medigraphic.com

2015, Number 1

<< Back Next >>

Rev Hematol Mex 2015; 16 (1)

Which is the best treatment for extranodal lymphomas?

Figueroa-Sandoval F, Jesús-Alva MA

Language: Spanish
References: 69
Page: 17-27
PDF size: 352.69 Kb.


ABSTRACT

Background: Extranodal primary lymphomas should meet the following criteria: a) absence of superficial adenomegalies in the physical exam, b) without adenomegalies at mediastinum assessed by thorax radiography, computed axial tomography or positron emission tomography, c) dominant lesion at extranodal site, d) it may be adenomegalies in proximity to primary lesion, e) cytometric studies, chemical hepatic, of bone marrow and the remaining studies of extension normal or negative. In the last two decades it has been an increased incidence of extranodal primary lymphomas, in literature there are several reports related to a determined organ, but there are only 10 reports related, in group, to epidemiology, pathology and behavior and this one is the first in Mexico in comment the multidisciplinary treatment of extranodal primary lymphomas.
Objective: To report the experience of extranodal lymphomas, attended from 1989 to 2003, with emphasis on the established treatment.
Material and method: A retrospective study done at Specialties Hospital of CMNO, Mexico, in which patients with extranodal lymphomas were included.
Results: Forty-one patients (22 men) were included, with a mean age of 45 years (limits of 19 and 65), 39 patients were immunocompetent and 2 immunocompromised. The site of localization was distributed as follows: 11 at central nervous system, 12 craniofacial, 6 at orbit, 5 gastric, 2 of breast, 2 of femur, one at small bowel, one of cervix and one of urinary bladder. Patients with primary lymphoma of central nervous were treated with biopsy and chemotherapy with CHOP and/or methotrexate, plus steroid and radiotherapy. In patients with lymphomas of stomach and jejunum the treatment included surgery, six cycles of chemotherapy and radiotherapy. Lymphomas of paranasal sinuses were treated with chemotherapy plus radiotherapy. Patients with lymphomas of femur, after biopsy, were given chemotherapy and radiotherapy. Patients with lymphomas of breast, after biopsy, received chemotherapy and radiotherapy. In patients with lymphomas of orbit, the treatment included biopsy plus radiotherapy with or without chemotherapy. Patients with lymphoma of cervix were submitted to surgery plus radiotherapy. Lymphomas of urinary bladder were treated with biopsy and radiotherapy. Control was obtained in 27% of lymphomas of central nervous system, in 47% of craniofacial, in 50% of femur and in 100% of orbit, gastric, breast, cervix, urinary bladder and small bowel.
Conclusion: In primary lymphomas of central nervous system there are a therapeutic arsenal, it should be selected that with high index of initial and long-term response and that provokes the less neuropsychologic toxicity. Trend is the treatment including rituximab + methotrexate + procarbazine + vincristine, followed by consolidation of radiotherapy at dose of 23 Gy + citarabine. Prescription of radiotherapy is supported by longer time of survival free of disease compared to the series administering exclusively chemotherapy.


REFERENCES

  1. Ferry JA. Extranodal lymphoma. Arch Pathol Lab Med 2008;132:565-578.

  2. Dawson IP, Cornes JS, Morson BC. Primary malignant lymphoid tumours of the intestinal tract. Report of 37 cases with a study of factors influencing prognosis. Br J Surg1961;49:80-89.

  3. Krol AD, Cessie S, Snijder S, et al. Primary extranodal non- Hodgkins lymphoma: The impact of alternative definitions tested in the Comprhensive Cancer Centre West population based NHL registry. Ann Oncol 2003;14:1-139.

  4. Freeman C, Berg JW, Cutler SJ. Occurrence and prognosis of extranodal lymphomas. Cancer 1972;29:252-260.

  5. Gospodarowicz MK, Sutcliffe SB. The extranodal lymphomas. Semin Radiat Oncol 1995;5:281-300.

  6. Zucca E, Roggero E, Bertoni F, et al. Primary extranodal non-Hodgkins lymphomas. Part 2: Head and neck central nervous system and other less common sites. Ann Oncol 1999;10:1023-1033.

