 | Allo versus Auto SCT:
Outcome of BEAM-autologous and BEAM-alemtuzumab allogeneic transplantation in relapsed advanced stage follicular lymphoma.
Br J Haematol. 2008 Mar 3 PMID: 18318762
| Related
articles
|
| CNS outcomes: Primary central nervous system lymphoma:
mono-center, long-term, intent-to-treat analysis.
Cancer. 2008 Mar 4; PMID: 18318432
| Related
articles
Promising long-term results could be achieved with HDMTX-based
chemotherapy in patients with PCNSL in this monocenter study. The
MSKCC score proved useful for predicting survival.
|
| MRI imaging: Magnetic resonance imaging for the detection of bone marrow involvement in malignant lymphoma.
Br J Haematol. 2008 Apr;141(1):60-8. PMID: 18324967
MRI is probably sufficiently sensitive to rule out bone marrow
involvement in patients with malignant lymphoma. However, a
well-designed study with a large sample size is needed to confirm
current results.
|
| New study of
interest:
|
| Secondary treatment
risks: Liver dysfunction after chemotherapy in lymphoma
patients infected with hepatitis C blackwell-synergy.com
... "baseline screening for HBV and HCV before initiation
of chemotherapy is crucial. High-risk patients having chronic
active hepatitis, high baseline HCV viral load, HBV co-infection
and receiving cytotoxic drugs, corticosteroids and rituximab
(particularly if combined) should be closely monitored for serum
transaminase, bilirubin and HCV RNA levels."
|
| Drug development: Traditional Medicine: Identifying Potential Cancer Treatments Of Herbal Origin
http://www.sciencedaily.com
ScienceDaily (Mar. 5, 2008) — Curing cancer with natural products -- a case for shamans and herbalists? Not at all, for many chemotherapies to fight cancer applied in modern medicine are natural products or were developed on the basis of natural substances. Thus, taxanes used in prostate and breast cancer treatment are made from yew trees.
The popular periwinkle plant, which grows along the ground of many front yards, is the source of vinca alkaloids that are effective, for example, against malignant lymphomas.
The modern anti-cancer drugs topotecan and irinotecan are derived from a constituent of the Chinese Happy Tree.
|
| DLBCL Outcomes:
CHOP-Zevalin(R) Investigational Regimen Produces 95% Complete Remission and 75% Estimated Two Year Progression-Free Survival in Elderly Patients with Diffuse Large B-cell Lymphoma
prnewswire.com:
In this study, 20 previously untreated elderly patients were
treated with a novel combination of six cycles of CHOP
chemotherapy followed by Zevalin given six to ten weeks later.
|
| MCL outcomes
report: Low-dose metronomic, multidrug therapy with the PEP-C oral combination chemotherapy regimen for mantle cell lymphoma.
Leuk Lymphoma. 2008 Mar;49(3):447-50. PMID: 18297520
Eighty-two percent achieved an objective response with 46%
complete responses and 36% partial responses. Median time on
therapy was 17 months. The regimen was well tolerated. Our
findings demonstrate that low-dose oral agents administered in
combination for continuous, prolonged periods with minimal
drug-free intervals (metronomic therapy) may represent a novel,
effective, easily tolerated approach to MCL and that this
treatment approach warrants further exploration.
|
| Association: Prognostic influence of tumor-infiltrating mast cells in follicular lymphoma patients treated with rituximab and CHOP.
Blood. 2008 Feb 28; PMID: 18309035
... the data demonstrate that high MC (tumor-associated
mast cells) score is associated with unfavorable prognosis and it
eliminates the positive prognostic value of TAMs (tumor associated
macrophage) in FL patients treated with immunochemotherapy.
|
| Early Prognostic: C-MYC translocation in t(14;18) positive follicular lymphoma at presentation: An adverse prognostic indicator? Leuk Lymphoma. 2008 Mar;49(3):470-6.
PMID: 18297523
This is a small series but one which raises the possibility
that the presence of a C-MYC translocations at presentation may
identify a particularly aggressive subtype of FL. Further studies
are required to investigate the true incidence of this aberration,
the impact on C-MYC regulation, clinical course and response to
treatment.
|
| Newsy report:
low dose Radiotherapy + CpG immunotherapy: smh.com.au
Professor Ronald Levy, acclaimed cancer researcher and head of
the Division of Oncology at Stanford University, said the
radiotherapy killed cancer cells at the injection site, but the
stimulant triggered the immune system to track and exterminate
deadly cells elsewhere in the body.
"Of the 13 patients in the pilot study, four are in
remission," Prof Levy said.
|
| Quality of life: Expressive
Writing Appears To Change Thoughts And Feelings About Cancer http://www.medicalnewstoday.com:80/articles/98355.php
49 percent of participants who completed the writing exercise
reported that writing changed their thoughts about their illness,
while 35 percent reported writing changed they way they felt about
their illness. At the three week follow-up, 54 percent of those
completing all parts of the study reported writing changed their
thoughts and 38 percent reported writing changed their feelings
about their illness. Two factors -- younger age, and less time
since diagnosis, were associated with more change in thoughts and
feelings.
|
| Future target for
therapy? B Cell Mutations That May
Cause Cancers And
Autoimmune Diseases medicalnewstoday.com/
Dr Brink believes his team has uncovered an important clue as
to how these diseases may be treated in the future. "When we
examined the genes expressed in the long-lived B cells, we noticed
that mutations in the TRAF2 or TRAF3 gene cause major changes to
other genes within the B cell. We found around 20 genes whose
expression went up dramatically in these cells.
