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Klyuchnikov E, Bacher U, Ahn KW, Carreras J, Kröger NM, Hari PN, Ku GH, Ayala E, Chen AI, Chen YB, Cohen JB, Freytes CO, Gale RP, Kamble RT, Kharfan-Dabaja MA, Lazarus HM, Martino R, Mussetti A, Savani BN, Schouten HC, Usmani SZ, Wiernik PH, Wirk B, Smith SM, Sureda A, Hamadani M. Long-term survival outcomes of reduced-intensity allogeneic or autologous transplantation in relapsed grade 3 follicular lymphoma. Bone Marrow Transplant 2016; 51:58-66. [PMID: 26437062 PMCID: PMC4703480 DOI: 10.1038/bmt.2015.223] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 07/29/2015] [Accepted: 08/15/2015] [Indexed: 01/04/2023]
Abstract
Grade 3 follicular lymphoma (FL) has aggressive clinical behavior. To evaluate the optimal first transplantation approach in relapsed/refractory grade 3 FL patients, we compared the long-term outcomes after allogeneic (allo-) vs autologous hematopoietic cell transplantation (auto-HCT) in the rituximab era. A total of 197 patients undergoing first reduced-intensity conditioning (RIC) allo-HCT or first auto-HCT during 2000-2012 were included. Rituximab-naive patients were excluded. Allo-HCT recipients were younger, more heavily pretreated and had a longer interval between diagnosis and HCT. The 5-year probabilities of non-relapse mortality (NRM), relapse/progression, PFS and overall survival (OS) for auto-HCT vs allo-HCT groups were 4% vs 27% (P<0.001), 61% vs 20% (P<0.001), 36% vs 51% (P=0.07) and 59% vs 54% (P=0.7), respectively. On multivariate analysis, auto-HCT was associated with reduced risk of NRM (relative risk (RR)=0.20; P=0.001). Within the first 11 months post HCT, auto- and allo-HCT had similar risks of relapse/progression and PFS. Beyond 11 months, auto-HCT was associated with higher risk of relapse/progression (RR=21.3; P=0.003) and inferior PFS (RR=3.2; P=0.005). In the first 24 months post HCT, auto-HCT was associated with improved OS (RR=0.42; P=0.005), but in long-time survivors (beyond 24 months) it was associated with inferior OS (RR=3.6; P=0.04). RIC allo-HCT as the first transplant approach can provide improved PFS and OS, in long-term survivors.
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Affiliation(s)
- Evgeny Klyuchnikov
- Department for Stem Cell Transplantation, University Cancer Center Hamburg, Hamburg, Germany
| | - Ulrike Bacher
- Department for Hematology/Oncology, Georg August University Göttingen, Göttingen, Germany
| | - Kwang Woo Ahn
- CIBMTR (Center for International Blood and Marrow Transplant Research) Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
- Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI
| | - Jeanette Carreras
- CIBMTR (Center for International Blood and Marrow Transplant Research) Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Nicolaus M. Kröger
- Department for Stem Cell Transplantation, University Cancer Center Hamburg, Hamburg, Germany
| | - Parameswaran N. Hari
- CIBMTR (Center for International Blood and Marrow Transplant Research) Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Grace H. Ku
- Division of Blood and Marrow Transplantation, Department of Medicine, University of California, San Diego, San Diego, CA
| | - Ernesto Ayala
- Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Andy I. Chen
- Oregon Health and Science University, Portland, OR
| | - Yi-Bin Chen
- Division of Hematology/Oncology, Massachusetts General Hospital, Boston, MA
| | - Jonathon B. Cohen
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA
| | - César O. Freytes
- South Texas Veterans Health Care System and University of Texas Health Science Center San Antonio, San Antonio, TX
| | - Robert Peter Gale
- Hematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College of London, London, United Kingdom
| | - Rammurti T. Kamble
- Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX
| | - Mohamed A. Kharfan-Dabaja
- Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Hillard M. Lazarus
- Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH
| | - Rodrigo Martino
- Division of Clinical Hematology, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - Alberto Mussetti
- S.C. Ematologia e Trapianto Midollo Osseo, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Università degli Studi di Milano, Milan, Italy
| | - Bipin N. Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Harry C. Schouten
- Department of Hematology, Academische Ziekenhuis, Maastricht, Netherlands
| | - Saad Z. Usmani
