• 제목/요약/키워드: NHL

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Lymphoma - clinical questions

  • 김효철
    • 대한핵의학회:학술대회논문집
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    • 대한핵의학회 2002년도 춘계학술대회 및 총회
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    • pp.32-36
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    • 2002
  • Lymphoma is a group of neoplastic disease of lymphoid tissues, which can be classified into categories of Hodgkin's disease and non-Hodgkin's lymphoma(NHL). Prognosis of lymphoma depends on the extent of disease(staging) especially in Hodgkin's disease, but also depends on the histologic make up in non-Hodgkin's lymphoma. Although non-Hodgkin's lymphoma is a neoplastic transformation of lymphoid cell it is a collection of disease with merphologically and immunologically diverse make up. Consequently the classification of NHL has changed frequently and evolved according to the progress of immunologic and molecular knowledge added to the original morphologic classification. Lymphoma is a disorder sensitive to chemotherapy which often leads to cure of the disease even in advanced stage, while many other patients die from the progression of disease. Therefore, better understanding in newer classification and sensitive imaging technique, such as PET, in lymphoma will likely lead to the improvement of survival rate.

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동측 이하선과 측경부에 발생한 혈관면역모세포 T세포 림프종 1예 (A Case of Angioimmunoblastic T-cell Lymphoma Involving the Ipsilateral Parotid and Lateral Neck)

  • 홍석정;이미지;김승우
    • 대한두경부종양학회지
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    • 제35권1호
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    • pp.37-40
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    • 2019
  • Angioimmunoblastic T-cell lymphoma (AITL) is a rare subtype of malignant lymphoma (ML), accounting for only 1 to 2% of all non-Hodgkin's lymphoma (NHL). Although ML of the parotid gland is rare, the majority are B-cell types. The AITL occurring synchronously in the parotid gland and lateral neck has not been reported earlier. It is classified as a high-grade malignancy with aggressive clinical features, and the prognosis is worse than any other type of NHL. We recently encountered a 72-year-old man with multiple mass on the ipsilateral parotid tail and lateral neck, and he was finally diagnosed as AITL. We report the unique and rare disease entity with a brief literature review.

Paraneoplastic demyelination in the brain presenting as a clinically occult non-Hodgkin's lymphoma

  • Son, Hyoshin;Choi, Jongsuk;Kim, Sung Un;Park, Kyung Seok
    • Annals of Clinical Neurophysiology
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    • 제21권2호
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    • pp.108-112
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    • 2019
  • Non-Hodgkin's lymphoma (NHL) may initially present with atypical neurological manifestations, including paraneoplastic neurological syndromes. Herein, we report the case showing an initial manifestation of systemic NHL with paraneoplastic demyelination in the brain that initially mimicked the symptoms of stroke, seizure, and brain tumor. A high index of suspicion and timely diagnostic workup is required to prevent diagnostic delay and commence proper management of the condition. In this situation, a whole-body FDG PET/CT could be useful to screen for occult malignancy.

Changing Trends of Adult Lymphoma in the Kingdom of Saudi Arabia - Comparison of Data Sources

  • Rauf, Muhammad Shahzad;Akhtar, Saad;Maghfoor, Irfan
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권5호
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    • pp.2069-2072
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    • 2015
  • Background: Lymphoma is one of the most common malignancies affecting the young Saudi population. This disease has diversified pathologies and clinical stages that necessitate well optimized clinical management. Regular updates of epidemiological behavior of lymphoma from various parts of the world are available but studies from the Kingdom of Saudi Arabia (KSA) in this field are not consistent. Objectives: The aim of this study was to investigate the current trends in presentation and distribution of lymphoma with special reference to incidence and mortality, gender, age, histopathological subtypes, and clinical stages at King Faisal Specialist Hospital and Research Centre (KFSH&RC). Materials and Methods: Our study included lymphoma data from Saudi Cancer Registry, and relative comparison against KFSH&RC tumor registry data, Gulf country data and International Agency for Research on Cancer data. Results: Common tumors in the West (lung, colon, and prostate) were found to be much less frequent in KSA while leukemia, lymphoma and thyroid cancers were more common. Non-Hodgkin Lymphoma (NHL) ranked 3rd most common cancer with age-adjusted incidence of 6/100,000. Estimated age adjusted mortality was 4/100,000 in KSA. There was a peak rise in incidence of lymphoma in 1997-2007. Most common NHL was diffuse large B cell lymphoma at KFSH&RC. A total of 434 cases were diagnosed in 5 years with 55% of them at advanced stage and 35% demonstrating bulky disease and high risk. KFSH&RC registered 35% of Hodgkins and 21% of total NHL identified in entire Saudi Cancer Registry, 2009. Conclusions: Results of this study are very unique, and reveal diverse trends. The findings provide valuable insights in the understanding of current epidemiological features of lymphoma in this part of the world.

