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1. Blum KA, Johnson JL, Niedzwiecki D, Piro LD, Saven A, Peterson BA, Byrd JC, Cheson BD, Cancer and Leukemia Group B Study 9153: Prolonged follow-up after initial therapy with 2-chlorodeoxyadenosine in patients with indolent non-Hodgkin lymphoma: results of Cancer and Leukemia Group B Study 9153. Cancer; 2006 Dec 15;107(12):2817-25
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  • [Title] Prolonged follow-up after initial therapy with 2-chlorodeoxyadenosine in patients with indolent non-Hodgkin lymphoma: results of Cancer and Leukemia Group B Study 9153.
  • BACKGROUND: The objective of this study was to determine the efficacy and toxicity of 2-chlorodeoxyadenosine (2-CdA) in patients with untreated, indolent non-Hodgkin lymphoma (NHL).
  • METHODS: For this multicenter, single-arm, Phase II study, 44 patients with treatment-naive, stage III or IV, indolent NHL (International Working Formulation subtypes A, B, and C) were enrolled.
  • CONCLUSIONS: 2-CdA is an active, well-tolerated therapy for patients with untreated, indolent NHL.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Cladribine / therapeutic use. Lymphoma, Non-Hodgkin / drug therapy
  • [MeSH-minor] Adolescent. Adult. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Treatment Outcome

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  • [Copyright] Copyright 2006 American Cancer Society.
  • (PMID = 17120198.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA02599; United States / NCI NIH HHS / CA / CA03927; United States / NCI NIH HHS / CA / CA04326; United States / NCI NIH HHS / CA / CA04457; United States / NCI NIH HHS / CA / CA07968; United States / NCI NIH HHS / CA / CA08025; United States / NCI NIH HHS / CA / CA11789; United States / NCI NIH HHS / CA / CA12046; United States / NCI NIH HHS / CA / CA16450; United States / NCI NIH HHS / CA / CA26806; United States / NCI NIH HHS / CA / CA31946; United States / NCI NIH HHS / CA / CA31983; United States / NCI NIH HHS / CA / CA33601; United States / NCI NIH HHS / CA / CA35279; United States / NCI NIH HHS / CA / CA41287; United States / NCI NIH HHS / CA / CA47555; United States / NCI NIH HHS / CA / CA47559; United States / NCI NIH HHS / CA / CA47577; United States / NCI NIH HHS / CA / CA47642; United States / NCI NIH HHS / CA / CA77597; United States / NCI NIH HHS / CA / CA77658
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 47M74X9YT5 / Cladribine
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2. Tsimberidou AM, McLaughlin P, Younes A, Rodriguez MA, Hagemeister FB, Sarris A, Romaguera J, Hess M, Smith TL, Yang Y, Ayala A, Preti A, Lee MS, Cabanillas F: Fludarabine, mitoxantrone, dexamethasone (FND) compared with an alternating triple therapy (ATT) regimen in patients with stage IV indolent lymphoma. Blood; 2002 Dec 15;100(13):4351-7
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  • [Title] Fludarabine, mitoxantrone, dexamethasone (FND) compared with an alternating triple therapy (ATT) regimen in patients with stage IV indolent lymphoma.
  • Treatment for patients with stage IV indolent lymphoma ranges from watchful waiting to intensive chemotherapy and stem cell transplantation.
  • In this trial we compared 2 induction regimens followed by 1 year of interferon maintenance therapy.
  • Fludarabine, mitoxantrone (Novantrone), and dexamethasone (FND) were compared with an alternating triple therapy (ATT) regimen (CHOD-Bleo, ESHAP, and NOPP).
  • Maintenance interferon/dexamethasone was given for 1 year in both treatment arms.
  • One hundred forty-two patients with previously untreated stage IV indolent lymphoma were evaluable (73 on FND; 69 on ATT).
  • In a multivariate analysis, factors predicting for longer FFS were beta(2)-microglobulin less than 3 mg/L (P =.01) and ATT treatment (P =.03).
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Lymphoma, Non-Hodgkin / drug therapy. Vidarabine / analogs & derivatives
  • [MeSH-minor] Adult. Aged. Bleomycin / administration & dosage. Cisplatin / administration & dosage. Cyclophosphamide / administration & dosage. Cytarabine / administration & dosage. Dexamethasone / administration & dosage. Dexamethasone / adverse effects. Disease-Free Survival. Doxorubicin / administration & dosage. Etoposide / administration & dosage. Female. Follow-Up Studies. Hematologic Diseases / chemically induced. Humans. Male. Methylprednisolone / administration & dosage. Middle Aged. Mitoxantrone / administration & dosage. Mitoxantrone / adverse effects. Prednisone / administration & dosage. Procarbazine / administration & dosage. Prognosis. Remission Induction. Survival Rate. Vincristine / administration & dosage. beta 2-Microglobulin / analysis

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  • (PMID = 12393618.001).
  • [ISSN] 0006-4971
  • [Journal-full-title] Blood
  • [ISO-abbreviation] Blood
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA16672
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / beta 2-Microglobulin; 04079A1RDZ / Cytarabine; 11056-06-7 / Bleomycin; 35S93Y190K / Procarbazine; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 7S5I7G3JQL / Dexamethasone; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; BZ114NVM5P / Mitoxantrone; FA2DM6879K / Vidarabine; P2K93U8740 / fludarabine; Q20Q21Q62J / Cisplatin; VB0R961HZT / Prednisone; X4W7ZR7023 / Methylprednisolone; BACOD protocol; ESAP protocol; NOPP protocol
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3. Roden AC, Macon WR, Keeney GL, Myers JL, Feldman AL, Dogan A: Seroma-associated primary anaplastic large-cell lymphoma adjacent to breast implants: an indolent T-cell lymphoproliferative disorder. Mod Pathol; 2008 Apr;21(4):455-63
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  • [Title] Seroma-associated primary anaplastic large-cell lymphoma adjacent to breast implants: an indolent T-cell lymphoproliferative disorder.
  • Non-Hodgkin lymphomas of the breast are rare, encompassing approximately 0.04-0.5% of all malignant breast tumors, and the vast majority are B-cell lymphomas.
  • In our consultation practice, we have identified four patients with primary T-cell anaplastic large-cell lymphoma presenting adjacent to silicone or saline breast implants.
  • All patients presented with seroma and neoplastic cells were identified in suspension in the serous fluid without solid tissue invasion.
  • Three patients had no evidence of systemic disease (stage 1E), and one patient was not staged.
  • In all patients, the neoplastic cells had a T-cell phenotype, expressed CD30, cytotoxic granule-associated proteins, EMA and clusterin, and were anaplastic lymphoma kinase-1-negative.
  • One patient subsequently received chemotherapy and radiation therapy, and another was treated with radiation alone.
  • The third patient received no further therapy and the fourth patient has been recently diagnosed.
  • After a mean time of 13 months (range, 9-20 months), all three patients with follow-up were alive and well without any recurrence or systemic disease.
  • Although the follow-up time was relatively short, our series and other reported cases suggest that primary anaplastic large-cell lymphoma adjacent to breast implants is an indolent T-cell lymphoproliferative disorder.
  • [MeSH-major] Breast Implants / adverse effects. Breast Neoplasms / etiology. Lymphoma, Large-Cell, Anaplastic / etiology. Seroma / etiology
  • [MeSH-minor] Adult. Female. Humans. Immunohistochemistry. Immunophenotyping. Mastectomy. Middle Aged


