Lymphoma Diagnosis and Classification
|
|
- Amos Conley
- 8 years ago
- Views:
Transcription
1 Lymphoma Diagnosis and Classification By Atef Shrit, MD, Pathology B- and T/NK-cell lymphomas are clonal neoplasms of immature and mature B-lymphocytes, T-lymphocytes or natural killer cells at various stages of differentiation. In general, B- and T-cell lymphomas appear to recapitulate stages of normal B-cell or T-cell differentiation. The classification of lymphoid neoplasms is based on the utilization of all available information to define disease entities (e.g., clinical history, morphology, immunophenotyping and genetic findings). Morphology and immunophenotype are sufficient for the diagnosis of most lymphoid neoplasms; however, no one antigenic marker is specific for any neoplasm and the combination of morphologic features and a panel of antigenic markers are necessary for correct diagnosis. Immune profiling is very helpful in the diagnosis of B-cell lymphoma, but it is somewhat less helpful in the subclassification of T-cell lymphomas. Moreover, while certain antigens are commonly associated with specific disease entities, these associations are not entirely disease-specific. For example, CD3 is a universal feature of anaplastic large cell lymphoma (ALCL), but can be expressed in other T-cell and B-cell lymphomas as well as classical Hodgkin s lymphoma. Genetic features are playing an increasingly important role in the classification of lymphoid malignancies. For many of small B-cell lymphomas and leukemias, recurrent genetic alterations have been identified. Lymphoid malignancies range in their clinical behavior from low grade to high grade. Moreover, histological and clinical progression is often encountered during a patient s clinical course. Therefore, the World Health Organization (WHO) classification does not solidify lymphoid malignancies in terms of grade. Both morphology and immunophenotype often change over time, as the lymphoid neoplasm undergoes clonal evolution with the acquisition of additional genetic features. The fourth edition of WHO classification also recognizes grey zone lymphomas. These lymphomas bridge the gap between various forms of lymphomas. Precursor lymphoid neoplasms, including precursor B-cell acute lymphoblastic leukemia (B-lymphoblastic leukemia/lymphoma) and precursor T-cell acute lymphoblastic leukemia (T-lymphoblastic leukemia/lymphoma), are primarily diseases of children as 75 percent of cases occur in children under six years of age. Mature B-cell neoplasms comprise over 9 percent of lymphoid neoplasms worldwide. They represent approximately 4 percent of all new cancers each year. The most recent survey from the Surveillance, Epidemiology and End Results (SEER) Program in the United States indicated an incidence rate Oncology Services Annual Report 1
2 Reference: WHO Classification of Tumours of Hematopoietic and Lymphoid Tissues, 4th Edition, Lyon, 8. Non- Hodgkin s Lymphoma Incidence by AJCC Stage per 1, persons per year of for all lymphoid neoplasms, for B-cell neoplasms, 1.79 for all T-cell neoplasms and 2.67 for Hodgkin s lymphoma. Infectious agents have been shown to contribute to the development of several types of mature B-cell, T-cell and NK-cell lymphomas: Epstein-Barr virus (EBV) is present in nearly 1 percent of endemic Burkitt s lymphoma and in percent of sporadic and HIVassociated cases. EBV is also involved in the pathogenesis of many B-cell lymphomas arising in immune-suppressed and elderly patients, including post-transplant lymphoproliferative disorders, plasmablastic lymphoma and EBV+ large B-cell lymphoma of the elderly. EBV is also associated with extranodal NK/T-cell lymphoma. Some cases of classical Hodgkin s lymphoma are associated with EBV infection. Human herpesvirus-8 (HHV-8) is found in the primary effusion lymphoma and lymphomas associated with multicentric Castleman s disease commonly seen in HIV-infected patients. Human T-cell lymphotropic virus type 1 (HTLV-1) is a causative agent for adult T-cell lymphoma/leukemia. Hepatitis C virus has been implicated in some cases of lymphoplasmacytic lymphoma, splenic marginal zone lymphoma, nodal marginal zone lymphoma and diffuse large B-cell lymphoma. Immune response to Helicobacter pylori has been implicated in the pathogenesis of gastric MALT (Mucosa-Associated Lymphoid Tissue). In conclusion, the fourth edition of WHO classification emphasizes a multi-parameter approach to classification including clinical history, histology, immunophenotyping and genetic features I II III IV AJCC Stage Non-Hodgkin s Lymphoma Incidence Gender Race Age Range Total M F W B CH Stage I denotes involvement of a single lymph node region (I) or localized involvement of a single extra-lymphatic organ or site (IE). Stage II indicates the involvement of 2 or more lymph node regions on the same side of the diaphragm (II) or localized involvement of a single associated extra-lymphatic organ or site and its regional lymph nodes, with or without other lymph node regions on the same side of the diaphragm (IIE). The number of lymph node regions involved may be indicated by a subscript, (e.g., II 3 ). Stage III implies involvement of lymph node regions on both sides of the diaphragm (III) that may also be accompanied by localized involvement of an extra-lymphatic organ or site (IIIE), by involvement of the spleen (IIIS), or both (IIISE). Stage IV is disseminated (multifocal) involvement of 1 or more extra-lymphatic sites with or without associated lymph node involvement or isolated extra-lymphatic organ involvement with distant (non-regional) nodal involvement. Source: emedicine from WebMD, 7 2 Miami Valley Hospital
3 Non-Hodgkin s Lymphoma Histology Indolent Types Cases Follicular lymphoma 42 3.% Small B lymphocytic lymphoma % Marginal zone B-cell lymphoma % Lymphoplasmacytic lymphoma % Subtotal Indolent % Aggressive Types Cases Large B-cell diffuse lymphoma % Mantle cell lymphoma % Large B-cell diffuse immunoblastic lymphoma % Mixed small & large cell diffuse lymphoma % Mediastinal large B-cell lymphoma 1.71% Subtotal Aggressive % Other Type Cases Burkitt s lymphoma % Total 1 1.% Non-Hodgkin s Lymphoma by Clinical Behavior Indolent Aggressive Other Cases Oncology Services Annual Report 3
