Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification
Open accessAbstract
The purpose of this work was to modernize recommendations for evaluation, staging, and response assessment of patients with Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). A workshop was held at the 11th International Conference on Malignant Lymphoma in Lugano, Switzerland, in June 2011, that included leading hematologists, oncologists, radiation oncologists, pathologists, radiologists, and nuclear medicine physicians, representing major international lymphoma clinical trials groups and cancer centers. Clinical and imaging subcommittees presented their conclusions at a subsequent workshop at the 12th International Conference on Malignant Lymphoma, leading to revised criteria for staging and of the International Working Group Guidelines of 2007 for response. As a result, fluorodeoxyglucose (FDG) positron emission tomography (PET)–computed tomography (CT) was formally incorporated into standard staging for FDG-avid lymphomas. A modification of the Ann Arbor descriptive terminology will be used for anatomic distribution of disease extent, but the suffixes A or B for symptoms will only be included for HL. A bone marrow biopsy is no longer indicated for the routine staging of HL and most diffuse large B-cell lymphomas. However, regardless of stage, general practice is to treat patients based on limited (stages I and II, nonbulky) or advanced (stage III or IV) disease, with stage II bulky disease considered as limited or advanced disease based on histology and a number of prognostic factors. PET-CT will be used to assess response in FDG-avid histologies using the 5-point scale. The product of the perpendicular diameters of a single node can be used to identify progressive disease. Routine surveillance scans are discouraged. These recommendations should improve evaluation of patients with lymphoma and enhance the ability to compare outcomes of clinical trials.
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Lenalidomide enhances proliferation and activation of both T cells and natural killer cells.
“Lenalidomide enhances proliferation and activation of both T cells and natural killer cells. 17”
From Epcoritamab, lenalidomide, and rituximab versus lenalidomide and rituximab for relapsed or refractory follicular lymphoma (EPCORE FL-1): a global, open-label, randomised, phase 3 trial. (2026) · cites this paper as [17]
The Anatomic Staging and Assessment of Response After Treatment passages discuss imaging and lymphoma response, not lenalidomide’s effects on immune cells. Searches for the quoted claim and for lenalidomide with T-cell and NK-cell activation or proliferation found no passage addressing it in our copy. (LLM, conf=0.76)
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FDG PET/CT-based response assessment in malignancies
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- Authors
- Cheson, B. D., Fisher, R. I., Barrington, S. F., Cavalli, F., Schwartz, L. H., Zucca, E., & Lister, T. A.
- Affiliations
- Fox Chase Cancer Center (US)
- Venue
- Journal of Clinical Oncology
- Published
- 2014-09-20
- Volume
- 32
- Issue
- 27
- Pages
- 3059-3067
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- PMC
- PMC4979083
- OpenAlex
- W2119147717
- Cited by
- 5,715
- References
- 74
- Citations by year
- 2026: 553 · 2025: 632 · 2024: 612 · 2023: 665 · 2022: 629 · 2021: 647 · 2020: 532 · 2019: 379 · 2018: 319 · 2017: 288 · 2016: 245 · 2015: 169 · 2014: 23 · 2013: 2 · 2012: 4
- FWCI
- 178.29
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Oncology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Funders
- AstraZeneca
- Gilead Sciences
- Celgene
- Genentech
- Pharmacyclics
- National Cancer Institute (U10CA180888)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Lymphoma Diagnosis and Treatment
- Health Sciences › Medicine › Emergency Medicine › Hematological disorders and diagnostics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Keywords
- Hodgkin's disease, non-Hodgkin lymphoma, lymphoma staging, Lugano classification, treatment response assessment, FDG PET/CT, Ann Arbor stage, bone marrow biopsy, bulky disease, diffuse large B-cell lymphoma, clinical trial comparability
- MeSH terms
- Hodgkin Disease, Humans, International Cooperation, Liver Neoplasms, Lymphoma, Non-Hodgkin, Neoplasm Staging, Predictive Value of Tests, Prognosis, Tomography, X-Ray Computed, Treatment Outcome, Bone Marrow Neoplasms, Radiopharmaceuticals, Fluorodeoxyglucose F18, Positron-Emission Tomography
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