1
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Minimal Disease Monitoring in Pediatric Non-Hodgkin's Lymphoma: Current Clinical Application and Future Challenges. Cancers (Basel) 2021; 13:cancers13081907. [PMID: 33921029 PMCID: PMC8071445 DOI: 10.3390/cancers13081907] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/07/2021] [Accepted: 04/11/2021] [Indexed: 12/13/2022] Open
Abstract
Minimal residual disease (MRD) detection is established routine practice for treatment stratification in leukemia and used for treatment optimization in adult lymphomas. Minimal disease studies in childhood non-Hodgkin lymphomas are challenged by stratified treatment in different subtypes, high cure rates, low patient numbers, limited initial tumor material, and early progression. Current clinical applications differ between the subtypes. A prognostic value of minimal disseminated disease (MDD) could not yet be clearly established for lymphoblastic lymphoma using flow cytometry and PCR-based methods for T-cell receptor (TCR) or immunoglobulin (IG) rearrangements. MYC-IGH fusion sequences or IG rearrangements enable minimal disease detection in Burkitt lymphoma and -leukemia. An additional prognostic value of MDD in Burkitt lymphoma and early MRD in Burkitt leukemia is implicated by single studies with risk-adapted therapy. MDD and MRD determined by PCR for ALK-fusion transcripts are independent prognostic parameters for patients with ALK-positive anaplastic large cell lymphoma (ALCL). They are introduced in routine clinical practice and used for patient stratification in clinical studies. Early MRD might serve as an endpoint for clinical trials and for guiding individual therapy. Validation of MDD and MRD as prognostic parameters is required for all subtypes but ALCL. Next-generation sequencing-based methods may provide new options and applications for minimal disease evaluation in childhood lymphomas.
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2
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Allogeneic hematopoietic stem cell transplant for relapsed and refractory non-Hodgkin lymphoma in pediatric patients. Blood Adv 2020; 3:2689-2695. [PMID: 31511228 DOI: 10.1182/bloodadvances.2018026203] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 04/25/2019] [Indexed: 11/20/2022] Open
Abstract
Allogeneic hematopoietic stem cell transplant (HSCT) for relapsed pediatric non-Hodgkin lymphoma (NHL) is often reserved for patients with certain NHL subtypes or high-risk disease whereas the remainder receive autologous HSCT. Given the aggressive nature of pediatric NHL, we performed allogeneic HSCTs for all patients regardless of disease risk. We report overall survival (OS) and prognostic variables in 36 pediatric patients who underwent allogeneic HSCT between 1998 and 2016. OS at 3 years was 67%. The 3-year OS varied based on NHL subtype: 100% for anaplastic large cell lymphoma (n = 14), 63% for diffuse large B-cell lymphoma (n = 8), 17% for lymphoblastic lymphoma (LL; n = 9) and 80% for other subtypes combined (n = 5). Disease status influenced outcome with 3-year OS of 100% for patients in complete remission (n = 15), 59% with partial remission (PR; n = 17), and 0% with progressive/stable disease (n = 3) (P = .004). Of the 17 patients in PR, all 6 with LL died of relapsed disease, whereas the other 11 attained remission after HSCT and remained disease-free. The cumulative incidence of relapse after HSCT for LL was 78% compared with 15% for all other NHL subtypes combined (P < .0001). Cumulative incidence of nonrelapse mortality (NRM) was low in our cohort at 6%. Hence, allogeneic HSCT is a well-tolerated and useful therapeutic option with low rates of NRM and relapse for all NHL subtypes except LL with active disease at HSCT.
