[An update on recent developments in non-Hodgkin's lymphoma].
The management of non-Hodgkin's lymphoma (NHL) has changed considerably over the last 15 years with the recognition of independent prognostic factors leading to the development of a predictive model of outcome, the International Non-Hodgkin's Lymphoma Prognostic Factors Index (IPI) and more recently gene array studies. Since then, the therapeutic approaches have tried to improve the outcome of patients with adverse prognostic factors with the building of intensified regimens rather than the classical CHOP regimen. The introduction of monoclonal antibodies (MoAb) into the management of NHL has dramatically improved the response rates and rituximab is now approved for the treatment of diffuse large B-cell lymphoma and follicular lymphoma. Subsequently, MoAb have been conjugated to radioisotopes to target radiotherapy to tumor sites and improve overall survival. The advantages of these radiolabeled antibodies are not only to enhance the therapeutic potency of MoAb by targetting specifically CD20+ tumour cells but also to protect the neighbouring normal organs from cytotoxicity. Finally, the initial staging as well as the evaluation of the response after treatment has been better defined with the introduction of positron emission tomography (PET) into the assessment of NHL. The accuracy of PET imaging in the detection of residual disease and extranodal localizations appears to be the most helpful non-ivasive modality in NHL. The aim of this review is to focus on recent and most significant improvements in the management of lymphomas.
Bouabdallah
Krimo
K
Service des maladies du sang, Hôpital Haut-Lévèque, 33604 Pessac. krimo.bouabdallah@chu-bordeaux.fr
Milpied
Noël
N
D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging / Q000628:therapy*; D049268:Positron-Emission Tomography; D011241:Prednisone / Q000008:administration & dosage; D011379:Prognosis; D016499:Radioimmunotherapy / Q000379:methods; D000069283:Rituximab; D014750:Vincristine / Q000008:administration & dosage
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone