Modern Radiation Therapy for Nodal Non-Hodgkin Lymphoma—Target Definition and Dose Guidelines From the International Lymphoma Radiation Oncology Group

Radiation therapy (RT) is that the best single modality for local control of non-Hodgkin lymphoma (NHL) and is a crucial component of therapy for several patients. Many of the historic concepts of dose and volume have recently been challenged by the arrival of recent imaging and RT planning tools. The International Lymphoma Radiation Oncology Group (ILROG) has developed these guidelines after multinational meetings and analysis of obtainable evidence. the rules represent an agreed consensus view of the ILROG committee on the utilization of RT in NHL within the era . The roles of reduced volume and reduced doses are addressed, integrating modern imaging with 3-dimensional planning and advanced techniques of RT delivery. within the era , during which combined-modality treatment with systemic therapy is acceptable , the previously applied extended-field and involved-field RT techniques that targeted nodal regions have now been replaced by limiting the RT to smaller volumes based solely on detectable nodal involvement at presentation. [1]

Non-Hodgkin’s Lymphoma After Primary Hodgkin’s Disease in the German Hodgkin’s Lymphoma Study Group: Incidence, Treatment, and Prognosis

PURPOSE: The cumulative incidence for non-Hodgkin lymphoma’s (NHL) after primary Hodgkin’s disease (HD) ranges between 1% and 6%. to research the course of disease for secondary NHL, we retrospectively analyzed patients treated within clinical trials of the German Hodgkin’s Lymphoma Study Group (GHSG) since 1981.

PATIENTS AND METHODS: From 1981 to 1998, the GHSG conducted three generations of clinical trials for the treatment of primary HD involving a complete of 5,406 patients. Reference histology by an expert panel was obtained for 4,104 of the patients. Data on incidence, treatment, and outcome of secondary NHL were updated in March 1999. [2]

Testicular lymphoma.

Non-Hodgkin’s lymphoma of the testis is an uncommon disease. It accounts for about 9% of testicular neoplasms. Despite this low overall incidence, however, it’s the foremost common testicular malignancy within the elderly. Testicular lymphoma features a rather high incidence of bilateral involvement and a propensity for extranodal spread to the skin, subcutaneous tissue, CNS, lung, and Waldeyer’s ring. Although intermediate-grade diffuse large B-cell lymphoma is that the commonest histologic pattern among primary testicular lymphoma, secondary infiltration of the testis, especially in high-grade Burkitt’s lymphoma, is more prevalent. Although excellent results with a doxorubicin-containing chemotherapy regimen are achieved in early-stage disease, patients with advanced disease have a grave prognosis. [3]

Safety and feasibility of anti-CD19 CAR T cells with fully human binding domains in patients with B-cell lymphoma

Anti-CD19 chimeric antigen receptor (CAR)-expressing T cells are an efficient treatment for B-cell lymphoma, but often cause neurologic toxicity. We treated 20 patients with B-cell lymphoma on a phase I clinical trial , first-in-human clinical test of T cells expressing the new anti-CD19 CAR Hu19-CD828Z (NCT02659943). the first objective was to assess safety and feasibility of Hu19-CD828Z T-cell therapy. Secondary objectives included assessments of blood levels of CAR T cells, anti-lymphoma activity, second infusions and immunogenicity. All objectives were met. Fifty-five percent of patients who received Hu19-CD828Z T cells obtained complete remission. Hu19-CD828Z T cells had clinical anti-lymphoma activity almost like that of T cells expressing FMC63-28Z, an anti-CD19 CAR tested previously by our group, which contains murine binding domains and is employed in axicabtagene ciloleucel. [4]

A Rare Case Report of Duodenal Marginal Zone B-cell Lymphoma Related to Immunoproliferative Small Intestinal Disease and Associated Lymphoma (IPSID)

Marginal zone B-cell lymphoma may be a unique lymphoma of the alimentary canal most ordinarily in developing countries with poor socioeconomic conditions, poor hygiene, malnutrition, and a high degree of intestinal infections where IPSID is common.

We experienced a rare case of extranodal MZBCL in duodenum (sub sort of MALT) during a 14-year-old girl who complained of epigastric pain.

Abdominal computerized tomography (CT) with Intravenous (IV) contrast showed mixed mass infiltrate the intestinal wall with mesenteric lymphadenopathy.

Upper alimentary canal endoscopy had showed obstruction within the 2nd segment of duodenum, biopsies were taken. [5]

Reference

[1] Illidge, T., Specht, L., Yahalom, J., Aleman, B., Berthelsen, A.K., Constine, L., Dabaja, B., Dharmarajan, K., Ng, A., Ricardi, U. and Wirth, A., 2014. Modern radiation therapy for nodal non-Hodgkin lymphoma—target definition and dose guidelines from the International Lymphoma Radiation Oncology Group. International Journal of Radiation Oncology* Biology* Physics, 89(1), (Web Link)

[2] Rueffer, U., Josting, A., Franklin, J., May, M., Sieber, M., Breuer, K., Engert, A. and Diehl for the German Hodgkin’s Lymphoma Study Group, V., 2001. Non-Hodgkin’s lymphoma after primary Hodgkin’s disease in the German Hodgkin’s Lymphoma Study Group: incidence, treatment, and prognosis. Journal of clinical oncology, 19(7), (Web Link)

[3] Shahab, N. and Doll, D.C., 1999, June. Testicular lymphoma. In Seminars in oncology (Web Link)

[4] Safety and feasibility of anti-CD19 CAR T cells with fully human binding domains in patients with B-cell lymphoma
Jennifer N. Brudno, Norris Lam, Danielle Vanasse, Yueh-wei Shen, Jeremy J. Rose, John Rossi, Allen Xue, Adrian Bot, Nathalie Scholler, Lekha Mikkilineni, Mark Roschewski, Robert Dean, Raul Cachau, Philippe Youkharibache, Rashmika Patel, Brenna Hansen, David F. Stroncek, Steven A. Rosenberg, Ronald E. Gress & James N. Kochenderfer
Nature Medicine (2020) (Web Link)

[5] Aljarad, Z., Nasser, M., Ghazal, A., Alkhaled, M., Obeed, B., Shaghaleh, M. and Alhussein, M. W. (2017) “A Rare Case Report of Duodenal Marginal Zone B-cell Lymphoma Related to Immunoproliferative Small Intestinal Disease and Associated Lymphoma (IPSID)”, Journal of Advances in Medicine and Medical Research, 20(8), (Web Link)

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