4 Management of Non-Hodgkin s Lymphoma By Basel Yanes, MD, Medical Oncology Table 1. Lymphomas are a heterogeneous group of malignancies of the lymphoid system. This article explains in detail the treatment of the two most common types and briefly discusses the less common lymphoid malignancies. Advanced Indolent (Slow-Growing) Lymphoma This group is comprised mainly of Grade 1-2 follicular lymphomas, which account for 25-3 percent of non-hodgkin s lymphoma (NHL). The majority of patients present with advanced disease (Stage III-IV). The prognosis is determined by the Follicular Lymphoma International Prognostic Index (FLIPI), Table 1 below. Follicular Lymphoma International Prognostic Index Scoring: one point for each of the following characteristics: Age > 6 Stage III or IV LDH above normal Number of invaded nodal areas > 4 Hgb < 12 Overall Overall FLIPI Score Survival 5 Years Survival 1 Years Low Risk -1 9% 7% Intermediate Risk 2 8% 5% High Risk 3 5% 35% Advanced indolent lymphomas have the paradox of good prognosis and no cure. While there is no curative therapy, the median survival of untreated patients is about 1 years. There are multiple management options. The first option is watchful waiting. Asymptomatic patients with a stable or slowly progressive disease should be considered for watchful waiting where treatment is initiated when the disease becomes symptomatic or rapidly progresses. If patients require treatment, there are multiple chemotherapy options ranging from single alkylating agents to combination chemotherapy. More recently, the monoclonal antibody Rituxan (rituximab) has become a major type of treatment in these lymphomas. It is usually given in combination with chemotherapy or alone in certain patients. Perhaps the most widely used treatment regimens are: 1) Rituxan COP (+/- Adriamycin i.e. CHOP). The use of Adriamycin in these patients is controversial. 2) Fludarabine-Novantron-Rituxan (FNR) These regimens induce remission in approximately 8 percent of patients with about percent complete remission. Rituxan alone induces remission in approximately 5 percent of patients but these patients have shorter remissions. Rituxan maintenance prolongs remission but remains controversial as there is no definite survival benefit reported to date. Diffuse Large B-Cell Lymphoma Diffuse Large B-Cell Lymphoma (DLBCL) comprises approximately 3 percent of NHL. It is an aggressive disease and can be rapidly fatal if untreated. Fortunately, chemotherapy is very effective and often curative. The standard regimen is a combination of Cytoxan, Adriamycin, Vincristine, Prednisone (CHOP). Studies in the last few years showed significant improvement in outcome by adding Rituxan (R-CHOP). Currently the standard treatment is R-CHOP at 3-week intervals, usually given for 6-8 cycles. The treatment induces remission in many patients as shown in the above table; most relapses occur in 4 Miami Valley Hospital
5 2-3 years. A significant number of these patients are cured. The percentage is determined by the International Prognostic Index (IPI), Table 2 below. Table 2. International Prognostic Index Scoring: one point for each of the following characteristics: Age > 6 Number of extra-nodal sites > 1 LDH above normal Performance status > 1 Stage III or IV Complete Overall IPI Score Remission Survival 5 Year Low Risk -1 85% 7% Low-Intermediate Risk 2 7% 5% High-Intermediate Risk 3 55% % High Risk % 25% 5-Year Comparative Observed Survival Rates Comparative Data source: Elekta IMPAC Systems National Oncology Data Alliance (NODA) Idolent Type Lymphoma (N=68) Less Common Lymphomas Mantle Cell NHL This is one of the most challenging lymphomas as it has a relatively aggressive behavior but can t be cured with chemotherapy. It comprises approximately 7 percent of NHL. There is no standard approach and treatment ranges from R-CHOP to high dose chemotherapy with bone marrow transplant. Marginal Zone B-Cell Lymphomas This is an indolent type with multiple variants. The most known is gastric MALT (Mucosa-Associated Lymphoid Tissue). These patients often benefit from local treatment and have a good prognosis. Systemic therapy includes Rituxan and a variety of chemotherapy agents and combinations. Small Lymphocytic Lymphomas This is the tissue variant of chronic lymphocytic leukemia and is managed in a similar fashion. In general it has a good prognosis and often can be managed with watchful waiting. Lymphoplasmacytic Lymphoma Formally known as Waldenstrom s macroglobulinemia, this entity has an indolent course. It can often be managed with watchful waiting. When treatment is needed, a variety of chemotherapy agents and combinations as well as Rituxan can be effective At Dx Years Aggressive Type Lymphoma (N=64) At Dx Years Other Type Lymphoma (N=8) At Dx Years MVH NODA Oncology Services Annual Report 5
6 Radiation Therapy and Lymphoma By Douglas W. Ditzel, DO, Radiation Oncology Radiation therapy continues to play an important role in the treatment of lymphomas. As the classification of lymphomas continues to evolve and systemic treatments become more effective, the specific use of radiation is being refined. The larger fields used in the past are being replaced by more local-regional targets. In addition, doses will vary depending on the lymphoma subtype. Typically, involved field radiation will be used as primary treatment in Stage I-II follicular lymphomas, Stage I or II H. pylori negative gastric and non-gastric MALT lymphomas, and early stage primary cutaneous marginal zone or follicular center B-cell lymphomas. Limited field radiation therapy is also used in combination with chemotherapy in diffuse large cell lymphomas and mantle cell lymphomas. Total skin electron beam therapy is an aggressive, highly technical treatment utilized in generalized stage IIB mycosis fungoides. Radiation doses range from -3 Gy with low grade lymphoma to Gy with more resistant aggressive lymphomas. An emerging technology is radioimmunotherapy. Antibodies directed at specific lymphoma cell antigens are tagged with radioactive yttrium or iodine, resulting in eradication of the tumor. Radiation therapy is also effective for palliation of advanced lymphoma. Doses as low as 4 Gy can provide symptomatic relief. In summary, radiation therapy remains an important tool in fighting non-hodgkin s lymphoma. Doses and targets, however, are changing as we improve our understanding of this diverse disease. First Course of Therapy Non-Hodgkin s Lymphoma Number of Cases Stage I Stage II Stage III Stage IV No treatment Chemotherapy and Immunotherapy* Radiation Therapy and Chemotherapy Surgery, Radiation Therapy and Chemotherapy Hormone**, Chemotherapy and Other Total * Transplant or biological response modifier ** Prednisone coded as hormone when given with chemotherapy 6 Miami Valley Hospital
MALIGNANT LYMPHOMAS. Dr. Olga Vujovic (Updated August 2010)
MALIGNANT LYMPHOMAS Dr. Olga Vujovic (Updated August 2010) Malignant lymphomas consist of Hodgkin and non-hodgkin lymphomas. The current management of these diseases involves a multi-disciplinary approach.
