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Follicular lymphoma elderly

Mitsuhiro Akiyama, Tsutomu Takeuchi
IgG4-related disease is a heterogeneous immune-mediated fibroinflammatory condition that can affect every single organ. This disease is more prevalent in the elderly (the mean age of patients is above 60 years) and the prevalence rate is estimated to be over 4.6 per 100,000 population. Before making a diagnosis, the exclusion of malignancies, lymphoma, anti-neutrophil cytoplasmic antibody-associated vasculitis, multicentric Castleman disease, and other mimickers is crucial for appropriate treatment. Broad management guidelines have been published emphasizing the need for prompt treatment and the use of glucocorticoids as first-line drug therapy for induction of remission...
March 15, 2018: Drugs & Aging
C Buske, M Hutchings, M Ladetto, V Goede, U Mey, P Soubeyran, M Spina, R Stauder, M Trnený, U Wedding, P Fields
The European Society for Medical Oncology (ESMO) consensus conference on mature B cell lymphomas and chronic lymphocytic leukaemia (CLL) was held on 20 June 2015 in Lugano, Switzerland, and included a multidisciplinary panel of 25 leading experts. The aim of the conference was to develop recommendations on critical subjects difficult to consider in detail in the ESMO Clinical Practice Guidelines. The following areas were identified: (1) the elderly patient, (2) prognostic factors suitable for clinical use, and (3) the 'ultra-high-risk' group...
November 29, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Fatima Zahra Jelloul, Qiang Hua Chen, Tianyu Yang, Nina Haghi, Judith Brody, Xinmin Zhang, Silvat Sheikh-Fayyaz
BACKGROUND: Composite small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) and follicular lymphoma (FL) is extremely rare, and only 13 cases have been reported previously. METHODS: We identified 6 cases of composite SLL/CLL and FL in our database and studied their clinical, histologic, immunophenotypic, and cytogenetic features. A literature review of the existing cases was also conducted. RESULTS: The patients included 4 males and 2 females, with a median age of 72 years...
October 1, 2017: International Journal of Surgical Pathology
Jun-Ichi Tamaru
The 2016 revision of the World Health Organization (WHO) classification of lymphoid neoplasms have been published in "Blood" as a review form. A major revision is being published that will be an update of the current fourth edition and not a truly new fifth edition. Because it is considered a part of the fourth edition, while some provisional entities will be promoted to definite entities and a small number of new provisional entities added, there will be no new definite entities. As with the 2001 and 2008 classifications, an all-important Clinical Advisory Committee meeting was held to obtain the advice and consent of clinical hematologists/oncologists and other physicians critical to the revision...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Ulrike Paul, Julia Richter, Christiane Stuhlmann-Laiesz, Markus Kreuz, Inga Nagel, Heike Horn, Annette M Staiger, Sietse M Aukema, Michael Hummel, German Ott, Rainer Spang, Andreas Rosenwald, Alfred C Feller, Sergio Cogliatti, Harald Stein, Martin-Leo Hansmann, Peter Moller, Monika Szczepanowski, Birgit Burkhardt, Michael Pfreundschuh, Norbert Schmitz, Markus Loeffler, Lorenz Trümper, Reiner Siebert, Wolfram Klapper
The incidence of diffuse large B-cell lymphoma (DLBCL) increases with age being patient age at diagnosis an adverse prognostic factor. However, elderly patients are often underrepresented in common studies. To investigate the effect between age and biological characteristics in DLBCL, we analyzed data of 1534 patients encompassing all adult age groups, enriched for the age ≥75 years. Follicular lymphoma (FL) grade 3B with histopathological characteristics of DLBCLs were included. Gender, centroblastic cytology, FL grade 3B morphology, CD10 expression, and ABC/non-GCB-subtype were significantly associated with age after correction for multiple testing and after adjusting for cohorts...
May 2018: Leukemia & Lymphoma
Iris de Weerdt, Suzanne M Koopmans, Arnon P Kater, Michel van Gelder
The use of novel B-cell receptor signaling inhibitors results in high response rates and long progression-free survival in patients with indolent B-cell malignancies, such as chronic lymphocytic leukemia, follicular lymphoma, mantle cell lymphoma and Waldenström macroglobulinemia. Ibrutinib, the first-in-class inhibitor of Bruton tyrosine kinase, and idelalisib, the first-in-class inhibitor of phosphatidylinositol 3-kinase δ , have recently been approved for the treatment of several indolent B-cell malignancies...
