Abstract
The rate of increase in the incidence of non-Hodgkin lymphoma (NHL) is outstripping that of other cancers. NHL is increasingly being treated in the context of immune compromise due to age or concomitant disease. Whilst most NHLs fall into the clearly aggressive and indolent categories, it is clear that distinction of less common entities such as Burkitt and mucosa-associated lymphoid tissue (MALT) lymphomas is essential for appropriately targeted treatment. Better diagnostic tools including the WHO histopathological criteria and quality imaging systems for CT, magnetic resonance imaging (MRI), and positron emission tomography (PET) scanning have facilitated accurate disease classification. Prognostic indices have been validated for both aggressive and indolent disease, and multidisciplinary input into diagnosis and management has proved beneficial.
Aggressive disease can be cured in most patients. Survival advantages have been shown with modification of the CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone) regimen including acceleration to a 14-day cycle supported by granulocyte colony-stimulating factor and combination with rituximab. Indolent disease remains incurable for the majority of patients but the therapeutic armamentarium has widened considerably. Radiotherapy has hitherto provided synergistic support for standard treatment; the introduction of radioimmunoconjugates has extended its curative potential to include advanced disease. Salvage with the potential for cure has become attainable in relapsed and refractory disease.
Autologous transplantation can now safely be performed in older patients because of more rapid engraftment with the use of mobilized peripheral stem cells, and better supportive care. The development of reduced-intensity conditioning for allograft has resulted in a significant reduction in transplant-related mortality when compared with the conventional approach. Allograft is no longer only for the young and fit. Exploitation of a graft versus lymphoma effect with donor lymphocyte infusion has been demonstrably effective, particularly in indolent disease.
Molecular strategies and vaccine therapies have been successful in early trials. Antiangiogenic agents and proteasome inhibitors show potential. Advances in treatment have been attained with both rigorous application and extension of historically successful treatment, and with development of experimental approaches in vitroand in vivo.Introduction of genomic and proteomic assessment into routine clinical practice will undoubtedly impact on the management of NHL in the future.
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References
Cancer facts & figures 2004. Atlanta (GA): American Cancer Society, 2004
Baris D, Zahm SH. Epidemiology of lymphomas. Curr Opin Oncol 2000Sep; 12(5): 383–94
A predictive model for aggressive non-Hodgkin’s lymphoma. The International Non-Hodgkin’s Lymphoma Prognostic Factors Project N Engl J Med 1993Sep 30; 329(14): 987–94
Solal-Celigny P, Roy P, Colombat P, et al. Follicular lymphoma international prognostic index. Blood 2004Sep 1; 104(5): 1258–65
Bain BJ, Clark DM, Lampert IA, et al. Bone marrow pathology. 3rded. Oxford: Blackwell Science, 2001
Dojcinov S. Differential diagnosis of clinical non-aggressive non-Hodgkin’s lymphoma [online]. Available from URL: http://http://www.lymphoma.org.uk [Accessed 2001 Aug 1]
