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6 Non-Hodgkin Lymphoma

61

 

 

As soon as ANC (absolute neutrophil count) is more than 500, the next cycle of chemotherapy can be started

Prognosis depends on the response rate to chemotherapy and to initial tumor stage

Decrease in serum lactate dehydrogenate (LDH) level indicates the type of response to chemotherapy

Overall long-term survival between 70 and 90%

6.10.2 Therapy and Prognosis of LL

Therapy as in ALL: induction, consolidation with CNS-prophylaxis by intrathecal and/or high-dose chemotherapy or irradiation, followed by maintenance treatment

Duration of chemotherapy: 1–3 years as in ALL depending on cell type and stage

Prognosis: 80–90% long-term survival

– Thirty months after diagnosis relapse is unusual

6.10.3 Therapy and Prognosis of ALCL

Therapy according to BL/LCBL or LL (see above)

Results are similar to other NHL with 80% long-term survival

6.11Novel Immunologic Treatment

Targeted monoclonal anti-CD 20 antibody (Rituximab) against surface protein of B-cells in conjuction with chemotherapy is being currently evaluated

In ALCL monoclonal anti-CD 30 antibody and anti-ALK circulating antibodies in ALK-positive ALCL are in clinical evaluation

Antitumor vaccination and tumor-specific cell therapies are being evaluated

6.12Patients with Partial Response or with Relapse of NHL

Diagnosis and staging with biopsy as well as PET or PET/CT scanning

Therapy:

BL, BLL, LCBL: after reinduction [e.g., ifosfamide, cisplatin, etoposide (ICE)], high-dose chemotherapy with autologous or allogeneic stem-cell transplantation

Alternative or adjuvant treatment: CD20 monoclonal antibody (Rituximab)

In isolated relapse of CNS: conventional therapy and intrathecal chemotherapy (see above)

In relapsed LL: after reinduction (see above) allogeneic stem cell transplantation (as in early relapse of ALL)

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