- Department of Hematology – Medical Oncology, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC
| | | | - Baldeep Wirk
- Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA
| | - Sonali M. Smith
- Section of Hematology/Oncology, The University of Chicago, Chicago, IL
| | - Anna Sureda
- Servei d'Hematologia, Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain
- Secretary, European Group for Blood and Marrow Transplantation
| | - Mehdi Hamadani
- CIBMTR (Center for International Blood and Marrow Transplant Research) Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
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Provencio Pulla M, Alfaro Lizaso J, de la Cruz Merino L, Gumá I Padró J, Quero Blanco C, Gómez Codina J, Llanos Muñoz M, Martinez Banaclocha N, Rodriguez Abreu D, Rueda Domínguez A. SEOM clinical guidelines for the treatment of follicular non-Hodgkin's lymphoma. Clin Transl Oncol 2015; 17:1014-9. [PMID: 26586117 PMCID: PMC4689757 DOI: 10.1007/s12094-015-1437-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 10/09/2015] [Indexed: 12/11/2022]
Abstract
Follicular non-Hodgkin's lymphoma (FL) is a nodal B lymphoid malignancy that originates from the germinal center of a lymph node. FL is the second most frequent lymphoma subtype. The course of the disease is usually characterised by a typically indolent clinical course, with a median survival rate of 8-10 years, although most patients relapse after treatment. Diagnosis should always be based on a surgical specimen like an excisional node lymph biopsy. The first-line treatment of FL will depend of extension disease, tumour burden, patient symptoms, performance status and also patient decision. The addition of rituximab to conventional chemotherapy has improved ORR, PFS and OS. As first line in patients that need treatment, a combination of chemotherapy with rituximab induction followed by 2 years of rituximab maintenance is the best option. High-dose chemotherapy with autologous stem-cell transplantation in first line has not shown improvement and is not recommended as first-line therapy. Before any treatment decision in relapsed patients, a repeat biopsy is mandatory to rule out a transformation into large cell aggressive lymphoma. Standard treatment is controversial, depends on the efficacy of prior treatment, duration of the time-to-relapse, patient's age and histological findings at relapse.
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Affiliation(s)
- M Provencio Pulla
- Servicio de Oncología Médica, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
| | - J Alfaro Lizaso
- Servicio de Oncología Médica, Instituto Oncológico de Guipúzcoa, San Sebastián, Spain
| | - L de la Cruz Merino
- Servicio de Oncología Médica, Complejo Hospitalario Regional Virgen Macarena, Sevilla, Spain
| | - J Gumá I Padró
- Servicio de Oncología Médica, Hospital Universitari de Sant Joan de Reus, Reus, Spain
| | - C Quero Blanco
- Servicio de Oncología Médica, Complejo Hospitalario Regional y Virgen de la Victoria, Málaga, Spain
| | - J Gómez Codina
- Servicio de Oncología Médica, Hospital Universitari i Politècnic la Fe, Valencia, Spain
| | - M Llanos Muñoz
- Servicio de Oncología Médica, Hospital Universitario de Canarias (H.U.C), San Cristóbal de La Laguna, Tenerife, Spain
| | - N Martinez Banaclocha
- Servicio de Oncología Médica, Hospital General Universitario de Elche y Vega Baja, Elche, Spain
| | - D Rodriguez Abreu
- Servicio de Oncología Médica, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canarias, Spain
| | - A Rueda Domínguez
- Área de Oncología y Hematología, Hospital Costa del Sol, Marbella, Spain
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Outcomes of Treatment in Slovene Follicular Lymphoma Patients. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2015; 15:586-91. [PMID: 26423702 DOI: 10.1016/j.clml.2015.07.631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 07/22/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND The outcome of follicular lymphoma (FL) patients has dramatically improved over the last 2 decades by introduction of rituximab in combination chemotherapy and into maintenance setting. We retrospectively analyzed the treatment outcomes in Slovene FL patients in the era of rituximab and compared them to the results reported by pivotal clinical studies. PATIENTS AND METHODS Two hundred seventy-eight patients with FL treated in Slovenia between 2000 and 2010 with a median follow-up of 5.7 years were included in our retrospective analysis. One hundred