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Classical Hodgkin lymphoma (cHL) patients who fail autologous stem cell transplantation (ASCT) have extremely poor prognosis with a median overall survival (OS) of two years.[1][1] In this setting, treatment with brentuximab vedotin (BV) resulted in an objective response rate (ORR) of 75%, with 35%

Diffuse large B cell lymphoma is the most common Non-Hodgkin Lymphoma in Europe. First and second line of treatment are well established and provide a high percentage of durable responses, while third and further lines of therapy represent a challenge for clinicians. We report the results of a national observational study on the use of lenalidomide combined with rituximab or dexamethasone in patients with relapsed or refractory DLBCL, in a real-life context. Forty-seven patients, median age 72.8 years, were treated with a median of 4 cycles of therapy; 29.8% of patients achieved a complete response (CR), with an overall response rate of 42.6%. A subset of patients maintained response over time; in fact, 6-year-progression free survival (PFS) and overall survival (OS) were 23% and 30%, respectively. Treatment was well tolerated. Combination of lenalidomide with rituximab or dexamethasone represents a valid therapeutic option for patients with relapsed or refractory DLBCL.

Purpose A large number of new therapeutic agents have been studied for patients with relapsed/refractory follicular lymphoma (FL). Among new therapies, idelalisib, a novel PI3K inhibitor, shows promising results in the management of this disease. Case report We describe the case of a 39-year-old patient with a diagnosis of grade 3a FL and a Follicular Lymphoma International Prognostic Index score of 2, who underwent several lines of therapy (including autologous stem cell transplant) with transient responses or no response at all. The patient was subsequently treated with 5 courses of idelalisib monotherapy, achieving a partial response. No relevant toxicities occurred. The patient underwent allogeneic stem cell transplant (allo-SCT) from an unrelated donor and obtained a complete response, which was confirmed after 3, 6, 9, and 12 months, and is still ongoing. Conclusions As previously reported, the achievement of a good response is predictive for a better outcome after allo-SCT: idelalisib represents an effective treatment option for patients with relapsed/refractory FL, which can also be adopted as a bridge to allo-SCT.

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Background The purpose of this study is to investigate the most suitable first-line approach and the best combination treatment for primary mediastinal large B-cell lymphoma (PMLBCL) as they have been matter of debate for at least two decades. Methods Our single centre experience in the treatment of 98 de novo PMLBCL patients over the last 20 years is reviewed. All patients received MACOP-B chemotherapy. Thirty-seven received both rituximab and mediastinal radiotherapy; 30 were irradiated after chemotherapy, although not receiving rituximab and 20 received rituximab without radiotherapy consolidation. Eleven patients received chemotherapy only. Results Sixty-one (62.2%) patients achieved a complete response after MACOP-B (with or without rituximab); among the 27 (27.6%) partial responders, 21 obtained a complete response after radiotherapy. At the end of their scheduled treatment, 82 patients (83.7%) had a complete and 6 a partial response (6.1%). Eleven patients relapsed within the first 2 years of follow-up. The 17-year overall survival is 72.0% (15 patients died); progression-free and disease-free survival are 67.6% and 88.4%, respectively. A statistically significant difference in overall and progression-free survival was noted among treatment groups, although no disease-free survival difference was documented. Conclusions Our data indicate that a third-generation regimen like MACOP-B could be considered a suitable first-line treatment. Mediastinal consolidation radiotherapy impacts on survival and complete response rates and remains a good strategy to convert partial into complete responses. Data suggest that radiotherapy may be avoided in patients obtaining a complete response after (immuno)chemotherapy, but this requires confirmation with further ad hoc studies.