• Title/Summary/Keyword: s lymphoma

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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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    • v.17 no.3
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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.

Efficacy and Safety of First Line Vincristine with Doxorubicin, Bleomycin and Dacarbazine (ABOD) for Hodgkin's Lymphoma: a Single Institute Experience

  • Ozdemir, Nuriye;Dogan, Mutlu;Sendur, Mehmet Ali Nahit;Yazici, Ozan;Abali, Huseyin;Yazilitas, Dogan;Akinci, Muhammed Bulent;Aksoy, Sercan;Zengi, Nurullah
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8715-8718
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    • 2014
  • Background: ABVD (doxorubicin, bleomycin, vinblastine (Vb) and dacarbazine) is the standard regimen in Hodgkin's lymphoma (HL).Vincristine (O) is a mitotic spindle agent like Vb. We aimed to evaluate the efficacy and safety of O as a part of ABOD in HL. Materials and Methods: Patients who had ABOD were enrolled. Stage I-II HL were evaluated for unfavorable risk factors according to NCCN. National Cancer Institute Common Toxicity Criteria was used for toxicity. Results: Seventy-nine HL patients in our center between 2003 and 2007 were evaluated retrospectively. Median follow-up was 54 months. Most of the patients were male in their third decade. Median ABOD cycles were 6 (2-8). Primary refractory disease rate was 17.7% whereas it was 5.1% for early relapse and 5.1% for late relapse disease. Response rates were as 82.3% for complete response, 11.4% for partial response, 5.1% for stable disease and 1.3% for progressive disease. Half of relapsed patients had autologous stem cell transplantation. Estimated 5-year failure-free survival was 71% and significantly longer in early stage patients without risk factors, bulky disease or radiotherapy (RT) (p=0.05, p<0.0001, p=0.02; respectively). Estimated 5-year overall survival was 74% and significantly longer in those who had no RT (p=0.001). Dose modification rate was 5.1% and chemotherapy delay rate was 19%. There were no toxicity-related deaths. Conclusions: ABOD seems to be effective with managable toxicity in HL, even in those with poor prognostic factors.

Intra-abdominal Kikuchi's Disease Mimicking Malignant Lymphoma on FDG PET-CT (FDG PET-CT에서 악성림프종처럼 보이는 복부 기쿠치병)

  • Han, Hye-Suk;Kim, Gi-Hyun;Cho, Young-Shim;Joo, Hye-Jin;Lee, Ok-Jun;Ryu, Dong-Hee;Lee, Ki-Hyeong;Kim, Seung-Taik
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.4
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    • pp.363-365
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    • 2009
  • Kikuchi's disease is a self-limiting benign disease characterized by cervical lymphadenopathy, but it can be mistaken for malignant disease, and when involved lymph nodes are unusually located, diagnosis can be more difficult. The authors report the case of a 19-year-old man with Kikuchi's disease, who had isolated intra-abdominal lymphadenopathy and increased 18-fluoro-deoxyglucose (FDG) uptake in positron emission tomography-computed tomography (PET-CT). Although its incidence is extremely rare, intra-abdominal Kikuchi's disease with increased FDG uptake in PET-CT image should be considered in the differential diagnosis when constitutional symptoms mimic those of malignant lymphoma.

A Case of Cardiac Lymphoma Developed in Right Atrium (우심방에 발생한 심장 임파종 -1례 보고-)

  • Won, Yong-Soon;Kim, Jin-Ho;Kweon, Jong-Bum;Park, Kuhn;Kwack, Moon-Sub
    • Journal of Chest Surgery
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    • v.33 no.12
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    • pp.971-973
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    • 2000
  • 원발성 심장 림프종은 드문 질환으로 원발성 심장종양의 1.3%를 차지하며 절외성 림프종의 0.5%에서 발생한다. 그러나 악성 림프종에 의한 이차성 심장 전이는 비교적 빈번해서 약 8.7-27.2%로 보고 되고 있다. 66세남자 환자는 호흡곤란을 주소로 내원하였다. 경흉부 심초음파에서 우심방내에 종괴가 관찰되었다. 종양의 수술적 제거를 시행하였고 조직학적 검사에서 우심방을 침범한 악성 임파종으로 진단되었다. 환자는 급성 종격동염이 발생하였고 술후 9일째 패혈증과 수술부위 출혈로 사망하였다.

