scholarly journals Treatment strategies for diffusive large B-cell lymphoma

2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Kong Linling ◽  
Zou Lingqing ◽  
Gu Siyu ◽  
Liu Hong ◽  
Song Guoqi ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Treatment Strategies ◽  
B Cell Lymphoma ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Early 18fluorodeoxyglucose PET Scan as a Prognostic Tool in Diffuse Large B-Cell Lymphoma Patients Treated with An Anthracycline-Based Chemotherapy Plus Rituximab.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 98-98 ◽  
Author(s):  
Violaine Safar ◽  
Jehan Dupuis ◽  
Fabrice Jardin ◽  
Christophe Fruchart ◽  
Stéphane Bardet ◽  
...  
Keyword(s):  
B Cell ◽  
Prognostic Value ◽  
Cell Lymphoma ◽  
Treatment Strategies ◽  
B Cell Lymphoma ◽  
Rank Test ◽  
Log Rank Test ◽  
Large B Cell Lymphoma ◽  
Dose Dense ◽  
Large B Cell

Abstract Abstract 98 Background: 18Fluorodeoxyglucose PET has been quickly integrated to the diagnostic and therapeutic armamentarium in diffuse large-B cell lymphoma (DLBCL). Moreover, early PET appears a promising prognostic tool for tailoring treatment strategies. We evaluated the predictive value of early PET in a large prospective cohort of patients treated with immunochemotherapy. Patients and methods: 112 previously untreated patients from three institutions were treated between January 2000 and October 2008 for DLBCL using an anthracycline-based regimen plus Rituximab. Chemotherapy was either an R-CHOP21 regimen (n=57) or a dose-dense regimen (R-ACVBP, n=31 or R-CHOP14, n= 24). PET was performed at diagnosis and after two cycles of treatment. Early PET results were interpreted visually as positive (PET2p) or negative (PET2n), as previously described1, but did not modify the scheduled therapy. Results: Median age at diagnosis was 59 years (range 20–79 years) and 67% of patients were males, 44% were over 60 years, 81% presented with an advanced Ann Arbor stage (III–IV), 29% had a poor performance status (ECOG 2-4), 36% had more than one extra-nodal site involved and LDH were elevated in 68%. The repartition on the basis of the International Prognosis Index was the following: low=5%, low-intermediate =35%, intermediate-high=37% and high risk=23%. After two cycles, 70 patients (63%) were PET2n and 42 (38%) were PET2p (38 patients in partial response and 4 with stable disease). Median follow-up was 38 months for living patients. Ten of 70 (14%) PET2n patients showed progression versus 22 of 42 (52%) PET2p patients. The estimated 5-year progression free survival (PFS) was 81% for PET2n and 47% for PET2p patients (log rank test, p<0.0001). Prognostic value of early PET was significant in terms of PFS whether patients were treated with R-CHOP21 (p=0.0006) or with dose-dense regimens (p=0.0056). Nine of 70 (13%) PET2n and 15 of 42 (36%) PET2p patients died. The estimated 5-year overall survival (OS) was 88% for PET2n and 62% for PET2p patients (log rank test, p<0.0034). Prognostic value of early PET was significant in terms of OS for patients treated with R-CHOP21 (p=0. 0225) but not for those treated with dose-dense regimens (p=0.133). Conclusion: Early PET after 2 cycles of treatment is a powerful tool to predict outcome in DLBCL patients treated with Rituximab combined with an anthracycline-based chemotherapy. It brings promising opportunities in the designing of new treatment strategies for DLBCL. Reference : 1 Haioun et al. Blood 2005; 106(4):1376–81. Disclosures: No relevant conflicts of interest to declare.

Primary breast diffuse large B-cell lymphoma: treatment strategies and patterns of failure

2018 ◽  
Vol 59 (12) ◽  
pp. 2896-2903 ◽  
Author(s):  
Ethan B. Ludmir ◽  
Sarah A. Milgrom ◽  
Chelsea C. Pinnix ◽  
Jillian R. Gunther ◽  
Jason Westin ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Treatment Strategies ◽  
B Cell Lymphoma ◽  
Patterns Of Failure ◽  
Large B Cell Lymphoma ◽  
Lymphoma Treatment ◽  
Large B Cell

The molecular pathogenesis of primary mediastinal large B-cell lymphoma

Blood ◽  
2011 ◽  
Vol 118 (10) ◽  
pp. 2659-2669 ◽  
Author(s):  
Christian Steidl ◽  
Randy D. Gascoyne
Keyword(s):  
B Cell ◽  
Hodgkin Lymphoma ◽  
Immune Escape ◽  
Cell Lymphoma ◽  
Treatment Strategies ◽  
B Cell Lymphoma ◽  
Janus Kinase ◽  
Molecular Characteristics ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Abstract Primary mediastinal large B-cell lymphoma (PMBCL) is a recognized non-Hodgkin lymphoma entity with unique pathologic, clinical, and molecular characteristics distinct from those of other diffuse large B-cell lymphomas. Immunohistochemical characterization and molecular studies strongly suggest that PMBCL is of germinal center or postgerminal center origin. Pivotal gene expression profiling work defined major deregulated pathway activities that overlap with Hodgkin lymphoma and prompted a more detailed analysis of candidate genes. In particular, the nuclear factor-κB and the Janus Kinase-Signal Transducer and Activator of Transcription signaling pathways are targeted by multiple genomic hits, and constitutive activity of both pathways can be considered molecular hallmark alterations of PMBCL. Moreover, data are emerging giving unique insight into remodeling of the epigenome that affects transcriptional regulation of a multitude of genes. More recently, the tumor microenvironment of PMBCL has shifted into focus based on a number of gene perturbations altering expression of surface molecules that contribute to immune escape. These findings highlight the importance of immune privilege in the pathogenesis of PMBCL and suggest that disrupting crosstalk between the tumor cells and the microenvironment might be a rational new therapeutic target in conjunction with traditional treatment strategies.

