bluuebunny/crossref_metadata_2025_split huggingface dataset:
More Than 4 Cycles of ABVD for the Treatment of Stage I–II Hodgkin’s Lymphoma?.
Authors: Tartas Norma , Zerga Marta , Alfonso Graciela , Copello María P. Amoroso , Santos Isabel , Korin Jorge , Nucifora Elsa , Fantl Dorotea , Luchetta Patricia , Ferro Hugo , Chacón Carolina , Barazzutti Lucía , Scoles Alba , Rainieri Fernanda , Alberbide Jorge , VijnovichBarón Anahí , Kusminsky Gustavo , Foncuberta María , Avalos Julio Sánchez 
Published: October 2019

Abstract
Patients with stage I-II A non bulky Hodgkin’s lymphoma (HL) are successfully treated with 2–4 cycles of ABVD plus IF radiotherapy (RT). Although the negative impact in DFS and OS of B symptoms and bulky disease(X) is widely accepted, other risk factors such as number of lymph node regions involved or extensive spleen involvement have also been reported. What is the best treatment for such patients? Is radiotherapy necessary? We report here our experience with protocol HD 98 in 62 patients, with stage I–II HL. Since January 98 we have included 30 individuals without risk factors and 32 with one of the following risk factors: B symptoms (n:11), X (n:9), extensive spleen involvement (n:1) and involvement of more than two lymph node regions (n:11). Other patient characteristics were: age: x 31yrs (15–69), sex: females 31, males :31. Ann Arbor stage IA :11, IB :1, IIA: 36, IIB :14. Histologic subtypes were: LP: 4, NS: 42, MC: 15, lymphocyte rich :1. Patients with favourable features received 4 cycles of ABVD plus IFRT, those with unfavourable factors received 6–8 cycles of ABVD plus RT in areas of bulky or residual disease.
Results: 59/61 evaluable patients obtained CR or CRu. Two patients were considered primary resistant. Three patients relapsed at 7, 13 and 30 months after completion of treatment. Autologus bone marrow transplant was performed in four patients. The two primary resistant patients relapsed after the transplant and died with proggressive disease. Those patients transplanted in a chemosensitive relapse are currently in CR. With a median follow up of 46m (13–84) 96.7% of the patients are alive, in CR.
Conclusions: In our experience patients with unfavourable stages I–II HL are succesfully treated with 6–8 cycles of ABVD. In such patients RT might only be necessary in areas of bulky or residual disease.
Recommended Repeated Intrathecal Ara-C/MTX/PDN Injections during Rituximab-Based Therapy for B-Cell Lymphoma.
Authors: Wakao Daisuke , Suzuki Toshiya , Ito Katsuro , Yoshida Katsuhiko , Jinnai Itsuro , Bessho Masami 
Published: October 2019

Abstract
Rituximab-based chemotherapy for B-cell lymphoma is available in Japan since ‘01. We have treated twenty-eight B-cell lymphoma patients with rituximab and found four patients relapsed with posterior radiculopathy of the spinal cord due to lymphoma involvement. Because frequency of CNS lymphoma is reported to be 1~2%, we are surprised at the high incidence (14.2%) and thereafter we routinely repeat intrathecal cytarabine (Ara-C), methotrexate (MTX), and prednisolone (PDN) administrations during rituximab-based chemotherapy. Up to now, there is no new spinal cord relapse. The followings are the four spinal cord relapse cases we have experienced, which are characterized by severe back pain. (Case 1) A 46-years-old male with follicular lymphoma. Clinical stage (CS) was IIIB. He had cervical lymphadenopathy and breast involvement. He was treated with three courses of CHOP chemotherapy and achieved CR. Then he was treated with 1 course of rituximab alone and relapsed with severe neck and back pain five-days later. MRI imaging revealed posterior radiculopathy of the spinal cord between C2 and C4. (Case 2) A 48-years-old female with diffuse large B-cell lymphoma, CS IIIA. She had uterine cervix lymphoma and cervical lymphadenopathy four-years after acute lymphocytic leukemia (ALL) therapy. She was treated with 8 courses of biweekly R-CHOP and achieved CR. She relapsed with severe back and left arm pain with double vision six-months later. MRI imaging revealed posterior radiculopathy of the spinal cord between C5 and C6, and Th2 and Th3. She also had trigeminal radiculopathy and facial nerve oppression. The involved nerves were swollen like dumbbell. (Case 3) An 83-years-old female with MALToma, CSIIA. She had cervical lymphadenopathy. She was treated with 5 courses of rituximab alone and relapsed with severe back and lumbar pain one-month later. MRI imaging revealed posterior radiculopathy of the spinal cord between Th6 and Th7, and, Th12 and L1. (Case 4) A 63-years-old male with mantle cell lymphoma, CSIIIB. He had general lymphadenopathy. He was treated with 8 courses of CHOP, achieved CR, and relapsed with general lymphadenopathy and breast involvement thirteen-months later. He was treated with additional 7 courses of R-CHOP and relapsed again with severe oral, bilateral leg, and back pain seven-days later. MRI imaging revealed posterior radiculopathy of C2 and sacrum. All the patients except case 3 died due to lymphomas. When we treated the four patients with rituximab-based therapy, we did not repeat intrathecal Ara-C/MTX/PDN injections. Our data suggest that rituximab possibly induce posterior radiculopathy of spinal cord lymphoma involvement via some unknown pathway. In conclusion, we recommend repeated intra-thecal injections during rituximab administration.
Echocardiography Identifies Changes in Left Ventricular Cardiac Function after Low Doses of Anthracycline, Particularly in Older Patients.
Authors: Kruger Anton R. , Mepham Sophie , Belham Mark 
Published: October 2019

Abstract
Anthracyclines remain an essential component of treatment regimes for lymphoma. Increasing numbers of older patients are being offered potentially curative treatment for lymphoma and a corresponding increase in cases of cardiac toxicity might be expected. Upper limits for total doses of anthracycline are published, but there is little information on whether age predicts independently for cardiac susceptibility to anthracyclines. There is also little data on the effect of low doses of anthracycline on the heart. We have prospectively studied cardiac function in patients receiving Doxorubicin (DOX) for High Grade Non Hodgkin’s Lymphoma and Hodgkin’s disease. 28 patients are included: 18 male, 9 female aged 16 to 89 (median 59) years. Echocardiographic examinations were undertaken before and after patients received DOX at a median dose of 85 mg/m2 (50 mg/m2 to 150 mg/m2). The Left Ventricular (LV) Tei index was calculated in all cases as the sum of the isovolumetric contraction time and isovolumetric relaxation time divided by the ejection time. Higher values represent cardiac dysfunction and a rise post treatment was regarded as deterioration in LV function. For the group, there was a significant post treatment deterioration in LV function as measured by the Tei index: 0.400 ± 0.12 pre-treatment to 0.475 ± 0.16 post treatment (P = 0.0076). Multivariate analysis of age, pre-treatment Tei index and DOX dose (in this low range) revealed age to be the only significant predictor of deterioration in cardiac function after treatment (correlation coefficient 0.69, p < 0.0001).
We conclude that measurable changes in cardiac function occur after very low doses of DOX and that these changes are more marked in older patients. Whether these changes will predict for further deterioration after higher doses of DOX and potentially predict for long term symptomatic cardiac dysfunction post therapy will require further study and follow up.
Surgical Complications in Patients Treated with Chemotherapy for Gastric Diffuse Large B Cell Lymphoma.