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Primary Orbital Lymphoma : A Retrospective Analysis of Results of Radiation Therapy (원발성 안와 림프종의 방사선치료 성적에 관한 후향적 분석)

  • Kim Sussan;Ahn Seung Do;Chang Hyesook;Kim Kyoung Ju;Lee Sang-wook;Choi Eun Kyung;Kim Jong Hoon;Huh Jooryung;Suh Cheol Won;Kim Sung Bae
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.139-146
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    • 2002
  • Purpose : This study evaluated the treatment outcomes, patterns of failure, and treatment related complications of primary lymphoma patients who received definitive radiation therapy. Materials and Methods : A retrospective analysis was undertaken for 31 patients with primary orbital lymphoma at the Asan Medical Center between February 1991 and April 2001. There were 18 males and 13 females with ages ranging from 3 to 73 years (median, 44 years). The involved sites were 9 conjunctivae, 12 eyelids and 10 other orbits. The histological types were 28 MALT lymphomas (low-grade B-cell lymphoma of mucosa-associated lymphoid tissue type), 1 diffuse large B-cell lymphoma, 1 anaplastic large cell lymphoma and 1 lymphoblastic lymphoma. The Ann Arbor stages were all IE $(100\%)$. Ann Arbor stage III or IV patients were excluded from this study, Bilateral orbital involvement occurred in 6 cases. Radiation therapy was given with one anterior port of high energy electrons $(6\~16\;MeV)$ for the lesions located at the anterior structures like the conjunctivae or eyelids. Lesions with a posterior extension or other orbital lesions were treated with 4 or 6 MeV photons with appropriately arranged portals. In particular, lens blocks composed of lead alloy were used in conjunctival or eyelid lesions. Twelve patients received chemotherapy. The median follow-up period was 53 months. Results : The 5-year overall, cause-specific, and disease-free survival was $91\%,\;96\%,\;and\;80\%$, respectively. The complete response rate 6 months after radiation therapy was $100\%$. Local recurrences were observed in 2 patients at 16 and 18 months after completion of radiation treatment. They were salvaged with additional radiation therapy. Two patients developed distant metastases. A MALT lymphoma patient with a lung relapse was successfully salvaged with radiotherapy, but the other lymphoblastic lymphoma patient with bone marrow relapse expired. There were no severe complications but 5 patients developed radiation-induced cataracts and 2 patients developed dry eye. Conclusion : Most primary orbital lymphomas consisted of MALT lymphomas. Radiation therapy was a successful treatment modality for orbital lymphoma without any severe complications. In cases of local relapses, radiation therapy is also a very successful salvage treatment modality.

Dose Assessment of Orbital Adnexa in Electron Beam Therapy for Orbital Lymphoma (안와림프종의 전자선 치료 시 안구 부속기관에 대한 선량평가)

  • Dong Hwan Kim;Yong In Cho
    • Journal of the Korean Society of Radiology
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    • v.18 no.3
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    • pp.283-292
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    • 2024
  • Radiation side effects and complications on the ocular adnexa during electron beam therapy for orbital lymphoma can increase the incidence of posterior subcapsular cataracts. This study simulated a medical linear accelerator and a mathematical model of the eye using monte carlo simulations to evaluate the dose to the ocular adnexa and compare the shielding effectiveness on different parts of the ocular adnexa based on lens shield thickness. The dose assessment results of the ocular adnexa showed that the lens's sensitive area had the highest absorbed dose distribution when no shield was used, followed by the lens's non-sensitive area, the anterior chamber, vitreous humor, cornea, and eyelid in descending order. With the use of a shield, a 2 mm thick shield demonstrated a dose reduction effect of over 90% in the lens's sensitive area, over 83% in the non-sensitive area and anterior chamber, and a dose reduction effect of 30 to 62% in the vitreous body, cornea, and eyelid. For dose reduction in the lens's sensitive area during electron beam therapy for orbital lymphoma, it is necessary to use a shield of at least 2 mm thickness. Additionally, shielding strategies considering the thickness and area of the shield for other ocular adnexa besides the lens are required.

