Limited Stage Aggressive Non-Hodgkin Lymphoma: What Is Optimal Therapy?

Kumar, Abhijeet; Sundararajan, Srinath; Puvvada, Soham D.; Persky, Daniel O.

doi:10.1007/s11864-016-0424-2

Cited by 3 publications

(4 citation statements)

References 22 publications

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“…This presents an opportunity for future collaboration for the standardization of diagnostic processes for NHL. Treatment with CHOP-like regimens was the most frequently used, which is consistent with the descriptions of Kumar et al [20], Hu et al [21] in advanced disease, and Schmitz et al [22], in aggressive T-cell lymphomas.…”

Section: Discussionsupporting

confidence: 82%

Epidemiology and Clinical Characteristics of Non-Hodgkin Lymphoma in Mexico

Hernández-Ruiz¹,

Alvarado-Ibarra

Lien-Chang

et al. 2021

World J Oncol

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Background: There is no epidemiological registry in Mexico. The information about the epidemiology in our country is obtained by these types of studies, such as multicentric studies. A lot of improvements in the survival in non-Hodgkin lymphoma patients had occurred in the last 20 years. The access to treatment in these types of pathology could change the prognostic factors in Mexican Mestizos patients. The primary objective of the study was to learn what the most frequent histological varieties of non-Hodgkin lymphoma in Mexico are. The secondary objectives included clinical characteristics, treatments used, treatment response, disease-free survival and overall survival. Methods: A retrospective, descriptive study of consecutive cases was carried out in 14 hospitals across 14 Mexican states with patients diagnosed with non-Hodgkin lymphoma using the World Health Organization (WHO) 2008 criteria. Inclusion criteria included: ≥ 18 years of age, male or female, any clinical stage at diagnosis, who had received any chemotherapy regimen, with a known outcome. Descriptive statistics was performed for all variables, and survival was assessed using Kaplan-Meier curves. Results: Totally, 609 patients were enrolled, of which 545 were Bcell lymphomas and 64 were T-cell lymphomas. Median ages were 61 and 50, respectively. B-cell lymphomas were more common in males with 52.1%, and 65.5% of T-cell lymphomas occurred in females. For B-cell lymphomas, the two most frequent histological subtypes were diffuse large B-cell lymphoma in 63.9%, followed by follicular lymphoma at 18%. Meanwhile, 50% of T-cell lymphomas were of the T/natural killer (NK) subtype, and 87.1% of the patients received a CHOP-like regimen. Radiotherapy was given to 31% of B-cell Lymphomas and 46.9% of T-cell lymphomas. Overall survival at 9 years was 84.6% for B-cell lymphomas, and 73.4% for T-cell lymphomas. Conclusions: Diffuse large B-cell lymphoma constitutes the most frequent subtype for B-cell lymphomas in Mexico. The most frequent T-cell lymphoma is the NK/T histological subtype.

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Section: Discussionsupporting

confidence: 82%

Epidemiology and Clinical Characteristics of Non-Hodgkin Lymphoma in Mexico

Hernández-Ruiz¹,

Alvarado-Ibarra

Lien-Chang

et al. 2021

World J Oncol

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“…The majority of patients with B-NHL were diagnosed at an advanced stage resulting in poor prognoses because of being asymptomatic at early stages of the disease ( 21 ). For example, 70–75% of patients with DLBCL were diagnosed at an advanced stage ( 22 ), and only 25% of patients with FL were diagnosed at early stage ( 23 ). The patients with aggressive B-NHL that were diagnosed at early stages of the disease not only had improved prognosis compared with patients diagnosed at an advanced stage (5-year overall survival, 90 vs. <70%) but also had advantages of reduced dosages, toxicities of therapy and less economic burden ( 24 – 26 ).…”

Section: Discussionmentioning

confidence: 99%

Volatile metabonomic profiling in urine to detect novel biomarkers for B‑cell non‑Hodgkin's lymphoma