More informationNon-Hodgkin s Lymphoma
Non-Hodgkin s Lymphoma Luis Fayad, MD Assistant Professor Clinical Medical Director Lymphoma/Myeloma Department Non-Hodgkin s Lymphoma Non-Hodgkin s lymphomas (NHL) are a heterogeneous group of malignant
More informationLYMPHOMA. BACHIR ALOBEID, M.D. HEMATOPATHOLOGY DIVISION PATHOLOGY DEPARTMENT Columbia University/ College of Physicians & Surgeons
LYMPHOMA BACHIR ALOBEID, M.D. HEMATOPATHOLOGY DIVISION PATHOLOGY DEPARTMENT Columbia University/ College of Physicians & Surgeons Normal development of lymphocytes Lymphocyte proliferation and differentiation:
More informationNon-Hodgkin Lymphoma Richard Orlowski, MD
Non-Hodgkin Lymphoma Richard Orlowski, MD The American Cancer Society (ACS) estimates that 69,740 Americans will be diagnosed with non-hodgkin lymphoma (NHL) in 2013. Excluding non-melanoma skin cancers,
More informationAggressive lymphomas. Michael Crump Princess Margaret Hospital
Aggressive lymphomas Michael Crump Princess Margaret Hospital What are the aggressive lymphomas? Diffuse large B cell Mediastinal large B cell Anaplastic large cell Burkitt lymphoma (transformed lymphoma:
More informationNon Hodgkin Lymphoma:
Non Hodgkin Lymphoma: Non Hodgkin Lymphoma, often referred to as NHL, is a cancer originating in the lymphocytes, a type of blood cell, which are integral to the body s immune system. Non Hodgkin Lymphoma
More informationCollaboration to collect Autologous transplant outcomes in Lymphoma and Myeloma (CALM) Additional Questionnaire (MED C) INCLUSION CRITERIA CALM STUDY
Additional Questionnaire (MED C) CALM study Inclusion period: 01/01/2008 to 31/12/2011 PATIENT REGISTRATION FORM Disease Diagnosis Lymphoma S Non Hodgkin Lymphoma (NHL) Mature B-cell neoplasm Follicular
More informationMalignant Lymphomas and Plasma Cell Myeloma
Malignant Lymphomas and Plasma Cell Myeloma Dr. Bruce F. Burns Dept. of Pathology and Lab Medicine Overview definitions - lymphoma lymphoproliferative disorder plasma cell myeloma pathogenesis - translocations
More informationA 32 year old woman comes to your clinic with neck masses for the last several weeks. Masses are discrete, non matted, firm and rubbery on
A 32 year old woman comes to your clinic with neck masses for the last several weeks. Masses are discrete, non matted, firm and rubbery on examination. She also has fever, weight loss, and sweats. What
More informationLauren Berger: Why is it so important for patients to get an accurate diagnosis of their blood cancer subtype?
Hello, I m Lauren Berger and I m the Senior Director of Patient Services Programs at The Leukemia & Lymphoma Society. I m pleased to welcome Dr. Rebecca Elstrom. Dr. Elstrom is an Assistant Professor in
More informationHodgkin and Non-Hodgkin Lymphoma Pre-HCT Data
(Form 2018) This section of the CIBMTR Forms Instruction Manual is intended to be a resource for completing the Hodgkin and Non-Hodgkin Lymphoma Pre-HCT Data Form. E-mail comments regarding the content
More informationPROTOCOLS FOR TREATMENT OF MALIGNANT LYMPHOMA
2012 1 31,, PROTOCOLS FOR TREATMENT OF MALIGNANT LYMPHOMA Version 1.0 2012 DIVISION OF HAEMATOLOGY / ONCOLOGY DEPARTMENT OF MEDICINE KAOHSING VETERAN GENERAL HOSPTIAL General Guide Diagnosis 1.Adequate
More informationOncology Best Practice Documentation
Oncology Best Practice Documentation Click on the desired Diagnoses link or press Enter to view all information. Diagnoses: Solid Tumors Lymphomas Leukemias Myelodysplastic Syndrome Pathology Findings
More informationNon-Hodgkin s Lymphoma
LYMPHOMA Non-Hodgkin s Lymphoma About 71,380 people living in the United States will be diagnosed with lymphoma in 2007. This figure includes approximately 8,190 new cases of Hodgkin lymphoma (4,470 males
More informationMantle Cell Lymphoma Understanding Your Treatment Options
New Developments in Mantle Cell Lymphoma John P. Leonard, M.D. Richard T. Silver Distinguished Professor of Hematology and Medical Oncology Associate Dean for Clinical Research Vice Chairman, Department
More information亞 東 紀 念 醫 院 Follicular Lymphoma 臨 床 指 引
前 言 : 惡 性 淋 巴 瘤 ( 或 簡 稱 淋 巴 癌 ) 乃 由 體 內 淋 巴 系 統 包 括 淋 巴 細 胞 淋 巴 管 淋 巴 腺 及 一 些 淋 巴 器 官 或 組 織 如 脾 臟 胸 腺 及 扁 桃 腺 等 所 長 出 的 惡 性 腫 瘤 依 腫 瘤 病 理 組 織 型 態 的 不 同 可 分 為 何 杰 金 氏 淋 巴 瘤 (Hodgkin s disease) 與 非 何 杰 金
More information6/3/2013. Follicular and Other Slow Growing Lymphomas. Stephen Ansell, MD, PhD Mayo Clinic
Follicular and Other Slow Growing Lymphomas Stephen Ansell, MD, PhD Mayo Clinic 1 Learning Objectives Start with an overview of Follicular and other slow growing lymphomas Discuss current and emerging
More informationNon-Hodgkin s lymphoma. Univ. Prof. Dr. Werner Linkesch Univ. Klinik Graz
Non-Hodgkin s lymphoma Univ. Prof. Dr. Werner Linkesch Univ. Klinik Graz NON-HODGKIN S LYMPHOMA (NHL) Approximately 1.5 million people worldwide are living with non-hodgkin s lymphoma (NHL), and it is
More informationLeukemias and Lymphomas: A primer
Leukemias and Lymphomas: A primer Normal blood contains circulating white blood cells, red blood cells and platelets 700 red cells (oxygen) 1 white cell Neutrophils (60%) bacterial infection Lymphocytes
More informationFrequency of NHL Subtypes in Adults
Chemotherapy Options Stephanie A. Gregory, M.D. The Elodia Kehm Professor of Medicine Director, Section of Hematology Rush University Medical Center Chicago, Illinois Frequency of NHL Subtypes in Adults
More informationEstimated New Cases of Leukemia, Lymphoma, Myeloma 2014
ABOUT BLOOD CANCERS Leukemia, Hodgkin lymphoma (HL), non-hodgkin lymphoma (NHL), myeloma, myelodysplastic syndromes (MDS) and myeloproliferative neoplasms (MPNs) are types of cancer that can affect the
More informationNon-Hodgkin s lymphoma
Non-Hodgkin s lymphoma Univ. Prof. Dr. Werner Linkesch Leiter der Klinischen Abteilung für Hämatologie LKH-Univ. Klinikum Graz Univ. Klinik für Innere Medizin NON-HODGKIN S LYMPHOMA (NHL) Approximately
More informationMature Lymphoproliferative disorders (2): Mature B-cell Neoplasms. Dr. Douaa Mohammed Sayed
Mature Lymphoproliferative disorders (2): Mature B-cell Neoplasms Dr. Douaa Mohammed Sayed Small lymphocytic lymphoma/b-cell chronic lymphocytic leukemia BMB: nodular, interstitial, diffuse or a combination
More informationTreatment of low-grade non-hodgkin lymphoma
Produced 28.02.2011 Due for revision 28.02.2013 Treatment of low-grade non-hodgkin lymphoma Lymphomas are described as low grade if the cells appear to be dividing slowly. There are several kinds of low-grade
More informationNon-Hodgkin Lymphoma in Queensland An Overview 2012
Non-Hodgkin Lymphoma in Queensland An Overview 2012 Acknowledgements The authors acknowledge and appreciate the work of Queensland Health staff that contribute to and participate in the maintenance of
More informationwww.e-mercy.com Mercy Health Fairfield Hospital Annual Report on 2010 Activities Non-Hodgkin Lymphoma Outcomes Study
www.e-mercy.com Mercy Health Fairfield Hospital Annual Report on 2010 Activities Non-Hodgkin Lymphoma Outcomes Study Cancer Program Summary The Cancer Program at Mercy Health - Fairfield Hospital has maintained
More informationWhat is non-hodgkin lymphoma, how is it treated, and what is the unmet need?
