Indolent Lymphomas That Present With Clinically Aggressive Features: A Subset of Low-Grade Lymphomas With a Behavior Inconsistent With the Histologic Diagnosis

Cabanillas, Fernando; Rivera, Noridza; Pardo, Wandaly I.

doi:10.1016/j.clml.2016.08.011

Cited by 8 publications

(10 citation statements)

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“…Unfortunately, a subset of patients performs poorly despite treatment . These patients have been described as “clinically discordant indolent lymphomas.” At diagnosis, prognosis may be predicted using standard indices . These indices do not reliably predict early therapeutic failure, defined as relapse within 2 years of treatment with immunochemotherapy (IC) .…”

Section: Introductionmentioning

confidence: 99%

“…There is insufficient and inconsistent data regarding the predictive value of EN involvement detected by PET/CT in FL patients at diagnosis . Cabanillas et al described unusual EN areas of FL involvement (bone, pleura, central nervous system, soft tissue, and lung) based on CT and PET/CT findings, and suggested they were indicative of poor prognosis . Thus, PET/CT has been shown to be superior to CT in identifying EN lesions; however, whether the increased detection impacts prognosis remains unanswered.…”

Section: Introductionmentioning

confidence: 99%

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Detection of extranodal and spleen involvement by FDG‐PET imaging predicts adverse survival in untreated follicular lymphoma

et al. 2019

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Predicting early clinical failure in patients with untreated follicular lymphoma (FL) is important but difficult. This study aimed to determine the incidence and patterns of extranodal (EN) and spleen disease using PET/CT, and assess their utility in predicting early clinical failure. PET/CT images from 613 cases of untreated FL (2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016) were reviewed. The location and number of EN sites, patterns of bone involvement, and splenic involvement were recorded. Outcomes were assessed using event-free survival (EFS), overall survival (OS), and early clinical failure at 24 months (EFS24). So, 49% (301/613) of patients had PET/CT-detected EN involvement, and 28% (171/613) had spleen involvement. The presence of ≥2 EN sites, spleen, bone or soft tissue involvement all predicted failure to achieve EFS24. Presence of ≥2 EN sites and bone involvement pattern were also predictive of OS in a univariate analysis. In a multivariate analysis with FLIPI-2 factors, spleen involvement, pattern of bone involvement, and soft tissue involvement independently predicted a lower EFS (HR 1.49 (1.11-2.00), P = .007; HR 1.71 (1.10-2.65), P = .017; and HR 1.67(1.06-2.62), P = .026, respectively). When the multivariate analysis was performed using PRIMA-PI factors (marrow and B2M), the number of EN sites was an independent prognostic factor for inferior OS (HR 2.28; P = .05). Baseline PET/CT identifies EN involvement in nearly half of patients with untreated FL. The presence of ≥2 EN sites, bone, soft tissue, or splenic involvement predicts early clinical failure. These results, when combined with other factors, may better identify high-risk patients and guide therapy.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Detection of extranodal and spleen involvement by FDG‐PET imaging predicts adverse survival in untreated follicular lymphoma

et al. 2019

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“…Estes dados foram semelhantes aos nossos resultados. Dessemelhante, em humanos, linfomas foliculares de Grau I ocorrem mais frequentemente, correspondendo a 36,3% dos casos, seguido dos linfomas de Grau II (33,6%) e de Grau III (30,1% = 27,6% Grau IIIa e 2,5% Grau IIIb) (Cabanillas et al 2016).…”

Section: Achados Imuno-histoquímicosunclassified

“…Na medicina humana, o linfoma folicular de Grau III, principalmente Grau IIIb, apresenta comportamento biológico mais agressivo, com menor resposta à terapia e, consequentemente, um curto período de sobrevida (Harris & Ferry 1992, Federico et al 2000. Isso difere do que ocorre com os linfomas foliculares de graus I e II, que exibem melhor resposta ao tratamento, proporcionando maior sobrevida (entre cinco e 10 anos) e, por isso, denominados por alguns autores como "linfomas indolentes" (Federico et al 2000, Campo et al 2011, Cabanillas et al 2016. Apesar disso, existem variações entre pacientes no que tange a resposta ao tratamento, assim, linfomas foliculares de graus I e II podem, às vezes, apresentar comportamento biológico inconsistente com o diagnóstico histopatológico (Harris & Ferry 1992, Cabanillas et al 2016.…”

