Yonal-Hindilerden, Fehmi Hindilerden, Serkan Arslan, Nalan Turan-Guzel, Ibrahim Oner Dogan, Meliha Nalcaci
A 61-year-old woman was admitted to our hospital with an ulcerated palate mass and swelling of the right parotid gland. Incisional biopsy from the hard palate revealed an extranodal marginal zone B-cell lymphoma, also called mucosa-associated lymphoid tissue (MALT) lymphoma. Final diagnosis was MALT lymphoma of the parotid gland with concomitant involvement of an extremely seldom site of involvement: the hard palate. To our knowledge, this report illustrates the first case of MALT lymphoma of the hard palate and parotid gland without an underlying autoimmune disease...
November 2016: Journal of Clinical Medicine Research
L Y Ping, Y Q Song, W Zheng, X P Wang, Y Xie, N J Lin, M F Tu, Z T Ying, W P Liu, C Zhang, L J Deng, J Zhu
Objective: To investigate the efficacy and survival of the DICE regimen (cisplatin, ifosfamide, etoposide, dexamethasone) for relapsed and refractory NHL. Methods: Clinical data of 97 relapsed and refractory NHL patients treated with DICE regimen in Peking University Cancer Hospital between Sep 1. 2008 and Dec 31. 2013 were retrospectively analyzed, and then we evaluate the efficacy and safety of DICE regimen. Results: ① There were 64 males and 33 females with a median age of 49 years. The most common pathological type was DLBCL (73...
September 14, 2016: Zhonghua Xue Ye Xue za Zhi, Zhonghua Xueyexue Zazhi
S Huang, L Jin, J Yang, Y L Duan, M Zhang, C J Zhou, Y H Zhang
Objective: To analyze the clinical features and outcomes of Burkitt lymphoma with testicular involvement and study the efficiency of high dose methotrexate (HD-MTX: 5-8g/m(2)) in those patients without radiation therapy. Method: Retrospective analysis was conducted in 16 Burkitt's lymphoma cases with testicular lymphoma involvement between Jan 2009 and Dec 2014. We followed the BCH-NHL-2009 protocol, modified from FAB LMB 89 combined with rituximab. All patients were enrolled in high-risk group (treated by Group C protocol)...
September 14, 2016: Zhonghua Xue Ye Xue za Zhi, Zhonghua Xueyexue Zazhi
Seok Jin Kim, Jun Sik Hong, Myung Hee Chang, Jeong-A Kim, Jae-Yong Kwak, Jin Seok Kim, Dok Hyun Yoon, Won Sik Lee, Young Rok Do, Hye Jin Kang, Hyeon-Seok Eom, Yong Park, Jong-Ho Won, Yeung-Chul Mun, Hyo Jung Kim, Jung Hye Kwon, Jee Hyun Kong, Sung Yong Oh, Sunah Lee, Sung Hwa Bae, Deok-Hwan Yang, Hyun Jung Jun, Yang Soo Kim, Hwan Jung Yun, Soon Il Lee, Min Kyoung Kim, Eun Kyung Park, Won Seog Kim, Cheolwon Suh
Central nervous system involvement remains a challenging issue in the treatment of patients with diffuse large B-cell lymphoma. We conducted a prospective cohort study with newly diagnosed diffuse large B-cell lymphoma patients receiving rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone to identify incidence and risk factors for central nervous system involvement. Among 595 patients, 279 patients received pre-treatment central nervous system evaluation, and 14 patients had central nervous system involvement at diagnosis (2...
October 4, 2016: Oncotarget
Guozhen Liu, Jing Luan, Qiang Li
Diffuse large B cell lymphoma (DLBCL) is a common B cell malignancy. Complete remission can be achieved in most patients by conventional treatment with rituximab and chemotherapy. However, a subset of remission individuals will develop a relapsed disease for obscure reasons. CD4(+)Foxp3(-)IL-10(+) cell (Tr1) is a novel cell subtype with the capacity to suppress pro-inflammatory responses, but has not been extensively studied in most tumors. In this study, we investigated the potential role of Tr1 cells in DLBCL...