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4. Ganjoo K, Advani R, Mariappan MR, McMillan A, Horning S: Non-Hodgkin lymphoma of the breast. Cancer; 2007 Jul 1;110(1):25-30
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  • [Title] Non-Hodgkin lymphoma of the breast.
  • BACKGROUND: Primary lymphoma of the breast has been reported to have a high local and central nervous system recurrence (CNS) rate, suggesting the need for consolidation radiotherapy and CNS prophylaxis.
  • METHODS: In all, 37 patients with lymphoma involving the breast at initial diagnosis and managed at Stanford University from 1981-2005 were included.
  • Diagnostic tissue biopsies were obtained either from the breast mass or an involved lymph node.
  • Treatment and response data, patterns of recurrence, and outcomes were reviewed.
  • RESULTS: Diffuse large B cell lymphoma (DLBCL) was the most common histologic subtype seen in 18 of 37 (49%) patients.
  • Most patients presented with an incidental breast mass in stage I(E) or II(E).
  • DLBCL patients received doxorubicin-based chemotherapy, with 70% receiving involved field radiotherapy and a single patient receiving intrathecal therapy.
  • Patients with indolent lymphoma had an estimated 5-year PFS of 76% and an OS of 92%.
  • CONCLUSIONS: DLBCL of the breast was successfully treated with doxorubicin-based chemotherapy alone or with involved field radiotherapy in an estimated 61% of patients at 5 years.
  • [MeSH-major] Breast Neoplasms / pathology. Lymphoma, Non-Hodgkin / pathology
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Antibiotics, Antineoplastic / therapeutic use. Antigens, CD20 / analysis. Central Nervous System / pathology. Doxorubicin / therapeutic use. Female. Humans. Immunohistochemistry. Kaplan-Meier Estimate. Ki-67 Antigen / analysis. Lymphoma, B-Cell / metabolism. Lymphoma, B-Cell / pathology. Lymphoma, B-Cell / therapy. Lymphoma, Large B-Cell, Diffuse / metabolism. Lymphoma, Large B-Cell, Diffuse / pathology. Lymphoma, Large B-Cell, Diffuse / therapy. Middle Aged. Neoplasm Recurrence, Local. Radiotherapy / methods. Retrospective Studies

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  • [Copyright] Copyright (c) 2007 American Cancer Society.
  • (PMID = 17541937.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 0 / Antigens, CD20; 0 / Ki-67 Antigen; 80168379AG / Doxorubicin
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5. Arcaini L, Paulli M, Boveri E, Vallisa D, Bernuzzi P, Orlandi E, Incardona P, Brusamolino E, Passamonti F, Burcheri S, Schena C, Pascutto C, Cavanna L, Magrini U, Lazzarino M: Splenic and nodal marginal zone lymphomas are indolent disorders at high hepatitis C virus seroprevalence with distinct presenting features but similar morphologic and phenotypic profiles. Cancer; 2004 Jan 1;100(1):107-15
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  • [Title] Splenic and nodal marginal zone lymphomas are indolent disorders at high hepatitis C virus seroprevalence with distinct presenting features but similar morphologic and phenotypic profiles.
  • Due to their rarity, little is known concerning their relation, pattern of dissemination, and treatment outcome.
  • All lesional tissues obtained at diagnosis were reviewed histologically.
  • RESULTS: Among the patients with splenic MZL, 30 patients had Stage IV disease (based on the Ann Arbor staging system).
  • Seventeen patients underwent splenectomy, 8 patients received chemotherapy, and 7 patients were followed without initial treatment.
  • Interferon produced a lymphoma response in three of four HCV positive patients.
  • Among nine patients with nodal MZL, four patients had Stage IV disease.
  • Five patients responded to chemotherapy.
  • The median overall survival was not reached for patients with both types of MZL.
  • CONCLUSIONS: The results of the current study demonstrated that splenic and nodal MZL are indolent lymphomas with different presenting features but common morphologic and biologic characteristics, including high HCV seroprevalence.
  • Studies will be required to identify specific biologic markers and to define the best treatment.
  • [MeSH-major] Hepacivirus / pathogenicity. Lymph Nodes / pathology. Lymphoma, B-Cell, Marginal Zone / pathology. Lymphoma, B-Cell, Marginal Zone / virology. Lymphoma, Non-Hodgkin / pathology. Lymphoma, Non-Hodgkin / virology. Neoplasm Staging. Splenic Neoplasms / pathology. Splenic Neoplasms / virology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Disease-Free Survival. Female. Humans. Interferons / therapeutic use. Male. Middle Aged. Prognosis. Retrospective Studies. Seroepidemiologic Studies. Splenomegaly / etiology

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  • [Copyright] Copyright 2003 American Cancer Society.
  • (PMID = 14692030.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 9008-11-1 / Interferons
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6. Bairey O, Ruchlemer R, Shpilberg O: Non-Hodgkin's lymphomas of the colon. Isr Med Assoc J; 2006 Dec;8(12):832-5
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  • [Title] Non-Hodgkin's lymphomas of the colon.
  • BACKGROUND: Non-Hodgkin's lymphoma of the colon is a rare and consequently poorly studied extranodal lymphoma.
  • Most of the previous publications used old pathologic classifications and old diagnostic and treatment approaches.
  • OBJECTIVE: To examine the clinical presentation, pathologic classification, treatment and outcome of patients with NHL of the colon.
  • Aggressive histology was found in 12 patients: diffuse large B cell lymphoma in 11 and peripheral T cell lymphoma in 1.
  • Three patients had mantle cell lymphoma and two had indolent lymphomas: mucosa-associated lymphoid tissue (n=l) and small lymphocytic (n=l).
  • Disease stage influenced prognosis; six of seven patients with limited-stage DLBCL who received aggressive chemotherapy achieved complete remission and enjoyed prolonged survival, whereas patients with aggressive disseminated disease had resistant disease and poor survival (median 8 months).
  • Those with limited-stage disease when treated with aggressive chemotherapy may enjoy prolonged survival.
  • [MeSH-major] Colorectal Neoplasms / diagnosis. Lymphoma, Non-Hodgkin / diagnosis. Treatment Outcome
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Disease Progression. Female. Humans. Male. Middle Aged. Prognosis. Registries. Remission Induction. Retrospective Studies

