DOCSLIB.ORG

Aggressive Non-Hodgkin Lymphoma

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Aggressive Non-Hodgkin Lymphoma 19 th Congress of the European Hematology Association standard chemotherapy protocols. Planar and SPECT images were carried Aggressive Non-Hodgkin lymphoma - Clinical out 30 minutes and 3 hours after intravenous injection of 740 MBq 99m Tc- Tetrofosmin and analyzed qualitatively and quantitatively. The scintigraphic results were compared with the data of conventional methods (clinical PB1813 examination, x-ray, CT). Additionally, patients underwent 18F-FDG PET-CT scan. Beta-2-microglobulin was measured by radioimmunoassay. THE ROLE OF HIGH DOSE CHEMOTHERAPY FOLLOWED BY Results: 99mTc-Tetrofosmin scintigraphy was positive in 42 patients with HL AUTOLOGOUS STEM CELL TRANSPLANTATION AS FIRST LINE and NHL before treatment. From 58 detected lesions 40 had lymph node TREATMENT IN PATIENTS WITH AGGRESSIVE NON-HODGKIN involvement. Increased uptake of the radiotracer was demonstrated in LYMPHOMA: A SYSTEMATIC REVIEW AND META-ANALYSIS mediastinal, neck, supraclavicular, axillar and inguinal lymph nodes. Extranodal D Dahan-Shriki 1, A Gafter-Gvili 1,2, L Vidal 1,2, P Raanani 1,2, O Shpilberg 2, localization was detected in 18 lesions. The tumour/background ratio ranged R Gurion 1,2, * from 1.5 to 2.1. In six patients with false negative scintigraphy, CT investigation 1Institute of Hematology, Rabin Medical Center, Petah Tikva, 2Tel Aviv University, Tel Aviv, Israel showed enlarged abdominal lymph nodes. True negative 99mTc-Tetrofosmin scan after chemotherapy was registered in 37 patients. Focal pathological tetrofosmin uptake was seen in ten patients and 21 lesions were identified. Background: Rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) has been the mainstay of treatment in patients with Fourteen lymph node lesions were detected in mediastinal, neck, aggressive non-Hodgkin lymphoma (NHL). Despite the improvement in survival supraclavicular, axillar and inguinal area. Seven lesions had extranodal rate with the addition of rituximab, there are still a significant proportion of localization – lungs and bones. False negative scintigraphy was found in 8 patients, whereas CT scan showed lesion with subdiaphragmatic localization. patients who cannot be cured with conventional therapy . One of the strategies to improve survival rate is consolidation treatment with high dose chemotherapy The presence of B-symptoms and elevated beta-2-microglobulin were found (HDT) followed by autologous stem cell transplantation (ASCT), especially in in these patients. The patients with inconclusive 99mTc-Tetrofosmin scan were young patients with high risk aggressive NHL. Randomized controlled trials referred to PET-CT. Additional 22 PET-CT positive nodal and extranodal that addressed this issue yielded conflicting results. subdiaphragmatic lesions were detected. 99mTc-Tetrofosmin is a promising tracer in Aims: In order to examine the effect of HDT and ACST on overall survival, we Summary and Conclusions: performed a systematic review and meta-analysis. determining disease activity in supradiaphragmatic lesions. This method that has high sensitivity and low radiation burden, is appropriate in lymphoma Methods: Systematic review and meta-analysis of randomized controlled trials comparing HDT and ASCT after achievement of complete remission (CR) or patients especially with supradiaphragmatic localization of the lesions. In partial remission (PR) to standard dose chemotherapy, with or without rituximab patients with small subdiaphragmatic lesions (<15 mm) and inconclusive as first line treatment in patients with aggressive NHL. The Cochrane Library, 99mTc- Tetrofosmin scintigraphy, PET-CT is method of choice. MEDLINE, conference