Doxorubicin Dosage Guidelines in a Patient with Hyperbilirubinemia of Gilbert's Syndrome

1998 ◽  
Vol 32 (10) ◽  
pp. 1026-1029 ◽  
Author(s):  
Melanie Johns Cupp ◽  
Gerald M Higa
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Hepatic Clearance ◽  
Large Cell ◽  
Conclusive Evidence ◽  
Hodgkin's Lymphoma ◽  
Gilbert’S Syndrome ◽  
Medline Search ◽  
Gilbert's Syndrome ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

OBJECTIVE: To reconcile dosage modification guidelines for doxorubicin in a patient with hyperbilirubinemia of Gilbert's syndrome (GS). CASE SUMMARY: A 62-year-old white man with concurrent diagnoses of large-cell non-Hodgkin's lymphoma and GS was treated with standard doses of a doxorubicin-containing chemotherapy regimen. No increase of end-organ toxicity was observed during four treatment cycles. DISCUSSION: The relative prevalence of GS coupled with the rising incidence of non-Hodgkin's lymphoma increases the probability that both disorders will be present in the same individual. A MEDLINE search (1966 through July 1997) revealed little, and often conflicting, information pertaining to drug metabolism and disposition in GS. In addition, no information has been reported regarding the metabolic fate of doxorubicin in these patients. It is important to emphasize that the lack of enhanced extramedullary toxicity in this patient is not conclusive evidence that the hepatic abnormality of GS had no effect on doxorubicin metabolism. CONCLUSIONS: Based on information regarding mechanisms for hepatic clearance, dosage modification of doxorubicin may not be necessary in hyperbilirubinemia of GS.

Primary Large-Cell Non-Hodgkin's Lymphoma of the Testis: A Retrospective Analysis of Patterns of Failure and Prognostic Factors

2001 ◽  
Vol 2 (2) ◽  
pp. 109-115 ◽  
Author(s):  
John F. Seymour ◽  
Benjamin Solomon ◽  
Max M. Wolf ◽  
E. Henry Janusczewicz ◽  
Andrew Wirth ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Retrospective Analysis ◽  
Hodgkin’S Lymphoma ◽  
Large Cell ◽  
Hodgkin's Lymphoma ◽  
Patterns Of Failure ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

Maximum-tolerated dose, toxicity, and efficacy of (131)I-Lym-1 antibody for fractionated radioimmunotherapy of non-Hodgkin's lymphoma.

1998 ◽  
Vol 16 (10) ◽  
pp. 3246-3256 ◽  
Author(s):  
G L DeNardo ◽  
S J DeNardo ◽  
D S Goldstein ◽  
L A Kroger ◽  
K R Lamborn ◽  
...  
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Radiation Dosimetry ◽  
Large Cell ◽  
Maximum Tolerated Dose ◽  
Hodgkin's Lymphoma ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Iodine 131 ◽  
Grade 3 ◽  
Dose Limiting Toxicity

PURPOSE Lym-1, a monoclonal antibody that preferentially targets malignant lymphocytes, has induced remissions in patients with non-Hodgkin's lymphoma (NHL) when labeled with iodine 131 ((131)I). Based on the strategy of fractionating the total dose, this study was designed to define the maximum-tolerated dose (MTD) and efficacy of the first two, of a maximum of four, doses of (131)I-Lym-1 given 4 weeks apart. Additionally, toxicity and radiation dosimetry were assessed. MATERIALS AND METHODS Twenty patients with advanced NHL entered the study a total of 21 times. Thirteen (62%) of the 21 entries had diffuse large-cell histologies. All patients had disease resistant to standard therapy and had received a mean of four chemotherapy regimens. (131)I-Lym-1 was given after Lym-1 and (131)I was escalated in cohorts of patients from 40 to 100 mCi (1.5 to 3.7 GBq)/m2 body surface area. RESULTS Mean radiation dose to the bone marrow from body and blood (131)I was 0.34 (range, 0. 1 6 to 0.63) rad/mCi (0.09 mGy/MBq; range, 0.04 to 0.17 mGy/ MBq). Dose-limiting toxicity was grade 3 to 4 thrombocytopenia with an MTD of 100 mCi/m2 (3.7 GBq/m2) for each of the first two doses of (131)I-Lym-1 given 4 weeks apart. Nonhematologic toxicities did not exceed grade 2 except for one instance of grade 3 hypotension. Ten (71 %) of 14 entries who received at least two doses of (131)I-Lym-1 therapy and 11 (52%) of 21 total entries responded. Seven of the responses were complete, with a mean duration of 14 months. All three entries in the 100 mCi/m2 (3.7 MBq/m2) cohort had complete remissions (CRs). All responders had at least a partial remission (PR) after the first therapy dose of (131)I-Lym-1. CONCLUSION (131)I-Lym-1 induced durable remissions in patients with NHL resistant to chemotherapy and was associated with acceptable toxicity. The nonmyeloablative MTD for each of the first two doses of (131)I-Lym-1 was 100 mCi/m2 (total, 200 mCi/m2) (3.7 GBq/m2; total, 7.4 GBq/m2).

Coherent view of non-Hodgkin's lymphoma.