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  • (PMID = 17214096.001).
  • [ISSN] 1565-1088
  • [Journal-full-title] The Israel Medical Association journal : IMAJ
  • [ISO-abbreviation] Isr. Med. Assoc. J.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Israel
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7. Bischof M, Zierhut D, Neuhof D, Karagiozidis M, Treiber M, Roeder F, Debus J, Krempien R: Indolent stage IE non-Hodgkin's lymphoma of the orbit: results after primary radiotherapy. Ophthalmologica; 2007;221(5):348-52

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  • [Title] Indolent stage IE non-Hodgkin's lymphoma of the orbit: results after primary radiotherapy.
  • AIMS: Primary non-Hodgkin's lymphoma (NHL) of the orbit is uncommon, representing approximately 8% of extranodal NHLs.
  • Twenty-two patients with indolent stage IE NHL were reviewed retrospectively to analyze the outcome and late effects of primary local radiotherapy.
  • Extranodal mucosa-associated lymphoid tissue lymphoma (n = 15) was the most common histological subtype of NHL, followed by follicular (n = 6) and lymphoplasmacytic lymphoma (n = 1).
  • The median radiation dose was 40 Gy (range 30-46 Gy).
  • None of the patients received chemotherapy before irradiation.
  • The 5-year overall survival rate was 89%; there were no lymphoma-related deaths.
  • CONCLUSIONS: Indolent early stage orbital NHL can be controlled with local radiotherapy.
  • [MeSH-major] Lymphoma, Non-Hodgkin / pathology. Lymphoma, Non-Hodgkin / radiotherapy. Orbital Neoplasms / pathology. Orbital Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Cataract / etiology. Female. Humans. Kaplan-Meier Estimate. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Radiation Dosage. Radiation Injuries / complications. Sjogren's Syndrome / etiology. Time Factors

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  • [Copyright] (c) 2007 S. Karger AG, Basel.
  • (PMID = 17728558.001).
  • [ISSN] 1423-0267
  • [Journal-full-title] Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift für Augenheilkunde
  • [ISO-abbreviation] Ophthalmologica
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
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8. Seymour JF, Pro B, Fuller LM, Manning JT, Hagemeister FB, Romaguera J, Rodriguez MA, Ha CS, Smith TL, Ayala A, Hess M, Cox JD, Cabanillas F, McLaughlin P: Long-term follow-up of a prospective study of combined modality therapy for stage I-II indolent non-Hodgkin's lymphoma. J Clin Oncol; 2003 Jun 1;21(11):2115-22
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  • [Title] Long-term follow-up of a prospective study of combined modality therapy for stage I-II indolent non-Hodgkin's lymphoma.
  • PURPOSE: Standard therapy for patients with stage I-II indolent lymphoma has been involved-field radiation therapy (IF-XRT), which achieves 10-year disease-free survival in 40% to 50% of patients, with many of these patients cured.
  • We investigated the potential for combined-modality therapy to increase the disease-free survival for such patients.
  • PATIENTS AND METHODS: A total of 102 eligible patients with stage I-II low grade lymphoma (International Working Formulation criteria) were enrolled from 1984 to 1992.
  • Treatment comprised 10 cycles of risk-adapted chemotherapy (cyclophosphamide, vincristine, prednisone, bleomycin [COP-Bleo], and with doxorubicin added for some [CHOP-Bleo]) and 30 to 40 Gy IF-XRT.
  • RESULTS: The patients' median age was 56 years (range, 28 to 77), with follicular histology in 83%, bulky disease (>/= 5 cm) in 24%, and stage II in 52%.
  • There were no treatment-related deaths and 99% of patients attained complete remission.
  • With a median follow-up of 10 years, the 10-year time to treatment failure and overall survival were 76% and 82%, respectively.
  • For patients with follicular lymphoma, these figures were 72% and 80%, respectively.
  • The only factor associated with treatment failure, for follicular lymphoma patients, was stage-modified International Prognostic Factors Index score (P =.02).
  • None of 17 patients with diffuse small lymphocytic or mucosa-associated lymphoid tissue histology have relapsed.
  • CONCLUSION: With prolonged follow-up, combined-modality therapy with risk-adapted COP-/CHOP-Bleo and IF radiation has attained higher rates of disease control and survival than previously reported with IF-XRT alone.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bleomycin / therapeutic use. Cyclophosphamide / therapeutic use. Doxorubicin / therapeutic use. Lymphoma, Non-Hodgkin / drug therapy. Lymphoma, Non-Hodgkin / radiotherapy. Prednisone / therapeutic use. Vincristine / therapeutic use
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Disease-Free Survival. Female. Follow-Up Studies. Humans. Lymphoma, Follicular / drug therapy. Lymphoma, Follicular / mortality. Lymphoma, Follicular / pathology. Lymphoma, Follicular / radiotherapy. Male. Middle Aged. Radiotherapy / methods. Survival Rate

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  • (PMID = 12775737.001).
  • [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; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 5J49Q6B70F / Vincristine; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; VB0R961HZT / Prednisone; CHOP-B protocol
  • [Number-of-references] 60
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9. Pan D, Qin J, Farber C, O'Brien J, Filippa D, Portlock CS: CHOP with high dose cyclophosphamide consolidation versus CHOP alone as initial therapy for advanced stage, indolent non-Hodgkin's lymphomas. Leuk Lymphoma; 2003 Jun;44(6):967-71
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  • [Title] CHOP with high dose cyclophosphamide consolidation versus CHOP alone as initial therapy for advanced stage, indolent non-Hodgkin's lymphomas.
  • The role of high dose therapy, including autologous stem cell transplantation (ASCT) in indolent non-Hodgkin's lymphomas remains controversial.
  • We evaluated a dose intense regimen of CHOP induction followed by high dose cyclophosphamide consolidation (CHOP-HC) versus CHOP alone in a prospective comparison to assess intensified therapy without ASCT.
  • Twenty-five patients with previously untreated advanced stage indolent NHL were enrolled: follicular lymphoma, grade 1 (11 patients) and grade 2 (8 patients); small lymphocytic lymphoma (5 patients); and lymphoplasmacytic lymphoma (1 patient).
  • Three patients had intra-abdominal stage II, 2 patients with stage III, and 20 patients with stage IV disease.
  • Following induction, responding patients were given consolidation with either high dose cyclophosphamide @ 3 gm/m2 i.v. for 3 doses with G-CSF (weeks 13, 15, 17) or 2 additional cycles of CHOP (weeks 13, 16), stratified by stage and bulk of disease.
  • There were no treatment-related deaths.
  • With no obvious improvement in CR and with greater hematologic toxicity than CHOP, CHOP-HC is not recommended for treatment of indolent non-Hodgkin's lymphomas.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Lymphoma, Non-Hodgkin / drug therapy
  • [MeSH-minor] Adult. Aged. Cyclophosphamide / administration & dosage. Cyclophosphamide / adverse effects. Doxorubicin / administration & dosage. Doxorubicin / adverse effects. Doxorubicin / analogs & derivatives. Female. Humans. Male. Middle Aged. Neoplasm Staging. Prednisone / administration & dosage. Prednisone / adverse effects. Survival Rate. Time Factors. Vincristine / administration & dosage. Vincristine / adverse effects