proceedings and references were searched until December 2013. The primary outcome was overall survival (OS). Secondary outcomes were relapse rate, overall response (ORR), CR and secondary PB1815 malignancies. For dichotomous data, relative risk (RR) with 95% confidence BENDAMUSTINE PLUS RITUXIMAB FOR RELAPSED OR REFRACTORY intervals (CIs) were estimated and pooled and hazard ratios (HR) for time to DIFFUSE LARGE B CELL LYMPHOMA: A RETROSPECTIVE STUDY event data were estimated and pooled. We used fixed effect model to pool F Merchionne 1,* G Quintana 1, C Minoia 2, A Guarini 2, I Galise 3, G Quarta 1, results. G Loseto 2, A Melpignano 1 Results: Our search yielded 20 trials conducted between the years 1987 and 1Hematology Unit , Ospedale Antonio Perrino , Brindisi, 2Department of Medical 2011, including 4488 patients. In five trials rituximab was added to both arms. and Experimental Oncology, Hematology Unit, IRCCS National Cancer Median age of patients ranged between 31 to 51 years old. Seven trials Research Centre “Giovanni Paolo II”, 3Registro Tumori Puglia, IRCCS National included only patients with intermediate-high and high risk age-adjusted Cancer Research Centre “Giovanni Paolo II”, Bari, Italy international prognostic index (aaIPI). Ten trials were judged to be at low risk for selection bias (allocation concealment and sequence generation).Data from Background: After standard R-CHOP therapy, patients with relapsed or 19 trials were available for analysis of OS. Treatment with HDT and ASCT did refractory diffuse large B cell lymphoma (DLBCL) are generally treated with not improve OS as compared to standard dose chemotherapy, HR 1.09, 95% 2 aggressive salvage chemotherapy followed by high dose therapy with confidence interval (CI) 0.98-1.21, I for heterogeneity 32%. Also, no survival autologous stem-cell transplantation (ASCT). However, for patients who are not benefit was shown in a sub- analysis of patients with intermediate-high and high 2 eligible for intensive chemotherapies and ASCT because of comorbidities aaIPI (HR 1.08 95% CI (0.95-1.24), I =66%, 10 trials). However, HDT and and/or advanced age or relapse after heavy salvage regimens, treatment ASCT was associated with an increased rate of CR [RR 1.07 95% CI (1.02- options are very limited and prognosis is poor. Based on the demonstration of 1.11)], and a decreased rate of relapse, RR 0.58 95% CI (0.49-0.69). No efficacy and safety of bendamustine plus rituximab (BR) in patients with indolent statistically significant difference was observed regarding the incidence of and mantle cell non-Hodgkin lymphomas in terms of increased progression-free secondary malignancies. survival and fewer toxic effects than R-CHOP, additional studies are being HDT and ASCT as first line treatment for Summary and Conclusions: carried out to assess the activity and safety of this combination in patients with aggressive NHL is not associated with increased OS, yet it improves CR rate DLBCL not eligible for intensive chemotherapy regimens. and decreases relapse rate. The possibility to salvage relapsing patients with Aims: To analyze a group of patients with relapsed or refractory DLBCL treated HDT and ASCT may contribute to the lack of effect of this treatment on OS when with combination BR between July 2010 and January 2014, and to evaluate given as first line therapy. overall response rate (ORR), progression-free survival (PFS) and treatment safety. Methods: Of 22 patients registered, 19 (14 males and 5 females) are currently PB1814 available for this analysis. Patients gave informed consent. The median age USEFULNESS OF 99M TC-TETROFOSMIN SCINTIGRAPHY IN THE was 71 years (range 54-82); ECOG performance status was 1 (n=6, 27.2%), FOLLOW UP IN PATIENTS WITH MALIGNANT LYMPHOMA IN THE ERA OF 2 (n=15, 68.1%) and 3 (n=1, 4.5%); R-IPI scores before starting therapy were 18F-FDG PET-CT good (n=13, 59%) and poor (n=9, 41%). The median number of prior D Vassileva 1,* B Spassov 2, S Sergieva 3, M Garcheva 4, I Kostadinova 4 chemotherapy regimens was 2 (range 1-5); lactate dehydrogenase was 1Nuclear Medicine, 2Clinical hematology, NSBALHZ, 3Cancer Center, 4Nuclear elevated in 12 patients (54.5%) and normal in 10 (45.4%). The Ann Arbor Medicine, University Hospital Alexandrovska, Sofia, Bulgaria clinical stage at baseline was IV (n=8, 36.3%), III (n=8, 36.3%), and II (n=6, 27.2%). Rituximab was administered at the standard dose of 375 mg/m 2 and Background: In patients with malignant lymphomas the precise staging and bendamustine at a dose between 70 and 120 mg/m 2 (mean 90 mg/m 2) on days follow up is very important for treatment and prognosis of these patients. 1 and 2 of each 28-day cycle for up to six cycles. Nine patients (41%) completed 99mTc-Tetrofosmin is currently used to study myocardial perfusion, but also has six cycles of treatment and the median number of cycles received per patient been reported to be localized in various types of malignant tumours, including was 5 (range 1-6). lymphomas, giving their localization and proliferation activity. With previously Results: ORR was 47.3% (complete response: n=7 patients, 36.8% and partial used visualized techniques it has been extremely difficult to differentiate response: n=2 patients, 10.5%), with stable disease in 1 patient (5.2%) and metabolically active tumour tissue from post-therapy fibrosis. Nowadays 18F- progression disease in 9 patients (47.3%). At the median follow up of 6.4 FDG PET-CT is a method of choice for these applications. months (range 1 to 37.4 months), the median PFS was 7 months (95% CI 4.4 Aims: In this study, we aimed to evaluate the role of 99mTc-Tetrofosmin - 26.6) for all patients. Four patients showed remission lasting longer than 24 scintigraphy for therapy control of lymphoma patients in the era of 18F-FDG months. Grade 3 / 4 toxicities observed were: lymphopenia (42.1%), PET-CT.
Load more

Recommended publications
  • Tanibirumab (CUI C3490677) Add to Cart
    5/17/2018 NCI Metathesaurus Contains Exact Match Begins With Name Code Property Relationship Source ALL Advanced Search NCIm Version: 201706 Version 2.8 (using LexEVS 6.5) Home | NCIt Hierarchy | Sources | Help Suggest changes to this concept Tanibirumab (CUI C3490677) Add to Cart Table of Contents Terms & Properties Synonym Details Relationships By Source Terms & Properties Concept Unique Identifier (CUI): C3490677 NCI Thesaurus Code: C102877 (see NCI Thesaurus info) Semantic Type: Immunologic Factor Semantic Type: Amino Acid, Peptide, or Protein Semantic Type: Pharmacologic Substance NCIt Definition: A fully human monoclonal antibody targeting the vascular endothelial growth factor receptor 2 (VEGFR2), with potential antiangiogenic activity. Upon administration, tanibirumab specifically binds to VEGFR2, thereby preventing the binding of its ligand VEGF. This may result in the inhibition of tumor angiogenesis and a decrease in tumor nutrient supply. VEGFR2 is a pro-angiogenic growth factor receptor tyrosine kinase expressed by endothelial cells, while VEGF is overexpressed in many tumors and is correlated to tumor progression. PDQ Definition: A fully human monoclonal antibody targeting the vascular endothelial growth factor receptor 2 (VEGFR2), with potential antiangiogenic activity. Upon administration, tanibirumab specifically binds to VEGFR2, thereby preventing the binding of its ligand VEGF. This may result in the inhibition of tumor angiogenesis and a decrease in tumor nutrient supply. VEGFR2 is a pro-angiogenic growth factor receptor
    [Show full text]
  • Antibody Drug Conjugates in Lymphoma
    Review: Clinical Trial Outcomes Nathwani & Chen Antibody drug conjugates in lymphoma 6 Review: Clinical Trial Outcomes Antibody drug conjugates in lymphoma Clin. Investig. (Lond.) Antibody drug conjugates (ADCs) are comprised of monoclonal antibodies physically Nitya Nathwani1 & Robert linked to cytotoxic molecules. They expressly target cancer cells by delivering cytotoxic Chen*,1 agents to cells displaying specific antigens, and minimize damage to normal tissue. The 1Department of Hematology & Hematopoietic Cell Transplantation, City efficacy and tolerability of these agents are primarily determined by the target antigen, of Hope, Duarte, CA, USA the cytotoxic agent and the linker connecting the cytotoxic agent to the monoclonal *Author for correspondence: antibody. Following advances in technology, clinical trials have demonstrated greater Tel.: +626 256 4673 (ext. 65298) efficacy for ADCs compared with the corresponding naked monoclonal antibodies. Fax: +626 301 8116 This review summarizes the features of current clinically active ADCs in lymphoma and [email protected] emphasizes recent clinical data elucidating the benefit of antibody-directed delivery of cytotoxic agents to tumor cells. Keywords: antibody drug conjugates • lymphoma • monoclonal antibodies Lymphoma is the most common hematologic concentration and poor performance status malignancy, and is subdivided into two main are adverse prognostic factors. SEER (Sur- types: Hodgkin lymphoma (HL) and non- veillance, Epidemiology and End Results) Hodgkin lymphoma (NHL). In the United data from the National Cancer Institute, States, there are an estimated 731,277 people 2013 has revealed a significant improvement 10.4155/CLI.14.73 living with or in remission from lymphoma. in survival rates in this group of diseases in In 2013, there were an estimated 79,030 new the last four decades.
    [Show full text]
  • CD20-Negative Diffuse Large B-Cell Lymphomas: Biology and Emerging Therapeutic Options
    Expert Review of Hematology ISSN: 1747-4086 (Print) 1747-4094 (Online) Journal homepage: http://www.tandfonline.com/loi/ierr20 CD20-negative diffuse large B-cell lymphomas: biology and emerging therapeutic options Jorge J Castillo, Julio C Chavez, Francisco J Hernandez-Ilizaliturri & Santiago Montes-Moreno To cite this article: Jorge J Castillo, Julio C Chavez, Francisco J Hernandez-Ilizaliturri & Santiago Montes-Moreno (2015) CD20-negative diffuse large B-cell lymphomas: biology and emerging therapeutic options, Expert Review of Hematology, 8:3, 343-354, DOI: 10.1586/17474086.2015.1007862 To link to this article: http://dx.doi.org/10.1586/17474086.2015.1007862 Published online: 01 Feb 2015. Submit your article to this journal Article views: 165 View related articles View Crossmark data Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=ierr20 Download by: [North Shore Med Ctr], [Jorge Castillo] Date: 16 March 2016, At: 07:44 Review CD20-negative diffuse large B-cell lymphomas: biology and emerging therapeutic options Expert Rev. Hematol. 8(3), 343–354 (2015) Jorge J Castillo*1, CD20-negative diffuse large B-cell lymphoma (DLBCL) is a rare and heterogeneous group of Julio C Chavez2, lymphoproliferative disorders. Known variants of CD20-negative DLBCL include plasmablastic Francisco J lymphoma, primary effusion lymphoma, large B-cell lymphoma arising in human herpesvirus 8-associated multicentric Castleman disease and anaplastic lymphoma kinase-positive DLBCL. Hernandez-Ilizaliturri3 Given the lack of CD20 expression, atypical cellular morphology and aggressive clinical and Santiago 4 behavior characterized by chemotherapy resistance and inferior survival rates, CD20-negative Montes-Moreno DLBCL represents a challenge from the diagnostic and therapeutic perspectives.