FitzGerald R, Mehra R. How accurate is cancer scan reporting? Hosp Med 2000Sep; 61(9): 637–42
Shah N, Hoskin P, McMillan A, et al. The impact of FDG positron emission tomography imaging on the management of lymphomas. Br J Radiol 2000May; 73 (869): 482–7
Elstrom R, Guan L, Baker G, et al. Utility of FDG-PET scanning in lymphoma by WHO classification. Blood 2003May 15; 101(10): 3875–6
Maisey NR, Hill ME, Webb A, et al. Are 18fluorodeoxyglucose positron emission tomography and magnetic resonance imaging useful in the prediction of relapse in lymphoma residual masses? Eur J Cancer 2000Jan; 36(2): 200–6
Cheson BD, Horning SJ, Coiffier B, et al. Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphomas. NCI Sponsored International Working Group. J Clin Oncol 1999Apr; 17(4): 1244
Fields P, Goldstone AH. Non-Hodgkin’s lymphomas: clinical governance issues. Best Pract Res Clin Haematol 2002; 15(3): 577–96
Brandt L, Kimby E, Nygren P, et al. A systematic overview of chemotherapy effects in indolent non-Hodgkin’s lymphoma. Acta Oncol 2001; 40(2–3): 213–23
Kimby E, Brandt L, Nygren P, et al. SBU-Group. A systematic overview of chemotherapy effects in aggressive non-Hodgkin’s lymphoma. Acta Oncol 2001; 40(2–3): 198–212
Briggs JH, Algan O, Miller TP, et al. External beam radiation therapy in the treatment of patients with extranodal stage IA non-Hodgkin’s lymphoma. Am J Clin Oncol 2002Feb; 25(1): 34–7
Lote K, Holte H, Nome O, et al. Stage I high-grade non-Hodgkin’s lymphoma. Acta Oncol 2000; 39(7): 865–72
Briggs JH, Miller TP. Combined chemotherapy plus radiotherapy for treatment of early-stage intermediate- and high-grade non-Hodgkin’s lymphoma. Curr Oncol Rep 2000Mar; 2(2): 176–81
Miller TP, Dahlberg S, Cassady JR, et al. Chemotherapy alone compared with chemotherapy plus radiotherapy for localized intermediate- and high-grade non-Hodgkin’s lymphoma. N Engl J Med 1998Jul 2; 339(1): 21–6
Adding radiotherapy to CHOP improves results for early- or limited-stage non-Hodgkin lymphoma. Oncology News International 2002 Feb; 11 (2 Suppl 1)
Canales MA, Fernandez-Jimenez MC, Martin A, et al. Identification of factors associated with poor peripheral blood progenitor cell mobilization in Hodgkin’s disease. Haematologica 2001May; 86(5): 494–8
Hagenbeeck A, Eghbali H, Monfardini S, et al. Fludarabine compared with CVP chemotherapy in newly diagnosed patients with stages III and IV low grade malignant non-Hodgkin’s lymphoma: final analysis of a prospective randomised phase III intergroup study in 381 patients [abstract]. Blood 2001; 98: 3501
McLaughlin P, Hagemeister FB, Romaguera JE, et al. Fludarabine, mitoxantrone and dexamethasone: an effective new regimen for indolent lymphoma. J Clin Oncol 1996; 14: 1262–8
Hochster HS, Oken MM, Winter JN, et al. Phase I study of fludarabine plus cyclophosphamide in patients with previously untreated low-grade lymphoma: results and long-term follow-up: a report from the Eastern Cooperative Oncology Group. J Clin Onol 2000; 18: 987–94
Flinn IW, Byrd JC, Morrison C, et al. Fludarabine and cyclophosphamide with filgrastim support in patients with previously untreated indolent lymphoid malignancies. Blood 2000; 96: 71–5
Hochster H, Weller E, Kuzel T, et al. Increased mortality associated with higher dose cyclophosphamide plus fludarabine (CF) in advanced stage indolent lymphoma patients treated on E1496, an Eastern Cooperative Oncology Group (ECOG) and CALGB study [abstract 1125]. Proc Am Soc Clin Oncol 2002;21: 282a
McLaughlin P. Biotherapy for lymphoma. Curr Oncol Rep 2000; 2: 157–62
Haase-Statz S, Smalley RV. Role of interferon alfa in non-Hodgkin’s lymphoma: still controversial? Oncology (Huntingt) 1999Aug; 13(8): 1147–59
Rohatiner AZ, Gregory WM, Peterson B, et al. Meta-analysis to evaluate the role of interferon in follicular lymphoma. J Clin Oncol 2005; 23(10): 2215–23
Ahmad A, Govil Y, Frank BB. Gastric mucosa-associated lymphoid tissue lymphoma. Am J Gastroenterol 2003May; 98(5): 975–86
Baidas SM, Cheson BD, Kauh J, et al. Mantle cell lymphoma: clinicopathologic features and treatments. Oncology (Huntingt) 2003Jun; 17(6): 879–91, 896
Hiddemann W. Non-Hodgkin’s lymphomas: current status of therapy and future perspectives. Eur J Cancer 1995Dec; 31A(13–14): 2135–7
Itoh K, Ohtsu T, Wakita H, et al. Dose-escalation study of CHOP with or without prophylactic G-CSF in aggressive non-Hodgkin’s lymphoma. Ann Oncol 2000Oct; 11(10): 1241–7
Pfreundschuh M, Trumper L, Kloess M, et al. Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of elderly patients with aggressive lymphomas: results of the NHL-B2 trial of the DSHNHL. Blood 2004; 104(3): 634–41
Pfreundschuh M, Trumper L, Kloess M, et al. Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of young patients with good-prognosis (normal LDH) aggressive lymphomas: results of the NHL-B1 trial of the DSHNHL. Blood 2004; 104(3): 626–33
Mainwaring PN, Cunningham D, Gregory W, et al. Mitoxantrone is superior to doxorubicin in a multiagent weekly regimen for patients older than 60 with high-grade lymphoma: results of a BNLI randomised trial of PAdriaCEBO versus PMitCEBO. Blood 2001May 15; 97(10): 2991–7
Mead GM, Sydes MR, Walewski J, et al. An international evaluation of CODOX-M and CODOX-M alternating with IVAC in adult Burkitt’s lymphoma: results of United Kingdom Lymphoma Group LY06 study. Ann Oncol 2002Aug; 13(8): 1264–74
Reiser M, Josting A, Soltani M, et al. T-cell non-Hodgkin’s lymphoma in adults: clinicopathological characteristics, response to treatment and prognostic factors. Leuk Lymphoma 2002Apr; 43(4): 805–11
Vose JM, Zhang MJ, Rowlings PA, et al. Autologous transplantation for diffuse aggressive non-Hodgkin’s lymphoma in patients never achieving remission: a report from the Autologous Blood and Marrow Transplant Registry. J Clin Oncol 2001Jan 15; 19(2): 406–13
Zinzani PL, Tani M, Molinari AL, et al. Ifosfamide, epirubicin and etoposide regimen as salvage and mobilizing therapy for relapsed/refractory lymphoma patients. Haematologica 2002Aug; 87(8): 816–21
Cortelazzo S, Rambaldi A, Rossi A, et al. Intensification of salvage treatment with high-dose sequential chemotherapy improves the outcome of patients with refractory or relapsed aggressive non-Hodgkin’s lymphoma. Br J Haematol 2001Aug; 114(2): 333–41
Bouabdallah R, Stoppa AM, Coso D, et al. Clinical outcome after front-line intensive sequential chemotherapy (ISC) in patients with aggressive non-Hodgkin’s lymphoma and high-risk international prognostic index (IPI3): final analysis of survival in two consecutive ISC trials. Ann Oncol 2001Apr; 12(4): 513–7
Watts MJ, Ings SJ, Leverett D, et al. ESHAP and G-CSF is a superior blood stem cell mobilizing regimen compared to cyclophosphamide 1.5g/m@@@2@@ and G-CSF for pre-treated lymphomal patients: a matched pairs analysis of 78 patients. Br J Cancer 2000Jan; 82(2): 278–82
