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1. Cao TM, Horning S, Negrin RS, Hu WW, Johnston LJ, Taylor TL, Shizuru JA, Hoppe RT, Brown BW, Blume KG, Stockerl-Goldstein KE: High-dose therapy and autologous hematopoietic-cell transplantation for follicular lymphoma beyond first remission: the Stanford University experience. Biol Blood Marrow Transplant; 2001;7(5):294-301
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  • [Title] High-dose therapy and autologous hematopoietic-cell transplantation for follicular lymphoma beyond first remission: the Stanford University experience.
  • A retrospective analysis was performed to investigate the outcome of high-dose therapy (HDT) and autologous hematopoietic cell transplantation in patients with follicular lymphomas beyond first remission.
  • Ninety-two patients with primary induction failure or relapsed follicular low-grade lymphoma (FLGL), follicular large cell lymphoma (FLCL), and transformed follicular lymphoma (TFL) were treated with myeloablative therapy consisting of etoposide (60 mg/kg), cyclophosphamide (100 mg/kg), and either carmustine (BCNU;15 mg/kg) or fractionated total body irradiation (FTBI; 1200 cGy) followed by transplantation of purged autologous bone marrow or peripheral blood hematopoietic cells.
  • For the 49 patients with relapsed FLGL, the median age was 49 years and the median interval from diagnosis to HDT was 30 months.
  • Treatment with the FTBI-containing HDT regimen was associated with significantly longer DFS (P = .04) and OS (P = .04) in our multivariate analysis.
  • OS was also significantly longer among those treated with 3 or fewer chemotherapy regimens.
  • Among the 17 patients with TFL, 13 (76%) transformed at first relapse, and only 6 patients (35%) achieved complete remission with salvage therapy prior to HDT.
  • There were 3 occurrences of myelodysplasia (1 after treatment with TBI, 2 after BCNU treatment), yielding an estimated incidence of 7% (95% CI, 0%-16%) at 56 months.
  • This analysis shows that relapsed FLGL patients treated with 3 or fewer different chemotherapy regimens show inferior survival.
  • Lastly, patients with TFL or induction failure and relapsed FLCL can achieve survival outcome comparable to those observed with the indolent follicular lymphomas.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Hematopoietic Stem Cell Transplantation. Lymphoma, Follicular / therapy
  • [MeSH-minor] Adult. Aged. Carmustine / administration & dosage. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Disease-Free Survival. Etoposide / administration & dosage. Female. Humans. Male. Middle Aged. Neural Tube Defects / etiology. Prognosis. Recurrence. Remission Induction. Retrospective Studies. Survival Analysis. Transplantation, Autologous. Treatment Outcome. Whole-Body Irradiation

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  • (PMID = 11400952.001).
  • [ISSN] 1083-8791
  • [Journal-full-title] Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
  • [ISO-abbreviation] Biol. Blood Marrow Transplant.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide; U68WG3173Y / Carmustine
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2. Delaloye AB, Antonescu C, Louton T, Kuhlmann J, Hagenbeek A: Dosimetry of 90Y-ibritumomab tiuxetan as consolidation of first remission in advanced-stage follicular lymphoma: results from the international phase 3 first-line indolent trial. J Nucl Med; 2009 Nov;50(11):1837-43
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  • [Title] Dosimetry of 90Y-ibritumomab tiuxetan as consolidation of first remission in advanced-stage follicular lymphoma: results from the international phase 3 first-line indolent trial.
  • The objective of this analysis was to assess the radiation exposure associated with (90)Y-ibritumomab tiuxetan when used as consolidation therapy in adults with low or minimal tumor burden after first-line therapy of advanced follicular lymphoma (FL).
  • METHODS: The patients who were enrolled in the phase 3 first-line indolent trial were 18 y or older, with CD20(+) grade 1 or 2 stage III or IV FL, and a partial response, complete response, or unconfirmed complete response to first-line chemotherapy.
  • The patients were allocated randomly to receive a single infusion of unlabeled rituximab 250 mg/m(2) on day -7 and consolidation on day 0 with a single dose of (90)Y-ibritumomab tiuxetan, 14.8 MBq/kg, immediately after unlabeled rituximab, 250 mg/m(2), or no further treatment.
  • Radiation absorbed doses did not differ significantly between patients who had a partial response or complete response to initial therapy.
  • Progression-free survival correlated significantly with the whole-body (r = 0.4401; P = 0.0006) and bone marrow (r = 0.2976; P = 0.0246) radiation dose.
  • Neither the whole-body radiation dose nor the bone marrow radiation dose correlated with hematologic toxicity.
  • CONCLUSION: In patients with low or minimal residual tumor burden after first-line chemotherapy of advanced FL, whole-body and bone marrow exposure after (90)Y-ibritumomab tiuxetan consolidation showed a significant positive correlation with progression-free survival, whereas dosimetric data could not predict hematologic toxicity.
  • [MeSH-major] Antibodies, Monoclonal / therapeutic use. Internationality. Lymphoma, Follicular / pathology. Lymphoma, Follicular / radiotherapy. Radioimmunotherapy
  • [MeSH-minor] Adult. Aged. Environmental Exposure / adverse effects. Female. Humans. Male. Middle Aged. Neoplasm Staging. Radiation Dosage. Radiometry. Treatment Outcome

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  • (PMID = 19837764.001).
  • [ISSN] 1535-5667
  • [Journal-full-title] Journal of nuclear medicine : official publication, Society of Nuclear Medicine
  • [ISO-abbreviation] J. Nucl. Med.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase III; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / ibritumomab tiuxetan
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3. Khouri IF, McLaughlin P, Saliba RM, Hosing C, Korbling M, Lee MS, Medeiros LJ, Fayad L, Samaniego F, Alousi A, Anderlini P, Couriel D, de Lima M, Giralt S, Neelapu SS, Ueno NT, Samuels BI, Hagemeister F, Kwak LW, Champlin RE: Eight-year experience with allogeneic stem cell transplantation for relapsed follicular lymphoma after nonmyeloablative conditioning with fludarabine, cyclophosphamide, and rituximab. Blood; 2008 Jun 15;111(12):5530-6
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  • [Title] Eight-year experience with allogeneic stem cell transplantation for relapsed follicular lymphoma after nonmyeloablative conditioning with fludarabine, cyclophosphamide, and rituximab.
  • Nonmyeloablative stem cell transplantation in patients with follicular lymphoma has been designed to exploit the graft-versus-lymphoma immunity.
  • With a median follow-up time of 60 months (range, 19-94), the estimated survival and progression-free survival rates were 85% and 83%, respectively.
  • All 18 patients who were tested and had evidence of JH/bcl-2 fusion transcripts in the bone marrow at study entry experienced continuous molecular remission.
  • The incidence of grade 2-IV acute GVHD was 11%.
  • Only 5 patients were still undergoing immunosuppressive therapy at the time of last follow-up.
  • We believe that the described results are a step forward toward developing a curative strategy for recurrent follicular lymphoma.
  • [MeSH-major] Antibodies, Monoclonal / administration & dosage. Cyclophosphamide / administration & dosage. Hematopoietic Stem Cell Transplantation. Lymphoma, Follicular / drug therapy. Myeloablative Agonists / administration & dosage. Transplantation Conditioning / methods. Vidarabine / analogs & derivatives
  • [MeSH-minor] Adult. Aged. Antibodies, Monoclonal, Murine-Derived. Antineoplastic Agents / administration & dosage. Antineoplastic Agents / adverse effects. B-Lymphocytes / cytology. Combined Modality Therapy. Female. Follow-Up Studies. Graft vs Host Disease. Graft vs Tumor Effect. Humans. Male. Middle Aged. Prospective Studies. Recurrence. Remission Induction. Rituximab. Survival Rate. Transplantation Chimera. Transplantation, Homologous


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4. Sacchi S, Federico M, Vitolo U, Boccomini C, Vallisa D, Baldini L, Petrini M, Rupoli S, Di Raimondo F, Merli F, Liso V, Tabilio A, Saglio G, Vinci G, Brugiatelli M, Dastoli G, GISL: Clinical activity and safety of combination immunotherapy with IFN-alpha 2a and Rituximab in patients with relapsed low grade non-Hodgkin's lymphoma. Haematologica; 2001 Sep;86(9):951-8
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  • [Title] Clinical activity and safety of combination immunotherapy with IFN-alpha 2a and Rituximab in patients with relapsed low grade non-Hodgkin's lymphoma.
  • BACKGROUND AND OBJECTIVES: To determine the clinical activity and safety of the combination immunotherapy of the chimeric anti-CD20 antibody, Rituximab, and Interferon (IFN)- alpha 2a DESIGN AND METHODS: Sixty-four patients with relapsed low-grade or follicular B-cell non Hodgkin's lymphoma received 4 infusion of Rituximab (375 mg/m(2) x dose) after priming and simultaneous treatment with IFN- alpha 2a.
  • By univariate analysis none of the most common prognostic factors predicted for response to therapy.
  • After treatment 10 patients become bcl-2 negative in the bone marrow, but no correlation between molecular and clinical response was found.
  • Fifty-three patients (83%) had drug related or unknown origin adverse events.
  • Considering all 272 events, 231 (85%) were grade 1 or 2, 36 (13%) grade 3 and 5 (2%) grade 4.
  • Twenty-three patients required reduction in the dose and/or short discontinuation of IFN treatment, either during priming or subsequent treatment.
  • [MeSH-major] Antibodies, Monoclonal / administration & dosage. Antibodies, Monoclonal / adverse effects. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Interferon-alpha / administration & dosage. Interferon-alpha / adverse effects. Lymphoma, Non-Hodgkin / drug therapy
  • [MeSH-minor] Adult. Aged. Antibodies, Monoclonal, Murine-Derived. Female. Humans. Italy. Male. Middle Aged. Recombinant Proteins. Recurrence. Rituximab. Safety. Treatment Outcome

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  • (PMID = 11532623.001).
  • [ISSN] 0390-6078
  • [Journal-full-title] Haematologica
  • [ISO-abbreviation] Haematologica
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Interferon-alpha; 0 / Recombinant Proteins; 4F4X42SYQ6 / Rituximab; 76543-88-9 / interferon alfa-2a
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5. Rymkiewicz G, Paszkiewicz-Kozik E, Blachnio K, Pastwiska A, Kulik J, Pienkowska-Grela B, Walewski J: Unusual IgD+/CD38-follicular lymphoma with leukemic presentation. Med Oncol; 2006;23(1):131-5
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  • [Title] Unusual IgD+/CD38-follicular lymphoma with leukemic presentation.
  • Follicular lymphoma (FL) is a low-grade lymphoma, with rare presentation of leukemic phase in peripheral blood at the diagnosis.
  • We describe a 49-yr-old woman who developed leukemic phase of FL in a 3 mo period after histological diagnosis of peripheral lymph node.
  • To confirm the final diagnosis, flow cytometry (FCM) of peripheral blood, nested PCR with bcl-2 rearrangement, and cytogenetic analysis of peripheral blood and bone marrow cells were done.
  • Lymphoma cells were negative for CD38 and expressed monoclonal surface immunoglobulins with relatively strong and "bright" IgD and "dim" kappa-chain by FCM analysis.
  • Although the patient presented with generalized lymphadenopathy, massive peripheral blood and bone marrow involvement, she achieved complete clinical response after first-line chemotherapy COP and rituximab.
  • [MeSH-major] Antigens, CD38 / analysis. Immunoglobulin D / analysis. Leukemia / etiology. Lymphoma, Follicular / complications

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  • (PMID = 16645239.001).
  • [ISSN] 1357-0560
  • [Journal-full-title] Medical oncology (Northwood, London, England)
  • [ISO-abbreviation] Med. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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6. Snuderl M, Kolman OK, Chen YB, Hsu JJ, Ackerman AM, Dal Cin P, Ferry JA, Harris NL, Hasserjian RP, Zukerberg LR, Abramson JS, Hochberg EP, Lee H, Lee AI, Toomey CE, Sohani AR: B-cell lymphomas with concurrent IGH-BCL2 and MYC rearrangements are aggressive neoplasms with clinical and pathologic features distinct from Burkitt lymphoma and diffuse large B-cell lymphoma. Am J Surg Pathol; 2010 Mar;34(3):327-40
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  • [Title] B-cell lymphomas with concurrent IGH-BCL2 and MYC rearrangements are aggressive neoplasms with clinical and pathologic features distinct from Burkitt lymphoma and diffuse large B-cell lymphoma.
  • B-cell lymphomas with concurrent IGH-BCL2 and MYC rearrangements, also known as "double-hit" lymphomas (DHL), are rare neoplasms characterized by highly aggressive clinical behavior, complex karyotypes, and a spectrum of pathologic features overlapping with Burkitt lymphoma (BL), diffuse large B-cell lymphoma (DLBCL) and B-lymphoblastic lymphoma/leukemia (B-LBL).
  • The clinical and pathologic spectrum of this rare entity, including comparison to other high-grade B-cell neoplasms, has not been well defined.
  • Six patients had a history of grade 1 to 2 follicular lymphoma; review of the prior biopsy specimens in 2 of 5 cases revealed blastoid morphology.
  • Extranodal disease was present in 17/20 (85%), bone marrow involvement in 10/17 (59%) and central nervous system (CNS) disease in 5/11 (45%).
  • Nineteen patients were treated with combination chemotherapy, of whom 18 received rituximab and 14 received CNS-directed therapy.
  • Fourteen patients (70%) died within 8 months of diagnosis.
  • Twelve DHL cases (60%) were classified as B-cell lymphoma, unclassifiable, with features intermediate between DLBCL and BL, 7 cases (35%) as DLBCL, not otherwise specified, and 1 case as B-LBL.
  • DHL is a high-grade B-cell neoplasm with a poor prognosis, resistance to multiagent chemotherapy, and clinical and pathologic features distinct from other high-grade B-cell neoplasms.
  • The aggressive clinical behavior and combination of genetic abnormalities seen in these cases may warrant categorization as a separate entity in future classifications and call for novel therapeutic approaches.
  • [MeSH-major] Burkitt Lymphoma / genetics. Gene Expression Regulation, Neoplastic. Gene Rearrangement, B-Lymphocyte, Heavy Chain. Genes, Immunoglobulin Heavy Chain. Lymphoma, B-Cell / genetics. Lymphoma, Large B-Cell, Diffuse / genetics. Proto-Oncogene Proteins c-bcl-2 / genetics. Proto-Oncogene Proteins c-myc / genetics
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols. Child. Drug Resistance, Neoplasm. Female. Humans. Immunophenotyping. In Situ Hybridization, Fluorescence. Kaplan-Meier Estimate. Karyotyping. Male. Middle Aged. Neoplasm Staging. Polymerase Chain Reaction. Predictive Value of Tests. Proportional Hazards Models. Retrospective Studies. Risk Assessment. Terminology as Topic. Time Factors. Treatment Outcome. World Health Organization. Young Adult

