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Anti-TIF1γ antibody positivity without inflammatory myositis leading to expedited diagnosis of synchronous Epstein-Barr virus-positive marginal zone lymphoma and colon cancer: a case report 抗 TIF1γ 抗体阳性但无炎症性肌炎,导致快速诊断出同步的 Epstein-Barr 病毒阳性边缘区淋巴瘤和结肠癌:一份病例报告
Pub Date : 2024-07-01 DOI: 10.21037/aol-24-5
Ian J. Robertson, Guen M. Hunt, Michael Loncharich, Daniel V. Cordaro, Christin B. DeStefano
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引用次数: 0
Chronic lymphocytic leukemia infiltration of a transplanted kidney successfully treated with venetoclax and obinutuzumab: a case report 移植肾脏慢性淋巴细胞白血病浸润:成功治疗 venetoclax 和 obinutuzumab 的病例报告
Pub Date : 2024-06-01 DOI: 10.21037/aol-23-25
Sanjog Bastola, Manoj Rai, Nicole Andeen, Shehzad Rehman, Stephen Spurgeon
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引用次数: 0
Relapsed mantle cell lymphoma with parenchymal central nervous system involvement successfully treated with chimeric antigen receptor T-cell therapy—a case report 用嵌合抗原受体 T 细胞疗法成功治疗中枢神经系统实质受累的复发套细胞淋巴瘤--病例报告
Pub Date : 2024-05-01 DOI: 10.21037/aol-23-22
Manoj Rai, R. Maziarz, B. Ratterree, Elizabeth S. Bailey, Esmaa Alshalan, Pamela J. St. Clair, Stephen E. Spurgeon
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引用次数: 0
The role of pathologic testing in the diagnosis and management of patients with diffuse large B cell lymphoma: a narrative review 病理检测在弥漫大B细胞淋巴瘤患者诊断和管理中的作用:综述
Pub Date : 2024-05-01 DOI: 10.21037/aol-23-19
Michael Schneider, Daniel Landsburg
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引用次数: 0
Is more better? Increased doses of high dose methotrexate and addition of rituximab is associated with improved outcomes in a large primary CNS lymphoma cohort. 越多越好吗?在一个大型原发性中枢神经系统淋巴瘤队列中,增加高剂量甲氨蝶呤和利妥昔单抗的剂量与改善预后相关。
Pub Date : 2023-02-28 DOI: 10.21037/aol-22-19
Prakirthi Yerram, Samantha N Reiss, Lisa Modelevsky, Lauren Schaff, Anne S Reiner, Katherine S Panageas, Christian Grommes

Background: Primary central nervous system lymphoma (PCNSL) is a rare and aggressive primary brain tumor. While high dose methotrexate (HDMTX) regimens remain standard of care, it remains unclear if optimization of HDMTX doses and the addition of rituximab provide clinical benefit. Over the last 30 years, standard care given at Memorial Sloan Kettering Cancer Center (MSKCC) has evolved, allowing the comparison of patients receiving different numbers of HDMTX doses and those treated with and without rituximab. The purpose of this study was to describe outcomes based on treatment pattern changes.

Methods: This single-center, retrospective, IRB-approved study at MSKCC included patients with immunocompetent PCNSL, age ≥18 years and diagnosed between 1/1983-12/2017. Overall survival (OS) was modeled from date of last HDMTX for analyses associating HDMTX and OS. Multivariable Cox regression models estimated hazard ratios (HR) and corresponding 95% confidence intervals (CI).

Results: There were 546 patients identified with newly diagnosed PCNSL. Median overall survival (mOS) of the entire population was 4.7 years (95% CI: 3.8-5.7 years); 3.3 years (95% CI: 2.7-3.9 years) in patients diagnosed prior to 2006 and 8.1 years (95% CI: 6.6-11.1 years) in patients diagnosed 2006 onwards. Patients receiving ≥6 doses of HDMTX had improved survival compared to those receiving <6 doses of HDMTX (mOS: 7.8 vs. 4.3 years; P=0.001). Patients receiving induction rituximab had improved OS compared to those who did not receive rituximab (mOS: 10.5 vs. 3.2 years; P<0.0001). Patients receiving ≥6 doses of HDMTX and rituximab had greatest mOS at 13 years, with a 70% reduction in death (HR =0.30; 95% CI: 0.19-0.47) adjusting for treatment era, sex, and recursive partitioning analysis (RPA) classes comprising age and karnofsky performance score (KPS).

Conclusions: OS for PCNSL has improved significantly over the last few decades. Patients seem to benefit with ≥6 doses of HDMTX and the addition of rituximab, an effect independent of treatment era, age, and KPS.

