Current management of follicular lymphoma

Current Opinion in Oncology

Volumn 8, Issue 5, 1996, Pages 360-365

  Gupta, Rajnish K ^a   Lister, T Andrew ^a  

^a ST BARTHOLOMEW S HOSPITAL   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

CD19 ANTIGEN; CD20 ANTIGEN; CD22 ANTIGEN; CHLORAMBUCIL; CLADRIBINE; CYCLOPHOSPHAMIDE; DOXORUBICIN; ETOPOSIDE; FLUDARABINE; IDARUBICIN; MITOXANTRONE; MONOCLONAL ANTIBODY; PACLITAXEL; PURINE DERIVATIVE; TEMOZOLOMIDE;

BONE MARROW BIOPSY; CANCER RADIOTHERAPY; CANCER REGRESSION; CANCER SURVIVAL; CHROMOSOME TRANSLOCATION 18; COMBINATION CHEMOTHERAPY; COMPUTER ASSISTED TOMOGRAPHY; FOLLICULAR LYMPHOMA; MALIGNANT TRANSFORMATION; NONHODGKIN LYMPHOMA; PRIORITY JOURNAL; REVIEW; VACCINATION;

EID: 0029909610     PISSN: 10408746     EISSN: None     Source Type: Journal    
DOI: 10.1097/00001622-199609000-00004     Document Type: Review

References (49)

1. Harris NL, Jaffe ES, Stein H, Banks PM, Chan JK, Cleary ML, Delsol G, De Wolf Peeters C, Falini B, Gatter KC, Grogan TM, lsaacson PG, Knowles DM, Mason DY, Muller-Hermelink H-K, Pileri SA, Piris MA, Ralfkiaer E, Warnke RA: A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood 1994, 84:1361-1392.
2. Pittaluga S, Wlodarska I, Stul MS, Thomas J, Verhoef G, Cassiman JJ, Van den Berghe H, de Wolf Peeters C: Mantle cell lymphoma: a clinicopathological study of 55 cases. Histopathology 1995, 26:17-24.
3. Gallagher CJ, Gregory WM, Jones AE, Stansfeld AG, Richards MA, Dhaliwal HS, Malpas JS, Lister TA: Follicular lymphoma: prognostic factors for response and survival. J Clin Oncol 1986, 4:1470-1480.
4. Yuen AR, Kamel OW, Halpern J, Horning SJ: Long-term survival after histologic transformation of low-grade follicular lymphoma. J Clin Oncol 1995, 13:1726-1733. A retrospective analysis of 74 patients managed at Stanford that demonstrates a subset of patients in whom there is histological transformation from low-grade to intermediate- or high-grade lymphoma, who attain a complete response to therapy and have a relatively long median survival.
5. Aisenberg AC: Coherent view of non-Hodgkin's lymphoma. J Clin Oncol 1995, 13:2656-2675. A useful, comprehensive review.
6. Whelan JS, Reznek RH, Daniell SJ, Norton AJ, Lister TA, Rohatiner AZ: Computed tomography (CT) and ultrasound (US) guided core biopsy in the management of non-Hodgkin's lymphoma. Br J Cancer 1991, 63:460-462.
7. Hermans J, Krol AD, van Groningen K, Kluin PM, Kluin Nelemans JC, Kramer MH, Noordijk EM, Ong F, Wijermans PW: International Prognostic Index for aggressive non-Hodgkin's lymphoma is valid for all malignancy grades. Blood 1995,86:1460-1463. A study done on a population-based database of 1168 patients with lymphoma to assess the value of the International Prognostic Index. It concluded that this index was applicable to all malignancy grades using the International Working Formulation, including low-grade lymphoma.
8. Gribben JG, Freedman AS, Neuberg D, Roy DC, Blake KW, Woo SD, Grossbard ML, Rabinowe SN, Coral F, Freeman GJ, Ritz J, Nadler LM: Immunologic purging of marrow assessed by PCR before autologous bone marrow transplantation for B-cell lymphoma. N Engl J Med 1991, 325:1525-1533.
9. Price CG, Meerabux J, Murtagh S, Cotter FE, Rohatiner AZ, Young BD, Lister TA: The significance of circulating cells carrying t(14;18) in long remission from follicular lymphoma. J Clin Oncol 1991, 9:1527-1532.
10. Young RC, Longo DL, Glatstein E, Ihde DC, Jaffe ES, DeVita VT Jr: The treatment of indolent lymphomas: watchful waiting vs aggressive combined modality treatment. Semin Hematol 1988, 25:11-16.
11. Horning SJ, Rosenberg SA: The natural history of initially untreated low-grade non-Hodgkin's lymphomas. N Engl J Med 1984, 311:1471-1475.
12. McLaughlin P, Fuller LM, Velasquez WS, Sullivan Halley JA, Butler JJ, Cabanillas F: Stage I-II follicular lymphoma: treatment results for 76 patients. Cancer 1986, 58:1596-1602.
13. Richards MA, Gregory WM, Hall PA, Dhaliwal HS, Fernandez J, Stansfeld AG, Jones AE, Lister TA: Management of localized non-Hodgkin's lymphoma: the experience at SL Bartholomew's Hospital 1972-1985. Hematol Oncol 1989, 7:1-18.
14. Reddy S, Saxena VS, Pellettiere EV, Hendrickson FR: Stage I and II non-Hodgkin's lymphomas: long-term results of radiation therapy. Int J Radiat Oncol Biol Phys 1989, 16:687-692.
15. Pendlebury S, el Awadi M, Ashley S, Brada M, Horwich A: Radiotherapy results in early stage low grade nodal non-Hodgkin's lymphoma. Radiother Oncol 1995, 36:167-171.
16. MacManus MP, Hoppe RT: Is radiotherapy curative for stage I and II low grade follicular lymphoma? Results of long-term follow-up study of patients treated at Stanford University. J Clin Oncol 1996, 14:1282-1290. A retrospective review of 177 patients with stage I or II low-grade follicular lymphoma treated with radiotherapy since 1961 at Stanford. The median follow-up was 7.7 years. The authors suggest that radiotherapy remains the treatment of choice for early stage low-grade follicular lymphoma.
17. Besa PC, McLaughlin PW, Cox JD, Fuller LM: Long term assessment of patterns of treatment failure and survival in patients with stage I or II follicular lymphoma. Cancer 1995, 75:2361-2367 A retrospective analysis of 144 patients with early-stage follicular lymphoma treated at The University of Texas M.D. Anderson Cancer Center with a median follow-up of 8.7 years. It demonstrates that the patients whom received chemotherapy with radiotherapy, compared with those who had radiotherapy alone, had a better disease-free survival rate. The authors concluded that the addition of chemotherapy to radiotherapy may have increased the probability of cure. This was not a randomized study, however.
18. Jelic S, Frim O, Jovanovic V, Gligorijevic G, Opric M, Gavrilovic D: Watch and wait policy for patients with non Hodgkln's lymphoma clinical stage I or IE with no lymphoma left following diagnostic surgery [abstract]. Ann Oncol 1996, 7(suppl 3):55. The interesting results (in all grades of lymphoma) presented in this abstract suggest that a randomized study is necessary and that radiotherapy may not always be indicated at presentation.
19. Soubeyran P, Eghbali H, Trojani M, Quenel N, Richaud P, Hoerni B: Wait and see policy in stage I follicular lymphoma [abstract]. Ann Oncol 1996, 7(suppl 3):144. Another abstract in which 26 patients with stage I follicular lymphoma were given no further therapy following diagnostic surgical excision of the involved lymph node. Median follow-up is 7 years, and overall survival is 74.5%.
20. Jones SE, Rosenberg SA, Kaplan HS, Kadin ME, Dorfman RF: Non-Hodgkin's lymphomas: II. Single agent chemotherapy. Cancer 1972, 30:31-38.
21. Tallman MS, Hakimian D: Purine nucleoside analogs: emerging roles in indolent lymphoproliferative disorders. Blood 1995, 86:2463-2474. A useful review article.
22. Redman JR, Cabanillas F, Velasquez WS, McLaughlin P, Hagemeister FB, Swan F Jr, Rodriguez MA, Plunkett WK, Keating MJ: Phase II trial of fludarabine phosphate in lymphoma: an effective new agent in low-grade lymphoma. J Clin Oncol 1992, 10:790-794
23. Keating MJ, O'Brien S, Robertson LE, Kantarjian H, Dimopoulos M, McLaughlin P, Cabanillas F, Gregoire V, Li YY, Gandhi V, Estey E, Plunkett W: The expanding role of fludarabine in hematologic malignancies. Leuk Lymphoma 1994, 2:11-16.
24. Solal-Celigny P, Brice P, Brousse N, Caspard H, Bastion Y, Haioun C, Bosly A, Tilly H, Bordessoule D, Sebban C, Harousseau JL, Morel P, Dupas B, Plassart F, Vasile N, Fort N, Leporrier M: Phase II trial of fludarabine monophosphate as first-line treatment in patients with advanced follicular lymphoma: a multicenter study by the Groupe d'Etude des Lymphomes de l'Adulte. J Clin Oncol 1996, 14:514-519. This study confirms that fludarabine is active as a first-line treatment in patients with follicular lymphoma. In the 49 assessable patients, the overall response rate was 65%, and complete response rate was 37%. The median progression-free survival for all patients was 13.5 months. These results are most probably no better than results seen with other single-agent chemotherapy regimens used in follicular lymphoma, however.
25. Saven A, Emanuele S, Kosty M, Koziol J, Ellison D, Piro L: 2-Chlorodeoxyadenosine activity in patients with untreated, indolent non-Hodgkin's lymphoma. Blood 1995, 86:1710-1716. In this study, 28 patients with untreated low-grade lymphoma were given 2-Cda as a 7-day continuous infusion. Ten patients had follicular lymphoma. The overall response rate was 88% and the complete response rate was 35%, but the median duration of response was only 10 months.
26. Fenchel K, Bergmann L, Wijermans P, Engert A, Pralle H, Mitrou PS, Diehl V, Hoelzer D: Clinical experience with fludarabine and its immunosuppressive effects in pretreated chronic lymphocytic leukemias and low-grade lymphomas. Leuk Lymphoma 1995, 18:485-492.
27. Myint H, Copplestone JA, Orchard J, Craig V, Curtis D, Prentice AG, Hamon MD, Oscier DG, Hamblin TJ: Fludarabine-related autoimmune haemolytic anaemia in patients with chronic lymphocytic leukaemia. Br J Haematol 1995, 91:341-344.
28. Lister TA, Cullen MH, Beard ME, Brearley RL, Whitehouse JM, Wrigley PF, Stansfeld AG, Sutcliffe SB, Malpas JS, Crowlher D: Comparison of combined and single-agent chemotherapy in non-Hodgkin's lymphoma of favourable histological type. Br Med J 1978, 1:533-537.
29. Rodriguez V, Cabanillas F, Burgess MA, McKelvey EM, Valdivieso M, Bodey GP, Freireich EJ: Combination chemotherapy ("CHOP-Bleo") in advanced (non-Hodgkin's) malignant lymphoma. Blood 1977, 49:325-333.
30. Dana BW, Dahlberg S, Nathwani BN, Chase E, Coltman C, Miller TP, Fisher RI: Long-term follow-up of patients with low-grade malignant lymphomas treated with doxorubicin-based chemotherapy or chemoimmunotherapy. J Clin Oncol 1993, 11:644-651.
31. McLaughlin P, Hagemeister FB, Romaguera JE, Sarris AH, Pate O, Younes A, Swan F, Keating M, Cabanillas F: Fludarabine, mitoxantrone, and dexamethasone: an effective new regimen for indolent lymphoma. J Clin Oncol 1996, 14:1262-1268. A phase II trial evaluating a fludarabine-based combination regimen. The results suggest that this is a highly activity therapy in patients with recurrent or relapsed indolent lymphoma. There was considerable myelosuppresion, however, and infections occurred in 12% of courses.
32. Zinzani PL, Bendandi M, Tura S: FMP regimen (fludarabine, mitoxantrone, prednisone) as therapy in recurrent low-grade non-Hodgkin's lymphoma. Eur J Haematol 1995, 55:262-266. A further study of a fludarabine-based combination regimen, although the follow-up is short.
33. McLaughlin P, Cabanillas F, Younes A, Lee MS, Rodriguez MA, Hagemeister FB, Sarris A, Preti A: Stage IV low grade lymphoma: randomized trial of two innovative regimens, with monitoring of BCL-2 by PCR [abstract]. Ann Oncol 1996, 7(suppl 3):34. An abstract presenting early results of a randomized study of FND and the intensive 11 -drug ATT regimen from the M.D. Anderson Cancer Center. The concept of molecular remission on PCR analysis is also part of this study.
34. Haas R, Moos M, Karcher A, Mohle R, Witt B, Goldschmidt H, Fruhauf S, Flentje M, Wannenmacher M, Hunstein W: Sequential high-dose therapy with peripheral-blood progenitor-cell support in low-grade non-Hodgkin's lymphoma. J Clin Oncol 1994, 12:1685-1692.
35. Gorin NC, Lopez M, Laporte JP, Quittet P, Lesage S, Lemoine F, Berenson RJ, Isnard F, Grande M, Stachowiak J, Labopin M, Fouillard L, Morel P, Jouet J-P, Noel-Walter M-P, Detourmignies L, Aoudjhane M, Bauters F, Najman A, Douay L: Preparation and successful engraftment of puri-fled CD34+ bone marrow progenitor cells in patients with non-Hodgkin's lymphoma. Blood 1995, 85:1647-1654. This study provides further evidence that CD34+ progenitor cells can be used to support patients following high-dose therapy. There is also a decrease in lymphoma contamination of the graft.
36. Rohatiner AZ, Johnson PW, Price CG, Arnott SJ, Amess JA, Norton AJ, Dorey E, Adams K, Whelan JS, Matthews J, MacCallum PK, Oza AM, Lister TA: Myeloablative therapy with autologous bone marrow transplantation as consolidation therapy for recurrent follicular lymphoma. J Clin Oncol 1994, 12:1177-1184.
37. Morel P, Laporte JP, Noel MP, Lopez M, Douay L, Fouillard L, Detourmignies L, Dupriez B, Lesage S, Isnard F, Grande M, Jonet JP, Najman A, Bauters F, Gorin NC: Autologous bone marrow transplantation as consolidation therapy may prolong remission in newly diagnosed high-risk follicular lymphoma: a pilot study of 34 cases. Leukemia 1995, 9:576-582. In this study, newly diagnosed poor-risk patients were treated with an aggressive strategy. Patients received BEAM (carmustine, etoposide, cytosine arabinoside, and melphalan) conditioning with autologous bone marrow transplantation after first-line treatment with CVP (cyclophosphamide, vincristine, and prednisone) or ACVBP (doxorubicin, cyclophosphamide, vindesine, bleomycin, and prednisone) if a minimal disease state had been achieved. The median follow-up is only 36 months.
38. Bastion Y, Brice P, Haioun C, Sonet A, Salles G, Marolleau JP, Espinouse D, Reyes F, Gisselbrecht C, Coiffier B: Intensive therapy with peripheral blood progenitor cell transplantation in 60 patients with poor-prognosis follicular lymphoma. Blood 1995, 86:3257-3262. Another study of an intensive therapy approach, this time using peripheral blood progenitor cells to support myeloablative therapy. Median follow-up of 21 months.
39. van Besien KW, Khouri IF, Giralt SA, McCarthy P, Mehra R, Andersson BS, Przepiorka D, Gajewski JL, Bellare N, Nath R, Romaguera BS, McLaughlin P, Korbling M, Deisseroth AB, Cabanillas FF, Champlin RE: Allogeneic bone marrow transplantation for refractory and recurrent low-grade lymphoma: the case for aggressive management J Clin Oncol 1995, 13:1096-1102. A very interesting and provocative study in which 10 patients with chemotherapy-refractory and recurrent low-grade lymphoma were treated with myeloablative therapy and allogeneic bone marrow transplantation. Eight patients achieved a complete remission and were still alive at a median follow-up time of nearly 2.5 years.
40. Solal-Celigny P, Lepage E, Brousse N, Reyes F, Haioun C, Leporrier M, Peuchmaur M, Bosly A, Parlier Y, Brice P, Coiffier B, Gisselbrecht C: Recombinant Interferon alfa-2b combined with a regimen containing doxorubicin In patients with advanced follicular lymphoma: Groupe d'Etude des Lymphomes de l'Adulte. N Engl J Med 1993, 329:1608-1614.
41. Maloney DG, Liles TM, Czerwinski DK, Waldichuk C, Rosenburg J, Grillo Lopez A, Levy R: Phase I clinical trial using escalating single-dose Infusion of chimeric anti-CD20 monoclonal antibody (IDEC-C2B8) in patients with recurrent B-cell lymphoma. Blood 1994, 84:2457-2466.
42. McLaughlin P, Grillo-Lopez AJ, Czuczman M, Levy R, Link BK, Dillman RO, Ho AD, Bennett JM, Heyman MR, Schilder RJ, Cabanillas F, Rogers J, Dallaire BK: Pivotal phase III clinical trial of the chimeric anti-CD20 antibody IDEC-C2B8 in patients with relapsed low-grade or follicular lymphoma: a preliminary report [abstract]. Ann Oncol 1996, 7(suppl 3):57. An extremely interesting abstract with very promising preliminary results suggesting that IDEC-C2B8 has clinical activity as a single agent and may be able to induce molecular remission, as detected by PCR analysis.
43. Rogers J, Jackson J, Rosenberg J, Varns C, Leonard J, Grillo-Lopez AJ: Clearance of BCL-2 t(14;18) from peripheral blood and bone marrow in patients with relapsed low-grade or follicular lymphoma following single-agent therapy with the chlmerlc anti-CD20 antibody IDEC-C2B8 [abstract]. Ann Oncol 1996, 7(suppl 3):34. Another abstract on the potential of IDEC-C2B8 in the future treatment of patients with follicular lymphoma.
44. 131I-labeled anti-CD20 antibody in a phase II trial. There was an objective response in 18 of the 21 patients with relapsed lymphoma, including 16 complete remissions. Analysis of these patients, together with those from a phase I trial, reveals a progression-free survival rate of 62% and an overall survival rate of 93%, with a median follow-up of 2 years.
45. Hawkins RE, Zhu D, Ovecka M, Winter G, Hamblin TJ, Long A, Stevenson FK: Idiotypic vaccination against human B-cell lymphoma: rescue of variable region gene sequences from biopsy material for assembly as single-chain Fv personal vaccines. Blood 1994, 63:3279-3288.
46. Stevenson FK, Zhu D, King CA, Ashworth LJ, Kumar S, Thompsett A, Hawkins RE: A genetic approach to idiotypic vaccination for B cell lymphoma. Ann N Y Acad Sci 1995, 772:212-226.
47. Stevenson FK, Zhu D, King CA, Ashworth LJ, Kumar S, Hawkins RE: idiotypic DNA vaccines against B-cell lymphoma. Immunol Rev 1995, 145:211-228. A very good review.
48. Tao MH, Levy R: Idiotype/granulocyte-macrophage colony-stimulating factor fusion protein as a vaccine for B-cell lymphoma. Nature 1993, 362:755-758.
49. Hsu FJ, Benike C, Fagnoni F, Liles TM, Czerwinski D, Taidi B, Engleman EG, Levy R: Vaccination of patients with B-cell lymphoma using autologous antigen-pulsed dendritic cells. Nat Med 1996, 2:52-58. A pilot study investigating the ability of autologous dendritic cells pulsed ex vivo with tumor-specific idiotype protein to stimulate host immunity when used as a vaccine in patients with follicular lymphoma.