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  • (PMID = 20118770.001).
  • [ISSN] 1532-0979
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / R37 CA076404; United States / NIGMS NIH HHS / GM / T32 GM074897; United States / NIGMS NIH HHS / GM / T32 GM074897-07
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / MYC protein, human; 0 / Proto-Oncogene Proteins c-bcl-2; 0 / Proto-Oncogene Proteins c-myc
  • [Other-IDs] NLM/ NIHMS305320; NLM/ PMC3152212
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7. Chen CI, Crump M, Tsang R, Stewart AK, Keating A: Autotransplants for histologically transformed follicular non-Hodgkin's lymphoma. Br J Haematol; 2001 Apr;113(1):202-8
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  • [Title] Autotransplants for histologically transformed follicular non-Hodgkin's lymphoma.
  • Histological transformation from a follicular non-Hodgkin's lymphoma (NHL) to a higher grade lymphoma carries a poor prognosis despite treatment with aggressive anthracycline-based chemotherapy.
  • We retrospectively analysed 35 patients with histologically transformed NHL who underwent high-dose therapy and autotransplantation at our centre.
  • Patients up to 65 years old were eligible for autotransplant at the time of transformation or with subsequent relapses, provided that chemosensitivity to a salvage regimen could be demonstrated.
  • All patients received high-dose therapy [etoposide 60 mg/kg, melphalan 160 mg/m2 and fractionated total body irradiation (TBI) 12 Gy] followed by unpurged autologous bone marrow or blood stem cell rescue.
  • Most patients (69%) had advanced stage disease (stages 3--4) at transformation and bone marrow involvement was common (49%).
  • Twenty-six (74%) patients were in partial remission (PR) and nine (26%) in complete remission (CR) at the time of transplant.
  • Causes of death were progressive lymphoma in nine patients (26%), treatment-related mortality (TRM) in seven (20%) and myelodysplasia in three (8%).
  • Only five patients in our cohort were > 60 years old, but all died as a result of treatment-related causes (mostly pulmonary infections).
  • Five-year overall survival and progression-free survival from time of transplant were 37% and 36% respectively.
  • Using multivariate analysis of factors including gender, age, stage, extranodal disease, disease bulk, B symptoms, number of prior therapies, relapse status and CR/PR status at transplant, only advanced age significantly predicted for survival from autotransplant (P = 0.002).
  • Our survival data are comparable to previous reports of autotransplantation for transformed NHL and suggest a benefit over standard chemotherapy alone in selected patients.
  • However, our high TRM cautions the use of aggressive therapy, including TBI, in patients over 60 years old.
  • [MeSH-major] Hematopoietic Stem Cell Transplantation. Lymphoma, Follicular / surgery. Salvage Therapy
  • [MeSH-minor] Adult. Age Factors. Disease-Free Survival. Female. Humans. Lymphoma, Large B-Cell, Diffuse / mortality. Lymphoma, Large B-Cell, Diffuse / pathology. Lymphoma, Large B-Cell, Diffuse / surgery. Lymphoma, Non-Hodgkin / mortality. Lymphoma, Non-Hodgkin / pathology. Lymphoma, Non-Hodgkin / surgery. Male. Middle Aged. Multivariate Analysis. Retrospective Studies. Survival Rate. Transplantation, Autologous. Treatment Outcome

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  • (PMID = 11328303.001).
  • [ISSN] 0007-1048
  • [Journal-full-title] British journal of haematology
  • [ISO-abbreviation] Br. J. Haematol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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8. Dillman RO: Radioimmunotherapy of B-cell lymphoma with radiolabelled anti-CD20 monoclonal antibodies. Clin Exp Med; 2006 Mar;6(1):1-12

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Radioimmunotherapy of B-cell lymphoma with radiolabelled anti-CD20 monoclonal antibodies.
  • CD20 has proven to be an excellent target for the treatment of B-cell lymphoma, first for the chimeric monoclonal antibody rituximab (Rituxan), and more recently for the radiolabelled antibodies Y-90 ibritumomab tiuxetan (Zevalin) and I-131 tositumomab (Bexxar).
  • Radiation therapy effects are due to beta emissions with path lengths of 1-5 mm; gamma radiation emitted by I-131 is the only radiation safety issue for either product.
  • Dose-limiting toxicity for both radiolabelled antibodies is reversible bone marrow suppression.
  • They produce response rates of 70%-90% in low-grade and follicular lymphoma and 40%-50% in transformed low-grade or intermediate-grade lymphomas.
  • Both products produce higher response rates than related unlabelled antibodies, and both are highly active in patients who are relatively resistant to rituximab-based therapy.
  • Median duration of response to a single course of treatment is about 1 year with complete remission rates that last 2 years or longer in about 25% of patients.
  • Clinical trials suggest that anti- CD20 radioimmunotherapy is superior to total body irradiation in patients undergoing stem cell supported therapy for B-cell lymphoma, and that it is a safe and efficacious modality when used as consolidation therapy following chemotherapy.
  • Among cytotoxic treatment options, current evidence suggests that one course of anti-CD20 radioimmunotherapy is as efficacious as six to eight cycles of combination chemotherapy.
  • A major question that persists is how effective these agents are in the setting of rituximab- refractory lymphoma.
  • These products have been underutilised because of the complexity of treatment coordination and concerns regarding reimbursement.
  • [MeSH-major] Antibodies, Monoclonal / therapeutic use. Antigens, CD20 / immunology. Lymphoma, B-Cell / radiotherapy. Radioimmunotherapy

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  • (PMID = 16550338.001).
  • [ISSN] 1591-8890
  • [Journal-full-title] Clinical and experimental medicine
  • [ISO-abbreviation] Clin. Exp. Med.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antigens, CD20
  • [Number-of-references] 80
  • [Other-IDs] NLM/ PMC2779347
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9. Ganguly S, Divine CL, Deauna-Limayo D, Bodensteiner DC, Cook JD, Lewis JN, Skikne BS: Autologous transplantation in patients with relapsed or high-grade follicular lymphoma provides long term disease-free survival and best median duration of response. Ann Hematol; 2005 Aug;84(8):526-31
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Autologous transplantation in patients with relapsed or high-grade follicular lymphoma provides long term disease-free survival and best median duration of response.
  • The best treatment option for patients with relapsed or high-grade follicular lymphoma (FL) is unknown.
  • In spite of major advances in the therapy for FL, disease-free survival remains short, and median time to progression is just over a year.
  • In an attempt to examine whether autologous stem cell transplantation provides long-term disease control in patients with relapsed or high-grade FL, we retrospectively evaluated our experience and analyzed the outcomes of autologous stem cell transplantation in patients with FL from 1991 to 2003.
  • Twenty-one patients were salvaged after relapse with second-line chemotherapy.
  • Of these, 14 were in CR at the time of transplantation, and seven patients were transplanted with active disease.
  • Bone marrow was used in six patients as the source of stem cells prior to 1995 and peripheral blood stem cells were used in 18 patients.
  • Median time for neutrophil recovery was 11.5 days (range 9-35 days) and 15 days (range 10-40 days) for platelets.
  • Three patients developed moderate to severe treatment-related toxicity, two with grade III mucositis and one with life-threatening infection.
  • [MeSH-major] Hematopoietic Stem Cell Transplantation / methods. Lymphoma, Follicular / therapy
  • [MeSH-minor] Adult. Bone Marrow Transplantation / methods. Bone Marrow Transplantation / mortality. Disease-Free Survival. Female. Graft Survival. Humans. Kinetics. Lymphoma, Non-Hodgkin / therapy. Male. Middle Aged. Peripheral Blood Stem Cell Transplantation / methods. Peripheral Blood Stem Cell Transplantation / mortality. Retrospective Studies. Salvage Therapy / methods. Survival Analysis. Transplantation, Autologous


10. Peltier J, Fichten A, Lefranc M, Toussaint P, Desenclos C, Pruvot AS, Nicot B, Le Gars D: [Follicular dural lymphoma. Case report]. Neurochirurgie; 2009 Jun;55(3):345-9
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  • [Title] [Follicular dural lymphoma. Case report].
  • A case of a meningeal B-cell lymphoma is described.
  • An initial diagnosis of extradural hematoma was made based on the results of the cerebral computerized tomography scan.
  • Magnetic resonance images demonstrated an enhanced mass with a dural tail attached to the meningeal layer of the temporal bone, suggesting a meningioma "en plaque".
  • Operative inspection also suggested a meningioma, but histological analysis and electron microscopy revealed a grade IV follicular B-cell lymphoma.
  • The patient underwent chemotherapy and radiotherapy.
  • The clinicopathological features and treatments were discussed.
  • [MeSH-major] Lymphoma, B-Cell / surgery. Lymphoma, Follicular / surgery. Meningeal Neoplasms / surgery
  • [MeSH-minor] Combined Modality Therapy. Hematoma / etiology. Humans. Male. Middle Aged. Treatment Outcome

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  • (PMID = 19428037.001).
  • [ISSN] 0028-3770
  • [Journal-full-title] Neuro-Chirurgie
  • [ISO-abbreviation] Neurochirurgie
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] France
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11. Pham RN, Gooley TA, Keeney GE, Press OW, Pagel JM, Greisman HA, Bensinger WI, Holmberg LA, Petersdorf SH, Maloney DG, Gopal AK: The impact of histologic grade on the outcome of high-dose therapy and autologous stem cell transplantation for follicular lymphoma. Bone Marrow Transplant; 2007 Dec;40(11):1039-44
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The impact of histologic grade on the outcome of high-dose therapy and autologous stem cell transplantation for follicular lymphoma.
  • The impact of the follicular lymphoma (FL) histologic grade on outcomes after high-dose therapy (HDT) and autologous stem cell transplantation (ASCT) is unknown.
  • Overall survival (OS), progression-free survival (PFS), relapse and non-relapse mortality (NRM) was estimated for each grade after controlling for other predictive factors.
  • PFS and relapse were nearly identical among patients with grade 3 FL versus grades 1-2 FL after adjusting for other contributing factors (hazard ratio (HR)=0.90, P=0.68; HR=1.07, P=0.80, respectively).
  • The hazard for mortality (HR=0.70, P=0.23) and NRM (HR=0.33, P=0.07) was non-significantly lower among patients with grade 3 FL compared to patients with grades 1-2 disease.
  • Factors associated with inferior PFS included elevated lactate dehydrogenase (HR=1.52, P=0.03), chemoresistance (HR=1.82, P=0.02), > or =2 prior therapies (HR=1.8, P=0.03) and prior radiation (HR=1.99, P=0.003).
  • These data suggest that the histologic grade of FL does not impact PFS or relapse following HDT and ASCT.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Hematopoietic Stem Cell Transplantation. Lymphoma, Follicular / drug therapy. Lymphoma, Follicular / pathology
  • [MeSH-minor] Adult. Aged. Cohort Studies. Combined Modality Therapy. Disease Progression. Dose-Response Relationship, Drug. Female. Humans. Kaplan-Meier Estimate. Male. Middle Aged. Prognosis. Radiotherapy, Adjuvant. Retrospective Studies. Transplantation Conditioning. Transplantation, Autologous

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  • (PMID = 17922043.001).
  • [ISSN] 0268-3369
  • [Journal-full-title] Bone marrow transplantation
  • [ISO-abbreviation] Bone Marrow Transplant.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / K08CA095448; United States / NCI NIH HHS / CA / K23CA85479; United States / NCI NIH HHS / CA / P01CA44991
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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12. Williams CD, Harrison CN, Lister TA, Norton AJ, Blystad AK, Coiffier B, Taghipour G, Schmitz N, Goldstone AH, European Bone Marrow Transplant Lymphoma Working Party: High-dose therapy and autologous stem-cell support for chemosensitive transformed low-grade follicular non-Hodgkin's lymphoma: a case-matched study from the European Bone Marrow Transplant Registry. J Clin Oncol; 2001 Feb 01;19(3):727-35
ClinicalTrials.gov. clinical trials - ClinicalTrials.gov .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] High-dose therapy and autologous stem-cell support for chemosensitive transformed low-grade follicular non-Hodgkin's lymphoma: a case-matched study from the European Bone Marrow Transplant Registry.
  • PURPOSE: To assess the outcome of high-dose therapy with autologous stem-cell support in patients with histologic transformation of low-grade follicular non-Hodgkin's lymphoma (NHL) and identify significant prognostic factors, as well as to compare survival of these patients with that of patients with matched low-grade and de novo high- or intermediate-grade NHL undergoing the same procedure.
  • PATIENTS AND METHODS: Fifty patients with transformed low-grade NHL have been reported to the European Bone Marrow Transplant registry.
  • Outcome from high-dose therapy and significant prognostic factors were analyzed.
  • Their survival was also compared with that of 200 patients with matched low-grade NHL and 200 patients with matched de novo high- or intermediate-grade NHL by a case-matched analysis.
  • RESULTS: The procedure-related death rate among the 50 transformed NHL patients was 18%.
  • Median PFS time was 13 months.
  • A subgroup of patients with residual chemosensitive disease who attained complete remission after high-dose therapy had the best outcome, with an OS at 5 years of 69%.
  • A comparison with matched patients with low-grade disease and with de novo high- or intermediate-grade lymphoma showed no significant difference in OS (P =.939 and P =.438, respectively).
  • CONCLUSION: Patients with chemosensitive transformed lymphoma should be seriously considered for high-dose therapy and autologous stem-cell support.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bone Marrow Transplantation. Hematopoietic Stem Cell Transplantation. Lymphoma, Non-Hodgkin / drug therapy. Lymphoma, Non-Hodgkin / pathology
  • [MeSH-minor] Adult. Case-Control Studies. Cell Transformation, Neoplastic / pathology. Combined Modality Therapy. Disease Progression. Disease-Free Survival. Dose-Response Relationship, Drug. Female. Follow-Up Studies. Humans. Lymphoma, Follicular / drug therapy. Lymphoma, Follicular / pathology. Male. Middle Aged. Survival Rate

