What is the optimal management of older CLL patients?
Publication date: March 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 1Author(s): Jennifer A. WoyachAbstractCLL is the most common leukemia in older adults with a median age at diagnosis of 71. Therefore, management of patients with this disease must take into account the older age of most patients and consequences of this in terms of functional status and organ function. This review will discuss the management of CLL with regards to observation prior to the initiation of therapy, functional status, and initial treatment. We will discuss criteria for the initiation of therapy, and how init...
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

Index
Publication date: March 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 1Author(s): (Source: Best Practice and Research Clinical Haematology)
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

Novel therapies for relapsed/refractory mantle cell lymphoma
Publication date: March 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 1Author(s): Puja C. Arora, Craig A. PortellAbstractMantle cell lymphoma is an aggressive Non-Hodgkin's lymphoma that is considered incurable with standard therapies. Most patients treated with frontline immunochemotherapy relapse within a few years and do not usually respond to salvage chemotherapy. Persistent activation of the B-cell receptor pathway is critical to the pathogenesis of mantle cell lymphoma. Inhibition of Bruton's tyrosine kinase, an essential B-cell receptor pathway component with ibrutinib has shown cli...
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

Editorial Board / Aims & Scope
Publication date: March 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 1Author(s): (Source: Best Practice and Research Clinical Haematology)
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

Indolent lymphomas
Publication date: March 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 1Author(s): Brad Kahl (Source: Best Practice and Research Clinical Haematology)
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

Pathogenesis of follicular lymphoma
Publication date: March 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 1Author(s): Tracy Lackraj, Rashmi Goswami, Robert KridelAbstractFollicular lymphoma (FL) is presented as a germinal centre B cell lymphoma that is characterized by an indolent clinical course, but remains – paradoxically – largely incurable to date. The last years have seen significant progress in our understanding of FL lymphomagenesis, which is a multi-step process beginning in the bone marrow with the hallmark t(14;18)(q32;q21) translocation. The pathobiology of FL is complex and combines broad somatic cha...
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

Risk stratification in follicular lymphoma
Publication date: March 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 1Author(s): Carla CasuloAbstractAdvances in the understanding of FL biology, molecular characteristics and clinical risk factors are further highlighting the heterogeneity of this disease. Historically used prognostic factors were broadly based on clinical and laboratory features at the time of diagnosis. However novel prognostic factors are emerging that can be studied at the time of diagnosis, and relapse, and use a variety of tools including gene alterations and diagnostic imaging. These novel discoveries are being im...
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

What is the optimal initial management of the older MCL patient?
Publication date: March 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 1Author(s): Johanna C. Kluin-Nelemans, Jeanette K. DoorduijnAbstractThe current first line treatment of a patient with mantle cell lymphoma (MCL) is often considered as too toxic for elderly patients. The elderly, however, comprise the majority of the patients with MCL. The results of several recent studies have shown that the outcome of this patient group is not as dismal as in the past. Indeed, if patients are not considered frail, and can tolerate rituximab and moderate intensive chemotherapy such as R-CHOP followed b...
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

The role of stem cell transplantation in follicular lymphoma
Publication date: March 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 1Author(s): Georg HessAbstractWith the introduction of novel treatments paradigms to if or when to use transplantation strategies for patients with follicular lymphoma have changed substantially. Autologous transplantation has been intensively evaluated as consolidation after first induction treatment with positive effects, however the introduction of Rituximab led to comparable improvements and HDT has been moved to relapse treatment. In this indication HDT was frequently use already at first relapse, but now is dominan...
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

Novel agents for relapsed and refractory follicular lymphoma
Publication date: March 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 1Author(s): Chan Yoon Cheah, Nathan H. FowlerAbstractFollicular lymphoma is one of the most common non-Hodgkin's lymphomas. Although current frontline regimens are associated with high response rates, most patients still relapse. When progression is discovered, re-establishing the diagnosis and ruling out transformation in paramount. The outcomes following relapse have been improving due to the activity and increasing availability of novel agents with various mechanisms of action. Despite these advances, single agent act...
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

