Non-Hodgkin s Lymphoma
|
|
- Millicent Todd
- 6 years ago
- Views:
Transcription
1 Non-Hodgkin s Lympoma Non-Hodgkin s Lymphomas Janet H. Van Cleave MSN, ACNP-CS, CS, AOCN Acute Care Nurse Practitioner The Mount Sinai Medical Center of New York City Doctoral Student, Yale University School of Nursing Mr. L. is a 65 year old gentleman Has enlarged cervical lymph node Surgeons remove lymph node Pathology shows small lymphocytic lymphoma Doctor recommends to watch and wait Non-Hodgkin s Lymphoma Mr. D is a 65 year old Has enlarged cervical lymph node Surgeons remove lymph node Shows Diffuse Large B-cell B Lymphoma Oncologist recommends R-CHOP R Non-Hodgkin s Lymphomas Why are these two patients treated differently? Normal Maturation of Lymphocytes Differentiation of healthy lymphocytes Stem cells in bone marrow Rearrangement of genes to form immunoglobulin or T-T cell receptors Exposure to antigen Large proliferating cells Hypermutation improves antigen specificity Hennessy et al., Lancet Oncology, 2004 Non-Hodgkin s Lymphoma Differentiation of healthy lymphocytes Lymphocyte differentiation and maturation Antigen profile determines B or T cell B Cell: CD19, CD20, CD22, CD40, CD45, CD 79a T Cell: CD3, CD4, CD5, CD8, CD 45 Hennessy et al., Lancet Oncology,
2 Non-Hodgkin s Lymphoma: Definition Malignancy Chromosomal translocation Gene rearrangements Proto-oncogenes oncogenes Hennessy et al., Lancet Oncology, 2004 Epidemiology 2004 New cases Total: 54,370 Male: 28,850 Female: 25,520 Deaths Total: 19,410 Male: 10,390 Female: 9,020 5 th most common cause of cancer-related related deaths ACS Cancer Society, 2004 Epidemiology Slightly greater incidence in caucasian population Slightly more common in men Incidence rises steadily with age One of the most common cancers between ages 20 and 40 Incidence nearly doubled between 1970 and 1990 Epidemiology and Etiology Children: Burkitt, lymphoblastic, and diffuse large B-cell B lymphoma Adult: Diffuse large B-cell B lymphomas Follicular and small lymphocytic lymphoma increase with age Most cases occur in people over age 50 May be associated with immunodeficiency Freedman & Nadler, 2003; Hennessy, Hanrahan,, Daly, 2004 Exposure Epstein-Barr virus Human T-cell T leukemia lymphoma virus Helicobacter pylori HHV-8 Diphenylhydantoin Dioxin, phenoxyherbicides Radiation Prior Differential Diagnosis Infectious Bacterial, Viral, Mycobacterial, Parasitic Autoimmune SLE, Sjogren s syndrome, Hydantoin derivatives Ganulomatosis Sarcoidosis Neoplasms Hodgkin s disease, SCLC Freedman & Nadler,
3 Diagnosis History and physical exam Systemic Symptoms or B Symptoms Fever > 38 o Night sweats Weight loss > 10% of body weight in past 5 months Diagnosis Initial biopsy of mass Bone marrow biopsy CBC, routine chemistries, liver function tests Beta2 microglobulin LDH Chest X ray CT Scans Radionuclide scans Freedman & Nadler, 2003 Non-Hodgkin s Lymphoma Non-Hodgkin s Lymphoma Diagnosis Morphology Cytogenetics 70-90% patients have chromosomal breakpoints Translocations more common Cell surface markers Molecular techniques Immunoglobulin and T cell receptor gene rearrangements Pathology Classification Schemes Evolved over 30 years Basis Pattern of lymph node architecture Cytologic classification of neoplastic cells 3
4 Pathology: Classification Revised European American classification of lymphoid neoplasms (REAL) Morphology Immunophenotype Genotype Clinical features Pathology: Classification Indolent lymphomas Follicular lymphoma B-chronic lymphocytic leukemia/small lymphocytic lymphoma Lymphoplasmacytic lymphoma Marginal zone lymphoma T/natural killer large cell granular lymphocyte leukemia T-chronic lymphocytic leukemia/prolyphocytic leukemia Pathology: Classification Aggressive lymphomas Mantle cell lymphoma Diffuse large B-cell B lymphoma Peripheral T-cell T lymphoma (unspecified) Peripheral T-cell T lymphoma (angioimmuoblastic angiocentric) T/natural killer cell, hepatosplenic gamma/delta, intestinal T cell lymphoma Anaplastic large cell lymphomas Pathology: Classification Highly aggressive lymphomas Precursor T or B lymphoblastic leukemia/lymphoma Burkitt and Burkitt-like lymphoma Adult T-cell T leukemia/lymphoma (HTLV-1+) Staging: Ann Arbor Staging System Stage I Single lymph node or single extralymphatic organ/site Stage II Two or more lymph node regions on same side of diaphragm or localized involvement of extralymphatic site Stage III Involvement on both sides of diaphragm Stage IV Diffuse or disseminated involvement one or more extralymphatic organs AJCC Cancer Staging Manual (2002) Staging Staging in Non-hodgkin s Lymphomas has less impact on decisions Prognosis depends more on histology and clinical parameters Age Extranodal disease Performance status Ann arbor staging LDH NCCN (2004) 4