Adult Non Hodgkin's Lymphoma Patients: Experience from a Tertiary Care Cancer Centre in North East India

  • Hazarika, Munlima;Iqbal, Asif;Krishnatreya, Manigreeva;Sharma, Jagannath Dev;Bhuyan, Chidananda;Saikia, Bhargab Jyoti;Roy, Partha Sarathi;Das, Rashmi;Nandy, Pintu;Kataki, Amal Chandra
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권7호
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    • pp.2879-2881
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    • 2015
  • There is paucity of data on non Hodgkin's lymphoma (NHL) from our population in North-East India. In this retrospective study, patients were consecutively followed-up to see the clinic-pathological pattern of NHL, various responses, and pattern of relapses to first line treatment with chemotherapy. All patients in the present study received standard regimen of cyclophosphamde, doxorubicin, vincristine, prednisolone (CHOP) with or without rituximab (R-CHOP) as per our institutional protocol as first line therapy. Our study has shown that, in our adult population, the majority of NHL cases present with stage II and stage III disease and extra nodal involvement, B-cell lymphomas and diffuse large cell lymphomas being the most common subtypes. International prognostic index was a significant factor for varied responses to treatment. The majority of relapses after complete remission occurred in the first year.

Lack of Association between Using Aspirin and Development of Non-Hodgkins Lymphoma: A Meta-analysis

  • Cheraghi, Maria;Amoori, Neda;Fallahzadeh, Hosein;Rahmani, Hossein
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권2호
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    • pp.787-792
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    • 2015
  • Background: Non-Hodgkins lymphoma (NHL) is a heterogeneous group of malignancies, originating in the lymphatic organs, whose incidence is increasing in developed as well as developing countries. Epidemiological evidence suggests that aspirin may reduce the incidence and mortality of several cancers. The main objective of this study was to evaluate the potential relationship between using aspirin and development of NHL with a meta-analysis. Materials and Methods: A total of 7 studies were included. Outcome was calculated and reported as odds ratios (ORs). Heterogeneity was assessed with Cochrane Q and $I^2$ statistics. Dissemination bias was evaluated by funnel plot visualization and trim-and-fill analysis. Results: Our analysis showed OR of developing NHL overall of 1(95% CI: 0.87-1.16, p=0.9), and in females this was 0.81 (95%CI: 0.72-.92, p=0.001) and in males 1.01 (95%CI: 0.82-1.26, p=0.86). The odds ratio (OR) of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) was 0.85 (95%CI: 0.75-0.97, p=0.02), The ORs of follicular lymphoma (FL) and large B-cell lymphoma (DLBCL) in individuals exposed to aspirin were 1.12 (95%CI: 0.86-1.45, p=0.37) and 1.03 (95%CI: 0.9-1.19, p=0.6) respectively. Conclusions: In conclusion, individuals taking aspirin do not demonstrate any change in risk of Non-Hodgkins lymphoma.

