First-Line Therapy for Nodal T-cell Non-Hodgkin Lymphomas: an Unmet Need in Hematology.

PURPOSEOF REVIEW: The main aim of this review is to summarize first-line therapy of nodal T-cell non-Hodgkin lymphoma. RECENT FINDINGS: Current treatment with CHOP chemotherapy results in poor outcomes in the majority of patients. However, there are advances within the field. First breakthrough is the ECHELON-2 trial which showed that the addition of brentuximab vedotin improves outcomes in anaplastic large cell lymphoma. However, other types of peripheral T-cell non-Hodgkin lymphoma were underrepresented with optimal treatment not known. Second breakthrough is an increase of autologous stem cell transplantation usage in the first complete metabolic remission, except in ALK + anaplastic large cell lymphoma, offering better disease control. Despite advances in the field, CHOP remains the standard treatment for the majority of these lymphomas, but multiple trials are underway with the aim to improve this unmet need in hematology and, hopefully, leading us to a new era in the treatment of peripheral T-cell lymphomas.

FDA's and EMA's approval of brentuximab vedotin for advanced Hodgkin lymphoma: Another player in the town?

ECHELON-1 study is a randomized open-labeled controlled trial investigating whether addition of brentuximab vedotin to chemotherapy offers benefit over the standard chemotherapy regimen in advanced Hodgkin lymphoma. After a median follow-up of 24.6 months, it has met its primary endpoint the reduction of modified progression-free survival being 23 percent. However, the beneficial effects have not been seen across all subgroups leading to further questions. The main aim of this review is to tackle these questions to provide the reader with in-depth insight of pros and cons of this novel, promising but ultimately controversial regimen.

BENDAMUSTINE: AN OLD DRUG IN THE NEW ERA FOR PATIENTS WITH NON-HODGKIN LYMPHOMAS AND CHRONIC LYMPHOCYTIC LEUKEMIA.

- The aim of this review is to present data on bendamustine, a non-cross resistant alkylating agent, alone or in combination for treatment of non-Hodgkin lymphoma (NHL) and chronic lymphocytic leukemia (CLL). Bendamustine is currently approved for rituximab-resistant indolent NHL and CLL in patients not fit for conventional chemotherapy. Recent studies have shown superiority of bendamustine combination with rituximab (B-R) in first line treatment of indolent NHLs and mantle cell lymphoma, suggesting a shift of the standard of care in this setting. B-R regimen has also shown efficacy in relapsed setting suggesting the possible treatment option for patients failing conventional chemotherapy. In rituximab-resistant NHL, the recent GADOLIN study exploring the addition of obinutuzumab to bendamustine has yielded impressive result changing the standard of care in this hard-to-treat population. Concerning CLL, despite inferiority to the standard of care in young fit patients, as defined in CLL10 study, B-R has yielded a more beneficial toxicity profile and its use in first line treatment should be decided individually. In relapsed setting, the addition of ibrutinib to B-R has shown superior results compared to B-R alone, possibly changing the paradigm of treatment of relapsed CLL. In conclusion, bendamustine as a single agent or in combinations has shown activity with acceptable toxic profile in the treatment of patients with indolent NHLs or CLL without del(17p) mutation.

The prevalence of allergic diseases among Croatian school children according to the ISAAC Phase One questionnaire.

BACKGROUND: The prevalence of asthma and allergic diseases in children has been increasing worldwide over the past decades. The ISAAC Phase I results supplies valuable information on the worldwide variations in the prevalence of these diseases. Although ISAAC Phase I was completed in 56 countries, not all regions of Croatia were covered. Because of Croatia's high regional diversity, the aim was to explore the prevalence of asthma, allergic rhinitis/rhinoconjuctivitis, and atopic eczema symptoms in the Medimurje region in northern Croatia and compare the results with data from other regions in Croatia and other countries. MATERIAL/METHODS: The study was undertaken between January and April 2005 among 12- to 14-year-old children in 27 elementary schools. Data were collected using the standardized ISAAC written and asthma video questionnaires. RESULTS: A total of 3111 children participated in the study, with a participation rate of 94.33%. 27.6% of the children had symptoms of allergic diseases at some time in their life. Estimated lifetime (ever) prevalence of symptoms were: wheezing 11.86%, allergic rhinitis symptoms 12.21%, and atopic dermatitis symptoms 7.01%. Estimated 12-month prevalence rates were: wheezing 5.11%, allergic rhinitis symptoms 10.87%, allergic rhinoconjunctivitis 7.14%, and atopic dermatitis symptoms 5.34%. CONCLUSIONS: Compared with previous studies conducted in other Croatian regions (the city of Zagreb and a northern Adriatic region) using similar methods, the prevalence of asthma and allergic rhinitis was lower than in the northern Adriatic region but comparable with that in the city of Zagreb, and of atopic dermatitis symptoms in the same range.