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  • (PMID = 12854895.001).
  • [ISSN] 1042-8194
  • [Journal-full-title] Leukemia & lymphoma
  • [ISO-abbreviation] Leuk. Lymphoma
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial
  • [Publication-country] England
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; VB0R961HZT / Prednisone; CHOP protocol; CHOP protocol, modified
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10. El Helw LM, Lorigan PC, Robinson MH, Coleman RE, Hancock BW: VEDex (vincristine, epirubicin dexamethasone): an effective and well tolerated palliative chemotherapy regimen for non-Hodgkin's lymphoma. Int J Oncol; 2000 Apr;16(4):777-82
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  • [Title] VEDex (vincristine, epirubicin dexamethasone): an effective and well tolerated palliative chemotherapy regimen for non-Hodgkin's lymphoma.
  • An evaluation was carried out of the efficacy and toxicity of a novel weekly palliative chemotherapy regimen comprising vincristine, epirubicin and dexamethasone (VEDex) in 57 patients with non-Hodgkin's lymphoma (NHL) treated at this centre.
  • Thirty patients (53%) had high grade NHL; 7 had relapsed after conventional chemotherapy and were not fit for high-dose chemotherapy, 7 were heavily pre-treated, 8 had received prior radiotherapy and 8 had not received any prior therapy.
  • Responding patients received a total of 8 weeks of treatment, but treatment could be repeated at a later stage if required.
  • The median survival from the onset of treatment was 6 months.
  • There were no treatment related deaths.
  • We conclude that VEDex is an effective palliative treatment in patients with indolent or aggressive lymphoma with poor performance status or who have been heavily pre-treated.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Lymphoma, Non-Hodgkin / drug therapy. Palliative Care
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Dexamethasone / administration & dosage. Epirubicin / administration & dosage. Female. Humans. Male. Middle Aged. Vincristine / administration & dosage

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  • (PMID = 10717248.001).
  • [ISSN] 1019-6439
  • [Journal-full-title] International journal of oncology
  • [ISO-abbreviation] Int. J. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] GREECE
  • [Chemical-registry-number] 3Z8479ZZ5X / Epirubicin; 5J49Q6B70F / Vincristine; 7S5I7G3JQL / Dexamethasone
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11. Friedberg JW, Cohen P, Chen L, Robinson KS, Forero-Torres A, La Casce AS, Fayad LE, Bessudo A, Camacho ES, Williams ME, van der Jagt RH, Oliver JW, Cheson BD: Bendamustine in patients with rituximab-refractory indolent and transformed non-Hodgkin's lymphoma: results from a phase II multicenter, single-agent study. J Clin Oncol; 2008 Jan 10;26(2):204-10
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  • [Title] Bendamustine in patients with rituximab-refractory indolent and transformed non-Hodgkin's lymphoma: results from a phase II multicenter, single-agent study.
  • This phase II multicenter study evaluated the efficacy and toxicity of bendamustine in patients with B-cell non-Hodgkin's lymphoma (NHL) refractory to rituximab.
  • RESULTS: Seventy-six patients, ages 38 to 84 years, with predominantly stage III/IV indolent (80%) or transformed (20%) disease were treated; 74 were assessable for response.
  • Twenty-four (32%) were refractory to chemotherapy.
  • The median duration of response was 6.7 months (95% CI, 5.1 to 9.9 months), 9.0 months (95% CI, 5.8 to 16.7) for patients with indolent disease, and 2.3 months (95% CI, 1.7 to 5.1) for those with transformed disease.
  • CONCLUSION: Single-agent bendamustine produced durable objective responses with acceptable toxicity in heavily pretreated patients with rituximab-refractory, indolent NHL.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Lymphoma, Non-Hodgkin / drug therapy. Nitrogen Mustard Compounds / therapeutic use
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antibodies, Monoclonal / therapeutic use. Antibodies, Monoclonal, Murine-Derived. Bendamustine Hydrochloride. Female. Humans. Male. Middle Aged. Rituximab. Survival Analysis. Treatment Outcome

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  • [ErratumIn] J Clin Oncol. 2008 Apr 10;26(11) 1911
  • (PMID = 18182663.001).
  • [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 States / NCI NIH HHS / CA / CA-102216
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Antineoplastic Agents; 0 / Nitrogen Mustard Compounds; 4F4X42SYQ6 / Rituximab; 981Y8SX18M / Bendamustine Hydrochloride
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12. Kahn ST, Flowers C, Lechowicz MJ, Hollenbach K, Johnstone PA: Value of PET restaging after chemotherapy for non-Hodgkin's lymphoma: implications for consolidation radiotherapy. Int J Radiat Oncol Biol Phys; 2006 Nov 15;66(4):961-5
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  • [Title] Value of PET restaging after chemotherapy for non-Hodgkin's lymphoma: implications for consolidation radiotherapy.
  • PURPOSE/OBJECTIVE: Patients treated for non-Hodgkin's Lymphoma (NHL) frequently are restaged for response using positron emission tomography (PET) scanning.
  • This study investigates the role of subsequent consolidation radiation therapy (CRT) based on PET response to chemotherapy.
  • MATERIALS/METHODS: An IRB-approved database was queried for patients who underwent PET scans after chemotherapy for NHL between 1995 and 2004; 77 patients were identified.
  • Multivariate analysis adjusted for age, indolent vs. aggressive histology, and time from chemotherapy to PET revealed PET positive scans (RR = 30.5; 95%CI = 5.9, 156.4), lack of RT (RR = 5.25; 95%CI = 1.26, 21.79), and Stage III/IV presentation (RR = 4.35; 95%CI = 1.03, 20) predicted increased likelihood of recurrence.
  • Patients with positive PET scans after chemotherapy had significantly higher risk of relapse than those with negative scans (58.1% vs. 15.2%; p < 0.0001), although not everyone with positive scans recurred.
  • CONCLUSIONS: While RT may control relapse in PET negative patients, NHL patients who remain PET positive after chemotherapy are not well managed by RT alone.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Lymphoma, Non-Hodgkin / radionuclide imaging. Lymphoma, Non-Hodgkin / therapy. Neoplasm Recurrence, Local / radiotherapy. Positron-Emission Tomography / methods. Radiotherapy, Adjuvant / methods
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Female. Humans. Male. Middle Aged. Neoplasm Staging. Prognosis. Reproducibility of Results. Retrospective Studies. Sensitivity and Specificity. Treatment Outcome