  7. Padhi S, Roshni T, Challa S, et al. Primary extranodal non Hodgkin lymphoma: A 5 year retrospective analysis. Asian Pacific J Cancer Prev 2012;13:4889-4895.

  8. Arora N, Manipadam MT, Pulimood A, et al. Gastrointestinal lymphomas: Pattern of distribution and histological subtypes: 10 years experience in a tertiary centre in South India. Ind J Pathol Microbiol 2011;54:712-719.

  9. Morton LM, Wang SS, Devesa SS, et al. Lymphoma incidence patterns by WHO subtype in the United States, 1992-2001. Blood 2006;107:265-276.

  10. Stephens J, Smith J. Treatment of primary gastric lymphoma and gastric mucosa associated lymphoid tissue lymphoma. J Am Coll Surg 1998;187:312-320.

  11. Brands F, Moning SP, Raab M. Treatment and prognosis of gastric lymphoma Eur J Surg 1997;163:803-813.

  12. Haim N, Leviov M, Ben-arieh Y, et al. Intermediate and high grade gastric non Hodgkin lymphoma: a prospective study of non-surgical treatment with primary chemotherapy with or without radiotherapy. Leuk Lymphoma 1995;17:321-326.

  13. Ferreri AJ, Cordio S, Ponzoni M. Non-surgical treatment with primary chemotherapy with or without radiotherapy, of stage I-II high grade gastric lymphoma. Leuk Lymphoma 1999;33:531-541.

  14. Rabbi C, Aitini E, Cavazzini G, et a. Stomach preservation in low-and high grade primary gastric lymhoma. Haematologica 1996;8:15-19.

  15. Koch P, Grothaus-Pinke B, Hiddemann W, et al. Primary lymphoma of the stomach: three-year results of a prospective multicenter study. Ann Oncol 1997;8:85-88.

  16. Willich NA, Reimartz G, Horst EJ, et al. Operative and conservative management of primary gastric lymphoma: interim results of a German multicenter study. Int J Radiation Oncology Biology Physics 2000;46:895-901.

  17. Gospodarowics MR, Sutcliffe SB, Clark RM. Outcome analysis of localized gastrointestinal lymphomas treated with surgery and postoperative radiation. Int J Radiat Oncol Biol Phys 1990;19:1351-1355.

  18. Figueroa-Sandoval JF. Linfomas primarios del sistema nervioso central. Gac Méd Méx 2002;138:124.

  19. Linhares P, Aran E, Goncalves JM. Biopsias estereotáxicas. Revisión de una serie de 80 casos. ¿Está justificada la realización de una tomografía computarizada en las primeras horas tras el procedimiento? Neurocirugía 2002;13:299- 304.

  20. Gelabert González M, Castro D, Serramito R. Linfomas primarios del sistema nervioso central. Neurología 2013;28:283-293.

  21. Ferreri AJM. How I treat primary CNS lymphoma. Blood 2011;118:510-522.

  22. DeAngelis LM, Seiferheld W, Schold SC. Combination chemotherapy and radiotherapy for primary central nervous system lymphoma: Radiation Therapy Oncology Group Study 93-10. J Clin Oncol 2002;20:4643-4648.

  23. Omuro AM, Taillandier L, Chinot O, et al. Temozolamide and methotrexate for primary central nervous system lymphoma in the elderly. J Neurooncol 2007;85:207-211.

  24. Illerhaus G, Muller F, Feuerhake F. High dose chemotherapy and autologous stem cell transplantation without consolidating radiotherapy as first line treatment for LPCNS. Haematologica 2008;93:147-148.

  25. Rubenstein JL, Hsi ED, Johson JL. Intensive chemotherapy and immunotherapy in patients with newly diagnosed primary CNS lymphoma. CALGB 50202. J Clin Oncol 2013;31:3061-3068.

  26. Abla O, Weitzman S, Blay JY, et al. Primary CNS lymphoma in children and adolescents: a descriptive analysis from the international primary CNS lymphoma collaborative group. Clin Cancer Res 2011;17:346-352.

  27. Morris PG, Correa D, Yahalom J, et al. Rituximab, methotrexate, procarbazine, and vincristine followed by consolidation reduce dose whole brain radiotherapy and cytarabine in newly diagnosed primary CNS lymphoma: final results and long-term outcome. J Clin Oncol 2013;31:3971-3979.

