Changes to This Summary (07/28/2011)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

General Information About Adult Non-Hodgkin Lymphoma ¹

Updated statistics ² with estimated new cancer cases and deaths for 2011 (cited American Cancer Society as reference 1).

Cellular Classification of Adult Non-Hodgkin Lymphoma ³

Added text ⁴ to state that as a revised Follicular Lymphoma International Prognostic Index, an elevated beta-2-microglobulin and lymph node size of more than 6 cm are proposed prognostic factors instead of serum lactate dehydrogenase and the number of nodal areas (cited Federico et al. as reference 22).

Added text ⁵ to include bortezomib with single-agent alkylators and combination chemotherapy with or without rituximab, all of which show similar response rates (cited Ghobrial et al. as reference 47). Also added that a combination of bortezomib, dexamethasone, and rituximab has been proposed for its high response rate, rapidity of action, and avoidance of an IgM rebound (cited Treon et al. as reference 48).

Added Zullo et al. as reference 67 ⁶.

Added Lenz et al. as reference 110 ⁷.

Added text ⁸ to include concurrently as another recommendation for the administration of radiation therapy prior to the start of chemotherapy, and for intrathecal prophylaxis and/or prophylactic cranial radiation therapy (cited Yamaguchi et al. as reference 143; Kim et al. as reference 144; and Li et al. as reference 145). Also added that extranasal presentation along with advanced stage in patients who endure the highly aggressive course has led some investigators to recommend bone marrow or peripheral stem cell transplantation consolidation (cited Au et al. as reference 147 ⁸).

Added Kyriakou et al. as reference 155 ⁹.

Added Sieniawski et al. as reference 179 ¹⁰ and level of evidence 3iiiDiii.

Added Damon et al. as reference 233 ¹¹.

Added Evens et al. as reference 241 ¹².

Stage Information for Adult Non-Hodgkin Lymphoma ¹³

Added text ¹⁴ to state that interim positron-emission tomography (PET) scans after two to four cycles of therapy have not provided reliable prognostic information yet because of problems of interobserver reproducibility in a large cooperative group trial and lack of difference in outcome between PET-negative and PET-positive/biopsy-negative patients in a single-institution trial (cited Horning et al. as reference 7 and Moskowitz et al. as reference 8).

Indolent, Noncontiguous Stage II/III/IV Adult Non-Hodgkin Lymphoma ¹⁵

Revised text ¹⁶ to state that at 6 years' median follow-up, rituximab maintenance was better for median progression-free survival and borderline for 5-year overall survival (cited van Oers et al. as reference 24 and level of evidence 1iiDiii). Also added that most patients in both arms received extensive rituximab during post-protocol salvage treatment.

Added text ¹⁷ to include cyclophosphamide plus vincristine plus prednisone followed by rituximab maintenance to the combination chemotherapy alone option in the list of standard treatment options (cited Hochster et al. as reference 46).

Indolent, Recurrent Adult Non-Hodgkin Lymphoma ¹⁸

Added text ¹⁹ to state that responses of 20% to 30% have been reported for lenalidomide, especially for follicular lymphoma and small lymphocytic lymphoma (cited Witzig et al. as reference 15 and level of evidence 3iiiDiv).

Revised text ²⁰ to state that in many institutions autologous or allogeneic stem cell transplantations are being used for patients whose disease has relapsed (cited Thomson et al. as reference 28).

Aggressive, Recurrent Adult Non-Hodgkin Lymphoma ²¹

Added Larouche et al. as reference 16 ²².