Gazitt Y, Shaughnessy P, Liu Q. Differential mobilization of CD 34+ cells and lymphoma cells in non-Hodgkin’s lymphoma patients mobilized with different growth factors. J Hematother Stem Cell Res 2001Feb; 10(1): 167–76
Rick O, Beyer J, Kingreen D, et al. Successful autologous bone marrow rescue in patients who failed peripheral blood stem cell mobilization. Ann Hematol 2002Dec; 79(12): 681–6
Vellenga E, vanAgthoven M, Croockewit AJ, et al. Autologous peripheral blood stem cell transplantation in patients with relapsed lymphoma results in accelerated haematopoietic reconstitution, improved quality of life and cost reduction compared with bone marrow transplantation: the Hovon 22 study. Br J Haematol 2001Aug; 114(2): 319–27
Kanteti R, Miller K, McCann J, et al. Randomized trial of peripheral blood progenitor cell vs bone marrow as hematopoietic support for high-dose chemotherapy in patients with non-Hodgkin’s lymphoma and Hodgkin’s disease: a clinical and molecular analysis. Bone Marrow Transplant 1999; 24: 473–81
Bensinger WI, Storb R. Allogeneic peripheral blood stem cell transplantation. Rev Clin Exp Hematol 2001Jun; 5(2): 67–86
Zallio F, Cuttica A, Caracciolo D, et al. Feasibility of peripheral blood progenitor cell mobilization and harvest to support chemotherapy intensification in elderly patients with poor prognosis: non-Hodgkin’s lymphoma. Ann Hematol 2002Aug; 81(8): 448–53
Deconinck E, Foussard C, Milpied N, et al. High dose therapy followed by autologous purged stem cell transplantation and doxorubicin based chemotherapy in patients with advanced follicular lymphoma: a randomized multicenter study by the GOELAMS. Blood 2005; 105(10): 3817–23
Freedman AS, Neuberg D, Mauch P, et al. Long-term follow-up of autologous bone marrow transplantation in patients with relapsed follicular lymphoma. Blood 1999Nov 15; 94(10): 3325–33
Oinonen R, Jantunen E, Itala M, et al. Autologous stem cell transplantation in patients with mantle cell lymphoma. Leuk Lymphoma 2002Jun; 43(6): 1229–37
Philip T, Guglielmi C, Hagenbeek A, et al. Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin’s lymphoma. N Engl J Med 1995Dec 7; 333(23): 1540–5
Hahn T, Wolff S, Czuczman M, et al. The role of cytotoxic therapy with hematopoietic stem cell transplantation in the therapy of diffuse large cell B-cell non-Hodgkin’s lymphoma: an evidence-based review. ASBMT expert panel report. Biol Blood Marrow Transplant 2001; 7: 308–31
Kluin-Nelemans HC, Zagonel V, Anastasopoulou A, et al. Standard chemotherapy with or without high-dose chemotherapy for aggressive non-Hodgkin’s lymphoma: randomized phase III EORTC study. J Natl Cancer Inst 2001Jan 3; 93(1): 22–30
Kaiser U, Uebelacker I, Abel U, et al. Randomized study to evaluate the use of high-dose therapy as part of primary treatment for “aggressive” lymphoma. J Clin Oncol 2002Nov 15; 20(22): 4413–9
Milligan DW, Ruiz DeElvira MC, Kolb HJ, et al. Secondary leukaemia and myelodysplasia after autografting for lymphoma: results from the EBMT: EBMT Lymphoma and Late Effects Working Parties, European Group for Blood and Marrow Transplantation. Br J Haematol 1999; 106: 1020–6
Peniket AJ, Ruiz deElvira MC, Taghipour G, et al. An EBMT registry matched study of allogeneic stem cell transplants for lymphoma: allogeneic transplantation is associated with a lower relapse rate but a higher procedure-related mortality rate than autologous transplantation. Bone Marrow Transplant 2003Apr; 31(8): 667–78
