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Hematologic Cancers

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Abstract

This chapter discusses the general management of patients with hematologic cancers, with special focus on principles that guide radiotherapy management. Several key components of trimodality care and radiotherapy field design are discussed.

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References

  1. Hartman AR, Williams SF, Dillon JJ. Survival, disease-free survival and adverse effects of conditioning for allogeneic bone marrow transplantation with busulfan/cyclophosphamide vs total body irradiation: a meta-analysis. Bone Marrow Transplant. 1998;22:439–43.

    Article  CAS  Google Scholar 

  2. Clift RA, Buckner CD, Appelbaum FR, et al. Allogeneic marrow transplantation in patients with chronic myeloid leukemia in the chronic phase: a randomized trial of two irradiation regimens. Blood. 1991;77:1660–5.

    CAS  PubMed  Google Scholar 

  3. Clift RA, Buckner CD, Appelbaum FR, et al. Allogeneic marrow transplantation in patients with acute myeloid leukemia in first remission: a randomized trial of two irradiation regimens. Blood. 1990;76:1867–71.

    CAS  PubMed  Google Scholar 

  4. Bylund A, Stattin P, Widmark A, et al. Predictive value of bcl-2 immunoreactivity in prostate cancer patients treated with radiotherapy. Radiother Oncol. 1998;49:143–8.

    Article  CAS  Google Scholar 

  5. Cook B DT: Wikibooks radiation oncology. https://en.wikibooks.org/wiki/Radiation_Oncology. Accessed April 2018.

  6. Edge S, Byrd D, Compton C, et al. AJCC cancer staging manual. New York: Springer; 2010.

    Google Scholar 

  7. Hansen ERM. Handbook of evidence-based radiation oncology. 2nd ed: Springer; 2010.

    Google Scholar 

  8. Hristov BLS, Christodouleas JP. Radiation oncology - a question based review. 2nd ed: LWW; 2014.

    Google Scholar 

  9. Aleman BM, Raemaekers JM, Tirelli U, et al. Involved-field radiotherapy for advanced Hodgkin's lymphoma. N Engl J Med. 2003;348:2396–406.

    Article  Google Scholar 

  10. Engert A, Franklin J, Eich HT, et al. Two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine plus extended-field radiotherapy is superior to radiotherapy alone in early favorable Hodgkin's lymphoma: final results of the GHSG HD7 trial. J Clin Oncol. 2007;25:3495–502.

    Article  CAS  Google Scholar 

  11. Engert A, Plutschow A, Eich HT, et al. Reduced treatment intensity in patients with early-stage Hodgkin's lymphoma. N Engl J Med. 2010;363:640–52.

    Article  CAS  Google Scholar 

  12. Engert A, Schiller P, Josting A, et al. Involved-field radiotherapy is equally effective and less toxic compared with extended-field radiotherapy after four cycles of chemotherapy in patients with early-stage unfavorable Hodgkin's lymphoma: results of the HD8 trial of the German Hodgkin's Lymphoma Study Group. J Clin Oncol. 2003;21:3601–8.

    Article  Google Scholar 

  13. Ferme C, Eghbali H, Meerwaldt JH, et al. Chemotherapy plus involved-field radiation in early-stage Hodgkin's disease. N Engl J Med. 2007;357:1916–27.

    Article  CAS  Google Scholar 

  14. Laskar S, Gupta T, Vimal S, et al. Consolidation radiation after complete remission in Hodgkin's disease following six cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine chemotherapy: is there a need? J Clin Oncol. 2004;22:62–8.

    Article  CAS  Google Scholar 

  15. Longo DL, Glatstein E, Duffey PL, et al. Radiation therapy versus combination chemotherapy in the treatment of early-stage Hodgkin's disease: seven-year results of a prospective randomized trial. J Clin Oncol. 1991;9:906–17.

    Article  CAS  Google Scholar 

  16. Noordijk EM, Carde P, Dupouy N, et al. Combined-modality therapy for clinical stage I or II Hodgkin's lymphoma: long-term results of the European Organisation for Research and Treatment of Cancer H7 randomized controlled trials. J Clin Oncol. 2006;24:3128–35.

    Article  Google Scholar 

  17. Press OW, LeBlanc M, Lichter AS, et al. Phase III randomized intergroup trial of subtotal lymphoid irradiation versus doxorubicin, vinblastine, and subtotal lymphoid irradiation for stage IA to IIA Hodgkin's disease. J Clin Oncol. 2001;19:4238–44.

    Article  CAS  Google Scholar 

  18. Carde P, Karrasch M, Fortpied C, et al. Eight Cycles of ABVD Versus Four Cycles of BEACOPPescalated Plus Four Cycles of BEACOPPbaseline in Stage III to IV, International Prognostic Score >/= 3, High-Risk Hodgkin Lymphoma: First Results of the Phase III EORTC 20012 Intergroup Trial. J Clin Oncol. 2016;34:2028–36.

    Article  CAS  Google Scholar 

  19. Diehl V, Franklin J, Pfreundschuh M, et al. Standard and increased-dose BEACOPP chemotherapy compared with COPP-ABVD for advanced Hodgkin's disease. N Engl J Med. 2003;348:2386–95.

    Article  CAS  Google Scholar 

  20. Eichenauer DA, Bredenfeld H, Haverkamp H, et al. Hodgkin's lymphoma in adolescents treated with adult protocols: a report from the German Hodgkin study group. J Clin Oncol. 2009;27:6079–85.

    Article  CAS  Google Scholar 

  21. Engert A, Diehl V, Franklin J, et al. Escalated-dose BEACOPP in the treatment of patients with advanced-stage Hodgkin's lymphoma: 10 years of follow-up of the GHSG HD9 study. J Clin Oncol. 2009;27:4548–54.

    Article  Google Scholar 

  22. Hasenclever D, Diehl V. A prognostic score for advanced Hodgkin's disease. International Prognostic Factors Project on Advanced Hodgkin's Disease. N Engl J Med. 1998;339:1506–14.

    Article  CAS  Google Scholar 

  23. Hutchings M, Loft A, Hansen M, et al. Position emission tomography with or without computed tomography in the primary staging of Hodgkin's lymphoma. Haematologica. 2006;91:482–9.

    PubMed  Google Scholar 

  24. Specht L, Yahalom J, Illidge T, et al. Modern radiation therapy for Hodgkin lymphoma: field and dose guidelines from the international lymphoma radiation oncology group (ILROG). Int J Radiat Oncol Biol Phys. 2014;89:854–62.

    Article  Google Scholar 

  25. Steidl C, Lee T, Shah SP, et al. Tumor-associated macrophages and survival in classic Hodgkin's lymphoma. N Engl J Med. 2010;362:875–85.

    Article  CAS  Google Scholar 

  26. Herbst C, Rehan FA, Skoetz N, et al. Chemotherapy alone versus chemotherapy plus radiotherapy for early stage Hodgkin lymphoma. Cochrane Database Syst Rev. 2011:Cd007110.

    Google Scholar 

  27. Raemaekers JM, Andre MP, Federico M, et al. Omitting radiotherapy in early positron emission tomography-negative stage I/II Hodgkin lymphoma is associated with an increased risk of early relapse: Clinical results of the preplanned interim analysis of the randomized EORTC/LYSA/FIL H10 trial. J Clin Oncol. 2014;32:1188–94.

    Article  Google Scholar 

  28. De Bruin ML, Sparidans J, van't Veer MB, et al. Breast cancer risk in female survivors of Hodgkin's lymphoma: lower risk after smaller radiation volumes. J Clin Oncol. 2009;27:4239–46.

    Google Scholar 

  29. Chen RC, Chin MS, Ng AK, et al. Early-stage, lymphocyte-predominant Hodgkin's lymphoma: patient outcomes from a large, single-institution series with long follow-up. J Clin Oncol. 2010;28:136–41.

    Article  Google Scholar 

  30. Al-Mansour M, Connors JM, Gascoyne RD, et al. Transformation to aggressive lymphoma in nodular lymphocyte-predominant Hodgkin's lymphoma. J Clin Oncol. 2010;28:793–9.

    Article  Google Scholar 

  31. Bonadonna G, Bonfante V, Viviani S, et al. ABVD plus subtotal nodal versus involved-field radiotherapy in early-stage Hodgkin's disease: long-term results. J Clin Oncol. 2004;22:2835–41.

    Article  Google Scholar 

  32. Donaldson SS, Link MP, Weinstein HJ, et al. Final results of a prospective clinical trial with VAMP and low-dose involved-field radiation for children with low-risk Hodgkin's disease. J Clin Oncol. 2007;25:332–7.

    Article  CAS  Google Scholar 

  33. Dorffel W, Ruhl U, Luders H, et al. Treatment of children and adolescents with Hodgkin lymphoma without radiotherapy for patients in complete remission after chemotherapy: final results of the multinational trial GPOH-HD95. J Clin Oncol. 2013;31:1562–8.

    Article  Google Scholar 

  34. Engert A, Haverkamp H, Kobe C, et al. Reduced-intensity chemotherapy and PET-guided radiotherapy in patients with advanced stage Hodgkin's lymphoma (HD15 trial): a randomised, open-label, phase 3 non-inferiority trial. Lancet. 2012;379:1791–9.

    Article  CAS  Google Scholar 

  35. Friedman DL, Chen L, Wolden S, et al. Dose-intensive response-based chemotherapy and radiation therapy for children and adolescents with newly diagnosed intermediate-risk hodgkin lymphoma: a report from the Children's Oncology Group Study AHOD0031. J Clin Oncol. 2014;32:3651–8.

    Article  Google Scholar 

  36. van Nimwegen FA, Schaapveld M, Cutter DJ, et al. Radiation Dose-Response Relationship for Risk of Coronary Heart Disease in Survivors of Hodgkin Lymphoma. J Clin Oncol. 2016;34:235–43.

    Article  Google Scholar 

  37. Wolden SL, Chen L, Kelly KM, et al. Long-term results of CCG 5942: a randomized comparison of chemotherapy with and without radiotherapy for children with Hodgkin's lymphoma--a report from the Children's Oncology Group. J Clin Oncol. 2012;30:3174–80.

    Article  Google Scholar 

  38. Littrup PJ, Williams CR, Egglin TK, et al. Determination of prostate volume with transrectal ultrasound for cancer screening. Radiology. 1991;179:49–53.

    Article  CAS  Google Scholar 

  39. Bonnet C, Fillet G, Mounier N, et al. CHOP alone compared with CHOP plus radiotherapy for localized aggressive lymphoma in elderly patients: a study by the Groupe d'Etude des Lymphomes de l'Adulte. J Clin Oncol. 2007;25:787–92.

    Article  CAS  Google Scholar 

  40. Horning SJ, Weller E, Kim K, et al. Chemotherapy with or without radiotherapy in limited-stage diffuse aggressive non-Hodgkin's lymphoma: Eastern Cooperative Oncology Group study 1484. J Clin Oncol. 2004;22:3032–8.

    Article  CAS  Google Scholar 

  41. Miller TP, Dahlberg S, Cassady JR, et al. Chemotherapy alone compared with chemotherapy plus radiotherapy for localized intermediate- and high-grade non-Hodgkin's lymphoma. N Engl J Med. 1998;339:21–6.

    Article  CAS  Google Scholar 

  42. Friedberg JW, Byrtek M, Link BK, et al. Effectiveness of first-line management strategies for stage I follicular lymphoma: analysis of the National LymphoCare Study. J Clin Oncol. 2012;30:3368–75.

    Article  CAS  Google Scholar 

  43. Friedberg JW, Taylor MD, Cerhan JR, et al. Follicular lymphoma in the United States: first report of the national LymphoCare study. J Clin Oncol. 2009;27:1202–8.

    Article  Google Scholar 

  44. Hoskin PJ, Kirkwood AA, Popova B, et al. 4 Gy versus 24 Gy radiotherapy for patients with indolent lymphoma (FORT): a randomised phase 3 non-inferiority trial. Lancet Oncol. 2014;15:457–63.

    Article  Google Scholar 

  45. Pfreundschuh M, Trumper L, Osterborg A, et al. CHOP-like chemotherapy plus rituximab versus CHOP-like chemotherapy alone in young patients with good-prognosis diffuse large-B-cell lymphoma: a randomised controlled trial by the MabThera International Trial (MInT) Group. Lancet Oncol. 2006;7:379–91.

    Article  CAS  Google Scholar 

  46. Phan J, Mazloom A, Medeiros LJ, et al. Benefit of consolidative radiation therapy in patients with diffuse large B-cell lymphoma treated with R-CHOP chemotherapy. J Clin Oncol. 2010;28:4170–6.

    Article  Google Scholar 

  47. Lowry L, Smith P, Qian W, et al. Reduced dose radiotherapy for local control in non-Hodgkin lymphoma: a randomised phase III trial. Radiother Oncol. 2011;100:86–92.

    Article  Google Scholar 

  48. Dunleavy K, Pittaluga S, Maeda LS, et al. Dose-adjusted EPOCH-rituximab therapy in primary mediastinal B-cell lymphoma. N Engl J Med. 2013;368:1408–16.

    Article  CAS  Google Scholar 

  49. Solal-Celigny P, Roy P, Colombat P, et al. Follicular lymphoma international prognostic index. Blood. 2004;104:1258–65.

    Article  CAS  Google Scholar 

  50. Haas RL, Poortmans P, de Jong D, et al. High response rates and lasting remissions after low-dose involved field radiotherapy in indolent lymphomas. J Clin Oncol. 2003;21:2474–80.

    Article  CAS  Google Scholar 

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

    Google Scholar 

  52. Hoppe BS, Moskowitz CH, Filippa DA, et al. Involved-field radiotherapy before high-dose therapy and autologous stem-cell rescue in diffuse large-cell lymphoma: long-term disease control and toxicity. J Clin Oncol. 2008;26:1858–64.

    Article  Google Scholar 

  53. Pugh TJ, Ballonoff A, Rusthoven KE, et al. Cardiac mortality in patients with stage I and II diffuse large B-cell lymphoma treated with and without radiation: a surveillance, epidemiology, and end-results analysis. Int J Radiat Oncol Biol Phys. 2010;76:845–9.

    Article  Google Scholar 

  54. Aviles A, Neri N, Delgado S, et al. Residual disease after chemotherapy in aggressive malignant lymphoma: the role of radiotherapy. Med Oncol. 2005;22:383–7.

    Article  CAS  Google Scholar 

  55. Held G, Murawski N, Ziepert M, et al. Role of radiotherapy to bulky disease in elderly patients with aggressive B-cell lymphoma. J Clin Oncol. 2014;32:1112–8.

    Article  Google Scholar 

  56. Christie D, Dear K, Le T, et al. Limited chemotherapy and shrinking field radiotherapy for Osteolymphoma (primary bone lymphoma): results from the trans-Tasman Radiation Oncology Group 99.04 and Australasian Leukaemia and Lymphoma Group LY02 prospective trial. Int J Radiat Oncol Biol Phys. 2011;80:1164–70.

    Article  Google Scholar 

  57. Pellegrini C, Gandolfi L, Quirini F, et al. Primary bone lymphoma: evaluation of chemoimmunotherapy as front-line treatment in 21 patients. Clin Lymphoma Myeloma Leuk. 2011;11:321–5.