|
| Preclinical
immunotherapy: Novel Way To Develop Tumor Vaccines:
Regulate Immune Inhibitor To
Overcome Tumor Suppression sciencedaily.com/
The study identified a new molecular player called A20, an
enzyme that restricts inflammatory signal transduction in
dendritic cells. When it is inhibited, the dendritic cells
overproduce an array of cytokines and co-stimulatory molecules
that triggers unusually strong immune responses that cannot be
suppressed by regulatory T cells. The resulting hyperactivated
immune responses triggered by A20-deficient dendritic cells are
capable of destroying various types of tumors that are resistant
to current tumor vaccines in mice.
|
| Clinical trial
participation: Most Cancer
Patients Satisfied With Clinical Trial Experience,
Yet Few Aware of
Opportunity foxcentraloregon.com/
The survey determined that only 10 percent of the 1,788 cancer
survivors knew participation in a cancer clinical trial was an
option. Of those who learned about trials, 73 percent cited their
physician as the source of information. The participants' type of
cancer influenced their awareness, as did type of treatment.
"One of the most important steps a patient can take to regain
some control when faced with a cancer diagnosis is to be as
informed as possible about his or her disease," said Dr.
Miller. "It was encouraging to find that most patients would
be inclined to participate if enrollment in a clinical trial was
presented as a treatment option."
|
| Infection-driven?
Eliminating Infection at Diagnosis of Slow-growing NHL May Be
Important Treatment Step cancerconsultants.com:
It appears that indolent NHL in patients with an infection may
have a different biology from indolent NHL in patients without an
infection, as evidenced by the differences in time required for
NHL therapy. As well, it appears that antimicrobial therapy may
provide benefit for some patients with indolent NHL and an
infection. Although this topic needs further study, these results
provide provocative data that may lead to different treatment
strategies in NHL.
|
|
|
| The Big
picture: Battling the Hematological Malignancies: The 200 Years' War
Full article http://theoncologist.alphamedpress.org/cgi/content/full/13/2/126
The delineation of the hematological malignancies began near the end
of the first third of the 19th century ... These challenges will be gradually overcome, if we (a) develop new
models of cooperation among academia, industry, and government
[and patients], (b) continue the growth of international participation in cancer research
(more keen minds to the task), and (c) convince the governments of the
world, including that of the U.S., that an investment in minimizing
the effects of cancer is as important as defending against other threats to the welfare and longevity of their citizens.
|
| Education: Spotlight on New Discoveries in NHL:
leukemia-lymphoma.org
Update from the American Society of Hematoloty (ASH) Annual Meeting
This program featured Wyndham Wilson, M.D., Ph.D, senior investigator, head, Lymphoma Therapeutics Section, National Cancer Institute, Bethesda, MD.
|
| Updated
Clinical Practice Guidelines for Oncologists: nccn.org
pdf 2008
Technical guidance for treatments of lymphomas by type.
|
|
|
| Review:
Zevalin in Mantle Cell Lymphoma touchbriefings.com
pdf 2007
Conclusion: Radiotherapy is an active treatment modality in
MCL. Ibritumomab radioimmunotherapy (Zevalin) is an interesting
alternative to other consolidation methods. In younger patients
subjected to intensive chemotherapy followed by autologous
transplant, it may be an element of a transplant conditioning
regimen (i.e. Z-BEAM). In elderly patients, the role of zevalin
consolidation should be further investigated in a phase III trial.
|
| CLL Outcomes: Phase I-II study of oxaliplatin, fludarabine, cytarabine, and rituximab combination therapy
in patients with Richter's syndrome or fludarabine-refractory CLL.
J Clin Oncol. 2008 Jan 10;26(2):196-203. PMID: 18182662
The OFAR regimen is highly active in RS and has activity in
fludarabine-refractory patients with CLL. This regimen warrants
further investigation in the treatment of these disorders.
|
| Risk factors for development of a second lymphoid malignancy in patients with
CLL.
Br J Haematol. 2007 Nov;139(3):398-404. PMID: 17910629
|
| Preclinical: AT-101 markedly enhances the therapeutic effects of chemotherapeutic agents in in vitro and in vivo models of B-cell lymphoma.
Blood. 2008 Feb 21; PMID: 18292288
Over-expression of anti-apoptotic members of the Bcl-2 family
are observed in approximately 80% of B-cell lymphomas,
contributing to intrinsic and acquired drug resistance. Nullifying
anti-apoptotic function can potentially overcome this intrinsic
and acquired drug resistance. ... The addition of AT-101 to
cyclophosphamide (Cy) and rituximab (R) in a schedule-dependent
manner enhanced the efficacy of the conventional therapy [ in cell
culture and animal models].
Clinical
trials with AT-101
|
| AITL Prognostic
factors: Clinical, biological and pathological features in 157 patients with angioimmunoblastic T-cell lymphoma treated within the Groupe d'Etude des Lymphomes de l'Adulte
(GELA) trials.
Blood. 2008 Feb 21; PMID: 18292286
"In multivariate analysis, only male gender (p=0.004),
mediastinal lymphadenopathy (p=0.041) and anemia (p=0.042)
adversely affected overall survival.
