Hodgkin's lymphoma: new insights in an old disease
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2007
|
| Schriftenreihe: | Hematology, oncology clinics of North America
21,5 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XIV S., S. 769 - 983 Ill., graph. Darst. |
| ISBN: | 9781416050810 1416050817 |
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Datensatz im Suchindex
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ELSEV1ER ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^H
SAUNDERS ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^imH^^^^^I
Hodgkin s Lymphoma: New Insights
in an Old Disease
CONTENTS VOLUME 21 « NUMBER 5 « CCTOBER 2007
Preface xiii
Volker Diehl, Andreas Engert, and Daniel Re
World Health Organization and Beyond: New
Aspects in the Pathology of an Old Disease 769
Michael Hummel
Hodgkin s lymphoma is a highly enigmatic lymphoma disease that still
covers most of its secrets up to now. Much effort has been made to
successfully wrest at least some of the pathogenetic particularities.
The current diagnostic criteria are well established allowing hematopa
thologists to make a clear cut distinction from other lymphomas in
almost all cases. Although classic Hodgkin s lymphoma is curable in
the vast majority of cases by treatment widi highly aggressive drugs
with or without radiotherapy, further molecular studies may lead to
the identification of therapeutic targets diat enable a more tailored treat¬
ment with fewer side effects.
The Pathogenesis of Classical Hodgkin s
Lymphoma: A Model for B Cell Plasticity 787
Stephan Mathas
It has been shown that differentiated lymphoid cells can display a broad
developmental potential and might even differentiate into other cell
types. Recent data implicate such processes in the pathogenesis of clas¬
sical Hodgkin s lymphoma (HL). In the malignant, B cell derived
Hodgkin s and Reed Sternberg (HRS) cells of HL the expression of
B cell specific genes is lost, and B lineage inappropriate genes are up
regulated. Experimental evidence has been presented in recent years
that functional disruption of the B lineage specific transcription factor
program contributes to this process. HRS cells might be reprogrammed
into cells resembling undifferentiated progenitor cells, which might offer
an explanation for the unique HL phenotype and demonstrate a high
degree of plasticity of human lymphoid cells.
vii
CONTENTS continued
The Potential Role of the Innate Immunity
in the Pathogenesis of Hodgkin s Lymphoma 805
Gunilla Enblad, Daniel Molin, Ingrid Glimelius, Marie Fischer,
and Gunnar Nilsson
The innate immune system is our first line of defense against danger
signals but in Hodgkin s lymphoma the role seems opposite, favoring
malignant development. In this article we describe interactions between
Hodgkin s and Reed Sternberg cells and the cells of die innate immune
system: eosinophils, mast cells, neutrophils, and macrophages. These
cells clearly contribute to the pathogenesis of this disease and to the
prognosis. Cytokines and chemokines released from the activated
immune cells probably promote tumor cell growth and survival along
widi angiogenesis. Mast cells and eosinophils seem also to contribute
to the fibrosis that is so characteristic for nodular sclerosis.
New Aspects in Descriptive, Etiologic,
and Molecular Epidemiology of Hodgkin s Lymphoma 825
Ola Landgren and Neil E. Caporaso
Epstein Barr virus (EBV) has remained the main candidate suggested as
the infection causing Hodgkin s lymphoma for several years. However,
EBV genome has been found only within the tumor in about 2O°/o 4O°/o
of Hodgkin s lymphoma cases with a prior diagnosis of infectious
mononucleosis. Recendy, autoimmune and related conditions have
drawn attention to a potential role for immune related and inflamma¬
tory conditions in the etiology and pathogenesis of the malignancy.
Evidence from multiple affected families from case series, a twin study,
a case control study, and population based registry studies implicate
a role for genetic factors. Simultaneously, data from Eastern Asia and
among Chinese immigrants in North America indicate increasing inci¬
dence trends for Hodgkin s lymphoma being associated widi westerni¬
zation. These results emphasize an interaction between environmental
and genetic risk factors in Hodgkin s lymphoma.
The International Harmonization Project
for Response Criteria in Lymphoma Clinical Trials 841
Bruce D. Cheson
Clinical trials are critical to die development of newer and more effec¬
tive treatments. Standardized response criteria are essential to assess
and compare the activity of various therapies within and among studies
and to facilitate the evaluation of new treatments by regulatory
agencies. The International Harmonization Project developed revised
guidelines with die goal of improved comparability among studies,
leading to accelerated new agent development resulting in the rapid
availability of improved dierapies for patients who have lymphoma.
