Adult Non-Hodgkin Lymphoma Treatment–for health professionals (PDQ®)
Changes to This Summary (11/06/2015)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Added two diseases to the list of PDQ modification of Revised European American Lymphoma classification of lymphoproliferative diseases: posttransplantation lymphoproliferative disorder and plasmablastic lymphoma.
Added text to state that in previously treated patients, the B-cell receptor-inhibitor ibrutinib was given to 63 symptomatic patients, with a response rate of 90%, 2-year progression-free survival (PFS) of 69%, and 2-year overall survival (OS) of 95% (cited Treon as reference 49 and level of evidence 3iiiDiv).
Added plasmablastic lymphoma to list of new subtypes.
Added Tse et al. as reference 53.
Added text to state that asymptomatic patients with low-risk scores on the International Prognostic Index may do well when initial therapy is deferred (cited Martin et al. as reference 149 and level of evidence 3iiiDiv).
Added text to state that the B-cell receptor-inhibitor ibrutinib showed a response rate of 86% in previously treated patients with a median PFS of 14 months (cited Wang et al. as reference 162 and level of evidence 3iiiDiv).
Revised subsection title to read Posttransplantation Lymphoproliferative Disorder.
Added Plasmablastic Lymphoma as a new subsection.
Added text to state that in a retrospective study of 130 patients with diffuse large B-cell lymphoma, positron emission–tomography scanning identified all clinically important marrow involvement from lymphoma, and bone marrow biopsy did not upstage any patient (cited Khan et al. as reference 10). Bone marrow biopsies are required for some clinical trials and when the identification of marrow involvement would change the therapeutic plan.
Added idelalisib to the list of standard treatment options for indolent, noncontiguous stage II/III/IV adult NHL.
Added Kahl et al. as reference 26.
Added Federico et al. as reference 34.
Added Idelalisib as a new subsection.
Added text to state that in the RESORT study, 289 previously untreated patients with asymptomatic, low-burden disease were randomly assigned to rituximab induction alone, with a re-treatment strategy that used rituximab at relapse, or rituximab induction plus maintenance rituximab every 13 weeks until treatment failure (added level of evidence 1iiC). Also added that with a median follow-up of 4.5 years, there was no difference in median time-to-treatment failure or in health-related quality of life; a re-treatment strategy achieved comparable disease control using significantly fewer doses of rituximab.
Added text to state that in a randomized prospective trial, 619 patients with relapsed or refractory aggressive lymphoma received either R-DHAP (rituximab, dexamethasone, high-dose cytarabine, and cisplatin) or R-GDP (rituximab, gemcitabine, dexamethasone, and cisplatin) followed by autologous stem cell transplantation; at a median follow-up of 53 months, there was no difference in event-free survival or OS, but patients who received R-GDP reported less toxicity (cited Crump et al. as reference 17 and level of evidence 1iiC).
Added text to state that a multicenter retrospective analysis of 50 patients described pregnancy termination in 3 patients, deferral of therapy to postpartum in 15 patients, and antenatal therapy applied to the remaining 32 patients. Also added that with a median follow-up of 41 months, the 3-year PFS was 53%, and OS was 82%, using R-CHOP (rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisone) or modifications of this regimen (cited Evens et al. as reference 7 and level of evidence 3iiiDiv).
This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ® - NCI's Comprehensive Cancer Database pages.
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