Bierman PJ. Allogeneic bone marrow transplantation for lymphoma. Blood Rev 2000Mar; 14(1): 1–62
Freytes CO, Loberiza FR, Rizzo JD, et al. Myeloablative allogeneic hematopoietic stem cell transplantation in patients who experience relapse after autologous stem cell transplantation for lymphoma: a report of the International Bone Marrow Transplant Registry. Blood 2004; 104(12): 3797–803
Chopra R, Goldstone AH, Pearce R, et al. Autologous versus allogeneic bone marrow transplantation for non-Hodgkin’s lymphoma: a case-controlled analysis of the European Bone Marrow Transplant Group Registry data. J Clin Oncol 1992; 10: 1690–5
vanBesien K, deLima M, Giralt S, et al. Management of lymphoma recurrence after allogeneic transplantation: the relevance of graft-versus-lymphoma effect. Bone Marrow Transplant 1997; 19: 977–82
Morris E, Thomson K, Craddock C, et al. Outcomes after alemtuzumab-containing reduced-intensity allogeneic transplantation regimen for relapsed and refractory non-Hodgkin lymphoma. Blood 2004; 104(13): 3865–71
Peggs KS, Mackinnon S. Clinical trials with CMV-specific T cells. Cytotherapy 2002; 4(1): 21–8
Robinson SP, Goldstone AH, Mackinnon S, et al. Chemoresistant or aggressive lymphoma predicts for a poor outcome following reduced-intensity allogeneic progenitor cell transplantation: an analysis from the Lymphoma Working Party of the European Group for Blood and Bone Marrow Transplantation. Blood 2002Dec 15; 100(13): 4310–6
Khouri IF, Saliba RM, Giralt SA, et al. Nonablative allogeneic hematopoietic transplantation as adoptive immunotherapy for indolent lymphoma: low incidence of toxicity, acute graft-versus-host disease, and treatment-related mortality. Blood 2001Dec 15; 98(13): 3595–9
Onrust SV, Lamb HM, Barman Balfour JA. Rituximab. Drugs 1999; 58(1): 79–88
McLaughlin P, Grillo-Lopez AJ, Link BK, et al. Rituximab chimeric anti-CD20 monoclonal antibody therapy for relapsed indolent lymphoma: half of patients respond to a four-dose treatment program. J Clin Oncol 1998Aug; 15(8): 2825–33
Press O, Leonard JP. Immunotherapy of non-Hodgkin’s Lymphomas. Hematology (Am Soc Hematol Educ Program) Jan 2001, 21–40
Coiffier B, Haioun C, Ketterer N, et al. Rituximab (anti-CD20 monoclonal antibody) for the treatment of patients with relapsing or refractory aggressive lymphoma: a multicenter phase II study. Blood 1998; 92: 1927–32
Hainsworth JD, Burrism HA, Morrissey LH, et al. Rituximab monoclonal antibody as initial systemic therapy for patients with low-grade non-Hodgkin lymphoma. Blood 2000; 95: 3052–6
Ghielmini M, Hsu Schmitz SF, Cogliatti SB, et al. Maintenance treatment with 2-monthly rituximab after standard weekly x 4 rituximab induction significantly improves event-free survival in patients with follicular lymphoma [abstract]. Ann Oncol 2002; 13: 112a
Davis TA, Grillo-Lopez AJ, White CA, et al. Rituximab anti-CD20 monoclonal antibody therapy in non-Hodgkin’s lymphoma: safety and efficacy of retreatment. J Clin Oncol 2000; 18: 3135–43
Coiffier B, Lepage E, Briere J, et al. CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med 2002Jan 24; 346(4): 235–42