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  • (PMID = 11157024.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Multicenter Study
  • [Publication-country] United States
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13. Lichtman SM, Petroni G, Schilsky RL, Johnson JL, Perri RT, Niedzwiecki D, Sklar J, Barcos M, Peterson BA: High dose cyclophosphamide plus recombinant human granulocyte-colony stimulating factor (rhG-CSF) in the treatment of follicular, low grade non-Hodgkin's lymphoma: CALGB 9150. Leuk Lymphoma; 2001 Nov-Dec;42(6):1255-64
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  • [Title] High dose cyclophosphamide plus recombinant human granulocyte-colony stimulating factor (rhG-CSF) in the treatment of follicular, low grade non-Hodgkin's lymphoma: CALGB 9150.
  • The main objectives of this study were to determine the feasibility of administering high doses of cyclophosphamide plus recombinant human granulocyte-colony stimulating factor (rhG-CSF) every 14-21 days to patients with follicular small cleaved cell lymphoma.
  • For each patient, the treatment was not considered feasible if fewer than four cycles of cyclophosphamide chemotherapy could be administered on schedule (i.e. at least every 29 days) or (1) hospitalization of the patient for longer than three days was necessary for neutropenic fever (38 degrees C) or bacteriologically documented infection in > 50% of the cycles, or (2) grade > or = 2 hemorrhage in association with thrombocytopenia of grade > or = 3 severity occurred in > 50% of the cycles or (3) non-hematologic toxicity (excluding nausea/vomiting and alopecia) of grade > or = 3 occurred in > 50% of cycles.
  • The goal was to have a treatment program feasible in 75% or more of the treated patients.
  • The secondary objectives were to determine the toxicities, the complete and partial response rates, and the time to treatment failure (TTF).
  • The trial also attempted to assess the effectiveness of this treatment program in eradicating Bcl-2 rearrangements by PCR, and to assess complete remission duration in relationship to PCR results in patients who respond to this chemotherapy program.
  • Patients were required to have histologically documented non-Hodgkin's lymphoma of the subtypes follicular, predominantly small cleaved cell (IWF-B) or follicular mixed, (IWF-C).
  • Patients were required to have Stage IV disease including histologic evidence of bone marrow involvement.
  • Submission of fresh bone marrow for molecular genetic studies for the presence of Bcl-2-Ig fusion DNA was mandatory in previously untreated patients.
  • Patients had to be between 18 and physiologic age 55 years (carefully selected patients over age 55 years were also eligible), expected survival > 2 years, performance status 0-1, and have adequate renal, hepatic and bone marrow function, and a cardiac ejection fraction > or = 50%.
  • The median follow-up time is 5.0 years, with a range of 2.5-6.7 years.
  • The 1-year estimated probability of freedom from treatment failure was 50% and of survival at 1 year was 92%.
  • Post-treatment specimens were submitted for seven of the 13 patients.
  • Four of the seven converted to Bcl-2 negative following treatment.
  • Eight of 13 Bcl-2 positive patients (62%) had a clinical response to treatment.
  • This study demonstrates that repetitive doses of cyclophosphamide at 4.5 g/m2 every two weeks with rhG-CSF support can be administered to selected younger patients with advanced follicular lymphoma with morphologic involvement of the bone marrow with acceptable non-hematologic toxicity.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cyclophosphamide / administration & dosage. Granulocyte Colony-Stimulating Factor / administration & dosage. Lymphoma, Follicular / drug therapy. Lymphoma, Non-Hodgkin / drug therapy

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  • (PMID = 11911406.001).
  • [ISSN] 1042-8194
  • [Journal-full-title] Leukemia & lymphoma
  • [ISO-abbreviation] Leuk. Lymphoma
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Recombinant Proteins; 143011-72-7 / Granulocyte Colony-Stimulating Factor; 8N3DW7272P / Cyclophosphamide
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14. Link BK, Martin P, Kaminski MS, Goldsmith SJ, Coleman M, Leonard JP: Cyclophosphamide, vincristine, and prednisone followed by tositumomab and iodine-131-tositumomab in patients with untreated low-grade follicular lymphoma: eight-year follow-up of a multicenter phase II study. J Clin Oncol; 2010 Jun 20;28(18):3035-41
Hazardous Substances Data Bank. VINCRISTINE .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cyclophosphamide, vincristine, and prednisone followed by tositumomab and iodine-131-tositumomab in patients with untreated low-grade follicular lymphoma: eight-year follow-up of a multicenter phase II study.
  • PURPOSE: The efficacy and safety of cyclophosphamide, vincristine, and prednisone (CVP) followed by tositumomab and iodine-131 ((131)I) -tositumomab therapy were evaluated in a multicenter phase II study in patients with untreated low-grade follicular lymphoma.
  • PATIENTS AND METHODS: Patients received six cycles of CVP followed by one cycle of tositumomab and (131)I-tositumomab (one dosimetric dose and one therapeutic dose).
  • The treatment was evaluated for efficacy and safety.
  • RESULTS: All 30 patients enrolled completed CVP as well as tositumomab and (131)I-tositumomab therapy.
  • The overall response rate after completion of therapy was 100%, with 28 patients (93%) achieving a complete response (CR) and two patients achieving a partial response.
  • Of the 17 patients with bone marrow involvement at enrollment, 15 achieved a confirmed CR.
  • Fourteen of 15 patients with bulky disease (> or = 5 cm) had a CR after treatment completion.
  • The most common grade > or = 3 hematologic adverse events were neutropenia (87%) and thrombocytopenia (37%).
  • No patients developed human antimurine antibodies.
  • Two patients developed myelodysplastic syndrome/acute myeloid leukemia.
  • CONCLUSION: These mature data demonstrate that sequential therapy with a non-anthracycline-containing regimen comprising CVP followed by one cycle of tositumomab and (131)I-tositumomab produced high response rates with adequate safety and durable remissions and that this regimen represents a highly active treatment for first-line therapy of follicular non-Hodgkin's lymphoma.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Lymphoma, Follicular / drug therapy. Lymphoma, Follicular / radiotherapy. Lymphoma, Non-Hodgkin / drug therapy. Lymphoma, Non-Hodgkin / radiotherapy. Radioimmunotherapy
  • [MeSH-minor] Adult. Aged. Antibodies, Monoclonal / administration & dosage. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Feasibility Studies. Follow-Up Studies. Humans. Maximum Tolerated Dose. Middle Aged. Prednisone / administration & dosage. Remission Induction. Survival Rate. Time Factors. Treatment Outcome. Vincristine / administration & dosage

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  • (PMID = 20458031.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / iodine-131 anti-B1 antibody; 5J49Q6B70F / Vincristine; 8N3DW7272P / Cyclophosphamide; VB0R961HZT / Prednisone
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15. Feuring-Buske M, Kneba M, Unterhalt M, Engert A, Gramatzki M, Hiller E, Trümper L, Brugger W, Ostermann H, Atzpodien J, Hallek M, Aulitzky E, Hiddemann W: IDEC-C2B8 (Rituximab) anti-CD20 antibody treatment in relapsed advanced-stage follicular lymphomas: results of a phase-II study of the German Low-Grade Lymphoma Study Group. Ann Hematol; 2000 Sep;79(9):493-500
Hazardous Substances Data Bank. RITUXIMAB .

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  • [Title] IDEC-C2B8 (Rituximab) anti-CD20 antibody treatment in relapsed advanced-stage follicular lymphomas: results of a phase-II study of the German Low-Grade Lymphoma Study Group.
  • PURPOSE: The current study was initiated to assess the clinical efficacy and side effects of rituximab in patients with relapsed advanced stage follicular lymphoma.
  • PATIENTS AND METHODS: The study was performed as an open-label non-randomized multicenter phase-II trial and included patients older than 18 years of age with relapsed advanced-stage follicular lymphomas (FL) grades I and II, according to the REAL classification, or with centroblastic/centrocytic (CB/CC lymphomas according to the Kiel classification.
  • The median time between primary diagnosis and study entry was 4.6 years (range 0.9-14.7 years).
  • Twenty grade-III/IV side effects were considered to be related to treatment: lymphocytopenia (3), granalocytopenia (1), thrombocytopenia (2), fever (1), hyperglycermia (1), venous thrombosis (1), syncope (1), plasmatic coagulation disorder (1), shortness of breath (2), photosensitivity (1), cardiac failure (1), chills (1), sepsis (1), tumor lysis (1), anemia (1), and pharyngeal edema (1).
  • Eight patients were not eligible for assessment of response because of non-follicular subtypes of low-grade lymphomas (n =6) or early termination of therapy at the first infusion because of severe side effects (n =2).
  • From the 30 evaluable cases with follicular lymphomas, five patients achieved a complete remission (CR) (17%), nine patients a partial remission (PR) (30%), and two patients a minor response (MR) (7%).
  • The median time to treatment progression (TTP) was 201 days (range 64-293 days), with five patients experiencing long-lasting remissions of 214-293 days duration.
  • Bulky disease (P=0.058) and/or bone-mar row involvement (P=0.046) were associated with poor response.
  • CONCLUSION: This study confirms the moderate treatment-related toxicity and the high antilymphoma activity of rituximab in patients with relapsed follicular lymphoma.
  • Further studies are needed to determine the role of rituximab in the first-line treatment of these disorders and its combination with conventional chemotherapy.
  • [MeSH-major] Antibodies, Monoclonal / therapeutic use. Antineoplastic Agents / therapeutic use. Lymphoma, Follicular / drug therapy
  • [MeSH-minor] Adult. Aged. Antibodies, Monoclonal, Murine-Derived. Female. Humans. Male. Middle Aged. Neoplasm Staging. Recurrence. Rituximab. Treatment Outcome

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  • (PMID = 11043420.001).
  • [ISSN] 0939-5555
  • [Journal-full-title] Annals of hematology
  • [ISO-abbreviation] Ann. Hematol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] GERMANY
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Antineoplastic Agents; 4F4X42SYQ6 / Rituximab
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16. Braun E, Katz D, Venugopal P, Larson M, Shammo J, Fung H, Gregory S: Safety analysis of radioimmunotherapy (RIT) in patients with relapsed or refractory low grade, follicular or transformed non-Hodgkin's lymphoma and mantle cell lymphoma based on age at time of therapy. J Clin Oncol; 2009 May 20;27(15_suppl):e19529

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Safety analysis of radioimmunotherapy (RIT) in patients with relapsed or refractory low grade, follicular or transformed non-Hodgkin's lymphoma and mantle cell lymphoma based on age at time of therapy.
  • : e19529 Background: Radioimmunotherapy is a therapeutic option for relapsed or refractory indolent, follicular and transformed non Hodgkin's lymphoma and mantle cell lymphoma.
  • Although prolongued myelotoxicity has been described with use of iodine I 131 tositumomab (TOSI) and yttrium 90 ibritumomab tiuxetan (IBRI), analysis of toxicity according to patients' age at therapy still lacks.
  • METHODS: Utilizing the Rush University Medical Center database 61 subjects who received RIT between November/2003 and June/2008, either with TOSI or IBRI were divided in 2 groups according to age at time of therapy.
  • Parameters compared between groups were: Time to nadir of lowest absolute neutrophil count (ANC), time to recovery ANC above 1000/mcL, time to nadir of lowest hemoglobin levels, time to recovery to hemoglobin levels above 8g/dL, time to lowest platelet count and time to recovery to platelet count above 100,000/mcL.
  • Groups characteristics such as sex, type of RIT, presence of disease in bone marrow, FLIPI/IPI and use of G-CSF were noted.
  • RESULTS: There was no significant statistical difference between groups in time (number of days) to achieve nadir of ANC (group 1 85.3±208; group 2 50.3±19.9), nadir of hemoglobin levels (group 1 106±60.6; group 2 84±57.0) and time to nadir of platelet level (group 1 53.5±70.7; group 2 41.8±9.6).
  • There was no statistical significant difference between groups in duration of cytopenias, except for time for platelet recovery which was significant longer in group 2 using the Pearson Correlation analysis. (p=0.008). (Days for platelets recovery to levels above 100,000/mcL group 1 29.4±27.7; group 2 108.8 ±207.3).
  • One patient in group 1 and three patients on group 2 were diagnosed with MDS but were also treated with different chemotherapy regimens.
  • CONCLUSIONS: RIT should be considered a safe therapeutic modality in patients with refractory or relapsed indolent, follicular, NHL, transformed and Mantle Cell lymphoma regardless of age.

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  • (PMID = 27960911.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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17. Shipley DL, Spigel DR, Carrell DL, Dannaher C, Greco FA, Hainsworth JD: Phase II trial of rituximab and short duration chemotherapy followed by <sup>90</sup>Y-ibritumomab tiuxetan as first-line treatment for patients with follicular lymphoma: A Minnie Pearl Cancer Research Network phase II trial. J Clin Oncol; 2004 Jul 15;22(14_suppl):6519

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Phase II trial of rituximab and short duration chemotherapy followed by <sup>90</sup>Y-ibritumomab tiuxetan as first-line treatment for patients with follicular lymphoma: A Minnie Pearl Cancer Research Network phase II trial.
  • : 6519 Background: First-line treatment with combination chemotherapy + rituximab improves molecular complete remission (CR) rates and lengthens remission duration in patients (pts) with follicular NHL.
  • In a previous phase II trial, we demonstrated a high CR rate with short course chemotherapy + rituximab (CHOP-R or CVP-R).
  • METHODS: Previously untreated pts with follicular lymphoma (grades 1-3) and stages II-IV were eligible.
  • After complete restaging, responding pts with bone marrow involvement < 25% received <sup>90</sup>Y-ibritumomab tiuxetan 5 weeks after the last dose of CHOP-R.
  • 22 pts have completed therapy and been restaged: 19 pts (86%) are in CR, with 3 PR's. 10 pts with PR converted to CR after <sup>90</sup>Y-ibritumomab tiuxetan.
  • No unexpected toxicity was seen during CHOP-R therapy.
  • <sup>90</sup>Y-ibritumomab tiuxetan caused no grade 3/4 nonhematologic toxicities.
  • CONCLUSIONS: First-line CHOP-R followed by <sup>90</sup>Y-ibritumomab tiuxetan is highly active and well tolerated in pts with follicular NHL.