What is non-hodgkin lymphoma, how is it treated, and what is the unmet need? Tim Illidge BSc PhD MRCP FRCR FRCPath Institute of Cancer Sciences, University of Manchester Manchester Cancer Research Centre,
More informationAnti-HCV therapy in HCV-related NHL
Gabriele Pozzato M.D. University of Trieste Anti-HCV therapy in HCV-related NHL Questions about HCV+ in NHL Is the NHL related with HCV infection? Which is the best therapeutic strategy? Is the antiviral
More informationMany people with non-hodgkin lymphoma have found an educational support group helpful. Support
Track 2: Treatment Options [Narrator] Many people with non-hodgkin lymphoma have found an educational support group helpful. Support groups take many forms: some meet the needs of people with all kinds
More informationNon-Hodgkin Lymphoma. Rick, non-hodgkin lymphoma survivor
Non-Hodgkin Lymphoma Rick, non-hodgkin lymphoma survivor This publication was supported in part by grants from Revised 2013 A Message From John Walter President and CEO of The Leukemia & Lymphoma Society
More informationCorporate Medical Policy
Corporate Medical Policy Hematopoietic Stem-Cell Transplantation for CLL and SLL File Name: Origination: Last CAP Review: Next CAP Review: Last Review: hematopoietic_stem-cell_transplantation_for_cll_and_sll
More informationLymphoma. Measurability of Quality Performance Indicators Version 2.0
Lymphoma Measurability of Quality Performance Indicators Version 2.0 To be read in conjunction with: Lymphoma Clinical Quality Performance Indicators (September 2013) Lymphoma Data Definitions V2.0 (September
More informationMedical Policy Manual. Topic: Hematopoietic Stem-Cell Transplantation for Non- Hodgkin Lymphomas. Date of Origin: May 2010
Medical Policy Manual Topic: Hematopoietic Stem-Cell Transplantation for Non- Hodgkin Lymphomas Date of Origin: May 2010 Section: Transplant Last Reviewed Date: August 2015 Policy No: 45.23 Effective Date:
More informationAbout B Cell Lymphomas Groupmeeting Klipp/Spang, December 09 2002 Dennis Kostka Max-Planck-Institute for Molecular Genetics Computational Molecular Biology Berlin 1 Overview Short History of Lymphoma Classification
More informationAudience Response Question? Non-Hodgkin s Lymphomas: Optimizing Therapeutic Choices for Initial Management. Presenter Disclosure Information
Welcome to Master Class for Oncologists Session 4: 10:00 AM - 10:45 AM Miami, FL December 18, 2009 Non-Hodgkin s Lymphomas: Optimizing Therapeutic Choices for Initial Management Speaker: Arnold S. Freedman,
More informationBecause non-hodgkin's lymphoma is a more frequent and distinct disease I will discuss it in more details in this site study.
Southern New Hampshire Medical Center Site report 2009 Lymphomas. Roger Hakimian, MD Foundation Hematology/Oncology 10 Prospect Street, Suite 202 Introduction Lymphomas are group of heterogeneous malignancy
More informationLow grade non-hodgkin Lymphoma
Low grade non-hodgkin Lymphoma www.lymphomas.org.uk The knowledge to challenge lymphatic cancers The Lymphoma Association provides: freephone helpline emotional support for those affected by lymphomas
More informationUnderstanding Non-Hodgkin Lymphoma
Understanding Non-Hodgkin Lymphoma A Guide For Patients, Survivors, and Loved Ones Fourth Edition This guide is an educational resource compiled by the Lymphoma Research Foundation (LRF) that provides
More informationTherapeutic Options in Refractory or Relapsed CD20-positive Follicular Lymphoma
a report by Martin Dreyling Therapeutic Options in Refractory or Relapsed CD20-positive Follicular Lymphoma Head, Lymphoma Section, Department of Medicine III, University Hospital Großhadern, Ludwig Maximilians-University
More informationAudience Response Question?
Presenter Disclosure Information Session 4: 3:30 PM - 4:15 PM Non-Hodgkin s Lymphomas: Optimizing Therapeutic Choices for Initial Management Speaker: Arnold S. Freedman, MD The following relationships
More informationCutaneous Lymphoma FAST FACTS
Cutaneous Lymphoma FAST FACTS What is Cutaneous Lymphoma? Cutaneous lymphomas are types of non-hodgkin s lymphomas (NHL) that originate in the lymphocytes (white blood cells). Unlike most other types of
More informationAre CAR T-Cells the Solution for Chemotherapy Refractory Diffuse Large B-Cell Lymphoma? Umar Farooq, MD University of Iowa Hospitals and Clinics
Are CAR T-Cells the Solution for Chemotherapy Refractory Diffuse Large B-Cell Lymphoma? Umar Farooq, MD University of Iowa Hospitals and Clinics Disclosure(s) I do not intend to discuss an off-label use
More informationLocoregional & advanced esophagus or esophagogastric junction cancer
Eloxatin (oxaliplatin) Prior Authorization Request (For Maryland Only) Send completed form to: Case Review Unit CVS/caremark Specialty Programs Fax: 866-249-6155 CVS/caremark administers the prescription
More informationLymphoid Neoplasms. Sylvie Freeman Department of Clinical Immunology, University of Birmingham
Lymphoid Neoplasms Sylvie Freeman Department of Clinical Immunology, University of Birmingham Incidence of Haematological Malignancies UK2001 (CRUK) Malignancy New Cases All Cancers 271,000 Leukaemia 6,760
More informationIndolent Lymphomas. American Academy of Insurance Medicine 121 st Annual Meeting. Hilton LaJolla October 2012
Indolent Lymphomas American Academy of Insurance Medicine 121 st Annual Meeting Hilton LaJolla October 2012 Scottsdale, Arizona Rochester, Minnesota Jacksonville, Florida Joseph Mikhael, MD, MEd, FRCPC,