scholarly journals Two-Year Complete Remission of Diffuse Large B-Cell Lymphoma in an Immunological Nonresponder HIV-Infected Patient: Case Report

2017 ◽  
Vol 10 (1) ◽  
pp. 356-360
Author(s):  
Miodrag Vrbic ◽  
Ivan Petkovic ◽  
Svetislav Vrbic ◽  
Maja Jovanovic ◽  
Aleksandar Rankovic ◽  
...  
Keyword(s):  
Case Report ◽  
Complete Remission ◽  
B Cell ◽  
Cell Lymphoma ◽  
Treatment Strategies ◽  
B Cell Lymphoma ◽  
Virologic Response ◽  
Close Monitoring ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Introduction: HIV-infected patients are affected significantly more frequently by all types of lymphoma, with diffuse large B-cell lymphoma (DLBCL) as the most prevalent histological type. Since the introduction of combination antiretroviral therapy (cART) morbidity and mortality of DLBCL has been markedly reduced, which is primarily interpreted as a result of the drug-mediated immune reconstitution. Case Report: We present a previously healthy, 44-year-old HIV-infected man with DLBCL of the oral cavity, treated with immunochemotherapy and cART. During HIV-directed treatment, despite the successful virologic response, a satisfactory immunological response was not achieved. However, the patient had a 2-year complete remission after first-line treatment of DLBCL. Conclusion: Response to cART strongly predicts outcome in patients with DLBCL. Close monitoring of HIV-directed therapy efficacy, especially as to achievement of successful virologic response, independently associated with prolonged survival, is essential for estimating future DLBCL treatment strategies.

Treatment strategies and outcomes in diffuse large B-cell lymphoma among 1011 patients aged 75 years or older: A Danish population-based cohort study

2018 ◽  
Vol 99 ◽  
pp. 86-96 ◽  
Author(s):  
Maja Bech Juul ◽  
Pernille Hammershoej Jensen ◽  
Henriette Engberg ◽  
Sonja Wehberg ◽  
Andriette Dessau-Arp ◽  
...  
Keyword(s):  
Cohort Study ◽  
B Cell ◽  
Cell Lymphoma ◽  
Treatment Strategies ◽  
B Cell Lymphoma ◽  
Population Based ◽  
Danish Population ◽  
Large B Cell Lymphoma ◽  
Large B Cell

scholarly journals Diffuse Large B-Cell Lymphoma: Optimizing Therapy for Relapsed/Refractory Disease

2021 ◽  
Vol 19 (11.5) ◽  
pp. 1327-1330
Author(s):  
Matthew J. Matasar
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Treatment Strategies ◽  
B Cell Lymphoma ◽  
Autologous Stem Cell Transplant ◽  
Cell Transplant ◽  
Large B Cell Lymphoma ◽  
Third Line ◽  
To Receive ◽  
Large B Cell

Despite a growing therapeutic arsenal to treat relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL), outcomes remain poor. Only approximately half of patients with this disease are eligible to receive curative autologous stem cell transplant, and of those, only half will be cured. Moreover, for patients who are transplant-ineligible, there are few effective options. Dr. Matthew J. Matasar discussed the current unmet needs in the treatment of patients with R/R DLBCL, treatment strategies in the second- and third-line settings, and emerging therapeutic options.

Treatment strategies for aggressive lymphomas: what works?

Hematology ◽  
2013 ◽  
Vol 2013 (1) ◽  
pp. 584-590 ◽  
Author(s):  
Wyndham H. Wilson
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Randomized Study ◽  
Treatment Strategies ◽  
B Cell Lymphoma ◽  
Convincing Evidence ◽  
Large B Cell Lymphoma ◽  
History Of ◽  
Large B Cell ◽  
Better Than

Abstract Over the past 30 years, many treatment platforms have been developed for diffuse large B-cell lymphoma, but none proved better than CHOP (cyclophosphamide, hydroxydaunorubicin, vincristine, prednisone/prednisolone). In the immunochemotherapy era, however, there is convincing evidence for superior chemotherapy platforms. A randomized study from the Groupe d'Etude des Lymphomes de l'Adulte showed that R-ACVBP (rituximab plus doxorubicin, cyclophosphamide, vindesine, bleomycin, prednisone) was superior to rituximab plus CHOP (R-CHOP) in patients under 60 years of age, but toxicity limits its use to younger patients. Studies also suggest that DA-EPOCH-R (dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, rituximab) is more effective in some subtypes of diffuse large B-cell lymphoma and a randomized comparison with R-CHOP is now nearing completion. The simplicity and safety of R-CHOP and the long history of failed contenders, however, has set a high bar for new approaches.

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