Lymphoma

The treatment of APL in the modern era is a success of modern hematology. In this review we have attempted to plant the seeds of understanding regarding how diagnosis and treatment of APL will be pursued over the next decade.

Updated clinical data from the pivotal phase II global PACE trial of ponatinib confirm its impressive antileukemic activity in patients with chronic myeloid leukemia or Philadelphia-chromosome-positive acute lymphoblastic leukemia at all stages who are resistant or intolerant to dasatinib or nilotinib.

Bendamustine plus rituximab should be considered as the preferred first-line treatment of follicular and indolent lymphomas, and the elderly with mantle cell lymphoma.

In a phase I study the targeted drug crizotinib, a small molecule inhibitor of anaplastic lymphoma kinase and met proto oncogene, delayed or eliminated signs of tumor growth in pediatric patients with aggressive cancers.

A new study has identified independent risk factors for the development of non-Hodgkin lymphoma (NHL) including high fetal growth, older age of the mother, low birth order, and male sex. A family history of NHL in either parent or sibling was found to be the strongest risk factor.

Researchers at the University of Pennsylvania have identified a protein that could be targeted to turn off B-cell lymphomas. The protein, CD19, was found to be a major regulator of B-cell neoplastic growth driven by the MYC oncogene.

Dr. Hoppe and colleagues present a strong case supporting the use of proton therapy (PT) for the treatment of patients with Hodgkin lymphoma (HL).

Proton radiotherapy is here to stay. Despite the high initial cost, the number of proton therapy machines in the United States and elsewhere is increasing rapidly.[1] The major questions now relate to defining and optimizing their appropriate use.

If there is one disease for which patients have experienced a significant improvement in the cure rate over the past 10 years, it is diffuse large B-cell lymphoma (DLBCL).

In their article in this issue of ONCOLOGY, Nastoupil, Rose, and Flowers give a very careful assessment of the options for treating diffuse large B-cell lymphoma (DLBCL), with a focus on the importance of dose density in improving outcomes in this disease.

This article examines clinical and biological features of DLBCL patients with poor outcomes, and reviews recent studies addressing alternatives to standard front-line management strategies together with unresolved questions.

This review addresses the rationale and evidence for-and the challenges, cost implications, and future development of-proton therapy as an important part of the treatment strategy in Hodgkin lymphoma.

Leukemias and lymphomas are estimated to contribute up to 7% of all new malignant cases in the United States.[1]

The leukemias and lymphomas represent a group of heterogeneous myeloid or lymphoid clonal stem cell disorders with variable clinical presentation, pathological characteristics, prognosis and recommendations for treatment.[1]

The management of leukemias and lymphomas now includes the use of many targeted therapies. Nurses need to have an understanding of the targeted therapies and their side effects so they can appropriately manage the side effects that their patients with leukemias and lymphomas may experience.

Two researchers from the Mayo Clinic have published an editorial calling for new approaches in the treatment of AML, arguing that "using the same old drugs in different doses or different schedules is not going to cut it."

Cancer treatment is undergoing significant developments and entering the new golden era of genomics which has true potentials for the promise of personalized medicine. Large-scale sequencing is changing our understanding of malignant disorders particularly acute myeloid leukemia.

Inotuzumab ozogamicin has achieved a markedly long antitumor response in patients with refractory or relapsed indolent B-cell non-Hodgkin lymphoma (NHL) in an ongoing phase II study. Interim findings were reported by lead investigator Kenneth Luu, PhD, associate director of Pfizer global R&D.

A combination of TL32711, an investigational second mitochondrial-derived activator of caspases (Smac), and tumor necrosis factor-related apoptosis inducing ligand at low concentrations produced marked apoptosis in germinal center lines, with minimal to no effect for each agent alone.

Preliminary findings of a phase I/II randomized clinical trial indicate that SGI-110, a novel DNA methylation inhibitor, is safe, well tolerated and efficacious in patients with acute myelogenous leukemia.

In this article, we review the current knowledge on the biological findings, clinical features, and therapeutic approaches for splenic marginal zone lymphoma.

Four publications on cancer treatment during pregnancy were published last week in the journal Lancet, serving as new treatment guidelines for chemotherapy and surgery in pregnant patients with solid tumors and hematologic malignancies.

Splenic lymphomas are a diverse group of lymphoid malignancies that have clinical behavior ranging from indolent to aggressive and that have both B-cell and T-cell histologies.

The article by Thieblemont and colleagues very nicely summarizes the key pathogenetic and diagnostic features and present treatment of splenic marginal zone lymphoma (SMZL).

Until we fully engage in understanding the biologic mechanisms that separate NMZL from other indolent NHLs, however, we will continue to deliver “impersonalized medicine” that does not exploit the unique properties of the former.

Typically, when one authors a commentary piece, a good template to follow is to start with some background material, review the major findings of the paper in question, and then focus on areas of controversy and unanswered questions.

The aim of this review is twofold: to summarize descriptions of the clinical presentation provided in published series in order to help clinicians recognize and treat patients, and to discuss diagnostic difficulties faced by hematopathologists when dealing with these lesions and others in the differential diagnosis that must be distinguished from one another.

The results of the 2-year follow-up of the dasatinib DASISION phase III trial show the continued superiority of the drug compared to imatinib. The results provide further support for treatment of first-line chronic phase chronic myeloid leukemia patients that harbor the Philadelphia chromosome.

Results of the phase III SWOG S0016 trial comparing 2 chemotherapy regimens for follicular lymphoma (FL), presented this week at ASH, show no statistically significant differences in either progression-free survival (PFS) or overall survival. Both regimens produced “excellent” results, according to the presenter.

The phase III randomized RESORT (ECOG Protocol E4402) trial asked whether a maintenance schedule of rituximab every 3 months would lead to a superior disease control outcome compared to retreatment upon progression. The answer, presented this week at ASH, is no.