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Mason EF, Kovach AE. Update on Pediatric and Young Adult Mature Lymphomas. Clin Lab Med 2021; 41:359-387. [PMID: 34304770 DOI: 10.1016/j.cll.2021.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
After acute leukemia and brain and central nervous system tumors, mature lymphomas represent the third most common cancer in pediatric patients. Non-Hodgkin lymphoma accounts for approximately 60% of lymphoma diagnoses in children, with the remainder representing Hodgkin lymphoma. Among non-Hodgkin lymphomas in pediatric patients, aggressive lymphomas, such as Burkitt lymphoma, diffuse large B-cell lymphoma, and anaplastic large cell lymphoma, predominate. This article summarizes the epidemiologic, histopathologic, and molecular features of selected mature systemic B-cell and T-cell lymphomas encountered in this age group.
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Affiliation(s)
- Emily F Mason
- Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, 4603A TVC, Nashville, TN 37232-5310, USA.
| | - Alexandra E Kovach
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Mailstop #32, Los Angeles, CA 90027, USA
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Prusila REI, Haapasaari KM, Marin K, Pollari M, Soini Y, Vornanen M, Karjalainen-Lindsberg ML, Turpeenniemi-Hujanen T, Kuittinen O. R-Bendamustine in the treatment of nodular lymphocyte-predominant Hodgkin lymphoma. Acta Oncol 2018. [PMID: 29537344 DOI: 10.1080/0284186x.2018.1450522] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Roosa Enni Inkeri Prusila
- University of Oulu, Oulu, Finland
- Cancer and Translational Medicine Research Unit, Medical Research Center Oulu, Oulu, Finland
| | | | - Katja Marin
- Cancer Center, Department of Oncology, Kuopio University Hospital, Kuopio, Finland
| | - Marjukka Pollari
- Department of Oncology, Tampere University Hospital, Tampere, Finland
| | - Ylermi Soini
- Department of Pathology, University of Oulu, Oulu, Finland
- University of Eastern Finland, Kuopio, Finland
- Cancer Center, Department of Pathology and Forensic Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Martine Vornanen
- Department of Oncology, Tampere University Hospital, Tampere, Finland
- Department of Pathology, Tampere University Hospital and Fimlab Laboratories, Tampere, Finland
| | - Marja-Liisa Karjalainen-Lindsberg
- Department of Pathology, University of Helsinki, Helsinki, Finland
- Department of Pathology, Helsinki University Hospital, Helsinki, Finland
| | - Taina Turpeenniemi-Hujanen
- University of Oulu, Oulu, Finland
- Department of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland
| | - Outi Kuittinen
- University of Eastern Finland, Kuopio, Finland
- Department of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland
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Gemici A, Aydogdu I, Terzi H, Sencan M, Aslan A, Kaya AH, Dal MS, Akay MO, Dogu MH, Ayyildiz O, Sahin F, Cagliyan GA, Yilmaz M, Gokgoz Z, Bilen Y, Demir C, Sevindik OG, Korkmaz S, Eser B, Altuntas F. Nodular lymphocyte predominant Hodgkin's lymphoma in daily practice: A multicenter experience. Hematol Oncol 2017; 36:116-120. [PMID: 28707314 DOI: 10.1002/hon.2460] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 04/01/2017] [Accepted: 06/19/2017] [Indexed: 01/01/2023]
Abstract
Nodular lymphocyte predominant Hodgkin's lymphoma (NLPHL) is a rare subtype of Hodgkin's lymphoma. In this study, we aimed to investigate the clinical features and therapeutic outcomes of patients with NLPHL who were diagnosed at different institutes in Turkey. We retrospectively reviewed the records of the patients diagnosed with NLPHL. Adult patients who were diagnosed after 2005 with histological confirmation were selected for the study. Forty-three patients were included in the study. Median age of patients was 37.5 years (18-70) at the time of diagnosis. About 60.5% patients were diagnosed as stage I and II NLPHL, and remaining 39.5% had stage III and IV disease. Median follow-up was 46 months. During follow-up, none of the patients died. Seven patients relapsed or progressed after initial therapy at a median of 12 months. Five of 7 relapsed/refractory patients (71.4%) were salvaged with chemotherapy only (DHAP, ICE), and the remaining 2 (28.6%) were salvaged with chemoimmunotherapy. All of relapsed/refractory patients were able to achieve complete remission after salvage therapy. Lactate dehydrogenase levels were significantly higher in patients with progressive disease compared with nonprogressive disease. Our study showed an excellent outcome with all patients alive at last contact with a median follow up of 46 months despite a wide range of different therapeutic approaches. All relapsed and refractory patients were successfully salvaged despite a low frequency of patients received immunotherapy in conjunction with chemotherapy. Our results suggest that immunotherapy may be reserved for further relapses.
