Outcomes of patients with non-Hodgkin's lymphoma treated with Bexxar with or without external-beam radiotherapy.

PURPOSE: To compare the efficacy and toxicity of external-beam radiotherapy (EBRT) to sites of bulky lymphadenopathy in patients with chemotherapy-refractory low-grade non-Hodgkin's lymphoma (NHL) immediately before receiving Bexxar (tositumomab and (131)I) vs. in patients receiving Bexxar alone for nonbulky disease. METHODS AND MATERIALS: Nineteen patients with chemotherapy-refractory NHL were treated with Bexxar at our institution (University of Florida, Gainesville, FL) from 2005 to 2008. Seventeen patients had Grade 1-2 follicular lymphoma. Ten patients received a median of 20 Gy in 10 fractions to the areas of clinical involvement, immediately followed by Bexxar (EBRT + Bexxar); 9 patients received Bexxar alone. The median tumor sizes before EBRT + Bexxar and Bexxar alone were 4.8 cm and 3.3 cm, respectively. All 5 patients with a tumor diameter >5 cm were treated with EBRT + Bexxar. A univariate analysis of prognostic factors for progression-free survival (PFS) was performed. RESULTS: The median follow-up was 2.3 years for all patients and 3.1 years for 12 patients alive at last follow-up. Of all patients, 79% had a partial or complete response; 4 of the 8 responders in the EBRT + Bexxar group achieved a durable response of over 2 years, including 3 of the 5 with tumors >5 cm. Three of 9 patients treated with Bexxar alone achieved a durable response over 2 years. Actuarial estimates of 3-year overall survival and PFS for EBRT + Bexxar and Bexxar alone were 69% and 38% and 62% and 33%, respectively. The median time to recurrence after EBRT + Bexxar and Bexxar alone was 9 months. Having fewer than 4 involved lymph-node regions was associated with superior PFS at 3 years (63% vs. 18%). There was no Grade 4 or 5 complications. CONCLUSIONS: Adding EBRT immediately before Bexxar produced PFS equivalent to that with Bexxar alone, despite bulkier disease. Hematologic toxicity was not worsened. EBRT combined with Bexxar adds a safe and effective therapeutic treatment for managing recurrent low-grade follicular NHL.

Xerostomia in long-term survivors of aggressive non-Hodgkin's lymphoma of Waldeyer's ring: a potential role for parotid-sparing techniques?

BACKGROUND: The degree of xerostomia in patients treated for intermediate-and high-grade non-Hodgkin lymphoma (NHL) of Waldeyer's ring (WR) is unknown. METHODS AND MATERIALS: Fifteen patients treated for stage I-IV NHL of WR with radiotherapy (RT) were administered a xerostomia questionnaire. Numerical responses (0 = no xerostomia; 100 = maximum xerostomia) were compared with responses from 5 sets of patients treated for head and neck squamous cell carcinoma who were grouped by amount of parotid in RT field: larynx-only, ipsilateral parotid, bilateral-partial parotid, bilateral-total parotid, parotid-sparing intensity-modulated radiotherapy. RESULTS: Waldeyer's patients' median xerostomia questionnaire score was 31, which was significantly different from the larynx-only group, bilateral-partial parotid group, and bilateral-total parotid group, but not significantly different from the ipsilateral parotid group or parotid-sparing intensity-modulated radiotherapy group. CONCLUSIONS: Xerostomia in survivors WR NHL is a detectable toxicity with severity like that in head and neck squamous cell carcinoma patients who receive ipsilateral parotid irradiation, and warrants parotid-sparing RT techniques.

Laboratory and field studies of Macrocyclops albidus (Crustacea: Copepoda) for biological control of mosquitoes in artificial containers in a subtropical environment.

The cyclopoid copepod Macrocyclops albidus (Jurine) was tested as a potential biological control agent of mosquitoes in laboratory microcosms, in controlled field conditions, and in a 22-mo field experiment using discarded tires. The predator was highly efficient in controlling mosquitoes in all three settings, reaching close to 90% reduction in larval survival under field conditions and exceeding the recommended predation rates for effective mosquito control in laboratory experiments. The predator was most effective on 1-4-d-old larvae. Alternate food and habitat structure significantly influenced the predation rates on mosquito larvae. Once established, the copepod was able to maintain reproducing populations in the field for the duration of the experiments. However, the predator failed to establish populations at four of the experimental field sites. Two of the failures can be attributed to characteristics of the individual tires, such as leaching chemicals, whereas the other two were probably due to site-specific factors. This copepod species is a promising candidate for control of mosquito larvae because it is a widespread and highly effective predator that is capable of establishing and maintaining populations under a wide variety of field conditions. Additionally, M. albidus is relatively easy to culture, maintain, and deliver to the target areas.