    Article  CAS  Google Scholar 

  58. Schechter NR, Portlock CS, Yahalom J. Treatment of mucosa-associated lymphoid tissue lymphoma of the stomach with radiation alone. J Clin Oncol. 1998;16:1916–21.

    Article  CAS  Google Scholar 

  59. Fischbach W, Goebeler ME, Ruskone-Fourmestraux A, et al. Most patients with minimal histological residuals of gastric MALT lymphoma after successful eradication of Helicobacter pylori can be managed safely by a watch and wait strategy: experience from a large international series. Gut. 2007;56:1685–7.

    Article  CAS  Google Scholar 

  60. Tournier-Rangeard L, Lapeyre M, Graff-Caillaud P, et al. Radiotherapy for solitary extramedullary plasmacytoma in the head-and-neck region: A dose greater than 45 Gy to the target volume improves the local control. Int J Radiat Oncol Biol Phys. 2006;64:1013–7.

    Article  Google Scholar 

  61. Tsang RW, Gospodarowicz MK, Pintilie M, et al. Solitary plasmacytoma treated with radiotherapy: impact of tumor size on outcome. Int J Radiat Oncol Biol Phys. 2001;50:113–20.

    Article  CAS  Google Scholar 

  62. Greipp PR, San Miguel J, Durie BG, et al. International staging system for multiple myeloma. J Clin Oncol. 2005;23:3412–20.

    Article  Google Scholar 

  63. Steensma DP, Gertz MA, Greipp PR, et al. A high bone marrow plasma cell labeling index in stable plateau-phase multiple myeloma is a marker for early disease progression and death. Blood. 2001;97:2522–3.

    Article  CAS  Google Scholar 

  64. Rades D, Hoskin PJ, Stalpers LJ, et al. Short-course radiotherapy is not optimal for spinal cord compression due to myeloma. Int J Radiat Oncol Biol Phys. 2006;64:1452–7.

    Article  Google Scholar 

  65. Salazar OM, Rubin P, Hendrickson FR, et al. Single-dose half-body irradiation for palliation of multiple bone metastases from solid tumors. Final radiation therapy oncology group report. Cancer. 1986;58:29–36.

    Article  CAS  Google Scholar 

  66. Olsen E, Vonderheid E, Pimpinelli N, et al. Revisions to the staging and classification of mycosis fungoides and Sezary syndrome: a proposal of the International Society for Cutaneous Lymphomas (ISCL) and the cutaneous lymphoma task force of the European Organization of Research and Treatment of Cancer (EORTC). Blood. 2007;110:1713–22.

    Article  CAS  Google Scholar 

  67. Quaglino P, Pimpinelli N, Berti E, et al. Time course, clinical pathways, and long-term hazards risk trends of disease progression in patients with classic mycosis fungoides: a multicenter, retrospective follow-up study from the Italian Group of Cutaneous Lymphomas. Cancer. 2012;118:5830–9.

    Article  Google Scholar 

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Authors and Affiliations

  1. Penn State Cancer Institute, Hershey, PA, USA

    Nicholas G. Zaorsky

  2. Mayo Clinic, Jacksonville, FL, USA

    Daniel M. Trifiletti & Jennifer L. Peterson

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  1. Nicholas G. Zaorsky
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  2. Daniel M. Trifiletti
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  3. Jennifer L. Peterson
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Corresponding author

Correspondence to Nicholas G. Zaorsky .

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Editors and Affiliations

  1. Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL, USA

    Daniel M. Trifiletti

  2. Department of Radiation Oncology, Penn State Cancer Institute, Hershey, PA, USA

    Nicholas G. Zaorsky

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Zaorsky, N.G., Trifiletti, D.M., Peterson, J.L. (2019). Hematologic Cancers. In: Trifiletti, D., Zaorsky, N. (eds) Absolute Clinical Radiation Oncology Review. Springer, Cham. https://doi.org/10.1007/978-3-319-96809-4_10

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  • DOI: https://doi.org/10.1007/978-3-319-96809-4_10

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