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  • (PMID = 28016918.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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18. Bolwell BJ, Kalaycio M, Sobecks RM, Andresen S, Rybicki L, Kuczkowski E, West A, Bernhard L, Cherni K, Pohlman B: A prospective, randomized trial of stem cell mobilization with VP-16 + G-CSF with or without rituximab for B-cell lymphoid malignancies. J Clin Oncol; 2004 Jul 15;22(14_suppl):6640

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • It is unknown, however, whether the use of rituximab at the time of PSC mobilization will alter the ability to collect adequate numbers of CD34+ cells, or have a beneficial effect on long term survival.
  • The treatment plan consisted of VP-16 (2 gm/m<sup>2</sup>) + G-CSF, with peripheral blood stem cell mobilization beginning upon WBC recovery.
  • 68% had diffuse large B-cell lymphoma, 27% had follicular lymphomas, and 5% had high grade lymphoma.
  • The groups were balanced with respect to number of courses of prior chemotherapy, prior radiation therapy, disease status at transplant, LDH at transplant, and bone marrow involvement.
  • Engraftment was identical between the two treatment groups.

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  • (PMID = 28016347.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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19. Kingsley E, Richards D, Garbo L, Gersh R, Robbins G, Leopold L, Brill J, Di Bella N: An open-label, multicenter, phase II study of AT-101 in combination with rituximab (R) in patients with untreated, grade 1-2, follicular non-Hodgkin's lymphoma (FL). J Clin Oncol; 2009 May 20;27(15_suppl):8582

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] An open-label, multicenter, phase II study of AT-101 in combination with rituximab (R) in patients with untreated, grade 1-2, follicular non-Hodgkin's lymphoma (FL).
  • : 8582 Background: Bcl-2 family proteins are overexpressed in the majority of patients with FL and contribute to resistance to therapy.
  • METHODS: Patients with untreated FL who did not require immediate chemotherapy were eligible.
  • Treatment consisted of an induction cycle of AT-101 (30mg po daily × 21) and R (375 mg/m<sup>2</sup> weekly × 4) followed by up to 4 maintenance cycles of AT-101 (30mg po daily × 21) and R (375 mg/m<sup>2</sup>) every 8 weeks in nonprogressors.
  • Endpoints evaluated the response rate (RR) at week 8 (primary), overall response rate (ORR), molecular response rate (BCL-2JH rearrangement in blood and bone marrow), and safety of the combination.
  • RESULTS: 23 pts enrolled: median age 64 yrs; FLIPI 0-5: 0%/17%/65%/13%/4%; Grade 1/2: 61%/39%; bulky disease (>5cm<sup>3</sup>): 35%; stage: 1-4 4%/4%/30%/61%; bone marrow + 48%.
  • Grade 3/4 AEs that occurred in ≥2 pts: nausea 4(17%), vomiting 2(9%), abdominal pain 2(9%), fatigue 2(9%), and small bowel obstruction 2(9%).

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  • (PMID = 27962265.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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20. Armitage JO, Leonard JP, Gregory SA, Horning SJ, Zelenetz AD, Kaminski MS, Fisher RI: The effectiveness of tositumomab and iodine I 131 tositumomab in relapsed/refractory follicular grade 1/2 and small lymphocytic non-Hodgkin's lymphoma (NHL). J Clin Oncol; 2004 Jul 15;22(14_suppl):6573

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The effectiveness of tositumomab and iodine I 131 tositumomab in relapsed/refractory follicular grade 1/2 and small lymphocytic non-Hodgkin's lymphoma (NHL).
  • : 6573 Background: In an overall population of 995 pts, Iodine I 131 Tositumomab was administered to 740 eligible pts with relapsed/refractory follicular grade 1/2 (n = 651) and small lymphocytic (n = 89) NHL.
  • To be eligible, pts had to have a platelet count ≥ 100,000/mm<sup>3</sup> and ≤ 25% of bone marrow involvement with lymphoma.
  • RESULTS: Demographics (for follicular vs small lymphocytic NHL): male: 55%, 64%; age >65: 23%,37%; stage III/IV: 88%,92%; median time from diagnosis: 42mo,41mo; ≥ 4 prior therapies: 30%,35%; BM involvement: 44%, 62%; tumor diameter ≥ 5 cm: 48%,44%; prior Rituximab: 45%,60%; prior radiation: 21%,17%.
  • [Figure: see text] The OR rate for follicular grade 1/2 NHL was significantly higher than for small lymphocytic (P < .001; Table) NHL, whereas the durations of response were comparable.
  • Multivariate analyses: ≥ 4 prior therapies and tumor diameter < 5 cm were significant predictors for a higher OR in pts with either follicular or small lymphocytic NHL.
  • Different factors were predictive of a higher CR rate: follicular: tumor < 5cm (P < .001), < 4 prior chemotherapies (P = .001), age ≤ 65 yrs (P = .002), and female (P = .010).
  • Small lymphocytic: no bone marrow involvement (P = .007) and > 4 yr from diagnosis (P = .036).
  • CONCLUSIONS: Among 740 pts, Iodine I 131 Tositumomab produced a significantly higher OR rate and CR rate in follicular lymphoma grades 1/2 than in small lymphocytic lymphoma.
  • However, the duration of remission was similar for responders with either diagnosis.

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  • (PMID = 28016203.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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21. Ghielmini M, Schmitz SF, Bürki K, Pichert G, Betticher DC, Stupp R, Wernli M, Lohri A, Schmitter D, Bertoni F, Cerny T: The effect of Rituximab on patients with follicular and mantle-cell lymphoma. Swiss Group for Clinical Cancer Research (SAKK). Ann Oncol; 2000;11 Suppl 1:123-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The effect of Rituximab on patients with follicular and mantle-cell lymphoma. Swiss Group for Clinical Cancer Research (SAKK).
  • BACKGROUND: Clinical activity of the anti CD-20 monoclonal antibody Rituximab has been reported in patients with follicular lymphoma (FL) and mantle-cell lymphoma (MCL).
  • A central pathology review confirmed the diagnosis of FL in 76 of 78 and of MCL in 39 of 42 cases.
  • The response was evaluated after 8 weeks and confirmed after 12 weeks from the start of treatment.
  • RESULTS: The toxicity of the treatment was, as expected, grade 1-2 fever and rigors during the first infusion and mild asthenia during the treatment period.
  • Serious adverse events, probably or possibly related to the study treatment, included four deaths (3 of cardiac origin, 1 caused by P. carinii pneumonia) and 10 further nonfatal cases, including a permanent agranulocytosis and one case of heart failure.
  • After treatment, the BCL-2 rearrangement disappeared in 15 of 29 blood but only in 5 of 23 bone marrow samples; BCL-1 disappeared in 5 of 12 blood and 0 of 7 bone marrow specimens, as determined by PCR.
  • CONCLUSIONS: Rituximab is an active agent for the treatment of FL, while its efficacy is modest in MCL.
  • The effect in reducing minimal residual disease is more pronounced on the blood than it is on the bone marrow.

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  • (PMID = 10707793.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Antineoplastic Agents; 4F4X42SYQ6 / Rituximab
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22. Santini G, Chisesi T, Nati S, Porcellini A, Zoli V, Rizzoli V, Zupo S, Marino G, Rubagotti A, Polacco A, Spriano M, Vimercati R, Congiu AM, Ravetti JL, Aversa S, Candela M, Patti C: Fludarabine, cyclophosphamide and mitoxantrone for untreated follicular lymphoma: a report from the non-Hodgkin's lymphoma co-operative study group. Leuk Lymphoma; 2004 Jun;45(6):1141-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Fludarabine, cyclophosphamide and mitoxantrone for untreated follicular lymphoma: a report from the non-Hodgkin's lymphoma co-operative study group.
  • The aim of the study was to determine the safety and efficacy of the combination of fludarabine (FLU), cyclophosphamide (CY) and mitoxantrone (FLU/CY/MITO) in untreated follicular lymphomas (FL), Sixty patients with newly diagnosed stage II bulky to IV FL, median age 59 years (range 36-70), received FLU/CY/MITO regimen (FLU 25 mg/m2 days 1-3, CY 300 mg/m2 days 1-3, Mito 10 mg/m2 day 1).
  • Patients received antibiotic oral prophylaxis during all treatments, and growth factors (G-CSF) when grade III granulocytopenia (WHO) occurred.
  • Fifty patients are surviving with a median observation time of 31 months.
  • Sixty percent of patients experienced grade III-IV granulocytopenia.
  • Two patients suffered grade III pulmonary infection and one grade III liver toxicity.
  • In a subset of 46 patients, bcl-2 translocation was positive in bone marrow (BM) and/or peripheral blood (PB) of 36 patients.
  • At the end of treatment, 25 of these patients had CR and 19 (76%) converted to polymerase chain reaction (PCR) negativity.
  • FLU/CY/MITO regimen showed a high level of activity in follicular lymphoma.
  • Toxicity, mainly hematological, was acceptable and the treatment was made feasible by the use of antibiotic prophylaxis and G-CSF.
  • The conversion of bcl-2 from positive to negative by PCR in BM and/or PB suggests a possible role for this treatment in clearing minimal residual disease and improving patients' outcome.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Lymphoma, Follicular / drug therapy. Vidarabine / analogs & derivatives
  • [MeSH-minor] Adult. Aged. Bone Marrow. Cyclophosphamide / administration & dosage. Disease-Free Survival. Female. Humans. Male. Middle Aged. Mitoxantrone / administration & dosage. Neoplasm, Residual / drug therapy. Protein Transport. Proto-Oncogene Proteins c-bcl-2 / genetics. Proto-Oncogene Proteins c-bcl-2 / metabolism. Safety. Survival Rate. Treatment Outcome

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  • (PMID = 15359993.001).
  • [ISSN] 1042-8194
  • [Journal-full-title] Leukemia & lymphoma
  • [ISO-abbreviation] Leuk. Lymphoma
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Proto-Oncogene Proteins c-bcl-2; 8N3DW7272P / Cyclophosphamide; BZ114NVM5P / Mitoxantrone; FA2DM6879K / Vidarabine; P2K93U8740 / fludarabine
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23. Zinzani PL, Tani M, Pulsoni A, Gobbi M, Perotti A, De Luca S, Fabbri A, Zaccaria A, Voso MT, Fattori P, Guardigni L, Ronconi S, Cabras MG, Rigacci L, De Renzo A, Marchi E, Stefoni V, Fina M, Pellegrini C, Musuraca G, Derenzini E, Pileri S, Fanti S, Piccaluga PP, Baccarani M: Fludarabine and mitoxantrone followed by yttrium-90 ibritumomab tiuxetan in previously untreated patients with follicular non-Hodgkin lymphoma trial: a phase II non-randomised trial (FLUMIZ). Lancet Oncol; 2008 Apr;9(4):352-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Fludarabine and mitoxantrone followed by yttrium-90 ibritumomab tiuxetan in previously untreated patients with follicular non-Hodgkin lymphoma trial: a phase II non-randomised trial (FLUMIZ).
  • BACKGROUND: Follicular lymphoma is the most common form of lymphoma in Europe and the USA.
  • In this prospective, single-arm, open-labelled, multicentre non-randomised phase II trial (FLUMIZ [FLUdarabine, MItoxantrone, Zevalin] trial) we aimed to assess the efficacy and safety of fludarabine and mitoxantrone plus radioimmunotherapy in untreated patients with follicular non-Hodgkin lymphoma (NHL).
  • METHODS: Patients with stage III or IV untreated indolent follicular NHL were enrolled between June 1, 2004, and April 15, 2006, at 13 Italian institutions, and were treated with oral fludarabine (40 mg/m2 on days 1 to 3) and intravenous mitoxantrone (10 mg/m2 on day 1) every 28 days for six cycles.
  • Patients who had at least a partial response (PR) with normal platelet counts (>100x10(9)/L) and granulocyte counts (1.5x10(9)/L), and bone-marrow infiltration less than 25% 4-6 weeks after completion of the sixth cycle of chemotherapy were deemed eligible for consolidation treatment 6-10 weeks after the sixth cycle with one course of yttrium-90 ((90)Y)-labelled ibritumomab tiuxetan (Zevalin), which consisted of an initial infusion of intravenous rituximab (250 mg/m2) on day 1 followed by a second 250 mg/m2 infusion on day 7, 8, or 9.
  • Of the 14 patients who had PR after the initial treatment, 12 obtained CR after (90)Y-ibritumomab tiuxetan.
  • By the end of the entire treatment regimen 55 of 57 patients achieved CR.
  • 36 of 57 patients had grade 3 or 4 haematological toxic effects, and blood transfusions were given to 21 of 57 patients.
  • INTERPRETATION: This trial has provided evidence for the feasibility, tolerability, and efficacy of fludarabine and mitoxantrone plus (90)Y-ibritumomab tiuxetan in untreated patients with follicular NHL.
  • [MeSH-major] Antibodies, Monoclonal / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Lymphoma, Follicular / mortality. Lymphoma, Follicular / therapy. Radioimmunotherapy / methods
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Disease-Free Survival. Dose-Response Relationship, Drug. Drug Administration Schedule. Female. Follow-Up Studies. Humans. Italy. Kaplan-Meier Estimate. Lymphoma, Non-Hodgkin / mortality. Lymphoma, Non-Hodgkin / pathology. Lymphoma, Non-Hodgkin / therapy. Male. Maximum Tolerated Dose. Middle Aged. Mitoxantrone / administration & dosage. Mitoxantrone / adverse effects. Neoplasm Staging. Probability. Risk Assessment. Survival Analysis. Vidarabine / administration & dosage. Vidarabine / adverse effects. Vidarabine / analogs & derivatives. Yttrium Radioisotopes

