ESMO Consensus conferences: guidelines on malignant lymphoma. part 2: marginal zone lymphoma, mantle cell lymphoma, peripheral T-cell lymphoma

Abstract

To complement the existing treatment guidelines for all tumour types, ESMO organizes consensus conferences to focus on specific issues in each type of tumour. In this setting, a consensus conference on the management of lymphoma was held on 18 June 2011 in Lugano, next to the 11th International Conference on Malignant Lymphoma. The conference convened ∼30 experts from all around Europe, and selected six lymphoma entities to be addressed; for each of them, three to five open questions were to be addressed by the experts. For each question, a recommendation should be given by the panel, referring to the strength of the recommendation based on the level of evidence. This consensus report focuses on the three less common lymphoproliferative malignancies: marginal zone lymphoma, mantle cell lymphoma, and peripheral T-cell lymphomas. A first report had focused on diffuse large B-cell lymphoma, follicular lymphoma, and chronic lymphocytic leukaemia.

The EMT activator ZEB1 promotes tumor growth and determines differential response to chemotherapy in mantle cell lymphoma

“…22,23 Current first-line strategies in MCL comprise combinations of anti-CD20 antibody with doxorubicin, vincristine, cyclophosphamide and prednisone or with a hyperfractionated treatment of the above alternated with methotrexate and cytarabine. 1,22,23 Gemcitabine is also The EMT activator ZEB1 in MCL E Sánchez-Tilló et al used in second-line treatment of relapsed and refractory MCLs. 22 An important mechanism in the resistance of tumors to chemotherapy is the deregulated expression of proteins involved in the transport of anticancer drugs into/from malignant cells.…”

“…3,[5][6][7]21 Short-lived response and development of resistance to first-line immunochemotherapy are major challenges in MCL and new therapeutic strategies are being developed. 1,22,23 Constitutive Wnt signaling associates to increased cellular proliferation and higher resistance to apoptosis and chemotherapy in subsets of leukemias and lymphomas and established cell lines derived from them, including MCLs. 3,5,6,13,[15][16][17][18][19][20] In turn, inhibitors of Wnt pathway induce cytotoxicity in leukemia and lymphoma cells.…”

A MALT lymphoma prognostic index

“…[13][14][15][16] Patients are managed with a variety of treatments, which generally result in good outcomes. [17][18][19][20] Nonetheless, with the exception of Helicobacter pylori eradication in localized gastric lymphoma, the selection of an appropriate treatment can be challenging and, in the absence of a consensus, a simple validated prediction tool specific to MALT lymphoma patients could offer a means to optimize therapeutic management of this rare population.…”

Delayed Efficacy After Treatment With Lenalidomide or Thalidomide in Patients With Mucosa-Associated Lymphoid Tissue Lymphoma

“…The standardized follow-up protocol revealed a delayed-onset benefit for 28% of patients, with 16% improving to a better response after a median of 19.5 months. In analogy to HP eradication, for which follow-up periods of at least 1 year after eradication are recommended [5][6][7], these findings suggest that prolonged follow-up periods might be necessary to assess the full effect of this treatment.The ability to induce late remissions after the end of actual treatment with IMiDs appears to be unique for MALT lymphoma, because in other indications, lenalidomide achieved much more rapid responses. In patients with myelodysplastic syndrome and 5q31 deletion, the median TTR was documented after 4.6 weeks (range, 1-49) [8].…”