Modifications of these recommendations are expected as new informa¬
tion and improved technologies become available.
viii J
CONTENTS continued
Is [18F]fluorodeoxyglucose Positron Emission
Tomography the Ultimate Tool for Response
and Prognosis Assessment? 855
lieselot Brepoels and Sigrid Stroobants
[ Fjfluorodeoxyglucose positron emission tomography (FDG PET) is
currently the most accurate and reliable tool for the assessment of re¬
sponse in Hodgkin s lymphoma (HL). FDG PET is superior to conven¬
tional imaging techniques for detection of residual disease at the end of
treatment, especially in the presence of a residual mass, a frequent find¬
ing in HL. FDG PET response assessment has also a high predictive
value early after the initiation of therapy. However, whether risk
adapted treatment strategies based on FDG PET may also improve
patient outcome remains to be proved.
New Strategies for the Treatment of Early Stages
of Hodgkin s Lymphoma 871
David A. Macdonald and Joseph M. Connors
The treatment of early or limited stage Hodgkin s lymphoma continues
to evolve. With the likelihood of cure of die lymphoma approaching
95% it has become increasingly necessary to balance improved effective¬
ness of treatment with minimization of troublesome late toxicity. Care¬
fully crafted treatment strategies based on optimal combinations of brief
chemotherapy and involved field radiation or even reliance on brief
chemotherapy alone for carefully selected patients have emerged as
the most attractive approaches to achieve diis important balance.
Do We Need an Early Unfavorable (Intermediate)
Stage of Hodgkin s Lymphoma? 881
Lena Specht and John Raemaekers
The outcome of patients who have early unfavorable or intermediate
stage Hodgkin s lymphoma has gready improved. The increasing effi¬
cacy of chemodierapy and late toxic effects of wide field radiotherapy
justify the careful testing of die new involved node radiotherapy princi¬
ple in die combined modality approach. For the purpose of tailoring
treatment to die individual patient we need more accurate measures,
preferably predictive factors diat may tell us how the individual patient
should be treated. The result of an early positron emission tomography
scan widi fluorodeoxyglucose may well become die major new treat¬
ment related guidance for an individually tailored treatment approach.
New Strategies for the Treatment
of Advanced Stage Hodgkin s Lymphoma 897
Volker Diehl, Andreas Engert, and Daniel Re
In 2007, patients who have Hodgkin s lymphoma, even in advanced
stages, have a better than 85% chance of being cured of dieir disease
ix
CONTENTS continued
if adequate therapy is given at the outset. Most ongoing or planned in¬
ternational studies tailor therapy according to the needs of the individ¬
ual patient, also accounting for anatomic stage, tumor burden, age,
gender, and biologic host factors that affect prognosis. With this ap¬
proach it might be possible to use less aggressive treatment regimens
for the lower risk groups and limit the use of die more aggressive
dose and time intensified/dense regimens for die higher risk groups.
With this individualized approach it might be possible to yield higher
cure rates and simultaneously reduce the risk for late compKcations
and mortality.
Hodgkin s Lymphoma: The Role of Radiation
in the Modern Combined Strategies of Treatment 915
Richard T. Hoppe
A history of the treatment of Hodgkin s disease widi radiation therapy
and chemotherapy is presented. Studies are reviewed examining treat¬
ment for favorable and unfavorable presentation of stage I—II disease,
stage DI IV disease, and relapsed disease. In diis era of combined
modality therapy we have reached die point of near total conquest of
Hodgkin s lymphoma, but challenges remain. Directions for future
research are discussed.
Relapsed and Refractory Hodgkin s Lymphoma:
New Avenues? 929
George P. Canellos
Relapse or progression following therapy for Hodgkin s lymphoma
occurs in 10% to 60% of patients depending on initial clinical stage.
Patterns of failure in advanced disease determine prognosis of salvage
therapy. Progression or early relapse after less than 12 months requires
intensive salvage therapy. Only late, isolated, asymptomatic relapse,
which occurs in less than 25% of those relapsing from systemic therapy,
can be treated with conventional dose chemotherapy with or without
radiation. Overall about 40% to 50% of relapses from advanced disease
can be salvaged with higher percentages for patients relapsing from
early stage disease.
Autologous and Allogeneic Stem Cell
Transplantation in Hodgkin s Lymphoma 943
Anna Sureda
Newly diagnosed patients who have advanced stage Hodgkin s lym¬
phoma have an excellent prognosis because most of diem can be cured
with initial treatment. In contrast, die prognosis for patients relapsing
after first line therapy widi either combination chemotherapy or chemo
dierapy followed by radiodierapy remains poor in many cases. In most
x
CONTENTS continued
of these cases, high dose chemotherapy and autologous stem cell trans¬
plantation (ASCT) is currently considered to be the treatment of choice.