... In conclusion, AITL is a morphologically heterogeneous T-cell
lymphoma commonly expressing CXCL13 and CD10 and carrying few
prognostic factors. It portends a poor prognosis even when treated
intensively. However, not always lethal as 30% of patients are
alive at 7 years."
|
| Quality of life: Post-traumatic
stress (PTS) outcomes in NHL survivors. ncbi.nlm.nih.gov
 | About Post Traumatic
Stress Disorder http://www.medicinenet.com
"Posttraumatic stress disorder (PTSD) is an emotional
illness that develops as a result of a terribly frightening,
life-threatening, or otherwise highly unsafe experience. PTSD
sufferers re-experience the traumatic event or events in some
way, tend to avoid places, people, or other things that remind
them of the event (avoidance), and are exquisitely sensitive
to normal life experiences (hyperarousal). "
|
|
|
Treanda FDA review
starts: FDA Accepts Treanda New Drug Application for the
Treatment of Relapsed Indolent NHL drugs.com
We are pleased that the application for Treanda to treat
relapsed indolent NHL is on track. With two NDAs for Treanda
pending review decisions, 2008 is a significant year for this
product ...
|
| Insight: Into
Possible Cause of Lymphoma medicalnewstoday.com
What this means, Schatz said, is that researchers studying
lymphatic cancer must understand both the first and the second
step-the original mutations and then the repair process.
|
| CLL news: MabCampath
Available For First Line Treatment Of B-Cell Chronic Lymphocytic
Leukaemia (CLL) For Whom Fludarabine Chemotherapy Is Not
Appropriate medicalnewstoday.com/articles/97739.php
"In the Phase III trial MabCampath® produced the highest
response rate in patients with chronic lymphocytic leukaemia for
any single agent seen in previous front-line trials," said Dr
Peter Hillmen of the department of clinical haematology and
haematological malignancy diagnostic service at Leeds teaching
Hospital and principal trial investigator for MabCampath®.
|
| Caution on high dose
green teas supplements:
Green tea can be toxic at therapeutic dose levels pubs.acs.org
pdf
"Despite several human studies that showed no toxicity of
tea polyphenol preparations and that the major adverse effects
associated with consumption of high doses of tea preparations are
due to gastrointestinal irritation, there have been a number of
recent case reports of hepatotoxicity related to the consumption
of high doses of tea-based dietary supplements (10-29 mg/ kg/day
po) (18)."
|
| Quality of Life:
Optimism Not Required for Cancer Recovery healthtalk.com
Contrary to popular belief, there is no evidence that an
optimistic attitude leads to a better cancer outcome. In fact,
insisting on a cheery disposition when someone is struggling with
a scary disease may actually do more harm than good, according to
a leading psycho-oncologist (a psychiatrist specializing in the
treatment of cancer patients).
|
| Weighing the
evidence: The Dirt on Coming Clean: Perverse Effects of Disclosing Conflicts of Interest
Daylian M. Cain, George Loewenstein, and Don A. Moore http://www.cbdr.cmu.edu/mpapers/CainLoewensteinMoore2005.pdf
Notable quote: " While most people think conflicts of
interest are a problem of overt corruption, that is, that
professionals consciously and intentionally misrepresent the
advice they give so as to secure personal
gain, considerable research suggests that bias is more frequently
the result of motivational processes that are unintentional and
unconscious "
|
| Advocacy works! Congress
Grants Reprieve for Cancer Treatment (RIT) heartland.org
... Like chemotherapy, radioimmunotherapy drugs treat and kill
cancer cells, but they use radioactive material to do so. Bianco
said Congress responded to the *vast patient and physician outcry*
against CMS's decision.
|
| Sources of
information Webpages that
contain information about CAM interscience.wiley.com
Most breast cancer information that consumers are likely to
encounter online is accurate. However, commonly cited quality
criteria do not identify inaccurate information. Webpages that
contain information about CAM (Complementary and Alternative
Medicine) are relatively likely to contain inaccurate statements.
Consumers searching for health information online should still
consult a clinician before taking action.
|
|
Early/encouraging:
BiTE Antibodies (report on clinical responses) seekingalpha.com
A BiTE (Bispecific T Cell Engager) antibody is a bi-specific
antibody (bsAb) which directs T-cells to attack cancer cells, by
simultaneously binding the two cells.
... all three patients who received the highest dose, had an
objective response ( One had a CR and the other two had PRs). It
won’t be reasonable to expect that this dose can actually
achieve 100% response rate in larger populations, but this is
indeed a great sign of a dose dependent activity.
While the response rate of this trial is very encouraging, the
actual doses which led to the responses are nothing short of sensational.
MT103 was effective at doses at which most antibody-based
platforms are not even evaluated.
|
|
|
| Early encouraging: Novel
Anti-CD20 Monoclonal Antibody Ofatumumab Demonstrates Anti-tumour
Responses In Patients With Relapsed/refractory B-cell Chronic
Leukaemia medicalnewstoday.com
... four weeks after beginning treatment, 62% of patients
(N=32) obtained objective response
|
| HL Prognosis: Better Prognosis
for Patients with Lymphocyte-predominant Hodgkin’s Lymphoma patient.cancerconsultants.com
"In order to better understand characteristics of LPHL
[Lymphocyte-predominant HL], researchers from Germany conducted an
analysis of 8,298 HL patients treated within a German medical
trial to compare patient characteristics and treatment outcomes
among cHL [classical HL) patients and others diagnosed with LPHD .
"
|
| fNHL Outcomes: Comparing
intensive (R-HDS - with autografting) versus CHOP-R in high-risk
follicular lymphoma at diagnosis. Blood. 2008 Jan 31; PMID: 18239086
the superior disease control of R-HDS does not translate into
an over-all survival advantage.
|
| Background for patients: Factors
that can influence treatment decisions and timing: PAL
The purpose of this "inventory" of factors is to
show the complexity of treatment decisions - and how they can interact;
and how each case and lymphoma can be unique, thus treatments may need
to be tailored accordingly.
|
| HL: Prognostic impact of bone involvement in Hodgkin lymphoma.
Neoplasma. 2008;55(2):96-100. PMID: 18237246
... bone involvement is a relatively common finding in HL and is not an independent adverse prognostic factor. Key words: Hodgkin lymphoma - bone involvement - prognostic factors.
|
| Expert perspective: Follicular
Lymphoma Revisited, Saul A. Rosenberg jco.ascopubs.org
In conclusion, reflecting on our report of transformation of
follicular lymphoma, of 25 years ago, and the 50 years’
experience of the author, this event remains a most important one
in the course and life of a patient with follicular lymphoma, but
so is the attitude, skill, and judgment of the physician managing
these special patients.
|
| Health: Final Rule Promotes
Safe Use of Dietary Supplements fda.gov
Under the final rule, manufacturers are required to evaluate
the identity, purity, quality, strength, and composition of
dietary supplements.
|
| Outcomes CNS Lymphoma :
Methotrexate May Cure up to 20% of Patients With CNS lymphoma medscape
(free login req.)
"In this small, multicenter study we found that at almost 7 years of follow-up, 5 of the original 25 patients were still in remission after treatment with high-dose methotrexate alone and that toxicity was modest," principal investigator Tracy Batchelor, MD, told Medscape Neurology & Neurosurgery.
The study is published in the January 29 issue of Neurology.
|
|
Review of ASH: Report from the 49th Annual Meeting
8–11 December, 2007, Atlanta, Georgia
David Meiklejohn, Consultant Haematologist, Ninewells Hospital, Dundee, UK
lymphomaforum.org.uk
* Does upfront treatment of diffuse large B-cell lymphoma (DLBCL) with rituximab and chemotherapy (R-chemotherapy) make relapsed disease more difficult to treat successfully?
* When treating follicular lymphoma, does the choice of chemotherapy regimen used in combination with immunotherapy matter, or are they all of similar efficacy?
* What is the role of radioimmunotherapy in the treatment of follicular lymphoma?
* How can response rates and overall survival (OS) in mantle-cellbe improved?
|
|
Warning: Leukine (sargramostim)
recall
Audience: Oncologists, hematologists, other healthcare
professionals
[Posted 01/24/2008] Bayer and FDA informed healthcare
professionals of the market withdrawal of the current liquid
formulation of Leukine, a growth factor that helps fight infection
and disease in appropriate patients by enhancing immune cell
function. The product was withdrawn because of an upward trend in
spontaneous reports of adverse reactions, including syncope
(fainting), which are temporally correlated with a change in the
formulation of liquid Leukine to include edetate disodium (EDTA).
The upward trend in adverse reaction reporting rates has not been
observed with the use of lyophilized Leukine. Healthcare
professionals should immediately stop using liquid Leukine and
return unused vials to the manufacturer.
[January 23, 2008 - Dear
Healthcare Professional Letter - Bayer Healthcare]
|
|
SGN-35 Investigational
agent: Stock sale puts Seattle Genetics on solid ground seattlepi.nwsource.com
In November, Seattle Genetics presented a study showing that
SGN-35, an antibody linked to a drug to deliver it to target
cells, had shrunk tumors in patients with Hodgkin's lymphoma.
Siegall said Seattle Genetics would present "very
exciting" SGN-35 data later this year and then present its
plan to develop the treatment.
|
|
Expert Commentary: Areas
of Confusion in Oncology
What Is the Role of Maintenance Rituximab in Follicular NHL? cancernetwork.com/
David G. Maloney, Reviewed
by John D. Hainsworth and Bertrand Coiffier
Should rituximab maintenance become standard therapy for
follicular lymphoma?
|
|
DLBCL outcomes: Radiotherapy
(RT) improves outcomes of early-stage DLBCL patients
consultantlive.com/
"These are certainly very exciting findings and support
the role of radiation therapy in patients with localized diffuse
large B-cell lymphoma," said Dr. Ng, of the Dana-Farber
Cancer Institute. She cautioned that patients who received more
cycles of chemotherapy upfront or had a slow response to
chemotherapy before starting radiation therapy may not have been
recorded as receiving radiation therapy in SEER.
"So there's a small potential concern that patients scored as
receiving radiation therapy may represent a more favorable
subgroup of patients, such as those having small, nonbulky disease
or quicker response to chemotherapy so that less chemotherapy was
given." This potential bias in favor of the radiation therapy
cohort may limit the conclusions of the study, Dr. Ng commented. A
possible workaround would be to repeat the analysis using the
linked SEER Medicare database, which gives more detailed
information, she pointed out. "Using this database, however,
will limit the analysis to patients aged over 65," Dr. Ng
said, "but this may be okay for this disease, which mainly
affects older patients."
|
|
fNHL outcomes: Long-term molecular remissions in patients with indolent lymphoma treated with rituximab as a single agent or in combination with interferon alpha-2a: A randomized phase II study from the Nordic Lymphoma Group.
Leuk Lymphoma. 2008 Jan;49(1):102-12. PMID: 18203019
Extended rituximab is effective and well tolerated and
combination with IFN seems to improve both the quality and
duration of the responses, providing the opportunity to achieve
long-term molecular CRs and prolonged failure-free survival
without chemotherapy.
|
|
HL Outcomes: Superiority of reduced-intensity allogeneic transplantation over conventional treatment for relapse of Hodgkin's lymphoma following autologous stem cell transplantation.