  28. Wotherspoon AC, Diss TC, Pan LX, et al. Primary low grade B cell lymphoma of the conjunctiva: a mucosa-associated lymphoid tissue type lymphoma. Histopathology 1993;23:417-424.

  29. Kaushik M, Pulido J, Schild S. Risk of radiation retinopathy in patients with orbital and ocular lymphoma. Int J Radiation Oncol Biol Phys 2012;84:1145-1150.

  30. Harada K, Murakami N, Kitaguchi M, et al. Localized ocular adnexal mucosa-associated lymphoid tissue lymphoma treated with radiation therapy: a long-term outcome in 86 patients with 104 treated eyes. Int J Radiat Oncol Biol Phys 2014;88:650-654.

  31. Erak M, Mitric M. Radiotherapy for orbital lymphomas. Hematol Leuk 2014;2:1-3.

  32. Esik O, Ikeda H, Mukai K. A retrospective analysis of different modalities for treatment of primary orbital non hodgkin lymphoma. Radio Ther Oncol 1991;38:13-18.

  33. Yadav BS, Sharma SC. Orbital lymphoma: role of radiation. Indian J Ophthalmol 2009;57:91-97.

  34. Savage KJ, Chhanabhai M, Gascoyne RD, et al. Characterization of peripheral T-cell lymphomas in a single North American institution by the WHO classification. Ann Oncol 2004; 15:1467-1475.

  35. Aviles A, Díaz NR, Neri N, et al. Angiocentric nasal T/natural killer cell lymphoma. A single center study of prognostic factors in 108 patients. Clin Lab Haematol 2000;22:215- 220.

  36. Cheung MM, Chan JK, Lau WH, et al. Primary non Hodgkins lymphoma of the nose: clinical features, tumor immunophenotype and treatment outcome in 113 patients. J Clin Oncol 1998;16:70-77.

  37. Chim CS, Ma SY, Au WY, et al. Primary nasal natural killer cell lymphoma. Long-term treatment outcome and relationship with the international prognostic index. Blood 2004;103:216-221.

  38. Xiong Y, Yao B, Jin J, et al. Radiotherapy as primary treatment for stage IE and IIE nasal natural killer/T-cell lymphoma. J Clin Oncol 2006;24:181-189.

  39. Chalastras T, Elefteriadou A, Giotakis J. Non-Hodgkins lymphoma of nasal cavity and paranasal sinuses. A clinicopathological and immunohistochemical study. Acta Otorhinolaryngol Ital 2007;27:6-9.

  40. Yamaguchi M, Tobinai K, Oguchi M, et al. Phase I/II study of concurrent chemoradiotherapy for localized nasal natural killer/T cell lymphoma: Japan Clinical Oncology Group Study JCOGO211. J Clin Oncol 2009;27:5594-5600.

  41. Kim SJ, Kim K, Kim BS, Kim CY, et al. Phase II trial of concurrent radiation and weekly cisplatin followed by VIPD chemotherapy in newly diagnosed stage IE to IIE nasal, extranodalNK/T-Cell Lymphoma: Consortium for improving survival of lymphoma study. J Clin Oncol 2009;27:6027- 6032.

  42. Bekadja MA, Benredouane H, Audouin J, Mansouri D, et al. Nasal extranodal peripheral NK/T-cell lymphoma treated by the protocol NK/T cell high-dose-methotrexate lasparaginase dexamethasone. Hemato Oncol Stem Cell Ther 2011;4:49-50.

  43. Tse E, LamKwong Y. How I treat NK/T cell lymphoma. Blood 2013;121:10-30.

  44. Wiseman C, Liao KT. Primary lymphoma of the breast. Cancer 1972;29:1705-1712.

  45. Dao AH, Adkins RB, Glick AD. Malignant lymphoma of the breast: a review of 13 cases. Am Surg 1992;58:792- 796.

  46. Jennings WC, Baker RS, Murray SS. Primary breast lymphoma. The role of mastectomy and the importance of lymph node status. Ann Surg 2007;245:784-789.