    [Show full text]
  • Oligodendroglial Tumor Chemotherapy Using “Decreased-Dose- Intensity”
    Oligodendroglial Abstract—The authors propose “decreased-dose-intensity” PCV (procarbazine, lomustine [CCNU], and vincristine) chemotherapy for Asian patients with oli- tumor chemotherapy godendroglial tumors. In this study, all seven patients with oligodendroglioma using “decreased-dose- (OD) and eight with anaplastic oligodendroglioma (AO) had objective responses or stable disease. Median progression-free survival was greater than 29 intensity” PCV: A months (OD) and 36.5 months or greater (AO); 86% of patients with OD and Singapore experience 63% with AO remain progression-free. Twenty-four Common Toxicity Criteria Grade 3/4 adverse events were noted. NEUROLOGY 2006;66:247–249 A.U. Ty, MD; S.J. See, MD; J.P. Rao, MD; J.B.K. Khoo, MD, FRCR; and M.C. Wong, FRCP Oligodendroglial tumors are among the most chemo- (CR), partial response (PR), stable disease, and progressive dis- 3 ϩ sensitive of human solid malignancies. In terms of ease (PD) were used. The proportion of [CR PR] constituted the objective response rate. Progression-free survival (PFS) was the cost and availability, PCV (procarbazine, lomustine period from initiation of chemotherapy to disease progression or [CCNU], and vincristine) chemotherapy is the most death. Grade 3/4 Common Toxicity Criteria (NCI-CTC version 2.0) viable chemotherapeutic option for patients with oli- adverse events (AEs) were noted. godendroglial tumors in Asia. PCV-associated toxic- ity, particularly cumulative myelosuppression, is Results. Treatment outcome and PFS data are summa- well described among white patients.1,2 There are no rized in table 1. No patient had development of PD while reports in the published literature describing Asian undergoing chemotherapy.
    [Show full text]
  • Ep 2569287 B1
    (19) TZZ _T (11) EP 2 569 287 B1 (12) EUROPEAN PATENT SPECIFICATION (45) Date of publication and mention (51) Int Cl.: of the grant of the patent: C07D 413/04 (2006.01) C07D 239/46 (2006.01) 09.07.2014 Bulletin 2014/28 (86) International application number: (21) Application number: 11731562.2 PCT/US2011/036245 (22) Date of filing: 12.05.2011 (87) International publication number: WO 2011/143425 (17.11.2011 Gazette 2011/46) (54) COMPOUNDS USEFUL AS INHIBITORS OF ATR KINASE VERBINDUNGEN ALS HEMMER DER ATR-KINASE COMPOSÉS UTILISABLES EN TANT QU’INHIBITEURS DE LA KINASE ATR (84) Designated Contracting States: • VIRANI, Aniza, Nizarali AL AT BE BG CH CY CZ DE DK EE ES FI FR GB Abingdon GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO Oxfordshire OX144RY (GB) PL PT RO RS SE SI SK SM TR • REAPER, Philip, Michael Abingdon (30) Priority: 12.05.2010 US 333869 P Oxfordshire OX144RY (GB) (43) Date of publication of application: (74) Representative: Coles, Andrea Birgit et al 20.03.2013 Bulletin 2013/12 Kilburn & Strode LLP 20 Red Lion Street (73) Proprietor: Vertex Pharmaceuticals Inc. London WC1R 4PJ (GB) Boston, MA 02210 (US) (56) References cited: (72) Inventors: WO-A1-2010/054398 WO-A1-2010/071837 • CHARRIER, Jean-Damien Abingdon • C. A. HALL-JACKSON: "ATR is a caffeine- Oxfordshire OX144RY (GB) sensitive, DNA-activated protein kinase with a • DURRANT, Steven, John substrate specificity distinct from DNA-PK", Abingdon ONCOGENE, vol. 18, 1999, pages 6707-6713, Oxfordshire OX144RY (GB) XP002665425, cited in the application • KNEGTEL, Ronald, Marcellus Alphonsus Abingdon Oxfordshire OX144RY (GB) Note: Within nine months of the publication of the mention of the grant of the European patent in the European Patent Bulletin, any person may give notice to the European Patent Office of opposition to that patent, in accordance with the Implementing Regulations.