背景:原发性中枢神经系统淋巴瘤(PCNSL)是一种罕见的侵袭性原发性脑肿瘤。虽然高剂量甲氨蝶呤(HDMTX)方案仍然是标准的治疗方案,但目前尚不清楚HDMTX剂量的优化和利妥昔单抗的加入是否能提供临床益处。在过去的30年里,纪念斯隆凯特琳癌症中心(MSKCC)的标准治疗已经发展,可以比较接受不同剂量HDMTX的患者以及接受和不接受利妥昔单抗治疗的患者。本研究的目的是描述基于治疗模式改变的结果。方法:这项在MSKCC进行的单中心、回顾性、irb批准的研究纳入了年龄≥18岁、诊断于1983年1月至2017年12月期间的免疫功能正常的PCNSL患者。总生存期(OS)从最后一次HDMTX的日期开始建模,以分析HDMTX和OS之间的关系。多变量Cox回归模型估计了风险比(HR)和相应的95%置信区间(CI)。结果:新诊断PCNSL患者546例。整个人群的中位总生存期(mOS)为4.7年(95% CI: 3.8-5.7年);2006年以前诊断的患者为3.3年(95% CI: 2.7-3.9年),2006年以后诊断的患者为8.1年(95% CI: 6.6-11.1年)。与接受HDMTX治疗的患者相比,接受≥6剂HDMTX治疗的患者的生存期提高了4.3年;P = 0.001)。与未接受利妥昔单抗的患者相比,接受诱导性利妥昔单抗的患者OS得到改善(mOS: 10.5 vs. 3.2年;结论:在过去的几十年里,PCNSL的操作系统有了显著的改进。患者似乎受益于≥6剂量的HDMTX和利妥昔单抗的加入,这种效果与治疗时间、年龄和KPS无关。
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引用次数: 2
Complete renal and haematological remission in a case of mantle cell lymphoma associated paraneoplastic focal segmental glomerulosclerosis with ibrutinib: a case report and review of literature 伊鲁替尼治疗套细胞淋巴瘤相关副肿瘤局灶节段性肾小球硬化1例肾脏和血液学完全缓解:1例报告和文献回顾
Pub Date : 2023-01-01 DOI: 10.21037/aol-22-21
U. Bhattacharjee, S. Wadhera, Arihant Jain, R. Nada, S. Sreedharanunni, M. Sachdeva, P. Malhotra
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引用次数: 0
Transplant and chimeric antigen receptor T-cell therapies in elderly patients with lymphoma, a narrative review 移植和嵌合抗原受体t细胞治疗在老年淋巴瘤患者中的应用综述
Pub Date : 2022-09-01 DOI: 10.21037/aol-22-7
I. B. Greenwell, P. Dahi
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引用次数: 1
Age is just a number: managing relapsed or refractory DLBCL in older patients 年龄只是一个数字:在老年患者中管理复发或难治性DLBCL
Pub Date : 2022-01-01 DOI: 10.21037/aol-22-3
D. Wallace, P. Reagan
: Diffuse large B-cell lymphoma (DLBCL) is a disease of older adults, and these patients experience higher rates of relapsed and refractory disease than younger patients. While treatment options in this setting have expanded, this population represents an area of unmet need as they are frequently ineligible for curative or aggressive therapies based on medical comorbidities or functional status, and often excluded from clinical trials. However, it is important to recognize that this is a diverse group of patients, and treatment choices need to be considered on an individual basis. Herein, we discuss an approach to the treatment of older patients with relapsed aggressive lymphoma, including utilization of geriatric assessments to categorize patients based on their fitness. The role of cellular therapy, including autologous stem cell transplant (ASCT) and chimeric antigen receptor T-cell products are reviewed, as well as a discussion of novel, targeted agents available in the relapsed setting with a focus on the available data for older patients for these treatments. For patients who are not fit enough for these therapies, we discuss palliative treatments that are available. We also highlight several emerging classes of drugs that may offer new treatment options in the future and offer our current approach for the management of these patients based on their fitness. 13
弥漫性大b细胞淋巴瘤(DLBCL)是一种常见于老年人的疾病,这些患者的复发和难治性疾病的发生率高于年轻患者。虽然在这种情况下的治疗选择已经扩大,但这一人群代表着一个需求未得到满足的领域,因为他们经常没有资格接受基于医学合并症或功能状况的治愈性或积极治疗,并且经常被排除在临床试验之外。然而,重要的是要认识到这是一个不同的患者群体,治疗选择需要根据个人情况进行考虑。在此,我们讨论了一种治疗复发性侵袭性淋巴瘤的老年患者的方法,包括利用老年评估来根据他们的健康状况对患者进行分类。本文回顾了细胞治疗的作用,包括自体干细胞移植(ASCT)和嵌合抗原受体t细胞产品,并讨论了在复发环境中可用的新型靶向药物,重点是老年患者用于这些治疗的现有数据。对于不适合这些治疗的患者,我们讨论可用的姑息治疗。我们还重点介绍了几种新兴药物,它们可能在未来提供新的治疗选择,并根据这些患者的健康状况提供我们目前的治疗方法。13
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引用次数: 0
Initial treatment of elderly population with aggressive lymphoma: a narrative review of current evidence and future directions 老年人群侵袭性淋巴瘤的初始治疗:当前证据和未来方向的叙述性回顾
Pub Date : 2022-01-01 DOI: 10.21037/aol-22-9
Behzad Amoozgar, B. Kahl
