LWBK1006-30 LWW-Govindan-Review December 12, 2011 19:35
Chapter 30•Lymphomas 431maintenance after autologous stem cell transplantation is being evaluated
in clinical trials.Answer 30.21. The answer is B.
More than 90% of the patients with MCL have cytogenetic abnormalities
in addition to the classict(11;14)(q13;q32).Answer 30.22. The answer is C.
A panel of three immunohistochemical stains (CD10, BCL6, and MUM1)
has been validated for distinction of the CGB and ABC subtypes of
DLCBL. Localized stage I and II extranodal disease is seen in 30%
of cases. Host response, B-cell receptor/proliferation, and oxidative-
phosphorylation have been found by GEP to be associated with favorable
outcome.Answer 30.23. The answer is C.
The benefit of rituximab was greater in patients with lymphoma that
overexpressed bcl-2 on immunochemistry.Answer 30.24. The answer is B.
Primary testicular lymphomas is the most common testicular neoplasm in
men older than 60, and orchiectomy is the initial therapy of choice. The
most common histologies are diffuse large cell and immunoblastic lym-
phoma. Although described in the literature, primary testicular follicular
lymphoma is rare.Answer 30.25. The answer is D.
The Southwest Oncology Group Trial in a recent pilot study has shown
that R-CHOP×3 plus RT led to outstanding results. The mabThera
International Trial (Min T) used six cycles of CHOP-like chemotherapy in
young patients with favorable risk factors (75%) with early-stage disease.
In that study, the rituximab-containing arm had outstanding results with-
out added RT. Ongoing clinical trials are comparing radioimmunotherapy
with and without radiation and increasingly relying on FDG-PET imaging
to define optimal amount of therapy.Answer 30.26. The answer is C.
Abbreviated chemotherapy followed by RT has been shown to be supe-
rior to a full course of chemotherapy in patients with untreated limited-
stage DLBCL, but this has not been shown to be beneficial in patients
relapsing after chemotherapy. The role of R-CHOP (a regimen that was
previously used) in the treatment of relapsed aggressive lymphoma is
less optimal and may expose the patient to increased cardiac toxicity.
On the basis of the Parma trial, this patient would benefit from cytore-
ductive chemotherapy followed by autologous stem cell transplantation
if her lymphoma is still chemosensitive. The addition of granulocyte-
macrophage colony-stimulating factor/granulocyte colony-stimulating