October 2017: Haematologica
Joanna Mangana, Emmanuella Guenova, Katrin Kerl, Mirjana Urosevic-Maiwald, Valerie C Amann, Cornelia Bayard, Reinhard Dummer, Lars E French
Angioimmunoblastic T-cell lymphoma (AITCL) is a rare, aggressive lymphoma which derives from follicular helper T cells, commonly affecting the elderly population. It accounts for 2% of all non-Hodgkin lymphomas, with a reported 5-year overall survival rate of less than 30%. Very often, the clinical picture of AITCL encompasses systemic symptoms such as generalized lymphadenopathy, hepatosplenomegaly, skin rash, anemia, and polyclonal hypergammaglobulinemia. Here we report on the case of a female patient who presented with clinical features resembling drug reaction with eosinophilia and systemic symptoms (DRESS syndrome) prior to the definitive diagnosis of AITCL...
January 2017: Case Reports in Dermatology
Alessandro Broccoli, Pier Luigi Zinzani
Angioimmunoblastic T-cell lymphoma is a follicular T-helper-derived neoplasm displaying a peculiar morphologic appearance and biological complexity. New mutations have been described that contribute to elucidating the underlying pathogenetic events. The disease behaves aggressively and typically affects elderly patients. The outcomes reported with anthracycline-containing regimens are poor; therefore autologous transplantation in first remission should be offered whenever possible. Newer approaches are urgently needed for relapsed and refractory patients...
April 2017: Hematology/oncology Clinics of North America
Jean-Baptiste Gibier, Brigitte Bouchindhomme, Romain Dubois, Benedicte Hivert, Nathalie Grardel, Marie-Christine Copin
Age-related EBV-associated lymphoproliferative disorders form a new clinicopathological group. Until recently, this group was associated with diffuse large B-cell lymphoma (DLBCL), characterised by an aggressive clinical presentation and a poor prognosis. Recent findings in Western Caucasian patients, however, suggest that this entity covers a wide spectrum of diseases, ranging from reactive follicular hyperplasia (HR) to DLBCL. We report the case of an 85-year-old Caucasian man showing lymphadenopathy and numerous hypodense lesions of the liver...
March 2017: Pathology, Research and Practice
Daniel Benharroch, Miriam Zekzer, Karen Nalbandyan
An elderly woman presented with generalized lymphadenopathy, several systemic symptoms, and splenomegaly. An inguinal lymph node excision revealed a compound picture. One aspect of the lymph node morphology, including cells with follicular T-helper cell phenotype, was most consistent with angioimmunoblastic T-cell lymphoma. The other component, revealing spindle cells forming whorls with immunostaining for CD21, CD23, and fascin, might be an integral part of this T-cell lymphoma. However, due to the often massive involvement of the nodal tissue by these follicular dendritic cells, these areas were questionably suggestive of involvement by follicular dendritic cell sarcoma...
2017: Case Reports in Hematology
Giuseppina Ricciuti, Erica Finolezzi, Stefania Luciani, Elena Ranucci, Massimo Federico, Marta Di Nicola, Isaia Antonio Luca Zecca, Francesco Angrilli
The incidence of non-Hodgkin lymphoma in patients 80 years of age or older is 50 times higher than in 20- to 24-year-olds. Very elderly patients are often not treated with standard immunochemotherapy because of poor performance status, comorbidities, and toxicity concerns. We retrospectively analyzed data for 29 patients diagnosed with diffuse large B-cell lymphoma or grade 3B follicular lymphoma and treated with rituximab in combination with nonpegylated liposomal doxorubicin between January 2010 and August 2015...
February 3, 2017: Hematological Oncology
Ahmed E Eladl, Akira Satou, Ahmed Ali Elsayed, Yuka Suzuki, Seiichi Kato, Naoko Asano, Shigeo Nakamura
The presence of Hodgkin and Reed-Sternberg (HRS)-like B-cells in peripheral T-cell lymphoma (PTCL) is rare and its clinicopathological features still remain unclear. Here, we describe 30 cases of PTCL with HRS-like B-cells from Japan. Twenty-three cases (77%) presented evidence of follicular T-helper phenotype (TFH) derivation: 12 were angioimmunoblastic T-cell lymphoma and 11 PTCL with TFH phenotype (PTCL-TFH). The remaining seven cases were diagnosed as PTCL, not otherwise specified (PTCL-NOS). Epstein-Barr virus (EBV) reactivation was detected in 25 cases (83%), but HRS-like B-cells were EBER in only 20 cases (67%)...
April 2017: American Journal of Surgical Pathology
Alessia Castellino, Elisa Santambrogio, Maura Nicolosi, Barbara Botto, Carola Boccomini, Umberto Vitolo
Follicular lymphoma (FL) is the most common indolent non-Hodgkin lymphoma, which typically affects mature adults and elderly, whose median age at diagnosis is 65 years. The natural history of FL appears to have been favorably impacted by the introduction of Rituximab. Randomized clinical trials demonstrated that the addition of rituximab to standard chemotherapy induction has improved the overall survival and new strategies of chemo-immunotherapy, such as Bendamustine combined with Rituximab, showed optimal results on response and reduced hematological toxicity, becoming one of the standard treatments, particularly in elderly patients...