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  • [CommentIn] Lancet Oncol. 2008 Apr;9(4):309-11 [18374284.001]
  • (PMID = 18342572.001).
  • [ISSN] 1474-5488
  • [Journal-full-title] The Lancet. Oncology
  • [ISO-abbreviation] Lancet Oncol.
  • [Language] eng
  • [Publication-type] Classical Article; Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Yttrium Radioisotopes; 0 / ibritumomab tiuxetan; BZ114NVM5P / Mitoxantrone; FA2DM6879K / Vidarabine; P2K93U8740 / fludarabine
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24. Misgeld E, Wehmeier A, Krömeke O, Gattermann N: Primary non-Hodgkin's lymphoma of bone: three cases and a short review of the literature. Ann Hematol; 2003 Jul;82(7):440-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary non-Hodgkin's lymphoma of bone: three cases and a short review of the literature.
  • Primary non-Hodgkin's lymphoma of bone (PLB) is a rare entity.
  • If PLB is suspected radiologically, the diagnosis must be confirmed by open biopsy.
  • Histopathologically, PLB usually represents diffuse large B-cell lymphoma or lymphoma of the follicular center type.
  • Localized stages of the disease require involved-field radiotherapy (45-50 Gy) to the entire bone that is affected.
  • In cases of intermediate or high-grade lymphoma of bone, combined radiochemotherapy is the treatment of choice for all stages.
  • Six to eight cycles of chemotherapy (usually the CHOP regimen) are recommended for remission induction.
  • This is followed by involved-field radiotherapy with 45-50 Gy.
  • High-dose chemotherapy with autologous stem cell support is an option if there is no satisfactory response to conventional chemotherapy, or if early relapse occurs.
  • [MeSH-major] Bone Neoplasms / diagnosis. Lymphoma, Non-Hodgkin / diagnosis
  • [MeSH-minor] Adult. Combined Modality Therapy. Diagnostic Imaging. Female. Humans. Male. Middle Aged. Remission Induction / methods

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  • (PMID = 12761650.001).
  • [ISSN] 0939-5555
  • [Journal-full-title] Annals of hematology
  • [ISO-abbreviation] Ann. Hematol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Germany
  • [Number-of-references] 22
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25. Fenske TS, Kahl BS, Eickhoff J, Mitchell TL, Smith EP, Atkinson E, McCoy AG, Eckstein L, Flynn B, McMannes J, Howard S, Longo WL: Excessive toxicity of the high dose thiotepa and etoposide regimen when combined with radiation: Long-term autologous transplantation experience in follicular and mantle cell lymphoma. Leuk Lymphoma; 2005 Oct;46(10):1441-8
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  • [Title] Excessive toxicity of the high dose thiotepa and etoposide regimen when combined with radiation: Long-term autologous transplantation experience in follicular and mantle cell lymphoma.
  • We recently described a novel thiotepa plus etoposide high-dose therapy (HDT) conditioning regimen for aggressive histology non-Hodgkin's lymphoma (NHL) that had low regimen-related toxicity (RRT) and an efficacy rate comparable to other NHL HDT regimens.
  • Between 1992 and 1999, 28 patients with indolent or mantle cell lymphoma were treated on this protocol.
  • The median number of grade 3 - 4 non-hematologic toxicities was five.
  • In contrast, the thiotepa + etoposide conditioning regimen (without TBI or IFRT) given to 65 intermediate grade NHL patients resulted in only one treatment-related death and considerably fewer grade 3 - 4 toxicities.
  • [MeSH-major] Etoposide / adverse effects. Hematopoietic Stem Cell Transplantation. Lymphoma, Follicular / drug therapy. Lymphoma, Follicular / radiotherapy. Lymphoma, Mantle-Cell / drug therapy. Lymphoma, Mantle-Cell / radiotherapy. Thiotepa / adverse effects
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy / adverse effects. Female. Follow-Up Studies. Humans. Male. Middle Aged. Survival Rate. Time Factors. Transplantation, Autologous


26. Collins-Burow B, Santos ES: Rituximab and its role as maintenance therapy in non-Hodgkin lymphoma. Expert Rev Anticancer Ther; 2007 Mar;7(3):257-73
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Rituximab and its role as maintenance therapy in non-Hodgkin lymphoma.
  • Rituximab has proven to be a relatively well-tolerated drug, with its major side effects being infusion related.
  • Rituximab was approved initially by the US FDA and the European Medicines Agency for relapsed or refractory low-grade or follicular CD20+ B-cell non-Hodgkin lymphomas.
  • Subsequently, its use has been extended to include first-line therapy in low-grade lymphoma as well as the treatment of more aggressive histological subtypes such as diffuse large B-cell lymphoma.
  • In this article, we review the landmark trials that have impacted clinical practice in follicular and diffuse large B-cell lymphomas and the emerging data for use of rituximab as maintenance therapy in non-Hodgkin lymphoma.
  • [MeSH-major] Antibodies, Monoclonal / therapeutic use. Antineoplastic Agents / therapeutic use. Lymphoma, Non-Hodgkin / drug therapy
  • [MeSH-minor] Animals. Antibodies, Monoclonal, Murine-Derived. Antibody Specificity. Antigens, CD20 / immunology. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. B-Lymphocytes / immunology. Bone Marrow Diseases / chemically induced. Clinical Trials as Topic. Cyclophosphamide / administration & dosage. Doxorubicin / administration & dosage. Drug Resistance, Neoplasm. Forecasting. Half-Life. Humans. Immunoglobulin Constant Regions / genetics. Immunoglobulin Variable Region / genetics. Lymphoma, Follicular / drug therapy. Lymphoma, Large B-Cell, Diffuse / drug therapy. Mice. Prednisone / administration & dosage. Randomized Controlled Trials as Topic. Receptors, IgG / drug effects. Receptors, IgG / genetics. Remission Induction. Rituximab. Salvage Therapy. Treatment Outcome. Vincristine / administration & dosage

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  • (PMID = 17338647.001).
  • [ISSN] 1744-8328
  • [Journal-full-title] Expert review of anticancer therapy
  • [ISO-abbreviation] Expert Rev Anticancer Ther
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Antigens, CD20; 0 / Antineoplastic Agents; 0 / FCGR3A protein, human; 0 / Immunoglobulin Constant Regions; 0 / Immunoglobulin Variable Region; 0 / Receptors, IgG; 4F4X42SYQ6 / Rituximab; 5J49Q6B70F / Vincristine; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; VB0R961HZT / Prednisone; CHOP protocol
  • [Number-of-references] 109
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27. Riccioni R, Galimberti S, Cervetti G, Fazzi R, Caracciolo F, Petrini M: Oral cyclophosphamide therapy for patients with residual or relapsed indolent-type lymphoma after initial treatment for aggressive lymphomas. A sub-group of patients with apparent transformed indolent lymphoma. Leuk Lymphoma; 2002 Sep;43(9):1803-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Oral cyclophosphamide therapy for patients with residual or relapsed indolent-type lymphoma after initial treatment for aggressive lymphomas. A sub-group of patients with apparent transformed indolent lymphoma.
  • Lymph node or bone marrow biopsy from sixty-one patients affected by aggressive non-Hodgkin lymphomas (NHL) were retrospectively evaluated to assess the histology at relapse.
  • Eighteen cases (29.5%) were proven to have relapsed or persistent low-grade lymphoma after conventional therapy.
  • In 5/18 patients association of low and high-grade lymphoma was detectable at diagnosis by bone marrow biopsy.
  • In the remaining 13/18 no evidence of follicular lymphoma was detected at diagnosis.
  • The outcome of these patients was compared to that of 43 patients relapsed without change in histology and treated by a second line therapy.
  • The 18 patients with residual/relapsed indolent subtype received oral cyclophosphamide (100 mg/day for 15 days every month for six months): 3 of them had NR, 5 CR, and 10 PR.
  • The overall survival (OS) median time was 39 months in low-grade resistant/relapsed patients and 20 months in patients with aggressive histology.
  • Most of the patients with high-grade disease were refractory or relapsed after a median of five months, whereas cases with low-grade NHL showed a long lasting stable PR.
  • We suggest that the higher grade patients with residual or relapsed low grade lymphoma were, in fact, transformed low-grade at diagnosis and, after removing the more aggressive component by chemotherapy, it is possible to manage these patients by conventional therapy for indolent lymphomas.
  • [MeSH-major] Administration, Oral. Antineoplastic Agents, Alkylating / therapeutic use. Cyclophosphamide / therapeutic use. Lymphoma / drug therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Male. Middle Aged. Recurrence. Time Factors. Treatment Outcome

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  • (PMID = 12685835.001).
  • [ISSN] 1042-8194
  • [Journal-full-title] Leukemia & lymphoma
  • [ISO-abbreviation] Leuk. Lymphoma
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 8N3DW7272P / Cyclophosphamide
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28. Fisher RI, Kaminski MS, Wahl RL, Knox SJ, Zelenetz AD, Vose JM, Leonard JP, Kroll S, Goldsmith SJ, Coleman M: Tositumomab and iodine-131 tositumomab produces durable complete remissions in a subset of heavily pretreated patients with low-grade and transformed non-Hodgkin's lymphomas. J Clin Oncol; 2005 Oct 20;23(30):7565-73
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  • [Title] Tositumomab and iodine-131 tositumomab produces durable complete remissions in a subset of heavily pretreated patients with low-grade and transformed non-Hodgkin's lymphomas.
  • PURPOSE: This study is an integrated efficacy analysis of the five clinical trials of tositumomab and iodine-131 tositumomab in patients with relapsed or refractory low-grade, follicular, or transformed low-grade non-Hodgkin's lymphoma (NHL) that resulted in the regulatory approval of the iodine-131 tositumomab by the US Food and Drug Administration.
  • Eighty-one (32%) of 250 patients had a time to progression of > or = 1 year (termed durable response population).
  • The durable response population had many poor prognostic characteristics, including bone marrow involvement (41%), bulky disease > or = 5 cm (49%), and transformed histology (23%).
  • Forty-three percent of the patients had been treated with more than four prior therapies and 36% had not responded to their most recent therapy.
  • CONCLUSION: The tositumomab and iodine-131 tositumomab therapeutic regimen produces high response rates in patients with relapsed or refractory low-grade, follicular, and transformed low-grade NHL, with a sizable subgroup of patients achieving long-term durable responses.
  • [MeSH-major] Antibodies, Monoclonal / therapeutic use. Antineoplastic Agents / therapeutic use. Lymphoma, Follicular / radiotherapy. Lymphoma, Non-Hodgkin / radiotherapy. Neoplasm Recurrence, Local / radiotherapy. Radioimmunotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Drug Resistance, Neoplasm. Female. Humans. Iodine Radioisotopes / therapeutic use. Lymphoma, Mantle-Cell / drug therapy. Lymphoma, Mantle-Cell / immunology. Lymphoma, Mantle-Cell / radiotherapy. Male. Middle Aged. Remission Induction. Salvage Therapy. Survival Rate

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  • (PMID = 16186600.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antineoplastic Agents; 0 / Iodine Radioisotopes; 0 / iodine-131 anti-B1 antibody
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29. Waselenko JK, Burrows A, Nelson DA, Lucas M, Ekstrand J, Edenfield WJ, Myhand RC: Post-transplant interleukin-2 in patients with low-grade lymphoid neoplasms previously treated with fludarabine is limited by hematologic toxicity. Ann Hematol; 2003 Sep;82(9):552-7
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  • [Title] Post-transplant interleukin-2 in patients with low-grade lymphoid neoplasms previously treated with fludarabine is limited by hematologic toxicity.
  • Given the favorable immunologic effects of IL-2 post transplant, we conducted a feasibility study examining rIL-2 1.0x106 IU/m2/day (SQ) beginning on D+14 post-transplant and continuing for 90 days in 12 patients with low-grade lymphoproliferative disorders.
  • Prior to high-dose chemotherapy and autologous peripheral blood stem cell transplantation (HDCT), 11 patients underwent cytoreduction with fludarabine and cyclophosphamide (Flu/Cy); 11 were in complete remission (CR) and one was in partial remission at the time of HDCT.
  • Five patients required rIL-2 cessation at 8-58 days after starting the therapy due to hematologic toxicity.
  • These results are comparable to those achieved in other published bone marrow and peripheral blood stem cell transplantion (PBSCT) series without the addition of rIL-2.
  • [MeSH-major] Hematologic Diseases / chemically induced. Hematologic Neoplasms / therapy. Interleukin-2 / adverse effects. Peripheral Blood Stem Cell Transplantation. Vidarabine / adverse effects. Vidarabine / analogs & derivatives
  • [MeSH-minor] Adult. Antigens, CD34 / analysis. Cyclophosphamide / administration & dosage. Female. Humans. Leukemia, Lymphocytic, Chronic, B-Cell / therapy. Leukocyte Count. Lymphoma, Follicular / therapy. Lymphoma, Mantle-Cell / therapy. Male. Middle Aged. Neutrophils. Platelet Count. Prospective Studies. Recombinant Proteins. Remission Induction. Survival Rate