Transformation of follicular lymphoma – Why does it happen and can it be prevented?
Publication date: March 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 1Author(s): Brian K. LinkAbstractFollicular lymphoma is a clinical disease with a multitude of presentations and behaviors. Although infrequent, transformation of follicular lymphoma to a more aggressive behaving subtype – prototypically diffuse large B-cell lymphoma – confers a substantially adverse prognosis. There is no consensus for optimal management after transformation is recognized. Historically considered a distinct clinical event, this review highlights the multiple subclinical transformational even...
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

Overview on the management of non-gastric MALT lymphomas
Publication date: March 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 1Author(s): Irene Defrancesco, Luca ArcainiAbstractExtranodal marginal zone B-cell lymphomas (EMZLs) of the mucosa-associated lymphoid tissue (MALT) are indolent lymphomas which can present at any extranodal site. The most frequent localizations (other than stomach) are ocular adnexa, salivary gland, skin, lung and thyroid. Chronic inflammation and antigenic stimulation are a potential risk for the development of MALT lymphomas. While Helicobacter Pylori (HP) is known to be associated with gastric MALT lymphoma and antib...
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

Should rituximab replace splenectomy in the management of splenic marginal zone lymphoma?
Publication date: March 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 1Author(s): Christina Kalpadakis, Gerassimos A. Pangalis, Maria K. Angelopoulou, Sotirios Sachanas, Theodoros P. VassilakopoulosAbstractBackgroundSMZL is a relatively rare low grade B-cell lymphoma, characterized usually by an indolent clinical behavior. Since there is no prospective randomized trials to establish the best treatment approach, decision on therapeutic management should be based on the available retrospective series. Based on these data, rituximab and splenectomy appear to be the most effective. Splenectomy...
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

Optimal management of the young patient CLL patient
Publication date: March 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 1Author(s): John N. Allan, Richard R. FurmanAbstractThe emergence of targeted therapy for patients with chronic lymphocytic leukemia (CLL) has permanently altered the therapeutic landscape. In both upfront and relapsed settings, safe and effective oral kinase inhibitors are available which rival the responses and durability seen with standard chemo immunotherapy regimens. In 2016, ibrutinib was granted Federal Drug Administration approval for first-line therapy in patients with CLL. While its role as initial therapy for ...
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

What is the optimal initial management of the younger mantle cell lymphoma patient?
Publication date: March 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 1Author(s): Rory McCulloch, Simon RuleAbstractThe last 20 years has seen considerable advances made in the management of younger patients with mantle cell lymphoma. The use of high dose cytarabine and rituximab in induction therapy, usually followed by autologous stem cell transplant consolidation, has become established practice and the median overall survival now exceeds 10 years. However, this high intensity upfront approach is not necessarily appropriate for all newly diagnosed patients. A minority exhibit disease th...
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

Management of untreated advanced stage follicular lymphoma: Role of patient discernment
Publication date: March 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 1Author(s): Jayadev Manikkam Umakanthan, Mathew A. LunningAbstractFollicular lymphoma is the most common indolent non-Hodgkin lymphoma. Advanced stage disease is common at diagnosis. The timing of treatment for follicular lymphoma is best approached by considering the combination of presence or absence of symptoms along with estimation of tumor burden. Upfront treatment strategies should take into initial presentation variables, pace of disease progression and goals of care after discussion with the patient. Treatment ap...
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

Advances in the use of natural receptor- or ligand-based chimeric antigen receptors (CARs) in haematologic malignancies
Publication date: June 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 2Author(s): Joana M. Murad, David J. Graber, Charles L. SentmanAbstractChimeric antigen receptors (CAR)-T cell therapy has recently made promising advances towards treatment of B-cell malignancies. This approach makes use of an antibody-derived single chain variable fragment (scFv)-based CAR to target the CD19 antigen. Currently scFvs are the most common strategy for creation of CARs, but tumor cells can also be targeted using non-antibody based approaches with designs focused on the interaction between natural receptors ...
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