Authors: Spectre Galia , Libster Diana , Grisariu Sigal , Da’as Nael , Gimmon Zvi , Paltiel Ora 
Published: October 2019

Abstract
The management of patients with gastric lymphoma has undergone significant changes in the past few years, with a shift towards non-surgical treatment. However, surgical complications still occur in patients receiving chemotherapy. The rate of these complications is unknown. Our aim was to assess the frequency of bleeding, perforation and gastric outlet obstruction in patients with gastric diffuse large B cell lymphoma who received chemotherapy as a primary treatment for their disease. In this study we retrospectively reviewed files of patients with gastric diffuse large B cell lymphoma, who were diagnosed and treated in our medical center between 1990 and 2005. Results: 88 patients were diagnosed with gastric diffuse large B cell lymphoma of whom 73 were initially treated with chemotherapy, mainly CHOP or similar regimens. The remaining 15 patients were treated with gastrectomy, irradiation, or died before treatment could be initiated. 69 patients had primary lymphoma of the stomach, 4 had gastric involvement at relapse, one had transformed follicular lymphoma and one had post transplant lymphoma. 18 of 73 (25%) patients experienced surgical complications during the course of their treatment. Seven patients had gastric bleeding, of whom 3 were treated conservatively, one underwent angiography with embolization, one had a gastrectomy, and in two patients treatment was stopped due to bleeding and poor performance status. Nine patients had gastric outlet obstruction, of whom 3 were treated conservatively, 4 required surgery, 1 had repeated endoscopic pneumatic dilatations, and one stopped treatment. Seven of 9 patients had no evidence of active lymphoma at the time of gastric outlet obstruction. Two additional patients underwent gastrectomy, 1 due to resistant disease and 1 for relapsed disease. Gastric perforation was not observed. Overall 6 of 73 (8%) of patients eventually required gastric surgery; 3 are alive and free of disease, one died from lymphoma and two died from other causes. We conclude that there is a substantial rate of surgical complications in patients with gastric diffuse large B cell lymphoma receiving chemotherapy and thus, there is still a major role for the surgical consultant in the treatment of these patients. Gastric perforation is a rare complication.
High Resolution Computed Tomography of Bleomycin-Induced Lung Injury in Hodgkin Lymphoma.
Authors: Akay Meltem Olga , Ozkan Ragip , Uskudar Dondu , Gulbas Zafer 
Published: October 2019

Abstract
Bleomycin is the chemotherapeutic agent most commonly associated with pulmonary toxicity in about 4–20% of treated patients. The diagnosis of bleomycin-induced lung disease is primarily clinical and there is no true gold standart test available. In this study, we aimed to evaluate the role of high resolution computed tomography (HRCT) in monitoring patients for drug toxicity.
We prospectively evaluated the HRCT scans of 18 newly diagnosed hodgkin lymphoma patients baseline, after the fourth and the eight cycle of ABVD (Adriamycin-bleomycin-vinblastine-dacarbazine) chemotherapy. The age ranges of the patients was 17–69 years (mean, 35 years). Serial PFTs and arterial blood gases were obtained in addition to imaging studies during bleomycin therapy. The parenchymal abnormalities on HRCT were grouped into different categories according to the dominant pattern and distribution of disease: diffuse alveolar damage (DAD), nonspecific interstitial pneumonitis (NSIP), bronchiolitis obliterans organizing pneumonia (BOOP), interstitial pneumonitis and fibrosis and hypersensitivity reaction. Pulmonary parenchymal abnormalities were detected on HRCT in 5 of 18 patients (27.8%). Patient details, cumulative doses of bleomycin and patterns of lung injury are presented in table. Arterial O2 pressure (p<0.01), O2 saturation (p<0.01) and carbon monoxide diffusing capacity (DLCO) (p<0.01) were decreased after bleomycin therapy compared to baseline values in 18 patients.
Our results indicate that HRCT is useful in the diagnosis of bleomycin-induced lung disease by better characterization of the nature of the abnormality and assessment of extent and distribution of disease.
Bleomycin-induced lung disease No Age Sex Dose Pattern of lung injury 1 46 M 234 mg BOOP 2 30 M 128 mg NSIP 3 69 F 210 mg NSIP 4 26 M 162 mg BOOP 5 51 M 256 mg NSIP
Report of a Phase II Study of Proteasome Inhibitor Bortezomib (Velcade) in Patients with Relapsed or Refractory T-Cell Lymphoma.