5 Adverse Risk Factors Age >60 Serum LDH > 1 X normal ECOG performance status 2-42 Ann Arbor Stage III or IV Extranodal involvement > 1 site Group Risk Groups Risk Factors 5yr Survival Low risk % High risk % International Non-Hodgkin s Lymphoma Prognostic Factors Project (1993) NEJM, 329, 987 Risk Groups-Age < 60 Non-Hodgkin s Lymphoma Risk Factors 5 yr Survival 0 83% 1 69% 2 46% 3 32% Chemotherapy Regimens: Indolent Lymphomas Cyclophosphamide, Fludarabine +/- Bactrim FND (Fludarabine( Fludarabine, mitoxantrone, dexamethasone, bactrim DS) CVP (Cyclosphosphamide, Vincristine, Prednisone) CHOP (Cyclophosphamide, Doxorubicin, Vincristine, Prednisone) NCCN (2004), Chu & DeVita, Jr (2003) Chemotherapy Regimens: Aggressive Lymphomas R-CHOP (CHOP + Rituximab) ICE (Ifosfamide( Ifosfamide, Cisplatin, Etoposide) R-HyperCVAD ( Rituximab, cyclophosphamide, vincristine, doxorubicin, dexamethasone) R-EPOCH (Rituximab, etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin) ESHAP (Etoposide, methylprednisolone, cisplatin, cytarabine) Bortezomib NCCN (2004), Chu & DeVita, Jr. (2003) 5
6 Treatment: Indolent Lymphomas Stage I/II Radiation therapy Benefit of in stage I/II indolent NHL remains uncertain Advanced stage Close observation Systemic Rituximab Targeted radiotherapy NCCN (2004), Treatment: Aggressive Lymphomas Based on Diffuse Large B-Cell B Lymphoma (DLBCL) guidelines Approximately ~40% cured with induction R-CHOP standard treatment Radiotherapy in local disease Number of cycles dependent on stage and size of masses Consider clinical trial for high-intermediate/high intermediate/high risk categories NCCN (2004) Treatment: Aggressive Lymphomas in Older Patients Age over 60 in low and low-intermediate risk prognostic group Lower relapse-free and overall survival rates?less intensive regimens R-CHOP improved survival Treatment: Mantle Cell Lymphoma Chemotherapy resistant and aggressive disease Median survival 3 4 years No standard treatment Chemotherapy regimens used Rituxan-CHOP R-HyperCVAD R-EPOCH Autologous or allogeneic stem cell transplantation in clinical trialt Needs further study NCCN (2004) Marginal Zone Lymphoma Heterogeneous group Gastric versus nongastric Gastric associated with helicobacter pylori Gastric treatment Stage I/II: Antibiotic Advanced stage: similar to indolent lymphoma Nongastric treatment Stage I/II: Surgery, Radiation therapy Advanced: similar to follicular lymphoma NCCN (2004) Treatment: High Grade Lymphomas Lymphoblastic Lymphoma: Standard vincristine/prednisone -> > intensification Hyper-CVAD alternating w/ MTX + cytarabine Burkitt s and Burkitt s Like Lymphoma Intensive short course in clinical trial setting or combination with alkylating agents, anthracycline, intrathecal and high dose methotrexate NCCN (2004) 6
7 Treatment: Recurrent Disease New Therapeutic Approaches Low survival rate with conventional salvage Allogeneic stem cell transplantation Autologous stem cell transplantation Poor disease free survival in chemo resistant disease Poor survival in > 0 IPI prognostic risk factors New Therapeutic Approaches Dose dense (biweekly CHOP) in aggressive lymphoma age> 60 years with GCSF support Improved 5 year event-free and overall survival rates Increased myelosuppression Increased infection Increased cardiac toxicity Pfreundschuh et al. (2004) Blood, 104, New Therapeutic Approaches Patients aged 18 to 60 years with good prognosis aggressive lymphomas w/ GCSF support CHOP with etoposide achieved better complete remission Interval reduction achieved better results Increased myelosuppression Pfreundschuh et al. (2004) Blood, 104, Novel Therapies: Antisense Oligonucleotides G3139 (Oblimersen( [Genta Incorporated]) Targets BCL-2 Inhibits expression of target gene Dose limiting event Thrombocytopenia Hypotension Fever Asthenia Hennessy et al., Lancet Oncology, 2004 Novel Therapies Proteasome Inhibitors Ubiquitin-proteasome pathway Degradation of intracellular proteins Cell cycle control Apoptosis Bortezomib Bortezomib Phase I & II results promising Hennessy et al, Lancet Oncology (2004) 7
8 Novel Therapies Monoclonal Antibodies Rituximab Chimeric IgG1 anti CD20 monoclonal antibody First monoclonal antibody approved by FDA Proposed mechanisms of action Antibody-dependent dependent cellular cytotoxicity Complement-mediated mediated cytotoxicity Induction of apoptosis Recruitment of effector cells Cytokines Novel Therapies Monoclonal Antibodies Newer uses Combine with various chemotherapeutic agents Combination uses in transplantation regimens Use with other immunomodulatory agents Cheson,, Seminars in Oncology, 2002 Novel Therapies Monoclonal Antibodies Radioimunotherapy I anti-cd20 (tositumomab( [Bexxar]) Dosimetric dose Next week dosimetric dose followed by tositumomab Overall response rate 65% c/w 28% for last prior chemo Hematologic toxicities Evaluated in clinical trials for transplant setting Cheson,, Seminars in Oncology, 2002 Novel Therapies Monoclonal Antibodies Radioimmunotherapy 90-Yitrium anti-cd20 (ibritumomab( tiuxetan [Zevalin]) Indium-labeled tracer dose for dosimetry Overall response rate 74% in patients refractory to rituximab Grade IV neutropenia and thrombocytopenia in 35% and 9% patients Ineligible if > 25% bone marrow invasion Cheson 2002; Hennessy et al., 2004 Novel Therapies Monoclonal Antibodies Other monoclonal antibodies Alemtuzumab/Campath-1H Targets CD52 Present on most B and T lymphocytes Approved for CLL patients pretx d w/ fludarabine Epratuzumab Anti CD22 Aplizumab/Hu1d10 Directed against HLA-DR Hennessy 2004 Novel Therapies - Vaccines Idiotype markers present on all lymphoma cells Tumor cells harvested Tumor sequence identified by PCR Gene cloned Transfected into mammalian cells Produced for vaccine Ongoing trials Investigating methods to enhance the immune response Vose et al
