Current developments in the treatment of early-stage classical Hodgkin lymphoma

Purpose of review: After presenting the current treatment recommendations for early-stage Hodgkin lymphoma, we give an overview on recently published clinical trials in this setting. Furthermore, the potential influence of current trials on the treatment of early-stage Hodgkin lymphoma and integration of newly emerging drugs into treatment protocols will be discussed. Recent findings: Trials attempting treatment de-escalation and omission of radiotherapy on the basis of early interim PET-scans have been disappointing so far, but results of some large trials employing this strategy are still awaited. In contrast, a more defensive strategy of starting treatment with less aggressive doxorubicine, bleomycin, vinblastine, dacarbazine (ABVD) chemotherapy and intensifying treatment in early interim PET-positive patients has shown encouraging results. New drugs such as brentuximab vedotin and immune checkpoint inhibitors have shown promising results in relapsed and refractory Hodgkin lymphoma. Clinical trials of brentuximab vedotin in early-stage Hodgkin lymphoma have been initiated. Additionally, biomarker-based treatment de-escalation might be a possible route for future improvements. Summary: The challenge for future clinical research in early-stage Hodgkin lymphoma is to continue to cure the majority of patients with first-line treatment while reducing long-term toxicity. New strategies to achieve that goal are currently being developed and will further refine treatment of earl...
Source: Current Opinion in Oncology - Category: Cancer & Oncology Tags: LYMPHOMA: Edited by Dominique Bron Source Type: research

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AbstractThe aim of this study was to evaluate the prognostic relevance of early risk stratification in diffuse large B-cell lymphoma (DLBCL) using interim Deauville score on positron emission tomography-computed tomography (PET-CT) scan and baseline International Prognostic Index (IPI). This retrospective study included 220 patients (median age, 64 years; men, 60%) diagnosed with DLBCL between 2007 and 2016 at our institution, treated with rituximab-based chemotherapy. Interim PET-CT was performed after three cycles of immuno-chemotherapy. Interim Deauville score was assessed as 4 or 5 in 49 patients (22.3%), and 94 patien...
Source: Annals of Hematology - Category: Hematology Source Type: research
AbstractA 62-year-old woman was diagnosed with autoimmune hemolytic anemia (AIHA), with cytology- and culture-negative pleural effusion. AIHA did not improve with steroid therapy. Computerized tomography (CT) detected a left ovarian tumor, which was resected surgically, and AIHA improved temporarily. Pathological examination yielded a diagnosis of diffuse large B-cell lymphoma (DLBCL). Positron emission tomography with CT suggested systemic infiltration of lymphoma. Rituximab-containing chemotherapy (R-CHOP regimen) yielded rapid decreases in lymphoma lesions and pleural effusion with improvement of AIHA. After six courses...
Source: Journal of Hematopathology - Category: Pathology Source Type: research
Conclusion: Because of a favorable toxicity profile, MMF is increasingly being used as long-term immunomodulatory therapy for a wide variety of autoimmune disorders. Nevertheless, patients on long-term MMF should still undergo regular CNS surveillance, not only for opportunistic infections but also for opportunistic malignancies such as PCNSL. Progressive focal or non-focal neurological deficits should always raise the alarm. Prompt evaluation and management can prevent irreversible neurological sequelae.
Source: Joint Bone Spine - Category: Orthopaedics Source Type: research
ConclusionsDevelopment of WMC in PCNSL patients treated with MTX and MTX-R is common. WMC changes appear to be more frequent, occur earlier and are more extensive in patients treated with HD-MTX-R compared to HD-MTX. Prospective studies are required to determine whether WMC correlate with survival or neurocognitive outcomes.
Source: Journal of Neuro-Oncology - Category: Cancer & Oncology Source Type: research
ConclusionsOutcome of patients with first-line H.pylori eradication failure followed by delayed chemotherapy and/or radiotherapy on indication was excellent.Legal entity responsible for the studyThe authors.FundingHas not received any funding.DisclosureAll authors have declared no conflicts of interest.
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research
ConclusionsA substantial proportion of patients withH.pylori-negative gastric MALT lymphoma remain antibiotic-responsive and can be cured using radiotherapy and chemotherapy.Legal entity responsible for the studyThe authors.FundingHas not received any funding.DisclosureAll authors have declared no conflicts of interest.
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research
Authors: Maroun CA, Khalifeh I, Tfayli A, Moukarbel RV Abstract Extraosseous Ewing sarcoma is a rare, poorly differentiated round-cell tumour that is part of the Ewing sarcoma family of tumours. Here, we present an extremely rare case of primary extraosseous Ewing sarcoma arising in the larynx, with distant metastases. A 53-year-old man with a history of Hodgkin lymphoma treated 4 years earlier with 8 cycles of chemotherapy presented to our medical centre with a 2-week history of hoarseness. On physical examination, he was found to have a right supraglottic mass together with a fixed right vocal cord. Computed tomo...
Source: Current Oncology - Category: Cancer & Oncology Tags: Curr Oncol Source Type: research
This study showed and validated that Deauville score of 4–5 of PET-CT imaging taken after full-course of R-CHOP chemotherapy with or without RT could predict recurrence-free survival and overall survival in DLBCL patients.
Source: Clinical and Experimental Metastasis - Category: Cancer & Oncology Source Type: research
Publication date: Available online 30 August 2019Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): Zuzan Cayci, Kerem Ozturk, Celalettin Ustun, Aazim K. Omer, Erhan Dincer, Zohar Sachs, Bruce A. Peterson, Michael A. LindenAbstractSarcoidosis has been shown to be associated with increased risk of development of several malignancies including lymphomas. On the other hand, “sarcoid-like reactions” in the absence of other clinical signs of sarcoidosis, have also been described in patients who had been treated with chemotherapy for a wide variety of malignancies. In this article, we report 3 cases who had PET...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Authors: Kitajima K, Okada M, Yoshihara K, Tokugawa T, Sawada A, Yoshihara S, Tamaki H, Fujimori Y, Ueda S, Kawamoto H, Taniguchi J, Yamakado K Abstract Objectives: To examine the prognostic value of interim 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) findings after 2-4 cycles of rituximab, plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in patients with diffuse large B-cell lymphoma (DLBCL) receiving standardized treatment. Results: After a median 3.36 years (range 0.33 to 9.14 years), 24 of the 80 patients had documented relapse. In Interim-PET fin...
Source: Oncotarget - Category: Cancer & Oncology Tags: Oncotarget Source Type: research
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