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  • [CommentIn] Int J Radiat Oncol Biol Phys. 2007 Mar 15;67(4):1278; author reply 1278 [17336228.001]
  • (PMID = 17145526.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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13. 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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  • [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.
  • Responses were classified according to the International Workshop for Response Criteria for non-Hodgkin's lymphomas.
  • 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.
  • [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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14. Weide R, Hess G, Köppler H, Heymanns J, Thomalla J, Aldaoud A, Losem C, Schmitz S, Haak U, Huber C, Unterhalt M, Hiddemann W, Dreyling M, German Low Grade Lymphoma Study Group: High anti-lymphoma activity of bendamustine/mitoxantrone/rituximab in rituximab pretreated relapsed or refractory indolent lymphomas and mantle cell lymphomas. A multicenter phase II study of the German Low Grade Lymphoma Study Group (GLSG). Leuk Lymphoma; 2007 Jul;48(7):1299-306
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  • [Title] High anti-lymphoma activity of bendamustine/mitoxantrone/rituximab in rituximab pretreated relapsed or refractory indolent lymphomas and mantle cell lymphomas. A multicenter phase II study of the German Low Grade Lymphoma Study Group (GLSG).
  • On the basis of a preceding phase I study, the current trial explored bendamustine in combination with mitoxantrone and rituximab (BMR) in patients with stage III/IV relapsed or refractory indolent lymphomas and mantle cell lymphoma (MCL) with or without prior rituximab containing chemo-immunotherapy (R-chemo) treatment.
  • Therapy consisted of bendamustine 90 mg/m(2) days 1 + 2, mitoxantrone 10 mg/m(2) day 1, rituximab 375 mg/m(2) day 8.
  • Treatment was repeated on day 29 for a total of four cycles.
  • Between 3 April and 04 July, 57 patients were recruited from 24 participating institutions, 39% of whom had received prior R-chemo therapy.
  • Lymphoma subtypes were 29 follicular (FL), 18 MCL, and 10 other indolent lymphomas.
  • After a median observation time of 27 months (1 - 43), the estimated median progression free survival is 19 months.
  • Treatment related toxicities of grade 3/4 comprised a reversible myelosuppression (10% anemia, 78% leukocytopenia, 46% granulocytopenia, 16% thrombocytopenia).
  • BMR is a very effective new outpatient immuno-chemotherapy with low toxicity for patients with relapsed/refractory FL, MCL and other indolent lymphomas.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Lymphoma, Mantle-Cell / drug therapy. Lymphoma, Non-Hodgkin / drug therapy. Nitrogen Mustard Compounds / administration & dosage
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antibodies, Monoclonal / administration & dosage. Antibodies, Monoclonal, Murine-Derived. Bendamustine Hydrochloride. Female. Humans. Lymphoma, Follicular / complications. Lymphoma, Follicular / drug therapy. Lymphoma, Follicular / mortality. Male. Middle Aged. Mitoxantrone / administration & dosage. Remission Induction. Rituximab. Salvage Therapy / methods. Survival Analysis. Treatment Outcome

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  • [CommentIn] Leuk Lymphoma. 2007 Jul;48(7):1264-6 [17613752.001]
  • (PMID = 17613757.001).
  • [ISSN] 1042-8194
  • [Journal-full-title] Leukemia & lymphoma
  • [ISO-abbreviation] Leuk. Lymphoma
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Nitrogen Mustard Compounds; 4F4X42SYQ6 / Rituximab; 981Y8SX18M / Bendamustine Hydrochloride; BZ114NVM5P / Mitoxantrone
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15. Fisher RI, Dana BW, LeBlanc M, Kjeldsberg C, Forman JD, Unger JM, Balcerzak SP, Gaynor ER, Roy V, Miller T: Interferon alpha consolidation after intensive chemotherapy does not prolong the progression-free survival of patients with low-grade non-Hodgkin's lymphoma: results of the Southwest Oncology Group randomized phase III study 8809. J Clin Oncol; 2000 May;18(10):2010-6
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  • [Title] Interferon alpha consolidation after intensive chemotherapy does not prolong the progression-free survival of patients with low-grade non-Hodgkin's lymphoma: results of the Southwest Oncology Group randomized phase III study 8809.
  • PURPOSE: S8809 is a randomized phase III trial determining whether intensive cytoreductive treatment, followed by interferon consolidation at the time of minimal residual disease, prolongs the progression-free survival (PFS) or overall survival (OS) of indolent lymphoma patients.
  • PATIENTS AND METHODS: Five hundred seventy-one patients with previously untreated stage III or IV low-grade non-Hodgkin's lymphoma were registered.
  • Patients received six to eight cycles of prednisone, methotrexate, doxorubicin, cyclophosphamide, and etoposide/mechlorethamine, vincristine, procarbazine, and prednisone (ProMACE[day 1]-MOPP[day 8]) chemotherapy or chemotherapy plus radiotherapy.
  • Interferon alpha-2b 2 mU/m(2) was given subcutaneously three times weekly for 2 years.
  • With a median follow-up time from randomization among patients still alive of 6.2 years, the median PFS time was 4.1 years for patients who received interferon consolidation therapy and 3.2 years for patients who were observed after ProMACE-MOPP induction (P =.25).
  • CONCLUSION: Interferon alpha consolidation therapy after intensive treatment with anthracycline-containing combination chemotherapy and involved-field radiation therapy does not prolong the PFS or OS of patients with low-grade non-Hodgkin's lymphoma.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Interferon-alpha / therapeutic use. Lymphoma, Non-Hodgkin / drug therapy
  • [MeSH-minor] Adult. Aged. Cyclophosphamide / adverse effects. Cyclophosphamide / therapeutic use. Disease Progression. Disease-Free Survival. Doxorubicin / adverse effects. Doxorubicin / therapeutic use. Etoposide / adverse effects. Etoposide / therapeutic use. Female. Humans. Male. Mechlorethamine / adverse effects. Mechlorethamine / therapeutic use. Methotrexate / adverse effects. Methotrexate / therapeutic use. Middle Aged. Prednisone / adverse effects. Prednisone / therapeutic use. Procarbazine / adverse effects. Procarbazine / therapeutic use. Radiotherapy, Adjuvant. Recombinant Proteins. Remission Induction. Vincristine / adverse effects. Vincristine / therapeutic use