Mechanism of Radioresistance Induced by Low-Dose Irradiation (저준위 방사선에 의해 유도된 방사선저항의 기전)

  • Park, Sang-Hee;Cho, Chul-Koo;Yoo, Seong-Yul;Lee, Yeon-Hee
    • Journal of Radiation Protection and Research
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    • v.21 no.2
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    • pp.99-105
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    • 1996
  • After high-dose irradiation(8 Gy). the viability of lymphocyte with a prior low-dose irradiation was 3.7-fold higher than that without a prior low-dose irradiation The viability could be increased by the reduction of oxygen radicals or the removal of damaged molecules-DNA, protein. lipid membrane. or the removal of damaged cells. In this paper. we studied the radioresistance mechanism in lymphocytes and lymphoma cells by examining the activities of radical scavengers(catalase. peroxidase, superoxide dismutase, and glucose-6-phosphate dehydrogenase), and a radical protector(glutathione). Different enzymes were induced in lymphocyte and lymphoma with low-dose irradiation. The activity of peroxidase increased most(133.3%) in lymphoma while the enzymes increased most in lymphocyte were superoxide dismutase (138.5%), glucose-6-phosphate dehydrogenase (122.4%) and glutathione(120.8%). The activities of these enzymes were highest when the interval was 7 hours between low-dose and high-dose irradiation.

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Medical review of Insurance claims for GIST and MALToma (기스트와 말토마의 보험의학적 악성도 판단)

  • Lee, Sin-Hyung
    • The Journal of the Korean life insurance medical association
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    • v.27 no.2
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    • pp.68-74
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    • 2008
  • Medical verification of cancer diagnosis in insurance claims is a very important procedure in insurance administrations. Claims staffs are in need of medical experts' opinions about claim administration. This procedure is called medical claim review (MCR) and is composed of verification and advice. MCR verification evaluates the insured’s physical condition by medical records and compares it with product coverage. It is divided into assessment of living assurance benefit, verification of cancer, and assessment of the cause of death. Actually cancer verification of MCR is applicable to coding because the risk ratio in product development is usually coded data. There are some confusing neoplastic diseases in assessing the verification of cancer. This article reviews gastrointestinal stromal tumors (GIST) and mucosa-associated lymphoid tissue tumors (MALToma) of the stomach. The second most common group of stromal or mesenchymal neoplasms affecting the gastrointestinal tract is GIST. Nowadays there are many articles about the pathophysiology of GIST. However there are few confirmative theories except molecular cell biology of KIT mutation and some tyrosine kinase. Therefore, coding the GIST, which has previously been classified as an intermediate risk group according to NIH2001 criteria, for cancer verification of MCR is suitable for D37.1; neoplasm of uncertain or unknown behavior of digestive organs and the stomach. The gastrointestinal tract is the predominant site of extranodal non-Hodgkin's lymphomas. B-cell lymphomas of the MALT type, now called extranodal marginal zone B-cell lymphoma of MALT type in the REAL/WHO classification, are the most common primary gastric lymphomas worldwide. Its characteristics are as follows. First, it is different from traditional stomach cancers such as gastric adenocarcinoma. Second, the primary therapy of MALToma is the eradication of H. pylori by antibiotics and the remission rate is over 80%. Third, it has a different clinical course compared to traditional malignant lymphoma. Someone insisted that cancer verification is not possible for the above reasons. However, there have been findings on pathologic mechanism, and according to WHO classification, MALToma is classified into malignant B-cell lymphoma and it must be verified as malignancy in MCR.

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Effects of Radiotherapy on the Risk of Developing Secondary Malignant Neoplasms in Hodgkin's Lymphoma Survivors

  • Abou-Antoun, Tamara;Mikhael, Rachelle;Massoud, Marcel;Chahine, Georges;Saad, Aline
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.749-754
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    • 2016
  • Extended follow-up of Hodgkin lymphoma (HL) survivors indicates that these patients are at high risk of secondary malignant neoplasms (SMNs) contributing to increased morbidity and mortality. This study examined the characteristics of HL survivors who developed SMNs with the aim to report any correlation with radiotherapy (RT) dose. In this retrospective multi-center cohort study of HL patients treated between 1990 and 2011 at three major teaching hospitals in Lebanon, classification was into two groups including those treated with combined modality (RT and chemotherapy-CHT) and those treated with CHT alone. Approval from the University Institutional Review Board (IRB) was obtained. Of the 112 patients evaluated, 52.7% (59) received the combined modality while 47.3% (53) received CHT alone. There were 6 cases of SMNs in the combined modality cohort and 5 cases in the CHT cohort. The mean RT dose in the combined modality cohort was 34.5 Gray (Gy) ($SD{\pm}5.3$). A statistically significant increase (1.5 fold) in the risk of developing SMNs was observed among patients who received a dose higher than 41 Gy compared to a dose between 20 to 30 Gy (OR= 1.5; 95% confidence interval= 0.674 to 3.339, p=0.012). The risk of SMNs was not significantly higher among patients who received extended field compared to involved field RT (p=0.964). This study showed that the risk of developing SMNs is higher among patients treated with RT dose greater than 31 Gy, independent of the RT type used.