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3
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Gardenswartz A, Cairo MS. Hematopoietic Progenitor Cell Transplantation in Children, Adolescents, and Young Adults With Relapsed Mature B-Cell NHL. J Natl Compr Canc Netw 2020; 18:1135-1142. [PMID: 32755988 DOI: 10.6004/jnccn.2020.7617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 07/07/2020] [Indexed: 11/17/2022]
Abstract
Although children, adolescents, and young adults with newly diagnosed B-cell non-Hodgkin's lymphoma enjoy excellent overall survival with current chemoimmunotherapy, those with relapsed and/or refractory disease have a dismal prognosis. Although most clinicians would agree that hematopoietic progenitor cell transplantation after reinduction therapy is frontline therapy for these patients, there is no consensus as to what type of hematopoietic progenitor cell transplantation promises the best event-free and overall survival. This review outlines the disparate types of stem cell therapy that have been used in this difficult-to-treat population as well as the role of maintenance and CAR T-cell therapy in conjunction with stem cell therapy.
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Affiliation(s)
| | - Mitchell S Cairo
- Departments of Pediatrics.,Pathology.,Medicine.,Microbiology and Immunology, and.,Cell Biology and Anatomy, Maria Fareri Children's Hospital at Westchester Medical Center, New York Medical College, Valhalla, New York
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4
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Oliveira MCL, Sampaio KC, Brito AC, Campos MK, Murao M, Gusmão R, Fernandes AAL, Viana MB. 30 Years of Experience with Non-Hodgkin Lymphoma in Children and Adolescents: a retrospective cohort study. ACTA ACUST UNITED AC 2020; 66:25-30. [PMID: 32130377 DOI: 10.1590/1806-9282.66.1.25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 07/29/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Describe the clinical and demographic characteristics of pediatric patients with non-Hodgkin's lymphoma (NHL) enrolled in a tertiary unit of Pediatric Hematology between 1982-2015. PATIENTS AND METHODS A retrospective cohort study of 140 patients aged 16 years or less with NHL. Demographic characteristics, data on diagnosis, and outcomes were analyzed. The overall survival (OS) analysis and stratification by the most frequent histological subtypes were performed using the Kaplan-Meier method. RESULTS One hundred and thirty-six patients with de novo NHL and four with NHL as a second malignancy were analyzed. The median age at diagnosis was 6.4 years (interquartile range, 4.2 to 11.1 years); 101 patients were males. Four patients had primary immunodeficiency, four had human immunodeficiency virus, two post-liver transplantation, and one had autoimmune lymphoproliferative syndrome. The most frequent histological type was NHL of mature B- cell (B-NHL-B; 67.1%), with Burkitt's lymphoma being the most frequent subtype, and lymphoblastic lymphoma (LBL, 21.4%). The main clinical manifestation at the diagnosis was abdominal tumors (41.4%). During the follow-up time, 13 patients relapsed, but five of them reached a second remission. Thirty-five patients died, and 103 remained alive in clinical remission. No contact was possible for two patients. The OS at 5 years was 74.5% (± 3.8%). The OS estimated for patients with LBL, NHL-B, and the remaining was 80.4%±7.9%, 72.8%±4.7%, and 74.5%±11%, respectively (P = 0.58). CONCLUSION Our results are comparable with cohorts from other middle-income countries.
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Affiliation(s)
- Maria Christina L Oliveira
- . Divisão de Hematologia Pediátrica, Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais,Belo Horizonte, MG, Brasil
| | - Keyla C Sampaio
- . Divisão de Hematologia Pediátrica, Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais,Belo Horizonte, MG, Brasil
| | - Andrea C Brito
- . Divisão de Hematologia Pediátrica, Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais,Belo Horizonte, MG, Brasil
| | - Marcia K Campos
- . Divisão de Hematologia Pediátrica, Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais,Belo Horizonte, MG, Brasil
| | - Mitiko Murao
- . Divisão de Hematologia Pediátrica, Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais,Belo Horizonte, MG, Brasil
| | - Rebeca Gusmão
- . Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Ana Angélica L Fernandes
- . Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Marcos B Viana
- . Divisão de Hematologia Pediátrica, Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais,Belo Horizonte, MG, Brasil