However, results of ASCT in primary refractory patients are poor and
new therapeutic alternatives should be sought for these patients. Alloge
neic stem cell transplantation has been used increasingly in relapsed or
refractory Hodgkin s lymphoma patients, with the introduction of re¬
duced intensity conditioning protocols.
Are We Improving the Long Term Burden
of Hodgkin s Lymphoma Patients with Modern
Treatment? 961
Berthe M.P. Aleman and Flora E. van Leeuwen
The cure rate of patients who have Hodgkin s lymphoma (HL)
amounts to 8O°/o or more because of risk adapted treatment using mod¬
ern chemotherapy and radiotherapy schedules. In this article we de¬
scribe important late effects after treatment of HL and how we expect
the long term burden of patients who have HL to change applying
modern treatments. Because treatment always has side effects to some
extent, awareness of possible late effects after treatment remains impor¬
tant for patients and treating physicians.
Index 977
xi
|
| adam_txt |
5§[ ^^^^^^k^^^^^^^^^h
ELSEV1ER ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^H
SAUNDERS ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^imH^^^^^I
Hodgkin's Lymphoma: New Insights
in an Old Disease
CONTENTS VOLUME 21 « NUMBER 5 « CCTOBER 2007
Preface xiii
Volker Diehl, Andreas Engert, and Daniel Re
World Health Organization and Beyond: New
Aspects in the Pathology of an Old Disease 769
Michael Hummel
Hodgkin's lymphoma is a highly enigmatic lymphoma disease that still
covers most of its secrets up to now. Much effort has been made to
successfully wrest at least some of the pathogenetic particularities.
The current diagnostic criteria are well established allowing hematopa
thologists to make a clear cut distinction from other lymphomas in
almost all cases. Although classic Hodgkin's lymphoma is curable in
the vast majority of cases by treatment widi highly aggressive drugs
with or without radiotherapy, further molecular studies may lead to
the identification of therapeutic targets diat enable a more tailored treat¬
ment with fewer side effects.
The Pathogenesis of Classical Hodgkin's
Lymphoma: A Model for B Cell Plasticity 787
Stephan Mathas
It has been shown that differentiated lymphoid cells can display a broad
developmental potential and might even differentiate into other cell
types. Recent data implicate such processes in the pathogenesis of clas¬
sical Hodgkin's lymphoma (HL). In the malignant, B cell derived
Hodgkin's and Reed Sternberg (HRS) cells of HL the expression of
B cell specific genes is lost, and B lineage inappropriate genes are up
regulated. Experimental evidence has been presented in recent years
that functional disruption of the B lineage specific transcription factor
program contributes to this process. HRS cells might be reprogrammed
into cells resembling undifferentiated progenitor cells, which might offer
an explanation for the unique HL phenotype and demonstrate a high
degree of plasticity of human lymphoid cells.
vii
CONTENTS continued
The Potential Role of the Innate Immunity
in the Pathogenesis of Hodgkin's Lymphoma 805
Gunilla Enblad, Daniel Molin, Ingrid Glimelius, Marie Fischer,
and Gunnar Nilsson
The innate immune system is our first line of defense against danger
signals but in Hodgkin's lymphoma the role seems opposite, favoring
malignant development. In this article we describe interactions between
Hodgkin's and Reed Sternberg cells and the cells of die innate immune
system: eosinophils, mast cells, neutrophils, and macrophages. These
cells clearly contribute to the pathogenesis of this disease and to the
prognosis. Cytokines and chemokines released from the activated
immune cells probably promote tumor cell growth and survival along
widi angiogenesis. Mast cells and eosinophils seem also to contribute
to the fibrosis that is so characteristic for nodular sclerosis.
New Aspects in Descriptive, Etiologic,
and Molecular Epidemiology of Hodgkin's Lymphoma 825
Ola Landgren and Neil E. Caporaso
Epstein Barr virus (EBV) has remained the main candidate suggested as
the infection causing Hodgkin's lymphoma for several years. However,
EBV genome has been found only within the tumor in about 2O°/o 4O°/o
of Hodgkin's lymphoma cases with a prior diagnosis of infectious
mononucleosis. Recendy, autoimmune and related conditions have
drawn attention to a potential role for immune related and inflamma¬
tory conditions in the etiology and pathogenesis of the malignancy.
Evidence from multiple affected families from case series, a twin study,
a case control study, and population based registry studies implicate
a role for genetic factors. Simultaneously, data from Eastern Asia and
among Chinese immigrants in North America indicate increasing inci¬
dence trends for Hodgkin's lymphoma being associated widi westerni¬
zation. These results emphasize an interaction between environmental
and genetic risk factors in Hodgkin's lymphoma.
