{"title":"Clinical geriatric assessment in older patients with lymphoma: a narrative review","authors":"G. Soverini, A. Tucci","doi":"10.21037/aol-22-6","DOIUrl":"https://doi.org/10.21037/aol-22-6","url":null,"abstract":"","PeriodicalId":72224,"journal":{"name":"Annals of lymphoma","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78641128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"State of the art in the diagnosis, biology and treatment of primary mediastinal B-cell lymphoma: a review","authors":"V. Camus, F. Drieux, F. Jardin","doi":"10.21037/aol-22-13","DOIUrl":"https://doi.org/10.21037/aol-22-13","url":null,"abstract":"","PeriodicalId":72224,"journal":{"name":"Annals of lymphoma","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89139857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Older patients with mantle cell lymphoma: initial and subsequent therapies—a narrative review","authors":"Sowjanya Vuyyala, T. Phillips","doi":"10.21037/aol-22-8","DOIUrl":"https://doi.org/10.21037/aol-22-8","url":null,"abstract":"","PeriodicalId":72224,"journal":{"name":"Annals of lymphoma","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90725865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"From pathobiology to targeted treatment in Epstein Barr virus related T cell and Natural Killer cell lymphoproliferative diseases","authors":"Alexander Glover, C. Shannon-Lowe","doi":"10.21037/aol-21-33","DOIUrl":"https://doi.org/10.21037/aol-21-33","url":null,"abstract":"","PeriodicalId":72224,"journal":{"name":"Annals of lymphoma","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81809454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Epstein-Barr virus-associated lymphoproliferative disorders in immunosuppressed patients","authors":"D. Burns, S. Chaganti","doi":"10.21037/aol-20-42","DOIUrl":"https://doi.org/10.21037/aol-20-42","url":null,"abstract":": A diverse range of Epstein-Barr virus (EBV)-associated lymphoproliferative disorders (LPDs) arise in the context of immunodeficiency. Post-transplant lymphoproliferative disease (PTLD) encompasses multiple disease entities which develop due to iatrogenic immunosuppression necessary for organ transplantation, and are frequently EBV-positive. A similar spectrum of lymphoproliferative pathologies, many of which are EBV-associated, occur in non-transplant immunodeficiency states, including those secondary to disease-modifying agents, human immunodeficiency virus (HIV) infection, age-associated immunosenescence, and a wide array of primary immune conditions. Common to each of these disease settings is disruption of the normal immune responses that exert control over EBV, permitting the virus to contribute to tumourigenesis. In this review, we provide an overview of the classification of EBV-positive immunodeficiency-associated LPDs, highlighting the strengths and weaknesses of systems provided by the World Health Organisation (WHO) Classification of Tumours of Haematopoietic and Lymphoid Tissues in comparison to the Society for Hematopathology (SH) and the European Association for Haematopathology (EAH). As an exemplar of EBV-associated LPD, we then undertake a detailed review of the pathophysiology and management of PTLD. This includes a discussion of prophylactic, pre-emptive and therapeutic approaches, recognising important differences in the management of PTLD arising after haematopoietic stem cell and solid organ transplantation. We summarise recent published clinical data guiding the use of conventional chemo-immunotherapy, and cover the role of cellular and novel drug therapies. Thereafter, we provide focused reviews on a selection of other noteworthy EBV-positive LPD entities, highlighting current and emerging strategies for their management: EBV-positive mucocutaneous ulcer, EBV-positive diffuse large B-cell lymphoma, plasmablastic lymphoma, primary effusion lymphoma and lymphomatoid","PeriodicalId":72224,"journal":{"name":"Annals of lymphoma","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88541099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annals of lymphomaPub Date : 2021-09-01Epub Date: 2021-09-30DOI: 10.21037/aol-21-18
Rosemary Rochford
{"title":"Reframing Burkitt lymphoma: virology not epidemiology defines clinical variants.","authors":"Rosemary Rochford","doi":"10.21037/aol-21-18","DOIUrl":"10.21037/aol-21-18","url":null,"abstract":"<p><p>In 1964, Epstein-Barr virus (EBV) was identified in a biopsy from a patient with Burkitt lymphoma (BL) launching a new field of study into this ubiquitous human virus. Almost 60 years later, insights into the role of EBV in lymphomagenesis are still emerging. While all BL carry the hallmark c-myc translocation, the epidemiologic classification of BL (e.g., endemic, sporadic or immunodeficiency-associated) has traditionally been used to define BL clinical variants. However, recent studies using molecular methods to characterize the transcriptional and genetic landscape of BL have identified several unique features are observed that distinguish EBV+ BL including a high level of activation induced deaminase mutation load, evidence of antigen selection in the B cell receptor, and a decreased mutation frequency of TCF3/ID3, all found predominantly in EBV+ compared to EBV- BL. In this review, the focus will be on summarizing recent studies that have done in depth characterization of genetic and transcriptional profiles of BL, describing the differences and similarities of EBV+ and EBV- BL, and what they reveal about the etiology of BL. The new studies put forth a compelling argument that the association with EBV should be the defining etiologic feature of clinical variants of BL. This reframing of BL has important implications for therapeutic interventions for BL that distinguish the EBV+ from the EBV- lymphomas.</p>","PeriodicalId":72224,"journal":{"name":"Annals of lymphoma","volume":"5 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e4/cd/nihms-1757463.PMC8654190.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39710323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annals of lymphomaPub Date : 2021-09-01Epub Date: 2021-09-30DOI: 10.21037/aol-20-53
Prakash Ambady, Leland S Hu, Letterio S Politi, Nicoletta Anzalone, Ramon F Barajas
{"title":"Primary central nervous system lymphoma: advances in MRI and PET imaging.","authors":"Prakash Ambady, Leland S Hu, Letterio S Politi, Nicoletta Anzalone, Ramon F Barajas","doi":"10.21037/aol-20-53","DOIUrl":"https://doi.org/10.21037/aol-20-53","url":null,"abstract":"<p><p>Contrast enhanced magnetic resonance imaging (CE-MRI) remains the imaging modality of choice for initial workup, staging, and response assessment after therapy in patients with primary central nervous system lymphoma (PCNSL). While CE-MRI is a sensitive test to detect blood brain barrier (BBB) dysfunction, it does not biologically represent the true tumor burden. Current response assessment criteria relies heavily on two dimensional anatomical measurements on post contrast T1-weighted (T1W) images, as well as pre-contrast T2-weighted (T2W) imaging. Additional MRI features, such as diffusion-weighted imaging (DWI) and perfusion weighted imaging, can be routinely obtained at most centers with MRI capabilities. Emerging evidence supports the incorporation of these data to better define tumor physiology and provide additional valuable clinical tools capable of identifying high risk subgroups as well as early predictors of response to therapies. Further, novel advanced molecular and pathophysiologic characterization of PCNSL provides insights into promising targeted therapeutic approaches. However, significant institutional imaging variation and inconsistent clinical trial reporting diminishes the reliability, reproducibility and eventual translation in day to day management of patients with PCNSL. Here we review established neuroimaging concepts and provide an overview of published literature about novel imaging techniques that may improve diagnosis and response assessments. Finally, we highlight the need for standardization of image acquisition, post-processing, and incorporation of novel imaging biomarkers in early phase PCNSL clinical trials.</p>","PeriodicalId":72224,"journal":{"name":"Annals of lymphoma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/08/7f/nihms-1775723.PMC9387672.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40417046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annals of lymphomaPub Date : 2021-09-01Epub Date: 2021-09-30DOI: 10.21037/aol-20-43
Mazie Tsang, James L Rubenstein, Elisa Jacobsen Pulczynski
{"title":"Primary central nervous system lymphoma in older adults and the rationale for maintenance strategies: a narrative review.","authors":"Mazie Tsang, James L Rubenstein, Elisa Jacobsen Pulczynski","doi":"10.21037/aol-20-43","DOIUrl":"https://doi.org/10.21037/aol-20-43","url":null,"abstract":"<p><strong>Objective: </strong>To provide a summary and analysis of the evidence for various agents applied as maintenance therapy and highlight ongoing trials or trials in development that evaluate the efficacy of maintenance therapy strategies in older patients with primary central nervous system lymphoma (PCNSL).