ninety-three (69%) received systemic treatment (ST). RESULTS With a median follow-up of 5.7 years, the 5- and 10-year overall survival (OS) rates for the whole series were 77% and 53%, respectively. The 5-year progression-free survival (PFS) for 193 FL patients treated with ST was 37%. Patients treated with rituximab chemotherapy had a significantly better OS than patients treated with chemotherapy alone, with a 5-year OS of 79% versus 53% (hazard ratio [HR], 0.39; 95% confidence interval [CI], 0.22-0.67; P = .001). Adding rituximab to the first-line chemotherapy significantly improved PFS compared to chemotherapy alone (HR, 0.26; 95% CI 0.18-0.36; P < .001). Maintenance rituximab after immunochemotherapy in first-line treatment reduced the risk for progression by 61% and significantly prolonged the time to progression (HR, 0.39; 95% CI 0.20-0.73; P < .003). CONCLUSION The outcomes in our routinely treated FL patients confirm the benefit of adding rituximab to chemotherapy and are comparable to the results of pivotal clinical studies. The outcome of our FL patients was improved in terms of both PFS and OS.
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Jensen P, Bendtsen MD, Johnsen HE, Bøgsted M, El-Galaly TC. To maintain or not, that is the question. Br J Haematol 2015; 174:321-2. [PMID: 26403171 DOI: 10.1111/bjh.13761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Paw Jensen
- Department of Haematology, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Mette D Bendtsen
- Department of Haematology, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Hans E Johnsen
- Department of Haematology, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Martin Bøgsted
- Department of Haematology, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Tarec C El-Galaly
- Department of Haematology, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark. .,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
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Messori A, Fadda V, Maratea D, Trippoli S. Comparative effectiveness of treatments for newly diagnosed follicular non-Hodgkin lymphoma. Leuk Lymphoma 2015; 56:2728-30. [DOI: 10.3109/10428194.2015.1006219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Police RL, Trask PC, Wang J, Olivares R, Khan S, Abbe A, Colosia A, Njue A, Sherril B, Ruiz-Soto R, Kaye JA, Hamadani M. Randomized controlled trials in relapsed/refractory follicular lymphoma: a systematic review and meta-analysis. J Oncol Pharm Pract 2015; 22:666-78. [PMID: 26320127 DOI: 10.1177/1078155215603230] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This systematic literature review evaluated the clinical efficacy and safety of interventions used in relapsed/refractory follicular lymphoma. Primary efficacy outcomes were objective response rate, progression-free survival and overall survival. Safety endpoints were grade 3/4 toxicities, serious adverse events and withdrawals or deaths due to toxicity. Studies were selected if they were randomized controlled trials reporting on the efficacy or safety of treatments for relapsed or refractory follicular lymphoma, and if outcomes were reported separately from trials that included other lymphoid neoplasms. We used the Bucher method for conducting adjusted indirect comparisons within a meta-analysis. We identified 10 randomized controlled trials of treatments for relapsed/refractory follicular lymphoma. The most prominent drug investigated (alone or in combination) was rituximab. Most trials did not report median overall survival. Two trials reported median event-free survival (range, 1.2-23.2 months). Six of ten trials reported objective response rate (range, 9-93%). Meta-analysis showed only one statistically significant result: rituximab + bortezomib yielded a significantly higher objective response rate than rituximab monotherapy (relative risk, 1.28; 95% confidence interval, 1.11-1.47). Otherwise, there were no discernable differences in overall survival or progression-free survival, partly due to insufficient reporting of results in the clinical trials. The relatively small number of randomized controlled trials, few overlapping treatment arms, and variability in the randomized controlled trial features and in the endpoints studied complicate the formal comparison of therapies for relapsed/refractory follicular lymphoma. Additional well-designed randomized controlled trials are needed to fully understand the relative outcomes of older and more recently developed therapies.
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Affiliation(s)
| | | | | | | | | | | | - Ann Colosia
- Medical College of Wisconsin, Milawukee, USA
| | - Annete Njue
- Medical College of Wisconsin, Milawukee, USA
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Andrade-Campos MM, Montes-Limón AE, Soro-Alcubierre G, Lievano P, López-Gómez L, Baringo T, Giraldo P. Patients Older Than 65 Years With Non-Hodgkin Lymphoma Are Suitable for Treatment With 90Yttrium-Ibritumumab Tiuxetan: A Single-Institution Experience. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2015; 15:464-71. [DOI: 10.1016/j.clml.2015.02.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 02/26/2015] [Indexed: 11/30/2022]
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Vargo JA, Gill BS, Balasubramani GK, Beriwal S. What is the optimal management of early-stage low-grade follicular lymphoma in the modern era? Cancer 2015; 121:3325-34. [PMID: 26042364 DOI: 10.1002/cncr.29491] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 04/02/2015] [Accepted: 04/30/2015] [Indexed: 01/14/2023]
Abstract
BACKGROUND Despite international practice guidelines endorsing radiotherapy (RT) as the preferred initial therapy, treatment approaches vary for patients with early-stage follicular lymphoma. The authors engaged the National Cancer Data Base to analyze patterns of care and survival outcomes for patients with early-stage follicular lymphoma in the era of modern therapy. METHODS A National Cancer Data Base retrospective cohort study was conducted of 35,961 patients with lymph node and extranodal, American Joint Committee on Cancer stage I to II, WHO grade 1 to 2 follicular lymphoma who were diagnosed between 1998 and 2012. Univariate and multivariable analyses were performed to identify sociodemographic, treatment, and tumor characteristics that were predictive of overall survival (OS) and treatment use. Propensity score-adjusted Cox proportional hazards ratios for survival in patients treated for follicular lymphoma were used. RESULTS Of the 35,961 patients with follicular lymphoma included in the current study, 63% had stage I disease, 79% were without extranodal disease, and 61% were aged >60 years. RT use decreased from 37% in 1999 to 24% in 2012 (P<.0001), with corresponding significant increases in observation and single-agent chemotherapy. Patients who received RT had 5-year and 10-year OS rates of 86% and 68%, respectively, compared with 74% and 54%, respectively, for those who did not receive RT (P<.0001). On multivariable survival analysis, including a propensity score to account for potential uncaptured confounding variables due to a lack of randomization, upfront RT remained independently associated with improved OS (hazard ratio of death, 0.54; 95% confidence interval, 0.47-0.63 [P<.0001]). CONCLUSIONS RT is an increasingly underused treatment approach in the era of modern therapy for patients with early-stage follicular lymphoma. The use of RT appears to improve OS and should remain standard practice as encouraged by clinical practice guidelines.
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Affiliation(s)
- John A Vargo
- Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - Beant S Gill
- Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - Goundappa K Balasubramani
- Department of Epidemiology, Epidemiology Data Center, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Sushil Beriwal
- Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
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13-ICML Satellite symposia programs (updated on May 9, 2015). Hematol Oncol 2015. [DOI: 10.1002/hon.2231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Hwang JP, Somerfield MR, Alston-Johnson DE, Cryer DR, Feld JJ, Kramer BS, Sabichi AL, Wong SL, Artz AS. Hepatitis B Virus Screening for Patients With Cancer Before Therapy: American Society of Clinical Oncology Provisional Clinical Opinion Update. J Clin Oncol 2015; 33:2212-20. [PMID: 25964247 DOI: 10.1200/jco.2015.61.3745] [Citation(s) in RCA: 124] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
PURPOSE This updated provisional clinical opinion presents a revised opinion based on American Society of Clinical Oncology panel consensus in the context of an evolving database. CONTEXT Despite the 2010 provisional clinical opinion recommendation, there is still evidence of suboptimal hepatitis B virus (HBV) screening among patients at high risk for HBV infection or HBV reactivation after chemotherapy. This updated provisional clinical opinion introduces a risk-adaptive strategy to identify and treat patients with HBV infection to reduce their risk of HBV reactivation. PROVISIONAL CLINICAL OPINION Medical providers should screen by testing patients for HBV infection before starting anti-CD20 therapy or hematopoietic cell transplantation. Providers should also screen patients with risk factors for HBV infection. Screening should include both hepatitis B surface antigen (HBsAg) and hepatitis B core antibody (anti-HBc), because reactivation can occur in patients who are HBsAg positive/anti-HBc positive or HBsAg negative/anti-HBc positive. Either total anti-HBc or anti-HBc immunoglobulin G (not immunoglobulin M) test should be used. Clinicians should start antiviral therapy for HBsAg-positive/anti-HBc-positive patients before or contemporaneously with cancer therapy and monitor HBsAg-negative/anti-HBc-positive patients for reactivation with HBV DNA and ALT levels, promptly starting antivirals if reactivation occurs. Clinicians can initiate antivirals for HBsAg-negative/anti-HBc-positive patients anticipating cancer therapies associated with a high risk of reactivation, or they can monitor HBV DNA and ALT levels and initiate on-demand antivirals. For patients who neither have HBV risk factors nor anticipate cancer therapy associated with a high risk of reactivation, current evidence does not support HBV screening before initiation of cancer therapy. Two panel members provided a minority viewpoint, involving a strategy of universal HBsAg and selective anti-HBc testing.
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Affiliation(s)
- Jessica P Hwang
- Jessica P. Hwang, University of Texas MD Anderson Cancer Center; Anita L. Sabichi, Baylor College of Medicine, Houston, TX; Mark R. Somerfield, American Society of Clinical Oncology, Alexandria, VA; Devena E. Alston-Johnson, Upstate Oncology Associates, Greenville, SC; Donna R. Cryer, Global Liver Institute, Washington, DC; Jordan J. Feld, Toronto Western Hospital Liver Centre, Toronto, Ontario, Canada; Barnett S. Kramer, National Cancer Institute, Bethesda, MD; Sandra L. Wong, University of Michigan, Ann Arbor, MI; and Andrew S. Artz, University of Chicago, Chicago, IL
| | - Mark R Somerfield
- Jessica P. Hwang, University of Texas MD Anderson Cancer Center; Anita L. Sabichi, Baylor College of Medicine, Houston, TX; Mark R. Somerfield, American Society of Clinical Oncology, Alexandria, VA; Devena E. Alston-Johnson, Upstate Oncology Associates, Greenville, SC; Donna R. Cryer, Global Liver Institute, Washington, DC; Jordan J. Feld, Toronto Western Hospital Liver Centre, Toronto, Ontario, Canada; Barnett S. Kramer, National Cancer Institute, Bethesda, MD; Sandra L. Wong, University of Michigan, Ann Arbor, MI; and Andrew S. Artz, University of Chicago, Chicago, IL
| | - Devena E Alston-Johnson
- Jessica P. Hwang, University of Texas MD Anderson Cancer Center; Anita L. Sabichi, Baylor College of Medicine, Houston, TX; Mark R. Somerfield, American Society of Clinical Oncology, Alexandria, VA; Devena E. Alston-Johnson, Upstate Oncology Associates, Greenville, SC; Donna R. Cryer, Global Liver Institute, Washington, DC; Jordan J. Feld, Toronto Western Hospital Liver Centre, Toronto, Ontario, Canada; Barnett S. Kramer, National Cancer Institute, Bethesda, MD; Sandra L. Wong, University of Michigan, Ann Arbor, MI; and Andrew S. Artz, University of Chicago, Chicago, IL
| | - Donna R Cryer
- Jessica P. Hwang, University of Texas MD Anderson Cancer Center; Anita L. Sabichi, Baylor College of Medicine, Houston, TX; Mark R. Somerfield, American Society of Clinical Oncology, Alexandria, VA; Devena E. Alston-Johnson, Upstate Oncology Associates, Greenville, SC; Donna R. Cryer, Global Liver Institute, Washington, DC; Jordan J. Feld, Toronto Western Hospital Liver Centre, Toronto, Ontario, Canada; Barnett S. Kramer, National Cancer Institute, Bethesda, MD; Sandra L. Wong, University of Michigan, Ann Arbor, MI; and Andrew S. Artz, University of Chicago, Chicago, IL
| | - Jordan J Feld
- Jessica P. Hwang, University of Texas MD Anderson Cancer Center; Anita L. Sabichi, Baylor College of Medicine, Houston, TX; Mark R. Somerfield, American Society of Clinical Oncology, Alexandria, VA; Devena E. Alston-Johnson, Upstate Oncology Associates, Greenville, SC; Donna R. Cryer, Global Liver Institute, Washington, DC; Jordan J. Feld, Toronto Western Hospital Liver Centre, Toronto, Ontario, Canada; Barnett S. Kramer, National Cancer Institute, Bethesda, MD; Sandra L. Wong, University of Michigan, Ann Arbor, MI; and Andrew S. Artz, University of Chicago, Chicago, IL
| | - Barnett S Kramer
- Jessica P. Hwang, University of Texas MD Anderson Cancer Center; Anita L. Sabichi, Baylor College of Medicine, Houston, TX; Mark R. Somerfield, American Society of Clinical Oncology, Alexandria, VA; Devena E. Alston-Johnson, Upstate Oncology Associates, Greenville, SC; Donna R. Cryer, Global Liver Institute, Washington, DC; Jordan J. Feld, Toronto Western Hospital Liver Centre, Toronto, Ontario, Canada; Barnett S. Kramer, National Cancer Institute, Bethesda, MD; Sandra L. Wong, University of Michigan, Ann Arbor, MI; and Andrew S. Artz, University of Chicago, Chicago, IL
| | - Anita L Sabichi
- Jessica P. Hwang, University of Texas MD Anderson Cancer Center; Anita L. Sabichi, Baylor College of Medicine, Houston, TX; Mark R. Somerfield, American Society of Clinical Oncology, Alexandria, VA; Devena E. Alston-Johnson, Upstate Oncology Associates, Greenville, SC; Donna R. Cryer, Global Liver Institute, Washington, DC; Jordan J. Feld, Toronto Western Hospital Liver Centre, Toronto, Ontario, Canada; Barnett S. Kramer, National Cancer Institute, Bethesda, MD; Sandra L. Wong, University of Michigan, Ann Arbor, MI; and Andrew S. Artz, University of Chicago, Chicago, IL
| | - Sandra L Wong
- Jessica P. Hwang, University of Texas MD Anderson Cancer Center; Anita L. Sabichi, Baylor College of Medicine, Houston, TX; Mark R. Somerfield, American Society of Clinical Oncology, Alexandria, VA; Devena E. Alston-Johnson, Upstate Oncology Associates, Greenville, SC; Donna R. Cryer, Global Liver Institute, Washington, DC; Jordan J. Feld, Toronto Western Hospital Liver Centre, Toronto, Ontario, Canada; Barnett S. Kramer, National Cancer Institute, Bethesda, MD; Sandra L. Wong, University of Michigan, Ann Arbor, MI; and Andrew S. Artz, University of Chicago, Chicago, IL
| | - Andrew S Artz
- Jessica P. Hwang, University of Texas MD Anderson Cancer Center; Anita L. Sabichi, Baylor College of Medicine, Houston, TX; Mark R. Somerfield, American Society of Clinical Oncology, Alexandria, VA; Devena E. Alston-Johnson, Upstate Oncology Associates, Greenville, SC; Donna R. Cryer, Global Liver Institute, Washington, DC; Jordan J. Feld, Toronto Western Hospital Liver Centre, Toronto, Ontario, Canada; Barnett S. Kramer, National Cancer Institute, Bethesda, MD; Sandra L. Wong, University of Michigan, Ann Arbor, MI; and Andrew S. Artz, University of Chicago, Chicago, IL
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El-Galaly TC, Hutchings M. Imaging of non-Hodgkin lymphomas: diagnosis and response-adapted strategies. Cancer Treat Res 2015; 165:125-46. [PMID: 25655608 DOI: 10.1007/978-3-319-13150-4_5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Optimal lymphoma management requires accurate pretreatment staging and reliable assessment of response, both during and after therapy. Positron emission tomography with computerized tomography (PET/CT) combines functional and anatomical imaging and provides the most sensitive and accurate methods for lymphoma imaging. New guidelines for lymphoma imaging and recently revised criteria for lymphoma staging and response assessment recommend PET/CT staging, treatment monitoring, and response evaluation in all FDG-avid lymphomas, while CT remains the method of choice for non-FDG-avid histologies. Since interim PET imaging has high prognostic value in lymphoma, a number of trials investigate PET-based, response-adapted therapy for non-Hodgkin lymphomas (NHL). PET response is the main determinant of response according to the new response criteria, but PET/CT has little or no role in routine surveillance imaging, the value which is itself questionable. This review presents from a clinical point of view the evidence for the use of imaging and primarily PET/CT in NHL before, during, and after therapy. The reader is given an overview of the current PET-based interventional NHL trials and an insight into possible future developments in the field, including new PET tracers.