    [Show full text]
  • (12) Patent Application Publication (10) Pub. No.: US 2017/0224667 A1 AZUMA Et Al
    US 20170224667A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2017/0224667 A1 AZUMA et al. (43) Pub. Date: Aug. 10, 2017 (54) CANCER CHEMOPREVENTIVE AGENT (30) Foreign Application Priority Data (71) Applicants: Arata AZUMA, Mitaka-shi, Tokyo Oct. 15, 2014 (JP) ................................. 2014-210690 (JP); KDL, Inc., Chiyoda-ku, Tokyo Publication Classification (JP) (51) Int. Cl. (72) Inventors: Arata AZUMA, Tokyo (JP); Yukiko A6II 3/448 (2006.01) MIURA, Tokyo (JP) A6II 45/06 (2006.01) (52) U.S. Cl. CPC .......... A61K 31/4418 (2013.01); A61K 45/06 (21) Appl. No.: 15/519,360 (2013.01) (22) PCT Filed: Apr. 21, 2015 (57) ABSTRACT (86) PCT No.: PCT/UP2015/062117 Provided is a medicine for cancer chemoprevention, the medicine being characterized by containing, as an active S 371 (c)(1), ingredient, pirfenidone or a pharmaceutically acceptable salt (2) Date: Apr. 14, 2017 thereof. Patent Application Publication Aug. 10, 2017 US 2017/0224667 A1 FG. 3 : E 838 C. ii-ECE 8A: i: 833 A883 :8. AER 8 ; ::::A; CARY 88C3S REAE i ! 3: R.EC8: 33 -x 8.8 : 88 38 3: & 2. US 2017/0224667 A1 Aug. 10, 2017 CANCER CHEMOPREVENTIVE AGENT lead to an increase in lung cancer risk (non-patent document 2-3). Although a certain number of new compounds have TECHNICAL FIELD been reported to show chemopreventive activities, none of 0001. This invention is in the field of cancer chemopre them has shown effects in human. (patent document 1-6). vention. More precisely, this invention is to provide the 0008 Pirfenidone, 5-methyl-1-phenyl-2-(1H)-pyridone, method of cancer chemoprevention using the drug contain is widely known as an effective drug for the prevention and ing pirfenidone as a pharmacological active ingredient.
    [Show full text]
  • Drug Resistance in Non-Hodgkin Lymphomas
    International Journal of Molecular Sciences Review Drug Resistance in Non-Hodgkin Lymphomas Pavel Klener 1,2,* and Magdalena Klanova 1,2 1 First Department of Internale Medicine-Hematology, University General Hospital in Prague, 128 08 Prague, Czech Republic; [email protected] 2 Institute of Pathological Physiology, First Faculty of Medicine, Charles University, Prague, 128 53 Prague, Czech Republic * Correspondence: [email protected] or [email protected] Received: 3 February 2020; Accepted: 15 March 2020; Published: 18 March 2020 Abstract: Non-Hodgkin lymphomas (NHL) are lymphoid tumors that arise by a complex process of malignant transformation of mature lymphocytes during various stages of differentiation. The WHO classification of NHL recognizes more than 90 nosological units with peculiar pathophysiology and prognosis. Since the end of the 20th century, our increasing knowledge of the molecular biology of lymphoma subtypes led to the identification of novel druggable targets and subsequent testing and clinical approval of novel anti-lymphoma agents, which translated into significant improvement of patients’ outcome. Despite immense progress, our effort to control or even eradicate malignant lymphoma clones has been frequently hampered by the development of drug resistance with ensuing unmet medical need to cope with relapsed or treatment-refractory disease. A better understanding of the molecular mechanisms that underlie inherent or acquired drug resistance might lead to the design of more effective front-line treatment algorithms based on reliable predictive markers or personalized salvage therapy, tailored to overcome resistant clones, by targeting weak spots of lymphoma cells resistant to previous line(s) of therapy. This review focuses on the history and recent advances in our understanding of molecular mechanisms of resistance to genotoxic and targeted agents used in clinical practice for the therapy of NHL.