Phase III of Study of R-CHOP-21 vs R-CHOP-14 for Untreated Stage III and IV B-cell Non-Hodgkin's Lymphoma: a Report from Iran

  • Payandeh, Mehrdad;Najafi, Safa;Shojaiyan, Fateme-Zahra;Sadeghi, Masoud
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권3호
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    • pp.1513-1517
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    • 2016
  • Background: A combination of rituximab to cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is one of the most effective front-line therapies to treat B-cell non-Hodgkin's lymphoma (NHL). The aim of this trial was to evaluate overall survival (OS), progression free survival (PFS) and toxicity of R-CHOP-14 compared to R-CHOP-21 in untreated stage III and IV B-cell NHL patients with Iranian ethnicity. Materials and Methods: In phase III trial, patients with previously untreated stage III and IV indolent and aggressive B-cell NHL were randomly assigned by using a minimization method to receive six to eight cycles of either R-CHOP-21 (administered every 21 days) or R-CHOP-14 (administered every 14 days with granulocyte colony-stimulating factor). Results: A total of 143 patients were randomly enrolled in our study (66 patients in R-CHOP-14 group and 77 patients in R-CHOP-21), between 2011 and 2014. The mean follow-up was 45 months at the time of treatment analysis. The 2-year and 5-year PFS rates for the R-CHOP-14 group were 83.6% vs 73.6% and for R-CHOP-21 group were 75% vs 54%. The 2-year and 5-year OS rates for R-CHOP-14 group were 98% vs 89% and for R-CHOP-21 group were 84.4% vs 67.5%. There was a significant correlation for PFS and OS in the two arms. There was no significant difference between adverse events with the two regimens. Conclusions: In our research improved survival was found with CHOP-14 as compared to CHOP-21. It is possible that drug metabolism in different races/ethnicities may be one important factor.

The effect of the dexamethasone, cytarabine, and cisplatin (DHAP) regimen on stem cell mobilization and transplant outcomes of patients with non-Hodgkin's lymphoma who are candidates for up-front autologous stem cell transplantation

  • Jeon, So Yeon;Yhim, Ho-Young;Kim, Hee Sun;Kim, Jeong-A;Yang, Deok-Hwan;Kwak, Jae-Yong
    • The Korean journal of internal medicine
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    • 제33권6호
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    • pp.1169-1181
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    • 2018
  • Background/Aims: Data on dexamethasone, cytarabine, and cisplatin (DHAP) as a mobilization regimen, compared to high-dose cyclophosphamide (HDC), for up-front autologous stem cell transplantation (ASCT) in non-Hodgkin's lymphoma (NHL) is limited. Methods: Consecutive patients with aggressive NHL treated with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or rituximab-CHOP who underwent chemomobilization using HDC or DHAP plus granulocyte-colony stimulating factor (G-CSF) for up-front ASCT were enrolled from three institutions between 2004 and 2014. Results: Ninety-six patients (57 men) were included. Sixty-five patients (67.7%) received HDC; and 31 (32.3%), DHAP. The total CD34+ cells mobilized were significantly higher in patients receiving DHAP (16.1 vs. $6.1{\times}10^6/kg$, p = 0.001). More patients achieved successful mobilization with DHAP (CD34+ cells ${\geq}5.0{\times}10^6/kg$) compared to HDC (87.1% vs. 61.5%, respectively; p = 0.011), particularly within the first two sessions of apheresis (64.5% vs. 32.3%, respectively; p = 0.003). Mobilization failure rate (CD34+ cells < $2.0{\times}10^6/kg$) was significantly higher in patients receiving HDC (20.0% vs. 3.2%, p = 0.032). On multivariate analysis, the DHAP regimen (odds ratio, 4.12; 95% confidence interval, 1.12 to 15.17) was an independent predictor of successful mobilization. During chemomobilization, patients receiving HDC experienced more episodes of febrile neutropenia compared to patients receiving DHAP (32.3% vs. 12.9%, p = 0.043). Conclusions: The DHAP regimen was associated with a significantly higher efficacy for stem cell mobilization and lower frequency of febrile neutropenia. Therefore, DHAP plus G-CSF is an effective for mobilization in patients with aggressive NHL who were candidates for up-front ASCT.