October 5, 2016: DNA and Cell Biology
Chaitra S Ujjani, Sin-Ho Jung, Brandelyn Pitcher, Peter Martin, Steven I Park, Kristie A Blum, Sonali M Smith, Myron Czuczman, Matthew S Davids, Ellis Levine, Lionel D Lewis, Scott E Smith, Nancy L Bartlett, John P Leonard, Bruce D Cheson
Chemoimmunotherapy in follicular lymphoma is associated with significant toxicity. Targeted therapies are being investigated as potentially more efficacious and tolerable alternatives for this multiply-relapsing disease. Based on promising activity with rituximab and lenalidomide in previously untreated follicular lymphoma (ORR 90-96%) and ibrutinib in relapsed disease (ORR 30-55%), the Alliance for Clinical Trials in Oncology conducted a phase I trial of rituximab, lenalidomide, and ibrutinib. Previously untreated patients with follicular lymphoma received rituximab 375 mg/m(2) on Day 1, 8, 15, 22 of Cycle 1 and Day 1 of Cycle 4, 6, 8, 10, lenalidomide as per cohort dose on Days 1-21/28 for 18 cycles, and ibrutinib as per cohort dose daily until progression...
October 3, 2016: Blood
Duncan M Gascoyne, Alison H Banham
Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of mature B-cell lymphoma. While the majority of patients are cured with immunochemotherapy incorporating the anti-CD20 monoclonal antibody rituximab (R-CHOP), relapsed and refractory patients still have a dismal prognosis. DLBCL subtypes including an aggressive activated B-cell-like (ABC) and a more favorable prognosis germinal center-like (GCB) DLBCL have been identified by gene expression profiling and are characterized by distinct genetic abnormalities and oncogenic pathways...
September 27, 2016: Leukemia & Lymphoma
Kazuyo Nagashima, Hiroaki Tanaka, Yurie Nagai, Yasumasa Sugita
During treatment for malignant lymphoma, cytopenia can develop for several reasons. In the treatment of cytopenia, various possibilities should be considered because inadequate treatment causes exacerbation of cytopenia and can lead to fatal conditions, such as infection and bleeding. Herein, we describe immune pancytopenia 3 months after the last exposure to chemotherapy in a patient with diffuse large B-cell lymphoma (DLBCL). She suffered from severe pancytopenia after two courses of rituximab and bendamustine therapy for a second relapse of DLBCL...
September 20, 2016: BMJ Case Reports
Gwyneth Soon, Guan Wei Ow, Hian Li Chan, Siok Bian Ng, Shi Wang
Primary cardiac lymphoma (PCL) is a rare extranodal lymphoma that involves only the heart and/or pericardium. Primary cardiac lymphoma is much less common in immunocompetent patients compared with those who are immunosuppressed. Patients with PCL have variable clinical manifestations that may lead to misdiagnosis and delay in treatment. Modern radiologic imaging now allows for earlier detection of these tumors. This study describes the clinical, histologic/cytologic, immunophenotypic, and molecular genetic findings for 3 immunocompetent patients with primary cardiac diffuse large B-cell lymphoma...
October 2016: Annals of Diagnostic Pathology
Nadine G D Schirmbeck, Ulrich J M Mey, Attilio Olivieri, Yon-Dschun Ko, Ulrich Kaiser, Dimitri Flieger, Mathias Witzens-Harig, Ingo G H Schmidt-Wolf
This analysis reports on 72 patients with relapsed or refractory non-Hodgkin lymphoma who were treated with R-DHAP salvage chemotherapy regimen followed by high-dose chemotherapy and stem cell transplantation. The overall remission rate was 58.3%. Median time of follow-up was 28.7 months. Median progression-free survival was 29 months, estimated median overall survival was 37 months. Within a matched pair analysis these results were compared to a group that received DHAP salvage therapy without rituximab showing similar overall response rates and better estimated five-year overall survival of 59...