1995 ◽  
Vol 13 (10) ◽  
pp. 2656-2675 ◽  
Author(s):  
A C Aisenberg
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Large Cell ◽  
Hodgkin's Lymphoma ◽  
Malignant Neoplasms ◽  
Low Grade ◽  
Cell Leukemia Virus Type ◽  
Microscopic Appearance ◽  
Non Hodgkin’S Lymphoma ◽  
Incidence And Mortality ◽  
Non Hodgkin's Lymphoma

PURPOSE Even though non-Hodgkin's lymphoma is already sixth in incidence and mortality among malignant neoplasms (and the incidence was increasing at a rate of 3% to 4% per year before the advent of AIDS epidemic-associated lymphomas), most physicians and many oncologists find the disorder arcane. The problem lies in the complexity of human lymphoma, which encompasses more than a dozen neoplasms of the lymphoid system. The goal of this review is to provide user-friendly access to the condition. METHODS The variety of inputs required for a subdivision of non-Hodgkin's lymphoma that is useful to clinicians includes lymphocyte lineage and sublineage based on microscopic appearance and immunophenotype, clinical behavior manifest in survival and early dissemination, and analysis of molecular genetic and cytogenetic abnormalities, which reflect pathogenic oncogene derangements. Epstein-Barr virus (EBV) and human T-cell leukemia virus type 1 (HTLV-1) are important in certain uncommon lymphomas. RESULTS AND CONCLUSION The subtypes of primary B-lineage nodal lymphoma include low-grade (small lymphocytic, lymphoplasmacytic-lymphoplasmacytoid, follicular small cleaved cell, and follicular mixed small cleaved and large cell), intermediate-grade (follicular large cell, diffuse small cleaved or mixed, and intermediate lymphocytic), and high-grade (diffuse large cell, immunoblastic, and small noncleaved cell) neoplasms. The less common lymphomas of T lineage and lymphomas that arise in extranodal sites are placed in separate subdivisions. This subdivision serves as a guide to prognosis and treatment.

scholarly journals t(3;22)(q27;q11): a novel translocation associated with diffuse non- Hodgkin's lymphoma [see comments]

Blood ◽  
1989 ◽  
Vol 74 (6) ◽  
pp. 1876-1879 ◽  
Author(s):  
K Offit ◽  
S Jhanwar ◽  
SA Ebrahim ◽  
D Filippa ◽  
BD Clarkson ◽  
...  
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Cell Lymphoma ◽  
Large Cell ◽  
Hodgkin's Lymphoma ◽  
Cell Type ◽  
Cell Surfaces ◽  
Lambda Light Chain ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Immunodeficiency Virus

Abstract Of 187 specimens of non-Hodgkin's lymphoma and four hyperplastic lymphoid proliferations with clonal chromosome abnormalities ascertained serially over a 4 1/2-year period, nine cases with t(3;22)(q27;q11) were identified. Seven of the lymphomas were diffuse tumors, predominantly large cell type. The eighth tumor, a follicular small cleaved cell lymphoma, exhibited a t(3;22) and a t(14;18)(q32;q21). The ninth case was a lymph node from a human immunodeficiency virus-positive patient which showed atypical hyperplasia. Overall survival of t(3;22) diffuse lymphoma patients was not different from that of patients with abnormal karyotypes without t(3;22). The t(3;22) diffuse tumors studied showed a disproportionate frequency of lambda light chain on their cell surfaces, a finding similar to that observed in t(8;22)(q24;q11) Burkitt's lymphomas. Our results indicate that the t(3;22)(q27;q11) is the third most common recurring translocation in diffuse non-Hodgkin's lymphoma.

Outcome of Young Children with Non-Hodgkin's Lymphoma

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 5106-5106
Author(s):  
Laura Rodriguez ◽  
Mohammed Zolaly ◽  
Sheila Weitzman ◽  
Ahmed Naqvi ◽  
Angela Punnet ◽  
...  
Keyword(s):  
Young Children ◽  
Hodgkin’S Lymphoma ◽  
Conflicts Of Interest ◽  
Cell Lymphoma ◽  
Organ Transplant ◽  
B Cell Lymphoma ◽  
Large Cell ◽  
Hodgkin's Lymphoma ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

Abstract Abstract 5106 Background: The incidence and biology of non-Hodgkin's lymphoma (NHL) vary according to age, and the outcome differs amongst children being less favorable in infants and adolescents. Objectives: To analyze the outcome and toxicity patterns of young children with NHL comparing patients aged < 10 years to those 10–18 years of age. Methods: A retrospective review of children ≤ 18 years of age diagnosed with NHL over a period of 13 years. Patients were treated according to different protocols and treatment subgroups included: Burkitt lymphoma (BL), diffuse large B-cell lymphoma (DLBCL), lymphoblastic lymphoma (LL), anaplastic large cell lymphoma (ALCL), and peripheral T-cell lymphoma (PTCL). Post-organ transplant lymphoproliferative disorder (PTLD) and immunodeficient patients were excluded. Results: From 01/1995 to 12/2008, 173 children with NHL were reviewed. Of these, 81 pts (47%) were <10 years of age, with BL (29 pts), DLBCL (5 pts), PTCL (6 pts), LL (27 pts), and ALCL (14 pts). The 10-year overall survival (OS) was 93. 6+2. 8% in patients aged < 10 years compared to 77. 3+7. 2 in patients 10–18 years of age (P=0. 02). The 10-year event-free survival (EFS) was 89. 4+3. 5% in patients aged < 10 years compared to 70+9. 3% in patients 10–18 years of age (P=0. 03). BL was the most common subtype in patients <10 years, with a 10-year EFS of 96. 4+3. 5% versus 82. 6+7. 9% in patients 10–18 years of age (P=0. 10). The most common subtype in patients 10–18 years of age was ALCL (36%), the 10-year EFS was 78. 5+8. 3 versus 92. 9+6. 9 in patients < 10 years (P=0. 29). Children 10–18 years of age were more likely to develop neurotoxicity (9. 7% vs 0%), gastrointestinal toxicity (30% vs 12%), and treatment-related mortality (4. 3% vs 2. 4%). Conclusions: Children < 10 years with NHL have better outcomes and less treatment-related toxicity than older children. Disclosures: No relevant conflicts of interest to declare.

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