</p><p><strong>Background: </strong>PCNSL are rare neoplasms that can have an aggressive course with short-lived remissions when compared to systemic diffuse large B-cell lymphoma (DLBCL). There is currently a paucity of evidence on treatment in older adults with PCNSL, who may be unfit to tolerate effective therapies for PCNSL. Those who can tolerate these therapies and survive PCNSL are at increased risk from developing treatment-related toxicity, functional decline, and debilitating neurotoxicity. While there is no clearly defined role for maintenance therapy after treatment of systemic DLBCL, it should be considered in PCNSL because central nervous system (CNS) recurrence often has a devastating and irreversible impact on neurologic function. Therefore, at least theoretically, use of effective maintenance therapy in older adults with PCNSL, either in lieu of consolidation or after consolidation therapy, may be better tolerated and help delay tumor progression, resulting in an improved overall global neurologic function and quality of life.</p><p><strong>Methods: </strong>We systematically searched MEDLINE (via PubMed) for all studies of drug treatments for maintenance therapy in PCNSL and also relied on expert opinion. We provide a summary and analysis of the evidence for various maintenance therapy agents, including methotrexate, rituximab, lenalidomide, temozolomide, ibrutinib, and procarbazine. We also highlight ongoing trials or trials in development that evaluate the efficacy of maintenance therapy in PCNSL.</p><p><strong>Conclusions: </strong>Prospective clinical studies focusing on PCNSL patients who are not candidates for intensive post-induction therapy are scarce. To date, there are no studies that clarify whether maintenance therapy can be used in lieu of consolidation therapy with autologous stem cell transplant or radiation. Prospective studies may provide critical data regarding the identification of optimal agents, whether consolidation therapy could be replaced by maintenance therapy, and the overall role of maintenance therapy as a means to potentially improve survival and preserve quality of life and function in a vulnerable, older patient population.</p>","PeriodicalId":72224,"journal":{"name":"Annals of lymphoma","volume":"5 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cd/7c/nihms-1758988.PMC8802984.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39756426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Habermann, David Rossi, F. Bertoni, M. Coleman, E. Zucca
{"title":"Preface: why this special series on marginal zone lymphomas?","authors":"T. Habermann, David Rossi, F. Bertoni, M. Coleman, E. Zucca","doi":"10.21037/aol-21-22","DOIUrl":"https://doi.org/10.21037/aol-21-22","url":null,"abstract":"","PeriodicalId":72224,"journal":{"name":"Annals of lymphoma","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89469789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Overcoming the blood-brain barrier in primary central nervous system lymphoma: a review on new strategies to solve an old problem","authors":"T. Calimeri, F. Marcucci, A. Corti","doi":"10.21037/AOL-20-54","DOIUrl":"https://doi.org/10.21037/AOL-20-54","url":null,"abstract":"A great deal of research is being dedicated to the identification of new strategies to improve the transport of medicines across the blood-brain barrier (BBB), which typically hampers the transport of molecules and particles into the brain. Primary DLBCL of the CNS (PCNSL) is a paradigmatic example of this challenge both from a diagnostic and therapeutic point of view. PCNSL is a neoplasm confined to the brain, eyes, meninges, and other structures of the CNS. Histopathologic analyses of tissue sections have demonstrated that tumor cells can be detected not only in the areas highlighted by modern neuroimaging, but also far from these zones. Furthermore, some tumor areas revealed by gadolinium-enhanced MRI are concomitant with histological lesions with only T2-weighted-fluid-attenuated inversion recovery (FLAIR) changes, or with no radiologic abnormalities at all, suggesting the presence of a blood-brain tumor barrier (BBTB) heterogeneously altered in PCNSL, or even intact in some tumor areas. Since the unaltered barrier may impair the homogeneous penetration of low-molecular weight MRI contrast agents and therapeutic compounds in tumors, this issue represents an important diagnostic and therapeutic challenge. Based on these considerations, the induction of BBTB permeabilization to enhance tumor penetration of drugs and molecules could be attractive investigational approaches in this setting. The aim of this review article is to report and critically discuss the strategies recently developed to overcome this obstacle in PCNSL patients, with a special focus on the use of targeted tumor necrosis factor-alpha (TNF) to enhance CNS bioavailability of therapeutic agents.","PeriodicalId":72224,"journal":{"name":"Annals of lymphoma","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87808925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}