Bone Marrow Transplant. 2008 Jan 14; PMID: 18195684
These data demonstrate the potential efficacy of RIT in heavily
pre-treated patients whose outlook with conventional therapy is
dismal, and provide evidence of a clinically relevant
graft-versus-lymphoma effect.
|
|
Expert background: Optimal
Use of Prognostic Factors in NHL asheducationbook.
2006 pdf
The management of non-Hodgkin lymphoma is complicated by wide
heterogeneity within recognized subtypes. Patients with supposedly
similar diagnoses can have remarkably varied clinical
presentations, molecular profiles and clinical outcomes. Reliable
prognostic markers could allow the identification of patient
subsets that may benefit from alternate approaches.
|
|
Expert background: Reduced-Intensity Regimens in Allogeneic
Stem-Cell Transplantation
for NHL and CLL asheducationbook
2006 pdf
|
|
Rituxan maintenance? What Is the
Role of Maintenance Rituximab in Follicular NHL? consultantlive.com
Dr. Hainsworth has conducted clinical research with funding
received by the Sarah Cannon Research Institute from
Genentech.
Perhaps the most interesting and unexpected benefit of rituximab
in the treatment of follicular lymphoma has been its use in
maintenance therapy. The efficacy of this targeted agent in
chronic therapy contrasts with the well documented futility of
maintenance therapy using cytotoxic agents, and raises the
possibility that the strategy underlying targeted-agent therapy
may be fundamentally different.
|
|
Risk factors:
Treatment of Hepatitis C Reduces Incidence of Non-Hodgkin’s
Lymphoma cancerconsultants.com
Researchers
from Japan have reported that viral elimination in hepatitis C
virus (HCV) infected patients reduces the incidence of
non-Hodgkin’s lymphoma (NHL). The details of this study appeared
in the December, 2007 issue of the American Journal of Medicine.
|
| DLBCL outcomes: Rituximab Plus
CHOP Boosts Survival in Older Lymphoma Patients
medpagetoday.com
The addition of rituximab improved three-year event-free
survival from 47.2% with six cycles of CHOP and 53% with eight
cycles to 66.5% and 63.1%, respectively, Michael Pfreundschuh,
M.D., of Saarland University Medical School, and colleagues
reported in the February issue of the Lancet Oncology.
|
| Study Search: Clinical Trials
for DLBCL and Radioimmunotherapy? ClinicalTrials.gov
|
| Outcomes /Press release:
Zevalin Combined With High-Dose Chemotherapy and Autologous Stem-Cell Transplantation
(ASCT) Produces High Overall Survival and Progression-Free Survival Rates in Patients With Relapsed Non-Hodgkin's Lymphoma
http://money.cnn.com
produced a high rate (70 percent) of progression-free survival
at two years without a significant increase in the toxicity of the
HDC regimen underscoring the potential role for RIT in ASCT.
|
| Side effects: Rituxan and
Late-onset neutropenia (LON): Related abstracts http://www.ncbi.nlm.nih.gov
|
| Outcomes Cutaneous T-cell: Stem
cell transplantation for patients with primary cutaneous
T-cell lymphoma.
... more than two-thirds of the allogeneic transplant
recipients reported in the literature experienced long-term
durable remissions of more than 3 years, which would appear
superior to the expected median survival for such patients.
|
|
MCL cure? Mantle Cell Lymphoma
Can Be Cured by Intensive Immunochemotherapy with In-Vivo Purged
Stem-Cell Support; Final Report of the Nordic Lymphoma Group MCL2
Study ASH
abstracts2view.com
Conclusion: The demonstration of long-term event-free survival
in a large, consecutive prospective series now for the first time
indicates that intensive immunochemotherapy including AraC and
Rituximab with in-vivo purged stem-cell support may cure mantle
cell lymphoma.
|
|
fNHL survival: Survival
in Follicular Lymphoma: The Stanford Experience ASH
2007 abstracts2view.com
Conclusions: OS of patients with FL managed at Stanford
University significantly improved in the 1986-2003 eras,
particularly among younger and advanced stage patients.
|
|
MCL: A new prognostic index (MIPI)
for patients with advanced-stage mantle cell lymphoma bloodjournal.hematologylibrary.org
According to the MIPI, patients were classified into low risk
(44% of patients, median OS not reached), intermediate risk
(35%, 51 months), and high risk groups (21%, 29 months),
based on the 4 independent prognostic factors: age,
performance status, lactate dehydrogenase (LDH), and
leukocyte count. Cell proliferation (Ki-67) was
exploratively analyzed as an important biologic marker
and showed strong additional prognostic relevance.
|
|
HL study of interest: Phase II
Combination Clinical Trial With MGCD0103 and Vidaza® in Patients
With Relapsed or Refractory Hodgkin Lymphoma or Non-Hodgkin
Lymphoma marketwire.com
"announced the enrollment of the first patient in a Phase
II clinical trial (Trial 012) evaluating MGCD0103,
the Companies' isotype-selective histone deacetylase inhibitor (HDACi)
product candidate, in combination with Vidaza® (azacitidine
for injection), Pharmion's DNA demethylating agent, in patients
with relapsed or refractory Hodgkin lymphoma (HL) or non-Hodgkin
lymphoma (NHL).
|
| Immune adjuvant: CPG-7909
(PF-3512676, ProMune®): toll-like receptor-9 agonist
in cancer therapy expertopin.com
Stimulation of toll-like receptor (TLR)9 activates human
plasmacytoid dendritic cells and B cells, and induces potent
innate immune responses in preclinical tumor models and in
patients. CpG oligodeoxynucleotides (ODNs) are TLR9 agonists that
show promising results as vaccine adjuvants and in the treatment
of cancers, infections, asthma and allergy.