Off the shelf T cell therapies for hematologic malignancies
Publication date: June 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 2Author(s): Bruce J. McCreedy, Vladimir V. Senyukov, Kim T. NguyenAbstractAdoptive transfer of autologous CAR-T cells can induce durable remissions in patients with relapsed/refractory hematologic malignancies. However, multiple challenges exist for manufacturing CAR-T cells from patients with advanced disease including inability to manufacture a product, disease progression or death while waiting for the CAR-T product to be available, and heterogeneity among autologous CAR-T products that contributes to unpredictable and...
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

Index
Publication date: June 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 2Author(s): (Source: Best Practice and Research Clinical Haematology)
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

Editorial Board / Aims & Scope
Publication date: June 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 2Author(s): (Source: Best Practice and Research Clinical Haematology)
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

CAR T cells, immunologic and cellular therapies in hematologic malignancies
Publication date: June 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 2Author(s): Renier Brentjens, Marco L. Davila (Source: Best Practice and Research Clinical Haematology)
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

Pre-clinical development of chimeric antigen receptor T-cell immunotherapy: Implications of design for efficacy and safety
Publication date: June 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 2Author(s): Leena Halim, Adam Ajina, John MaherAbstractFollowing the landmark approvals by the United States Food and Drug Administration, the adoptive transfer of CD19-directed chimeric antigen receptor (CAR) T-cells has now entered mainstream clinical practice for patients with chemotherapy-resistant or refractory B-cell malignancies. These approvals have followed on from a prolonged period of pre-clinical evaluation, informing the design of clinical trials that have demonstrated unprecedented efficacy in this difficult...
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

GMP CAR-T cell production
This article reviews the issues that must be addressed in order to achieve this goal. It includes the manufacturing infrastructure, the regulatory environment, practical aspects of production, and the costs involved. (Source: Best Practice and Research Clinical Haematology)
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

CAR T cell therapy for B-cell lymphomas
Publication date: June 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 2Author(s): Julio C. Chavez, Frederick L. LockeAbstractB-cell non-Hodgkin's lymphoma (NHLs)is a very heterogonous malignancy with diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL) as the most common subtypes. Standard treatment with anti-CD20 based chemoimmunotherapy is usually very effective for disease control. However a significant proportion of patients with high-risk features (double hit lymphoma, transformed lymphomas or early relapses) will become refractory to standard therapies and will have limi...
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

CARs and other T cell therapies for MM: The clinical experience
Publication date: June 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 2Author(s): Sophia Danhof, Michael Hudecek, Eric L. SmithAbstractHarnessing the endogenous immune system to eliminate malignant cells has long been an intriguing approach. After considerable success in the treatment of B-cell acute lymphoblastic leukemia, chimeric antigen receptor (CAR)-modified T cells have entered early clinical evaluation in the field of multiple myeloma (MM). The choice of suitable non-CD19 target antigens is challenging and a variety of myeloma-associated surface molecules have been under preclinical...
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

Toxicities associated with immunotherapies for hematologic malignancies
Publication date: June 2018Source: Best Practice & Research Clinical Haematology, Volume 31, Issue 2Author(s): Mark B. Leick, Marcela V. MausAbstractImmunotherapy has generated tremendous hope for patients with cancer that is refractory to standard approaches. Hematologic malignancies have taken the lead in harnessing the most recent advances in cell-based immunotherapies, such as CAR T cells, and some patients have achieved durable remissions. However, these T-cell-engaging therapies are associated with a new set of toxicities which need to be managed by caretakers, oncologists, nurses, and healthcare staff. In this r...
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

