Top

Published in:

01-03-2013 | Original Article

Clinical significance of jejunoileal involvement of non-Hodgkin’s lymphoma detected by double-balloon enteroscopy

Authors: Takashi Ibuka, Hisashi Tsurumi, Hiroshi Araki, Takeshi Hara, Fumito Onogi, Naoe Goto, Yasushi Kojima, Nobuhiro Kanemura, Makoto Shiraki, Senji Kasahara, Masahito Shimizu, Kengo Ogawa, Soranobu Ninomiya, Takayuki Nakanishi, Tomohiro Kato, Tsuyoshi Takami, Hisataka Moriwaki

Published in: International Journal of Hematology | Issue 3/2013

Abstract

Jejunoileal involvement of non-Hodgkin’s lymphoma (NHL) is an important diagnostic factor in determining optimal treatment strategies. Here, we used double-balloon enteroscopy (DBE) to detect jejunoileal involvement of NHL and studied its clinical significance in a series of patients with NHL. Adults aged between 18 and 85 years with infiltration of the stomach, duodenum, or colon confirmed by gastrointestinal endoscopy or colonoscopy, suspected jejunoileal involvement determined by CT or FDG-PET, or any other gastrointestinal symptoms, were eligible for inclusion in the study. Among 428 patients with histologically confirmed NHL between 2004 and 2011, 83 were eligible for DBE, but 20 patients were excluded due to rejection or poor clinical status. Thus, 63 underwent DBE. The 3-year overall survival rate was significantly lower in patients with (n = 33), than without (n = 30) jejunoileal involvement of NHL confirmed by DBE (49 vs. 92 %, p < 0.005). Four participants developed aspiration pneumonia, but recovered after treatment with antibiotics.

Rosenberg SA, Diamond HD, Jaslowitz B, Craver LF. Lymphosarcoma: a review of 1269 cases. Medicine. 1961;40:31–84.PubMedCrossRef

Freeman C, Berg JW, Cutler SJ. Occurrence and prognosis of extranodal lymphomas. Cancer. 1972;29:252–60.PubMedCrossRef

Bush RS. Primary lymphoma of the gastrointestinal tract. JAMA. 1974;228:1291–4.PubMedCrossRef

Yamamoto H, Sekine Y, Sato Y, Higashizawa T, Miyata T, Iino S, et al. Total enteroscopy with a nonsurgical steerable double-balloon method. Gastrointest Endosc. 2001;53:216–20.PubMedCrossRef

Jaffe ES, Harris NL, Stein H, Vardiman JW, eds. World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of Haematopoietic and Lymphoid Tissues. Lyon, France: IARC; 2001.

May A, Nachbar L, Wardak A, Yamamoto H, Ell C. Double-balloon enteroscopy: preliminary experience in patients with obscure gastrointestinal bleeding or chronic abdominal pain. Endoscopy. 2003;35:985–91.PubMedCrossRef

Yamamoto H, Kita H, Sunada K, Hayashi Y, Sato H, Yano T, et al. Clinical outcomes of double-balloon endoscopy for the diagnosis and treatment of small-intestinal diseases. Clin Gastroenterol Hepatol. 2004;2:1010–6.PubMedCrossRef

Yamamoto H, Kita H. Double-balloon endoscopy. Curr Opin Gastroenterol. 2005;21:573–7.PubMedCrossRef

Takagi T, Oguro M. (2″-R)-4′-o-tetrahydropyranyladriamycin, a new anthracycline derivative: its effectiveness in lymphoid malignancies. Cancer Chemother Pharmacol. 1987;20:151–4.PubMedCrossRef

10.

Miller AA, Salewski E. Prospects for pirarubicin. Med Pediatr Oncol. 1994;22:261–8.PubMedCrossRef

11.

Tsurumi H, Yamada T, Sawada M, Kasahara S, Kanemura N, Kojima Y, et al. Biweekly CHOP or THP-COP regimens in the treatment of newly diagnosed aggressive non-Hodgkin’s lymphoma. A comparison of doxorubicin and pirarubicin: a randomized phase II study. J Cancer Res Clin Oncol. 2004;130:107–13.PubMedCrossRef

12.

Tsurumi H, Hara T, Goto N, Kanemura N, Kasahara S, Sawada M, et al. A phase II study of a THP-COP regimen for the treatment of elderly patients aged 70 years or older with diffuse large B-cell lymphoma. Hematol Oncol. 2007;25:107–14.PubMedCrossRef

13.

