Pediatric Lymphomas

by Weinstein, Howard J.

• ISBN13: 9783540203568
• ISBN10: 3540203567
• Edition: 1st
• Format: Hardcover
• Copyright: 2007-01-15
• Publisher: Springer Verlag

Summary

The book covers the epidemiology, pathology, molecular biology, clinical features, diagnosis, and treatment of Hodgkin and non-Hodgkin lymphomas in children and adolescents. It is a combined effort of investigators who are leaders in the field of childhood lymphomas. Introductory chapters on Hodgkin and non-Hodgkin lymphomas in children provide a concise historical overview. All chapters have a standalone structure and those regarding the individual subtypes of lymphomas provide up-to-date results of recent clinical trials and practical guidelines for work-up and treatment. The pathology chapters are comprehensive and include excellent photographs as well as detailed review of the scientific advances pertaining to the molecular pathogenesis of each type of malignant lymphoma seen in childhood. There is also a concise chapter on post-transplant lymphoproliferative disease and lymphomas associated with congenital and acquired immunodeficiency states. The book is at the level of subspecialists in pediatric hematology and oncology, radiation oncology, pediatric surgery and hematopathology.

Table of Contents

Introduction and Historical Background: Pediatric Hodgkin Lymphoma
The Way It Was	p. 1
Lessons from the Children	p. 3
The Hidden Secrets - The Discovery of Late Effects	p. 3
Current Optimal Management	p. 4
References	p. 4
Biology and Pathology of Hodgkin's Disease
History of Hodgkin's Disease Pathologic Classification	p. 7
Lineage of Hodgkin Reed-Sternberg cells; B-cell phenotype	p. 9
Some Evidence of Antigen-Presenting Function	p. 10
Apoptosis	p. 10
NF-kappaB	p. 11
Jak/STAT Pathways	p. 12
Tumor Necrosis Factor Receptor (TNFR) Family	p. 12
Tumor Necrosis Factor Receptor-Associated Factors (TRAFs)	p. 12
Cytokines and Chemokines	p. 13
Cytogenetics	p. 14
Gene Profile	p. 14
Association with EBV	p. 14
Pathology of Classical Hodgkin Lymphoma	p. 16
Immunophenotype of Classical HRS cells	p. 17
Flow Cytometry	p. 18
Histologic Classification of CHL	p. 19
Nodular Sclerosis HL	p. 19
Mixed Cellularity HL	p. 20
Nodular Lymphocyte Rich CHL	p. 21
Lymphocyte Depleted HL	p. 22
Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL)	p. 22
Hodgkin Lymphoma in the Setting of HIV Infection	p. 23
Bone Marrow Involvement and Histologic Staging	p. 23
Pathology of Relapse and Second Malignancy	p. 24
Differential Diagnosis of HL	p. 25
References	p. 27
Treatment of Pediatric Hodgkin Lymphoma
Introduction	p. 35
Clinical Presentation	p. 36
Systemic Symptoms	p. 37
Laboratory Evaluation	p. 37
Immunologic Status	p. 38
Differential Diagnosis	p. 39
Diagnostic Evaluation and Staging	p. 40
Prognostic Factors	p. 43
Combination Chemotherapy	p. 45
Chemotherapy Alone Versus Combined Modality Therapy	p. 49
Risk-Adapted Therapy	p. 51
Treatment of Low-Risk Disease	p. 51
Treatment of Intermediate- and High-Risk Disease	p. 53
Principles of Radiation Therapy	p. 54
Volume Considerations	p. 56
Dose Considerations	p. 58
Energy	p. 59
Summary Recommendations for Primary Disease/Selection of Therapy	p. 59
Acute Effects of Therapy	p. 59
Chemotherapy Side-Effects	p. 59
Radiation Side-Effects	p. 61
Future Directions	p. 61
References	p. 61
Treatment of Relapsed/Refractory Hodgkin Lymphoma
Introduction	p. 67
Strategies for Re-induction	p. 67
Role of Re-induction Chemotherapy	p. 68
Standard Re-induction with ICE	p. 68
Re-induction with Ifosfamide/ Vinorelbine (IV)	p. 69
High-Dose Therapy	p. 70
Immunomodulation as a Therapeutic Strategy to Augment High-Dose Therapy	p. 71
Reduced-Intensity/Non-myeloablative Allogeneic Stem cell Transplantation	p. 72
Salvage Strategies Following Transplantation	p. 72
Combination Chemotherapy with Gemcitabine/Vinorelbine (GEM/VRB)	p. 73
Molecular Targeting of the NF-¿B Pathway	p. 74
Activation of NF-¿B	p. 74
Inhibition of NF-¿B Through Proteasome Inhibition	p. 75
Adult Clinical Trials	p. 76
Pediatric Clinical Trials	p. 77
Novel Retrieval Strategies Incorporating Proteasome Inhibition with Bortezomib	p. 77
Targeted Immunotherapy Strategies	p. 77
Epstein-Barr Virus Directed Therapy	p. 77
Monoclonal Antibodies Targeting Receptors Expressed in HL	p. 78
Radiolabeled Immunoglobulin Therapy in HL	p. 79
Future Considerations	p. 79
References	p. 79
Non-Hodgkin's Lymphoma: Introduction and Historical Background
Introduction	p. 85
The Early Era, Pre-1970	p. 86
The Latter Era, Post-1970s	p. 86
References	p. 88
Biology and Pathology of Pediatric Non-Hodgkin Lymphoma
Introduction	p. 91
Non-Hodgkin Lymphoma	p. 91
Pathologic Analysis	p. 93
Morphology	p. 93
Immunophenotypic Analysis	p. 94
Molecular and Cytogenetic Analysis	p. 95
WHO Classification of Hematolymphoid Tumors	p. 100
Molecular Pathogenesis of Pediatric NHL	p. 101
Burkitt Lymphomas	p. 101
Pathology	p. 101
Biology and Molecular Mechanisms	p. 104
Diffuse Large B-Cell Lymphomas	p. 107
Pathology	p. 107
Biology and Molecular Mechanisms	p. 109
Anaplastic Large-Cell Lymphoma	p. 112
Pathology	p. 112
Biology and Molecular Mechanisms	p. 117
Lymphoblastic Lymphoma	p. 119
Pathology	p. 119
Biology and Molecular Mechanisms	p. 121
References	p. 127
B-Cell Lymphoma/Burkitt Lymphoma
Introduction	p. 142
Diagnosis and Imaging	p. 142
Burkitt Lymphoma	p. 142
Diffuse Large B-cell Lymphoma	p. 143
Burkitt-like Lymphoma	p. 144
HIV-Associated B-cell Lymphomas	p. 144
Imaging Studies	p. 144
Clinical Features	p. 146
Staging	p. 148
Staging Procedures	p. 150
Treatment	p. 151
Early Studies in Africa	p. 151
Non-Cross-Resistant Drugs and Combination Therapy	p. 152
Therapy Directed Towards CNS Disease	p. 154
Early Studies in the USA	p. 154
Comparison with Leukemia Treatment	p. 155
Critical Components of Modern Treatment Protocols	p. 155
Basic Drugs	p. 155
High-Dose MTX	p. 156
The Role of Additional Drugs	p. 156
Dose Density	p. 157
Risk Adaptation	p. 157
Prevention of CNS Disease	p. 159
Treatment of DLBCL with Different Regimens	p. 160
Role of Surgery	p. 160
Role of Radiation	p. 161
Tumor Lysis Syndrome	p. 162
Prognostic Factors	p. 163
Tumor Burden and Stage	p. 163
Rapidity of Response	p. 164
Age and Sex	p. 164
Histology	p. 164
Molecular Characteristics	p. 165
Outcome	p. 165
Management of Relapse	p. 166
Follicle Center Cell and Marginal Zone Lymphomas	p. 167
Future Prospects	p. 167
References	p. 168
Anaplastic Large-Cell Lymphoma
Introduction	p. 175
Diagnosis and Imaging	p. 177
Clinical Features	p. 178
Staging	p. 181
Treatment and Outcome	p. 181
Stratification of Treatment Intensity	p. 185
CNS Prophylaxis and CNS Therapy	p. 185
Role of Local Therapy Modalities and Pattern of Therapy Failure	p. 186
Prognostic Factors	p. 187
Management of Relapse	p. 189
Future Prospects	p. 190
References	p. 192
Precursor B and Precursor T-Cell Lymphoblastic Lymphoma
Introduction	p. 199
Diagnosis and Imaging	p. 199
Diagnosis	p. 199
Imaging/Staging	p. 201
Clinical Features	p. 202
Treatment	p. 202
Initial Management	p. 202
Treatment Overview	p. 203
Limited Stage Disease	p. 203
Advanced Stage Disease	p. 204
Central Nervous System Prophylaxis and Treatment	p. 205
Prognostic Factors	p. 208
Outcome	p. 208
Management of Relapse	p. 208
Future Prospects	p. 208
References	p. 210
Cutaneous T-Cell Lymphomas and Rare T-Cell Non-Hodgkin Lymphomas
Introduction	p. 215
Mycosis Fungoides and Sezary Syndrome	p. 216
Clinical Features	p. 216
Pathology	p. 217
Immunophenotype	p. 218
Genetic Features	p. 218
Prognosis	p. 219
Therapy	p. 220
CD30+ Cutaneous T-Cell Lymphomas Including Lymphomatoid Papulosis	p. 221
Lymphomatoid Papulosis	p. 221
Clinical Features	p. 221
Pathology	p. 222
Immunophenotype	p. 223
Genetic Features	p. 223
Prognosis	p. 223
Primary Cutaneous Anaplastic Large-cell Lymphoma	p. 224
Clinical Features	p. 224
Pathology	p. 224
Differential Diagnosis	p. 224
Immunophenotype	p. 225
Genetic Features	p. 225
Therapy	p. 225
Subcutaneous Panniculitis-like T-Cell Lymphoma	p. 225
Clinical Features	p. 226
Pathology	p. 226
Immunophenotype	p. 226
Genetic Features	p. 227
Therapy	p. 227
Hepatosplenic T-Cell Lymphoma	p. 227
Clinical Features	p. 227
Pathology	p. 227
Immunophenotype	p. 227
Genetic Features	p. 227
Therapy	p. 228
References	p. 228
Lymphoproliferative Disorders Related to Immunodeficiencies
Introduction	p. 233
Epstein-Barr Virus	p. 234
Post-transplant Lymphoproliferative Disease	p. 236
PTLD Following Blood or Marrow Transplantation	p. 239
PTLD Following Solid Organ Transplantation	p. 240
HIV-Related Malignancies	p. 242
Lymphoproliferative Disease in Primary Immunodeficiencies	p. 246
Summary	p. 250
References	p. 250
Late Effects Following Lymphoma Treatment
Introduction	p. 259
Second Malignant Neoplasms	p. 260
Neurocognitive	p. 261
Cardiovascular	p. 261
Pulmonary	p. 263
Bone and Body Composition	p. 264
Endocrine	p. 264
Thyroid Gland	p. 264
Reproductive Endocrine	p. 265
Male Gonadal Function	p. 265
Female Gonadal Function	p. 265
Reproduction	p. 266
Dental	p. 267
Spleen	p. 267
Psychosocial	p. 268
Mortality	p. 268
Monitoring for Late Effects	p. 269
Research Challenges for Lymphoma Survivors	p. 269
Future Directions	p. 273
References	p. 274
Subject Index	p. 281
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