Indian Council of Medical Research Consensus Document for the Management of Non-Hodgkin’s Lymphoma (High Grade)

Dinesh Doval; Dinesh Chandra Bhurani; Reena Nair; Sumeet Gujral; Pankaj Malhotra; Ganpati Ramanan; Ravi Mohan; Ghanshyam Biswas; Satya Dattatreya; Shyam Agarwal; Dinesh Pendharkar; Pramod Julka; Suresh H Advani; Rupinder Singh Dhaliwal; Juhi Tayal; Rupal Sinha; Tanvir Kaur; Goura K Rath

doi:10.4103/0971-5851.203500

Indian Journal of Medical and Paediatric Oncology, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2017; 38(01): 51-58
DOI: 10.4103/0971-5851.203500

Review Article

Indian Council of Medical Research Consensus Document for the Management of Non-Hodgkin’s Lymphoma (High Grade)

Autoren

Dinesh Doval

Department of Research, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
Dinesh Chandra Bhurani

Department of Research, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
Reena Nair

Department of Hemato oncology, Tata Memorial Centre, Kolkata, West Bengal, India
Sumeet Gujral

Department of Hemato Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India
Pankaj Malhotra

Department of Clinical Haematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
Ganpati Ramanan

Department of Medical Oncology, Apollo MultiSpecialty Hospital, Chennai, Tamil Nadu, India
Ravi Mohan

Department of Internal Medicine and Medical Oncology, Guntur Medical College, Guntur, Andhra Pradesh, India
Ghanshyam Biswas

Department of Medical Oncology, Sparsh Hospitals and Critical Care, Bhubaneswar, Odisha, India
Satya Dattatreya

Department of Medical Oncology, Omega Hospital, Hyderabad, Telangana, India
Shyam Agarwal

Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
Dinesh Pendharkar

Division of Non Communicable Disease, Indian Council of Medical Research, New Delhi, India
Pramod Julka

Department of Radiotherapy, Dr. BR Ambedkar Institute of Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
Suresh H Advani

Department of Medical Oncology, SL Raheja Hospital, Mumbai, Maharashtra, India
Rupinder Singh Dhaliwal

Division of Non Communicable Disease, Indian Council of Medical Research, New Delhi, India
Juhi Tayal

Department of Research, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
Rupal Sinha

Department of Research, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
Tanvir Kaur

Division of Non Communicable Disease, Indian Council of Medical Research, New Delhi, India
Goura K Rath

Department of Radiotherapy, Dr. BR Ambedkar Institute of Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India

Abstract

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Abstract

This consensus document is based on the guidelines related to the management of Non Hodgkin's Lymphoma (High grade) in the Indian population as proposed by the core expert committee. Accurate diagnosis in hematolymphoid neoplasm requires a combination of detailed history,clinical examination, and various investigations including routine laboratory tests, good quality histology section (of tumor and also bone marrow aspirate/biopsy), immunostaining, cytogenetic and molecular studies and radiology investigations. The staging system used for adult high grade lymphomas is based on the Ann Arbor system and includes various parameters like clinical, haematology, biochemistry, serology and radiology. Response should be evaluated with radiological evaluation after 3-4 cycles and at the end of treatment based on criteria including and excluding PET. Treatment of high grade lymphomas is based on histologic subtype, extent of disease, and age of the patient. Autologous stem cell transplantation after high dose chemotherapy is effective in the treatment of relapsed NHL. Newer RT techniques like 3 dimensional conformal radiation therapy (3D-CRT) and intensity modulated radiation therapy (IMRT) can significantly reduce radiation doses to surrounding normal tissues in lymphoma patients. Patients should be followed up every 3 to 4 months for thefirst 2 years, followed by 6 monthly for the next 3 years and then annually.

Keywords

Guidelines - Indian Council of Medical Research - Non-Hodgkin's lymphoma (high grade)

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Referenzen

References
1 Swerdlow SH, Campo E, Harris NL. WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues. Vol. 2. Lyon: IARC; 2008. p. 185-92.
2 Naresh KN, Srinivas V, Soman CS. Distribution of various subtypes of non-Hodgkin's lymphoma in India: A study of 2773 lymphomas using R.E.A.L. and WHO Classifications. Ann Oncol 2000;11 Suppl 1:63-7.
3 Srinivas V, Soman CS, Naresh KN. Study of the distribution of 289 non-Hodgkin lymphomas using the WHO classification among children and adolescents in India. Med Pediatr Oncol 2002;39:40-3.
4 A predictive model for aggressive non-Hodgkin's lymphoma. The International Non-Hodgkin's Lymphoma Prognostic Factors Project. N Engl J Med 1993;329:987-94.
5 Hoster E, Dreyling M, Klapper W, Gisselbrecht C, van Hoof A, Kluin-Nelemans HC, et al. Anew prognostic index (MIPI) for patients with advanced-stage mantle cell lymphoma. Blood 2008;111:558-65.
6 Cheson BD, Horning SJ, Coiffier B, Shipp MA, Fisher RI, Connors JM, et al. Report of an international workshop to standardize response criteria for non-Hodgkin's lymphomas. NCI Sponsored International Working Group. J Clin Oncol 1999;17:1244.
7 Cheson BD, Pfistner B, Juweid ME, Gascoyne RD, Specht L, Horning SJ, et al. Revised response criteria for malignant lymphoma. J Clin Oncol 2007;25:579-86.
8 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 Med 1998;339:21-6.
9 Persky DO, Unger JM, Spier CM, Stea B, LeBlanc M, McCarty MJ, et al. Phase II study of rituximab plus three cycles of CHOP and involved-field radiotherapy for patients with limited-stage aggressive B-cell lymphoma: Southwest Oncology Group study 0014. J Clin Oncol 2008;26:2258-63.
10 Witzig TE. Current treatment approaches for mantle-cell lymphoma. J Clin Oncol 2005;23:6409-14.
11 Romaguera JE, Fayad L, Rodriguez MA, Broglio KR, Hagemeister FB, Pro B, et al. High rate of durable remissions after treatment of newly diagnosed aggressive mantle-cell lymphoma with rituximab plus hyper-CVAD alternating with rituximab plus high-dose methotrexate and cytarabine. J Clin Oncol 2005;23:7013-23.
12 Zelenetz AD. Mantle cell lymphoma: An update on management. Ann Oncol 2006;17 Suppl 4:iv12-4.
13 Lenz G, Dreyling M, Hoster E, Wörmann B, Dührsen U, Metzner B, et al. Immunochemotherapy with rituximab and cyclophosphamide, doxorubicin, vincristine, and prednisone significantly improves response and time to treatment failure, but not long-term outcome in patients with previously untreated mantle cell lymphoma: Results of a prospective randomized trial of the German Low Grade Lymphoma Study Group (GLSG). J Clin Oncol 2005;23:1984-92.
14 Howard OM, Gribben JG, Neuberg DS, Grossbard M, Poor C, Janicek MJ, et al. Rituximab and CHOP induction therapy for newly diagnosed mantle-cell lymphoma: Molecular complete responses are not predictive of progression-free survival. J Clin Oncol 2002;20:1288-94.
15 Rummel MJ, Al-Batran SE, Kim SZ, Welslau M, Hecker R, Kofahl-Krause D, et al. Bendamustine plus rituximab is effective and has a favorable toxicity profile in the treatment of mantle cell and low-grade non-Hodgkin's lymphoma. J Clin Oncol 2005;23:3383-9.
16 Khouri IF, Lee MS, Saliba RM, Jun G, Fayad L, Younes A, et al. Nonablative allogeneic stem-cell transplantation for advanced/recurrent mantle-cell lymphoma. J Clin Oncol 2003;21:4407-12.
17 Magrath I, Adde M, Shad A, Venzon D, Seibel N, Gootenberg J, et al. Adults and children with small non-cleaved-cell lymphoma have a similar excellent outcome when treated with the same chemotherapy regimen. J Clin Oncol 1996;14:925-34.
18 Soussain C, Patte C, Ostronoff M, Delmer A, Rigal-Huguet F, Cambier N, et al. Small noncleaved cell lymphoma and leukemia in adults. A retrospective study of 65 adults treated with the LMB pediatric protocols. Blood 1995;85:664-74.
19 Mead GM, Sydes MR, Walewski J, Grigg A, Hatton CS, Pescosta N, et al. An international evaluation of CODOX-M and CODOX-M alternating with IVAC in adult Burkitt's lymphoma: Results of United Kingdom Lymphoma Group LY06 study. Ann Oncol 2002;13:1264-74.
20 Mead GM, Barrans SL, Qian W, Walewski J, Radford JA, Wolf M, et al. Aprospective clinicopathologic study of dose-modified CODOX-M/IVAC in patients with sporadic Burkitt lymphoma defined using cytogenetic and immunophenotypic criteria (MRC/NCRI LY10 trial). Blood 2008;112:2248-60.