Related
studies: ClinicalTrials.gov
|
| Response marker for CLL: Serum
globulins as marker of immune restoration after treatment with
high-dose Rituxan for CLL PubMed
An important biological alteration in chronic lymphocytic
leukemia (CLL) is the dysregulation of immunoglobulin production,
as a consequence of complex and yet incompletely understood
interactions between plasma cells and the neoplastic B-cell clone.
As a result, most patients develop severe hypogammaglobulinemia
during the course of the disease.
|
| anti-cd74
antibody: Immunomedics Patents Internalizing
Anti-CD74 Antibodies Reuters
The Company's lead anti-CD74
product candidate, milatuzumab, is a humanized antibody currently
in Phase I/II studies for patients with multiple myeloma who have
failed at least two prior standard systemic anti-myeloma treatment
regimens. In addition, John P Leonard, MD, Weill Cornell Medical,
is conducting a Phase I, open-label study in patients with
recurrent non-Hodgkin's lymphoma or chronic lymphocytic leukemia
funded in part by a grant from the National Cancer
Institute.
Related
studies: ClinicalTrials.gov
|
|
RIT and SCT review:
Current status and future perspectives for Zevalin in stem cell
transplantation for NHL
http://www.ncbi.nlm.nih.gov/
The preliminary data are highly promising in terms of
conditioning tolerability and patient outcomes following
transplant; further phase II studies are now needed to consolidate
these data and to investigate specific patient populations and NHL
subtypes. PMID: 17922042
|
| Patient perspective: What
NOT To Say To A Cancer Survivor Kathy
on WebMagic
Whether you are a newly diagnosed survivor or someone who loves
him or her, cancer rocks your world. We survivors have our own
issues to face, but those of you who care for us can help by
learning what not to say. We know you mean well, but please avoid
the following platitudes ....
|
|
CLL outcomes:
Treanda™ (Bendamustine) Superior to Chlorambucil for Initial
Treatment of CLL cancerconsultants.com:
Researchers from Germany have reported that Treanda
(bendamustine) results in higher response rates and improved
progression-free survivals in patients with previously untreated
Binet stage B and C chronic lymphocytic leukemia (CLL) compared to
chlorambucil.
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Important: Cephalon Submits New
Drug Application For TREANDA (Benamustine) medicalnewstoday.com
The TREANDA NDA for relapsed indolent NHL is supported by three
studies in patients with NHL, including one in combination with
rituximab. In these studies, patients treated with TREANDA had a
high rate of response and a manageable and tolerable side effect
profile, with adverse events similar to those observed with other
chemotherapy agents.
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cutaneous NHL: Radiotherapy Suitable for Most Primary Cutaneous B-Cell Lymphomas
cancerpage.com
NEW YORK JAN 02, 2008 (Reuters Health) - Radiotherapy is appropriate for most patients with primary cutaneous B-cell lymphomas (CBCL), according to a recent Dutch study, but more aggressive treatment is needed in patients presenting with lesions on the leg.
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Pilot CAM study: Jefferson
scientists studying the effects of high-dose vitamin C on
non-Hodgkin lymphoma patients http://www.eurekalert.org
“This is a very unique study for a set of patients who have
really run out of options,” said Daniel Monti, M.D., director of
the Myrna Brind Center of Integrative Medicine, and primary
investigator of the study. “Vitamin C administered intravenously
has shown great promise in the laboratory and there has been some
anecdotal data in cancer patients, but no one has really ever run
a detailed study on humans. Vitamin C doesn’t cost much and is
very low in toxicity, making it a particularly desirable agent for
further study.”
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CLL secondary risks: Risk for
Second Neoplasms in Chronic Lymphocytic Leukemia abkhazia.com
"CLL is currently viewed as a long-term disease, for which
most available treatments (with the exception of allogeneic
transplantation) do not result in a cure. Awareness of physicians
following these patients needs to be raised to the fact that
significant morbidity and mortality stem not only from CLL itself,
but also from superimposed processes, most notably infections and
second malignancies."
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CT risks: Debate continues about
risks, and for which populations? cancernetwork.com
The authors recommend better equipment and techniques to lower
radiation exposure and the alternative use of MRI and ultrasound,
***especially for infants and children.*** They urge physicians to
avoid inappropriate CT utilization. ... Arl Van Moore,
Jr., MD, chair of the ACR board of chancellors, worried that
patients may mistakenly avoid what the ACR characterized as
"life-saving medical imaging care," because of the
article. "They may be terribly confused and unduly distressed
by some of the statements in this study," he said.
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preclinical / interesting:
New technique enhances binding avidity of monoclonal antibodies (MoAbs)
cancernetwork.com
a humanized anti-CD20 MoAb enhanced with DXL technology,
being developed for the treatment of non-Hodgkin's lymphoma.
The DXL technique involves modifying a MoAb by adding a small
peptide sequence that becomes self-recognizing when two or more
MoAb molecules are in close proximity. This self-binding property
causes the modified antibodies to cluster at the target receptor,
resulting in greater molecular mass on the surface of the target
cell
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Perspective on research obstacles: Why
so many dead-end phase II trials? cancernetwork.com
To expand evidence-based oncology care, we need to recognize
the flaws in the drug development system so they can be corrected.