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  • [CommentIn] J Clin Oncol. 2000 Sep 15;18(18):3322 [10986069.001]
  • [CommentIn] J Clin Oncol. 2000 May;18(10):2007-9 [10811663.001]
  • (PMID = 10811664.001).
  • [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 / CA32102; United States / NCI NIH HHS / CA / CA38926; United States / NCI NIH HHS / CA / CA46282; etc
  • [Publication-type] Clinical Trial; Clinical Trial, Phase III; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Interferon-alpha; 0 / Recombinant Proteins; 35S93Y190K / Procarbazine; 43K1W2T1M6 / interferon alfa-2b; 50D9XSG0VR / Mechlorethamine; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; VB0R961HZT / Prednisone; YL5FZ2Y5U1 / Methotrexate; ProMACE-MOPP protocol
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16. Passam FH, Sfiridaki A, Pappa C, Kyriakou D, Petreli E, Roussou PA, Alexandrakis MG: Angiogenesis-related growth factors and cytokines in the serum of patients with B non-Hodgkin lymphoma; relation to clinical features and response to treatment. Int J Lab Hematol; 2008 Feb;30(1):17-25
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  • [Title] Angiogenesis-related growth factors and cytokines in the serum of patients with B non-Hodgkin lymphoma; relation to clinical features and response to treatment.
  • Increased angiogenesis has been shown to be a feature of non-Hodgkin lymphomas (NHL).
  • In the current study, the pretreatment levels of circulating molecules related to angiogenesis were determined in 49 B-cell NHL patients and correlated with histological grade, disease stage and prognostic score.
  • In 25 patients, the same molecules were defined after standard treatment.
  • Increased levels of VEGF, IL-6 and IL-8 were found in the whole group of untreated patients in comparison with normal controls (P < 0.05), whereas, IL-2 was higher in the subgroup of indolent NHL.
  • Overall, there was no significant decrease in the levels of these molecules after treatment.
  • However, by stratification into group of responders vs. non-responders pretreatment IL-8 was significantly increased whereas IL-16 was decreased in the subgroup of complete responders.
  • There was no association with disease stage or the International Prognostic Score.
  • Both indolent and aggressive B cell lymphomas have increased production of angiogenic mediators and cytokines with IL-8 and IL-16 potentially reflecting the response to treatment.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Interleukins / blood. Lymphoma, B-Cell / blood. Lymphoma, B-Cell / drug therapy. Vascular Endothelial Growth Factor A / blood
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Case-Control Studies. Female. Humans. Male. Middle Aged. Neoplasm Staging. Neovascularization, Pathologic. Prognosis. Remission Induction

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  • (PMID = 18190463.001).
  • [ISSN] 1751-5521
  • [Journal-full-title] International journal of laboratory hematology
  • [ISO-abbreviation] Int J Lab Hematol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Interleukins; 0 / VEGFA protein, human; 0 / Vascular Endothelial Growth Factor A
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17. Qin Y, Shi YK, He XH, Yang JL, Yang S, Yu YX, Li B, Wang QL, Zhou LQ, Sun Y: [Clinical features of 89 patients with primary non-Hodgkin's lymphoma of the tonsil]. Ai Zheng; 2006 Apr;25(4):481-5
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  • [Title] [Clinical features of 89 patients with primary non-Hodgkin's lymphoma of the tonsil].
  • BACKGROUND & OBJECTIVE: Head and neck lymphoma develops predominantly in the tonsil.
  • This study was to investigate the clinical features of primary non-Hodgkin's lymphoma (NHL) of the tonsil, and to explore possible ways to improve the prognosis and quality of life of the patients after treatment.
  • Stage I-II patients received radiochemotherapy-predominant treatment, whereas stage III-IV patients received chemotherapy-predominant treatment.
  • RESULTS: Of the 89 cases, 60 (67%) were diffuse large B-cell subtype, 11 (12%) were peripheral T-cell subtype, 5 (6%) were indolent lymphoma, 1 was anaplastic large T-cell lymphoma, and 1 was T lymphoblastic lymphoma; 81 (91%) were stage I-II disease.
  • Of the 89 patients, 58 (72%) received radiochemotherapy, 19 (21%) received radiotherapy alone, 3 received chemotherapy alone, and 1 received radiochemotherapy combined with rituximab.
  • The 5-year overall survival rate was 80%, that of stage I-II patients was 84%.
  • Diffuse large B-cell lymphoma is the most common pathologic subtype.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Lymphoma, Non-Hodgkin. Tonsillar Neoplasms
  • [MeSH-minor] Adolescent. Adult. Aged. Child. Combined Modality Therapy. Cyclophosphamide / therapeutic use. Disease-Free Survival. Doxorubicin / therapeutic use. Drug Resistance, Neoplasm. Female. Follow-Up Studies. Humans. Lymphoma, Large B-Cell, Diffuse / drug therapy. Lymphoma, Large B-Cell, Diffuse / pathology. Lymphoma, Large B-Cell, Diffuse / radiotherapy. Lymphoma, T-Cell, Peripheral / drug therapy. Lymphoma, T-Cell, Peripheral / pathology. Lymphoma, T-Cell, Peripheral / radiotherapy. Male. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Prednisone / therapeutic use. Quality of Life. Retrospective Studies. Survival Rate. Vincristine / therapeutic use. Young Adult

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  • (PMID = 16613685.001).
  • [Journal-full-title] Ai zheng = Aizheng = Chinese journal of cancer
  • [ISO-abbreviation] Ai Zheng
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] China
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; VB0R961HZT / Prednisone; CHOP protocol
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18. Gustavsson A, Osterman B, Cavallin-Ståhl E: A systematic overview of radiation therapy effects in non-Hodgkin's lymphoma. Acta Oncol; 2003;42(5-6):605-19
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  • [Title] A systematic overview of radiation therapy effects in non-Hodgkin's lymphoma.
  • A systematic review of radiation therapy trials in several tumour types was performed by The Swedish Council of Technology Assessment in Health Care (SBU).
  • This synthesis of the literature on radiation therapy for non-Hodgkin's lymphoma (NHL) is based on data from seven randomized trials.
  • The conclusions reached can be summarized as follows: Indolent lymphomas.
  • Data indicate that one-third to one-half of patients with indolent lymphoma in stage I are cured by radiotherapy (follow-up more than 15 years).
  • Addition of chemotherapy to radiotherapy does not indicate any improvement in overall outcome.
  • Data indicate that half of the patients in stage I are cured by radiotherapy alone.
  • Although randomized and non-randomized studies favour combined modality treatment with chemotherapy followed by radiotherapy instead of radiotherapy or chemotherapy alone in localized disease, no firm conclusions can be drawn.
  • Optimal dose for radiation alone or after chemotherapy has not been established.
  • The value of TBI for treatment of NHL has not been proven.
  • There is no proof that fractionated TBI in conjunction with high-dose chemotherapy is superior to chemotherapy regimens alone.
  • High-dose methotrexate therapy seems to lead to longer survival than radiotherapy alone.
  • There is fairly good support for primary chemotherapy including high-dose methotrexate followed by radiotherapy in patients below 60 years.
  • To minimize the risk of neurotoxicity of combined modality treatment it has been proposed to use chemotherapy alone and delay radiotherapy for relapse, especially in patients above 60 years, or use it in chemotherapy-resistant disease.
  • Optimal chemotherapy regimen is not defined and the role of radiotherapy remains to be determined.
  • There is some support for combined modality treatment with chemotherapy and radiotherapy for aggressive lymphomas in Waldeyer's ring with limited disease.
  • There are sparse data supporting radiotherapy alone in localized indolent lymphomas in salivary glands.
  • Radioimmunotherapy is a new treatment modality with systemic radiation for patients with advanced NHL, where conventional external beam radiotherapy plays only a minor role.
  • A variety of monoclonal antibodies, radionuclides and study designs with both myeloablative and non-myeloablative approach have resulted in high response rates in patients with recurrent or refractory NHL.
  • One randomized clinical trial is published, showing superior therapy results with radiolabelled antibody compared with the corresponding unlabelled antibody.
  • [MeSH-major] Brachytherapy / methods. Lymphoma, Non-Hodgkin / mortality. Lymphoma, Non-Hodgkin / radiotherapy
  • [MeSH-minor] Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Female. Humans. Male. Middle Aged. Prognosis. Radiotherapy Dosage. Radiotherapy, Adjuvant. Randomized Controlled Trials as Topic. Risk Assessment. Survival Analysis. Sweden. Treatment Outcome