The International Harmonization Project
for Response Criteria in Lymphoma Clinical Trials 841
Bruce D. Cheson
Clinical trials are critical to die development of newer and more effec¬
tive treatments. Standardized response criteria are essential to assess
and compare the activity of various therapies within and among studies
and to facilitate the evaluation of new treatments by regulatory
agencies. The International Harmonization Project developed revised
guidelines with die goal of improved comparability among studies,
leading to accelerated new agent development resulting in the rapid
availability of improved dierapies for patients who have lymphoma.
Modifications of these recommendations are expected as new informa¬
tion and improved technologies become available. '
viii J
CONTENTS continued
Is [18F]fluorodeoxyglucose Positron Emission
Tomography the Ultimate Tool for Response
and Prognosis Assessment? 855
lieselot Brepoels and Sigrid Stroobants
[' Fjfluorodeoxyglucose positron emission tomography (FDG PET) is
currently the most accurate and reliable tool for the assessment of re¬
sponse in Hodgkin's lymphoma (HL). FDG PET is superior to conven¬
tional imaging techniques for detection of residual disease at the end of
treatment, especially in the presence of a residual mass, a frequent find¬
ing in HL. FDG PET response assessment has also a high predictive
value early after the initiation of therapy. However, whether risk
adapted treatment strategies based on FDG PET may also improve
patient outcome remains to be proved.
New Strategies for the Treatment of Early Stages
of Hodgkin's Lymphoma 871
David A. Macdonald and Joseph M. Connors
The treatment of early or limited stage Hodgkin's lymphoma continues
to evolve. With the likelihood of cure of die lymphoma approaching
95% it has become increasingly necessary to balance improved effective¬
ness of treatment with minimization of troublesome late toxicity. Care¬
fully crafted treatment strategies based on optimal combinations of brief
chemotherapy and involved field radiation or even reliance on brief
chemotherapy alone for carefully selected patients have emerged as
the most attractive approaches to achieve diis important balance.
Do We Need an Early Unfavorable (Intermediate)
Stage of Hodgkin's Lymphoma? 881
Lena Specht and John Raemaekers
The outcome of patients who have early unfavorable or intermediate
stage Hodgkin's lymphoma has gready improved. The increasing effi¬
cacy of chemodierapy and late toxic effects of wide field radiotherapy
justify the careful testing of die new involved node radiotherapy princi¬
ple in die combined modality approach. For the purpose of tailoring
treatment to die individual patient we need more accurate measures,
preferably predictive factors diat may tell us how the individual patient
should be treated. The result of an early positron emission tomography
scan widi fluorodeoxyglucose may well become die major new treat¬
ment related guidance for an individually tailored treatment approach.
New Strategies for the Treatment
of Advanced Stage Hodgkin's Lymphoma 897
Volker Diehl, Andreas Engert, and Daniel Re
In 2007, patients who have Hodgkin's lymphoma, even in advanced
stages, have a better than 85% chance of being cured of dieir disease
ix
CONTENTS continued
if adequate therapy is given at the outset. Most ongoing or planned in¬
ternational studies tailor therapy according to the needs of the individ¬
ual patient, also accounting for anatomic stage, tumor burden, age,
gender, and biologic host factors that affect prognosis. With this ap¬
proach it might be possible to use less aggressive treatment regimens
for the lower risk groups and limit the use of die more aggressive
dose and time intensified/dense regimens for die higher risk groups.
With this individualized approach it might be possible to yield higher
cure rates and simultaneously reduce the risk for late compKcations
and mortality.
Hodgkin's Lymphoma: The Role of Radiation
in the Modern Combined Strategies of Treatment 915
Richard T. Hoppe
A history of the treatment of Hodgkin's disease widi radiation therapy
and chemotherapy is presented. Studies are reviewed examining treat¬
ment for favorable and unfavorable presentation of stage I—II disease,
stage DI IV disease, and relapsed disease. In diis era of combined
modality therapy we have reached die point of near total conquest of
Hodgkin's lymphoma, but challenges remain. Directions for future
research are discussed.
Relapsed and Refractory Hodgkin's Lymphoma:
New Avenues? 929
George P. Canellos
Relapse or progression following therapy for Hodgkin's lymphoma
occurs in 10% to 60% of patients depending on initial clinical stage.