    [Show full text]
  • Non-Hodgkin Lymphoma
    Non-Hodgkin Lymphoma Rick, non-Hodgkin lymphoma survivor This publication was supported in part by grants from Revised 2013 A Message From John Walter President and CEO of The Leukemia & Lymphoma Society The Leukemia & Lymphoma Society (LLS) believes we are living at an extraordinary moment. LLS is committed to bringing you the most up-to-date blood cancer information. We know how important it is for you to have an accurate understanding of your diagnosis, treatment and support options. An important part of our mission is bringing you the latest information about advances in treatment for non-Hodgkin lymphoma, so you can work with your healthcare team to determine the best options for the best outcomes. Our vision is that one day the great majority of people who have been diagnosed with non-Hodgkin lymphoma will be cured or will be able to manage their disease with a good quality of life. We hope that the information in this publication will help you along your journey. LLS is the world’s largest voluntary health organization dedicated to funding blood cancer research, education and patient services. Since 1954, LLS has been a driving force behind almost every treatment breakthrough for patients with blood cancers, and we have awarded almost $1 billion to fund blood cancer research. Our commitment to pioneering science has contributed to an unprecedented rise in survival rates for people with many different blood cancers. Until there is a cure, LLS will continue to invest in research, patient support programs and services that improve the quality of life for patients and families.
    [Show full text]
  • Relapsed Mantle Cell Lymphoma: Current Management, Recent Progress, and Future Directions
    Journal of Clinical Medicine Review Relapsed Mantle Cell Lymphoma: Current Management, Recent Progress, and Future Directions David A Bond 1,*, Peter Martin 2 and Kami J Maddocks 1 1 Division of Hematology, The Ohio State University, Columbus, OH 43210, USA; [email protected] 2 Division of Hematology and Oncology, Weill Cornell Medical College, New York, NY 11021, USA; [email protected] * Correspondence: [email protected] Abstract: The increasing number of approved therapies for relapsed mantle cell lymphoma (MCL) provides patients effective treatment options, with increasing complexity in prioritization and se- quencing of these therapies. Chemo-immunotherapy remains widely used as frontline MCL treatment with multiple targeted therapies available for relapsed disease. The Bruton’s tyrosine kinase in- hibitors (BTKi) ibrutinib, acalabrutinib, and zanubrutinib achieve objective responses in the majority of patients as single agent therapy for relapsed MCL, but differ with regard to toxicity profile and dosing schedule. Lenalidomide and bortezomib are likewise approved for relapsed MCL and are active as monotherapy or in combination with other agents. Venetoclax has been used off-label for the treatment of relapsed and refractory MCL, however data are lacking regarding the efficacy of this approach particularly following BTKi treatment. Anti-CD19 chimeric antigen receptor T-cell (CAR-T) therapies have emerged as highly effective therapy for relapsed MCL, with the CAR-T treatment brexucabtagene autoleucel now approved for relapsed MCL. In this review the authors summarize evidence to date for currently approved MCL treatments for relapsed disease including Citation: Bond, D.A; Martin, P.; sequencing of therapies, and discuss future directions including combination treatment strategies Maddocks, K.J Relapsed Mantle Cell and new therapies under investigation.
    [Show full text]
  • Mantle Cell Lymphoma
    Leukemia (1998) 12, 1281–1287 1998 Stockton Press All rights reserved 0887-6924/98 $12.00 http://www.stockton-press.co.uk/leu Mantle cell lymphoma: a retrospective study of 121 cases H Samaha1, C Dumontet1, N Ketterer1, I Moullet1, C Thieblemont1, F Bouafia1, E Callet-Bauchu2, P Felman2, F Berger3, G Salles1 and B Coiffier1 1Service d’He´matologie, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, and UPRES-JE 1879 ‘He´mopathies Lymphoides malignes’, Universite´ Claude Bernard, Pierre-Be´nite; 2Laboratoire d’He´matologie, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Be´nite; and 3Laboratoire d’Anatomie Pathologique, Hoˆpital Edouard-Herriot, Hospices Civils de Lyon, France Mantle cell lymphoma (MCL) patients represent a difficult prob- phoma usually begins as a disseminated disease with wide- lem, sometimes to establish the diagnosis but mostly because spread involvement of lymph nodes, spleen, bone marrow of their refractoriness to standard lymphoma treatments. Which treatments to apply and to whom is not yet defined. In this and other extranodal sites, specially the gastrointestinal tract study, we attempted to analyze the clinical features, to identify and Waldeyer ring. However, patients usually present a good the major prognostic factors, and to evaluate the outcome of performance status (PS) at diagnosis although adverse prog- 121 MCL patients treated in our institution between 1979 and nostic factors, such as high serum lactic dehydrogenase (LDH) 1997. Clinical data, treatment modalities, and International and ␤2-microglobulin levels, may be present. Initially, these Prognostic Index (IPI) score were evaluated. Median age was 63 patients usually respond to different types of therapy, but years.
