Rituximab plus concurrent infusional EPOCH chemotherapy is highly effective in HIV-associated B-cell non-Hodgkin lymphoma

Sparano, Joseph A.; Lee, Jeannette; Kaplan, Lawrence D.; Levine, Alexandra M.; Ramos, Juan Carlos; Ambinder, Richard F.; Wachsman, William; Aboulafia, David M.; Noy, Ariela; Henry, David H.; Roenn, Jamie Von; Dezube, Bruce J.; Remick, Scot C.; Shah, Manisha H.; Leichman, Lawrence; Ratner, Lee; Cesarman, Ethel; Chadburn, Amy; Mitsuyasu, Ronald T.

doi:10.1182/blood-2009-08-231613

Cited by 229 publications

(191 citation statements)

References 41 publications

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“…Despite an initial good response, the patient did not tolerate the treatment of the recurrent disease. The lower CD4 count during the treatment of the recurrent disease supports the current recommendation that the caveat underlying the efficacy and safety of rituximab is the CD4 count [27,[36][37][38].…”

Section: • Dual Expression But Not Dual Rearrangements Of Myc and Bcl2supporting

confidence: 61%

AIDS-Associated Pediatric High Grade B-cell Lymphoma with MYC and BCL2 Translocations

Mz¹,

Ramdial²,

Jb³

et al. 2017

J AIDS Clin Res

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Abstract"Double hit" lymphomas (DHLs) are now included as a distinct entity in the 2016 revised World Health Classification of lymphoid neoplasms under the rubric "High-grade B-cell lymphoma (HGBCL), with MYC and BCL2 and/or BCL6 translocations". While DHL/HGBCL with MYC and BCL2 translocations accounts for approximately 10% of all lymphomas with the phenotypic and immunophenotypic features of diffuse large B-cell lymphoma (DLBCL), to date, the entity is unreported in children <12 years and in patients with AIDS. In reporting a DHL/HGBCL with MYC and BCL2 translocations in a 10 year old boy, we contextualize, for the first time, its occurrence and clinicopathological profile in the context of pediatric HIV infection and AIDS. In so doing, the defining features of DHL/ HGBCL with MYC and BCL2 translocations in the updated 2016 WHO classification are discussed. In addition, the clinicopathological features and therapeutic approaches in children and adults and related challenges thereof, are highlighted. Finally, the spectrum of AIDS-associated lymphomas in children and adults are tabulated and the associated diagnostic and therapeutic challenges are addressed briefly.Citation: Msimang MZ, Ramdial PK, Kuppusamy JB, Nargan K, Sheik-Gafoor MH (2017) anterior colonic resection with colo-anal anastomosis and covering ileostomy was successfully undertaken, but the patient developed sepsis and required a relaparotomy for resection of necrotic colonic tissue. On recovery he received radiotherapy and further chemotherapy, but responded poorly and demised from multi-organ failure. Pathological featuresGross features: The lower anterior resection specimen measured 38 × 8 cm ( Figure 1A) and contained a 14 × 9 × 7 cm exophytic, creamwhite, fleshy tumor ( Figure 1B) with hemorrhagic foci, 12 cm and 3 cm from the proximal and distal excision margins, respectively. The proximal and circumferential resection margins were tumor-free. The microscopic findings confirmed an ulcerative, invasive malignancy with transmural involvement and a diffusely infiltrative pattern ( Figure 1C). The pleomorphic tumor cells were large with scant eosinophilic cytoplasm, indistinct cell borders and large, vesicular nuclei with distinctive nuclear membranes and prominent nucleoli ( Figure 1D). Brisk mitotic activity was evident. Immunohistochemically, there was bright and diffuse CD45 (Figure 2A), CD20 ( Figure 2B), BCL2 ( Figure 2C), BCL6 ( Figure 2D) and CD10 ( Figure 2E) immunopositivity. In addition, there was patchy MUM-1 ( Figure 3A) and approximately 60%, variable nuclear and cytoplasmic C-MYC immunopositivity ( Figure 3B) and a Ki-67 proliferation index of >90% ( Figure 3C). T-lymphocyte and terminal deoxynucleotidyl transferase immunomarkers were negative. Epstein Barr virus (EBV)-encoded small RNA (EBER) positivity ( Figure 3D) was confirmed on chromogen in-situ hybridization investigation.