Patterns of failure in advanced disease determine prognosis of salvage
therapy. Progression or early relapse after less than 12 months requires
intensive salvage therapy. Only late, isolated, asymptomatic relapse,
which occurs in less than 25% of those relapsing from systemic therapy,
can be treated with conventional dose chemotherapy with or without
radiation. Overall about 40% to 50% of relapses from advanced disease
can be salvaged with higher percentages for patients relapsing from
early stage disease.
Autologous and Allogeneic Stem Cell
Transplantation in Hodgkin's Lymphoma 943
Anna Sureda
Newly diagnosed patients who have advanced stage Hodgkin's lym¬
phoma have an excellent prognosis because most of diem can be cured
with initial treatment. In contrast, die prognosis for patients relapsing
after first line therapy widi either combination chemotherapy or chemo
dierapy followed by radiodierapy remains poor in many cases. In most
x
CONTENTS continued
of these cases, high dose chemotherapy and autologous stem cell trans¬
plantation (ASCT) is currently considered to be the treatment of choice.
However, results of ASCT in primary refractory patients are poor and
new therapeutic alternatives should be sought for these patients. Alloge
neic stem cell transplantation has been used increasingly in relapsed or
refractory Hodgkin's lymphoma patients, with the introduction of re¬
duced intensity conditioning protocols.
Are We Improving the Long Term Burden
of Hodgkin's Lymphoma Patients with Modern
Treatment? 961
Berthe M.P. Aleman and Flora E. van Leeuwen
The cure rate of patients who have Hodgkin's lymphoma (HL)
amounts to 8O°/o or more because of risk adapted treatment using mod¬
ern chemotherapy and radiotherapy schedules. In this article we de¬
scribe important late effects after treatment of HL and how we expect
the long term burden of patients who have HL to change applying
modern treatments. Because treatment always has side effects to some
extent, awareness of possible late effects after treatment remains impor¬
tant for patients and treating physicians.
Index 977
xi |
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| illustrated | Illustrated |
| index_date | 2024-07-02T19:10:40Z |
| indexdate | 2024-07-09T21:08:59Z |
| institution | BVB |
| isbn | 9781416050810 1416050817 |
| language | English |
| oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-016218536 |
| oclc_num | 181421931 |
| open_access_boolean | |
| owner | DE-19 DE-BY-UBM DE-355 DE-BY-UBR |
| owner_facet | DE-19 DE-BY-UBM DE-355 DE-BY-UBR |
| physical | XIV S., S. 769 - 983 Ill., graph. Darst. |
| publishDate | 2007 |
| publishDateSearch | 2007 |
| publishDateSort | 2007 |
| publisher | Saunders |
| record_format | marc |
| series | Hematology, oncology clinics of North America |
| series2 | Hematology, oncology clinics of North America |
| spelling | Hodgkin's lymphoma new insights in an old disease guest ed. Volker Diehl ... Philadelphia [u.a.] Saunders 2007 XIV S., S. 769 - 983 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Hematology, oncology clinics of North America 21,5 Hodgkin's disease Lymphogranulomatose (DE-588)4127860-4 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Lymphogranulomatose (DE-588)4127860-4 s b DE-604 Diehl, Volker 1938- Sonstige (DE-588)120716437 oth Hematology, oncology clinics of North America 21,5 (DE-604)BV000625446 21,5 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=016218536&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Hodgkin's lymphoma new insights in an old disease Hematology, oncology clinics of North America Hodgkin's disease Lymphogranulomatose (DE-588)4127860-4 gnd |
| subject_GND | (DE-588)4127860-4 (DE-588)4143413-4 |
| title | Hodgkin's lymphoma new insights in an old disease |
| title_auth | Hodgkin's lymphoma new insights in an old disease |
| title_exact_search | Hodgkin's lymphoma new insights in an old disease |
| title_exact_search_txtP | Hodgkin's lymphoma new insights in an old disease |
| title_full | Hodgkin's lymphoma new insights in an old disease guest ed. Volker Diehl ... |
| title_fullStr | Hodgkin's lymphoma new insights in an old disease guest ed. Volker Diehl ... |
| title_full_unstemmed | Hodgkin's lymphoma new insights in an old disease guest ed. Volker Diehl ... |
| title_short | Hodgkin's lymphoma |
| title_sort | hodgkin s lymphoma new insights in an old disease |
| title_sub | new insights in an old disease |
| topic | Hodgkin's disease Lymphogranulomatose (DE-588)4127860-4 gnd |
| topic_facet | Hodgkin's disease Lymphogranulomatose Aufsatzsammlung |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=016218536&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
| volume_link | (DE-604)BV000625446 |
| work_keys_str_mv | AT diehlvolker hodgkinslymphomanewinsightsinanolddisease |