The unique biology and treatment of primary mediastinal B-cell lymphoma
Publication date: Available online 3 July 2018Source: Best Practice & Research Clinical HaematologyAuthor(s): Alessandro Broccoli, Pier Luigi ZinzaniAbstractThe unique biological features of primary mediastinal large B-cell lymphoma are offering suggestions for the development and application of innovative drugs in patients who do not respond to first-line regimens or relapse. This lymphoma, in fact, is characterised by high rates of curability with standard anthracycline-containing chemoimmunotherapy regimens, but still displays a severe prognosis if adequate responses are not rapidly achieved or if the disease recurs...
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

Extranodal NK/T-cell lymphoma: updates in biology and management strategies
Publication date: Available online 3 July 2018Source: Best Practice & Research Clinical HaematologyAuthor(s): Motoko Yamaguchi, Masahiko Oguchi, Ritsuro SuzukiAbstractExtranodal NK/T-cell lymphoma, nasal type (ENKL), is a rare lymphoma subtype of peripheral T/NK-cell lymphoma that is very common in East Asia and Latin America. Two-thirds of patients have localized disease in the nasal cavity or adjacent sites. Large retrospective studies have revealed the clinicopathologic features of ENKL patients, identified risk factors for short survival time, and developed prognostic models. Next-generation sequencing studies have...
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

Monitoring Clinical Outcomes in Aggressive B-cell Lymphoma: From Imaging Studies to Circulating Tumor DNA
Publication date: Available online 3 July 2018Source: Best Practice & Research Clinical HaematologyAuthor(s): Christopher Melani, Wyndham H. Wilson, Mark RoschewskiAbstractRecent guidelines have de-emphasized the role of routine surveillance computed tomography (CT) scans for diffuse large B-cell lymphoma (DLBCL) patients who achieve a complete response to front-line therapy. This shift in practice recommendations was prompted by retrospective studies that failed to demonstrate clear clinical utility for surveillance CT in unselected DLBCL patients. Controversy remains, however, over the role of routine surveillance CT...
Source: Best Practice and Research Clinical Haematology - July 5, 2018 Category: Hematology Source Type: research

CAR T Cell Therapy for B-cell Lymphomas
Publication date: Available online 11 April 2018 Source:Best Practice & Research Clinical Haematology Author(s): Julio C. Chavez, Frederick L. Locke B-cell non-Hodgkin’s lymphoma (NHLs)is a very heterogonous malignancy with diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL) as the most common subtypes. Standard treatment with anti-CD20 based chemoimmunotherapy is usually very effective for disease control. However a significant proportion of patients with high-risk features (double hit lymphoma, transformed lymphomas or early relapses) will become refractory to standard therapies and will hav...
Source: Best Practice and Research Clinical Haematology - April 12, 2018 Category: Hematology Source Type: research

GMP CAR-T cell production
This article reviews the issues that must be addressed in order to achieve this goal. It includes the manufacturing infrastructure, the regulatory environment, practical aspects of production, and the costs involved. (Source: Best Practice and Research Clinical Haematology)
Source: Best Practice and Research Clinical Haematology - April 2, 2018 Category: Hematology Source Type: research

Indolent lymphomas
Publication date: March 2018 Source:Best Practice & Research Clinical Haematology, Volume 31, Issue 1 Author(s): Brad Kahl (Source: Best Practice and Research Clinical Haematology)
Source: Best Practice and Research Clinical Haematology - April 2, 2018 Category: Hematology Source Type: research

CARs and other T cell therapies for MM: The clinical experience
Publication date: Available online 27 March 2018 Source:Best Practice & Research Clinical Haematology Author(s): Sophia Danhof, Michael Hudecek, Eric L. Smith Harnessing the endogenous immune system to eliminate malignant cells has long been an intriguing approach. After considerable success in the treatment of B-cell acute lymphoblastic leukemia, chimeric antigen receptor (CAR)-modified T cells have entered early clinical evaluation in the field of multiple myeloma (MM). The choice of suitable non-CD19 target antigens is challenging and a variety of myeloma-associated surface molecules have been under preclinical...
Source: Best Practice and Research Clinical Haematology - April 2, 2018 Category: Hematology Source Type: research