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Smith A, Crouch S, Lax S, Li J, Painter D, Howell D, Patmore R, Jack A, Roman E. Lymphoma incidence, survival and prevalence 2004-2014: sub-type analyses from the UK's Haematological Malignancy Research Network. Br J Cancer 2015; 112:1575-84. [PMID: 25867256 PMCID: PMC4453686 DOI: 10.1038/bjc.2015.94] [Citation(s) in RCA: 275] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 02/06/2015] [Accepted: 02/15/2015] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Population-based information about cancer occurrence and survival are required to inform clinical practice and research; but for most lymphomas data are lacking. METHODS Set within a socio-demographically representative UK population of nearly 4 million, lymphoma data (N=5796) are from an established patient cohort. RESULTS Incidence, survival (overall and relative) and prevalence estimates for >20 subtypes are presented. With few exceptions, males tended to be diagnosed at younger ages and have significantly (P<0.05) higher incidence rates. Differences were greatest at younger ages: the <15 year male/female rate ratio for all subtypes combined being 2.2 (95% CI 1.3-3.4). These gender differences impacted on prevalence; most subtype estimates being significantly (P<0.05) higher in males than females. Outcome varied widely by subtype; survival of patients with nodular lymphocyte predominant Hodgkin lymphoma approached that of the general population, whereas less than a third of those with other B-cell (e.g., mantle cell) or T-cell (e.g., peripheral-T) lymphomas survived for ≥5 years. No males/female survival differences were detected. CONCLUSIONS Major strengths of our study include completeness of ascertainment, world-class diagnostics and generalisability. The marked variations demonstrated confirm the requirement for 'real-world' data to inform aetiological hypotheses, health-care planning and the future monitoring of therapeutic changes.
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Affiliation(s)
- A Smith
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - S Crouch
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - S Lax
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - J Li
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - D Painter
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - D Howell
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - R Patmore
- Queens Centre for Oncology, Castle Hill Hospital, Hull HU16 5JQ, UK
| | - A Jack
- St James's Institute of Oncology, Leeds Teaching Hospitals NHS Trust, Leeds LS9 7TF, UK
| | - E Roman
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, YO10 5DD, UK
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63
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Arcaini L. Dulanermin in indolent lymphomas: an ineffective approach. LANCET HAEMATOLOGY 2015; 2:e136-7. [PMID: 26687955 DOI: 10.1016/s2352-3026(15)00044-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 03/04/2015] [Indexed: 11/25/2022]
Affiliation(s)
- Luca Arcaini
- Department of Hematology Oncology, Fondazione IRCCS Policlinico San Matteo and Department of Molecular Medicine, University of Pavia, Pavia, Italy.
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64
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Cencini E, Fabbri A, Schiattone L, Bartalucci G, Bocchia M. Radiotherapy with rituximab as first-line treatment for early-stage follicular lymphoma. Leuk Lymphoma 2015; 56:2997-8. [PMID: 25721753 DOI: 10.3109/10428194.2015.1022768] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Emanuele Cencini
- a Unit of Hematology, University Hospital of Siena , Siena , Italy.,b University of Siena , Siena , Italy
| | - Alberto Fabbri
- a Unit of Hematology, University Hospital of Siena , Siena , Italy
| | - Luana Schiattone
- a Unit of Hematology, University Hospital of Siena , Siena , Italy
| | | | - Monica Bocchia
- a Unit of Hematology, University Hospital of Siena , Siena , Italy.,b University of Siena , Siena , Italy
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