Pfreundschuh M, Truempe L, Gill D, et al. First analysis of the completed Mabthera International (MInT) Trial in young patients with low-risk diffuse large B-cell lymphoma (DLBCL): addition of rituximab to a CHOP-like regimen significantly improves outcome of all patients with the identification of a very favorable subgroup with IPI=O and no bulky disease [abstract no. 157]. Blood 2004Nov 16; 104: 48a
Marcus R, Imrie K, Belch A, et al. CVP chemotherapy plus rituximab compared with CVP as first-line treatment for advanced follicular lymphoma. Blood 2005Feb 15; 105(4): 1417–23
Lenz G, Dreyling M, Hoster E, et al. Immunochemotherapy with rituximab and cyclophosphamide, doxorubicin, vincristine, and prednisone significantly improves response and time to treatment failure, but not long-term outcome in patients with previously untreated mantle cell lymphoma: results of a prospective randomized trial of the German Low Grade Lymphoma Study Group (GLSG). J Clin Oncol 2005Mar 20; 23(9): 1984–92
Romaguera J, Cabanillas F, Dang N, et al. Mantle cell lymphoma: high rates of complete remission and prolonged failure-free survival with rituxanhyperCVAD without stem cell transplant [abstract no.3030A]. Blood 2001; 98Suppl. 1: 726a
Czuczman MS, Fallon A, Mohr A, et al. Phase II study of rituximab plus fludarabine in patients with low-grade lymphoma (LGL): final report. Blood 2001; 98 Suppl. 1: 601a
Forstpointner R, Dreyling M, Repp R, et al. The addition of rituximab to a combination of fludarabine, cyclophosphamide, mitoxantrone (FCM) significantly increases the response rate and prolongs survival as compared with FCM alone in patients with relapsed and refractory follicular and mantle cell lymphomas: results of a prospective randomized study of the German Low-Grade Lymphoma Study Group. Blood 2004; 104(10): 3064–71
Wilson WH, Gutierrez M, O’Connor P, et al. The role of rituximab and chemotherapy in aggressive B-cell lymphoma: a preliminary report of dose-adjusted EPOCH-R. Semin Oncol 2002; 29: 41–7
Brugger W, Hirsch J, Repp R, et al. Multicenter phase II study with rituximab treatment for follicular and mantle cell lymphoma after high-dose therapy and autologous blood stem cell transplantation [abstract]. Ann Oncol 2002; 13Suppl. 2: 38a
Muti G, Cantoni S, Oreste P, et al. Post-transplant lymphoproliferative disorders: improved outcome after clinico-pathologically tailored treatment. Haematologica 2002Jan; 87(1): 67–77
Friedberg JW, Neuberg D, Gribben JG, et al. Combination immunotherapy with rituximab and interleukin 2 in patients with relapsed or refractory follicular non-Hodgkin’s lymphoma. Br J Haematol 2002Jun; 117(4): 828–34
Ansell SM. Adding cytokines to monoclonal antibody therapy: does the concurrent administration of interleukin-12 add to the efficacy of rituximab in B-cell non-hodgkin lymphoma? Leuk Lymphoma 2003; 44(8): 1309–15
Hagenbeek A, Czuczman MS, Ghielmini M, et al. Rituximab therapy for indolent non-Hodgkin’s lymphoma. Anticancer Drugs 2002; 13 Suppl. 2: S11–7
Witzig TE, White CA, Wiseman GA, et al. Phase I/II trial of IDEC-Y2B8 radioimmunotherapy for treatment of relapsed or refractory CD20+ B-cell non-Hodgkin’s lymphoma. J Clin Oncol 1999; 17: 3793–803
Wiseman GA, White CA, Sparks RB, et al. Biodistribution and dosimetry results from a phase III prospectively randomised controlled trial of Zevalin radioimmunotherapy for low-grade, follicular, or transformed B-cell non-Hodgkin’s lymphoma. Crit Rev Oncol Hematol 2001Jul–Aug; 39(1–2): 181–4