2017: Mediterranean Journal of Hematology and Infectious Diseases
Michael P Chu, Jessica Lieffers, Sunita Ghosh, Andrew Belch, Neil S Chua, Amelie Fontaine, Randeep Sangha, Robert A Turner, Vickie E Baracos, Michael B Sawyer
BACKGROUND: While much cancer research focuses on tumours and their microenvironment, malignancies cause widespread physiologic changes. Cancer and treatment-related sarcopenia, measured with quantitative imaging or as a decrease in overall body mass, are indicative of poor prognosis in elderly diffuse large B-cell lymphoma (DLBCL) patients, skeletal muscle radiodensity (SMD) may be a better prognostic marker. SMD, a measure of muscle radiation attenuation on CT imaging, is more prognostic than sarcopenia or International Prognostic Index (IPI) scores in follicular lymphoma and multiple solid organ malignancies...
April 2017: Journal of Cachexia, Sarcopenia and Muscle
Mary Theresa Sylvia, Biswajit Dey, Debdatta Basu, Sajini Elizabeth Jacob, Rakhee Kar, Biswajit Dubashi
INTRODUCTION: Follicular lymphoma (FL) is an indolent lymphoproliferative disorder of B-cells with variable clinical behavior. It is the second most common subtype of Non-Hodgkin lymphoma in western countries but reported to have a lower incidence in Asia. MATERIALS AND METHODS: Cases of FL diagnosed in the Department of Pathology of our Institute from January 2009 to June 2015 were included in the study. The clinicopathological parameters including staging, histological details, and immunohistochemical markers CD20, CD10 and BCL-2 were recorded in all the cases...
2016: Mediterranean Journal of Hematology and Infectious Diseases
Ashish Rai, Loretta J Nastoupil, Jessica N Williams, Joseph Lipscomb, Kevin C Ward, David H Howard, Daniel Lee, Christopher R Flowers
The role of positron emission tomography (PET) in the initial assessment of follicular lymphoma (FL) has been a topic of debate. We examined the patterns of utilization of PET staging in FL and assessed the association of PET with survival. Using the SEER-Medicare database, we identified 5712 patients diagnosed with first primary FL between 2000 and 2009. Older age, African-American race, poor performance status, B-symptoms and history of anemia were negatively associated with PET staging. Receipt of PET staging was positively associated with treatment at institutions affiliated with research networks and with residence in areas with higher concentrations of nuclear medicine specialists...
July 2017: Leukemia & Lymphoma
C Demoor-Goldschmidt, P Agape, I Barillot, M A Mahé
Treatment with monoclonal antibodies, especially rituximab, is more and more frequent and questions the interest of radiotherapy in limited stages of diffuse B-cell large cell and follicular non-Hodgkin's lymphomas. From a review of literature, it appears that radiotherapy is of interest in bulky disease, patients with incomplete metabolic response, elderly patients receiving short chemotherapy and those with recurrence after exclusive chemotherapy. Finally, this article gives recommendations on available techniques of radiotherapy and doses to be delivered...
October 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Frank Verhoeven, Xavier Guillot, Mickaël Chouk, Clément Prati, Daniel Wendling
Introduction. Polymyalgia rheumatica (PMR) is one of the most common inflammatory rheumatism types in elderly population. The link between cancer and PMR is a matter of debate. Methods. We report two cases of PMR leading to the diagnosis of lymphoma and the growing interest of PET-TDM in this indication. Results. A 84-year-old man known for idiopathic neutropenia presented an inflammatory arthromyalgia of the limb girdle since one month. Blood exams highlighted the presence of a monoclonal B cell clone. Bone marrow concluded to a B cell lymphoma of the marginal zone...
2016: Case Reports in Rheumatology
Roberto Castelli, Antonio Gidaro, Giorgio Lambertenghi Deliliers
BACKGROUND: Splenic marginal zone lymphoma (SMZL) is a chronic B-cell lymphoproliferative disorder, comprising less than 2% of non-Hodgkin's lymphomas, and affecting mainly middle-aged and elderly patients with a median survival of >10 years. The typical clinical features of SMZL include splenomegaly. Treatment should be patient-tailored and can range from a 'watchful waiting' approach for asymptomatic patients without cytopenias to surgery, localized radiation therapy or immuno/chemotherapies...
2016: Mediterranean Journal of Hematology and Infectious Diseases
Alice Johl, Eva Lengfelder, Wolfgang Hiddemann, Wolfram Klapper
Current guidelines of the European Society of Medical Oncology recommend surgical excision biopsies of lymph nodes for the diagnosis of lymphoma whenever possible. However, core needle biopsies are increasingly used. We aimed to understand the common practice to choose the method of biopsy in Germany. Furthermore, we wanted to understand performance of surgical excision and core needle biopsies of lymph nodes in the diagnosis of lymphoma. The files of 1510 unselected, consecutive lymph node specimens from a consultation center for lymphoma diagnosis were analyzed...
August 2016: Annals of Hematology
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