ISSN:1040-8746    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1040-8746    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Malignant transformation of B cells can occur at various steps of lymphocyte development, starting from early B-cell progenitors up to mature B cells, which reflects the heterogeneity of B-cell malignancies with regard to their biologic and clinical behavior. The genetic characterization of B-cell neoplasms during the past two decades has elucidated the mechanisms underlying B-cell lymphomagenesis and led to a more precise definition of lymphoma subgroups. This progress is reflected in the upcoming World Health Organization classification for hematologic neoplasms, which stresses the diagnostic importance of recurrent genetic alterations in leukemias and lymphomas. In the recent past, several genes deregulated by such recurrent chromosomal aberrations have been identified. In addition, the recent introduction of microarray technology has now allowed a more global assessment of gene dysregulation in B-cell oncogenesis and provided a new means for more exactly defining the molecular hallmarks of distinct lymphoma subtypes. This review will focus on recently described molecular features of B-cell lymphomas discovered by the application of new molecular cytogenetic techniques, advanced breakpoint cloning strategies, and microarray approaches.

ISSN:1040-8746    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

A review of new or emerging ideas concerning diffuse large B-cell lymphomas is presented, with particular emphasis on histologic classification, genetic prognostic factors, first-line and salvage treatments, and specific locations such as neurologic, cutaneous, or gastrointestinal sites. This lymphoma remains the most heterogeneous of all lymphomas for its clinical characteristics and outcome. This heterogeneity is probably secondary to the fact that a large proportion of lymphomas seems to occur from a transformation of an unknown indolent lymphoma.

ISSN:1040-8746    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Low-grade lymphomas are generally considered incurable diseases with current standard therapies. Blood or marrow transplantation may be the exception. Nevertheless, the role of bone marrow transplantation in low-grade lymphomas has been limited by the usual indolent course of this heterogeneous group of diseases and the historically high rates of transplant-related mortality associated with most transplant procedures. This review discusses the current issues pertaining to bone marrow transplantation and comments on investigational approaches such as the use of monoclonal antibodies asin vivopurging mechanisms and nonmyeloablative and radioimmunoconjugated antibodies as alternate preparative regimens.

ISSN:1040-8746    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Mantle cell lymphoma is a distinct subtype and accounts for approximately 5 to 10% of non-Hodgkin lymphomas. The malignant cells express pan B-cell markers, including CD19, CD20 and CD22, and the T-cell marker CD5, whereas CD10 and CD23 expression are usually absent. By cytogenetic analysis, the t(11;14)(q13;q32) translocation is commonly observed, resulting in overexpression of cyclin D1. This entity often combines some unfavorable clinical features of the indolent and aggressive lymphoma subtypes, as it is generally incurable and relatively aggressive. It is most commonly observed in men 50 to 70 years of age and is characterized by disseminated disease, usually involving lymph nodes, bone marrow, and spleen. Frequently, there is extranodal involvement including the gastrointestinal tract. These tumors are incurable with the currently available therapeutic options, with usual time to progression after chemotherapy of approximately 1 year. Newer chemotherapy regimens (including stem cell transplantation) and monoclonal antibody-based therapies have shown limited evidence of additional benefit. Overall, the prognosis for patients with mantle cell lymphoma remains poor, and novel strategies are needed.

ISSN:1040-8746    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Epstein–Barr virus (EBV), a human herpes virus, is associated with a variety of malignancies.In vitro, it is able to transform B cells, which will grow as lymphoblastoid cell lines in the absence of T cells. Patients with a variety of immunodeficiency diseases are subject to the development of B-cell lymphomas that express viral antigens on their cell surface. Development of EBV-associated B-cell lymphomas is seen in solid organ transplant and bone marrow transplant recipients receiving immunosuppressive therapy. Transfer of mature T cells from EBV-immune marrow donors has been demonstrated to be effective in controlling these EBV-associated B-cell tumors.Recently the demonstration that EBV transcripts are found in other lymphomas (including Hodgkin disease cells) has led to the suggestion that transfer of EBV-specific T cells may also be effective in managing these tumors. Current research involves optimizing methods to expand cells that recognize the EBV antigens expressed in the lymphoma cells.

ISSN:1040-8746    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Infection with HIV increases the risk of developing non-Hodgkin lymphoma and, to a lesser extent, Hodgkin disease. The introduction of highly active antiretroviral therapy (HAART) in 1996 changed the natural history of HIV disease, but the HIV-infected population also has changed in composition. Accordingly, the epidemiology of HIV-associated lymphomas now differs from that observed in the first 15 years of the HIV epidemic. In populations with access to HAART, reductions in lymphoma risk have been reported for NHL and suggested for Hodgkin disease, but long-term risks are as yet unknown. Lymphomas are increasingly common cancers in persons with HIV and are fatal in most patients, warranting continued attention to their incidence and etiology.

ISSN:1040-8746    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Lymphoproliferative diseases (LPDs) associated with the Epstein–Barr virus (EBV) include non-Hodgkin lymphomas, which occur in the setting of immunosuppression, including that induced by human immunodeficiency virus, and posttransplant lymphoproliferative disorders. These LPDs are characterized by actively proliferating, latently infected EBV-positive B lymphocytes and often follow a rapidly progressive fatal clinical course. Pharmacologic treatment for herpesvirus infections has targeted the virus-specific enzyme, thymidine kinase (TK), with nucleoside analogs. The lack of viral TK expression in EBV-positive tumors, caused by viral latency, however, makes antiviral therapy alone ineffective as an antineoplastic therapy. Arginine butyrate selectively activates the EBVTKgene in latently infected EBV-positive tumor cells. We have developed a strategy for treatment of EBV-associated lymphomas using pharmacologic induction of the latent viral TK gene and enzyme in tumor cells using arginine butyrate, followed by treatment with ganciclovir. A phase I/II trial, using an intrapatient dose escalation of arginine butyrate combined with ganciclovir, is underway. This combination therapy has produced complete clinical responses in 5 of 10 previously refactory patients, with partial responses occurring in 2 additional patients. This virus-targeted antitumor strategy may provide a new therapeutic approach to EBV-associated neoplasms.

ISSN:1040-8746    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Acquired immune deficiency syndrome–associated Kaposi sarcoma is a progressive and occasionally fatal condition. The strong angiogenic component of this disease makes it particularly suitable for treatment with the emerging class of drugs that act as antiangiogenic agents. Matrix metalloproteinases have been shown to play prominent roles in the angiogenic process, and small molecule inhibitors of these enzymes are currently being tested as antiangiogenic agents in various malignancies. Given that matrix metalloproteinases contribute to multiple steps of the angiogenic process, inhibitors of these enzymes, either alone or in combination with other agents, may represent a particularly effective therapeutic approach for Kaposi sarcoma.

ISSN:1040-8746    

出版商:OVID    

年代:2001

数据来源: OVID