LARGE B CELL LYMPHOMA—YEAR BY YEAR

Authors

  • Abdus Samad Syed
  • Fauzia Abdus Samad
  • Mahmood ur Rahman

Abstract

Non Hodgkin’s Lymphoma (NHL) comprises a group of lymphoproliferative disorders thefrequency of which continues to rise. Although many classification systems exist foridentifying specific histological subtypes, NHL is generally divided into indolent (low-grade)and aggressive (intermediate- and high-grade) forms. Large B Cell Lymphoma (LBCL) is oneof the commonest aggressive NHLs. The aim of this review is to provide a general overviewof NHL, its clinically practicable cellular classification, epidemiology and in depth overviewof the evolution of treatment of LBCL during the past 5 years. Current guidelines fromNational Cancer Institute (NCI), USA and National Institute on Clinical Excellence (NICE),UK are mentioned and recommendations according to our own set-up are suggested.Keywords: Non-Hodgkin’s Lymphoma, Large B Cell Lymphoma, Rituximab

References

Armitage JO: Treatment of non-Hodgkin's lymphoma. N Engl

J Med 1993;328(14):1023-30.

American Cancer Society. Cance r Facts and Figures 2006.

Atlanta: American Cancer Society;2006.

Coiffier B, Lepage E, Briere J , Herbrecht R, Tilly H,

Bouabdallah R et al. CHOP chemotherapy plus ritux imab

compared with CHOP alone in el derly patients with diffuse

large B-cell lymphoma. New Engl J Med. 2002;346:235-242.

Pfreundschuh MG, Trümper L, Ma D, Sterborg A, Pettengell

R, Trneny M et al. Randomized intergroup trial of first-line

treatment for patients =60 y ears with diffuse large B -cell

non-Hodgkin's lymph oma (DLBCL) with a CHOP -like

regimen with or without the an ti-CD20 antibody rituximabearly stopping after the first interim analysis. Proc Am Soc

Clin Oncol. 2004;23:556.

National Cancer Institute sponsored study of classifications of

non-Hodgkin's lymphomas: summary and description of a

working formulation for clinic al usage. The Non -Hodgkin's

Lymphoma Pathologic Classifica tion Project. Cancer

;49(10):2112-35.

Pugh WC. Is the working formul ation adequate for the

classification of the low grade lymphomas? Leuk Lymphoma

; 10(Suppl):1-8.

Harris NL, Jaffe ES, Stein H, Banks PM, Chan JK, Cleary ML

et al. A revised European-American classification of lymphoid

neoplasms: a proposal from the International Lymphoma

Study Group. Blood 1994;84(5):1361-92.

Pittaluga S, Bijnens L, Teodor ovic I, Hagenbeek A,

Meerwaldt JH, Somers R, et al. Clinical analysis of 670 cases

in two trials of the European Organization for the Research

and Treatment of Cancer Lympho ma Cooperative Group

subtyped according to the Revise d European -American

Classification of Lymphoid Neoplasms: a comparison with the

Working Formulation. Blood 1996;87(10):4358-67.

Armitage JO, Weisenburger DD. New approach to classifying

non-Hodgkin's lymphomas: clinical features of the major

histologic subtypes. Non-Hodgkin's Lymphoma Classification

Project. J Clin Oncol 1998;16(8):2780-95.

A clinical evaluation of the I nternational Lymphoma Study

Group classification of non -Hodgkin's lymphoma. The Non -

Hodgkin's Lymphoma Classi fication Project. Blood

;89(11):3909-18.

Pileri SA, Milani M, Fraternali-Orcioni G, Sabattini E. From

the R.E.A.L. Classification to the upcoming WHO scheme: a

step toward universal categori zation of lymphoma entities?

Ann Oncol 1998;9(6):607-12.

Harris NL, Jaffe ES, Armitage JO. Lymphoma classification:

from R.E.A.L. to W.H.O. and beyond. Cancer: Principles and

Practice of Oncology Updates 1999;13(3):1-14.

Jaffe ES, Harris NL, Chan JKC. Proposed World Health

Organization Classification of Neoplastic Disease of

Hematopoietic and Lymphoid Tis sue. Am J Surg Pathol

;21(1):114-21.

Seow A, Lee J, Sng I, Fong CM, Lee HP. Non-Hodgkin's

lymphoma in an Asian population: 1968–1992 time trends and

ethnic differences in Singapore. Cancer 1996;77(9):1899.

Ries LAG, Kosary CL, Hankey BF . eds. SEER cancer

statistics review, 1973-1996. National Cancer Institute, 1999;

NIH publication No. 99-2789.

American Cancer Society. Cance r resource centre, non -

Hodgkin's lymphoma. www.cancer.org/cancerinfo (accessed

March 11).

Shipp MA, Mauch PM, Harris NL. Non -Hodgkin's

lymphomas. In: DeVita VT Jr, Hellman S, Rosenberg SA, eds.

Cancer: principles and practic e of oncology. 5 th ed.

Philadelphia: Lippincott-Raven 1997:2165-217.

Lin AY, Tucker MA. Epidemiology of Hodgkin's disease and

non-Hodgkin's lymphoma. In: Canell os GP, Lister TA, Sk lar

JL, eds. The lymphomas. Philadelphia: Saunders; 1998:43-61.

Dinse GE, Umbach DM, Sasco AJ, Hoel DG, Davis DL.

Unexplained increases in cancer incidence in the United States

from 1975 to 1994: possible sentinel health indicators? Annu

Rev Public Health 1999;20:173.

Delves PJ, Roitt IM. The immune system. First of two parts. N

Engl J Med 2000;343(1):37.

Hockenbery DM, Zutter M, Hickey W, Nahm M, Korsmeyer

SJ. BCL2 protein is topographica lly restricted in tissues

characterized by apoptotic cell death. Proc Natl Acad Sci USA

;88(16):6961.

Ehrlich P. On immunity with sp ecific reference to cell life.

Proc R Soc Lond Ser B. 1900; 66:424-48.

Köhler G, M ilstein C. Continuous cultures of fused cells

secreting antibody of predefin ed specificity. Nature.

;256:495-7.

Multani PS, Grossbard ML. Mono clonal antibody -based

therapies for haematologic mal ignancies. J Clin Oncol.

;16:3691-710.

Leget GA, Czuczman MS. Use of rituximab, the new FDAapproved antibody. Curr Opin Oncol. 1998;10:548-51.

Reff ME, Carner K, Chambers KS, Chinn PC, Leonard JE,

Raab R, et al. Depletion of B cells in vivo by a chimeric

mouse human monoclonal antibod y to CD20. Blood

;83:435-45.

Maloney DG, Press OW. Newer treatments for non-Hodgkin's

lymphoma: monoclonal antibodie s. Oncology. 1998 (suppl

:63-76.

Maloney DG. Unconjugated monoclonal antibody therapy of

lymphoma. In: Grossbard ML, ed. Monoclonal antibody-based

therapy of cancer. New York: Dekker; 1998:53-79.

Glennie MJ. Overview of monocl onal antibody-based targets

for antibody therapy of lympho ma. In: Biological therapy of

lymphoma. Baylor -Simmons Cancer Centre. Data fr om:

Barclay AN, Brown MH, Law SKA. The leukocyte antigen

facts book. 2nd ed. London: Academic Press;1997:3.

Anderson KC, Bates MP, Slaughe nhoupt BL, Pinkus GS,

Schlossman SF, Nadler LM. Expr ession of human B cell -

associated antigens on leukaemias and lymphomas: a model of

human B cell differentiation. Blood. 1984;63:1424-33.

Longo DL, DeVita VT Jr, Jaffe ES. Lymphocytic lymphomas.

In: DeVita VT Jr, Hellman S, R osenberg SA, eds. Cancer:

principles and practice of oncology. 4th e d. Philadelphia:

Lippincott; 1993:1859-927.