9 Summary Slide Not Available Non-Hodgkin s Lymphoma is a diagnosis comprising different types of diseases Low grade lymphoma has longer average survival but decreased response to Aggressive lymphoma has greater response to but shorter average survival Summary Diffuse large B-cell B lymphoma is the most common aggressive lymphoma and most common subtype of NHL First line treatment for diffuse large B-cell B lymphoma is R-CHOP R Approximately 40% can patients w/ diffuse large B-cell B lymphoma can be cured with Nursing Implications R-CHOP Chemotherapy Adverse Effects Doxorubicin/Vincristine strong vesicants Nausea/Vomiting Myelosuppression Cardiotoxicity Neuropathy Anaphylactic reactions Hemorrhagic cystitis Alopecia Chu & DeVita, Jr. (2003) Nursing Implications: R-CHOPR Generally outpatient except for co- morbid conditions or concern for risk for tumor lysis syndrome in setting of bulky disease Assess patient for adequate vascular access in setting of strong vesicants Evaluate cardiac left ventricular ejection fraction prior to initiating Evaluate for need for hematological growth factor support Use with caution in setting of liver dysfunction Fischer et al (2003), Chu & DeVita, Jr. (2003), Pfreundschuh et al (2004) Why did one patient receive and the other patient did not receive? Why did the doctor Watch and wait for recommend asymptomatic Mr. D indolent lymphoma (aggressive Chemotherapy lymphoma) and none aggressive lymphoma for Mr. L (indolent lymphoma)? 9
10 Thank You Mount Sinai Medical Center Thomas Smith RN Takao Ohnuma MD 10
Large cell immunoblastic Diffuse histiocytic (DHL) Lymphoblastic lymphoma Diffuse lymphoblastic Small non cleaved cell Burkitt s Non- Burkitt s
Non Hodgkin s Lymphoma Introduction 6th most common cause of cancer death in United States. Increasing in incidence and mortality. Since 1970, the incidence of has almost doubled. Overview The types of
More informationNon-Hodgkin lymphoma
Non-Hodgkin lymphoma Non-Hodgkin s lymphoma Definition: - clonal tumours of mature and immature B cells, T cells or NK cells - highly heterogeneous, both histologically and clinically Non-Hodgkin lymphoma
More informationIndolent Lymphomas: Current. Dr. Laurie Sehn
Indolent Lymphomas: Current Dr. Laurie Sehn Why does indolent mean? Slow growth Often asymptomatic Chronic disease with periods of relapse (long natural history possible) Incurable with current standard
More informationIndolent Lymphomas. Dr. Melissa Toupin The Ottawa Hospital
Indolent Lymphomas Dr. Melissa Toupin The Ottawa Hospital What does indolent mean? Slow growth Often asymptomatic Chronic disease with periods of relapse (long natural history possible) Incurable with
More informationNON HODGKINS LYMPHOMA: INDOLENT Updated June 2015 by Dr. Manna (PGY-5 Medical Oncology Resident, University of Calgary)
NON HODGKINS LYMPHOMA: INDOLENT Updated June 2015 by Dr. Manna (PGY-5 Medical Oncology Resident, University of Calgary) Reviewed by Dr. Michelle Geddes (Staff Hematologist, University of Calgary) and Dr.
More informationNON HODGKINS LYMPHOMA: AGGRESSIVE Updated June 2015 by Dr. Manna (PGY-5 Medical Oncology Resident, University of Calgary)
NON HODGKINS LYMPHOMA: AGGRESSIVE Updated June 2015 by Dr. Manna (PGY-5 Medical Oncology Resident, University of Calgary) Reviewed by Dr. Michelle Geddes (Staff Hematologist, University of Calgary) and
More informationLYMPHOMA Joginder Singh, MD Medical Oncologist, Mercy Cancer Center
LYMPHOMA Joginder Singh, MD Medical Oncologist, Mercy Cancer Center Lymphoma is cancer of the lymphatic system. The lymphatic system is made up of organs all over the body that make up and store cells
More informationAggressive Lymphomas - Current. Dr Kevin Imrie Physician-in-Chief, Sunnybrook Health Sciences Centre
Aggressive Lymphomas - Current Dr Kevin Imrie Physician-in-Chief, Sunnybrook Health Sciences Centre Conflicts of interest I have no conflicts of interest to declare Outline What does aggressive lymphoma
More informationCLINICAL MEDICAL POLICY
CLINICAL MEDICAL POLICY Policy Name: Rituxan (rituximab) Policy Number: MP-031-MD-DE Responsible Department(s): Medical Management; Clinical Pharmacy Provider Notice Date: 10/01/2017 Issue Date: 11/01/2017
More informationLymphomas and multiple myeloma 12/23/2018 1
60 Lymphomas and multiple myeloma 12/23/2018 1 Lymphomas Lymphoma is cancer of the lymphatic system. Lymphomas are subdivided into two main categories: Hodgkin's lymphoma (HL) and non- Hodgkin's lymphoma
More information1. Please review the following table, make any changes you think are necessary and highlight those changes. Feel free to put notes on the next page
COME HOME Non-Hodgkin pathway development worksheet, v6 September 2014 1. Please review the following table, make any changes you think are necessary and highlight those changes. Feel free to put notes
More informationIndium-111 Zevalin Imaging
Indium-111 Zevalin Imaging Background: Most B lymphocytes (beyond the stem cell stage) contain a surface antigen called CD20. It is possible to kill these lymphocytes by injecting an antibody to CD20.
