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Lymphoma CNS

Katherine C Pehlivan, Brynn B Duncan, Daniel W Lee
PURPOSE OF REVIEW: Genetically engineered T cells expressing a chimeric antigen receptor (CAR-T) targeting specific antigens present on acute lymphoblastic leukemia (ALL) blasts have generated promising results in children and adults with relapsed and refractory disease. We review the current evidence for CAR-T cell therapy in ALL, associated toxicities, and efforts to improve durable response to therapy. RECENT FINDINGS: CD19-directed CAR-T cells have recently been approved by the FDA for use in children and young adults with ALL and in adults with diffuse large B cell lymphoma (DLBCL) in the relapsed/refractory setting...
August 17, 2018: Current Hematologic Malignancy Reports
Jingjing Wu, Lingling Duan, Lei Zhang, Zhenchang Sun, Xiaorui Fu, Xin Li, Ling Li, Xinhua Wang, Xudong Zhang, Zhaoming Li, Hui Yu, Yu Chang, Feifei Nan, Jiaqin Yan, Li Tian, Xiaoli Wang, Mingzhi Zhang
OBJECTIVE: This prospective, randomized, controlled and open-label clinical trial sought to evaluate the tolerability and efficacy of the FTD regimen (fotemustine, teniposide and dexamethasone) compared to HD-MA therapy (high-dose methotrexate plus cytarabine) and to elucidate some biomarkers that influence outcomes in patients with newly diagnosed primary CNS lymphoma. METHODS: Participants were stratified by IELSG risk score (low versus intermediate versus high) and randomly assigned (1:1) to receive four cycles of FTD or HD-MA regimen...
August 14, 2018: Journal of Neuro-oncology
Matthijs van der Meulen, Linda Dirven, Esther J J Habets, Martin J van den Bent, Martin J B Taphoorn, Jacoline E C Bromberg
Incidence of primary CNS lymphoma (PCNSL) is increasing, while prognosis is improving as treatments advance. However, declined cognitive functioning remains a major challenge in the treatment of PCNSL. This cognitive decline, in conjunction with other symptoms caused by the disease or its treatment, or both, can compromise health-related quality of life (HRQOL). The aim of this Review was to give a comprehensive overview on cognitive functioning and HRQOL for patients with PCNSL, including an evaluation of patient-related and treatment-related factors that can influence cognitive functioning and HRQOL...
August 2018: Lancet Oncology
Eva Steliarova-Foucher, Miranda M Fidler, Murielle Colombet, Brigitte Lacour, Peter Kaatsch, Marion Piñeros, Isabelle Soerjomataram, Freddie Bray, Jan Willem Coebergh, Rafael Peris-Bonet, Charles A Stiller
BACKGROUND: A deceleration in the increase in cancer incidence in children and adolescents has been reported in several national and regional studies in Europe. Based on a large database representing 1·3 billion person-years over the period 1991-2010, we provide a consolidated report on cancer incidence trends at ages 0-19 years. METHODS: We invited all population-based cancer registries operating in European countries to participate in this population-based registry study...
August 8, 2018: Lancet Oncology
Jonathan Farhi, Kamel Laribi, Corentin Orvain, Jean-François Hamel, Mélanie Mercier, Aurélien Sutra Del Galy, Aline Clavert, Marie-Christine Rousselet, Aline Tanguy-Schmidt, Mathilde Hunault-Berger, Marie-Pierre Moles-Moreau
Primary central nervous system lymphomas (PCNSL) are non-Hodgkin lymphomas strictly localized to the CNS, occurring mainly in elderly patients with comorbidities. Current treatment in fit patients relies on high-dose methotrexate and high-dose cytarabine. The aim of this study was to evaluate the efficacy and feasibility of this treatment in elderly patients and to assess potential prognostic factors associated with survival. We conducted a retrospective study in two centers between January 2008 and September 2015 including 35 elderly immunocompetent patients who received first-line treatment with high-dose methotrexate...
August 8, 2018: Annals of Hematology
Tiziana Vavalà, Silvia Novello
Anaplastic lymphoma kinase (ALK) rearrangement is identified in 3-7% of advanced non-small cell lung cancer (NSCLC) cases, and ALK tyrosine kinase inhibitors (TKIs) have revolutionized the management of this subset of NSCLC patients. ALK-TKIs have been proven highly effective in ALK-rearranged advanced NSCLC patients, but after initial responses and benefit, a subsequent progression inevitably occurs. Understanding acquired-resistance mechanisms and defining an appropriate algorithm is becoming even more essential, particularly considering the availability of extremely efficacious next-generation ALK inhibitors...
2018: Therapeutic Advances in Medical Oncology
M Zhang, L Jin, J Yang, Y L Duan, S Huang, C J Zhou, Y H Zhang
Objective: To analyze the clinical features and prognostic factors of childhood Burkitt's lymphoma and to summarize the therapeutic effect of the mature B-cell lymphoma regimen of Beijing Children's Hospital. Methods: It was a retrospective study. From January 2007 to December 2015, 186 patients below 18 years of age with newly diagnosed, untreated Burkitt's lymphoma were enrolled. Three cases were eliminated because of the abandonment of the treatment and 183 cases were stratified and treated according to the mature B-cell lymphoma regimen of Beijing Children's Hospital, groups were as follows: A, n= 1; B, n= 59; C, n= 123 and 97 patients in group C received combined rituximab therapy during the treatment...