Advances in the use of Natural Receptor- or Ligand-Based Chimeric Antigen Receptors (CARs) in haematologic malignancies
Publication date: Available online 27 March 2018 Source:Best Practice & Research Clinical Haematology Author(s): Joana M. Murad, David Graber, Charles L. Sentman Chimeric antigen receptors (CAR)-T cell therapy has recently made promising advances towards treatment of B-cell malignancies. This approach makes use of an antibody-derived single chain variable fragment (scFv)-based CAR to target the CD19 antigen. Currently scFvs are the most common strategy for creation of CARs, but tumor cells can also be targeted using non-antibody based approaches with designs focused on the interaction between natural receptors and...
Source: Best Practice and Research Clinical Haematology - April 2, 2018 Category: Hematology Source Type: research

Off the shelf T cell therapies for hematologic malignancies
Publication date: Available online 28 March 2018 Source:Best Practice & Research Clinical Haematology Author(s): Bruce J. McCreedy, Vladimir V. Senyukov, Kim T. Nguyen Adoptive transfer of autologous CAR-T cells can induce durable remissions in patients with relapsed/refractory hematologic malignancies. However, multiple challenges exist for manufacturing CAR-T cells from patients with advanced disease including inability to manufacture a product, disease progression or death while waiting for the CAR-T product to be available, and heterogeneity among autologous CAR-T products that contributes to unpredictable and...
Source: Best Practice and Research Clinical Haematology - April 2, 2018 Category: Hematology Source Type: research

Toxicities associated with immunotherapies for hematologic malignancies
Publication date: Available online 28 March 2018 Source:Best Practice & Research Clinical Haematology Author(s): Mark B. Leick, Marcela V. Maus Immunotherapy has generated tremendous hope for patients with cancer that is refractory to standard approaches. Hematologic malignancies have taken the lead in harnessing the most recent advances in cell-based immunotherapies, such as CAR T cells, and some patients have achieved durable remissions. However, these T-cell-engaging therapies are associated with a new set of toxicities which need to be managed by caretakers, oncologists, nurses, and healthcare staff. In this r...
Source: Best Practice and Research Clinical Haematology - April 2, 2018 Category: Hematology Source Type: research

Novel therapies for relapsed/refractory mantle cell lymphoma
Publication date: Available online 2 November 2017 Source:Best Practice & Research Clinical Haematology Author(s): Puja C. Arora, Craig A. Portell Mantle cell lymphoma is an aggressive Non-Hodgkin's lymphoma that is considered incurable with standard therapies. Most patients treated with frontline immunochemotherapy relapse within a few years and do not usually respond to salvage chemotherapy. Persistent activation of the B-cell receptor pathway is critical to the pathogenesis of mantle cell lymphoma. Inhibition of Bruton's tyrosine kinase, an essential B-cell receptor pathway component with ibrutinib has shown cl...
Source: Best Practice and Research Clinical Haematology - December 16, 2017 Category: Hematology Source Type: research

Optimal management of the young patient CLL patient
Publication date: Available online 2 November 2017 Source:Best Practice & Research Clinical Haematology Author(s): John N. Allan, Richard R. Furman The emergence of targeted therapy for patients with chronic lymphocytic leukemia (CLL) has permanently altered the therapeutic landscape. In both upfront and relapsed settings, safe and effective oral kinase inhibitors are available which rival the responses and durability seen with standard chemo immunotherapy regimens. In 2016, ibrutinib was granted Federal Drug Administration approval for first-line therapy in patients with CLL. While its role as initial therapy for...
Source: Best Practice and Research Clinical Haematology - December 16, 2017 Category: Hematology Source Type: research

Risk stratification in follicular lymphoma
Publication date: Available online 15 November 2017 Source:Best Practice & Research Clinical Haematology Author(s): Carla Casulo Advances in the understanding of FL biology, molecular characteristics and clinical risk factors are further highlighting the heterogeneity of this disease. Historically used prognostic factors were broadly based on clinical and laboratory features at the time of diagnosis. However novel prognostic factors are emerging that can be studied at the time of diagnosis, and relapse, and use a variety of tools including gene alterations and diagnostic imaging. These novel discoveries are being ...
Source: Best Practice and Research Clinical Haematology - December 16, 2017 Category: Hematology Source Type: research

