Net Guides: Non-Hodgkin Lymphoma

OncologyLive, January 2011, Volume 12, Issue 1

Useful Online Resources and Clinical Trials for Non-Hodgkin Lymphoma


Atlas Focuses on Genes, Cytogenetics

The Atlas of Genetics and Cytogenetics in Oncology and Haematology is a free, peer-reviewed online journal whose offerings include a report on the classification of B-cell non-Hodgkin lymphomas (NHLs). The page begins with a summary of the identity of B-cell NHLs as a whole before moving into the clinical characteristics and pathology of each disease. The lymphomas listed include: small lymphocytic, lymphoplasmacytic, follicle centre cell, diffuse large cell, Burkitt, Burkitt-like, mantle cell, and marginal zone B-cell lymphoma. Each disease has brief notes on its phenotype/cell stem origin, clinical traits, and cytogenetics. By clicking on the name of a disease, a more detailed entry may be viewed that includes information such as the grade of the disease, its epidemiology, pathology, treatment, prognosis, morphological and molecular cytogenetics, involved genes and proteins, images, and more.


Lymphoma Research Foundation

The Lymphoma Research Foundation (LRF) is a nonprofit organization dedicated to funding lymphoma research and supporting patients with lymphoma by providing information on the disease. The LRF’s Website has a section devoted to information on NHL. This section includes an overview of the disease and discusses its development, signs and symptoms, risk factors, treatment, and current research. These pages also describe types of NHL and offer links to other resources on NHL in general as well as resources on specific types. The site includes downloadable booklets and fact sheets, educational programs, lymphoma news and press releases, a quarterly newsletter, Webcasts and podcasts, and various support programs. There also are sections for children and adolescents with lymphoma, young adults with lymphoma, and patients who are interested in clinical trials.


Community and expert perspectives: a 2010 update on NHL

Credits: 1.50

Fee: None

Expires: November 30, 2011

This CME activity is based on abstracts related to NHL from the American Society of Clinical Oncology (ASCO) and European Hematology Association (EHA) 2010 meetings. The CME activity consists of 5 slideshows with audio (which may also be downloaded as transcripts), featuring discussions between Dr James O. Armitage, MD, and other experts. Each presentation discusses a different type of NHL: diffuse large B-cell lymphoma, follicular lymphoma, mantle cell lymphoma, T-cell lymphoma, and chronic lymphocytic leukemia. In addition to these slideshows, the CME activity features 2 articles. In one, Armitage summarizes insights into the latest data from the ASCO and EHA meetings. The other features Jack F. Jacoub, MD, offering the perspective of the community physician on these data. After completing this activity, participants should be able to describe how the research data from the 2010 ASCO and EHA meetings relates to the management of patients with NHL. Participants also should have an understanding of how these new data can be incorporated into practice in order to improve patient outcomes and how these data are relevant at the community level.


Feasibility of second hematopoietic stem cell transplantation using reduced-intensity conditioning with fludarabine and melphalan after a failed autologous hematopoietic stem cell transplantation

Journal: Transplantation Proceedings

Authors: Hong JY, Choi MK, Kim DH, et al

Purpose: The purpose of this study was to evaluate whether using reduced-intensity conditioning with fludarabine and melphalan in patients with relapsed hematologic malignancies after a prior autologous hematopoietic stem cell transplantation (HSCT) would make a second HSCT a feasible treatment. In all, 12 patients were included in the study: 7 with multiple myeloma, 3 with NHL, and 2 with acute myeloid leukemia. The graft-versus-host disease prophylaxis was cyclosporine with a minidose of methotrexate.

Results: All patients achieved a neutrophil and platelet engraftment in a median 13.5 days and 17.5 days, respectively. Two patients experienced transplant-related mortality. Grade II-IV acute graft-versus-host disease was noted in 4 patient and chronic extensive graft-versus-host disease was noted in 1 patient. During a median follow-up of 376 days, 5 patients remained alive and without evidence of disease. The estimated rates for nonrelapse mortality, overall survival rate at 1 year, and event-free survival rate at 1 year were 28.4%, 58.3%, and 41.7%, respectively. The authors concluded that allogeneic HSCT using reduced-intensity conditioning with fludarabine and melphalan was feasible for a second HSCT in patients with hematologic malignancies that have relapsed after a failed autologous HSCT.


A study of YM155 plus rituximab in subjects with NHL who have received prior treatment

Study Type: Interventional

Age/Sex Requirements: ≥18 years

Sponsor: Astellas Pharma Inc Identifier: NCT01007292

Purpose: This clinical trial will test the use of the drug YM155 in the treatment of patients with NHL who have failed prior treatment. Patients will receive YM155 and rituximab via intravenous infusion over 14-day cycles. They will then be assessed at the end of each cycle to determine whether they may undergo another cycle. The primary outcome measure of the study will be the objective response rate. Secondary measures include complete remission rate, partial remission rate, time to response, duration of response, clinical benefit rate, progression-free survival, and overall survival. The study will also be evaluating the safety of the combination of YM155 and rituximab based on reports of adverse events, physical examinations, vital signs, laboratory assessments, and electrocardiograms.


Treanda (bendamustine HCI)

Treanda is a drug developed by Cephalon, Inc that is approved for the treatment of chronic lymphocytic leukemia and indolent B-cell NHL that has progressed within 6 months of treatment with rituximab. It is a chemotherapy drug with some of the properties of an alkylator, allowing it to inhibit the growth of new cancer cells and damage the DNA in existing ones. In a clinical trial testing Treanda as a single agent, the overall response rate for patients who experienced disease progression within 6 months of treatment with rituximab was 74% and the median duration of response was 9.2 months. Common non-hematologic side effects of Treanda include nausea, fatigue, vomiting, diarrhea, pyrexia, constipation, anorexia, cough, headache, weight loss, dyspnea, rash, and stomatitis.