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  • (PMID = 12910372.001).
  • [ISSN] 0939-5555
  • [Journal-full-title] Annals of hematology
  • [ISO-abbreviation] Ann. Hematol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antigens, CD34; 0 / Interleukin-2; 0 / Recombinant Proteins; 8N3DW7272P / Cyclophosphamide; FA2DM6879K / Vidarabine; P2K93U8740 / fludarabine
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30. O'Connor OA, Wright J, Moskowitz C, Muzzy J, MacGregor-Cortelli B, Stubblefield M, Straus D, Portlock C, Hamlin P, Choi E, Dumetrescu O, Esseltine D, Trehu E, Adams J, Schenkein D, Zelenetz AD: Phase II clinical experience with the novel proteasome inhibitor bortezomib in patients with indolent non-Hodgkin's lymphoma and mantle cell lymphoma. J Clin Oncol; 2005 Feb 1;23(4):676-84
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  • [Title] Phase II clinical experience with the novel proteasome inhibitor bortezomib in patients with indolent non-Hodgkin's lymphoma and mantle cell lymphoma.
  • PURPOSE: To determine the antitumor activity of the novel proteasome inhibitor bortezomib in patients with indolent and mantle-cell lymphoma (MCL).
  • Patients were required to have received no more than three prior chemotherapy regimens, with at least 1 month since the prior treatment, 3 months from prior rituximab, and 7 days from prior corticosteroids; absolute neutrophil count more than 1,500/microL (500/microL if documented bone marrow involvement); and platelet count more than 50,000/microL.
  • Ten patients had follicular lymphoma, 11 had MCL, three had small lymphocytic lymphoma (SLL) or chronic lymphocytic leukemia (CLL), and two had marginal zone lymphoma.
  • The overall response rate was 58%, with one complete remission (CR), one unconfirmed CR (CRu), and four partial remissions (PR) among patients with follicular non-Hodgkin's lymphoma (NHL).
  • Both patients with marginal zone lymphoma achieved PR lasting 8+ and 11+ months, respectively.
  • Overall, the drug was well tolerated, with only one grade 4 toxicity (hyponatremia).
  • The most common grade 3 toxicities were lymphopenia (n = 14) and thrombocytopenia (n = 7).
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Boronic Acids / therapeutic use. Lymphoma, Mantle-Cell / drug therapy. Lymphoma, Non-Hodgkin / drug therapy. Protease Inhibitors / therapeutic use. Pyrazines / therapeutic use

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  • [CommentIn] Nat Clin Pract Oncol. 2005 Aug;2(8):388-9 [16130931.001]
  • [CommentIn] J Clin Oncol. 2005 Feb 1;23(4):657-8 [15613690.001]
  • (PMID = 15613699.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / UO1 CA 69913
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Boronic Acids; 0 / Protease Inhibitors; 0 / Pyrazines; 69G8BD63PP / Bortezomib
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31. Mandigers CM, Verdonck LF, Meijerink JP, Dekker AW, Schattenberg AV, Raemaekers JM: Graft-versus-lymphoma effect of donor lymphocyte infusion in indolent lymphomas relapsed after allogeneic stem cell transplantation. Bone Marrow Transplant; 2003 Dec;32(12):1159-63
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  • [Title] Graft-versus-lymphoma effect of donor lymphocyte infusion in indolent lymphomas relapsed after allogeneic stem cell transplantation.
  • We treated seven patients with DLI for indolent non-Hodgkin's lymphoma relapsed after SCT.
  • In available blood and bone marrow samples, lymphoma cells were analysed by real-time quantitative polymerase chain reaction of t(14;18)-positive cells in follicular lymphoma, and by immunophenotyping in small lymphocytic lymphoma.
  • Evaluable responses to pre-DLI therapy were stable disease in one and partial remission (PR) in two patients.
  • After DLI, acute graft-versus-host disease (GVHD) occurred in 3/6 patients, classified as grade 2, whereas only limited chronic GVHD was seen (n=5).
  • In the remaining patient, not responding to DLI, progressive disease was seen later on; chemotherapy followed by another DLI resulted in CR.
  • In three cases, clinical responses to DLI could be substantiated by molecular or immunophenotypic analysis of lymphoma cells.
  • We conclude that DLI is effective for treatment of indolent lymphoma relapsing after SCT.
  • [MeSH-major] Graft vs Tumor Effect. Lymphocyte Transfusion. Lymphoma, Non-Hodgkin / therapy. Salvage Therapy
  • [MeSH-minor] Adult. Antibodies, Monoclonal / administration & dosage. Antibodies, Monoclonal, Murine-Derived. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Doxorubicin / administration & dosage. Etoposide / administration & dosage. Female. Graft vs Host Disease / etiology. Humans. Immunophenotyping. Lymphocyte Depletion. Male. Mechlorethamine / administration & dosage. Methotrexate / administration & dosage. Middle Aged. Peripheral Blood Stem Cell Transplantation. Polymerase Chain Reaction. Prednisolone / administration & dosage. Prednisone / administration & dosage. Procarbazine / administration & dosage. Radiotherapy, Adjuvant. Recurrence. Remission Induction. Rituximab. Tissue Donors. Transplantation, Homologous / adverse effects. Treatment Outcome. Vincristine / administration & dosage

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  • (PMID = 14647270.001).
  • [ISSN] 0268-3369
  • [Journal-full-title] Bone marrow transplantation
  • [ISO-abbreviation] Bone Marrow Transplant.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 35S93Y190K / Procarbazine; 4F4X42SYQ6 / Rituximab; 50D9XSG0VR / Mechlorethamine; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; 9PHQ9Y1OLM / Prednisolone; VB0R961HZT / Prednisone; YL5FZ2Y5U1 / Methotrexate; ProMACE-MOPP protocol; VAP-cyclo protocol
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32. Igarashi T, Kobayashi Y, Ogura M, Kinoshita T, Ohtsu T, Sasaki Y, Morishima Y, Murate T, Kasai M, Uike N, Taniwaki M, Kano Y, Ohnishi K, Matsuno Y, Nakamura S, Mori S, Ohashi Y, Tobinai K, IDEC-C2B8 Study Group in Japan: Factors affecting toxicity, response and progression-free survival in relapsed patients with indolent B-cell lymphoma and mantle cell lymphoma treated with rituximab: a Japanese phase II study. Ann Oncol; 2002 Jun;13(6):928-43
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Factors affecting toxicity, response and progression-free survival in relapsed patients with indolent B-cell lymphoma and mantle cell lymphoma treated with rituximab: a Japanese phase II study.
  • BACKGROUND: The aim of the study was to determine factors affecting the toxicity and efficacy of rituximab monotherapy in relapsed patients with indolent B-cell lymphoma and mantle cell lymphoma (MCL).
  • Central pathology review revealed that histologically, 81 patients had indolent B-cell lymphoma or MCL: 59 with follicular lymphoma, 17 with MCL, four with marginal zone lymphoma and one with lymphoplasmacytoid lymphoma.
  • Pre-treatment variables affecting toxicities were analyzed for all 90 patients, and those affecting response and progression-free survival (PFS) were analyzed for 77 eligible patients with confirmed indolent B-cell lymphoma or MCL.
  • RESULTS: Hematological toxicities (grade > or =3) occurred more frequently in females (P <0.05), and thrombocytopenia and leukopenia were more frequent in patients with high lactate dehydrogenase (LDH) levels (P <0.05).
  • Non-hematological toxicities (grade > or =2) were more frequent in patients with extranodal disease or bone marrow involvement.
  • The overall response rate (ORR) in patients receiving one prior chemotherapy regimen was higher than those receiving two or more regimens (P <0.05).
  • The median PFS was shorter in MCL patients, in those with extranodal disease, or in those receiving two or more prior chemotherapy regimens (P <0.01).

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  • (PMID = 12123339.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 4F4X42SYQ6 / Rituximab
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33. Plosker GL, Figgitt DP: Rituximab: a review of its use in non-Hodgkin's lymphoma and chronic lymphocytic leukaemia. Drugs; 2003;63(8):803-43
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  • [Title] Rituximab: a review of its use in non-Hodgkin's lymphoma and chronic lymphocytic leukaemia.
  • Rituximab is an anti-CD20 monoclonal antibody that has demonstrated efficacy in patients with various lymphoid malignancies, including indolent and aggressive forms of B-cell non-Hodgkin's lymphoma (NHL) and B-cell chronic lymphocytic leukaemia (CLL).
  • While the optimal use of the drug in many clinical settings has yet to be clarified, two pivotal trials have established rituximab as a viable treatment option in patients with relapsed or refractory indolent NHL, and as a standard first-line treatment option when combined with cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) chemotherapy in elderly patients with diffuse large B-cell lymphoma (the most common type of aggressive NHL).
  • The former was a noncomparative trial in relapsed indolent NHL (follicular and small lymphocytic subtypes) with clinical responses achieved in about half of patients treated with rituximab 375 mg/m(2) intravenously once weekly for 4 weeks, which was similar to some of the most encouraging results reported with traditional chemotherapeutic agents.
  • The latter was a randomised comparison of eight cycles of CHOP plus rituximab 375 mg/m(2) intravenously (one dose per cycle) versus CHOP alone in previously untreated elderly patients (60 to 80 years of age) with diffuse large B-cell lymphoma.
  • Treatment with rituximab is generally well tolerated, particularly in terms of adverse haematological effects and serious or opportunistic infections relative to standard chemotherapy.
  • CONCLUSIONS: Clinical trials with rituximab indicate that the drug has broad application to B-cell malignancies, although further clarification is needed to determine its optimal use in many of these clinical settings.
  • Importantly, rituximab in combination with CHOP chemotherapy has emerged as a new treatment standard for previously untreated diffuse large B-cell lymphoma, at least in elderly patients.
  • Compared with conventional chemotherapy, rituximab is associated with markedly reduced haematological events such as severe neutropenia, as well as associated infections.
  • Rituximab may be particularly suitable for elderly patients or those with poor performance status, and its tolerability profile facilitates its use in combination with cytotoxic drugs.
  • Although treatment with rituximab induces lymphopenia in most patients, typically lasting about 6 months, a full recovery of B lymphocytes in the peripheral blood is usually seen 9-12 months after therapy, as CD20 is not expressed on haematopoietic stem cells.
  • In addition, in vitro data indicate that rituximab sensitises tumour cells to the effects of conventional chemotherapeutic drugs.
  • When administered at a dose of 375 mg/m(2) once weekly for 4 weeks in a pivotal trial in patients with relapsed or refractory indolent B-cell NHL (follicular or small lymphocytic subtypes), peak serum concentrations essentially doubled from the first (239.1 mg/L) to the fourth (460.7 mg/L) infusion, while elimination half-life (t(1/2)) increased from 76.3 to 205.8 hours (3.2 to 8.6 days).
  • The pharmacokinetic properties of rituximab are also characterised by wide inter-individual variability, and serum drug concentrations that are correlated with clinical response.
  • Although pharmacokinetic data are limited in patients with aggressive forms of NHL, such as diffuse large B-cell lymphoma, rituximab appears to have a similar pharmacokinetic profile in these patients to that in patients with indolent B-cell NHL.
  • The pharmacokinetics of rituximab are also reported to be similar whether the drug is administered with or without cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) chemotherapy.
  • THERAPEUTIC USE: A number of studies have demonstrated efficacy of intravenous rituximab in patients with various lymphoid malignancies of B-cell origin, including indolent (e.g. follicular lymphoma) and aggressive (e.g. diffuse large B-cell lymphoma) forms of NHL, and CLL, but the drug has not yet been approved for use in CLL, and approved indications in NHL vary between countries.
  • In the US, for example, rituximab is available for the treatment of patients with low-grade or follicular, relapsed or refractory, CD20-positive B-cell NHL.
  • In Europe, the drug has similar approval for relapsed or refractory follicular NHL as in the US, but has also been approved for use in combination with CHOP chemotherapy for the most common aggressive form of NHL (CD20-positive, diffuse large B-cell lymphoma).
  • In Japan, rituximab has been approved for indolent B-cell NHL and mantle cell lymphoma (an aggressive form of B-cell NHL), primarily on the basis of results of a Japanese phase II trial.
  • Indolent NHL: Results of several studies evaluating rituximab 375 mg/m(2) once weekly for 4 weeks in patients with indolent forms of B-cell NHL (primarily follicular and small lymphocytic lymphomas) showed objective response (OR) rates ranging from approximately 40-60% in those receiving the drug for relapsed or refractory indolent B-cell NHL, and slightly higher (50-70%) for those receiving rituximab as first-line therapy.
  • In a pivotal trial in 166 patients with relapsed or refractory low-grade or follicular B-cell NHL, intent-to-treat (ITT) analysis showed an OR rate of 48%, and a projected median time to progression of 13 months.
  • CHOP, fludarabine-containing regimens) or other drugs (e.g. interferon-alpha2a) in previously untreated patients with indolent forms of B-cell NHL (primarily follicular and small lymphocytic subtypes).
  • Follow-up data from a study in 40 patients with low-grade or follicular B-cell NHL treated with rituximab plus CHOP as first-line therapy showed that responses were durable with a progression-free survival and median duration of response >5 years.Bcl-2 gene rearrangement (t14;18) occurs in malignant cells in up to 85% of patients with follicular lymphoma, and minimal residual disease in peripheral blood and bone marrow can be monitored using polymerase chain reaction (PCR).
  • In several studies assessing blood and/or bone marrow, rituximab has achieved molecular response (conversion from PCR-positive to PCR-negative bcl-2 status) in at least half of the patients.
  • Aggressive NHL: Studies with rituximab as monotherapy in aggressive B-cell NHL, a potentially curable disorder, have generally been restricted to patients with relapsed or recurrent disease, since CHOP has traditionally been the standard first-line treatment regimen.
  • However, promising results from phase II monotherapy studies prompted further clinical investigation of rituximab in conjunction with chemotherapy.
  • Thus, most studies with rituximab in patients with aggressive forms of B-cell NHL have involved combination therapy, including a pivotal randomised trial comparing eight cycles of standard CHOP therapy plus rituximab 375 mg/m(2) (one dose per cycle) versus CHOP alone in 399 previously untreated elderly patients (60-80 years of age) with diffuse large B-cell lymphoma.
  • Other, smaller trials with rituximab in combination with CHOP or other chemotherapeutic regimens, either as first-line therapy or for patients with relapsed or refractory aggressive B-cell NHL, have also shown promising results in terms of clinical response rates.CLL: In relatively small trials (n < 40) conducted primarily in patients with relapsed or refractory B-cell CLL, rituximab monotherapy (various regimens) achieved OR rates of 23-45%, with median duration of response ranging from approximately 3-10 months. (ABSTRACT TRUNCATED)
  • [MeSH-major] Antibodies, Monoclonal / pharmacology. Antibodies, Monoclonal / therapeutic use. Antineoplastic Agents / pharmacology. Antineoplastic Agents / therapeutic use. Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy. Lymphoma, Non-Hodgkin / drug therapy
  • [MeSH-minor] Antibodies, Monoclonal, Murine-Derived. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Clinical Trials as Topic. Drug Administration Schedule. Humans. Rituximab