Novel agents for relapsed and refractory follicular lymphoma
Publication date: Available online 16 November 2017 Source:Best Practice & Research Clinical Haematology Author(s): Chan Yoon Cheah, Nathan H. Fowler Follicular lymphoma is one of the most common non-Hodgkin's lymphomas. Although current frontline regimens are associated with high response rates, most patients still relapse. When progression is discovered, re-establishing the diagnosis and ruling out transformation in paramount. The outcomes following relapse have been improving due to the activity and increasing availability of novel agents with various mechanisms of action. Despite these advances, single agent a...
Source: Best Practice and Research Clinical Haematology - December 16, 2017 Category: Hematology Source Type: research

Overview on the management of non-gastric MALT lymphomas
Publication date: Available online 14 November 2017 Source:Best Practice & Research Clinical Haematology Author(s): Irene Defrancesco, Luca Arcaini Extranodal marginal zone B-cell lymphomas (EMZLs) of the mucosa-associated lymphoid tissue (MALT) are indolent lymphomas which can present at any extranodal site. The most frequent localizations (other than stomach) are ocular adnexa, salivary gland, skin, lung and thyroid. Chronic inflammation and antigenic stimulation are a potential risk for the development of MALT lymphomas. While Helicobacter Pylori is known to be associated with gastric MALT lymphoma and antibiot...
Source: Best Practice and Research Clinical Haematology - November 15, 2017 Category: Hematology Source Type: research

The role of stem cell transplantation in follicular lymphoma
Publication date: Available online 3 November 2017 Source:Best Practice & Research Clinical Haematology Author(s): Georg Hess With the introduction of novel treatments paradigms to if or when to use transplantation strategies for patients with follicular lymphoma have changed substantially. Autologous transplantation has been intensively evaluated as consolidation after first induction treatment with positive effects, however the introduction of Rituximab led to comparable improvements and HDT has been moved to relapse treatment. In this indication HDT was frequently use already at first relapse, but now is domina...
Source: Best Practice and Research Clinical Haematology - November 10, 2017 Category: Hematology Source Type: research

Should rituximab replace splenectomy in the management of splenic marginal zone lymphoma?
Publication date: Available online 7 November 2017 Source:Best Practice & Research Clinical Haematology Author(s): Christina Kalpadakis, Gerassimos A. Pangalis, Maria K. Angelopoulou, Sotirios Sachanas, Theodoros P. Vassilakopoulos Background SMZL is a relatively rare low grade B-cell lymphoma, characterized usually by an indolent clinical behavior. Since there is no prospective randomized trials to establish the best treatment approach, decision on therapeutic management should be based on the available retrospective series. Based on these data, rituximab and splenectomy appear to be the most effective. Splenecto...
Source: Best Practice and Research Clinical Haematology - November 8, 2017 Category: Hematology Source Type: research

What is the optimal initial management of the younger mantle cell lymphoma patient?
Publication date: Available online 1 November 2017 Source:Best Practice & Research Clinical Haematology Author(s): Rory McCulloch, Simon Rule The last 20 years has seen considerable advances made in the management of younger patients with mantle cell lymphoma. The use of high dose cytarabine and rituximab in induction therapy, usually followed by autologous stem cell transplant consolidation, has become established practice and the median overall survival now exceeds 10 years. However, this high intensity upfront approach is not necessarily appropriate for all newly diagnosed patients. A minority exhibit disease t...
Source: Best Practice and Research Clinical Haematology - November 1, 2017 Category: Hematology Source Type: research