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  • (PMID = 14596518.001).
  • [ISSN] 0284-186X
  • [Journal-full-title] Acta oncologica (Stockholm, Sweden)
  • [ISO-abbreviation] Acta Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Norway
  • [Number-of-references] 82
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19. Hollender A, Bjøro T, Otto Karlsen K, Kvaloy SO, Nome O, Holte H: Vitamin D deficiency in patients operated on for gastric lymphoma. Scand J Gastroenterol; 2006 Jun;41(6):673-81
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  • [Title] Vitamin D deficiency in patients operated on for gastric lymphoma.
  • OBJECTIVE: To determine the nutritional status in patients treated for gastric non-Hodgkin's lymphoma (NHL).
  • Those with aggressive lymphomas in stage IE-IIE underwent gastric surgery followed by CHOP-like chemotherapy.
  • Patients with indolent lymphomas and localized disease did not receive any further treatment if the operation was considered radical; otherwise, they received local radiotherapy after surgery.
  • [MeSH-major] Gastrectomy. Lymphoma, Non-Hodgkin / pathology. Lymphoma, Non-Hodgkin / surgery. Stomach Neoplasms / pathology. Stomach Neoplasms / surgery. Vitamin D Deficiency / blood
  • [MeSH-minor] Adult. Aged. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Nutritional Status. Prospective Studies. Retrospective Studies


20. Othieno-Abinya NA, Abwao HO, Maina JM, Nyabola LO, Opiyo A, Njuguna E, Ndege P, Musibi A: Non-Hodgkin's lymphomas at Kenyatta the National Hospital Nairobi in the 1990's. East Afr Med J; 2004 Sep;81(9):450-8
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  • [Title] Non-Hodgkin's lymphomas at Kenyatta the National Hospital Nairobi in the 1990's.
  • OBJECTIVES: To determine the clinico-pathologic and prognostic factors, treatment and outcome of non-Hodgkin's lymphomas as seen at the Kenyatta National Hospital in the 1990s.
  • DESIGN: Retrospective study of patients with non-Hodgkin's Iymphoma.
  • SUBJECTS: Patients aged 13 years and above, with non-Hodgkin's Iymphomas.
  • Twenty five out of 77(32.5%) tested positive for HIV infection, none of them being of the indolent variety.
  • Up to 57.1% of cases of Burkitt's lymphoma tested positive for HIV infection.
  • Cyclophosphamide, doxorubicin, vincristine and prednisone, (CHOP) chemotherapy was given to 68.7% of the patients with complete remission rates of 55.6% for those who got a minimum of six courses of chemotherapy.
  • Standard treatment was offered to the majority of patients, and those who could afford to purchase the medicines stood good chance of achieving complete remission.
  • Poor performance status at diagnosis correlated with shorter follow-up durations and early stage disease correlated with longer follow-up durations.
  • [MeSH-major] Lymphoma, Non-Hodgkin / epidemiology
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Cyclophosphamide / administration & dosage. Doxorubicin / administration & dosage. Female. Humans. Kenya / epidemiology. Lymphoma, AIDS-Related / diagnosis. Lymphoma, AIDS-Related / drug therapy. Lymphoma, AIDS-Related / epidemiology. Male. Middle Aged. Prednisolone / administration & dosage. Retrospective Studies. Vincristine / administration & dosage

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  • (PMID = 15626054.001).
  • [ISSN] 0012-835X
  • [Journal-full-title] East African medical journal
  • [ISO-abbreviation] East Afr Med J
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Kenya
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; 9PHQ9Y1OLM / Prednisolone; VAP-cyclo protocol
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21. Maruyama D, Watanabe T, Beppu Y, Kobayashi Y, Kim SW, Tanimoto K, Makimoto A, Kagami Y, Terauchi T, Matsuno Y, Tobinai K: Primary bone lymphoma: a new and detailed characterization of 28 patients in a single-institution study. Jpn J Clin Oncol; 2007 Mar;37(3):216-23
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  • [Title] Primary bone lymphoma: a new and detailed characterization of 28 patients in a single-institution study.
  • BACKGROUND: The incidence of primary bone lymphoma (PBL) is so rare that many of its aspects remain unknown.
  • All patients underwent chemotherapy with half receiving radiotherapy as their initial treatment.
  • Although 19 (68%) patients had diffuse large B-cell lymphoma (DLBCL), other histopathological subtypes (three B-lymphoblastic lymphoma, two anaplastic large cell lymphoma, two indolent B-cell lymphoma, one NK/T-cell lymphoma (NTCL) and one Hodgkin lymphoma) were also included.
  • While 68% of patients had stage IV disease, none of them showed bone marrow involvement at their initial diagnosis.
  • Only 'histopathological subtype (immunoblastic variant of DLBCL or NTCL versus others)' and 'response to initial treatment (progression versus remission)' were factors significantly affecting overall survival.
  • [MeSH-major] Bone Neoplasms / pathology. Lymphoma / pathology
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Child. Child, Preschool. Female. Hodgkin Disease / pathology. Humans. Lymphoma, B-Cell / pathology. Male. Middle Aged. Neoplasm Staging. Retrospective Studies. Survival Rate. Treatment Outcome

