Adult Non-Hodgkin Lymphoma Treatment (PDQ®)–Health Professional Version

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Changes to This Summary (10/27/2017)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Indolent Non-Hodgkin Lymphoma (NHL)

Added text to state that two retrospective analyses identified a high-risk group that had a 50% overall survival (OS) rate at 5 years when relapse occurred after induction chemoimmunotherapy at 24 or 30 months; this has not been validated in prospective studies or an independent cohort (cited Casulo et al. as reference 16 and Shi et al. as reference 17). Added that these higher-risk patients represent a target population for clinical trials.

Added Gavriatopoulou et al. as reference 42.

Added text to state that the durable remission responses to doxycycline are mainly seen in Italian trials and less often in trials conducted in other geographic sites (cited Grünberger et al. as reference 94).

Added text to state that a large, retrospective review of primary ocular adnexal mucosa-associated lymphatic tissue found that after 10 years of follow-up, 4% of stage I patients treated with radiation therapy transformed to diffuse large B-cell lymphoma (DLBCL), and 3% of them developed central nervous system involvement (cited Desai et al. as reference 96).

Aggressive NHL

Added Staiger et al. and Sesques et al. as references 16 and 18, respectively.

Added text to state that a retrospective review evaluated 159 patients with previously untreated DLBCL who underwent double-hit genetic testing by fluorescence in situ hybridization and achieved complete response (cited Landsburg et al. as reference 19). Also added that the induction therapy did not alter 3-year relapse-free survival or OS when autologous stem cell transplantation was employed.

Added Hapgood et al. as reference 51.

Added Yang et al. and Yamaguchi et al. as references 71 and 73, respectively.

Added Lunning et al. as reference 88.

Added Weisenburger et al. as reference 97.

Added text to state that the incorporation of new agents, including pralatrexate, bendamustine, belinostat, and brentuximab vedotin, with cyclophosphamide, doxorubicin, vincristine, and prednisone or CHOP chemotherapy is under clinical evaluation.

Treatment for Indolent, Noncontiguous Stage II/III/IV Adult NHL

Added text to state that in a trial that studied the use of induction without rituximab, 387 patients were randomly assigned to receive 2 years of rituximab maintenance. Also added statistical data about progression-free survival (PFS) but not OS improvement with maintenance at a median follow-up of 11.5 years (cited Barta et al. as reference 58 and level of evidence 1iiDiii). Concluded that for previously untreated patients, all of the studies showed improvement of PFS, with no change in OS.

Added text to summarize that for previously treated patients, there is more evidence to suggest an OS advantage with the use of rituximab maintenance.

This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ® - NCI's Comprehensive Cancer Database pages.

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Adult Non-Hodgkin Lymphoma Treatment (PDQ®)—Health Professional Version - National Cancer Institute