Witzig TE, Flinn IW, Gordon LI, et al. Treatment with Ibritumomab tiuxetan radioimmunotherapy in patients with rituximab-refractory follicular non-Hodgkin’s lymphoma. J Clin Oncol 2002; 20: 3262–8
Kaminski MS, Tuck M, Estes J, et al. 131I-tositumomab therapy as initial treatment for follicular lymphoma. N Engl J Med 2005; 352(5): 441–9
Connors JM. Radioimmunotherapy: hot new treatment for lymphoma. N Engl J Med 2005; 352(5): 496–8
Horning SJ, Younes A, Jain V, et al. Efficacy and safety of tositumomab and iodine-131 tositumomab (Bexxar) in B-cell lymphoma, progressive after rituximab. J Clin Oncol 2005; 23(4): 712–9
Lundin J, Osterborg A, Brittinger G, et al. CAMPATH-1H monoclonal antibody in therapy for previously treated low-grade non-Hodgkin’s lymphomas: a Phase II multicenter study. J Clin Oncol 1998; 16: 3257–63
Siegel AB, Goldenberg DM, Cesano A, et al. CD22-directed monoclonal antibody therapy for lymphoma. Semin Oncol 2003; 30(4): 457–64
Linden O, Tennvall J, Hindorf C, et al. 131I-labelled anti-CD22 MAb (LL2) in patients with B-cell lymphomas failing chemotherapy. Acta Oncol 2001May; 41(3): 297–303
Heuck F, Ellermann J, Borchmann P, et al. Combination of the human anti-CD30 antibody 5F11 with cytostatic drugs enhances its antitumor activity against Hodgkin and anaplastic large cell lymphoma cell lines. J Immunother 2004; 27(5): 347–53
Venugopal P, Sivaraman S, Huan X, et al. Upregulation of CD20 expression in chronic lymphocytic leukaemia (CLL) cells by in vitro exposure to cytokines [abstract]. Blood 1998; 92Suppl. 1: 97–106
Mounier N, Briere J, Gisselbrecht C, et al. Rituximab plus CHOP (R-CHOP) overcomes BCL-2-associated resistance to chemotherapy in elderly patients with diffuse large B-cell lymphoma (DLBCL). Blood 2003; 101(11): 4279–84. Epub 2003 Feb 06.
Cotter FE. Antisense therapy of hematologic malignancies. Semin Oncol 1999; 36(suppl. 6): 9–14
Veelken H, Osterroth F. Vaccination strategies in the treatment of lymphomas. Oncology 2002; 62(3): 187–200
Hsu FJ, Caspar CB, Czerwinski D, et al. Tumor-specific idiotype vaccines in the treatment of patients with B-cell lymphoma: long-term results of a clinical trial. Blood 1997; 89: 3129–35
Bendandi M, Gocke CD, Kobrin CB, et al. Complete molecular remission induced by patient-specific vaccination plus granulocyte-monocyte colony-stimulating factor against lymphoma. Nat Med 1999; 5: 11171–7
Timmerman JM, Czerwinski DK, Davis TA, et al. Idiotype-pulsed dendritic cell vaccination for B-cell lymphoma: clinical and immune responses in 35 patients. Blood 2002Mar 1; 99(5): 1517–26
Menoret A, Chandawarkar R. Heat-shock protein-based anticancer immunotherapy: an idea whose time has come. Semin Oncol 1998; 25: 654–60
Wendtner CM, Kofler DM, Theiss HD, et al. Efficient gene transfer of CD40 ligand into primary B-CLL cells using recombinant adeno-associated virus (rAAV) vectors. Blood 2002Sep 1; 100(5): 1655–61
Sun Q, Burton R, Reddy V, et al. Safety of allogeneic Epstein-Barr virus (EBV)-specific cytotoxic T lymphocytes for patients with refractory EBV-related lymphoma. Br J Haematol 2002Sep; 118(3): 799–908
Zinani PL. Non-Hodgkin’s lymphoma: the evolving role of purine analogues. Best Pract Res Clin Haematol 2002; 15(3): 505–16
Chau I, Watkins D, Cunningham D. Gemcitabine and its combinations in the treatment of malignant lymphoma. Clin Lymphoma 2002Sep; 3(3): 97–104