September 13, 2016: Cancer Investigation
Qing-Qing Cai, Li-Yang Hu, Qi-Rong Geng, Jie Chen, Zhen-Hai Lu, Hui-Lan Rao, Qing Liu, Wen-Qi Jiang, Hui-Qiang Huang, Tong-Yu Lin, Zhong-Jun Xia
BACKGROUND: In patients with diffuse large B-cell lymphoma (DLBCL), central nervous system (CNS) relapse is uncommon but is nearly always fatal. This study aimed to determine the risk factors for CNS relapse in DLBCL patients and to evaluate the efficacy of rituximab and intrathecal chemotherapy prophylaxis for CNS relapse reduction. METHODS: A total of 511 patients with newly diagnosed DLBCL treated at the Sun Yat-sen University Cancer Center between January 2003 and December 2012 were included in the study...
September 13, 2016: Chinese Journal of Cancer
Samir G Mallat, Houssam S Itani, Rana M Abou-Mrad, Rima Abou Arkoub, Bassem Y Tanios
Rituximab is a chimeric anti-CD20 antibody that results in depletion of B-cell lymphocytes. It is currently used in the treatment of a variety of autoimmune diseases, in addition to CD20-positive lymphomas. The use of rituximab in the treatment of the adult primary glomerular diseases has emerged recently, although not yet established as first-line therapy in international guidelines. In patients with steroid-dependent minimal change disease or frequently relapsing disease, and in patients with idiopathic membranous nephropathy (IMN), several retrospective and prospective studies support the use of rituximab to induce remission, whereas in idiopathic focal and segmental glomerulosclerosis (FSGS), the use of rituximab has resulted in variable results...
2016: Therapeutics and Clinical Risk Management
Ranjana H Advani, Daniel Lebovic, Andy Chen, Mark Brunvand, Andre Goy, Julie E Chang, Ephraim Hochberg, Sreeni Yalamanchili, Robert Kahn, Dan Lu, Priya Agarwal, Randall Dere, Hsin-Ju Hsieh, Surai Jones, Yu-Waye Chu, Bruce D Cheson
PURPOSE: Pinatuzumab vedotin is an antibody-drug conjugate with the potent antimicrotubule agent monomethyl auristatin E (MMAE) conjugated to an anti-CD22 antibody via a protease-cleavable linker. This Phase I study determined its recommended Phase II dose (RP2D) and evaluated its safety, tolerability, and anti-tumor activity alone and with rituximab in relapsed/refractory (r/r) non-Hodgkin's lymphoma (NHL) and chronic lymphocytic leukemia (CLL). EXPERIMENTAL DESIGN: Patients received escalating doses of pinatuzumab vedotin every 21 days...
September 6, 2016: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Wataru Munakata, Kensei Tobinai
Non-Hodgkin lymphoma (NHL) is a heterogeneous group of lymphoid malignancies. The treatment strategy for patients with NHL had remained unchanged until the advent of the era of molecular targeting agents. Although rituximab-containing chemotherapy has improved the response rates and survival of patients with B-cell NHL (B-NHL), several subtypes of B-NHL, especially indolent B-NHL and mantle cell lymphoma (MCL), remain incurable. Therefore, novel treatment modalities for B-NHL, especially for indolent B-NHL and MCL, are needed...
November 2016: Expert Opinion on Drug Discovery
Parul Thakral, Suhas Singla, Atul Vashist, Madhav P Yadav, Santosh K Gupta, Jaya S Tyagi, Atul Sharma, Chandra S Bal, EmptyYN Y Snehlata, Arun Malhotra
BACKGROUND AND OBJECTIVES: The aim of the study is to evaluate the therapeutic efficacy and safety of Yttrium- 90 radiolabelled chimeric anti CD20 antibody-Rituximab in the treatment of patients with relapsed/ refractory B cell Non-Hodgkins Lymphoma (NHL). METHODS: Twenty patients with relapsed/refractory CD20+ NHL in progressive state were included in the study. These patients had undergone a median of 2 (range 2-5) prior standard chemotherapy ± immunotherapy regimens...
2016: Current Radiopharmaceuticals
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