21 Reiter A, Schrappe M, Parwaresch R, Henze G, Müller-Weihrich S, Sauter S, et al. Non-Hodgkin's lymphomas of childhood and adolescence: Results of a treatment stratified for biologic subtypes and stage – A report of the Berlin-Frankfurt-Münster Group. J Clin Oncol 1995;13:359-72.
22 Thomas DA, Cortes J, O'Brien S, Pierce S, Faderl S, Albitar M, et al. Hyper-CVAD program in Burkitt's-type adult acute lymphoblastic leukemia. J Clin Oncol 1999;17:2461-70.
23 Rizzieri DA, Johnson JL, Niedzwiecki D, Lee EJ, Vardiman JW, Powell BL, et al. Intensive chemotherapy with and without cranial radiation for Burkitt leukemia and lymphoma: Final results of Cancer and Leukemia Group B Study 9251. Cancer 2004;100:1438-48.
24 Kantarjian HM, O'Brien S, Smith TL, Cortes J, Giles FJ, Beran M, et al. Results of treatment with hyper-CVAD, a dose-intensive regimen, in adult acute lymphocytic leukemia. J Clin Oncol 2000;18:547-61.
25 Thomas DA, O'Brien S, Cortes J, Giles FJ, Faderl S, Verstovsek S, et al. Outcome with the hyper-CVAD regimens in lymphoblastic lymphoma. Blood 2004;104:1624-30.
26 Stock W, La M, Sanford B, Bloomfield CD, Vardiman JW, Gaynon P, et al. What determines the outcomes for adolescents and young adults with acute lymphoblastic leukemia treated on cooperative group protocols? A comparison of Children's Cancer Group and Cancer and Leukemia Group B studies. Blood 2008;112:1646-54.
27 Bessell EM, Graus F, Lopez-Guillermo A, Lewis SA, Villa S, Verger E, et al. Primary non-Hodgkin's lymphoma of the CNS treated with CHOD/BVAM or BVAM chemotherapy before radiotherapy: Long-term survival and prognostic factors. Int J Radiat Oncol Biol Phys 2004;59:501-8.
28 Abrey LE, Yahalom J, DeAngelis LM. Treatment for primary CNS lymphoma: The next step. J Clin Oncol 2000;18:3144-50.
29 DeAngelis LM, Seiferheld W, Schold SC, Fisher B, Schultz CJ; Radiation Therapy Oncology Group Study. Combination chemotherapy and radiotherapy for primary central nervous system lymphoma: Radiation Therapy Oncology Group Study 93-10. J Clin Oncol 2002;20:4643-8.
30 Ferreri AJ, Reni M, Pasini F, Calderoni A, Tirelli U, Pivnik A, et al. Amulticenter study of treatment of primary CNS lymphoma. Neurology 2002;58:1513-20.
31 Shah GD, Yahalom J, Correa DD, Lai RK, Raizer JJ, Schiff D, et al. Combined immunochemotherapy with reduced whole-brain radiotherapy for newly diagnosed primary CNS lymphoma. J Clin Oncol 2007;25:4730-5.
32 Ferreri AJ, Reni M, Dell'Oro S, Ciceri F, Bernardi M, Camba L, et al. Combined treatment with high-dose methotrexate, vincristine and procarbazine, without intrathecal chemotherapy, followed by consolidation radiotherapy for primary central nervous system lymphoma in immunocompetent patients. Oncology 2001;60:134-40.
33 Enting RH, Demopoulos A, DeAngelis LM, Abrey LE. Salvage therapy for primary CNS lymphoma with a combination of rituximab and temozolomide. Neurology 2004;63:901-3.
34 Montemurro M, Kiefer T, Schüler F, Al-Ali HK, Wolf HH, Herbst R, et al. Primary central nervous system lymphoma treated with high-dose methotrexate, high-dose busulfan/thiotepa, autologous stem-cell transplantation and response-adapted whole-brain radiotherapy: Results of the multicenter Ostdeutsche Studiengruppe Hamato-Onkologie OSHO-53 phase II study. Ann Oncol 2007;18:665-71.
35 Zucca E, Conconi A, Mughal TI, Sarris AH, Seymour JF, Vitolo U, et al. Patterns of outcome and prognostic factors in primary large-cell lymphoma of the testis in a survey by the International Extranodal Lymphoma Study Group. J Clin Oncol 2003;21:20-7.
36 Shahab N, Doll DC. Testicular lymphoma. Semin Oncol 1999;26:259-69.
37 Møller MB, d'Amore F, Christensen BE. Testicular lymphoma: A population-based study of incidence, clinicopathological correlations and prognosis. The Danish Lymphoma Study Group, LYFO. Eur J Cancer 1994;30A: 1760-4.
38 Zucca E, Roggero E, Bertoni F, Cavalli F. Primary extranodal non-Hodgkin's lymphomas. Part 1: Gastrointestinal, cutaneous and genitourinary lymphomas. Ann Oncol 1997;8:727-37.
39 Sasai K, Yamabe H, Tsutsui K, Dodo Y, Ishigaki T, Shibamoto Y, et al. Primary testicular non-Hodgkin's lymphoma: A clinical study and review of the literature. Am J Clin Oncol 1997;20:59-62.
40 Seymour JF, Solomon B, Wolf MM, Janusczewicz EH, Wirth A, Prince HM. Primary large-cell non-Hodgkin's lymphoma of the testis: A retrospective analysis of patterns of failure and prognostic factors. Clin Lymphoma 2001;2:109-15.
41 Philip T, Guglielmi C, Hagenbeek A, Somers R, Van der Lelie H, Bron D, et al. Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin's lymphoma. N Engl J Med 1995;333:1540-5.