Follicular Lymphoma

Zevalin and Rituxan for relapsed large cell lymphoma or for consolidation – pro

Zevalin, 90Y-ibritumomab tiuxetan, is a novel radioimmunotherapeutic agent approved forthe treatment of relapsed or refractory, low-grade or follicular B-cell non-Hodgkin's lymphoma (NHL). Zevalin is also indicated for the treatment of previously untreated follicular NHL in patients who achieve a partial or complete response to first-line chemotherapy. 90Y-ibritumomab tiuxetan consists of a murine monoclonal antibody covalently attached to a metal

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PET for lymphomas – pro

Although CT remains the gold standard for the staging and follow-up of malignant lymphomas, 18F-FDG PET has a potential role in accurately staging disease and in predicting response to therapy. This role has the potential to affect both the initial choice of chemotherapy and the decision to alter management based on the initial response to therapy . PET performed early in a chemotherapeutic regimen has demonstrated a role in identifying patients

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Low Grade Follicular Lymphoma Treatment – pro

Lay Summary: I review options for follicular lymphoma treatment. Patients with low-grade non-Hodgkin's lymphoma (NHL) have a median survival of 4-8 years from diagnosis and a cause-specific survival of about 10 years. Radiotherapy can be curative in a small proportion of patients with very localized disease, but the majority of patients have advanced disease at diagnosis and it is not clear that any current therapy is curative in this situation.

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Maintenance Rituxan – pro

Lay Summary: Maintenance rituximab is becoming more common although questions remain about its benefit for DLBCL. The impact of maintenance treatment with rituximab on overall survival is one of the most important open questions for patients with indolent non-Hodgkin lymphoma. Recent randomized trials performed by the German Low Grade Lymphoma Study Group (GLSG) and by the EORTC demonstrated the superiority of rituximab maintenance after immunochemotherapy

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Revlimid for Chronic lymphocytic leukemia – pro

Lay Summary: Revlimid is promising for CLL. Revlimid is an orally administered derivative of thalidomide, which is a very active agent for the treatment of multiple myeloma but has serious side effects, especially thromboembolism. Revlimid is reported to have less toxicity than thalidomide but retains antimyeloma effects. Revlimid has recently been approved by the FDA for review of treatment of myelodysplastic syndromes (MDS) wih a 5q- mutation and

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Transformed follicular lymphoma – pro

Lay Summary: Transplants for transformed follicular lymphoma are supported by follicular lymphoma (transformed) guidelines of the NCCN. There is trial evidence supporting this approach. Takvorian and colleagues (1987) studied 49 patients with either high-grade (n = 29), intermediate-grade (n =14) or low-grade (n = 6) lymphoma. All patients were considered to have a poor prognosis either due to relapse (n = 41) or poor prognostic factors (n = 8).

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Autologous stem cell transplant for follicular lymphoma – pro

Follicular lymphoma is a low-grade lymphoma. This means that it is not generally curable with chemotherapy; at the same time, it grows slowly and tends to have a response and recurrence pattern. It cannot be cured by conventional chemotherapy but is sometimes cured with high dose chemo and transplantation. There are now 3 conflicitng studies of autologous transplant for follicular lymphoma but guidelines now recommend it. However, they recommend

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Gemzar and Navelbine salvage for lympnoma – pro

Gemcitabine, vinorelbine and prednisone or otehr drugs are being investigated to treat refractory or relapsed aggressive non-Hodgkin lymphomas (NHL). Lay Summary: Gemcitabine and vinorelbine are somewhat effective but toxic when few options remain, but more investigation is needed.   The optimum therapy for patients with relapsed or refractory aggressive NHL not qualifying for platinum-based and/or high-dose chemotherapy is not known. In one 

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How long to follow after remission of lymphoma – pro

Although CT remains the gold standard for the staging and follow-up of malignant lymphomas, 18F-FDG PET has a potential role in accurately staging disease and in predicting response to therapy. ON the otherhand, guidelines do not recommend MRI for surveillance.  2012 NCCN Guidelines for DLBCLon p. BCEL-4  recommend CT no more often than every 6 months for 2 years after completion oftreatment, then only as clicnally indicated. In contrast to the

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R-ASHAP regimen for salvage of lymphoma – pro

R-ASHAP chemotherapy is - rituximab, doxorubicine, methylprednisolone, high-dose cytarabine, cisplatin. This is fairly new regimen  with only a few reports of observational studies. There are no randomized controlled trials comparing different conventional dose salvage chemotherapy regimens (PACEBOM, ESHAP, RICE, IVAC) in people with relapsed aggressive non-Hodgkin's lymphoma. The consensus is that people with relapsed disease should be treated

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