    [Show full text]
  • Indolent Lymphoma in Dogs
    Indolent Lymphoma in Dogs You diagnose indolent lymphoma in a dog. What is indolent lymphoma? What is the prognosis and what are the treatment options? What is indolent lymphoma? Indolent lymphoma (also called small-cell or low-grade lymphoma) is an uncommon form of lymphoma in dogs, representing around 5-29%1 of all canine lymphoma. The subtypes described include follicular lymphoma, marginal zone lymphoma, mantle zone and T-zone lymphoma, which are all derived from B-cells (except for T-zone lymphoma, which is T-cell in origin).2,3 In general, indolent lymphoma is characterised by small lymphocytes, a low mitotic index and slow clinical course of progression. Most dogs with indolent lymphoma present with generalised lymphadenopathy. Some dogs present with solitary lymph node involvement or only splenic involvement. Few dogs present with clinical signs, and if clinical signs are present (including lymphadenopathy), it can wax and wane and is usually mild. T-zone lymphoma (TZL) T-zone lymphoma is the most common subtype in canine indolent lymphoma representing around 60% of dogs with indolent lymphoma.1 TZL is characterised by unique loss of CD45 expression, T-zone distinct histologic pattern and small clear cell cytomorphology.4-6 This subtype is associated with the longest median survival times in dogs with indolent lymphoma.1 Middle-aged to older dogs are primarily affected (median age 8 to 10 years).5 Common breeds affected include Golden retriever (40-50%)6,7 and Shih Tzu.5 There is no apparent gender predilection. Dogs typically present with generalised peripheral lymphadenopathy (that may wax and wane) and/or lymphocytosis with no clinical signs of illness (clinical substage a, 80%).5 If clinical signs are present, it is usually non-specific and mild.
    [Show full text]
  • Mantle Cell Lymphoma: Contemporary Diagnostic and Treatment Perspectives in the Age of Personalized Medicine
    Himmelfarb Health Sciences Library, The George Washington University Health Sciences Research Commons Medicine Faculty Publications Medicine 9-1-2017 Mantle Cell Lymphoma: Contemporary Diagnostic and Treatment Perspectives in the Age of Personalized Medicine. Jose D Sandoval-Sus Eduardo M Sotomayor George Washington University Bijal D Shah Follow this and additional works at: https://hsrc.himmelfarb.gwu.edu/smhs_medicine_facpubs Part of the Medicine and Health Sciences Commons APA Citation Sandoval-Sus, J., Sotomayor, E., & Shah, B. (2017). Mantle Cell Lymphoma: Contemporary Diagnostic and Treatment Perspectives in the Age of Personalized Medicine.. Hematology/Oncology and Stem Cell Therapy, 10 (3). http://dx.doi.org/10.1016/ j.hemonc.2017.02.003 This Journal Article is brought to you for free and open access by the Medicine at Health Sciences Research Commons. It has been accepted for inclusion in Medicine Faculty Publications by an authorized administrator of Health Sciences Research Commons. For more information, please contact [email protected]. Hematol Oncol Stem Cell Ther (2017) 10,99– 115 Available at www.sciencedirect.com ScienceDirect journal homepage: www.elsevier.com/locate/hemonc Mantle Cell Lymphoma: Contemporary Diagnostic and Treatment Perspectives in the Age of Personalized Medicine Jose D. Sandoval-Sus a,*, Eduardo M. Sotomayor b, Bijal D. Shah a a Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA b Department of Hematology/Oncology, George Washington University, Washington, D.C., USA Received 6 October 2015; accepted 20 February 2017 Available online 6 April 2017 KEYWORDS Abstract Mantle cell lymphoma; Mantle cell lymphoma is a clinically heterogeneous disease occurring within a heterogeneous Prognosis; patient population, highlighting a need for personalized therapy to ensure optimal outcomes.
    [Show full text]