مورد إلكتروني
Front-line management of non-Hodgkin lymphoma in Australia. Part 1: follicular lymphoma.
| العنوان: | Front-line management of non-Hodgkin lymphoma in Australia. Part 1: follicular lymphoma. |
|---|---|
| بيانات النشر: | Blackwell Publishing Australia 2019-04-15 |
| تفاصيل مُضافة: | Opat S. Trotman J. Cheah C.Y. Marlton P. |
| نوع الوثيقة: | Electronic Resource |
| مستخلص: | Outcomes with follicular lymphoma (FL) have improved in the modern era and median survival is now beyond 15 years. Therapeutic decisions need to consider this increased survival as well as recent clinical trial data and emerging treatments. In this context, we present here current approaches to front-line management of FL in Australia. Treatment choices depend on the disease stage, tumour burden, the patient's age, symptoms, comorbidities and preferences. Only about 10-15% of patients with FL are diagnosed with early stage disease. For patients with low-grade, early stage disease, radiotherapy (RT) is recommended. The addition of chemotherapy has been shown to increase progression-free survival (PFS) but without demonstrated overall survival advantage. For patients with low-tumour-burden, advanced-stage FL, immediate treatment may not be required and we recommend considering active monitoring. For stage III/IV disease that is symptomatic and/or with high tumour burden, established first-line treatment is chemotherapy in combination with rituximab, often followed by rituximab maintenance. The listing of bendamustine and now obinutuzumab on the Pharmaceutical Benefits Scheme has expanded the first-line treatment options in Australia to include bendamustine in combination with rituximab (without rituximab maintenance permitted) or with obinutuzumab plus 2 years obintuzumab maintenance. In the FL subgroup of the Study group indolent Lymphomas (StiL) trial, therapy with bendamustine plus rituximab significantly increased PFS compared with rituximab in combination with cyclophosphamide, doxorubicin, vincristine and prednisolone, without rituximab maintenance. Initial tolerability may be more favourable with bendamustine in combination with anti-CD20 antibody therapy than other therapies overall, but clinical vigilance is still required because of concerns of late infectious toxicities associated with prolonged T-cell depletion.Copyright © 2018 Royal Australasian College o |
| مصطلحات الفهرس: | cancer survival, clinical outcome, comorbidity, drug efficacy, drug tolerability, follicular lymphoma/di [Diagnosis], follicular lymphoma/dt [Drug Therapy], human, immunoregulation, infection/si [Side Effect], maintenance therapy, medical decision making, nonhodgkin lymphoma/di [Diagnosis], nonhodgkin lymphoma/dt [Drug Therapy], obinutuzumab/cb [Drug Combination], patient monitoring, patient preference, priority journal, progression free survival, review, second cancer/si [Side Effect], survival time, symptom, T cell depletion, treatment duration, treatment response, tumor volume, bendamustine/ae [Adverse Drug Reaction], bendamustine/cb [Drug Combination], bendamustine/dt [Drug Therapy], CD20 antibody/cb [Drug Combination], CD20 antibody/dt [Drug Therapy], obinutuzumab/dt [Drug Therapy], prednisolone/ae [Adverse Drug Reaction], prednisolone/cb [Drug Combination], prednisolone/dt [Drug Therapy], rituximab/ae [Adverse Drug Reaction], rituximab/cb [Drug Combination], rituximab/dt [Drug Therapy], vincristine/ae [Adverse Drug Reaction], vincristine/cb [Drug Combination], vincristine/dt [Drug Therapy], overall survival, cyclophosphamide/ae [Adverse Drug Reaction], cyclophosphamide/cb [Drug Combination], cyclophosphamide/dt [Drug Therapy], doxorubicin/ae [Adverse Drug Reaction], doxorubicin/cb [Drug Combination], doxorubicin/dt [Drug Therapy], lenalidomide/dt [Drug Therapy], advanced cancer/di [Diagnosis], age, asymptomatic disease/di [Diagnosis], Australia, cancer combination chemotherapy, cancer diagnosis, cancer immunotherapy, cancer recurrence, cancer staging, Review |
| URL: | Internal Medicine Journal LibKey Link |
| الإتاحة: | Open access content. Open access content Copyright 2019 Elsevier B.V., All rights reserved. |
| أرقام أخرى: | AUSHL oai:repository.monashhealth.org:1/35707 Internal Medicine Journal. 49 (4) (pp 422-433), 2019. Date of Publication: April 2019. 1444-0903 https://repository.monashhealth.org/monashhealthjspui/handle/1/35707Test 30230156 [http://www.ncbi.nlm.nih.gov/pubmed/?term=30230156Test] 627130374 (Trotman) Department of Haematology, Concord Hospital, Sydney, NSW, Australia (Trotman) Department of Medicine, University of Sydney, Sydney, NSW, Australia (Cheah) Department of Haematology, Sir Charles Gairdner Hospital, WA, Australia (Cheah) Department of Haematology, Pathwest Laboratory Medicine, WA, Australia (Cheah) School of Medicine, University of Western Australia, Perth, WA, Australia (Marlton) Division of Cancer Services, Clinical Haematology, Princess Alexandra Hospital, Brisbane, QLD, Australia (Marlton) University of Queensland School of Medicine, Brisbane, QLD, Australia (Opat) Clinical Haematology and School of Clinical Sciences, Monash Health, VIC, Australia (Opat) Department of Medicine, Monash University, Melbourne, VIC, Australia Trotman J.; judith.trotman@health.nsw.gov.au 1305125000 |
| المصدر المساهم: | MONASH HEALTH LIBRS From OAIster®, provided by the OCLC Cooperative. |
| رقم الانضمام: | edsoai.on1305125000 |
| قاعدة البيانات: | OAIster |
| الوصف غير متاح. |