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  • [Cites] Blood. 1994 Oct 15;84(8):2457-66 [7522629.001]
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  • (PMID = 12662126.001).
  • [ISSN] 0012-6667
  • [Journal-full-title] Drugs
  • [ISO-abbreviation] Drugs
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Randomized Controlled Trial; Review
  • [Publication-country] New Zealand
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Antineoplastic Agents; 4F4X42SYQ6 / Rituximab
  • [Number-of-references] 177
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34. Thomson KJ, Morris EC, Bloor A, Cook G, Milligan D, Parker A, Clark F, Yung L, Linch DC, Chakraverty R, Peggs KS, Mackinnon S: Favorable long-term survival after reduced-intensity allogeneic transplantation for multiple-relapse aggressive non-Hodgkin's lymphoma. J Clin Oncol; 2009 Jan 20;27(3):426-32
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Favorable long-term survival after reduced-intensity allogeneic transplantation for multiple-relapse aggressive non-Hodgkin's lymphoma.
  • PURPOSE: The role of allogeneic transplantation with reduced-intensity conditioning in diffuse large B-cell lymphoma (DLBCL) is currently unclear, with relatively little published data.
  • We report the outcome of reduced-intensity transplantation (RIT) in a cohort of 48 consecutive patients with relapsed/refractory DLBCL (30 patients with de novo disease and 18 patients with transformed follicular lymphoma) who underwent transplantation with an alemtuzumab-containing regimen, with a median follow-up of 52 months.
  • PATIENTS AND METHODS: Patients had experienced treatment failure with a median of five lines of prior therapy, including autologous transplantation in 69%, and 17% of patients were chemotherapy refractory at transplantation.
  • Only 17% of patients developed grade 2 to 4 acute GVHD, with 13% experiencing extensive chronic GVHD.
  • Patients who had chemotherapy-sensitive disease before RIT had current PFS and OS rates at 4 years of 55% and 54%, respectively.
  • Chemotherapy-refractory patients had a poor outcome.
  • CONCLUSION: The encouraging survival rates with extended follow-up suggest a role for RIT in chemotherapy-sensitive relapsed DLBCL, even in patients who have previously experienced treatment failure with autologous transplantation.
  • [MeSH-major] Bone Marrow Transplantation / methods. Lymphoma, Large B-Cell, Diffuse / therapy

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  • (PMID = 19064981.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United Kingdom / Department of Health / /
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; 0 / Antibodies, Neoplasm; 0 / Antineoplastic Agents; 3A189DH42V / alemtuzumab; FA2DM6879K / Vidarabine; P2K93U8740 / fludarabine; Q41OR9510P / Melphalan
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35. Wood L, Robinson R, Gavine L, Juritz J, Jacobs P: A single unit lymphoma experience: outcome in a Cape Town academic centre. Transfus Apher Sci; 2007 Aug;37(1):93-102
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  • [Title] A single unit lymphoma experience: outcome in a Cape Town academic centre.
  • Diagnosis was according to World Health Organization criteria, prognosis assigned by the international index and therapy risk-stratified with results subject to appropriate statistical methodology.
  • Constitutional symptoms were present in 22%; a quarter had previous chemotherapy and a third some form of irradiation prior to referral.
  • Fifty-seven percent were stage I or II and 21% had nodal disease above and below the diaphragm whilst in the remainder cells were present in the circulation and this included the subset of chronic lymphocytic leukaemia -- small lymphocytic lymphoma.
  • Further adverse factors included any prior treatment, intermediate or high-grade histopathology, risk factors defined by the International Prognostic Index as well as late Rai stages.
  • Analysed by disease category Hodgkin lymphoma (n=17) when managed according to the German Study Group protocols and hairy cell leukaemia (n=10) treated with two chlorodeoxyadenosine -- both had a stable plateau in excess of 90%.
  • The corresponding figures for follicular variants (n=31) was 72% in the low risk and 58% in the remainder when treated with cyclophosphamide, vincristine and prednisone.
  • Curves for the aggressive or diffuse large B-cell lymphoma (n=44) fell initially to 48%, but relapse continued in stages III and IV to the current level of 18% when receiving cyclophosphamide, hydroxydaunorubicin, vincristine and prednisone on the 21-day schedule.
  • Chronic lymphocytic leukaemia -- small lymphocytic lymphoma (n=58) were initially given pulsed chlorambucil and sustained response was over 90% with low bulk, but declined to reach 30% as prognostic score rose.
  • It is concluded that precise diagnosis, accurate staging and therapy on standardised risk-stratified programmes, delivered uniformly by a single multidisciplinary group, creates the all-important centre effect; matching figures are unlikely to apply outside these disciplined circumstances.
  • It follows that late referral and prior therapy will adversely affect performance status and compromise life span: These alternative approaches are inappropriate and strongly discouraged.
  • [MeSH-major] Hospitals, Private. Leukemia, Lymphocytic, Chronic, B-Cell / mortality. Leukemia, Lymphocytic, Chronic, B-Cell / therapy. Lymphoma / mortality. Lymphoma / therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols. Child. Cohort Studies. Developing Countries. Disease-Free Survival. Female. Humans. Male. Middle Aged. Neoplasm Staging. Risk Factors. South Africa. Survival Rate

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  • (PMID = 17931976.001).
  • [ISSN] 1473-0502
  • [Journal-full-title] Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis
  • [ISO-abbreviation] Transfus. Apher. Sci.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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36. Zinzani PL, Gandolfi L, Stefoni V, Fanti S, Fina M, Pellegrini C, Montini GC, Derenzini E, Broccoli A, Argnani L, Pileri S, Baccarani M: Yttrium-90 ibritumomab tiuxetan as a single agent in patients with pretreated B-cell lymphoma: evaluation of the long-term outcome. Clin Lymphoma Myeloma Leuk; 2010 Aug;10(4):258-61
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Yttrium-90 ibritumomab tiuxetan as a single agent in patients with pretreated B-cell lymphoma: evaluation of the long-term outcome.
  • BACKGROUND: Based on historical data on the role of radioimmunotherapy (RIT) in pretreated non-Hodgkin lymphoma, we reviewed our hospital's clinical database.
  • PATIENTS AND METHODS: Between 2005 and 2008, 57 patients previously treated with at least 1 rituximab-containing chemotherapy were treated with Yttrium-90-labeled ibritumomab tiuxetan ((90)Y-IT).
  • A total of 46 patients had stage III/IV disease (31 with bone marrow involvement); 6 had bulky disease.
  • According to histology, 53 were follicular lymphoma (FL), 2 were marginal zone lymphoma, and 2 were small lymphocytic lymphoma.
  • All patients achieving a CCR had FL, and 21 of them with stage III/IV disease; 12 of 26 had been heavily pretreated (>or= 3 previous treatments), and 2 had had autologous stem cell transplantation.
  • Toxicity was primarily hematologic and mostly transient; no grade 4 extrahematologic toxicity was observed.
  • [MeSH-major] Antibodies, Monoclonal / therapeutic use. Lymphoma, B-Cell / radiotherapy. Radioimmunotherapy / methods. Yttrium Radioisotopes / therapeutic use
  • [MeSH-minor] Adult. Aged. Female. Humans. Male. Middle Aged. Neoplasm Staging. Retrospective Studies. Time. Treatment Outcome

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  • (PMID = 20709661.001).
  • [ISSN] 2152-2669
  • [Journal-full-title] Clinical lymphoma, myeloma & leukemia
  • [ISO-abbreviation] Clin Lymphoma Myeloma Leuk
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Yttrium Radioisotopes; 0 / ibritumomab tiuxetan
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37. Andersson PO, Brune M, Ekman T: Remission inversion and no transplant-related mortality--a single centre experience of autologous stem cell transplantation in malignant lymphoma. Acta Oncol; 2000;39(7):849-56
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  • [Title] Remission inversion and no transplant-related mortality--a single centre experience of autologous stem cell transplantation in malignant lymphoma.
  • Between 1989 and 1998 93 patients with malignant lymphoma were treated, in our centre, with high-dose chemotherapy and autologous stem cell transplantation.
  • Diagnosis according to the REAL-classification were: 38 patients with high-grade lymphoma (diffuse large B-cell lymphoma (DLCL) (n = 26), anaplastic T-cell (n = 5), lymfoblastic (n = 3) and others (n = 4)), 31 patients with low-grade lymphoma (follicular (n = 18), mantle cell (n = 4), B-CLL (n = 3) and others (n = 6)) and, finally, 24 patients with Hodgkin's disease.
  • The source of stem cells was bone marrow (14 patients), peripheral blood stem cells (64 patients) or a combination of both sources (15 patients).
  • One patient died 11 months post-transplant in unexplained liver failure and all other causes of death were related to relapse of lymphoma.
  • (b) follicular (18 patients, 3-year probability) OS 79%, PFS 52%;.
  • (c) Hodgkin's lymphoma (24 patients, 5-year probability) OS 65%, PFS 55%.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Hematopoietic Stem Cell Transplantation. Lymphoma / mortality. Lymphoma / therapy

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  • (PMID = 11145444.001).
  • [ISSN] 0284-186X
  • [Journal-full-title] Acta oncologica (Stockholm, Sweden)
  • [ISO-abbreviation] Acta Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Norway
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38. Wiseman GA, Gordon LI, Multani PS, Witzig TE, Spies S, Bartlett NL, Schilder RJ, Murray JL, Saleh M, Allen RS, Grillo-López AJ, White CA: Ibritumomab tiuxetan radioimmunotherapy for patients with relapsed or refractory non-Hodgkin lymphoma and mild thrombocytopenia: a phase II multicenter trial. Blood; 2002 Jun 15;99(12):4336-42
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Ibritumomab tiuxetan radioimmunotherapy for patients with relapsed or refractory non-Hodgkin lymphoma and mild thrombocytopenia: a phase II multicenter trial.
  • Mildly thrombocytopenic patients with relapsed or refractory low-grade non-Hodgkin lymphoma (NHL) have an increased risk of chemotherapy-induced myelosuppression following treatment.
  • The safety and efficacy of radioimmunotherapy with a reduced dose of (90)Y ibritumomab tiuxetan (0.3 mCi/kg [11 MBq/kg]; maximum 32 mCi [1.2 GBq]) was evaluated in 30 patients with mild thrombocytopenia (100-149 x 10(9) platelets/L) who had advanced, relapsed or refractory, low-grade, follicular, or transformed B-cell NHL.
  • Patients (median age, 61 years; 90% stage III/IV at study entry; 83% follicular lymphoma; and 67% with bone marrow involvement) had a median of 2 prior therapy regimens (range, 1-9).
  • Kaplan-Meier estimated median time to progression (TTP) was 9.4 months (range, 1.7-24.6).
  • The incidence of grade 4 neutropenia, thrombocytopenia, and anemia was 33%, 13%, and 3%, respectively.
  • [MeSH-major] Antibodies, Monoclonal / administration & dosage. Antineoplastic Agents / administration & dosage. Lymphoma, Non-Hodgkin / therapy. Radioimmunotherapy. Thrombocytopenia / chemically induced
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Radiation Dosage. Remission Induction / methods. Salvage Therapy. Tissue Distribution. Treatment Outcome. Yttrium Radioisotopes / administration & dosage. Yttrium Radioisotopes / pharmacokinetics. Yttrium Radioisotopes / toxicity

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  • (PMID = 12036859.001).
  • [ISSN] 0006-4971
  • [Journal-full-title] Blood
  • [ISO-abbreviation] Blood
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antineoplastic Agents; 0 / Yttrium Radioisotopes; 0 / ibritumomab tiuxetan
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39. Lim ST, Fayad L, Tulpule A, Modiano M, Cabanillas F, Laffranchi B, Allievi C, Bernareggi A, Levine AM: A phase I/II trial of pixantrone (BBR2778), methylprednisolone, cisplatin, and cytosine arabinoside (PSHAP) in relapsed/refractory aggressive non-Hodgkin's lymphoma. Leuk Lymphoma; 2007 Feb;48(2):374-80
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A phase I/II trial of pixantrone (BBR2778), methylprednisolone, cisplatin, and cytosine arabinoside (PSHAP) in relapsed/refractory aggressive non-Hodgkin's lymphoma.
  • The purpose of the study was to evaluate the safety, efficacy, and pharmacokinetics of pixantrone (BBR2778) when substituted for etoposide in the ESHAP regimen in patients with aggressive relapsed or refractory non-Hodgkin's lymphoma.
  • Nineteen patients received protocol therapy, consisting of pixantrone 80 mg/m2 over 1 h on day 1, methylprednisolone 500 mg on days 1 - 5, cisplatin 25 mg/m2 on days 1 - 4, and cytarabine 2000 mg/m2 on day 5.
  • Dose limiting toxicity, consisting of bone marrow suppression, occurred at the first dose level (80 mg/m2), which was defined as the recommended dose.
  • Grade 3 and 4 toxicities were mainly hematologic.
  • Only one patient had grade 4 febrile neutropenia.
  • Median time to progression and overall median survival were 5.7 months and 14.5 months, respectively.
  • There is no significant interaction between pixantrone and the combined drugs.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Lymphoma, B-Cell / drug therapy. Lymphoma, Follicular / drug therapy. Lymphoma, Large B-Cell, Diffuse / drug therapy. Neoplasm Recurrence, Local / drug therapy. Salvage Therapy
  • [MeSH-minor] Adult. Aged. Cisplatin / administration & dosage. Cytarabine / administration & dosage. Female. Humans. Isoquinolines / administration & dosage. Male. Methylprednisolone / administration & dosage. Middle Aged. Prospective Studies. Remission Induction. Treatment Outcome

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  • (PMID = 17325899.001).
  • [ISSN] 1042-8194
  • [Journal-full-title] Leukemia & lymphoma
  • [ISO-abbreviation] Leuk. Lymphoma
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase I; Clinical Trial, Phase II; Journal Article; Multicenter Study; Randomized Controlled Trial
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Isoquinolines; 04079A1RDZ / Cytarabine; F5SXN2KNMR / pixantrone; Q20Q21Q62J / Cisplatin; X4W7ZR7023 / Methylprednisolone
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40. Zinzani PL, Magagnoli M, Bendandi M, Gherlinzoni F, Orcioni GF, Cellini C, Stefoni V, Pileri SA, Tura S: Efficacy of fludarabine and mitoxantrone (FN) combination regimen in untreated indolent non-Hodgkin's lymphomas. Ann Oncol; 2000 Mar;11(3):363-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • PURPOSE: In the last years, fludarabine (FLU) alone or in combination with other drugs has been reported to be effective in the treatment of previously treated low-grade non-Hodgkin's lymphomas (LG-NHL).
  • The aim of this study was to define the therapeutic efficacy and toxicity of a combination of FLU and mitoxantrone (FN regimen) in untreated LG-NHL.
  • PATIENTS AND METHODS: We used a two-drug combination of FLU (25 mg/m2 i.v. on days 1 to 3) and mitoxantrone (10 mg/m2 i.v. on day 1) to treat 27 previously untreated patients with LG-NHL, Chemotherapy was repeated every four weeks for a total of six cycles.
  • Among 27 patients, 17 (63%) were diagnosed with follicular, 6 (22%) with small lymphocytic, and 4 (15%) with immunocytoma subtypes.
  • RESULTS: Of the 27 patients, 18 (67%) achieved complete response (CR) and 6 (22%) partial response, while the remaining 3 (11%) showed no benefit from the treatment.
  • Regarding histology, in the follicular subtype we observed an overall response rate of 94%, with a 76.5% CR rate.
  • Hematologic grade 3-4 toxicity was seen in only five (3.3%) patients; no opportunistic infections or deaths were associated with the administration of the FN regimen.
  • CONCLUSIONS: These preliminary data show that the FN regimen is a very active, well-tolerated combination chemotherapy for untreated patients with advanced LG-NHL.