Background and Objective: Diffuse large B-cell lymphoma (DLBCL), a subtype of non-Hodgkin lymphomas (NHL), is commonly diagnosed in older individuals, and its mortality directly correlates with age. Despite recent advancements in treatment modalities for DLBCL, there is no universally accepted approach for elderly patients. R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) has remained the core therapy for decades but has higher toxicity and lower cure rates in the senior subgroup. This review article discusses the strategies for frailty assessment and subcategorization of the elderly population based on multidomain assessment tools. Further, it outlines potential regimens for the initial treatment of DLBCL based on different levels of frailty. Methods: We conducted a thorough literature review via PubMed and Google Scholars databases to identify the most relevant articles on our subject. Publication dates or languages did not limit our search methodology. Key Content and Findings: The older population is a heterogeneous group with different degrees of frailty and diminished functional reserve. Coexisting comorbidities in the elderly create additional management challenges. The lack of a global and comprehensive functionality assessment guideline is an area of unmet need. Despite these challenges, R-CHOP, or R-CHOP with modified components, and other chemoimmunotherapy regimens that were investigated as frontline therapies in elderly DLBCL have resulted in promising outcomes, particularly if the investigators carefully subcategorized the studied population using multidomain functionality assessment guidelines and consistently followed up with the patients. Conclusions: R-CHOP is still considered the best initial treatment for the senior population 60–80 years old, but with careful genetic and functionality classifications. We recommend attenuated and modified versions of R-CHOP, such as R-miniCHOP, as an alternative option for the fit elderly over >80 years. For elderly patients with cardiac co-morbidities, R-CEOP (substituting doxorubicin with etoposide in R-CHOP) has proven to have curative potential. For fit, unfit, and frail, very elderly DLBCL patients ( ≥ 85 and mostly ≥ 90 years), initial treatment options remain challenging, and patients may be best served with a palliative approach. 13 doxorubicin patients received across all cycles. The study investigated the influence of IDI and RDI with factors including age, Eastern Cooperative Oncology Group performance status (ECOG PS), CIRS-G score, lactate dehydrogenase (LDH), tumor bulkiness, hemoglobulin level, and albumin on outcomes for DLBCL patients years. each
背景与目的:弥漫性大b细胞淋巴瘤(DLBCL)是非霍奇金淋巴瘤(NHL)的一种亚型,常见于老年人,其死亡率与年龄直接相关。尽管最近DLBCL的治疗方式取得了进展,但对于老年患者尚无普遍接受的治疗方法。R-CHOP(利妥昔单抗、环磷酰胺、阿霉素、长春新碱和强的松)几十年来一直是核心治疗方法,但在老年亚组中毒性较高,治愈率较低。本文综述了基于多领域评估工具的老年人口脆弱性评估和分类策略。此外,它概述了基于不同虚弱程度的DLBCL初始治疗的潜在方案。方法:我们通过PubMed和Google学者数据库进行了全面的文献综述,以确定与我们主题最相关的文章。出版日期或语言没有限制我们的搜索方法。关键内容和发现:老年人群是一个异质性群体,具有不同程度的虚弱和功能储备下降。老年人共存的合并症带来了额外的管理挑战。缺乏全面和全面的功能评估指南是一个未满足需求的领域。尽管存在这些挑战,R-CHOP或改良成分的R-CHOP和其他化疗免疫治疗方案作为老年DLBCL的一线治疗方法进行了研究,结果很有希望,特别是如果研究人员使用多域功能评估指南仔细地对研究人群进行了细分,并对患者进行了持续的随访。结论:R-CHOP仍被认为是60-80岁老年人群的最佳初始治疗方案,但需要仔细进行遗传和功能分类。我们推荐R-CHOP的减毒和改良版本,如R-miniCHOP,作为80岁以上健康老年人的替代选择。对于有心脏合并症的老年患者,R-CEOP (R-CHOP用依托泊苷替代阿霉素)已被证明具有治疗潜力。对于健康、不健康和虚弱的高龄DLBCL患者(≥85岁,大多数≥90岁),初始治疗方案仍然具有挑战性,患者可能最好采用姑息治疗方法。13例患者接受了所有周期的阿霉素治疗。本研究探讨了年龄、东部肿瘤合作组表现状态(ECOG PS)、CIRS-G评分、乳酸脱氢酶(LDH)、肿瘤体积、血红蛋白水平、白蛋白等因素对DLBCL患者预后的影响。每一个
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引用次数: 1
Preface: virus-associated lymphomas 前言:病毒相关淋巴瘤
Pub Date : 2022-01-01 DOI: 10.21037/aol-2022-2
C. Fox, C. Shannon-Lowe
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引用次数: 1
期刊
Annals of lymphoma
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