Authors: Zinzani Pier Luigi , Tani Monica , Stefoni Vittorio , Alinari Lapo , Marchi Enrica , Fina Mariapaola , Baccarani Michele 
Published: October 2019

Abstract
The 26S proteasome plays a vital role in degrading regulatory proteins such as p53, p21, p27, NF-kB, I-kB, and bcl-2, that govern cell cycle, transcription factors activation, apoptosis and cell trafficking. Thus, the mechanisms by which bortezomib elicits its antitumor activity may vary among tumor types, and the extent to which each affected pathway is critical to the inhibition of tumor growth could also differ. The aim of this study was to determine the efficacy and toxicity of bortezomib in previously pretreated patients with peripheral T-cell lymphoma unspecified (PTCLU) and cutaneous T-cell lymphomas (CTCL). Each patient had to meet the following inclusion criteria to be enrolled in the study: histologically confirmed PTCLU or CTCL (according to REAL/WHO classification); any stage, any IPI, any bone marrow status; second or more relapse or refractory disease; age ≥ 18; ECOG performance status ≤ 2; Hb ≥ 10 g/dL, ANC ≥ 1.5x109/L and platelets ≥ 100 x 109/L; normal hepatic, renal and cardiac functions; and voluntary written informed consent. Bortezomib was given at 1.3 mg/m2 IV push on days 1, 4, 8 and 11 every 21 days. Restaging was done every 2 cycles. Patients were treated for up to a total of 6 cycles unless removed from study for failure to respond or toxicity. The response criteria were those recommended by NCI sponsored Working Group. A total of 30 patients will be enrolled; so far 10 patients entered and preliminary results of this trial will be presented.
Comparison of Outcome of Unselected Patients with Diffuse Large B-Cell Lymphoma Diagnosed before and after Approval of Rituximab in France in This Indication.
Authors: Ghesquières Hervé , Sebban Catherine , Chassagne Catherine , Carausu Liana , Gargi Thérèse , Favier Bertrand , Philip Irène , Blay Jean Yves , Biron Pierre 
Published: October 2019

Abstract
Two randomized-controlled trials had demonstrated improved outcome with adding rituximab to CHOP for elderly patients and young low-risk patients with DLBCL (Coiffier et al., NEJM 2002 and Pfreundschuh et al., ASH 2004, abstr #88). It seemed interesting to assess whether this was confirmed in daily practice in an unselected patient population. We compared the outcome of newly diagnosed patients treated in our department between two time periods, before and after approval of rituximab for treatment of DLBCL in France, in March 2002. Patients with primary cerebral lymphoma, secondary transformation of indolent lymphoma or HIV positivity were excluded of the study but no selection was made on type of initial treatment or therapeutic intent (palliative or curative) to conform with daily clinical practice. 229 patients were identified, with median age 61 years (range, 20–90), elevated LDH (66%), extranodal sites >1 (26%), stage III-IV (57%), poor performance status >1 (24%), IPI score 0–1 (37%), 2 (20%), 3(21%), 4–5 (22%). 148 patients were diagnosed between 01/1996 and 03/2004 (time period 1) and 81 between 04/2002 and 07/2004 (time period 2). Patient characteristics did not differ between the two time periods (median age, performance status, stage, elevated LDH, extra-nodal involvement, IPI distribution). 11% of patients received rituximab as part of initial treatment in time period 1, and 93% in time period 2. Response rates at the end of treatment for time periods 1 and 2 were CR/CRu 71% and 79% (p=0.1), PR 6% and 10% (p=0.3), progression 17% and 9% (p=0.08), toxic death 6% and 2% (p=0.2), respectively. At the time of this abstract, the follow-up for living patients was 60 and 18 months for time periods 1 and 2 respectively, with no difference in terms of progression-free survival (PFS), event-free survival (EFS) and overall survival (OS). The lack of outcome difference between the two cohorts could be due to short follow-up of time period 2 and efficiency of rituximab in the patients treated in time period 1. In fact, PFS is significantly improved for patients under rituximab compared to patients not treated with rituximab (see survival outcomes in table). In conclusion, this global evaluation of treatment with rituximab in an unselected population of DLBCL patients before and after date of approval of rituximab requires further follow-up for validation of outcome benefit.