More informationLymphoma: What You Need to Know. Richard van der Jagt MD, FRCPC
Lymphoma: What You Need to Know Richard van der Jagt MD, FRCPC Overview Concepts, classification, biology Epidemiology Clinical presentation Diagnosis Staging Three important types of lymphoma Conceptualizing
More informationChange Summary - Form 2018 (R3) 1 of 12
Summary - Form 2018 (R3) 1 of 12 Form Question Number (r3) Type Description New Text Previous Text Today's date was removed 2018 N/A Today's Date Removed from Key Fields 2018 N/A HCT Type 2018 N/A Product
More informationUnderstanding your diagnosis. Dr Graham Collins Consultant Haemtologist Oxford University Hospitals
Understanding your diagnosis Dr Graham Collins Consultant Haemtologist Oxford University Hospitals Common questions I get asked What is lymphoma? What subtype do I have and what does that mean? What are
More informationBACKGROUND INFORMATION ON NON-HODGKIN S LYMPHOMA
BACKGROUND INFORMATION ON NON-HODGKIN S LYMPHOMA General Non-Hodgkin s lymphomas (NHLs) encompass several unique malignant lymphoid disease entities that vary in clinical behavior, morphologic appearance,
More informationDisclosures WOJCIECH JURCZAK
Disclosures WOJCIECH JURCZAK ABBVIE (RESEARCH FUNDING), CELGENE (RESEARCH FUNDING); EISAI (RESEARCH FUNDING); GILEAD (RESEARCH FUNDING); JANSEN (RESEARCH FUNDING); MORPHOSYS (RESEARCH FUNDING), MUNDIPHARMA
More informationLymphoma/CLL 101: Know your Subtype. Dr. David Macdonald Hematologist, The Ottawa Hospital
Lymphoma/CLL 101: Know your Subtype Dr. David Macdonald Hematologist, The Ottawa Hospital Function of the Lymph System Lymph Node Lymphocytes B-cells develop in the bone marrow and influence the immune
More informationLEUKAEMIA and LYMPHOMA. Dr Mubarak Abdelrahman Assistant Professor Jazan University
LEUKAEMIA and LYMPHOMA Dr Mubarak Abdelrahman Assistant Professor Jazan University OBJECTIVES Identify etiology and epidemiology for leukemia and lymphoma. Discuss common types of leukemia. Distinguish
More informationLymphoma: The Basics. Dr. Douglas Stewart
Lymphoma: The Basics Dr. Douglas Stewart Objectives What is lymphoma? How common is it? Why does it occur? How do you diagnose it? How do you manage it? How do you follow patients after treatment? What
More informationBlood Cancers. Blood Cells. Blood Cancers: Progress and Promise. Bone Marrow and Blood. Lymph Nodes and Spleen
Blood Cancers: Progress and Promise Mike Barnett & Khaled Ramadan Division of Hematology Department of Medicine Providence Health Care & UBC Blood Cancers Significant health problem Arise from normal cells
More informationNew Evidence reports on presentations given at EHA/ICML Bendamustine in the Treatment of Lymphoproliferative Disorders
New Evidence reports on presentations given at EHA/ICML 2011 Bendamustine in the Treatment of Lymphoproliferative Disorders Report on EHA/ICML 2011 presentations Efficacy and safety of bendamustine plus
More informationHead and Neck: DLBCL
Head and Neck: DLBCL Nikhil G. Thaker Chelsea C. Pinnix Valerie K. Reed Bouthaina S. Dabaja Department of Radiation Oncology MD Anderson Cancer Center Case 60 yo male Presented with right cervical LAD
More informationGazyva (obinutuzumab)
STRENGTH DOSAGE FORM ROUTE GPID 1000mg/40mL Vial Intravenous 35532 MANUFACTURER Genentech, Inc. INDICATION(S) Gazyva (obinutuzumab) is a CD20- directed cytolytic antibody and is indicated, in combination
More informationAntibody-Based Immunotherapeutic Agents for Treatment of Non-Hodgkin Lymphoma
Antibody-Based Immunotherapeutic Agents for Treatment of Non-Hodgkin Lymphoma Steven I. Park, MD, 1* and Kristy L. Richards, PhD, MD 1 ABSTRACT Antibody-based immunotherapeutic agents have emerged as important
More informationCorporate Medical Policy
Corporate Medical Policy Hematopoietic Stem-Cell Transplant for Non-Hodgkin Lymphomas File Name: Origination: Last CAP Review: Next CAP Review: Last Review: hematopoietic_stem-cell_transplant_for_non_hodgkin_lymphomas
More informationAggressive NHL and Hodgkin Lymphoma. Dr. Carolyn Faught November 10, 2017
Aggressive NHL and Hodgkin Lymphoma Dr. Carolyn Faught November 10, 2017 What does aggressive mean? Shorter duration of symptoms Generally need treatment at time of diagnosis Immediate, few days, few weeks
More informationNon-Hodgkin lymphomas (NHLs) Hodgkin lymphoma )HL)
Non-Hodgkin lymphomas (NHLs) Hodgkin lymphoma )HL) Lymphoid Neoplasms: 1- non-hodgkin lymphomas (NHLs) 2- Hodgkin lymphoma 3- plasma cell neoplasms Non-Hodgkin lymphomas (NHLs) Acute Lymphoblastic Leukemia/Lymphoma
More informationAcute Lymphoblastic Leukemia (ALL) Ryan Mattison, MD University of Wisconsin March 2, 2010
Acute Lymphoblastic Leukemia (ALL) Ryan Mattison, MD University of Wisconsin March 2, 2010 ALL Epidemiology 20% of new acute leukemia cases in adults 5200 new cases in 2007 Most are de novo Therapy-related
More informationUpdate: Non-Hodgkin s Lymphoma
2008 Update: Non-Hodgkin s Lymphoma ICML 2008: Update on non-hodgkin s lymphoma Diffuse Large B-cell Lymphoma Improved outcome of elderly patients with poor-prognosis diffuse large B-cell lymphoma (DLBCL)
More informationNICE guideline Published: 20 July 2016 nice.org.uk/guidance/ng52
Non-Hodgkin s lymphoma: diagnosis and management NICE guideline Published: 20 July 2016 nice.org.uk/guidance/ng52 NICE 2017. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-ofrights).