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5
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Ehrhardt MJ, Chen Y, Sandlund JT, Bluhm EC, Hayashi RJ, Becktell K, Leisenring WM, Metzger ML, Ness KK, Krull KR, Oeffinger KC, Gibson TM, Cairo MS, Gross TG, Robison LL, Armstrong GT, Yasui Y, Hudson MM, Mulrooney DA. Late Health Outcomes After Contemporary Lymphome Malin de Burkitt Therapy for Mature B-Cell Non-Hodgkin Lymphoma: A Report From the Childhood Cancer Survivor Study. J Clin Oncol 2019; 37:2556-2570. [PMID: 31283408 DOI: 10.1200/jco.19.00525] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
PURPOSE The widely used, risk-based Lymphome Malin de Burkitt (LMB) chemotherapy regimen has improved survival rates for children with mature B-cell non-Hodgkin lymphoma (NHL); however, associated late effects remain understudied. We assessed late health outcomes after LMB treatment in the Childhood Cancer Survivor Study. PATIENTS AND METHODS Multivariable regression models compared chronic health conditions, health status, and socioeconomic and neurocognitive outcomes between survivors of NHL treated with the LMB regimen (n = 126), survivors of NHL treated with non-LMB regimens (n = 444), and siblings (n = 1,029). RESULTS LMB survivors were a median age of 10.2 years (range, 2.5 to 20.5 years) at diagnosis and 24.0 years (range, 10.3 to 35.3 years) at evaluation. Compared with siblings, LMB survivors were at increased risk for adverse health outcomes. However, survivors of NHL treated with LMB and non-LMB regimens did not differ with regard to risk of having any chronic health conditions, impaired health status, neurocognitive deficits, or poorer socioeconomic outcomes. Increased risk for the following specific neurologic conditions was observed in LMB survivors compared with non-LMB survivors: epilepsy (relative risk [RR], 15.2; 95% CI, 3.1 to 73.4); balance problems (RR, 8.9; 95% CI, 2.3 to 34.8); tremors (RR, 7.5; 95% CI, 1.9 to 29.9); weakness in legs (RR, 8.1; 95% CI, 2.5 to 26.4); severe headaches (RR, 3.2; 95% CI, 1.6 to 6.3); and prolonged arm, leg, or back pain (RR, 4.0; 95% CI, 2.2 to 7.1). The survivors from the group C LMB risk group (n = 50) were at the highest risk for these conditions; however, except for worse functional status (odds ratio, 2.7; 95% CI, 1.2 to 5.8), they were not at increased risk for other adverse health status or socioeconomic outcomes compared with non-LMB survivors. CONCLUSION Survivors treated with LMB and non-LMB regimens are largely comparable in late health outcomes except for excess neurotoxicity among LMB survivors. These data inform treatment efforts seeking to optimize disease control while minimizing toxicity.
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Affiliation(s)
| | - Yan Chen
- University of Alberta, Edmonton, Alberta, Canada
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Yutaka Yasui
- St Jude Children's Research Hospital, Memphis, TN
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6
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Ehrhardt MJ, Hochberg J, Bjornard KL, Brinkman TM. Long-term survivors of childhood, adolescent and young adult non-Hodgkin lymphoma. Br J Haematol 2019; 185:1099-1110. [PMID: 30714126 DOI: 10.1111/bjh.15775] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Progress in overall survival rates for childhood non-Hodgkin lymphoma (NHL) can be largely attributed to effective development and conduct of a number of international treatment studies. Knowledge gained from these studies has shifted the treatment paradigm from a "one-size fits all" strategy to a histologically dependent approach. More specifically, many now adhere to a risk-stratified approach, prescribing cumulative doses and intensities of chemotherapeutic exposures based upon the aggressiveness of disease. Moreover, recognition that high cure rates could be achieved without the use of radiation has eliminated the use of this modality in frontline settings for the majority of newly diagnosed children. These changes have contributed to the emergence of a heterogeneous group of NHL survivors. As the number of NHL survivors continues to increase, providers will encounter a wide spectrum of individuals whose risk for long-term complications are accordingly diverse. The following review summarizes the existing literature surrounding late effects, such as chronic health conditions, functional and neurocognitive performance outcomes, and health-related quality of life, that are unique to NHL survivors, as well as those extrapolated from the broader childhood cancer survivor population.