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Affiliation(s)
- Aliihsan Gemici
- Division of Hematology, Sanliurfa Mehmet AkifInan Training and Research Hospital, Sanliurfa, Turkey
| | - Ismet Aydogdu
- Department of Hematology, Celal Bayar University, Manisa, Turkey
| | - Hatice Terzi
- Department of Hematology, Cumhuriyet University, Sivas, Turkey
| | - Mehmet Sencan
- Department of Hematology, Cumhuriyet University, Sivas, Turkey
| | - Alma Aslan
- Department of Medical Oncology, Hacettepe University, Ankara, Turkey
| | - Ali Hakan Kaya
- Hematology and Stem Cell Transplantation Clinic, Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Mehmet Sinan Dal
- Hematology and Stem Cell Transplantation Clinic, Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Meltem Olga Akay
- Department of Hematology, Osmangazi University, Eskisehir, Turkey
| | - Mehmet Hilmi Dogu
- Division of Hematology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Orhan Ayyildiz
- Department of Hematology, Dicle University, Diyarbakir, Turkey
| | - Fahri Sahin
- Department of Hematology, Ege University, Izmir, Turkey
| | | | - Mehmet Yilmaz
- Department of Hematology, Gaziantep University, Gaziantep, Turkey
| | - Zafer Gokgoz
- Ordu State Hospital, Division of Hematology, Ordu, Turkey
| | - Yusuf Bilen
- Department of Hematology, Ataturk University, Erzurum, Turkey
| | - Cengiz Demir
- Department of Hematology, YuzuncuYil University, Van, Turkey
| | | | - Serdal Korkmaz
- Division of Hematology, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Bulent Eser
- Department of Hematology, Erciyes University, Kayseri, Turkey
| | - Fevzi Altuntas
- Hematology and Stem Cell Transplantation Clinic, Ankara Oncology Training and Research Hospital, Ankara, Turkey
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Lazarovici J, Dartigues P, Brice P, Obéric L, Gaillard I, Hunault-Berger M, Broussais-Guillaumot F, Gyan E, Bologna S, Nicolas-Virelizier E, Touati M, Casasnovas O, Delarue R, Orsini-Piocelle F, Stamatoullas A, Gabarre J, Fornecker LM, Gastinne T, Peyrade F, Roland V, Bachy E, André M, Mounier N, Fermé C. Nodular lymphocyte predominant Hodgkin lymphoma: a Lymphoma Study Association retrospective study. Haematologica 2015; 100:1579-86. [PMID: 26430172 DOI: 10.3324/haematol.2015.133025] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 09/25/2015] [Indexed: 12/18/2022] Open
Abstract
Nodular lymphocyte predominant Hodgkin lymphoma represents a distinct entity from classical Hodgkin lymphoma. We conducted a retrospective study to investigate the management of patients with nodular lymphocyte predominant Hodgkin lymphoma. Clinical characteristics, treatment and outcome of adult patients with nodular lymphocyte predominant Hodgkin lymphoma were collected in Lymphoma Study Association centers. Progression-free survival (PFS) and overall survival (OS) were analyzed, and the competing risks formulation of a Cox regression model was used to control the effect of risk factors on relapse or death as competing events. Among 314 evaluable patients, 82.5% had early stage nodular lymphocyte predominant Hodgkin lymphoma. Initial management consisted in watchful waiting (36.3%), radiotherapy (20.1%), rituximab (8.9%), chemotherapy or immuno-chemotherapy (21.7%), combined modality treatment (12.7%), or radiotherapy plus rituximab (0.3%). With a median follow-up of 55.8 months, the 10-year PFS and OS estimates were 44.2% and 94.9%, respectively. The 4-year PFS estimates were 79.6% after radiotherapy, 77.0% after rituximab alone, 78.8% after chemotherapy or immuno-chemotherapy, and 93.9% after combined modality treatment. For the whole population, early treatment with chemotherapy or radiotherapy, but not rituximab alone (Hazard ratio 0.695 [0.320-1.512], P=0.3593) significantly reduced the risk of progression compared to watchful waiting (HR 0.388 [0.234-0.643], P=0.0002). Early treatment appears more beneficial compared to watchful waiting in terms of progression-free survival, but has no impact on overall survival. Radiotherapy in selected early stage nodular lymphocyte predominant Hodgkin lymphoma, and combined modality treatment, chemotherapy or immuno-chemotherapy for other patients, are the main options to treat adult patients with a curative intent.