An Applicational Observation of Low-Dose Rituximab in Elderly Patients with Nodal Marginal Zone Lymphomas.
Authors: Roggero Enrico , Palumbo Antonella , Di Martino Stefania , Busi Giancarla , Pedrazzini Augusto 
Published: October 2019

Abstract
Background: Single-agent rituximab was shown to prolong overall response rate (ORR) in marginal zone lymphomas. However, despite the confirmed activity of this immuno-biologic agent a significant number of adverse events were reported in this commonly considered indolent lymphoma entity.
Methods: To reduce the impact of rituximab toxicity we investigated the activity of low-dose rituximab infusions in 3 consecutive elderly patients (over 70 years) with nodal marginal zone lymphomas. All patients (Ann Arbor stage IV with bone marrow (BM) involvement, age range from 71 to 84 years, normal LDH and WHO performance status = 0) were treated with weekly low-dose rituximab (75 mg/m2) administred for 6 consecutive weeks.
Results: All patients complleted the treatment program. No complete response were observed. All patients confirmed a partial response (PR) with reduction of symptoms and disease related BM involvement. The median response duration was 14 months. At a median follow-up of 18 months, 2 patients relapsed and one patient (chemiotherapy naive) is still responding. The 3 patients did not experienced any adverse events and depsite the older age of patients, no expected infusion-related side effects were recorded.
Conclusion: This investigative report demostrated the efficacy and the well tolerability of low-dose rituximab (75 mg/m2 administreted weekly for 6 consecutive weeks) in elderly patients with well defined diagnosis of nodal marginal zone lymphoma. These observations can lead to the hypothesis that the dose and the schedule of rituximab should be redefined in this lymphoma entity.
R-CHOP in the Treatment of DLBCL: Single Institution Experience from North India.
Authors: Vaid Ashok K. , Gupta Sachin , Doval Dinesh C. , Talwar Vineet , Gupta Rajeev , Sharma J. B. , Chaturvedi A. K. , Prakesh Neeraj 
Published: October 2019

Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most frequent type of NHL. Different chemotherapy regimens tested in the past showed RR of appx 80% with no improvement in prognosis & OS. CHOP regimen has been the standard treatment for these patients (pts). Rituximab has improved response rates & survival in CD20 positive lymphoma pts, especially elderly (GELA trial: CR 73% vs. 63%). We retrospectively evaluated pts of DLBCL treated with R-CHOP regimen between April 2001 & June 2005. All pts had biopsy and IHC of lymph node/extranodal site, & CT scan of neck, chest, abdomen; BM biopsies; CBC, serum chemistries; 2D echocardiography/MUGA scans. All pts received Rituximab (375mg/m2) & CHOP 3 weekly for a maximum of 8 cycles. Pts who received at least 1 & 3 cycles of R-CHOP were evaluable for toxicity and response respectively. In total, 36 pts were included for analysis. The median age was 53 years, 10/36 pts (27.8%) were >60 years. 25/36 were male (69.4%). ECOG performance status: 0–1 in 30/36, and 2–4 in 6/36. 11/36 had B-symptoms, 16/36 had high LDH, 6/36 had bulky disease. Extranodal involvement was present in 19/36; 10/36 had ≥2 sites of extranodal involvement. Lymph nodal swelling was most common presentation in 24/36 (66.7%), followed by pain 10/36 (27.8%), weight loss 9/36 (25%), fever 7/36 (19.4%), skin nodules 3/36 (8.3%). Extranodal sites were: bone marrow 5/36, bone 4/36, skin 3/36, GIT 3/36, pleural effusion 2/36, lungs 2/36, other soft tissue 2/36, and parotid, nasopharynx, orbit, adrenal, testes, kidneys-1 each. Gallium scan at base line, done in 12/36, was positive in 11 pts (91%). Stage distribution was as follows: stage-I none, stage-II 10/36 (27.8%), stage-III 13/36 (36.1%), stage-IV 13/36 (36.1%). IPI scoring was-low risk 13/36 (36.1), low intermediate 9/36 (25.0%), high intermediate 13/36 (36.1) & high risk 1/36 (2.8%). A total of 199 cycles of R-CHOP were administered with a median of 6 cycles per patient. Of the 33 pts evaluable for response, 22 achieved CR (66.7%), 9 PR (27.3%), 1 each SD & PD. There were 2 treatment related mortalities. Toxicities were: grade III/IV neutropenia in 12/36 (33.3%), thrombocytopenia 4/36 (11.1%), peripheral neuropathy 2/36 (5.6%). Mild hypersensitivity to Rituximab was seen in 2/36 (5.6%) pts. Only 1 patient had cardiac toxicity in form of CHF. Our study showed response rates (94%) and toxicity profile similar to what has been reported in other studies with R-CHOP. The follow-up is too short to evaluate survival rates. Keywords: DLBCL, Rituximab, CHOP.