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Affiliation(s)
- Matthew J Ehrhardt
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.,Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Jessica Hochberg
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA
| | - Kari L Bjornard
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Tara M Brinkman
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.,Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
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7
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Hazar V, Kesik V, Karasu GT, Öztürk G, Küpesiz A, Kılıç SÇ, Ataş E, Uygun V, Eker N, Erbey F, Bengoa ŞY, Emir S, Anak S, Öniz H, Daloğlu H, Aksoylar S, Koçak Ü, Karakükçü M, Elli M, Kurucu N, Yeşilipek A. Risk factors predicting the survival of pediatric patients with relapsed/refractory non-Hodgkin lymphoma who underwent hematopoietic stem cell transplantation: a retrospective study from the Turkish pediatric bone marrow transplantation registry. Leuk Lymphoma 2017; 59:85-96. [DOI: 10.1080/10428194.2017.1330472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Volkan Hazar
- Departments of Pediatric Hematology and Oncology and BMT Unit, Medical Park Göztepe Hospital, Istanbul, Turkey
| | - Vural Kesik
- Gülhane Military Medical Academy, Ankara, Turkey
| | - Gülsün Tezcan Karasu
- Faculty of Medicine, Göztepe Medical Park Hospital, Bahçeşehir University, Istanbul, Turkey
| | - Gülyüz Öztürk
- Faculty of Medicine, Acıbadem Atakent Hospital, Acıbadem University Istanbul, Turkey
| | - Alphan Küpesiz
- Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Suar Çakı Kılıç
- Faculty of Medicine, Göztepe Medical Park Hospital, Bahçeşehir University, Istanbul, Turkey
| | - Erman Ataş
- Gülhane Military Medical Academy, Ankara, Turkey
| | - Vedat Uygun
- Faculty of Medicine, Antalya Medical Park Hospital, Bahçeşehir University, Antalya, Turkey
| | - Nurşah Eker
- Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Fatih Erbey
- Faculty of Medicine, Acıbadem Atakent Hospital, Acıbadem University Istanbul, Turkey
| | | | - Suna Emir
- Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Sema Anak
- Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Haldun Öniz
- Tepecik Training and Research Hospital, Izmir, Turkey
| | - Hayriye Daloğlu
- Faculty of Medicine, Antalya Medical Park Hospital, Bahçeşehir University, Antalya, Turkey
| | | | - Ülker Koçak
- Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Musa Karakükçü
- Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Murat Elli
- Faculty of Medicine, On Dokuz Mayıs University, Samsun, Turkey
| | - Nilgün Kurucu
- Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Akif Yeşilipek
- Faculty of Medicine, Göztepe Medical Park Hospital, Bahçeşehir University, Istanbul, Turkey
- Turkish Pediatric BMT Study Group, Istanbul, Turkey
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8
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Li J, Zhai XW, Wang HS, Qian XW, Miao H, Zhu XH. Circulating MicroRNA-21, MicroRNA-23a, and MicroRNA-125b as Biomarkers for Diagnosis and Prognosis of Burkitt Lymphoma in Children. Med Sci Monit 2016; 22:4992-5002. [PMID: 27991481 PMCID: PMC5198749 DOI: 10.12659/msm.897417] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background The aim of this study was to investigate the diagnostic and prognostic value of microRNA (miRNA)-21, miRNA-23a, and miRNA-125b in Burkitt lymphoma (BL) in children. Material/Methods We recruited 41 children with BL for the case group, 56 children with lymph node inflammation for the positive control group, and 60 healthy children for the negative control group. Real-time fluorescent quantitative polymerase chain reaction (RT-qPCR) was conducted for detection of circulating miRNA-21, miRNA-23a, and miRNA-125b. A receiver operating characteristic (ROC) curve was drawn to compare the diagnostic value of miRNA-21, miRNA-23a, and miRNA-125b. Kaplan-Meier method and log-rank test were used for prognostic analyses. Results MiRNA-21 and miRNA-23a had significantly higher expression in cases than in positive and negative controls (all P<0.05). Overexpression of miRNA-21 and miRNA-23a were associated with staging, WBC, upregulated serum lactate dehydrogenase (LDH) level, presence of lymphoma size ≥6 cm, and cluster of differentiation 10 (CD10) expression, while miRNA-125b expression had an association with staging and upregulated serum LDH level (both P<0.05). ROC curves of miRNA-21, miRNA-23a, and miRNA-125b presented an area under curve (AUC) of 0.759, 0.853 and 0.615, respectively. MiRNA-21 and miRNA-23a in combination had an AUC of 0.869. After treatment, both miRNA-21 and miRNA-23a expression were significantly decreased (both P<0.05). Advanced clinical stage, upregulated LDH, and lymphoma size of ≥6 cm were related to low complete remission rate (all P<0.05). Conclusions Patients with high expression of miRNA-21 and miRNA-23a had significantly lower complete remission rates and survival rates than those with low expression. Expression of miRNA-21 and miRNA-23a may serve as useful diagnostic and prognostic biomarkers in children with BL.