More informationB-cell lymphoma vaccine (BiovaxID) for follicular non-hodgkin s lymphoma
B-cell lymphoma vaccine (BiovaxID) for follicular non-hodgkin s lymphoma May 2010 This technology summary is based on information available at the time of research and a limited literature search. It is
More informationYESCARTA (axicabtagene ciloleucel)
YESCARTA (axicabtagene ciloleucel) Non-Discrimination Statement and Multi-Language Interpreter Services information are located at the end of this document. Coverage for services, procedures, medical devices
More informationNon-Hodgkin Lymphoma in Clinically Difficult Situations
Winship Cancer Institute of Emory University Non-Hodgkin Lymphoma in Clinically Difficult Situations James Armitage, MD Professor, Department of Internal Medicine Joe Shapiro Distinguished Chair of Oncology
More informationLymphatic system component
Introduction Lymphatic system component Statistics Overview Lymphoma Non Hodgkin s Lymphoma Non- Hodgkin's is a type of cancer that originates in the lymphatic system. It is estimated to be the sixth most
More informationB Cell Lymphoma: Aggressive
B Cell Lymphoma: Aggressive UpToDate: Introduction: Risk Factors: Biology: Symptoms: Diagnosis: Ibrutinib approved for mantle cell lymphoma as 2nd line therapy. - Aggressive lymphomas are a group of malignant
More informationTRANSPARENCY COMMITTEE OPINION. 27 January 2010
The legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION 27 January 2010 TORISEL 25 mg/ml, concentrate for solution and diluent for solution for infusion Box containing 1
More informationWhat is a hematological malignancy? Hematology and Hematologic Malignancies. Etiology of hematological malignancies. Leukemias
Hematology and Hematologic Malignancies Cancer of the formed elements of the blood What is a hematological malignancy? A hematologic malignancy is a malignancy (or cancer) of any of the formed elements
More informationLymphoma 101. Nathalie Johnson, MDPhD. Division of Hematology Jewish General Hospital Associate Professor of Medicine, McGill University
Lymphoma 101 Nathalie Johnson, MDPhD Division of Hematology Jewish General Hospital Associate Professor of Medicine, McGill University Disclosures Consultant and Advisory boards for multiple companies
More information7 Omar Abu Reesh. Dr. Ahmad Mansour Dr. Ahmad Mansour
7 Omar Abu Reesh Dr. Ahmad Mansour Dr. Ahmad Mansour -Leukemia: neoplastic leukocytes circulating in the peripheral bloodstream. -Lymphoma: a neoplastic process in the lymph nodes, spleen or other lymphatic
More informationLancashire and South Cumbria Haematology NSSG Guidelines for Follicular Lymphoma:
1 Lancashire and South Cumbria Haematology NSSG Guidelines for Follicular Lymphoma: 2018-19 1.1 Pretreatment evaluation The following tests should be performed: FBC, U&Es, creat, LFTs, calcium, LDH, Igs/serum
More informationClinical Commissioning Policy Proposition: Bendamustine with rituximab for relapsed indolent non-hodgkin s lymphoma (all ages)
Clinical Commissioning Policy Proposition: Bendamustine with rituximab for relapsed indolent non-hodgkin s lymphoma (all ages) Reference: NHS England 1607 1 First published: TBC Prepared by NHS England
More informationRADIOIMMUNOTHERAPY FOR TREATMENT OF NON- HODGKIN S LYMPHOMA
RADIOIMMUNOTHERAPY FOR TREATMENT OF NON- HODGKIN S LYMPHOMA Pier Luigi Zinzani Institute of Hematology and Medical Oncology L. e A. Seràgnoli University of Bologna, Italy Slovenia, October 5 2007 Zevalin
More informationA CASE OF PRIMARY THYROID LYMPHOMA. Prof Dr.Dilek Gogas Yavuz Marmara University School of Medicine Endocrinology and Metabolism Istanbul, Turkey
A CASE OF PRIMARY THYROID LYMPHOMA Prof Dr.Dilek Gogas Yavuz Marmara University School of Medicine Endocrinology and Metabolism Istanbul, Turkey 38 year old female She recognized a mass in her right neck
More informationBendamustine is Effective Therapy in Patients with Rituximab-Refractory, Indolent B-Cell Non-Hodgkin Lymphoma
Bendamustine is Effective Therapy in Patients with Rituximab-Refractory, Indolent B-Cell Non-Hodgkin Lymphoma Kahl BS et al. Cancer 2010;116(1):106-14. Introduction > Bendamustine is a novel alkylating
More informationRituxan Hycela. Rituxan Hycela (rituximab and hyaluronidase human) Description
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.21.96 Subject: Rituxan Hycela Page: 1 of 5 Last Review Date: September 15, 2017 Rituxan Hycela Description
More informationLymphoma John P. Leonard, M.D.