August 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Stephan D Voss
Most pediatric malignancies require some form of cross-sectional imaging, either for staging or response assessment. The majority of these are solid tumors and this review addresses the role of MRI, as well as other cross-sectional and functional imaging techniques, for evaluating the most common pediatric solid tumors. The primary emphasis is on neuroblastoma, hepatoblastoma and Wilms tumor, three of the most common non-central-nervous-system (CNS) pediatric solid tumors encountered in young children. The initial focus will be a review of the imaging techniques and approaches used for diagnosis, staging and early post-treatment response assessment, followed by a discussion of the role surveillance imaging plays in pediatric oncology and a brief review of other emerging imaging techniques...
August 2018: Pediatric Radiology
O Mazanowska, P Donizy, J Kuźmińska, K Roczek, A Zimny, M Banasik, D Kaminska, K Hap, M Klinger, A Halon
INTRODUCTION: Acute central nervous system (CNS) damage in a patient who has received organ transplant is an extremely difficult and complex clinical issue that spans a wide spectrum of differential diagnoses with ischemia, post-transplant lymphoproliferative disorders (PTLDs), infections, lymphomas, and progressive multifocal leukoencephalopathy (PML). PTLDs are a clinically and histopathologically heterogeneous group of diseases that most often occur in heavily immunocompromised populations after solid organ transplantation (SOT), probably related to the infection or reactivation of Epstein-Barr virus (EBV) infection, whereas PML is an infectious disease caused by the John Cunningham virus (JCV)...
July 2018: Transplantation Proceedings
Leila Pourtalebi Jahromi, Soliman Mohammadi-Samani, Reza Heidari, Amir Azadi
PURPOSE: Although it passes through blood-brain barrier (BBB) very poorly, methotrexate (MTX) is an important therapeutic in the treatment of many central nervous system malignancies. Accordingly, intranasal (IN) administration accompanied with a muco-adhesive chitosan-based nanoformulation is expected to overcome this problem. METHODS: Nanogel containing MTX was prepared through an ionic gelation method and then characterized in terms of particle size, morphology, zeta potential, drug loading and drug release behavior...
2018: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
Mª Carmen Areses Manrique, Joaquín Mosquera Martínez, Jorge García González, Francisco Javier Afonso Afonso, Martín Lázaro Quintela, Natalia Fernández Núñez, Cristina Azpitarte Raposeiras, Margarita Amenedo Gancedo, Lucía Santomé Couto, Mª Rosario García Campelo, Jose Muñoz Iglesias, Alexandra Cortegoso Mosquera, Rocío Vilchez Simo, Joaquín Casal Rubio, Begoña Campos Balea, Iria Carou Frieiro, Guillermo Alonso-Jaudenes Curbera, Urbano Anido Herranz, Jesus García Mata, José Luis Fírvida Pérez
Background: Recently, immunotherapy has changed the standard of treatment in non-small cell lung cancer (NSCLC). Outside clinical trials, data of real life is lacking. This is an observational study that represents the real world experience with nivolumab in pretreated NSCLC. Methods: Eligibility criteria included, histologically confirmed NSCLC, stage IIIB and IV, evaluable disease and at least one prior therapy. Patients received nivolumab until progressive disease (PD) or unacceptable toxicity...
June 2018: Translational Lung Cancer Research
C Chiavazza, A Pellerino, F Ferrio, A Cistaro, R Soffietti, R Rudà
Primary Central Nervous System Lymphoma (PCNSL) is a rare neoplasm that can involve brain, eye, leptomeninges, and rarely spinal cord. PCNSL lesions most typically enhance homogeneously on T1-weighted magnetic resonance imaging (MRI) and appear T2-hypointense, but high variability in MRI features is commonly encountered. Neurological symptoms and MRI findings may mimic high grade gliomas (HGGs), tumefactive demyelinating lesions (TDLs), or infectious and granulomatous diseases. Advanced MRI techniques (MR diffusion, spectroscopy, and perfusion) and metabolic imaging, such as Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) or amino acid PET (usually employing methionine), may be useful in distinguishing these different entities and monitoring the disease course...
2018: BioMed Research International
Kathryn Bower, Nilay Shah
With primary central nervous system lymphoma (PCNSL) being a rare disease, the subtype of Burkitt lymphoma (BL) presenting as a sole CNS lesion is an even more exceptional diagnosis. A case of coexistent primary CNS Burkitt lymphoma (PCNSBL) with cerebral palsy (CP) is presented. A 55-year-old Caucasian male presented with increasing bilateral lower extremity weakness above his baseline in addition to signs of increased intracranial pressure. Four abnormal enhancing masses were detected on MRI with biopsy results consistent with Burkitt lymphoma...
