Does Gender Matter in Non-Hodgkin Lymphoma? Differences in Epidemiology, Clinical Behavior, and Therapy
Non-Hodgkin lymphoma (NHL) is one of the most common hematologic malignancies worldwide. The incidence of NHL has been rising for several decades; however, in the last 20 years, it reached a plateau. NHL incidence among males is significantly higher than in females. In addition to gender itself, gra...
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| Format: | Article |
| Language: | English |
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Rambam Health Care Campus
2014-10-01
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| Series: | Rambam Maimonides Medical Journal |
| Subjects: | |
| Online Access: | http://rmmj.org.il/Pages/ArticleHTM.aspx?manuId=450 |
| _version_ | 1819065461172600832 |
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| author | Nurit Horesh Netanel A. Horowitz |
| author_facet | Nurit Horesh Netanel A. Horowitz |
| author_sort | Nurit Horesh |
| collection | DOAJ |
| description | Non-Hodgkin lymphoma (NHL) is one of the most common hematologic malignancies worldwide. The incidence of NHL has been rising for several decades; however, in the last 20 years, it reached a plateau. NHL incidence among males is significantly higher than in females. In addition to gender itself, gravidity has a protective role against NHL occurrence. Gender also matters in terms of NHL clinical characteristics. For example, female predominance was found in three extra-nodal sites (the breast, thyroid, and the respiratory system) occasionally involved in NHL. The diagnosis of NHL during pregnancy is associated with a unique clinical behavior. It is usually diagnosed in the second or third trimester and in advanced stage. Furthermore, the histological subtype is highly aggressive, and reproductive organ involvement is common. The reduced rate of NHL among females may be explained by direct effects of estrogens on lymphoma cell proliferation or by its effect on anti-tumor immune response. Gender has an important role in responsiveness to standard B cell NHL treatment. Among older adults, women benefited more from the addition of the anti-CD20 antibody rituximab to standard chemotherapy regimens. This phenomenon can be explained by the difference in clearance rate of rituximab that was found to be significantly lower among older females than older males. In mantle cell lymphoma, women receiving lenalidomide have higher rates of response. An understanding of the mechanisms responsible for gender-associated NHL differences will ultimately improve the clinical approach, allowing for a more accurate assessment of prognosis and patient-tailored treatment. |
| first_indexed | 2024-12-21T15:46:50Z |
| format | Article |
| id | doaj.art-9549161a82dc4c83b1bc08baf12b815f |
| institution | Directory Open Access Journal |
| issn | 2076-9172 |
| language | English |
| last_indexed | 2024-12-21T15:46:50Z |
| publishDate | 2014-10-01 |
| publisher | Rambam Health Care Campus |
| record_format | Article |
| series | Rambam Maimonides Medical Journal |
| spelling | doaj.art-9549161a82dc4c83b1bc08baf12b815f2022-12-21T18:58:21ZengRambam Health Care CampusRambam Maimonides Medical Journal2076-91722014-10-0154e003810.5041/RMMJ.10172Does Gender Matter in Non-Hodgkin Lymphoma? Differences in Epidemiology, Clinical Behavior, and TherapyNurit Horesh0Netanel A. Horowitz1Department of Internal Medicine H, Rambam Health Care Campus, Haifa, IsraelDepartment of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel and Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, IsraelNon-Hodgkin lymphoma (NHL) is one of the most common hematologic malignancies worldwide. The incidence of NHL has been rising for several decades; however, in the last 20 years, it reached a plateau. NHL incidence among males is significantly higher than in females. In addition to gender itself, gravidity has a protective role against NHL occurrence. Gender also matters in terms of NHL clinical characteristics. For example, female predominance was found in three extra-nodal sites (the breast, thyroid, and the respiratory system) occasionally involved in NHL. The diagnosis of NHL during pregnancy is associated with a unique clinical behavior. It is usually diagnosed in the second or third trimester and in advanced stage. Furthermore, the histological subtype is highly aggressive, and reproductive organ involvement is common. The reduced rate of NHL among females may be explained by direct effects of estrogens on lymphoma cell proliferation or by its effect on anti-tumor immune response. Gender has an important role in responsiveness to standard B cell NHL treatment. Among older adults, women benefited more from the addition of the anti-CD20 antibody rituximab to standard chemotherapy regimens. This phenomenon can be explained by the difference in clearance rate of rituximab that was found to be significantly lower among older females than older males. In mantle cell lymphoma, women receiving lenalidomide have higher rates of response. An understanding of the mechanisms responsible for gender-associated NHL differences will ultimately improve the clinical approach, allowing for a more accurate assessment of prognosis and patient-tailored treatment.http://rmmj.org.il/Pages/ArticleHTM.aspx?manuId=450Gendernon-Hodgkin lymphomarituximab |
| spellingShingle | Nurit Horesh Netanel A. Horowitz Does Gender Matter in Non-Hodgkin Lymphoma? Differences in Epidemiology, Clinical Behavior, and Therapy Rambam Maimonides Medical Journal Gender non-Hodgkin lymphoma rituximab |
| title | Does Gender Matter in Non-Hodgkin Lymphoma? Differences in Epidemiology, Clinical Behavior, and Therapy |
| title_full | Does Gender Matter in Non-Hodgkin Lymphoma? Differences in Epidemiology, Clinical Behavior, and Therapy |
| title_fullStr | Does Gender Matter in Non-Hodgkin Lymphoma? Differences in Epidemiology, Clinical Behavior, and Therapy |
| title_full_unstemmed | Does Gender Matter in Non-Hodgkin Lymphoma? Differences in Epidemiology, Clinical Behavior, and Therapy |
| title_short | Does Gender Matter in Non-Hodgkin Lymphoma? Differences in Epidemiology, Clinical Behavior, and Therapy |
| title_sort | does gender matter in non hodgkin lymphoma differences in epidemiology clinical behavior and therapy |
| topic | Gender non-Hodgkin lymphoma rituximab |
| url | http://rmmj.org.il/Pages/ArticleHTM.aspx?manuId=450 |
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