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  • (PMID = 17472971.001).
  • [ISSN] 1465-3621
  • [Journal-full-title] Japanese journal of clinical oncology
  • [ISO-abbreviation] Jpn. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
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22. Dunn P, Kuo TT, Shih LY, Lin TL, Wang PN, Kuo MC, Tang CC: Primary salivary gland lymphoma: a clinicopathologic study of 23 cases in Taiwan. Acta Haematol; 2004;112(4):203-8
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  • [Title] Primary salivary gland lymphoma: a clinicopathologic study of 23 cases in Taiwan.
  • Twenty-three patients with primary salivary gland lymphoma were diagnosed between 1990 and 2001.
  • The sites of lymphoma involvement beyond the salivary glands were the cervical lymph nodes in 7, bone marrow in 3, the axillary lymph nodes in 3, the nasopharynx in 2, the abdominal lymph nodes in 2, the palate, the subconjunctiva, and the spleen in 1 each patient.
  • Histologically, 19 patients had lymphomas of mucosa-associated lymphoid tissue (MALT) with myoepithelial sialadenitis in 13, 3 patients had diffuse large cell lymphomas and 1 had follicular lymphoma.
  • Six patients were in stage I, 4 in II, 1 in III and 12 in IV.
  • Eight of 23 patients (35%) had autoimmune diseases before or after the diagnosis of NHL and all suffered from MALT lymphoma.
  • Four patients with parotid MALT lymphoma had primary or secondary Sjogren's syndrome.
  • All the 6 stage I patients had achieved complete remission (CR) without relapses 17-84 months (median 44 months) after treatment.
  • Excluding a stage IV patient with follicular lymphoma who died at 3.5 months without treatment, CR was achieved in all of the remaining 16 patients.
  • However, a high relapse rate (9/16, 56%) was noted in stage II-IV patients.
  • These patients tended to relapse in the original sites, but achieved CR again after chemotherapy or radiotherapy.
  • One patient with MALT lymphoma developed histologic transformation into diffuse large lymphoma during relapse and died of refractory disease.
  • Thus, salivary gland lymphoma proved to be an indolent disease.
  • [MeSH-major] Lymphoma, Non-Hodgkin. Salivary Gland Neoplasms
  • [MeSH-minor] Adult. Aged. Antineoplastic Combined Chemotherapy Protocols. Autoimmune Diseases / complications. Disease-Free Survival. Female. Humans. Lymphoma, B-Cell, Marginal Zone / complications. Male. Middle Aged. Radiotherapy. Remission Induction. Survival Rate. Taiwan

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  • [Copyright] 2004 S. Karger AG, Basel.
  • (PMID = 15564732.001).
  • [ISSN] 0001-5792
  • [Journal-full-title] Acta haematologica
  • [ISO-abbreviation] Acta Haematol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
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23. Coupland SE, Hummel M, Stein H: Ocular adnexal lymphomas: five case presentations and a review of the literature. Surv Ophthalmol; 2002 Sep-Oct;47(5):470-90
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  • The Revised European and American Lymphoma (REAL) Classification and the new World Health Organization Classification of Tumors of Hemopoietic and Lymphoid Tissues are the most suitable for subdividing the ocular adnexal lymphomas, whereby the extranodal marginal zone B-cell lymphoma represents the most common lymphoma subtype.
  • This review is based on five cases subtyped according to the above classifications-three "typical" lymphomas (an extranodal marginal zone B-cell lymphoma, a diffuse large cell B-cell lymphoma arising from an extranodal marginal zone B-cell lymphoma, and a follicular lymphoma) and two "atypical" lymphomas (a non-endemic Burkitt lymphoma in an immune competent elderly patient, and a primary Hodgkin lymphoma of the eyelid) of the ocular adnexa.
  • Management of patients with ocular adnexal lymphomas includes a thorough systemic medical examination to establish the clinical stage of the disease.
  • The majority of patients with ocular adnexal lymphoma have stage IE disease.
  • Current recommended therapy in stage IE tumors is radiotherapy, while disseminated disease is treated with chemotherapy.
  • Despite usually demonstrating an indolent course, extranodal marginal zone B-cell lymphomas are renowned for recurrence in extranodal sites, including other ocular adnexal sites.
  • Major prognostic criteria for the ocular adnexal lymphomas include anatomic location of the tumor; stage of disease at first presentation; lymphoma subtype as determined using the REAL classification; immunohistochemical markers determining factors such as tumor growth rate; and the serum lactate dehydrogenase level.
  • [MeSH-major] Conjunctival Neoplasms / pathology. Eyelid Neoplasms / pathology. Hodgkin Disease / pathology. Lymphoma, Non-Hodgkin / pathology. Orbital Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biomarkers, Tumor / analysis. Combined Modality Therapy. DNA, Neoplasm / analysis. Female. Humans. Magnetic Resonance Imaging. Male. Neoplasm Proteins / analysis. Radiotherapy

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  • (PMID = 12431695.001).
  • [ISSN] 0039-6257
  • [Journal-full-title] Survey of ophthalmology
  • [ISO-abbreviation] Surv Ophthalmol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / DNA, Neoplasm; 0 / Neoplasm Proteins
  • [Number-of-references] 87
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24. Biswas G, Parikh PM, Nair R, Bhagwat R, Bakshi A, Prabhash K, Vora A, Gupta S, Pai VR, Menon H, Sastry PS: Rituximab (anti-CD20 monoclonal antibody) in lymphoproliferative malignancies: Tata Memorial experience. J Assoc Physicians India; 2006 Jan;54:29-33
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  • The histology was aggressive NHL in 35, indolent NHL in 22 and 7 cases were diagnosed as CLL.
  • Among NHL, sixteen were in early stage (I/II) and the remaining forty-one were in advanced stage (III/IV) of disease.
  • Rituximab was used in combination with chemotherapy in the other 47 cases.
  • The patient who developed anaphylaxis required discontinuation of further Rituximab.
  • A total of seven patients died, three due to progressive disease, three due to chemotherapy related toxicity and one due to an unrelated cause.
  • We conclude that Rituximab is a valuable addition to the treatment armamentarium of lymphoproliferative disorders.
  • [MeSH-major] Antibodies, Monoclonal / therapeutic use. Antigens, CD20 / drug effects. Antineoplastic Agents / therapeutic use. Lymphoma, Non-Hodgkin / drug therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Antibodies, Monoclonal, Murine-Derived. Disease Progression. Female. Humans. India. Male. Middle Aged. Proto-Oncogene Proteins c-bcl-2 / drug effects. Retrospective Studies. Rituximab. Survival Rate

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  • (PMID = 16649735.001).
  • [ISSN] 0004-5772
  • [Journal-full-title] The Journal of the Association of Physicians of India
  • [ISO-abbreviation] J Assoc Physicians India
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] India
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Antigens, CD20; 0 / Antineoplastic Agents; 0 / Proto-Oncogene Proteins c-bcl-2; 4F4X42SYQ6 / Rituximab
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