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  • (PMID = 10811507.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] BZ114NVM5P / Mitoxantrone; FA2DM6879K / Vidarabine; P2K93U8740 / fludarabine
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41. Yakushijin Y, Sakai I, Takada K, Yasukawa M, Fujita S: [Double B-cell malignancies with simultaneous onset]. Rinsho Ketsueki; 2004 Mar;45(3):218-22
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • We encountered a case of a 59-year-old female who simultaneously contracted a non-Hodgkin lymphoma (NHL) and a plasma cell neoplasm.
  • She was diagnosed as having NHL (follicular center lymphoma, grade I, stage IIA) after an open tumor biopsy, and treated by cycles of CHOP chemotherapy which resulted in complete remission.
  • A tumor biopsy was performed laparoscopically at that time.
  • Follicular lymphoma (with positive LCA, L-26, and bcl-2 immuno-staining) with the development of retroperitoneal fibrosis was diagnosed again.
  • When a bone marrow puncture was performed because of a condition of monoclonal gammopathy which had continued for two years, a smoldering myeloma was additionally diagnosed.
  • This diagnosis was made after the presence of IgG-lambda M protein when the marrow showed an increase in the number of plasma cells.
  • In a Southern blot analysis which studied the abdominal tumor and the bone marrow cells, each B-cell tumor had a different IgH gene rearrangement pattern.
  • [MeSH-major] Abdominal Neoplasms. Lymphoma, Follicular. Multiple Myeloma. Neoplasms, Multiple Primary
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. B-Lymphocytes / pathology. Fatal Outcome. Female. Gene Rearrangement, B-Lymphocyte, Heavy Chain. Humans. Middle Aged. Neoplasm Recurrence, Local

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  • (PMID = 15103935.001).
  • [ISSN] 0485-1439
  • [Journal-full-title] [Rinshō ketsueki] The Japanese journal of clinical hematology
  • [ISO-abbreviation] Rinsho Ketsueki
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] Japan
  • [Number-of-references] 17
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42. Spectre G, Gural A, Amir G, Lossos A, Siegal T, Paltiel O: Central nervous system involvement in indolent lymphomas. Ann Oncol; 2005 Mar;16(3):450-4

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • PATIENTS AND METHODS: We retrospectively reviewed the disease characteristics and clinical course in seven patients (six females, one male) with indolent B-cell lymphomas who developed CNS involvement during various stages of their illness.
  • RESULTS: The median ages at diagnosis of systemic and CNS lymphoma were 60 and 63 years, respectively.
  • Histologies were: small lymphocytic lymphoma (two), follicular lymphoma grade I (two), follicular lymphoma grade II (two) and unclear low-grade histology (one).
  • Systemic lymphoma was found in all patients, all but one having bone marrow involvement.
  • Four patients had a transformation to high-grade histology.
  • Six patients were treated with systemic and intra-cerebrospinal fluid chemotherapy, and two received radiotherapy as well.
  • CONCLUSIONS: CNS involvement is a rare and unexpected complication of indolent NHL, which should be considered in the differential diagnosis of patients presenting with new neurological signs.

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  • (PMID = 15642707.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] England
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43. Kanungo A, Medeiros LJ, Abruzzo LV, Lin P: Lymphoid neoplasms associated with concurrent t(14;18) and 8q24/c-MYC translocation generally have a poor prognosis. Mod Pathol; 2006 Jan;19(1):25-33
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • None of these patients had a history of follicular lymphoma.
  • The biopsy specimens were obtained from bone marrow, lymph node, and extranodal sites.
  • Morphologically, nine neoplasms had features of Burkitt or atypical Burkitt lymphoma/leukemia and three were diffuse large B-cell lymphoma with high-grade cytologic features.
  • The remaining two cases were plasmablastic myeloma and low-grade B-cell lymphoma, respectively.
  • The proliferation index assessed by using Ki-67 (MIB1) was 5% in the low-grade B-cell lymphoma, 80% in the plasmablastic myeloma, 90-95% in three cases of diffuse large B-cell lymphoma, and ranged from 90 to >99% in most Burkitt and atypical Burkitt neoplasms.
  • The patient with low-grade B-cell lymphoma was treated with rituximab.
  • All other patients received intensive combination chemotherapy.
  • Two of these patients underwent bone marrow transplantation, and one patient received radiation therapy in addition to transplantation.
  • We conclude that most B-cell lymphomas with concurrent t(14;18) and 8q24/c-MYC translocations fall within the morphologic spectrum of diffuse large B-cell and Burkitt lymphoma.
  • These neoplasms are high-grade and are associated with a poor prognosis.
  • However, this combination of molecular abnormalities can also rarely occur in other neoplasms, such as the cases of low-grade B-cell lymphoma and plasmablastic myeloma in this study.
  • [MeSH-major] Lymphoma / pathology. Proto-Oncogene Proteins c-myc / genetics. Translocation, Genetic
  • [MeSH-minor] Adult. Aged. Antigens, CD20 / analysis. Antigens, CD5 / analysis. Burkitt Lymphoma / genetics. Burkitt Lymphoma / immunology. Burkitt Lymphoma / pathology. Chromosomes, Human, Pair 14 / genetics. Chromosomes, Human, Pair 18 / genetics. Chromosomes, Human, Pair 8 / genetics. Female. Flow Cytometry. Humans. Immunohistochemistry. Immunophenotyping. In Situ Hybridization, Fluorescence. Karyotyping. Ki-67 Antigen / analysis. Lymphoma, B-Cell / genetics. Lymphoma, B-Cell / immunology. Lymphoma, B-Cell / pathology. Lymphoma, Large B-Cell, Diffuse / genetics. Lymphoma, Large B-Cell, Diffuse / immunology. Lymphoma, Large B-Cell, Diffuse / pathology. Male. Middle Aged. Neprilysin / analysis. Prognosis. Proto-Oncogene Proteins c-bcl-2 / analysis

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  • (PMID = 16258503.001).
  • [ISSN] 0893-3952
  • [Journal-full-title] Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
  • [ISO-abbreviation] Mod. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, CD20; 0 / Antigens, CD5; 0 / Ki-67 Antigen; 0 / Proto-Oncogene Proteins c-bcl-2; 0 / Proto-Oncogene Proteins c-myc; EC 3.4.24.11 / Neprilysin
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44. Tóthová E, Kafková A, Guman T, Stecová N, Fricová M: Efficiency of in vivo purging with autologous stem cell transplantation and monoclonal antibody in B-cell lymphomas. Neoplasma; 2003;50(1):22-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Elimination of tumor cells from hematopoietic stem cell products is a major goal of bone marow-suported high-dose cancer chemotherapy.
  • In patients (pts) with low-grade lymphoma Gianni et al (2000) assessed the ability of Rituximab, given in combination with high-dose chemotherapy, to eradicate PCR-detectable disease and enable the harvesting of large amounts of uncontaminated circulating progenitor cells.
  • Our study was conducted in 27 consecutive pts with untreated bcl2 positive NHL (follicular lymphoma--7, chronic lymphocytic leukemia--13 and NHL in leukemic phase--7), 14 pts received Rituximab.
  • Patients received 4 courses of standard-dose chemotherapy (CHOP or FLU-CY), followed by one course of high-dose cyclophosphamid plus G-CSF.
  • Clinical response after transplantation was evaluated in 26 pts who completed the treatment.
  • Aside from providing PCR-negative harvests, the chemoimmunotherapy treatment produced complete clinical (100%) and molecular remission in 79% of evaluable pts.
  • We showed that Rituximab in combination with effective high-dose anti- lymphoma chemotherapy, allowed the harvesting of large amounts of tumor free progenitor cells in evaluable pts.
  • [MeSH-major] Antibodies, Monoclonal / therapeutic use. Hematopoietic Stem Cell Transplantation. Lymphoma, B-Cell / therapy

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  • (PMID = 12687274.001).
  • [ISSN] 0028-2685
  • [Journal-full-title] Neoplasma
  • [ISO-abbreviation] Neoplasma
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Slovakia
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 4F4X42SYQ6 / Rituximab
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45. Russell NH, Byrne JL, Faulkner RD, Gilyead M, Das-Gupta EP, Haynes AP: Donor lymphocyte infusions can result in sustained remissions in patients with residual or relapsed lymphoid malignancy following allogeneic haemopoietic stem cell transplantation. Bone Marrow Transplant; 2005 Sep;36(5):437-41
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Patients with low-grade disease received DLI alone (n = 7) or following radiotherapy (n = 1).
  • Patients with aggressive disease (n = 9) received prior chemotherapy.
  • In all, 10/17 patients achieved CR including 3/4 patients with chronic lymphatic leukaemia (CLL), 4/4 with mantle cell lymphoma (MCL), 3/4 with follicular NHL but 0/5 with aggressive NHL/Richters.
  • Grade II-IV acute GVHD developed in 45% and chronic GVHD in 8/9 evaluable patients.
  • Low-grade NHL and MCL have a high response rate and sustained remissions following DLI.
  • Aggressive disease responds poorly however, despite pre-DLI chemotherapy.
  • [MeSH-major] Graft vs Host Disease / therapy. Hematopoietic Stem Cell Transplantation. Living Donors. Lymphocyte Transfusion. Lymphoproliferative Disorders / therapy. T-Lymphocytes / transplantation

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  • (PMID = 15980879.001).
  • [ISSN] 0268-3369
  • [Journal-full-title] Bone marrow transplantation
  • [ISO-abbreviation] Bone Marrow Transplant.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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46. Wolach O, Bairey O, Lahav M: Late-onset neutropenia after rituximab treatment: case series and comprehensive review of the literature. Medicine (Baltimore); 2010 Sep;89(5):308-18
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Late-onset neutropenia after rituximab treatment: case series and comprehensive review of the literature.
  • Rituximab is a chimeric monoclonal antibody against CD20 that is used mainly for the treatment of CD20-positive lymphoma.
  • Recently, its use has been expanded to include treatment of other nonmalignant diseases such as rheumatologic diseases and autoimmune cytopenia.
  • Most investigators define LON as grade III-IV neutropenia occurring 3-4 weeks after the last treatment with rituximab, in the absence of an alternative explanation for the neutropenia.We report 6 cases of LON identified in our institution.
  • Four patients were treated for diffuse large B-cell lymphoma, and 2 patients for follicular lymphoma.
  • One patient presented with LON and concomitant subacute pulmonary disease that was attributed to rituximab therapy.In addition to our own case series we present a systematic review of the literature, which we performed to compile data to describe better the syndrome of LON.
  • The incidence of LON is generally reported to be in the range of 3%-27%.
  • Data regarding populations at risk are not consistent, and in some instances are conflicting.Patients considered at increased risk of LON include patients after autologous stem cell transplantation, patients treated for acquired immunodeficiency syndrome (AIDS)-related lymphoma, and patients treated with purine analogues.
  • Patients who received previous cytotoxic treatment as well as those treated with more intensive chemotherapy or with chemotherapy in combination with radiotherapy are also considered to be at risk of LON.
  • The concept of a lymphocyte subpopulation imbalance leading to LON has been presented based on the demonstration of T-LGL in peripheral blood and bone marrow of patients with LON.
  • A recent study correlated specific polymorphism in the immunoglobulin G Fc receptor FCγRIIIa 158 V/F with increased rates of LON.The clinical significance of LON is important because it may affect treatment strategies.
  • Re-treatment with rituximab after LON may result in recurrent episodes, but the implications and risks are uncertain at the present time.
  • The role of growth factors once LON appears is ill defined, and the decision to use them should be made on a case-by-case basis.
  • [MeSH-major] Antibodies, Monoclonal / adverse effects. Antineoplastic Agents / adverse effects. Neoplasms / drug therapy. Neutropenia / chemically induced
  • [MeSH-minor] Adult. Age of Onset. Aged. Aged, 80 and over. Antibodies, Monoclonal, Murine-Derived. Female. Humans. Lung Diseases / chemically induced. Lung Diseases / epidemiology. Male. Middle Aged. Risk Factors. Rituximab. Time Factors

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  • (PMID = 20827108.001).
  • [ISSN] 1536-5964
  • [Journal-full-title] Medicine
  • [ISO-abbreviation] Medicine (Baltimore)
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Antineoplastic Agents; 4F4X42SYQ6 / Rituximab
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