The incidence, natural history, biology, and treatment of transformed lymphomas.

@article{Bernstein2009TheIN,
  title={The incidence, natural history, biology, and treatment of transformed lymphomas.},
  author={Steven H. Bernstein and W Richard Burack},
  journal={Hematology. American Society of Hematology. Education Program},
  year={2009},
  pages={
          532-41
        }
}
Treatment of patients with transformed lymphoma presents a significant challenge to the practicing physician. Indeed, the transformation of follicular lymphoma to a more aggressive histology is inherent to the biology of this disease and is often associated with an aggressive clinical course, resulting in a poor prognosis. Recent population-based studies have better defined the incidence of this event, and recent laboratory studies have defined the molecular and immunological processes… 

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References

SHOWING 1-10 OF 60 REFERENCES

Incidence, predictive factors, and outcome of lymphoma transformation in follicular lymphoma patients.

Transformation is an early event in the course of the disease and is mainly observed in patients with known adverse prognostic factors or those who do not achieve CR after initial treatment, and may be useful to select follicular lymphoma patients for intensive therapeutic approaches.

The natural history of initially untreated low-grade non-Hodgkin's lymphomas.

The actuarial risk of transformation among the initially untreated patients was similar to that in a group of patients treated at this institution immediately after diagnosis, and the time to histologic transformation nor the incidence of transformation was influenced by when therapy was started.

Addition of Rituximab to CHOP Chemotherapy Significantly Improves Survival of Patients with Transformed Lymphoma.

In rituximab-naive patients with indolent lymphoma, the addition of ritUXimab to CHOP chemotherapy significantly improves overall survival after transformation.

The Architecural Pattern of FOXP3+ T Cells Predicts Risk of Transformation in Patients with Follicular Lymphoma (FL).

Treg cell distribution within the tumor is an important predictor of Tly in advanced-stage FL patients treated uniformly with an aggressive treatment regimen and reinforces the importance of a FOXP3 follicular pattern as a good surrogate for functionally active Treg cellswithin the tumor microenvironment.

Population-based analysis of incidence and outcome of transformed non-Hodgkin's lymphoma.

  • A. Al-TourahK. Gill J. Connors
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2008
Clinically diagnosed transformation has an equal impact on outcome as biopsy proven transformation, and advanced stage at diagnosis is predictive of future transformation.

Gene-expression and immunohistochemical study of specific T-cell subsets and accessory cell types in the transformation and prognosis of follicular lymphoma.

  • A. GlasL. Knoops D. de Jong
  • Biology, Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2007
The identification of FL as an immunologically functional disease in which an interaction of the tumor cells and the functional composition of the microenvironment determines the clinical behavior is supported.

Transformation of follicular lymphoma to diffuse large B‐cell lymphoma proceeds by distinct oncogenic mechanisms

T‐FL is a germinal centre B (GCB‐like malignancy that evolves by two pathways, one that is similar in proliferation rate to the antecedent FL and the other that has a higher proliferation rate and is characterised by the presence of recognised oncogenic abnormalities.

The Follicular Lymphoma International Prognostic Index (FLIPI) and the histological subtype are the most important factors to predict histological transformation in follicular lymphoma.

FLIPI and histology were the most important variables predicting HT, and only patients achieving CR reached prolonged survival, thus emphasizing the need for effective therapies once this event occurs.

Histologic conversion in the non-Hodgkin's lymphomas.

Documented histologic conversion was often associated with a more aggressive clinical behavior of the lymphoma, and the median survival after conversion was less than 1 yr, however, those patients who achieved a CR after conversion had a more favorable outcome.

Long-term survival after histologic transformation of low-grade follicular lymphoma.

A subset of patients with HT from low-grade follicular lymphoma to intermediate- or high-grade lymphoma enjoys relatively long-term survival and patients with limited disease and no previous exposure to chemotherapy have the most favorable prognosis.
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