Mediastinal Diffuse Large-Cell Lymphoma with Sclerosis

Haı̈oun, Corinne; Gaulard, Philippe; Roudot-Thoraval, F; Diviné, Marine; Jouault, Hélène; Lebourgeois, J. P.; Kuentz, Mathieu; Farcet, Jean Pierre; Reyes, F

doi:10.1097/00000421-198910000-00013

Cited by 55 publications

(24 citation statements)

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“…Outcome or phase II non-comparative studies in mediastinal lymphomas (evidence grade 3) reported the results of approaches with first-generation [44][45][46][47][48][49][50][51][52][53] to thirdgeneration 34,40,42,54-60 chemotherapy protocols. One comparative study (evidence grade II) analyzing the use of different chemotherapeutic regimens (CHOP or CHOPlike vs. third-generation regimens) for advanced nonHodgkin's lymphoma was used as indirect evidence.…”

Section: Chemotherapymentioning

confidence: 99%

Practice guidelines for the management of extranodal non-Hodgkin's lymphomas of adult non-immunodeficient patients. Part I: primary lung and mediastinal lymphomas. A project of the Italian Society of Hematology, the Italian Society of Experimental Hematology and the Italian Group for Bone Marrow Transplantation

Zinzani¹,

Martelli²,

Poletti³

et al. 2008

Haematologica

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Extranodal non-Hodgkin's lymphomas constitute 20-25% of overall non-Hodgkin's lymphomas cases and can be managed with very different therapeutic strategies. Therefore, the Italian Society of Hematology and the two affiliate societies (the Italian Society of Experimental Hematology and the Italian Group of Bone Marrow Transplantation) appointed a panel of experts to produce clinical practice-guidelines for the management of these conditions. Primary lung and mediastinal lymphomas were the objective of this part of the project. The panel of experts produced the following key recommendations that were graded according to the strength of evidence and clinical judgement. The first-line therapy for non-MALT primary lung non-Hodgkin's lymphomas should include anthracycline-based chemotherapy with CHOP or CHOP-like, MACOP-B or MACOP-B-like regimens (grade D). Rituximab association with chemotherapy needs to be evaluated within approved clinical trials. Second-line therapy with high-dose chemotherapy and autologous stem cell transplantation is recommended (grade B). In patients with MALT primary lung non-Hodgkin's lymphomas, the recommended first-line therapy should include chlorambucil, CHOP, CHOP-like or fludarabine-containing regimens (grade B). Radiotherapy is to be reserved for patients with a unique, small lesion in a poorly mobile site and with contraindication to surgery (grade D). Rituximab should be administered only within approved clinical trials. For treatment of primary mediastinal large B-cell lymphomas, the recommended first-line therapy is a chemotherapy and radiotherapy association (grade B). An anthracycline-based chemotherapy with CHOP, MACOP-B or VACOP-B is recommended (grade B). Rituximab combination with chemotherapy is highly suggested but only for patients enrolled into approved clinical trials. Patients with an inadequate early response should be candidates for early intensification with high-dose chemotherapy (grade C). Patients with refractory or relapsed disease should undergo rescue programs including intensive, non-cross-resistant debulking treatment followed, in chemosensitive patients, by high-dose chemotherapy and autologous stem cell transplantation (grade B).

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Section: Chemotherapymentioning

confidence: 99%

Practice guidelines for the management of extranodal non-Hodgkin's lymphomas of adult non-immunodeficient patients. Part I: primary lung and mediastinal lymphomas. A project of the Italian Society of Hematology, the Italian Society of Experimental Hematology and the Italian Group for Bone Marrow Transplantation

Zinzani¹,

Martelli²,

Poletti³

et al. 2008

Haematologica

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“…45,[49][50][51][52] Some centers were, however, able to document improved responses in small numbers of patients when treated with more intensive regimens. Lazzarino et al reported a series of 29 assessable patients.…”

Section: Is a Third Generation Chemotherapy Regimen Needed For Pmbl?mentioning

confidence: 99%

Primary mediastinal B‐cell lymphoma

Boleti

Johnson

2007

Hematological Oncology

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Primary mediastinal B-cell lymphoma is a discrete clinicopathologic entity. Molecular analysis reveals it to be distinct from other types of large B-cell lymphoma, and retrospective analysis suggests that it may respond better to multi-agent chemotherapy regimens than to the more commonly used CHOP. The addition of rituximab may mitigate such differences, and may also diminish the role of consolidation radiotherapy, which is often used to treat residual mediastinal masses. For the future the role of FDG-PET scanning requires prospective examination, and it is hoped that this may allow the de-escalation of treatment if it can be shown to yield reliable prognostic information. The relative rarity of this type of lymphoma necessitates international collaboration in clinical trials, with a prospective clinicopathologic study, IELSG 26, already underway.

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“…A thin band of sclerosis often compartmentalises neoplastic elements (Menestrina et al, 1986). Lymphoma cells are CD45, CD20, CD19 and CD22 positive, while CD5, CD10, CD21 and HLA-DR are usually absent (Yousem et al, 1985;Addis and Isaacson, 1986;Moller et al, 1987;Haioun et al, 1989;Lamarre et al, 1989;Al-Sharabati et al, 1991;van Besien et al, 2001). Expression of CD30 is often present but weak.…”

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confidence: 99%

“…Most cases are stage I -II. When the lymphoma spreads beyond the diaphragm, it usually involves the kidney and suprarenal glands (Perrone et al, 1986;Haioun et al, 1989;Todeschini et al, 1990;Kirn et al, 1993;Lazzarino et al, 1993). Bone marrow involvement is extremely rare (Cazals-Hatem et al, 1996;Abou-Ella et al, 1999).…”

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confidence: 99%