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Affiliation(s)
| | - Peggy Dartigues
- Département de Biologie et Pathologie Médicales, Gustave Roussy, Villejuif, France
| | - Pauline Brice
- Hopital Saint-Louis APHP, Université Paris Diderot, France
| | - Lucie Obéric
- Department of Hematology, IUC Toulouse Oncopole, France
| | | | | | | | - Emmanuel Gyan
- Service d'hématologie et thérapie cellulaire, Centre Hospitalier Universitaire, Tours, France
| | - Serge Bologna
- Department of Hematology, CHU Nancy-Brabois, Vandoeuvre, France
| | | | | | | | | | | | | | - Jean Gabarre
- Department of Hematology, Hopital Pitié Salpétrière AP-HP, Paris, France
| | - Luc-Matthieu Fornecker
- Department of Oncology and Hematology, Hôpitaux Universitaires de Strasbourg and Université de Strasbourg, France
| | | | - Fréderic Peyrade
- Department of onco-hematology Centre Antoine Lacassagne-Comprehensive anticancer center, Nice, France
| | - Virginie Roland
- Service d'hématologie clinique, Centre Hospitalier Saint Jean, Perpignan, France
| | - Emmanuel Bachy
- Department of Hematology, Lyon Sud Hospital, Pierre Benite, France
| | - Marc André
- Hematology, CHU Dinant Godinne, UCL Namur, Yvoir, Belgium
| | | | - Christophe Fermé
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
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Advani RH, Horning SJ, Hoppe RT, Daadi S, Allen J, Natkunam Y, Bartlett NL. Mature results of a phase II study of rituximab therapy for nodular lymphocyte-predominant Hodgkin lymphoma. J Clin Oncol 2014; 32:912-8. [PMID: 24516013 DOI: 10.1200/jco.2013.53.2069] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Universal expression of CD20 by malignant cells in nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) led us to evaluate rituximab (R) as a therapeutic option. PATIENT AND METHODS Patients with previously treated or newly diagnosed NLPHL were treated with R (375 mg/m(2) once per week for 4 weeks) or, after a protocol amendment, with R plus R maintenance (MR; administered once every 6 months for 2 years). Primary and secondary outcome measures were progression-free survival (PFS) and overall response rate (ORR), respectively. RESULTS A total of 39 patients were enrolled (R, n = 23; R + MR, n = 16). After four once-per-week treatments, ORR was 100% (complete response, 67%; partial response, 33%). At median follow-ups of 9.8 years for R and 5 years for R + MR, median PFS were 3 and 5.6 years (P = .26), respectively; median overall survival (OS) was not reached. Estimated 5-year PFS and OS for patients treated with R versus R + MR were 39.1% (95% CI, 23.5 to 65.1) and 95.7% (95% CI, 87.7 to 100) versus 58.9% (95% CI, 38.0 to 91.2) and 85.7% (95% CI, 69.2 to 100), respectively. Nine of 23 patients experiencing relapse had evidence of transformation to aggressive B-cell lymphoma; six of these patients had infradiaphragmatic involvement at study entry. CONCLUSION R is an active agent in NLPHL. Although responses are not durable in most patients, a significant minority experience remissions lasting > 5 years. R + MR results in a nonsignificant increase in PFS compared with R. R may be considered in the relapsed setting for NLPHL. The potential for transformation of NLPHL to aggressive B-cell lymphoma underscores the importance of rebiopsy and long-term follow-up.
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Affiliation(s)
- Ranjana H Advani
- Ranjana H. Advani, Sandra J. Horning, Richard T. Hoppe, Sarah Daadi, John Allen, and Yasodha Natkunam, Stanford University Medical Center, Stanford, CA; and Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO
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Hodgkin lymphoma: pathology, pathogenesis, and a plethora of potential prognostic predictors. Adv Anat Pathol 2014; 21:12-25. [PMID: 24316907 DOI: 10.1097/pap.0000000000000002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Hodgkin lymphoma (HL) encompasses 2 unique clinicopathologic entities, classical Hodgkin lymphoma (CHL) (∼95% of cases) and nodular lymphocyte predominant HL (∼5% of cases). Both subtypes demonstrate a paucity of surreptitious (in CHL) neoplastic B cells within a background of reactive inflammatory cells underscoring both the relatedness of these 2 entities to each other, as well as their distinction from other types of lymphoid neoplasia. Clinically, they are primarily nodal diseases that disseminate in a predictable manner to contiguous nodal regions. The biology of HL as a whole, as well as the genetic and pathologic features that distinguish CHL from nodular lymphocyte predominant HL and other lymphomas has been the subject of a wealth of investigation in recent decades. The aim of this review is to detail the pathologic features of HL and to highlight the recent insights into its molecular basis and the myriad prognostic markers being described.
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Carbone A, Gloghini A. Nodular lymphocyte predominant Hodgkin lymphoma may show a nodular pattern in which tumour cells do not invade the surrounding spaces. Br J Haematol 2013; 163:537-8. [DOI: 10.1111/bjh.12510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Antonino Carbone
- Department of Pathology; Centro di Riferimento Oncologico Aviano; Istituto Nazionale Tumori; IRCCS; Aviano Italy
| | - Annunziata Gloghini
- Department of Diagnostic Pathology and Laboratory Medicine; Fondazione IRCCS Istituto Nazionale dei Tumori; Milano Italy
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