Lymphoma 2017 John P. Leonard, M.D. Richard T. Silver Distinguished Professor of Hematology and Medical Oncology Associate Dean for Clinical Research Vice Chairman, Department of Medicine Disclosures Consulting
More informationNCCN Non Hodgkin s Lymphomas Guidelines V Update Meeting 06/14/12 and 06/15/12
NCCN Non Hodgkin s Lymphomas Guidelines V.1.213 Update Meeting 6/14/12 and 6/15/12 Guidelines Page and Request Chronic Lymphocytic Leukemia/ Small Lymphocytic Lymphoma (CLL/SLL) Panel Discussion References
More informationLymphomas in Prof Paul Ruff Division of Medical Oncology
Lymphomas in 2010 Prof Paul Ruff Division of Medical Oncology Most Common Lymphomas: ~90% B-cell and ~10% T-cell T lymphoblastic: 2% Marginal zone, nodal: 2% Other: 9% Burkitt: 2% Anaplastic large cell:
More informationExtranodal natural killer/t-cell lymphoma with long-term survival and repeated relapses: does it indicate the presence of indolent subtype?
VOLUME 47 ㆍ NUMBER 3 ㆍ September 2012 THE KOREAN JOURNAL OF HEMATOLOGY ORIGINAL ARTICLE Extranodal natural killer/t-cell lymphoma with long-term survival and repeated relapses: does it indicate the presence
More information2012 by American Society of Hematology
2012 by American Society of Hematology Common Types of HIV-Associated Lymphomas DLBCL includes primary CNS lymphoma (PCNSL) Burkitt Lymphoma HIV-positive patients have a 60-200 fold increased incidence
More informationHAEMATOLOGICAL MALIGNANCY
HAEMATOLOGICAL MALIGNANCY Reference Compulsory reading Haematology at Glance 2 nd ed. Atul Mehta & Victor Hoffbrand Chapters: 20 to 31 Pages: 46 to 69 Pathogenesis of Haematological Malignancy Figure (a)
More informationCorporate Medical Policy
Corporate Medical Policy Monoclonal Antibodies for Non-Hodgkin Lymphoma and Acute Myeloid File Name: Origination: Last CAP Review: Next CAP Review: Last Review: monoclonal_antibodies_for_non_hodgkin_lymphoma_acute_myeloid_leukemia
More informationTRANSPARENCY COMMITTEE OPINION. 8 November 2006
The legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION 8 November 2006 MABTHERA 100 mg, concentrate for solution for infusion (CIP 560 600-3) Pack of 2 MABTHERA 500 mg,
More informationBendamustine for relapsed follicular lymphoma refractory to rituximab
LONDON CANCER NEW DRUGS GROUP RAPID REVIEW Bendamustine for relapsed follicular lymphoma refractory to rituximab Bendamustine for relapsed follicular lymphoma refractory to rituximab Contents Summary 1
More informationCAR-T cell therapy pros and cons
CAR-T cell therapy pros and cons Stephen J. Schuster, MD Professor of Medicine Perelman School of Medicine of the University of Pennsylvania Director, Lymphoma Program & Lymphoma Translational Research
More informationPolicy for Central Nervous System [CNS] Prophylaxis in Lymphoid Malignancies
Policy for Central Nervous System [CNS] Prophylaxis in Lymphoid Malignancies UNCONTROLLED WHEN PRINTED Note: NOSCAN Haematology MCN has approved the information contained within this document to guide
More informationPatterns of Care in Medical Oncology. Follicular Lymphoma
Patterns of Care in Medical Oncology Follicular Lymphoma CASE 1: A 72-year-old man with multiple comorbidities including COPD/asthma presents with slowly progressive cervical adenopathy. Bone marrow biopsy
More informationTargeted Radioimmunotherapy for Lymphoma
Targeted Radioimmunotherapy for Lymphoma John Pagel, MD, PhD Fred Hutchinson Cancer Center Erik Mittra, MD, PhD Stanford Medical Center Brought to you by: Financial Disclosures Disclosures Erik Mittra,
More informationStrategies for the Treatment of Elderly DLBCL Patients, New Combination Therapy in NHL, and Maintenance Rituximab Therapy in FL
New Evidence reports on presentations given at ASH 2009 Strategies for the Treatment of Elderly DLBCL Patients, New Combination Therapy in NHL, and Maintenance Rituximab Therapy in FL From ASH 2009: Non-Hodgkin
More informationThe legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION. 18 July 2012
The legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION 18 July 2012 MABTHERA 100 mg, concentrate for solution for infusion B/2 (CIP code: 560 600-3) MABTHERA 500 mg, concentrate
More informationDisclosures for Dr. Peter Borchmann 48 th ASH Annual meeting, Orlando, Florida
Phase II Study of Pixantrone in Combination with Cyclophosphamide, Vincristine, and Prednisone (CPOP) in Patients with Relapsed Aggressive Non-Hodgkin s Lymphoma P Borchmann Universitaet de Koeln, Koeln,
More informationUPDATE Autologous Stem Cell Transplantation for Lymphoma and Myeloma
UPDATE Autologous Stem Cell Transplantation for Lymphoma and Myeloma Supported by a grant from Supported by a grant from UPDATE Autologous Stem Cell Transplantation for Lymphoma and Myeloma Jonathan W.