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Affiliation(s)
- Jun Li
- Department of Hematology and Oncology, Children's Hospital of Fudan University, Shanghai, China (mainland)
| | - Xiao-Wen Zhai
- Department of Hematology and Oncology, Children's Hospital of Fudan University, Shanghai, China (mainland)
| | - Hong-Sheng Wang
- Department of Hematology and Oncology, Children's Hospital of Fudan University, Shanghai, China (mainland)
| | - Xiao-Wen Qian
- Department of Hematology and Oncology, Children's Hospital of Fudan University, Shanghai, China (mainland)
| | - Hui Miao
- Department of Hematology and Oncology, Children's Hospital of Fudan University, Shanghai, China (mainland)
| | - Xiao-Hua Zhu
- Department of Hematology and Oncology, Children's Hospital of Fudan University, Shanghai, China (mainland)
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9
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Abstract
The recent application of next-generation sequencing technologies lead to significant improvements in our understanding of genetic underpinnings of non-Hodgkin lymphomas with identification of an unexpectedly high number of novel mutation targets across the different B-cell lymphoma entities. These recently discovered molecular lesions are expected to have a major impact on development of novel biomarkers and targeted therapies as well as patient stratification based on the underlying genetic profile. This review will cover the major discoveries in B-cell lymphomas using next-generation sequencing technologies over the last few years, highlighting alterations associated with relapse and progression of these diseases.
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Affiliation(s)
- Csaba Bödör
- MTA-SE Lendulet Molecular Oncohematology Research Group, Budapest, Hungary.,1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Lilla Reiniger
- 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary. .,2nd Department of Pathology, MTA-SE NAP, Brain Metastasis Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary.
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10
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Lenz JA, Robat CS, Stein TJ. Vinblastine as a second rescue for the treatment of canine multicentric lymphoma in 39 cases (2005 to 2014). J Small Anim Pract 2016; 57:429-34. [DOI: 10.1111/jsap.12500] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 02/17/2016] [Accepted: 02/22/2016] [Indexed: 12/26/2022]
Affiliation(s)
- J. A. Lenz
- Department of Medical Sciences, School of Veterinary MedicineUniversity of Wisconsin 2015 Linden Drive Madison WI 53706 USA
| | - C. S. Robat
- Department of Medical Sciences, School of Veterinary MedicineUniversity of Wisconsin 2015 Linden Drive Madison WI 53706 USA
| | - T. J. Stein
- Department of Medical Sciences, School of Veterinary MedicineUniversity of Wisconsin 2015 Linden Drive Madison WI 53706 USA
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11
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Ceppi F, Weitzman S, Woessmann W, Davies K, Lassaletta A, Reismüller B, Mellgren K, Uyttebroeck A, Maia I, Abdullah S, Miakova N, Glaser D, Cohn R, Abla O, Attarbaschi A, Alexander S. Safety and efficacy of intrathecal rituximab in children with B cell lymphoid CD20+ malignancies: An international retrospective study. Am J Hematol 2016; 91:486-91. [PMID: 26872652 DOI: 10.1002/ajh.24329] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 01/21/2016] [Accepted: 02/08/2016] [Indexed: 01/11/2023]
Abstract