Section: Achados Imuno-histoquímicosunclassified

“…Isso difere do que ocorre com os linfomas foliculares de graus I e II, que exibem melhor resposta ao tratamento, proporcionando maior sobrevida (entre cinco e 10 anos) e, por isso, denominados por alguns autores como "linfomas indolentes" (Federico et al 2000, Campo et al 2011, Cabanillas et al 2016. Apesar disso, existem variações entre pacientes no que tange a resposta ao tratamento, assim, linfomas foliculares de graus I e II podem, às vezes, apresentar comportamento biológico inconsistente com o diagnóstico histopatológico (Harris & Ferry 1992, Cabanillas et al 2016. Em nosso estudo, 40% dos casos foram incluídos como IIIa e 60% como IIIb, no entanto, não há dados na literatura veterinária a respeito do real comportamento biológico do linfoma folicular em cães, principalmente quanto aos seus diferentes graus.…”

Section: Achados Imuno-histoquímicosunclassified

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Aspectos epidemiológicos, clínicos e anatomopatológicos do linfoma folicular em cães

et al. 2018

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RESUMO: Linfomas foliculares são uma rara forma de distúrbio linfoproliferativo descrita em medicina veterinária. Juntamente com a não reconhecida ocorrência dos linfomas de Hodgkin em cães, essa é a maior diferença acerca de linfoma entre humanos e cães. O objetivo deste artigo é descrever os achados epidemiológicos, clínicos e anatomopatológicos vistos em cinco cães com linfoma folicular. Destes, dois eram machos (40%) e três eram fêmeas (60%). A idade dos cães afetados variou de 11 a 13 anos. Quatro dos cinco (80%) cães eram de raça pura e um (20%) não tinha raça definida. Todos os cães apresentaram linfadenomegalia generalizada e esplenomegalia, o que incluiu os casos como linfoma multicêntrico. Na necropsia, os linfonodos e o baço demonstraram um padrão nodular à superfície de corte, caracterizado por dezenas a centenas de nódulos brancos, multifocais ou coalescentes e de tamanhos variáveis. Na superfície natural do baço, frequentemente (4/5, 80%), havia miríades de pontos brancos, multifocais ou coalescentes, de tamanhos variáveis. Na histopatologia, os tumores foram confirmados como linfomas foliculares. Todos os casos eram Grau III, sendo dois (40%) incluídos como IIIa e outros três (60%) como IIIb. Em um caso (1/5, 20%), o linfoma folicular foi considerado como IIIb variante de pequenos centroblastos semelhantes aos linfócitos neoplásicos vistos no linfoma de Burkitt. Os linfomas foram validados como tendo origem em células B através da imuno-histoquímica, utilizando anticorpos anti-CD20. Os casos de linfomas foliculares descritos comportaram-se de forma agressiva e levaram os pacientes à morte.

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Prognostic Factors in Patients with Low-Grade Nonhodgkin Lymphoma

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et al. 2019

Indian J Hematol Blood Transfus

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Low-grade Nonhodgkin lymphoma (LG-NHL) is characterized by indolent clinical course, which consist of marginal zone lymphoma (MZL), follicular lymphoma (FL), chronic lymphocytic leukemia/small lymphocytic lymphoma, lymphoplasmacytic lymphoma, waldenstrom macroglobulinemia (WM) as the most common subtypes. Factors affecting prognosis and treatment need in these patients have long been the subject of research. A retrospective study was conducted with patients diagnosed with LG-NHL in Hematology Departments of two centres between 2010 and 2018. At the time of diagnosis, demographic and disease characteristics, hematological and biochemical parameters were examined. Using these data, treatment requirements, response and survival rates were calculated. The effect of parameters on survival and need to treatment were analyzed. 93 LG-NHL patients were included in this study. 40 (43%) of these patients were MZL, 28 (30.1%) were FL and 25 (26.8%) were others. In comparison of patients required treatment with patients without treatment, there was significant difference among the number of comorbidity, platelet count, neutrophil count, disease subgroups and ferritin levels. Logistic regression analysis revealed that disease subgroup (other than MZL and FL) and ferritin levels were independent risk factors for need to treatment. Only ferritin level was found to be associated with overall survival. The current study demonstrated an association between serum ferritin levels and prognosis in patients with LG-NHL. Given that it is easily available and low-cost, the initial ferritin level can be used as a prognostic marker for patients with indolent lymphoma.

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Indolent Lymphomas That Present With Clinically Aggressive Features: A Subset of Low-Grade Lymphomas With a Behavior Inconsistent With the Histologic Diagnosis

Cited by 8 publications

References 22 publications

Detection of extranodal and spleen involvement by FDG‐PET imaging predicts adverse survival in untreated follicular lymphoma

Detection of extranodal and spleen involvement by FDG‐PET imaging predicts adverse survival in untreated follicular lymphoma

Aspectos epidemiológicos, clínicos e anatomopatológicos do linfoma folicular em cães

Prognostic Factors in Patients with Low-Grade Nonhodgkin Lymphoma

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