More informationLymphoma: An Overview. Dr Louise Connell 05/03/2103
Lymphoma: An Overview Dr Louise Connell 05/03/2103 Overview Concepts, classification, biology Epidemiology Clinical presentation Diagnosis/Staging Treatment/Prognosis Stem cell transplantation What is
More informationNon-Hodgkin Lymphoma
Non-Hodgkin Lymphoma What is non-hodgkin lymphoma? Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer, and can spread to other areas
More informationDiffuse Large B-cell Lymphoma, Burkitt Lymphoma and the Gray Zone. Relative Frequency of B-cell NHL. Diffuse Large B-cell Lymphoma Definition
Diffuse Large B-cell Lymphoma, Burkitt Lymphoma and the Gray Zone L. Jeffrey Medeiros, M.D. M.D. Anderson Cancer Center Relative Frequency of B-cell NHL Diffuse large B-cell lymphoma 37 % Follicular lymphoma
More informationCHAPTER 26 LATE BREAKING DEVELOPMENTS: IMPACT OF ANTI-CD20 MONOCLONAL ANTIBODIES ON LYMPHOMA THERAPY
CHAPTER 26 LATE BREAKING DEVELOPMENTS: IMPACT OF ANTI-CD20 MONOCLONAL ANTIBODIES ON LYMPHOMA THERAPY 26.1 Introduction rituximab Subsequent to the completion of drafts for the guidelines earlier in 2004,
More informationUpdate in Hematology Oncology Targeted Therapies. Mark Holguin
Update in Hematology Oncology Targeted Therapies Mark Holguin 25 years ago Why I chose oncology People How to help people with possibly the most difficult thing they may have to deal with Science Turning
More informationFollicular Lymphoma. Aruna K. Reddy, MD. Hematology& Oncology Peace Health Southwest Medical Center
Follicular Lymphoma Aruna K. Reddy, MD Hematology& Oncology Peace Health Southwest Medical Center Follicular Lymphoma Malignant neoplasm resulting from clonal proliferation of malignant B-cells Second
More informationRituximab in Non - Hodgkins Lymphoma. Fatima Bassa, Dept. of Haematology October 2008
Rituximab in Non - Hodgkins Lymphoma Fatima Bassa, Dept. of Haematology October 2008 World Health Organization lymphoma classification (2001) Peripheral B-cell neoplasms: B-chronic lymphocytic leukemia/small
More informationHodgkin Lymphoma Disease Specific Biology and Treatment Options. John Kuruvilla
Hodgkin Lymphoma Disease Specific Biology and Treatment Options John Kuruvilla My Disclaimer This is where I work Objectives Pathobiology what makes HL different Diagnosis Staging Treatment Philosophy
More informationBendamustine with rituximab for the first-line treatment of advanced indolent non-hodgkin's and mantle cell lymphoma
LONDON CANCER NEW DRUGS GROUP RAPID REVIEW Bendamustine with rituximab for the first-line treatment of advanced indolent non-hodgkin's and mantle cell lymphoma Bendamustine with rituximab for the first-line
More informationTreatment and Care of Cancer Patients: Colorectal Cancer, Pancreatic Cancer, Lymphoma, and Bone Metastasis
Treatment and Care of Cancer Patients: Colorectal Cancer, Pancreatic Cancer, Lymphoma, and Bone Metastasis Satellite Conference and Live Webcast Friday, May 10, 2013 8:30 10:30 a.m. Central Time Produced
More informationTwo Retroperitoneal Low-Grade B-Cell Lymphoma Successfully Treated With a Combination of Chimeric Anti-CD20 Monoclonal Antibody and CHOP Chemotherapy
Two Retroperitoneal Low-Grade B-Cell Lymphoma Successfully Treated With a Combination of Chimeric Anti-CD20 Monoclonal Antibody and CHOP Chemotherapy Yoichi Kitamura, MD Kazuhiko Hayashi, MD Kazumi Uchida,
More informationInteresting Case Series. Periorbital Richter Syndrome
Interesting Case Series Periorbital Richter Syndrome MarkGorman,MRCS,MSc, a Julia Ruston, MRCS, b and Sarath Vennam, BMBS a a Division of Plastic Surgery, Royal Devon and Exeter Hospital, Exeter, Devon,
More informationHistopathologic results
Self evaluation 1 Clinical Case 55-year-old woman Bilateral enlargement of cervical, axillary and inguinal lymph nodes, largest diameter > 6 cm Hepatosplenomegaly. Enlargement of retroperitoneal, mesenteric
More informationUpdate on Follicular Lymphoma. Brad Kahl, M.D.
Update on Follicular Lymphoma Brad Kahl, M.D. Follicular Lymphoma: 25% of NHL Cases Other subtypes (9%) T and NK cell (12%) Burkitt (2.5%) Diffuse large B cell (DLBCL) (30%) Mantle cell (6%) Follicular
More informationFDA approves Rituxan/MabThera for first-line maintenance use in follicular lymphoma
Media Release Basel, 31 January 2011 FDA approves Rituxan/MabThera for first-line maintenance use in follicular lymphoma Approval provides option that improves the length of time people with incurable
More informationCoding for Lymphoma. Audio Seminar/Webinar. Practical Tools for Seminar Learning. February 28, 2008
Audio Seminar/Webinar February 28, 2008 Practical Tools for Seminar Learning Copyright 2008 American Health Information Management Association. All rights reserved. Disclaimer The American Health Information
More informationLymphoma Overview Joseph Leach, MD
Lymphoma Overview Joseph Leach, MD 71 year old male presents with complaints of mild fa5gue and a visible mass in the le: supraclavicular region PE demonstrates a firm easily palpable mass in the le: supraclavicular
More informationIntroduction. About 10,500 new cases of acute myelogenous leukemia are diagnosed each
Introduction 1.1 Introduction: About 10,500 new cases of acute myelogenous leukemia are diagnosed each year in the United States (Hope et al., 2003). Acute myelogenous leukemia has several names, including
More informationB-cell Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma
2008 WHO Classification of Lymphoid Neoplasms: Small B-Cell Neoplasms Chronic lymphocytic leukemia/small lymphocytic lymphoma B-cell prolymphocytic leukemia Splenic marginal zone B-cell lymphoma Hairy
More information-Examination of key pipeline candidates with in-depth clinical and commercial profiles of Phase III candidates
Brochure More information from http://www.researchandmarkets.com/reports/1215469/ Pipeline Insight: Lymphomas, Multiple Myeloma & Myelodysplastic Syndromes - Optimization of clinical practice creates opportunities
More informationWaldenström Macroglobulinemia: The Burning Questions. IWMF Ed Forum May 18 2014 Morie Gertz MD, MACP
Waldenström Macroglobulinemia: The Burning Questions IWMF Ed Forum May 18 2014 Morie Gertz MD, MACP Are my kids going to get this? Familial seen in approximately 5 10% of all CLL patients and can be associated
More informationACUTE MYELOID LEUKEMIA (AML),
1 ACUTE MYELOID LEUKEMIA (AML), ALSO KNOWN AS ACUTE MYELOGENOUS LEUKEMIA WHAT IS CANCER? The body is made up of hundreds of millions of living cells. Normal body cells grow, divide, and die in an orderly
More informationPeripheral T-Cell Lymphoma Facts
Peripheral T-Cell Lymphoma Facts No. 25 in a series providing the latest information for patients, caregivers and healthcare professionals www.lls.org Information Specialist: 800.955.4572 Highlights l
More informationEVIDENCE IN BRIEF OVERALL CLINICAL BENEFIT
perc also deliberated on the alignment of bendamustine with patient values. perc noted that bendamustine has a progression-free survival advantage, may be less toxic than currently available therapies
More informationAn overview of CLL care and treatment. Dr Dean Smith Haematology Consultant City Hospital Nottingham
An overview of CLL care and treatment Dr Dean Smith Haematology Consultant City Hospital Nottingham What is CLL? CLL (Chronic Lymphocytic Leukaemia) is a type of cancer in which the bone marrow makes too
More informationGuidelines for the Management of Follicular Lymphoma
Guidelines for the Management of Follicular Lymphoma Scope The following guidance for first- and second-line therapy applies to follicular lymphoma histological grades 1, 2 and 3a according to the World
More informationNon-Hodgkin Lymphoma. National Cancer Institute. What You Need TM. To Know About
National Cancer Institute What You Need TM To Know About Non-Hodgkin Lymphoma U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Contents About This Booklet 1 What Is Non-Hodgkin
More informationState-of-the-Art Treatment for Lymphoma December 19, 2007 Guests: David Maloney, M.D., Ph.D Hosted by Andrew Schorr INTRODUCTION
State-of-the-Art Treatment for Lymphoma December 19, 2007 Guests: David Maloney, M.D., Ph.D Hosted by Andrew Schorr Please remember the opinions expressed on Patient Power are not necessarily the views
More informationThe Lymphoma Guide Information for Patients and Caregivers
The Lymphoma Guide Information for Patients and Caregivers Ashton, lymphoma survivor This publication was supported in part by grants from Revised 2013 A Message From John Walter President and CEO of The
More informationRADIATION THERAPY FOR LYMPHOMA. Facts to Help Patients Make an Informed Decision TARGETING CANCER CARE AMERICAN SOCIETY FOR RADIATION ONCOLOGY
RADIATION THERAPY FOR Facts to Help Patients Make an Informed Decision TARGETING CANCER CARE AMERICAN SOCIETY FOR RADIATION ONCOLOGY FACTS ABOUT The lymphatic system is a network of tiny vessels extending
More informationImmunohistochemical classification of malignant lymphomas
Immunohistochemical classification of malignant lymphomas Prof. Mogens Vyberg NordiQC Institute of Pathology Aalborg, Denmark Thanks to Jan Klos Important issues Distinction from non-hematopoietic neoplasms
More informationNew Targets and Treatments for Follicular Lymphoma. Disclosures
Winship Cancer Institute of Emory University New Targets and Treatments for Follicular Lymphoma Jonathon B. Cohen, MD, MS Assistant Professor Div of BMT, Emory University Disclosures Consulting fees from:
More informationAcute myeloid leukemia (AML)
Acute myeloid leukemia (AML) Adult acute myeloid leukemia (AML) is a type of cancer in which the bone marrow makes abnormal myeloblasts (a type of white blood cell), red blood cells, or platelets. Adult
More informationNon-Hodgkin s lymphomas (NHLs) are a
Oncology 33 Non-Hodgkin s lymphoma in the elderly The incidence of non-hodgkin s lymphoma (NHL) is increasing, and this increase is even more rapid in the older population. Although treatment of NHL in
More informationMichael Crump MD. Lymphoma Site Leader Princess Margaret Hospital University of Toronto
Evolution of Lymphoma Therapy: What can we expect for the rest of the millenium decade? Michael Crump MD Lymphoma Site Leader Princess Margaret Hospital University of Toronto disclaimers Served on advisory
More informationRituximab in non-hodgkin Lymphoma (NHL)
Original Article ISSN: 2070-254X Rituximab in non-hodgkin Lymphoma (NHL) Manal Elhabbash MD 1, Abukris Alwindi MD 2 (1) Assistant Professor, Tripoli University, (2) Medical consultant in oncology & hematology
More informationLeukemia, Lymphoma, and Multiple Myeloma: Toward a New Understanding
Leukemia, Lymphoma, and Multiple Myeloma: Toward a New Understanding Statement of Richard Klausner, M.D. Director National Cancer Institute National Institutes of Health Department of Health and Human
More informationEffective for dates of service on or after September 1, 2015, refer to: https://www.bcbsal.org/providers/drugpolicies/index.cfm