Central nervous system (CNS) involvement in patients with mature B non-Hodgkin lymphoma, post-transplantation proliferative disorder and acute lymphoblastic leukemia confers a significantly inferior prognosis as compared to patients without CNS disease. Intrathecal (IT) or intraventricular administration of rituximab is an option for this group of patients. We report 25 children with CNS involvement of CD20+ B lymphoid malignancies who received in total 163 IT/intraventricular rituximab doses. The median number of doses received by each patient was 6, with a median dose of 25 mg. The most common adverse events were Grades 1 and 2 peripheral neuropathies in five patients (20%), allergy in two patients, and headache in two patients. These events were self-limited, occurring in the 48 hours after treatment and resolving within 24 hr. Three patients presented with more severe though transient side effects, one with a Grade III neuropathy and two with seizure. Eighteen patients (72%) of those treated with IT/intraventricular rituximab, with or without other CNS directed treatment, achieved a CNS remission. This case series suggests that IT/intraventricular rituximab has therapeutic efficacy and relatively limited toxicity. Prospective trials of IT/intraventricular rituximab for patients with CNS involvement of CD20 + B lymphoid malignancies are warranted.
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Affiliation(s)
- Francesco Ceppi
- Department of Pediatrics, Division of Hematology/Oncology; Hospital for Sick Children; Ontario Toronto Canada
| | - Sheila Weitzman
- Department of Pediatrics, Division of Hematology/Oncology; Hospital for Sick Children; Ontario Toronto Canada
| | - Wilhelm Woessmann
- Department of Pediatric Hematology and Oncology; University Children's Hospital and Justus-Liebig-University; Giessen Germany
| | - Kimberly Davies
- Department of Pediatric Oncology; Dana-Farber/Boston Children's Cancer and Blood Disorders Center; Boston
| | - Alvaro Lassaletta
- Department of Pediatric Hematology/Oncology; Hospital Infantil Universitario Niño Jesús; Madrid Spain
| | - Bettina Reismüller
- Department of Pediatric Hematology and Oncology; Medical University of Vienna, St. Anna Children's Hospital; Vienna Austria
| | - Karin Mellgren
- Department of Paediatrics; Institution for Clinical Sciences, Sahlgrenska University Hospital; Gothenburg Sweden
| | - Anne Uyttebroeck
- Department of Pediatric Hemato-Oncology; University Hospitals of Leuven; Leuven Belgium
| | - Iris Maia
- Pediatric Service, Portuguese Institute of Oncology; Porto Portugal
| | - Shaker Abdullah
- Pediatric Oncology, King Abdulaziz Medical City - National Guard Health Affairs; Jeddah Kingdom of Saudi Arabia
| | - Natasha Miakova
- Department of Hematology/Oncology; Federal Center for Pediatric Hematology, Oncology and Immunology Named by D. Rogachev; Moscow Russia
| | - Darryl Glaser
- Division of Hematology/Oncology, Department of Pediatrics; University of Hawai‘I John a. Burns School of Medicine; Honolulu Hawai‘i
| | - Richard Cohn
- Kids Cancer Centre, Sydney Children's Hospital and School of Women's and Children's Health; University of New South Wales; Sydney Australia
| | - Oussama Abla
- Department of Pediatrics, Division of Hematology/Oncology; Hospital for Sick Children; Ontario Toronto Canada
| | - Andishe Attarbaschi
- Department of Pediatric Hematology and Oncology; Medical University of Vienna, St. Anna Children's Hospital; Vienna Austria
| | - Sarah Alexander
- Department of Pediatrics, Division of Hematology/Oncology; Hospital for Sick Children; Ontario Toronto Canada
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12
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Aukema SM, Theil L, Rohde M, Bauer B, Bradtke J, Burkhardt B, Bonn BR, Claviez A, Gattenlöhner S, Makarova O, Nagel I, Oschlies I, Pott C, Szczepanowski M, Traulsen A, Kluin PM, Klapper W, Siebert R, Murga Penas EM. Sequential karyotyping in Burkitt lymphoma reveals a linear clonal evolution with increase in karyotype complexity and a high frequency of recurrent secondary aberrations. Br J Haematol 2015; 170:814-25. [DOI: 10.1111/bjh.13501] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 04/10/2015] [Indexed: 12/24/2022]
Affiliation(s)
- Sietse M. Aukema
- Institute of Human Genetics; University Hospital Schleswig-Holstein Campus Kiel/Christian-Albrechts University Kiel; Kiel Germany