Serological response 5 months after the BNT162b2 COVID-19 vaccination in patients with various hematological disorders in Japan

  • Yoshiaki Marumo;Takashi Yoshida;Yuki Furukawa;Kenji Ina;Ayumi Kamiya;Takae Kataoka;Satoshi Kayukawa
    • Clinical and Experimental Vaccine Research
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    • 제12권4호
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    • pp.319-327
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    • 2023
  • Purpose: Patients with hematological malignancies are at an increased risk of severe infection with coronavirus disease 2019 (COVID-19). However, developing an adequate immune response after vaccination is difficult, especially in patients with lymphoid neoplasms. Since the long-term effects of the BNT162b2 vaccine are unclear, the humoral immune response 5 months after the two vaccinations in patients with hematological disorders was analyzed. Materials and Methods: Samples were collected from 96 patients vaccinated twice with BNT162b2 and treated with at least one line of an antitumor or immunosuppressive drug in our hospital from November 2021 to February 2022. Serum anti-severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) spike (S) antibody titers were analyzed. Patients were age- and sex-matched using propensity matching and compared with a healthy control group. Patients with serum anti-SARS-CoV-2 S antibodies were defined as 'responder' if >50 U/mL. The patients had B-cell non-Hodgkin lymphoma (B-NHL), multiple myeloma, chronic myeloid leukemia, etc. Results: Patients had significantly low antibody levels (median, 55.3 U/mL vs. 809.8 U/mL; p<0.001) and a significantly low response rate (p<0.001). Multivariate analysis showed that patients with B-NHL, aged >72 years, were associated with a low response to vaccination. There were no significant differences between patients with chronic myeloid leukemia and healthy controls. Conclusion: Our study shows that patients with hematological disorders are at risk of developing severe COVID-19 infections because of low responsiveness to vaccination. Moreover, the rate of antibody positivity differed between the disease groups. Further studies are warranted to determine an appropriate preventive method for these patients, especially those with B-NHL.

건강근로자효과 보정 전후의 메타 분석 결과 비교 -직업적 트리클로로에틸렌 노출과 암의 연관성- (Comparison of Meta-analysis Results with and Without Adjustment for Healthy Worker Effect on the Association Between Occupational Exposure to Trichloroethylene and Cancer Risk)

  • 박태원;황성호;이경무
    • 한국환경보건학회지
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    • 제40권5호
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    • pp.385-396
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    • 2014
  • Objectives: By conducting a meta-analysis of cohort studies reporting standardized mortality ratios (SMRs) for workers exposed to trichloroethylene, we attempted to adjust for healthy hired effect by applying the same methods as described in a recent report from the Agricultural Health Study. Methods: Among all cohort studies that evaluated the association between all cancer, non-Hodgkin's lymphoma (NHL), kidney cancer, liver cancer and occupational exposure to trichloroethylene, a total of 10 studies reporting SMR values were selected. A random-effects model was used to estimate the summary SMRs or rSMRs and 95% confidence intervals. Relative SMR ($rSMR=SMR_x/SMR_{not\;x}$) was calculated comparing observed and expected counts for all cancer, NHL, kidney cancer, and liver cancer with an independent referent set of values consisting of the observed and expected counts for other causes. Results: The SMR values for all causes ranged from 0.68 to 1.03, suggesting moderate to weak healthy worker effect for the selected studies. When the healthy worker hire effect was taken into account, the summarized risk became statistically significant; the summary SMR of all cancer was 0.95 (0.91-1.00) and the summary rSMR of all cancer was 1.10 (1.04-1.15). The summary SMR of NHL was 1.04 (0.93-1.14) and the summary rSMR of NHL was 1.23 (1.04-1.46). The summary SMR of kidney cancer was 1.08 (0.88-1.33) and the summary rSMR of kidney cancer was 1.23 (1.02-1.49). The summary SMR of liver cancer was 0.88 (0.78-0.99), and the summary rSMR of liver cancer was 0.95 (0.84-1.07). Conclusion: The rSMR method is useful to determine summary risk adjusted for healthy worker effect through meta-analysis.