Effective for dates of service on or after September 1, 2015, refer to: https://www.bcbsal.org/providers/drugpolicies/index.cfm Name of Policy: Uses of Monoclonal Antibodies for the Treatment of Non-Hodgkin
More informationchronic leukemia lymphoma myeloma differentiated 14 September 1999 Pre- Transformed Ig Surface Surface Secreted Myeloma Major malignant counterpart
Disease Usual phenotype acute leukemia precursor chronic leukemia lymphoma myeloma differentiated Pre- B-cell B-cell Transformed B-cell Plasma cell Ig Surface Surface Secreted Major malignant counterpart
More informationCancer. 9p21.3 deletion. t(12;21) t(15;17)
CANCER FISH PROBES INDIVIDUAL AND PANEL S Acute Lymphoblastic Leukemia (ALL) ALL FISH Panel (includes all probes below) 8010 LSI MYB/CEP6 LSI p16 (CDKN2A) LSI BCR/ABL with ASS LSI ETV6 (TEL)/AML1 (RUNX1)
More informationLenalidomide (LEN) in Patients with Transformed Lymphoma: Results From a Large International Phase II Study (NHL-003)
Lenalidomide (LEN) in Patients with Transformed Lymphoma: Results From a Large International Phase II Study (NHL-003) Reeder CB et al. Proc ASCO 2010;Abstract 8037. Introduction > Patients (pts) with low-grade
More informationSummary & Conclusion
The prognostic value of angiogenesis markers in patients with non-hodgkin lymphoma. Summary & Conclusion The current study aims to asses the prognostic value of some angiogenesis markers in patients with
More informationRITUXAN (rituximab) RATIONALE FOR INCLUSION IN PA PROGRAM
RATIONALE FOR INCLUSION IN PA PROGRAM Background Rituxan is a monoclonal antibody that is manufactured through biotechnology methods rather than by the human body s own immune system. The drug works by
More informationYour NHL Journey. RITUXAN for Follicular Lymphoma and Diffuse Large B-cell Lymphoma (DLBCL) Indications. Important Safety Information
* Your NHL Journey RITUXAN for Follicular Lymphoma and Diffuse Large B-cell Lymphoma (DLBCL) * Non-Hodgkin s Lymphoma Indications RITUXAN (rituximab) is indicated for the treatment of: Follicular CD20-positive
More informationChildhood Non-Hodgkin Lymphoma
Understanding Childhood Non-Hodgkin Lymphoma A Guide for Patients, Survivors and Loved Ones First Edition Understanding Childhood Non-Hodgkin Lymphoma A Guide for Patients, Survivors and Loved Ones First
More informationOutline of thesis and future perspectives.
Outline of thesis and future perspectives. This thesis is divided into two different sections. The B- section involves reviews and studies on B- cell non- Hodgkin lymphoma [NHL] and radioimmunotherapy
More informationInteresting Case Review. Renuka Agrawal, MD Dept. of Pathology City of Hope National Medical Center Duarte, CA
Interesting Case Review Renuka Agrawal, MD Dept. of Pathology City of Hope National Medical Center Duarte, CA History 63 y/o male with h/o CLL for 10 years Presents with worsening renal function and hypercalcemia
More informationLymphoma in Dogs: Diagnosis & Treatment
c o n s u l t a n t o n c a l l O N C O L O G Y David M.Vail, DVM, Diplomate ACVIM (Oncology), University of Wisconsin Madison Lymphoma in Dogs: Diagnosis & Treatment Profile Definitions Lymphoma can be
More informationBone Marrow Evaluation for Lymphoma. Faizi Ali, MD Hematopathology Fellow William Beaumont Hospital
Bone Marrow Evaluation for Lymphoma Faizi Ali, MD Hematopathology Fellow William Beaumont Hospital Indications One of the most common indications for a bone marrow biopsy is to evaluate for malignant lymphoma.
More informationFeline Lymphoma Chemotherapy and Chemotherapy Protocols
Feline Lymphoma Chemotherapy and Chemotherapy Protocols If you have reached this page, your cat probably has a definite diagnosis of feline lymphoma from your veterinarian. The information below is not
More informationGuidelines for the use of Rituximab in Non-Hodgkin s Lymphoma QEII Health Sciences Centre
Guidelines for the use of Rituximab in Non-Hodgkin s Lymphoma QEII Health Sciences Centre Background Non-Hodgkin s lymphoma (NHL) makes up approximately 85% of all lymphomas. They are a heterogeneous collection
More informationAn estimated 55,000 to 60,000 new cases of non- Non-Hodgkin Lymphoma: Diagnosis and Treatment STEPHEN M. ANSELL, MD, PHD, AND JAMES ARMITAGE, MD
SYMPOSIUM ON ONCOLOGY PRACTICE: HEMATOLOGICAL NON-HODGKIN LYMPHOMA: DIAGNOSIS MALIGNANCIES AND TREATMENT Non-Hodgkin Lymphoma: Diagnosis and Treatment STEPHEN M. ANSELL, MD, PHD, AND JAMES ARMITAGE, MD
More informationcancer cancer Hessamfar-Bonarek M et al. Int. J. Epidemiol. 2010;39:135-146
Hematopoietic Stem Cell Transplant in HIV- related lymphoma Song Zhao, MD PhD Hematology-Oncology Program University of Washington/FHCRC Underlying Causes of Death in HIV-infected Adults 2000 2005 cancer
More informationJ Clin Oncol 23:8447-8452. 2005 by American Society of Clinical Oncology INTRODUCTION
VOLUME 23 NUMBER 33 NOVEMBER 20 2005 JOURNAL OF CLINICAL ONCOLOGY O R I G I N A L R E P O R T New Treatment Options Have Changed the Survival of Patients With Follicular Lymphoma Richard I. Fisher, Michael
More informationFDG-PET/CT in Lymphoma 3rd IPET Meeting, Vienna, October 2015. Ora Israel, MD Department of Nuclear Medicine Rambam Health Care Campus Haifa, Israel
FDG-PET/CT in Lymphoma 3rd IPET Meeting, Vienna, October 2015 Ora Israel, MD Department of Nuclear Medicine Rambam Health Care Campus Haifa, Israel Lymphoma Clinical Data & Challenges Broad spectrum, heterogeneous
More information