ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Epstein-Barr virus, Kaposi’s sarcoma-associated herpesvirus/human herpesvirus 8, and human T-cell lymphotrophic virus are viruses that are implicated in lymphoid neoplasia in humans. Their association with specific subsets of lymphomas suggests that they play an important, although not sufficient, etiologic role in their development. Current knowledge suggests that these viruses contribute to lymphomagenesis by subverting the host-cell molecular machinery to deregulate cell growth and survival. In this article, the basic information and recent developments that have contributed to our understanding of viral lymphomagenesis are reviewed.

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The understanding of specific lymphoma entities continues to evolve. This is perhaps most clearly illustrated by developments concerning gastric lymphomas of mucosa-associated lymphoid tissue (MALT) origin, ranging from further evidence of the role played byHelicobacter pylori, to new information about the role of an apoptotic regulatory gene,bcl-10. Another area of productive research is the study of the mechanism of immune recognition and death signaling in follicular lymphomas. This should lead to refinements and improvements in an already very promising array of immunotherapeutic approaches, which currently ranges from vaccine development to allogeneic transplant strategies designed to induce a graft-versus-lymphoma effect. The clinical success of the chimeric anti-CD20 antibody, rituximab, leaves no doubt that biologic insights can lead to therapeutic advances. Researchers appear to be breaking free of the notion that alkylating agent therapy is the best option and the only viable treatment strategy for the indolent lymphomas. The current challenge is to apply new insights wisely.

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Noninvasive imaging methods are the cornerstone of the conventional staging of patients with Hodgkin’s disease and non-Hodgkin’s lymphoma. Gallium-67 scintigraphy has become an important and essential imaging method, especially in the restaging for assessment of residual masses in patients with lymphoma. Magnetic resonance imaging will be used in the future for confirmation of suspect local lesions. Imaging of lymphoma patients with somatostatin receptor scintigraphy will remain a secondary imaging method, which will not be as routine. Positron emission tomography with 18-F-fluorodeoxyglucose (FDG) has made the greatest steps forward and offers, when whole-body FDG-PET is used, the advantage that the entire body of the patient can be imaged. Nodal, extranodal, and bone marrow involvement have been imaged by FDG-PET with great sensitivity and specificity. Perhaps in the future, staging laparotomy for exact staging of lymphoma patients will be unnecessary, and patients will be staged solely with noninvasive staging methods.

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Biologic approaches to lymphoma treatment are now a practical reality rather than a vaguely perceived hope for the future. Interferon alfa seems to have been established as a life-extending therapy for selected patients with follicular lymphoma. Humanized anti-CD20 monoclonal antibody (rituximab) has an authentic 50% response rate in patients with follicular lymphoma, frequently works when given a second time, and is demonstrating what seems to be synergistic activity when combined with chemotherapy. Radioimmunoconjugates using iodine-131 and yttrium-90 as payload are producing responses in refractory and aggressive lymphomas. Vaccines and adoptive cellular therapies are also showing promising results in early phase clinical testing.

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Most human lymphomas remain heterogeneous biologic entities in spite of recent advances in the description of their clinical presentation, cellular morphology, immunophenotype, and genotype. Elucidation of genetic alterations causing malignant transformation may explain pathogenesis, refine differential diagnosis, clarify prognosis, and provide rational basis for new therapy. During the last year the expression of anaplastic lymphoma kinase clarified presentation and provided clues toward the outcome of anaplastic large cell lymphoma; the breakpoints of t(2;5) were mapped; constitutive activation of anaplastic lymphoma kinase by a chromosomal inversion was described; transformation was shown to be independent of nuclear localization of anaplastic lymphoma kinase; and phospholipase C-γ was identified as a molecular target for the kinase activity of anaplastic lymphoma kinase. Molecular characterization of recurrent chromosome abnormalities has identified new candidate oncogenes:bcl-9,bcl-10,PAX-5,MMSET, andc-maf. Their precise role in malignant transformation, and the frequency of their alteration in lymphoma and myeloma, is not yet defined. The expression of the antiapoptotic proteinbcl-2on aggressive lymphomas was shown to be associated with inferior disease-free survival by several investigators. This may be a target of pharmacologic reduction ofbcl-2levels. Can these advances in molecular pathogenesis improve cure rates for lymphoma? The spectacularly successful molecular modeling of inhibitors for HIV protease suggests that this may be an attainable objective.

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Normal lymphocytes constantly receive death and survival signals. The balance between these two opposing pathways ensures lymphocyte homeostasis and prevents autoimmunity. This article focuses on the opposing functions of CD40 and Fas receptor/ligand pairs in B-cell lymphoid malignancies and Hodgkin’s disease. Understanding these pathways may enhance the future design of immunotherapy against lymphoid malignancies.

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

In most cases, lymphoma is a systemic disease even when detected at an early stage. Although radiation is primarily a local treatment, the exquisite radiosensitivity of lymphomas to radiation has allowed radiotherapy to remain an important component in the management of both indolent and aggressive types of lymphoma. Recent studies established the following points: 1) For early-stage intermediate grade lymphoma, combined modality is the treatment of choice. 2) A large fraction of patients with stage I–II low-grade lymphoma attain long-term disease-free survival with radiation alone. 3) Extranodal mucosa associated lymphoid tissue lymphomas are easily controlled with low-dose involved-field radiotherapy. Preliminary data suggest that even in an advanced-stage, intermediate-grade, adjuvant radiotherapy to bulky sites may improve outcome. This issue merits further study.

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

After more than a decade of unfulfilled promises, radioimmunotherapy for the treatment of non-Hodgkin’s lymphoma has been demonstrated to be efficacious in the treatment of refractory disease. It is likely that in the near future, the Food and Drug Administration will approve one or more radioimmunoconjugates for clinical use. However, the optimal use of the agents in the treatment of non-Hodgkin’s lymphoma remains to be defined. The role for these drugs is influenced by the target antigen as well as the radionuclide. In this review, the biologic principles, seminal clinical results, and avenues for future development of RIT are discussed.

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID