Aggressive NHL
Pathophysiology
World Health Organization classification of neoplastic diseases of the hematopietic and lymphoid tissues: report of the Clinical Advisory Committee Meeting: Airlie House, Virginia, November 1997.
Harris NL, Jaffe ES, Diebold J, et al.
J Clin Oncol. 1999;17:3835-3849.
Description: Revised classification, the standard, for pathologists, clinicians, and researchers to communicate.
PubMed citation number: 10577857
A predictive model for aggressive non-Hodgkin’s lymphoma: the International Non-Hodgkin’s Lymphoma Prognostic Factors Project.
N Engl J Med. 1993;329:987-994.
Description: In this article, the International Prognostic Index (IPI) score and age-adjusted IPI (aaIPI) are presented. These scores serve the clinician as a prognostic aid in classifying patients with DLCL as high risk, intermediate risk (two levels), and low risk. This classification further helps in making treatment plans, such as transplantation.
PubMed citation number: 8141877
Diffuse large B cell lymphoma outcome prediction by gene expression profiling and supervised machine learning.
Shipp MA, Ross KN, Tamayo P, et al.
Nat Med. 2002;8:68-74.
Description: Nice model of correlating clinical courses of diffuse large B-cell lymphoma with the various types of gene expression. Not yet standard in clinical practice, but helpful in understanding the diversity of DLCL.
PubMed citation number: 11786909
Prediction of survival in diffuse large B-cell lymphoma based on the expression of six genes.
Lossos IS, Czerwinski DK, Alizadeh AA, et al.
N Engl J Med. 2004;350:1828-2837.
Description: Univariate analysis of 36 genes shown to be expressed in DLBCL showed 6 to be highly correlated with outcome.
PubMed citation number: 15115829
The use of molecular profiling to predict survival after chemotherapy for diffuse large-B-cell lymphoma
Rosenwald A, Wright G, Chan WC, et al, for the Lymphoma/Leukemia Molecular Profiling Project.
N Engl J Med. 2002;346:1937-1947.
Description: Gene profiling identified 3 gene expression subgroups of DLBCL: “germinal-center B-cell–like,” “activated B-cell–like,” and “type 3 diffuse large-B-cell lymphoma.” Subgroup predicted 5-year overall survival independent of IPI.
PubMed citation number: 12075054
Review
Primary mediastinal B cell lymphoma: a review of pathology and management.
Van Besien K, Kelta M, Bahaguna P.
J Clin Oncol. 2001;19:1855-1864.
Description: Review of a distinct subtype of diffuse large-cell NHL. This review includes diagnosis, pathology, staging, and treatment options.
PubMed citation number: 11251018
Management of Adult Aggressive Non-Hodgkin’s Lymphomas.
Bernard C, Dujols J-P, Mokhtari F, Norkowski J-L, Slawinski J-C, Schlaifer D.
Crit Rev Oncol Hematol. 2000;35:33-48.
Description: A good review of treatment options in the various stages of aggressive NHL.
PubMed citation number: 10863150
Treatment
Chemotherapy alone compared with chemotherapy plus radiotherapy for localized intermediate and high grade Non-Hodkin’s Lymphoma.
Miller TP, Dahlberg S, Cassady RJ, et al.
N Engl J Med. 1998;339:21-26.
Description: Establishing a standard of care for early stage DLCL (stages I and II), incorporating fewer doses of chemotherapy and radiation therapy.
PubMed citation number: 9647875
Chemotherapy with or without radiotherapy in limited-stage diffuse aggressive non-Hodgkin’s lymphoma: Eastern Cooperative Oncology Group Study 1484.
Horning SJ, Weller E, Kim K, et al.
J Clin Oncol. 2004;22:3032-3038.
Description: Increased 6-year overall survival with radiotherapy after chemotherapy for limited-stage disease. PubMed citation number: 15210738
Comparison of standard regimen (CHOP) with three intensive chemotherapy regimens for advanced non-Hodgkin’s lymphoma.
Fisher RJ, Gaynor ER, Dahlberg S, et al.
N Engl J Med. 1993;328:1002-1006.
Description: CHOP chemotherapy is the standard regimen for DLCL NHL. This study is a prospective randomized phase 3 trial comparing CHOP with 3 other regimens in NHL. There was no difference in outcomes re-establishing CHOP as the standard of care for the first-line treatment of DLCL.
PubMed citation number: 7680764
CHOP chemotherapy plus rituximab compared to CHOP alone in elderly patients with diffuse large B-cell lymphoma.
Coiffier B, Lepage E, Briere J, et al.
N Engl J Med. 2002;346:235-242.
Description: Landmark study that changed standard of care for CD20 plus DLCL.
PubMed citation number: 11807147
Survival benefit of high-dose therapy in poor-risk aggressive non-Hodgkin's lymphoma: final analysis of the prospective LNH87-2 protocol--a groupe d'Etude des lymphomes de l'Adulte study.
Haioun C, Lepage E, Gisselbrecht C, et al.
J Clin Oncol. 2000;18:3025-3030.
Description: This article describes a potential role for transplantation for patients with high-risk aggressive non-Hodgkin’s Lymphoma based on IPI score. Data from a randomized trial in poor-risk patients definitively address the issue.
PubMed citation number: 10944137
Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive Non-Hodgkin’s lymphoma.
Philip T, Guglielmi C, Hagenbeek A, et al.
N Engl J Med. 1995;333:1540-1545.
Description: This article describes a role for transplantation in patients with aggressive Non-Hodgkin’s lymphoma in first relapse.
PubMed citation number: 7477169
High-dose chemoradiotherapy and autologous stem cell transplantation for patients with primary refractory aggressive non-Hodgkin lymphoma: an intention-to-treat analysis.
Kewalramani T, Zelenetz AD, Hedrick EE, et al.
Blood. 2000;96:2399-2404.
Description: Supports the use of autologous stem cell transplantation in patients with primary refractory aggressive NHL.
PubMed citation number: 11001890
Rituximab and ICE as second-line therapy before autologous stem cell transplantation for relapsed or primary refractory diffuse large B-cell lymphoma.
Kewalramani T, Zelenetz AD, Nimer SD, et al.
Blood. 2004;103:3684-3688.
Description: R-ICE is an effective conditioning regimen that allows for optimal stem cell harvest prior to transplantation for relapsed/refractory DLBCL.
PubMed citation number: 14739217