2018: Case Reports in Oncological Medicine
Prakash Ambady, Laszlo Szidonya, Jenny Firkins, Jessica James, Kirsten Johansson, Tricia White, Caroline Jezierski, Nancy D Doolittle, Edward A Neuwelt
No abstract text is available yet for this article.
July 22, 2018: Leukemia & Lymphoma
Anna Brandt, Jakob Matschke, Wilfried Fehrle, Lisa von Wenserski, Carsten Bokemeyer, Gerald Illerhaus, Mascha Binder
Clonal bone marrow (BM) B-cell populations are a common finding in patients with suspected primary central nervous system lymphoma (PCNSL). To assess their clinical significance, benign monoclonal B-cell lymphocytosis (MBL) needs to be differentiated from concomitant BM involvement, since patients with secondary central nervous system lymphoma (SCNSL) generally require more intensive treatment directed also at the component outside the central nervous system (CNS). Here, we retrospectively analyzed BM samplings in 51 patients with suspected PCNSL...
July 22, 2018: Leukemia & Lymphoma
Julia Paik, Sohita Dhillon
Alectinib (Alecensa® ) is a potent and highly selective anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitor. Oral alectinib monotherapy is approved in the EU as first-line treatment for adults with advanced ALK-positive non-small cell lung cancer (NSCLC) and for the treatment of adults with advanced ALK-positive NSCLC previously treated with crizotinib. In the USA, alectinib is indicated for the treatment of adults with ALK-positive metastatic NSCLC. The recommended dosage for alectinib in the EU and USA is 600 mg twice daily...
July 20, 2018: Drugs
B Lee, J E Park, A Bjørnerud, J H Kim, J Y Lee, H S Kim
BACKGROUND AND PURPOSE: A small subset of primary central nervous system lymphomas exhibits high cerebral blood volume, which is indistinguishable from that in glioblastoma on dynamic susceptibility contrast MR imaging. Our study aimed to test whether estimates of combined perfusion and vascular permeability metrics derived from DSC-MR imaging can improve the diagnostic performance in differentiating hypervascular primary central nervous system lymphoma from glioblastoma. MATERIALS AND METHODS: A total of 119 patients (with 30 primary central nervous system lymphomas and 89 glioblastomas) exhibited hypervascular foci using the reference method of leakage-corrected CBV (reference-normalized CBV)...
July 19, 2018: AJNR. American Journal of Neuroradiology
Friederike Erdmann, Tengfei Li, George Luta, Brenda M Giddings, Guillermo Torres Alvarado, Eva Steliarova-Foucher, Joachim Schüz, Ana M Mora
BACKGROUND: Estimating childhood cancer incidence globally is hampered by a lack of reliable data from low- and middle-income countries. Costa Rica is one of the few middle-income countries (MIC) with a long-term high quality nationwide population-based cancer registry. METHODS: Data on incident cancers in children aged under 15 years reported to the Costa Rica National Cancer Registry between 2000 and 2014 were analyzed by diagnostic group, age, sex, and geographical region and compared with incidence data for Hispanic and Non-Hispanic White (NHW) children in California, USA...
July 16, 2018: Cancer Epidemiology
Sai-Hong Ignatius Ou, Mark A Socinski, Shirish Gadgeel, Leena Gandhi, Howard West, Alberto Alejandro Chiappori, Victor Cohen, Gregory J Riely, Vlatka Smoljanovic, Walter Bordogna, Elaine Wright, Kendra Debusk, Ali Zeaiter, Alice T Shaw
Background: In a phase II North American study (NP28761; NCT01871805), the anaplastic lymphoma kinase (ALK) inhibitor alectinib demonstrated both systemic and central nervous system (CNS) efficacy with good tolerability in patients with ALK -positive non-small cell lung cancer. We describe patient-reported outcomes (PROs) from the NP28761 study. Patients and methods: PROs and health-related quality of life (HRQoL) benefits were assessed using two self-administered questionnaires (the European Organisation for Research and Treatment of Cancer 30-Item Quality of Life Questionnaire-Core (EORTC QLQ-C30), and the 13-item EORTC QLQ-lung cancer-specific module) at enrolment and every 6 weeks until week 66, disease progression or death...
2018: ESMO Open
Florian Gessler, Joshua D Bernstock, Bedjan Behmanesh, Uta Brunnberg, Patrick Harter, Daniel Ye, Gregory K Friedman, Martin-Leo Hansmann, Marlies Wagner, Volker Seifert, Lutz Weise, Gerhard Marquardt
BACKGROUND: The optimal timing of corticosteroid (CS) treatment in patients with primary central nervous system (CNS) lymphoma (PCNSL) remains controversial. While poor clinical presentation may justify early treatment with CS, this may ultimately result in reduced concentrations of chemotherapeutic agents via perturbations in the permeability of the blood-brain barrier. OBJECTIVE: To investigate whether early CS exposure is associated with beneficial outcomes and/or reduced occurrence of adverse events as opposed to delayed/concomitant administration...
July 17, 2018: Neurosurgery
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