- Department of Pathology & Medical Biology; University Medical Centre Groningen; University of Groningen; Groningen the Netherlands
- Department of Haematology; University Medical Centre Groningen; University of Groningen; Groningen the Netherlands
| | - Laura Theil
- Institute of Human Genetics; University Hospital Schleswig-Holstein Campus Kiel/Christian-Albrechts University Kiel; Kiel Germany
| | - Marius Rohde
- Non-Hodgkin Lymphoma Berlin-Frankfurt-Münster Group Study Centre; Department of Paediatric Haematology and Oncology; Justus Liebig University; Gießen Germany
| | - Benedikt Bauer
- Department of Evolutionary Theory; Max Planck Institute for Evolutionary Biology; Plön Germany
| | - Jutta Bradtke
- Institute of Pathology; University Hospital Giessen and Marburg; Justus-Liebig-University Giessen; Giessen Germany
| | - Birgit Burkhardt
- Non-Hodgkin Lymphoma Berlin-Frankfurt-Münster Group Study Center; Department of Pediatric Haematology and Oncology; University Children's Hospital; Münster Germany
| | - Bettina R. Bonn
- Non-Hodgkin Lymphoma Berlin-Frankfurt-Münster Group Study Center; Department of Pediatric Haematology and Oncology; University Children's Hospital; Münster Germany
| | - Alexander Claviez
- Department of Paediatrics; University Hospital Schleswig-Holstein Campus Kiel/Christian-Albrechts University; Kiel Germany
| | - Stefan Gattenlöhner
- Institute of Pathology; University Hospital Giessen and Marburg; Justus-Liebig-University Giessen; Giessen Germany
| | - Olga Makarova
- Non-Hodgkin Lymphoma Berlin-Frankfurt-Münster Group Study Center; Department of Pediatric Haematology and Oncology; University Children's Hospital; Münster Germany
| | - Inga Nagel
- Institute of Human Genetics; University Hospital Schleswig-Holstein Campus Kiel/Christian-Albrechts University Kiel; Kiel Germany
| | - Ilske Oschlies
- Department of Pathology, Haematopathology Section and Lymph Node Registry; University Hospital Schleswig-Holstein Campus Kiel/Christian-Albrechts University Kiel; Kiel Germany
| | - Christiane Pott
- Second Medical Department; University Hospital Schleswig-Holstein Campus Kiel/Christian-Albrechts University Kiel; Kiel Germany
| | - Monika Szczepanowski
- Department of Pathology, Haematopathology Section and Lymph Node Registry; University Hospital Schleswig-Holstein Campus Kiel/Christian-Albrechts University Kiel; Kiel Germany
| | - Arne Traulsen
- Institute of Pathology; University Hospital Giessen and Marburg; Justus-Liebig-University Giessen; Giessen Germany
| | - Philip M. Kluin
- Department of Pathology & Medical Biology; University Medical Centre Groningen; University of Groningen; Groningen the Netherlands
| | - Wolfram Klapper
- Department of Pathology, Haematopathology Section and Lymph Node Registry; University Hospital Schleswig-Holstein Campus Kiel/Christian-Albrechts University Kiel; Kiel Germany
| | - Reiner Siebert
- Institute of Human Genetics; University Hospital Schleswig-Holstein Campus Kiel/Christian-Albrechts University Kiel; Kiel Germany
| | - Eva M. Murga Penas
- Institute of Human Genetics; University Hospital Schleswig-Holstein Campus Kiel/Christian-Albrechts University Kiel; Kiel Germany
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Burkhardt B, Lenz G. XI. Management of paediatric and adult non-Hodgkin lymphoma: what lessons can each teach the other? Hematol Oncol 2015; 33 Suppl 1:62-6. [PMID: 26062057 DOI: 10.1002/hon.2219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Is there anything that we can learn from each other regarding paediatric and adult non-Hodgkin Lymphoma (NHL) management? Do we treat the same patients? Are there differences in lymphoma biology in the different age groups? Are the procedures of decision making and the infrastructure comparable? Is the weighing of toxicity and outcome aspects in the benefit and risk assessments prior to treatment decisions