News: Hodgkin's disease; Mammograms

News
*German researchers have suggested that in elderly patients with early stage Hodgkin's disease, the 4 cycles of ABVD normally planned before radiation were too toxic and not as effective.  They suggested up to 20% of patients were unable to complete planned therapy.

They also suggested truncated (AVD) combinations with Revlimid or Brentuximab Vedotin  as alternative options.

*Danish researchers have reported that over 400 cases of false alarm mammograms in a screening of 1300 women.  They further suggested that in some cases the false alarm rates could reach up to 60% of cases as reported by Medscape.  This is very remarkable with possibility to further evaluations including invasive surgical procedures.  And a lot of women could end up with an unnecessary Biopsy.  And this is bad news because hx of Biopsy increases Breast cancer risk!

SUGGESTION OF TREATMENT OPTIONS IN PATIENTS WITH ACTIVATED B CELL LYMPHOMA AFTER FAILURE OF R-CHOP IF PATIENT IS A POOR CANDIDATE

IN Not transplant candidates:
The options are:

1.Revlimid+ Rituxan
2.Rev+RICE is being trial
3.Reduced Conditioning Allogeneic Transplant
4.R+Bendamustine
5.Whyndam  R-EPOCH,
6.Velcade + Chemotherapy in the ABC subtype

Nn CNS prophylaxis, with addition of RITUXAN,  the  incidence of CNs relapse has decreased.
Large Cell lymphoma with Bone Marrow infiltration in 50% of case it is because of small cell component is actually infiltrating which does impact the  prognosis considerably.  So, NO CNS prophylaxis supported.
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TREATMENT OPTIONS IN MANTLE CELL (SOX 11 MARKS AN INDOLENT COURSE)

1.R-HYPERCVAD (MODIFIED)
2.R-BENDAMUSTINE
3. 4 CYCLES OF R-DHAP (LYMA TRIAL), COULD BE  FOLLOWED BY REVELIMD OR RITUXAN MAINTENANCE
4.HIGH DOSE ARA-C CONTAINING REGIMEN
5 R-CHOP ALTERNATING WITH R-DHAP
6. IBRUTINIB
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CLL, TREATMENT OPTION

1.RITUXAN-BENDAMUSTINE
2.FLUDARABINE, CYTOXAN, RITUXAN (FCR)
3.FOR AUTOIMMUNE HEMOLYTIC ANEMIA- PREDNISONE, IV IG , RITUXAN COMBINATION PRIOR TO STARTING THERAPY.
4. IBRUTINIB
5. LOW INTENSITY ALLO TRANSPLANT

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Tailored Hematology: Challenging Community Cases in Non-Hodgkin Lymphoma

February 8, 2013

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