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Section: • Dual Expression But Not Dual Rearrangements Of Myc and Bcl2supporting

confidence: 61%

AIDS-Associated Pediatric High Grade B-cell Lymphoma with MYC and BCL2 Translocations

Mz¹,

Ramdial²,

Jb³

et al. 2017

J AIDS Clin Res

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“…In this phase II randomized trial, complete response was observed in 73% and 55% of evaluable patients in the concurrent and sequential arms, respectively. 141 Toxicity was comparable in the arms, although patients with a baseline CD4 count of less than 50 had a high infectious death rate in the concurrent arm. The 2-year progression-free survival rates in the concurrent and sequential arms were 64% and 60%, re-spectively.…”

Section: Treatmentmentioning

confidence: 92%

Non-Hodgkin’s Lymphomas

Ad¹,

Js²,

Rh³

et al. 2010

J Natl Compr Canc Netw

220

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OverviewNon-Hodgkin's lymphomas (NHLs) are a heterogeneous group of lymphoproliferative disorders originating in B-, T-, or natural killer (NK) lymphocytes. In the United States, B-cell lymphomas represent 80% to 85% of all cases, with 15% to 20% being T-cell lymphomas; NK lymphomas are very rare. In 2009, an estimated 65,980 new cases of NHL will be diagnosed and 19,500 will die of the disease.1 NHL is the sixth leading site of new cancer cases among men and fifth among women, accounting for 4% to 5% of new cancer cases and 3% to 4% of cancer-related deaths. Non-Hodgkin's Lymphomas Clinical Practice Guidelines in OncologyKey Words NCCN Clinical Practice Guidelines, non-Hodgkin's lymphoma, chronic lymphocytic leukemia, follicular lymphoma, diffuse large B-cell lymphoma, mantle cell lymphoma, peripheral T-cell lymphoma, cutaneous T-cell lymphoma, mycosis fungoides, Sézary syndrome, marginal zone lymphoma, mucosaassociated lymphoid tissue lymphoma, diagnosis, treatment, hematopathology, immunohistochemistry, treatment guidelines, staging evaluation, lymphoma pathology (JNCCN 2010;8:288-334) NCCN Categories of Evidence and ConsensusCategory 1: The recommendation is based on high-level evidence (e.g., randomized controlled trials) and there is uniform NCCN consensus. Category 2A: The recommendation is based on lowerlevel evidence and there is uniform NCCN consensus. Category 2B: The recommendation is based on lowerlevel evidence and there is nonuniform NCCN consensus (but no major disagreement). Category 3: The recommendation is based on any level of evidence but reflects major disagreement. Please NoteThese guidelines are a statement of consensus of the authors regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult these guidelines is expected to use independent medical judgment in the context of individual clinical circumstances to determine any patient's care or treatment. The National Comprehensive Cancer Network makes no representation or warranties of any kind regarding their content, use, or application and disclaims any responsibility for their applications or use in any way.These guidelines are copyrighted by the National Comprehensive Cancer Network. All rights reserved. These guidelines and the illustrations herein may not be reproduced in any form without the express written permission of the NCCN © 2010. Disclosures for the NCCN Non-Hodgkin's Lymphomas Guidelines PanelAt the beginning of each NCCN guidelines panel meeting, panel members disclosed any financial support they have received from industry. Through 2008, this information was published in an aggregate statement in JNCCN and online. Furthering NCCN's commitment to public transparency, this disclosure process has now been expanded by listing all potential conflicts of interest respective to each individual expert panel member.Individual disclosures for the NCCN Non-Hodgkin's Lymphomas Guidelines Panel members can be found on page 334. (To view the most recent version of these guideli...

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“…18 Outcomes for patients with BL treated with CHOP are poor. 25 In our dataset, the majority of patients with Burkitt histology were treated either with intensive multi-agent regimens (n=73, 58%) 7,26,27 or infusional EPOCH (n=22, 18%), 28,29 both of which are considered highly active for BL. Therefore, it appears appropriate to apply the ARL-IPI to any subtype of ARL as long as the lymphoma is being treated with an adequate regimen.…”

Section: Discussionmentioning

confidence: 99%

A new prognostic score for AIDS-related lymphomas in the rituximab-era

et al. 2014

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Methods Patients and data collectionWe performed a systematic review of the literature to identify prospectively conducted clinical trials that assessed therapeutic interventions for HIV-associated NHL. A detailed description of the search strategy has been previously reported 12 and is available in the Online Supplementary Appendix. We limited our dataset to only patients treated with rituximab-containing chemoimmunotherapy.

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Rituximab plus concurrent infusional EPOCH chemotherapy is highly effective in HIV-associated B-cell non-Hodgkin lymphoma

Cited by 229 publications

References 41 publications

AIDS-Associated Pediatric High Grade B-cell Lymphoma with MYC and BCL2 Translocations

AIDS-Associated Pediatric High Grade B-cell Lymphoma with MYC and BCL2 Translocations

Non-Hodgkin’s Lymphomas

A new prognostic score for AIDS-related lymphomas in the rituximab-era

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