As Dr. Tannock pointed out, self-aggrandizement among ambitious
young researchers is one trend driving the troubling preponderance
of dead-end phase II trials.
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RIT at risk? Cell Therapeutics
buys drug (Zevalin) shown to shrink tumors seattlepi.nwsource.com
"In November, Medicare announced that it would cut back on
its reimbursements of radioimmunotherapies, such as Zevalin, which
can cost more than $20,000 to administer. An uproar ensued, and
last week Congress passed legislation extending the previous
reimbursement arrangement for six months."
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| fNHL outcomes:
Genitope Corporation Reports Initial Results of Phase 3 Clinical
Trial of MyVax(R) Personalized Immunotherapy genitope.com/
"We are excited by these results because the data clearly
show that MyVax personalized immunotherapy is a safe and active
drug for follicular lymphoma patients. Both arms of the trial
appear to show activity.
Patients who received MyVax personalized immunotherapy and mounted
a positive immune response to the tumor-specific target
demonstrated superior clinical outcomes compared to patients who
did not mount this specific immune response. While we recognize
that the regulatory path would be clearer had the trial met its
primary endpoint, we are pleased with the outcome of the trial. We
are working closely with the FDA to determine the path forward for
MyVax personalized immunotherapy,"
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| CLL Outcomes: Fludara
(Fludarabine) Not Superior to Cytoxan (Chlorambucil) for Elderly
with CLL cancerconsultants.com
involved 206 patients with CKK older than 64 years of age.
Eighty-five percent of patients in this study were Binet stage
B-C. The median age was 70 years.
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| Quality of Life: Cancer Docs
Often Miss Patient Fears webmd.com
The researchers recorded close to 400 conversations between
oncologists and patients and then counted how often the patients
sought empathy from the doctors and how often the doctors
responded empathetically to patient concerns. ... Showing support
or asking patients to elaborate on their concerns, legitimizing
the expressed emotion and praising patients for their strength
were all considered empathetic responses.
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CNS Prophylaxis: Central Nervous System (CNS) Relapse in
Aggressive Non-Hodgkins Lymphoma; Does CNS Prophylaxis Work?
abstracts2view.com
Conclusion: CNS relapse almost always occurs within 2 years of
initial treatment, is usually isolated, and portends a poor
prognosis. Patients with > 1 extranodal sites or those having a
high IPI score have a higher incidence of CNS relapse. There is no
evidence to suggest however, that CNS prophylaxis with either
cranial radiation or intrathecal MTX/Ara-C decreases the risk of
CNS relapse.
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aggressive NHL Outcomes: DOSE-
ESCALATED CHOP AND TAILORED INTENSIFICATION WITH IFE ACCORDING TO
EARLY RESPONSE IN POOR RISK AGGRESSIVE B CELL LYMPHOMA: A
PROSPECTIVE STUDY FROM THE GEL-TAMO STUDY GROUP. Abstract
No different outcomes were observed between patients
achieving an early negative Ga (67)S response treated with
MegaCHOP and BEAM/ ASCT and patients with midtreatment positive Ga
(67)S who received IFE prior BEAM/ ASCT. Conclusions: This
response adapted strategy including early treatment modifications
prior HDT/ ASCT have yielded encouraging PFS and OS in patients
with poor risk aggressive NHL.
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| CLL treatment decisions:
What Is the Optimal Initial
Treatment for Chronic Lymphocytic Leukemia? cancernetwork.com/
THOMAS S. LIN, MD, PhD
"The choice of initial therapy for an individual patient
should depend upon the patient's age and medical condition,
cytogenetic and other prognostic factors, and whether the goal of
therapy is maximization of CR and PFS or palliation of symptoms
with minimal toxicity."
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| HD Outcomes (small study): mTOR Inhibition
(everolimus) for Relapsed or Refractory Hodgkin Lymphoma: Promising Single Agent Activity with Everolimus (RAD001).
ASH Poster Session
Oral everolimus has promising activity with acceptable toxicity in Hodgkin lymphoma. These results provide the rationale for additional studies with this novel class of agents and to integrate mTOR inhibitors into salvage treatment regimens for Hodgkin lymphoma.
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| Angioimmunoblastic L Outcomes: High-Dose Therapy
(HDT)
and Autologous Stem-Cell Transplantation (ASCT) in Angioimmunoblastic Lymphoma: Complete Remission at Transplantation Is the Major Determinant of Outcome
J Clin Oncol. 2007 Dec 10; PMID: 18071187
This study shows that HDT and ASCT offers the possibility of
long-term disease-free survival to patients with AITL. Early
transplantation is necessary to achieve optimal results.
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| fNHL Prognostic marker: Biologic predictors in follicular lymphoma: Importance of markers of immune response.
Leuk Lymphoma. 2007 Dec;48(12):2403-11. PMID: 18067016
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| PTCL Prognostic marker: Expression of CYP3A4 as a predictor of response to chemotherapy in peripheral T-cell lymphomas.
Blood. 2007 Nov 1;110(9):3345-51. Epub 2007 Jul 18. PMID: 17634410
In conclusion, a high CYP3A4 tumoral expression could be useful
to predict poor response to the standard PTCL chemotherapy; in
these cases alternative chemotherapy combinations or doses should
be explored.