Chau I, Harries M, Cunningham D, et al. Gemcitabine, cisplatin and methyl-prednisolone chemotherapy (GEM-P) is an effective regimen in patients with poor prognostic primary progressive or multiply relapsed Hodgkin’s and non-Hodgkin’s lymphoma. Br J Haematol 2003Mar; 120(6): 970–7
Crump M, Baetz T, Couban S, et al. Gemcitabine, dexamethasone, and cisplatin in patients with recurrent or refractory aggressive histology B-cell non-Hodgkin lymphoma: a Phase II study by the National Cancer Institute of Canada Clinical Trials Group (NCIC-CTG). Cancer 2004; 101(8): 1835–42
Kahl BS, Bailey HH, Smith EP, et al. Phase II study of weekly low-dose paclitaxel for relapsed and refractory non-Hodgkin’s lymphoma: a Wisconsin Oncology Network Study. Cancer Invest 2005; 23(1): 13–8
Chau I, Webb A, Cunningham D, et al. An Oxaliplatin-based chemotherapy in patients with relapsed or refractory intermediate and high-grade non-Hodgkin’s lymphoma. Br J Haematol 2001Dec; 115(4): 786–92
Mohammad RM, Diwakaran H, Maki A, et al. Bryostatin 1 induces apoptosis and augments inhibitory effects of vincristine in human diffuse large cell lymphoma. Leuk Res 1995Sep; 19(9): 667–73
Aleskog A, Jonsson E, Larsson R, et al. In vitro evaluation of the efficacy of idarubicin in human tumour cells from patients with low-grade non-Hodgkin’s lymphoma. Br J Haematol 2002Jun; 117: 563–8
Zhai S, Senderowicz AM, Sausville EA, et al. Flavopiridol, a novel cyclin-dependent kinase inhibitor, in clinical development. Ann Pharmacother 2002May; 36(5): 905–11
Wanner K, Hipp S, Peschel C, et al. MTOR (Mammalian Target of Rapamycin) inhibition with RAD001 induces cell cycle arrest in diffuse large B-cell lymphoma cells and sensitized DLBCL cells to rituximab therapy [abstract no. 4620]. Blood 2004Nov 16; 104: 236b
Muthukkumar S, Ramesh TM, Bondada S. Rapamycin, a potent immunosuppressive drug, causes programmed cell death in B lymphoma cells. Transplantation 1995; 60: 264–70
Bartlett JB, Dredge K, Dalgleish AG. Targeted therapy in multiple myeloma. Nat Rev Cancer 2004Apr; 4(4): 314–22
Yao L, Pike SE, Pittaluga S, et al. Anti-tumor activities of the angiogenesis inhibitors interferon-inducible protein-10 and the calreticulin fragment vasostatin. Cancer Immunol Immunother 2002Sep; 51(7): 358–66
Giles FJ. The emerging role of angiogenesis inhibitors in hematologic malignancies. Oncology (Huntingt) 2002May; 16(5 Suppl. 4): 23–9
Strauss S, Maharaj L, Stec J, et al. Phase II clinical study of bortezomib in patients with relapsed/refractory non-Hodgkin’s lymphoma and Hodgkin’s disease [abstract 1386]. Blood 2004Nov 16; 104: 389a
Sparano JA. Clinical aspects and management of AIDS related lymphoma. Eur J Cancer 2001Jul; 37(10): 1296–305
Baiocchi OC, Colleoni GW, Navajas EV, et al. Impact of highly active antiretroviral therapy in the treatment of HIV-infected patients with systemic non-Hodgkin’s lymphoma. Acta Oncol 2002; 41(2): 192–6
Bower M. Acquired immunodeficiency syndrome-related systemic non-Hodgkin’s lymphoma. Br J Haematol 2001Mar; 112(4): 863–74
Tan B, Piwnica-Worms D, Ratner L. Multidrug resistance transporters and modulation. Curr Opin Oncol 2000Sep; 12(5): 450–8
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Everington, T., Goldstone, A.H. Novel Approaches to the Management of Non-Hodgkin Lymphoma. Am J Cancer 4, 145–158 (2005). https://doi.org/10.2165/00024669-200504030-00002
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DOI: https://doi.org/10.2165/00024669-200504030-00002