Phase I Clinical Study of Imatinib Mesylate in Combination with Tetra-Arsenic Tetra-Sulfide in the Treatment of CML Patients in Advanced Phase.
Authors: Li Junmin 
Published: October 2019

Abstract
OBJECTIVE: We performed a Phase I study to evaluate the toxicity and potential efficacy of Imatinib Mesylate (Glivec) in combination with Tetra-arsenic tetra-sulfide (As4S4) in patients with advanced CML.
PATIENTS AND METHODS: Ten CML patients in advanced phase were enrolled in this study. All patients received imatinib with As4S4 150mg/kg/d (day 1–14, each month) for 6 months. The initial dose of imatinib was 400mg/d in first 3 patients, with subsequent escalation to 600mg/d in other 7 patients. Adverse events and potential hematological, cytogenetic and molecular response was closely monitored. A concurrent control group of 10 patients received imatinib monotherapy at 600mg/d was included for the analysis of toxicity profile and clinical efficacy.
RESULTS: From Dec.2003 to Jun.2004, a total of 10 patients (6 males and 4 females with median age at 33.5) were enrolled in this trial, in which 5 in accelerated phase(AP)and 5 in blast crisis (BC). There were no significant differences in base-line characteristics between the study group and the concurrent control group. Non-hematologic toxicities such as gastrointestinal discomfort, edema, liver dysfunction and myalgia/bone pain were common and mild (Grade 1/2). Grade 3 or 4 hematologic toxicities, including neutropenia, thrombocytopenia and anemia, occurred in 3 patients. There was no difference in either hematological or non-hematological toxicities between the study and the control group. The patients in both group had equivalent complete hematological response (CHR= 70%) and complete cytogenetic response (CCR= 30%) rates. All 3 patients in the study group with CCR achieved more than 3 log reduction of BCR-ABL transcripts level while only one patient obtained a molecular response in control group. With a median follow-up of 14 months (2 to 18 months) in both group, the patients in study group showed a similar overall survival (1yr OS 68.6%±15.2%) and a slight better progress free survival (1yr PFS 75.0%±17.3%) compared to concurrent control group (1yr OS 70.0%±14.5% and 1yr PFS 50.5%±17.7%). Of notice, all patients with cytogenetic and molecular response did not have additional cytogenetic abnormality besides the Ph chromosome before the treatment.
CONCLUSIONS: The combination therapy with 600mg daily imanitib and 150mg/d As4S4 is safe and feasible for advanced CML patients. Though patients with additional cytogenetic abnormality were unlikely to response to the combination therapy, complete hematological, cytogenetic and even molecular response was documented in the advanced CML patients with combination therapy. The primary data suggested a potential clinical benefit in patients with advanced CML, thus clinical trial to further test in chronic phase CML without additional cytogenetic abnormality will be warranted.