Saturday, October 25, 2014

Imput on Non Hodgkin lymphoma

3 distinct groups of lymphoma
1.Germinal center
2.Activated B cell
3.Primary Mediastinal B cell lymphoma  (closer to Hodgkin disease)

when activated B cell, the prognosis is worse

somatic mutation may also influence outcome

Hans model   CD10     BCL-6   and MUM-1/IRF4   model to determine cell of origin

The Germinal Center B cell  lymphoma respond well to R-EPOCH  (CD10+, BCL-6+, MUM-1 -negative)
whereas the Activated B-cell lymphoma may be better of with Ibrutinib based treatment

Germinal Center responds better to Revlimid than Activated B cell lymphoma

Addition of Velcade allows to conquer the the resistance due to Activated B Cell Lymphoma

Those c-MYC positivity are the worse...and may need upfront transplant...or a clinical trial
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