  47. Wong WW, Schild SE, Halyard MY. Primary non-Hodgkin lymphoma of the breast: The Mayo Clinic experience. J Surg Oncol 2002;80:19-25.

  48. Joks M, Mysliwiec K, Lewandowski K. Primary breast lymphoma-a review of the literatura and report of three cases. Arch Med Sci 2011;7:27-33.

  49. Aviles A, Delgado S, Nambo MJ, et al. Primary breast lymphoma: results of a controlled clinical trial. Oncology 2005;69:256-260.

  50. Aviv A, Tadmor T, Polliack A. Primary diffuse large B cell lymphoma of the breast: looking at pathogenesis, clinical issues and therapeutic options. Ann Oncol 2013;1-9.

  51. Aviles A, Castañeda C, Neri N, et al. Rituximab and dose dense chemotherapy in primary breast lymphoma. Haematologica 2007;92:1147-1148.

  52. Kosari F, Daneshbod Y, Parwaresch R, et al. Lymphomas of the female genital tract. A study of 186 cases and review of the literature. Am J Surg Pathol 2005;29:1512-1520.

  53. Dursun P, Guitekin M, Bozdag G, et al. Primary cervical lymphoma: report of two cases and review of the literaturae. Gynecol Oncol 2005;98:484-489.

  54. Korcum AF, Karadogan I, Aksu G, et al. Primary follicular lymphoma of the cervix uteri: a review. Ann Hematol 2007;86:623-630.

  55. Baijal G, Vadiraja BM, Fernandes D. Diffuse large B cell lymphoma of the uterine cérvix: a rare case managed novelly. J Cancer Res Ther 2009;5:140-142.

  56. Strok EL, Besa PC, Cox L. Treatment of patients with lymphoma of the cervix with combined chemotherapy more radiotherapy. Cancer 1995;75:2392-2399.

  57. Heredia F, Bravo M, Pierotic E, et al. Neoadjuvant combined chemotherapy followed by external whole pelvis irradiation in two cases primary cervical lymphoma. Gynecol Oncol 2005;97:285-287.

  58. Anagnostopoulos A, Mouzakiti N, Ruthven J. Primary cervical and corpus lymphoma; a case report and literature review. Int J Clin Med 2013;6:298-306.

  59. De Greve T, Vanwalleghem L, Van Hoof A et al. An unusual cervical tumor as presentation of a non-hodgkin lymphoma. Obstetric and Gynecology 2014;2014:549619.

  60. Figueroa JF, Rodríguez J, Rosales S. Linfoma primario de cérvix uterino. Sangre 1994;39:58.

  61. Aigen AB, Phillips M. Primary malignant lymphoma of urinary bladder. Urology 1996;28:235-237.

  62. Bron D, Van den Neste E, Kentos A. BHS guidelines for the treatment of marginal zone lymphomas. Bel J Hematol 2014;5:12-21.

  63. Figueroa-Sandoval F, Peña-Peña P. Primary bladder lymphoma. Rev Hematol Mex 2014;15:76-78.

  64. Beal K, Allen L, Yahalom J. Primary bone lymphoma: treatment results and prognostic factors with long term follow-up of 82 patients. Cancer 2006;106:2652-2656.

  65. Ramadan KM, Shenkier L, Sehn LH, et al. A clinicopathological retrospective study of 131 patients with primary bone lymphoma: a population-based study of successively treated cohorts from the British Columbia Cancer Agency. Ann Oncol 2007;18:129-135.

  66. Alencar A, Pitcher D, Byme G, et al. Primary bone lymphoma- the University of Miami experience. Leuk Lymphoma 2010;51:39-49.

  67. Cai L, Stauder MC, Zhang YJ, et al. Early-stage primary bone lymphoma: a retrospective, multicenter rare cancer network study. Int J Radiation Oncol Biol Phys 2012,83:284- 291.

  68. Siddiqui YS, Khan AC, Sherwan MKA. Pathological fractures in primary non Hodgkins lymphoma of the bone: a case series with review of the literature. J Clin Diagn Res 2013;7:513-517.

  69. Liu M, Liu B, Han F. Primary bone lymphoma of the left radius: a case report and related literature review. Eur J Med Res 2014;19:19-21.




2020     |     www.medigraphic.com