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| aggressive NHL Outcomes: Two Studies
Demonstrate REVLIMID (R) (lenalidomide) Activity In Patients With
Relapsed/Refractory Aggressive Non-Hodgkin's Lymphoma - medilexicon.com
"The data from these studies are encouraging in that they
show an impressive response to REVLIMID in relapsed/refractory,
aggressive NHL," said John Leonard, M.D., The Richard T.
Silver Distinguished Professor of Hematology Medical Oncology at
Weill Cornell Medical College. "These data justify a wide
exploration of REVLIMID in a variety of lymphoma settings both
alone and in combination, and warrant a detailed assessment of
which patients can particularly benefit."
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| indolent / MCL Outcomes: Bendamustine Plus
Rituximab Versus CHOP Plus Rituximab in the First-Line Treatment
of Patients with Indolent and Mantle Cell Lymphomas 
First Interim Results of a Randomized Phase III Study of the StiL abstracts2view.com
Results: So far 439 patients have been randomized. 273 patients
are evaluable for response for this first interim analysis (B-R:
n=139; CHOP-R: n=134). Median patient age is 63 years. Histologies
are equally distributed between arms: follicular 52%, mantle cell
20%, and other indolent lymphomas 28% in both treatment groups,
each. The ORR for pts treated with B-R was similar to that
associated with CHOP-R (94% vs 93%, respectively). CR was also
similar at 51% for B-R compared to 40% for CHOP-R. The median
observation time for both groups is 17 months. Thus far, 15 deaths
have been observed (B-R: 7; CHOP-R: 8). Progressive or relapsed
disease has been documented during the follow-up period: 27 in pts
treated with B-R and 32 in the CHOP-R group. The B-R regimen
appears to have a better toxicity profile, as evidenced by a lower
rate of total alopecia (40% CHOP-R vs. 0% with B-R) and a lower
number of infectious complications (41 in CHOP-R pts vs. 19 in the
B-R group).
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| relapsed NHL Outcomes: "Mini"
Allogeneic stem cell transplantation can induce durable clinical
and molecular remissions in relapsed lymphomas: pre-transplant
disease status and histotype heavily influence outcome.
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CTCL - Interim outcome: ASH:
Forodesine HCl active single oral agent for advanced refractory
CTCL - abstracts2view.com
Forodesine is a rationally designed, potent inhibitor of purine
nucleoside phosphorylase (PNP) that leads to intracellular
accumulation of dGTP and then apoptosis. ... Conclusion: Oral
forodesine demonstrates clinical activity in subjects with
refractory CTCL, including those with SS, with minimal toxicity to
date.
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Cure word used: Mini-BMT:
follicular Non-Hodgkin's Lymphoma Cure? http://www.webmd.com/
83% in Complete Remission 5 to 9 Years After Mini-BMT for
Follicular Lymphoma
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| NHL Risk factors: Sun
exposure, vitamin D receptor gene polymorphisms and risk of
non-Hodgkin lymphoma. Abstract
"Recent findings suggest that ultraviolet (UV) radiation
exposure may reduce risk of developing non-Hodgkin lymphoma (NHL),
but the biologic basis for this relationship remains
unclear."
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| Improved bone marrow biopsy: FDA Clears Use of Novel Bone Marrow Biopsy System for Oncology
http://biz.yahoo.com/bw/071207/20071207005110.html?.v=1
"Necessary for the diagnosis and management of lymphoma, leukemia, myeloma and other hematological disorders, bone marrow biopsy has historically been very painful for patients. The Vidacare system enables the clinician performing the procedure to quickly and precisely enter the intraosseous space, successfully capture a core, with minimal patient discomfort or pain."
Comment: Also may improve clinical trial participation and utilization of radioimmunotherapies (Bexxar / Zevalin)
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| CLL: TREANDA New Drug
Application for the Treatment of Chronic Lymphocytic Leukemia
Granted Priority Review Status by FDA
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CLL: National Cancer Institute Study To Determine The Optimal Time For CLL Patients To Begin Treatment
Main Category: Lymphoma / Leukemia News Article Date: 05 Dec 2007 - 0:00 PST
The multi-center study will include 1,700 newly diagnosed patients with chronic lymphocytic leukemia (CLL) and is designed to test the hypothesis that early treatment of patients with certain negative risk factors leads to longer survival. Genzyme will perform the IgVH mutation analysis for the study.
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Preclinical imaging: New scan charts cancer treatment success
- telegraph.co.uk
A cool way to improve the sensitivity of body scanners more than 10,000 fold could allow cancer patients to see whether their tumours are being killed within days of treatment.
...chemical, called pyruvate, which cancer cells use to
generate energy, has been cooled to near absolute zero and then
heated rapidly again to change its magnetic properties and make it
much more visible to the radio waves used by the machine, a so
called magnetic resonance imaging scanner.
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Professional Background: Antibody Therapy in Aggressive Lymphomas - asheducationbook.hematologylibrary.org
Targeted therapies with monoclonal antibodies and monoclonal
antibodies conjugated to radioimmunoconjugates have altered
the natural history and the approach to treatment of
aggressive non-Hodgkin lymphomas.
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| Outcomes: Chemotherapy
Plus Radiation Recommended as Standard of Care in Early
Hodgkin’s - professional.cancerconsultants.com
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Patient
Perspectives on the issue of transfer of tissue for
clinical use – particularly for use in translational clinical
research - PDF
"... we may not have fully considered that requests for
transfer of tissue for clinical use could many times be in
harmony with the ultimate objective of achieving “personalized
medicine ...”
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