Management of untreated advanced stage follicular lymphoma: Role of patient discernment
Publication date: Available online 1 November 2017 Source:Best Practice & Research Clinical Haematology Author(s): Jayadev Manikkam Umakanthan, Mathew A. Lunning Follicular lymphoma is the most common indolent non-Hodgkin lymphoma. Advanced stage disease is common at diagnosis. The timing of treatment for follicular lymphoma is best approached by considering the combination of presence or absence of symptoms along with estimation of tumor burden. Upfront treatment strategies should take into initial presentation variables, pace of disease progression and goals of care after discussion with the patient. Treatment a...
Source: Best Practice and Research Clinical Haematology - November 1, 2017 Category: Hematology Source Type: research

What is the optimal management of older CLL patients?
Publication date: Available online 1 November 2017 Source:Best Practice & Research Clinical Haematology Author(s): Jennifer A. Woyach CLL is the most common leukemia in older adults with a median age at diagnosis of 71. Therefore, management of patients with this disease must take into account the older age of most patients and consequences of this in terms of functional status and organ function. This review will discuss the management of CLL with regards to observation prior to the initiation of therapy, functional status, and initial treatment. We will discuss criteria for the initiation of therapy, and how ini...
Source: Best Practice and Research Clinical Haematology - November 1, 2017 Category: Hematology Source Type: research

Pathogenesis of follicular lymphoma
Publication date: Available online 1 November 2017 Source:Best Practice & Research Clinical Haematology Author(s): Tracy Lackraj, Rashmi Goswami, Robert Kridel Follicular lymphoma (FL) is presented as a germinal centre B-cell lymphoma that is characterized by an indolent clinical course, but remains – paradoxically – largely incurable to date. The last years have seen significant progress in our understanding of FL lymphomagenesis, which is a multi-step process beginning in the bone marrow with the hallmark t(14; 18)(q32; q21) translocation. The pathobiology of FL is complex and combines broad somatic ...
Source: Best Practice and Research Clinical Haematology - November 1, 2017 Category: Hematology Source Type: research

Transformation of follicular lymphoma – Why does it happen and can it be prevented?
Publication date: Available online 1 November 2017 Source:Best Practice & Research Clinical Haematology Author(s): Brian K. Link Follicular lymphoma is a clinical disease with a multitude of presentations and behaviors. Although infrequent, transformation of follicular lymphoma to a more aggressive behaving subtype – prototypically diffuse large B-cell lymphoma – confers a substantially adverse prognosis. There is no consensus for optimal management after transformation is recognized. Historically considered a distinct clinical event, this review highlights the multiple subclinical transformational eve...
Source: Best Practice and Research Clinical Haematology - November 1, 2017 Category: Hematology Source Type: research

Mutational complexity in myelodysplasia
Publication date: Available online 25 October 2017 Source:Best Practice & Research Clinical Haematology Author(s): R. Coleman Lindsley Myelodysplastic syndromes are characterized by genetic and clinical heterogeneity. Some mutations are able to drive clonal hematopoiesis without causing clinical consequences, while other mutations may have significant impact, including the transformation to leukemia. This review aims to describe the pathogenesis of myelodysplastic syndromes (MDS) by focusing on 3 aspects: combinatorial genetic events, environmental factors, and inherited genetic conditions. (Source: Best Practice ...
Source: Best Practice and Research Clinical Haematology - October 26, 2017 Category: Hematology Source Type: research

Do cytogenetics affect the post-remission strategy for older patients with AML in CR1?
Publication date: Available online 7 October 2017 Source:Best Practice & Research Clinical Haematology Author(s): James Foran Data have shown that intensified cytarabine in consolidation for treatment of acute myeloid leukemia (AML) does not equally benefit patients older than 60 years, and older patients experience significantly more neurotoxicity than younger patients. In addition, older patients are more likely to have abnormal or unfavorable cytogenetics, which also tend to confer limited efficacy with intensified cytarabine. This poses a treatment dilemma as to the best post remission therapy to treat older p...
Source: Best Practice and Research Clinical Haematology - October 8, 2017 Category: Hematology Source Type: research