Hara T, Tsurumi H, Goto N, Kitagawa J, Kanemura N, Yoshikawa T, et al. Phase II study of rituximab combined with THP-COP as first-line therapy for patients younger than 70 years with diffuse large B cell lymphoma. J Cancer Res Clin Oncol. 2010;136:65–70.PubMedCrossRef

14.

Hara T, Tsurumi H, Kasahara S, Kanemura N, Yoshikawa T, Goto N, et al. Low-dose granulocyte colony-stimulating factor overcomes neutropenia in the treatment of non-Hodgkin’s lymphoma with higher cost-effectiveness. Int J Hematol. 2005;82:430–6.PubMedCrossRef

15.

Sawada M, Tsurumi H, Yamada T, Hara T, Fukuno K, Goto H, et al. A prospective study of P-IMVP-16/CBDCA: a novel salvage chemotherapy for patients with aggressive non-Hodgkin’s lymphoma who had previously received CHOP therapy as first-line chemotherapy. Eur J Haematol. 2002;68:354–61.PubMedCrossRef

16.

Cheson BD, Horning SJ, Coiffier B, Shipp MA, Fisher RI, Connors JM, et al. Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphomas. NCI Sponsored International Working Group. J Clin Oncol. 1999;17:1244.PubMed

17.

Yoshino T, Miyake K, Ichimura K, Mannami T, Ohara N, Hamazaki S, et al. Increased incidence of follicular lymphoma in the duodenum. Am J Surg Pathol. 2000;24:688–93.PubMedCrossRef

18.

Shia J, Teruya-Feldstein J, Pan D, Hegde A, Klimstra DS, Chaganti RS, et al. Primary follicular lymphoma of the gastrointestinal tract: a clinical and pathologic study of 26 cases. Am J Surg Pathol. 2002;26:216–24.PubMedCrossRef

19.

Damaj G, Verkarre V, Delmer A, Solal-Celigny P, Yakoub-Agha I, Cellier C, et al. Primary follicular lymphoma of the gastrointestinal tract: a study of 25 cases and a literature review. Ann Oncol. 2003;14:623–9.PubMedCrossRef

20.

Nakamura S, Matsumoto T, Iida M, Yao T, Tsuneyoshi M. Primary gastrointestinal lymphoma in Japan: a clinicopathologic analysis of 455 patients with special reference to its time trends. Cancer. 2003;97:2462–73.PubMedCrossRef

21.

Smith GA, O’Dwyer PJ. Sensitivity of double contrast barium enema and colonoscopy for the detection of colorectal neoplasms. Surg Endosc. 2001;15:649–52.PubMedCrossRef

22.

Postic G, Lewin D, Bickerstaff C, Wallace MB. Colonoscopic miss rates determined by direct comparison of colonoscopy with colon resection specimens. Am J Gastroenterol. 2002;97:3182–5.PubMedCrossRef

23.

Matsumoto T, Esaki M, Moriyama T, Nakamura S, Iida M. Comparison of capsule endoscopy and enteroscopy with the double-balloon method in patients with obscure bleeding and polyposis. Endoscopy. 2005;37:827–32.PubMedCrossRef

24.

Kameda N, Higuchi K, Shiba M, Machida H, Okazaki H, Yamagami H, et al. A prospective, single-blind trial comparing wireless capsule endoscopy and double-balloon enteroscopy in patients with obscure gastrointestinal bleeding. J Gastroenterol. 2008;43:434–40.PubMedCrossRef

25.

Mönkemüller K, Weigt J, Treiber G, Kolfenbach S, Kahl S, Röcken C. Diagnostic and therapeutic impact of double-balloon enteroscopy. Endoscopy. 2006;38:67–72.PubMedCrossRef

26.

May A, Nachbar L, Pohl J, et al. Endoscopic interventions in the small bowel using double balloon enteroscopy: feasibility and limitations. Am J Gastroenterol. 2007;102:527–35.PubMedCrossRef

27.

A predictive model for aggressive non-Hodgkin’s lymphoma. The International Non-Hodgkin’s Lymphoma Prognostic Factors Project. N Engl J Med. 1993;329:987–94.

28.

Sehn LH, Berry B, Chhanabhai M, Fitzgerald C, Gill K, Hoskins P, et al. The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood. 2007;109:1857–61.PubMedCrossRef

29.

Gallamini A, Stelitano C, Calvi R, Bellei M, Mattei D, Vitolo U, et al. Peripheral T-cell lymphoma unspecified (PTCL-U): a new prognostic model from a retrospective multicentric clinical study. Blood. 2004;103:2474–9.PubMedCrossRef

30.

Solal-Céligny P, Roy P, Colombat P, White J, Armitage JO, Arranz-Saez R, et al. Follicular lymphoma international prognostic index. Blood. 2004;104:1258–65.PubMedCrossRef

31.

Hara T, Tsurumi H, Takemura M, Goto H, Yamada T, Sawada M, et al. Serum-soluble fas level determines clinical symptoms and outcome of patients with aggressive non-Hodgkin’s lymphoma. Am J Hematol. 2000;64:257–61.PubMedCrossRef

32.

Hara T, Tsurumi H, Goto N, Kanemura N, Yoshikawa T, Kasahara S, et al. Serum soluble Fas level determines clinical outcome of patients with diffuse large B-cell lymphoma treated with CHOP and R-CHOP. J Cancer Res Clin Oncol. 2009;135:1421–8.PubMedCrossRef

33.

Goto H, Tsurumi H, Takemura M, Ino-Shimomura Y, Kasahara S, Sawada M, et al. Serum-soluble interleukin-2 receptor (sIL-2R) level determines clinical outcome in patients with aggressive non-Hodgkin’s lymphoma: in combination with the International Prognostic Index. J Cancer Res Clin Oncol. 2005;131:73–9.PubMedCrossRef

34.

Goto N, Tsurumi H, Takemura M, Hara T, Sawada M, Kasahara S, et al. Serum-soluble tumor necrosis factor receptor 2 (sTNF-R2) level determines clinical outcome in patients with aggressive non-Hodgkin’s lymphoma. Eur J Haematol. 2006;77:217–25.PubMedCrossRef

35.

Kitagawa J, Hara T, Tsurumi H, Goto N, Kanemura N, Yoshikawa T, et al. Serum-soluble interleukin-2 receptor (sIL-2R) is an extremely strong prognostic factor for patients with peripheral T-cell lymphoma, unspecified (PTCL-U). J Cancer Res Clin Oncol. 2009;135:53–9.PubMedCrossRef

36.

Yoshikawa T, Hara T, Tsurumi H, Goto N, Hoshi M, Kitagawa J, et al. Serum concentration of l-kynurenine predicts the clinical outcome of patients with diffuse large B-cell lymphoma treated with R-CHOP. Eur J Haematol. 2010;84:304–9.PubMedCrossRef

37.

Chott A, Dragosics B, Radaszkiewicz T. Peripheral T-cell lymphomas of the intestine. Am J Pathol. 1992;141:1361–71.PubMed

38.

Katoh A, Ohshima K, Kanda M, Haraoka S, Sugihara M, Suzumiya J, et al. Gastrointestinal T cell lymphoma: predominant cytotoxic phenotypes, including alpha/beta, gamma/delta T cell and natural killer cells. Leuk Lymphoma. 2000;39:97–111.PubMedCrossRef

Title: Clinical significance of jejunoileal involvement of non-Hodgkin’s lymphoma detected by double-balloon enteroscopy
Authors: Takashi Ibuka
Hisashi Tsurumi
Hiroshi Araki
Takeshi Hara
Fumito Onogi
Naoe Goto
Yasushi Kojima
Nobuhiro Kanemura
Makoto Shiraki
Senji Kasahara
Masahito Shimizu
Kengo Ogawa
Soranobu Ninomiya
Takayuki Nakanishi
Tomohiro Kato
Tsuyoshi Takami
Hisataka Moriwaki
Publication date: 01-03-2013
Publisher: Springer Japan
Published in: International Journal of Hematology / Issue 3/2013
Print ISSN: 0925-5710
Electronic ISSN: 1865-3774
DOI: https://doi.org/10.1007/s12185-013-1273-4

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 3/2013

Diagnosis and evaluation of intestinal graft-versus-host disease after allogeneic hematopoietic stem cell transplantation following reduced-intensity and myeloablative conditioning regimens

Risk factors influencing mortality related to Stenotrophomonas maltophilia infection in hematology–oncology patients

Inclusion of hemoglobin level in prognostic score provides better prognostic stratification in patients with acute promyelocytic leukemia (APL)

Hypopyon as the first sign of relapse in acute lymphoblastic leukaemia

Diffuse panbronchiolitis after humanized anti-CCR4 monoclonal antibody therapy for relapsed adult T-cell leukemia/lymphoma

Distinct efficacy of pegylated-interferon α2a and α2b during treatment of essential thrombocythemia

Keynote webinar | Spotlight on antibody–drug conjugates in cancer