Poor outcomes for double‐hit lymphoma patients treated with curative‐intent second‐line immunochemotherapy following failure of intensive front‐line immunochemotherapy

2019 ◽  
Vol 189 (2) ◽  
pp. 313-317 ◽  
Author(s):  
Daniel J. Landsburg ◽  
Emily C. Ayers ◽  
David A. Bond ◽  
Kami J. Maddocks ◽  
Reem Karmali ◽  
...  
Keyword(s):  
Second Line ◽  
Front Line ◽  
Curative Intent ◽  
Double Hit Lymphoma ◽  
Double Hit ◽  
Poor Outcomes

scholarly journals Outcomes of Patients With Double-Hit Lymphoma Who Achieve First Complete Remission

2017 ◽  
Vol 35 (20) ◽  
pp. 2260-2267 ◽  
Author(s):  
Daniel J. Landsburg ◽  
Marissa K. Falkiewicz ◽  
Joseph Maly ◽  
Kristie A. Blum ◽  
Christina Howlett ◽  
...  
Keyword(s):  
Complete Remission ◽  
Intensive Therapy ◽  
Front Line ◽  
Term Survival ◽  
Disease Response ◽  
Line Therapy ◽  
Double Hit Lymphoma ◽  
Double Hit ◽  
First Complete Remission

Purpose Patients with double-hit lymphoma (DHL) rarely achieve long-term survival following disease relapse. Some patients with DHL undergo consolidative autologous stem-cell transplantation (autoSCT) to reduce the risk of relapse, although the benefit of this treatment strategy is unclear. Methods Patients with DHL who achieved first complete remission following completion of front-line therapy with either rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) or intensive front-line therapy, and deemed fit for autoSCT, were included. A landmark analysis was performed, with time zero defined as 3 months after completion of front-line therapy. Patients who experienced relapse before or who were not followed until that time were excluded. Results Relapse-free survival (RFS) and overall survival (OS) rates at 3 years were 80% and 87%, respectively, for all patients (n = 159). Three-year RFS and OS rates did not differ significantly for autoSCT (n = 62) versus non-autoSCT patients (n = 97), but 3-year RFS was inferior in patients who received R-CHOP compared with intensive therapy (56% v 88%; P = .002). Three-year RFS and OS did not differ significantly for patients in the R-CHOP or intensive therapy cohorts when analyzed by receipt of autoSCT. The median OS following relapse was 8.6 months. Conclusion In the largest reported series, to our knowledge, of patients with DHL to achieve first complete remission, consolidative autoSCT was not associated with improved 3-year RFS or OS. In addition, patients treated with R-CHOP experienced inferior 3-year RFS compared with those who received intensive front-line therapy. When considered in conjunction with reports of patients with newly diagnosed DHL, which demonstrate lower rates of disease response to R-CHOP compared with intensive front-line therapy, our findings further support the use of intensive front-line therapy for this patient population.

scholarly journals How I treat double-hit lymphoma

Blood ◽  
2017 ◽  
Vol 130 (5) ◽  
pp. 590-596 ◽  
Author(s):  
Jonathan W. Friedberg
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Central Nervous System Involvement ◽  
B Cell Lymphoma ◽  
World Health ◽  
Large B Cell Lymphoma ◽  
Double Hit Lymphoma ◽  
Increased Risk ◽  
Double Hit ◽  
Large B Cell

Abstract The 2016 revision of the World Health Organization (WHO) classification for lymphoma has included a new category of lymphoma, separate from diffuse large B-cell lymphoma, termed high-grade B-cell lymphoma with translocations involving myc and bcl-2 or bcl-6. These lymphomas, which occur in <10% of cases of diffuse large B-cell lymphoma, have been referred to as double-hit lymphomas (or triple-hit lymphomas if all 3 rearrangements are present). It is important to differentiate these lymphomas from the larger group of double-expressor lymphomas, which have increased expression of MYC and BCL-2 and/or BCL-6 by immunohistochemistry, by using variable cutoff percentages to define positivity. Patients with double-hit lymphomas have a poor prognosis when treated with standard chemoimmunotherapy and have increased risk of central nervous system involvement and progression. Double-hit lymphomas may arise as a consequence of the transformation of the underlying indolent lymphoma. There are no published prospective trials in double-hit lymphoma, however retrospective studies strongly suggest that aggressive induction regimens may confer a superior outcome. In this article, I review my approach to the evaluation and treatment of double-hit lymphoma, with an eye toward future clinical trials incorporating rational targeted agents into the therapeutic armamentarium.

scholarly journals Double-Hit Lymphoma at Second Relapse of Burkitt-Like Lymphoma : A Case Report

2011 ◽  
Vol 51 (1) ◽  
pp. 43-47 ◽  
Author(s):  
Hiroaki Tanaka ◽  
Shinichiro Hashimoto ◽  
Daijiro Abe ◽  
Shio Sakai ◽  
Toshiyuki Takagi
Keyword(s):  
Case Report ◽  
Double Hit Lymphoma ◽  
Double Hit

scholarly journals Psychological Impact of the COVID-19 Outbreak on Nurses in China: A Nationwide Survey During the Outbreak

2020 ◽  
Vol 11 ◽  
Author(s):  
Yan Liu ◽  
Youlin Long ◽  
Yifan Cheng ◽  
Qiong Guo ◽  
Liu Yang ◽  
...  
Keyword(s):  
Public Health ◽  
Health Professionals ◽  
Psychological Impact ◽  
Nationwide Survey ◽  
Living Alone ◽  
Health Issue ◽  
Public Health Issue ◽  
Second Line ◽  
Front Line ◽  
Major Public Health Issue

Background: The COVID-19 pandemic is a major public health issue and challenge to health professionals. In similar epidemics, nurses experienced more distress than other providers.Methods: We surveyed both on-duty nurses caring for infected patients and second-line nurses caring for uninfected patients from Hubei and other provinces throughout China.Results: We received completed surveys from 1,364 nurses from 22 provinces: 658 front-line and 706 second-line nurses. The median (IQR) GHQ-28 score of all nurses was 17 (IQR 11–24). The overall incidence of mild-to-moderate distress (GHQ score &gt; 5) was 28%; that for severe distress (GHQ score &gt; 11) was 6%. The incidence of mild-to-moderate distress in the second-line nurses was higher than that in the front-line nurses (31 vs. 25%; OR, 0.74; 95 CI, 0.58–0.94). Living alone (OR, 0.62; 95% CI, 0.44–0.86) and feeling supported (OR, 0.82, 95% CI, 0.74–0.90) independently predicted lower anxiety.Conclusions: During the COVID-19 pandemic, the psychological problems of all nurses were generally serious. The interviewed second-line nurses face more serious issues than the front-line nurses.

Responses to second-line cisplatin-based intraperitoneal therapy in ovarian cancer: influence of a prior response to intravenous cisplatin.

1991 ◽  
Vol 9 (10) ◽  
pp. 1801-1805 ◽  
Author(s):  
M Markman ◽  
B Reichman ◽  
T Hakes ◽  
W Jones ◽  
J L Lewis ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Phase Ii ◽  
Small Volume ◽  
Recurrent Ovarian Cancer ◽  
Second Line ◽  
Front Line ◽  
Phase Ii Trials ◽  
Two Phase ◽  
Overall Response ◽  
Intraperitoneal Therapy

Phase II trials of second-line intraperitoneal (IP) cisplatin-based therapy in patients with ovarian cancer have demonstrated the ability of this approach to produce objective antitumor responses, including surgically defined complete responses (CRs), in individuals with persistent small-volume disease after front-line cisplatin-based intravenous (IV) treatment. To examine the influence of a prior response to systemic cisplatin on the activity of second-line IP cisplatin, we retrospectively analyzed two phase II trials of cisplatin-based IP therapy in persistent/recurrent ovarian cancer conducted at our institution. Of the 89 assessable patients on the two trials, 52 (58%) had previously responded to IV cisplatin. The overall response and CR rates to second-line IP cisplatin-based therapy in this previously responding population were 56% and 33%, respectively, compared with overall response and CR rates in the 37 nonresponders to IV cisplatin of 11% and 3%, respectively (P less than .001; chi 2, 1 df). In the 36 patients responding to systemic cisplatin and whose largest tumor mass measured less than 1 cm at IP cisplatin initiation, a 42% CR rate was observed, compared with a 7% CR rate in the 14 patients with the same bulk of disease who had previously failed to respond to systemic cisplatin (P less than .025). We conclude that a prior response to systemic cisplatin strongly influences the antineoplastic activity of second-line IP cisplatin in ovarian cancer.

Pembrolizumab and lenalidomide induced remission in refractory double-hit lymphoma

2016 ◽  
Vol 95 (11) ◽  
pp. 1917-1918 ◽  
Author(s):  
Thomas S. Y. Chan ◽  
Pek-Lan Khong ◽  
Yok-Lam Kwong
Keyword(s):  
Double Hit Lymphoma ◽  
Double Hit
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