More informationRituximab in the Treatment of NHL:
New Evidence reports on presentations given at ASH 2010 Rituximab in the Treatment of NHL: Rituximab versus Watch and Wait in Asymptomatic FL, R-Maintenance Therapy in FL with Standard or Rapid Infusion,
More informationTreatment results in ALL
Treatment results in ALL Adults Complete remission (CR) 80-85% Leukemia-free survival (LFS) 30-40% Children Complete remission (CR) 95-99% Leukemia-free survival (LFS) 70-80% Combination chemotherapy in
More informationNotification to Implement Issued by pcodr: December 14, 2012
PROVINCIAL FUNDING SUMMARY Bendamustine hydrochloride (Treanda) for indolent Non-Hodgkin Lymphoma and Mantle Cell Lymphoma (first-line and relapsed/refractory) perc Recommendation: Recommends For further
More informationWaldenstrom s Macroglobulinemia
Waldenstrom s Macroglobulinemia : Introduction Waldenstrom s macroglobulinemia (WM) is a lymphoma, or cancer of the lymphatic system. It occurs in a type of white blood cell called a B-lymphocyte or B-cell,
More informationDiffuse Large B-Cell Lymphoma (DLBCL)
Diffuse Large B-Cell Lymphoma (DLBCL) DLBCL/MCL Dr. Anthea Peters, MD, FRCPC University of Alberta/Cross Cancer Institute Disclosures Honoraria from Janssen, Abbvie, Roche, Lundbeck, Seattle Genetics Objectives
More informationThe treatment of DLBCL. Michele Ghielmini Medical Oncology Dept Oncology Institute of Southern Switzerland Bellinzona
The treatment of DLBCL Michele Ghielmini Medical Oncology Dept Oncology Institute of Southern Switzerland Bellinzona NHL frequency at the IOSI Mantle Cell Lymphoma 6.5 % Diffuse Large B-cell Lymphoma 37%
More informationLymphoma Read with the experts
Lymphoma Read with the experts Marc Seltzer, MD Associate Professor of Radiology Geisel School of Medicine at Dartmouth Director, PET-CT Course American College of Radiology Learning Objectives Recognize
More informationBrad S Kahl, MD. Tracks 1-21
I N T E R V I E W Brad S Kahl, MD Dr Kahl is Associate Professor and Director of the Lymphoma Service at the University of Wisconsin School of Medicine and Public Health and Associate Director for Clinical
More informationInstructions for Chronic Lymphocytic Leukemia Post-HSCT Data (Form 2113)
Instructions for Chronic Lymphocytic Leukemia Post-HSCT Data (Form 2113) This section of the CIBMTR Forms Instruction Manual is intended to be a resource for completing the CLL Post-HSCT Data Form. E-mail
More informationOverview of Cutaneous Lymphomas: Diagnosis and Staging. Lauren C. Pinter-Brown MD, FACP Health Sciences Professor of Medicine and Dermatology
Overview of Cutaneous Lymphomas: Diagnosis and Staging Lauren C. Pinter-Brown MD, FACP Health Sciences Professor of Medicine and Dermatology Definition of Lymphoma A cancer or malignancy that comes from
More informationC r h ist s op o h p e h r e R. R F l F ow o er e s, s M D, D M S
1 Christopher R. Flowers, MD, MS Associate Professor of Hematology and Medical Oncology Winship Cancer Institute Emory University School of Medicine Atlanta, Georgia 2 1 Anyone can get blood cancer One
More informationRelapsed/Refractory Hodgkin Lymphoma
Relapsed/Refractory Hodgkin Lymphoma Anas Younes, MD Chief, Lymphoma Service Memorial Sloan-Kettering Cancer Center New York, New York, United States Case Study 32-year-old woman was diagnosed with stage
More informationIndolent B-Cell Non-Hodgkin s Lymphomas
Review Article [1] December 01, 1997 Myelodysplastic Syndromes [2] By John E. Seng, MD [3] and Bruce A. Peterson, MD [4] The indolent B-cell non-hodgkin s lymphomas are a diverse group of disorders that
More informationMedcenter One Cancer Committee 2011 Annual Report
Medcenter One Cancer Committee 211 Annual Report With a Focus on Non-Hodgkin s Lymphoma 21 CND Cancer Registry Statistics Medcenter One Health Systems is proud to be recognized as an accredited cancer
More informationMANAGEMENT OF LYMPHOMAS
MANAGEMENT OF LYMPHOMAS Challenges & Recommendations F. Chite Asirwa, MD. Internal Medicine Physician Medical Oncologist & Hematologist Director-AMPATH Oncology & Hematology @Kenya Physicians Association
More informationRituximab and Combination Chemotherapy in Treating Patients With Non- Hodgkin's Lymphoma
Page 1 of 5 Home Search Study Topics Glossary Search Full Text View Tabular View No Study Results Posted Related Studies Rituximab and Combination Chemotherapy in Treating Patients With Non- Hodgkin's
More informationTositumomab and iodine I 131 tositumomab (Bexxar ) Corixa Corporation; marketed by GlaxoSmithKline 1
Generic (Trade Name): Manufacturer: Tositumomab and iodine I 131 tositumomab (Bexxar ) Corixa Corporation; marketed by GlaxoSmithKline 1 NO. 64 OCTOBER 2005 Indication: Current Regulatory Status: In the
More informationManaging Indolent Lymphomas in Relapse: Working Our Way Through a Plethora of Options
Managing Indolent Lymphomas in Relapse: Working Our Way Through a Plethora of Options Fernando Cabanillas (Chair), Sandra Horning, Mark Kaminski, and Richard Champlin The front-line management of stage
More informationThey are updated regularly as new NICE guidance is published. To view the latest version of this NICE Pathway see:
bring together everything NICE says on a topic in an interactive flowchart. are interactive and designed to be used online. They are updated regularly as new NICE guidance is published. To view the latest
More informationBLOOD RESEARCH REVIEW ARTICLE THE HISTORY OF KLWP-CISL INTRODUCTION
BLOOD RESEARCH VOLUME 48 ㆍ NUMBER 3 September 2013 REVIEW ARTICLE Review of the clinical research conducted by the Consortium for Improving Survival of Lymphoma of the Korean Society of Hematology Lymphoma
More informationNon Transplant-Related Treatment Options in Follicular Lymphoma
Biology of Blood and Marrow Transplantation 12:53-58 (2006) 2006 American Society for Blood and Marrow Transplantation 1083-8791/06/1201-0111$32.00/0 doi:10.1016/j.bbmt.2005.10.003 Non Transplant-Related
More informationwith increased frequency in HIVinfected
Non-Hodgkin s Lymphoma The use of highly active antiretroviral therapy (HAART) and effective prevention and treatment strategies for opportunistic illnesses (OIs) have dramatically increased survival for
More informationBarbara Barnes Rogers, CRNP, MN, AOCN, ANP-BC Adult Hematology-Oncology Nurse Practitioner Fox Chase Cancer Center Philadelphia, Pennsylvania
Barbara Barnes Rogers, CRNP, MN, AOCN, ANP-BC Adult Hematology-Oncology Nurse Practitioner Fox Chase Cancer Center Philadelphia, Pennsylvania Barbara.rogers@fccc.edu Disclosures Barbara Rogers, CRNP, MN,
More informationCLL: disease specific biology and current treatment. Dr. Nathalie Johnson
CLL: disease specific biology and current treatment Dr. Nathalie Johnson Disclosures Consultant and Advisory boards Roche, Abbvie, Gilead, Jansson, Lundbeck,Merck Research funding Roche, Abbvie, Lundbeck
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 informationConflict of Interest Disclosure Form NAME :James O. Armitage, M.D AFFILIATION: University of Nebraska Medical Center
What Is Personalized Medicine For Patients With Lymphoma? Conflict of Interest Disclosure Form NAME :James O. Armitage, M.D AFFILIATION: University of Nebraska Medical Center DISCLOSURE I have no potential
More informationMolecular Pathology of Lymphoma (Part 1) Rex K.H. Au-Yeung Department of Pathology, HKU
Molecular Pathology of Lymphoma (Part 1) Rex K.H. Au-Yeung Department of Pathology, HKU Lecture outline Time 10:00 11:00 11:15 12:10 12:20 13:15 Content Introduction to lymphoma Review of lymphocyte biology
More informationLymphoma and Myeloma Kris3ne Kra4s, M.D.
Lymphoma and Myeloma Kris3ne Kra4s, M.D. Hematologic Malignancies Leukemia Malignancy of hematopoie3c cells Starts in bone marrow, can spread to blood, nodes Myeloid or lymphoid Acute or chronic Lymphoma
More informationDr. Nicolas Ketterer CHUV, Lausanne SAMO, May 2009
Treatment of DLBCL Dr. Nicolas Ketterer CHUV, Lausanne SAMO, May 2009 Non-hodgkin lymphomas DLBCL Most common NHL subtype throughout the world many other types of lymphoma with striking geographic variations
More informationRituxan Hycela (rituximab and hyaluronidase human) (Subcutaneous)
Rituxan Hycela (rituximab and hyaluronidase human) (Subcutaneous) Document Number: IC-0322 Last Review Date: 02/06/2018 Date of Origin: 7/20/2010 Dates Reviewed: 09/2010, 12/2010, 02/2011, 03/2011, 05/2011,
More informationMantle Cell Lymphoma
Mantle Cell Lymphoma Clinical Case A 56 year-old woman complains of pain and fullness in the left superior abdominal quadrant for the last 8 months. She has lost 25 kg, and lately has had night sweats.
More informationHematopoietic Stem-Cell Transplantation for Non-Hodgkin Lymphomas. Original Policy Date
MP 7.03.13 Hematopoietic Stem-Cell Transplantation for Non-Hodgkin Lymphomas Medical Policy Section Therapy Issue 12/2013 Original Policy Date 12/2013 Last Review Status/Date Reviewed with literature search/12/2013
More informationWhat are the hurdles to using cell of origin in classification to treat DLBCL?
What are the hurdles to using cell of origin in classification to treat DLBCL? John P. Leonard, M.D. Richard T. Silver Distinguished Professor of Hematology and Medical Oncology Associate Dean for Clinical
More informationLearn more about diffuse large B-cell lymphoma (DLBCL), the most common aggressive form of B-cell non-hodgkin s lymphoma 1
Learn more about diffuse large B-cell lymphoma (DLBCL), the most common aggressive form of B-cell non-hodgkin s lymphoma 1 Expression of B-cell surface antigens drives several non-hodgkin s lymphomas (NHLs)
More informationBLOOD AND LYMPH CANCERS
BLOOD AND LYMPH CANCERS 2 Blood and Lymph Cancers Highlights from the 2009 Annual Meeting of the American Society of Clinical Oncology Edited by Kenneth C. Anderson, MD Harvard Medical School and Dana-Farber
More informationCLINICAL RESEARCH RESULTS FROM THE ANNUAL MEETINGS OF THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY AND THE SOCIETY OF NUCLEAR MEDICINE
FOR IMMEDIATE RELEASE CLINICAL RESEARCH RESULTS FROM THE ANNUAL MEETINGS OF THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY AND THE SOCIETY OF NUCLEAR MEDICINE Results of Studies of BEXXAR TM Therapy Show Promise
More informationMantle-Cell Leukemia: Lessons in Life and Death
Mantle-Cell Leukemia: Lessons in Life and Death James J. Stark, MD, FACP Medical Director, Cancer Program and Palliative Care Maryview Medical Center Professor of Medicine, EVMS Case Presentation 60 y.o.
More information