Maloney DG, Grillo-López AJ, Bodkin DJ, White CA, Liles

TM, Royston I et al. IDEC-C2B8 (rituximab) anti -CD20

monoclonal antibody therapy in patients with relapsed low -

grade non-Hodgkin's lymphoma. Blood. 1997;90:2188-95.

McLaughlin P, Grillo-López AJ, Link BK, Levy R, Czuczman

MS, Williams ME et al. Rituximab chimeric anti -CD20

monoclonal antibody therapy for relapsed indolent lymphoma:

J Ayub Med Coll Abbottabad;19(4)

half of patients respond to a four-dose treatment program. J

Clin Oncol. 1998; 16:2825-33.

Davis TA, White CA, Grillo -López AJ, Velásquez WS, Link

B, Maloney DG et al. Single-agent monoclonal antibody

efficacy in bulky non-Hodgkin's lymphoma: results of a Phase

II trial of rituximab. J Clin Oncol. 1999;17:1851-7.

Miller TP, Dahlberg S, Cassady JR, Adelstein DJ, Spier CM,

Grogan TM et al. Chemotherapy alone compared with

chemotherapy plus radiotherapy for localized intermediate -

and high-grade non-Hodgkin's lymphoma. N Engl J M ed

;339:21.

Coiffier B, Haioun C, Ketterer N, Engert A, Tilly H, Ma D, et

al. Rituximab (anti -CD20 monoclonal antibody) for the

treatment of patients with rel apsing or refractory aggressiv e

lymphoma: a multi -centre Phase II study. Blood.

;92:1927-32.

Vose JM, Link BK, Grossbard ML , Czuczman M, Grillo -

Lopez A, Fisher RI. Long-term update of a phase II stud y of

rituximab in combination with CHOP chemotherapy in

patients with previously untreated, aggressive non-Hodgkin's

lymphoma. Leuk Lymphoma. 2005 Nov;46(11):1569-73.

Maloney DG, Smith B, Appelbaum FR. The antitumor effect

of monoclonal anti -CD20 antibody therapy includes direct

anti-proliferative activity and induction of apoptosis in CD20

positive non -Hodgkin's lymphoma cell lines. B lood.

;88:637. Abstract.

Demidem A, Lam T, Alas S, Hariharan K, Hanna N, Bonavida

B.. Chimeric anti-CD20 (IDEC-C2B8) monoclonal anti-body

sensitizes a B cell lymphoma cell line to cell killing by

cytotoxic drugs. Cancer Biother. 1997;12:177-86.

Czuczman M, Grillo-Lopez AJ, White CA. Rituximab/CHOP

chemoimmunotherapy in patients with low grade lymphoma

(LG/F NHL): progression free s urvivals (PFS) after three

years (median) follow-up. Blood. 1999:94.Abstract 432.

Coiffier B, Lepage E, Briere J , Herbrecht R, Tilly H,

Bouabdallah R et al. CHOP chemotherapy plus ritux imab

compared with CHOP alone in el derly patients with diffuse

large B-cell lymphoma. New Engl J Med. 2002;346:235-42.

Sehn LH, Donaldson J, Chhanabhai M, Fitzgerald C, Gill K,

Klasa R, et al. Introduction of combined CHO P-rituximab

therapy dramatically improved outcome of diffuse large-B-cell

lymphoma (DLBC) in British Col umbia (BC). Blood

;102:29a Abstract 88.

Miller TP, Unger JM, Spier C, Stea B, Cantu E, LeBlanc M et

al. Effect of adding rituximab t o three cycles of CHOP plus

involved-field radiotherapy for limited-stage aggressive diffuse

B-cell lymphoma (SWOG-0014). Blood. 2004;104:49a.

National Institute of Clinical Excellence. Technology

Appraisal 65, Rituximab for ag gressive non -Hodgkin’s

lymphoma. www.nice.org.uk. (Accessed 21 March 2006)

National Cancer Institute. Tre atment of Common Cancers.

Non-Hodgkin’s Lymphoma. http://nci.nih.gov/cancertopics/

pdq/treatment/adult-non-hodgkins/healthprofessional.

(Accessed 21 March 2006)

Most read articles by the same author(s)