Lymphoma follicular

Intron A interferon a-2b Schering-Plough Hairy cell leukemia, genital warts, AIDS-related Kaposi s sarcoma, hepatitis C, hepatitis B, malignant melanoma, follicular lymphoma in conjunction with chemotherapy... 

Follicular lymphomas occur in older adults with a majority having advanced disease at diagnosis. The clinical course is generally indolent, with median survival of 8 to 10 years. The natural history of follicular lymphoma is unpredictable with spontaneous regression of objective disease seen in 20% to 30% of patients. 

Options for stage I and II follicular lymphoma include locoregional radiation therapy, chemotherapy followed by radiation therapy, and extended-field radiation therapy. 

Rituximab, a chimeric monoclonal antibody directed at the CD20 molecule on B cells, has become one of the most widely used therapies for follicular lymphoma. Rituximab is approved for first-line therapy either alone or combined with chemotherapy and as maintenance therapy for patients with stable disease or with partial or complete response following induction chemotherapy. 

High-dose chemotherapy followed by HSCT is an option for relapsed follicular lymphoma. The recurrence rate is lower after allogeneic than after autologous HSCT, but the benefit is offset by increased treatment-related mortality. The ideal candidate is young and does not have serious comorbidities. 

Hairy cell leukemia Genital warts AIDS-related Kaposi s sarcoma Non-A non-B hepatitis Hepatitis B Malignant melanoma Chronic viral hepatitis C Follicular lymphoma with chemotherapy June 1986 June 1988 Nov. 1988 Feb. 1991 July 1992 Dec. 1995 March 1997 Nov. 1997... 

Wood, B. L., Bacchi, M. M., Bacchi, C. E., Kidd, P., and Gown, A. M. (1994) Immunocytochemical differentiation of reactive hyperplasia from follicular lymphoma using monoclonal antibodies to cell surface and proliferation-related markers. Appl. Immunohistochem. 2,48-53. 

Zha H, Raffeld M, Charboneau L et al (2004) Similarities of prosurvival signals in Bcl-2-positive and Bcl-2-negative follicular lymphomas identified by reverse phase protein microarray. Lab Invest 84 235-244... 

A major breakthrough in the treatment of lymphoid malignancies was the discovery of monoclonal antibody activity, especially that of rituximab. Rituximab was the first monoclonal antibody approved by the U.S., FDA for the treatment of relapsed follicular lymphoma (1), and it has now been extensively used for the treatment of various lymphoid neoplasm which express CD20 antigen. Its efficacy has been also demonstrated against diffuse large B-cell lymphoma when administered as a combination regimen such as rituximab plus CHOP (R-CHOP) chemotherapy (2). 

This chapter reviews our current understanding of the mechanism of action of monoclonal antibody (especially rituximab), as well as the role of Fey receptor and Fey receptor gene polymorphisms, and their impact on treatment outcomes in hematologic malignancies including follicular lymphoma (FL), diffuse large B-cell lymphoma (DL-BCL), Waldenstrom s macroglobulinemia (WM), and chronic lymphocytic leukemia (CLL). 

Follicular lymphoma (FL) is the most extensively investigated subtype of lymphoid neoplasm regarding the influence of FeyRs polymorphism on treatment Depending on the clinical situation and patients circumstances, there are various options for the treatment for FL. In this chapter, we summarize the impact of FcyR gene pol5miorphisms not... 

The Influence of Single Nucleotide Polymorphism on the Treatment Outcomes for Follicular Lymphoma Patients... 

Abbreviations PFS, progression-free survival FL, follicular lymphoma EFS, event-free survival CR, complete reponse PR, partial response, significant... 

Weng WK, Levy R. Genetic polymorphism of the inhibitory IgG Fc receptor FcRIIb is not associated with clinical outcome of rituximab treated follicular lymphoma patients. Blood 2005 106 683a. 

Weng WK, Rosenberg A, Levy R. Immunoglobulin G Fc receptor polymorphisms and clinical course in follicular lymphoma patients. Blood2004 104 887a. 

Racila E, Weng WK, Wooldridge JE et al. A polymorphism in the ClqA component of complement correlates with prolonged complete remission following rituximab therapy of follicular lymphoma. A/ood 2005 106 229a. 

Niitsu N, Hayama M, Okamoto M et al. Phase I study of Rituximab-CHOP regimen in combination with granulocyte colony-stimulating factor in patients with follicular lymphoma. Clin Cancer Res 2004 10 4077 082. 

Kaminski MS, Tuck M, Estes J, Kolstad A, et al. 2005. 131I-Tositumomab therapy as initial treatment for follicular lymphoma. NEJM. 352 441-449. 

Skommer J, Wlodkowic D, Pelkonen J. 2006. Cellular foundation of curcumin-induced apoptosis in follicular lymphoma cell lines. Exp Hematol 34 463-474. 

Over the past 25 years, there has been a dramatic increase, by over 80%, in the incidence of non-Hodgkin s lymphoma. This is a heterogeneous disease, and the clinical characteristics of non-Hodgkin s lymphoma subsets are related to the underlying histopathologic features and the extent of disease involvement. In general, the nodular (or follicular) lymphomas have a far better prognosis, with a median survival up to 7 years, compared with the diffuse lymphomas, which have a median survival of about 1-2 years. 

The nodular follicular lymphomas are low-grade, indolent tumors that tend to present in an advanced stage and are usually confined to lymph nodes, bone marrow, and spleen. This form of non-Hodgkin s lymphomas, when presenting at an advanced stage, is considered incurable, and treatment is generally palliative. To date, there is no evidence that immediate treatment with combination chemotherapy offers clinical benefit over close observation and "watchful waiting" with initiation of chemotherapy at the time of disease symptoms. 

Rituximab Rituxan/ MabThera- Follicular lymphoma (grade III- IV) CD20-positive non-Hodgkirfs lymphoma 1997... 

CLL/SLL, Chronic lymphocytic leukemia/small lymphocytic lymphoma MCL, mantle cell lymphoma FL, follicular lymphoma MZL/MALT, marginal zone lymphoma/mucosa-associated lymphoid tisuse lymphoma SMZL, splenic marginal zone lymphoma HCL, hairy cell leukemia DLCL, diffuse large-cell lymphoma PCM, plasma cell myeloma BCL-1, cyclin D1 FDC MW, Follicular dendritic cell meshworks CK, cytokeratin LELs, lymphoepitheilal lesions. 

Follicular Lymphoma (FL). These tumors are indolent, primarily nodal, lymphomas and are composed of a mixture of centrocytes and centro-blasts. These lymphomas are graded based on the number of centroblasts, which are the proliferating cells. 

Follicular lymphoma cells, when forming nodules or follicles, are associated with CD21-positive follicular dendritic cell (FDC) meshworks (Fig. 7). These meshworks are often relatively tight and complete fragmentation of the FDCs... 

L2. Lai, R., Weiss, L. M., Chang, K. L., and Arber, D. A., Frequency of CD43 expression in non-Hodgkin lymphoma. A Survey of 742 cases and further characterization of rare CD43+follicular lymphomas. Am. J. Clin. Pathol. Ill, 488-494 (1999). 

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