comparable? Interestingly, the proportional distribution of the NHL subtypes and the spectrum of NHL occurring in children and adolescents differs significantly from that in adults. This observation might motivate biological studies aiming to elucidate the pathomechanisms of lymphomagenesis. Concerning NHL diagnosis and staging, the comparison of outcome data reported for paediatric and adult patient series is often impaired by the use of different staging systems. However, the impact of reference laboratories supporting correct subtyping and the advantages of population-based patient recruitment are experiences that might be transferable between paediatric and adult oncologists. Interestingly, the process of implementing new drugs into current treatment strategies and making these drugs available to patients varies substantially across patient's age groups. The far lower absolute number of patients, especially of relapsed patients, and the favorable outcome with current standard treatment may contribute to the marked differences in the kinetic of implementing new compounds comparing adult with paediatric NHL patients. Also, the basis for the conduction of cooperative clinical trials with pharmaceutical companies needs to be strengthened in paediatric clinical trial groups. In conclusion, both paediatric and adult oncologists benefit from the interdisciplinary discussion with each other, not only concerning results and experiences in clinical trials but also with respect to critical aspects of infrastructure.
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Affiliation(s)
- Birgit Burkhardt
- NHL-BFM Study Center and Department of Pediatric Hematology and Oncology, University Children's Hospital Münster, Münster, Germany
| | - Georg Lenz
- Translational Oncology, Department of Medicine A, University Hospital Münster, Münster, Germany
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Schuster FR, Stanglmaier M, Woessmann W, Winkler B, Siepermann M, Meisel R, Schlegel PG, Hess J, Lindhofer H, Borkhardt A, Buhmann R. Immunotherapy with the trifunctional anti-CD20 x anti-CD3 antibody FBTA05 (Lymphomun) in paediatric high-risk patients with recurrent CD20-positive B cell malignancies. Br J Haematol 2014; 169:90-102. [PMID: 25495919 DOI: 10.1111/bjh.13242] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 11/04/2014] [Indexed: 12/23/2022]
Abstract
Children with B cell malignancies refractory to standard therapy are known to have a poor prognosis and very limited treatment options. Here, we report on the treatment and follow-up of ten patients diagnosed with relapsed or refractory mature B-cell Non Hodgkin Lymphoma (B-NHL), Burkitt leukaemia (B-AL) or pre B-acute lymphoblastic leukaemia (pre B-ALL). All children were treated with FBTA05 (now designated Lymphomun), an anti-CD3 x anti-CD20 trifunctional bispecific antibody (trAb) in compassionate use. Within individual treatment schedules, Lymphomun was applied (a) after allogeneic stem cell transplantation (allo-SCT, n = 6) to induce sustained long-term remission, or (b) stand alone prior to subsequent chemotherapy to eradicate residual disease before allo-SCT (n = 4). Nine of ten children displayed a clinical response: three stable diseases (SD), one partial remission (PR) and five induced or sustained complete remissions (CR). Five of these nine responders died during follow-up. The other patients still maintain CR with a current overall survival of 874-1424 days (median: 1150 days). In conclusion, despite the dismal clinical prognosis of children refractory to standard therapy, immunotherapy with Lymphomun resulted in a favourable clinical outcome in this cohort of refractory paediatric patients.
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Affiliation(s)
- Friedhelm R Schuster
- Department of Paediatric Oncology, Haematology and Immunology, University of Duesseldorf, Duesseldorf, Germany
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