Hua

Wang

Liu³

et al. 2018

Oncol Lett

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To date, there have been a limited number of useful biomarkers for the screening and monitoring of B-cell non-Hodgkin's lymphoma (B-NHL), which leads to the impetus to discover novel biomarkers for the disease. In the present study, gas chromatography-mass spectrometry (GC-MS) combined with head-space solid-phase micro-extraction (HS-SPME) was employed to analyze the volatile metabolites in the urine samples of 131 subjects. The subjects were divided into 4 main groups: Aggressive B-NHL, indolent B-NHL, benign lymphatic diseases patients and healthy volunteers. The differences of the concentrations of the potential biomarkers among the groups were assessed by non-parametric Wilcoxon's test. The ability of the potential biomarkers to discriminate between the four aforementioned groups was evaluated by receiver operating characteristic curves (ROC). The present study indicated that 4-heptanone, 2-methylpyrazine, 2-methylbutanal, 2,6-dimethyl-7-octen-2-ol and decanoic acid may serve as potential biomarkers for B-NHL. The area under the curve (AUC) values of single potential biomarker ranged from 0.634 to 0.901. The diagnostic models established with combined biomarkers exhibited higher diagnostic values (AUC, 0.824–0.968) compared with the models established with single biomarkers. The present study indicated that urinary volatile metabolites might be potential biomarkers for screening and monitoring of B-NHL.

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“…This complex classification, which tries to group lymphomas according to their putative cell of origin, as well as their clinical and pathological features, reflects our deepening understanding of the immune system, with different lymphocyte subsets undergoing complex maturation steps and each step potentially having malignant counterparts. The precise classification of a patient's lymphoma is crucial to predict the clinical course (from indolent to aggressive) and to guide the choice of treatment regimen, from "watch and wait" to multimodal (radio-, immuno-, chemo-) therapy [16][17][18][19]. Histomorphologic and cytologic analyses of the growth pattern, tissue architecture, cell size, nuclear features, and reactive microenvironment of a given tumor by microscopy of stained tissue slides are still the most important tools for establishing a diagnosis of lymphoma.…”

Section: Malignant Lymphomas Mirror the Complexity Of The Immune Systemmentioning

confidence: 99%

“…At first diagnosis, it is important to classify the lymphoma correctly because the best therapy for an individual patient can vary from "watch and wait" to multimodal (radio-, immuno-, and chemo-) therapy, depending on variables such as disease subtype, evidence for high-grade transformation, and various molecular risk factors [16][17][18][19].…”

Section: Clinical and Radiological Implications Of Tumor Heterogeneitmentioning

confidence: 99%

Tumor Heterogeneity in Lymphomas: A Different Breed

Schürch¹,

Federmann²,

Quintanilla-Martı́nez³

et al. 2017

Pathobiology

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The facts that cancer represents tissues consisting of heterogeneous neoplastic, as well as reactive, cell populations and that cancers of the same histotype may show profound differences in clinical behavior have long been recognized. With the advent of new technologies and the demands of precision medicine, the investigation of tumor heterogeneity has gained much interest. An understanding of intertumoral heterogeneity in patients with the same disease entity is necessary to optimally guide personalized treatment. In addition, increasing evidence indicates that different tumor areas or primary tumors and metastases in an individual patient can show significant intratumoral heterogeneity on different levels. This phenomenon can be driven by genomic instability, epigenetic events, the tumor microenvironment, and stochastic variations in cellular function and antitumoral therapies. These mechanisms may lead to branched subclonal evolution from a common progenitor clone, resulting in spatial variation between different tumor sites, disease progression, and treatment resistance. This review addresses tumor heterogeneity in lymphomas from a pathologist's viewpoint. The relationship between morphologic, immunophenotypic, and genetic heterogeneity is exemplified in different lymphoma entities and reviewed in the context of high-grade transformation and transdifferentiation. In addition, factors driving heterogeneity, as well as clinical and therapeutic implications of lymphoma heterogeneity, will be discussed.

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Limited Stage Aggressive Non-Hodgkin Lymphoma: What Is Optimal Therapy?

Cited by 3 publications

References 22 publications

Epidemiology and Clinical Characteristics of Non-Hodgkin Lymphoma in Mexico

Epidemiology and Clinical Characteristics of Non-Hodgkin Lymphoma in Mexico

Volatile metabonomic profiling in urine to detect novel biomarkers for B‑cell non‑Hodgkin's lymphoma

Tumor Heterogeneity in Lymphomas: A Different Breed

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