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Delaying Chemotherapy Could Be Best Treatment Option For Certain Type Of Non-hodgkin Lymphoma (p 516)
August 13, 2003Delaying chemotherapy until symptoms develop for patients with asymptomatic advanced low-grade non-Hodgkin lymphoma is confirmed as an appropriate strategy authors of a UK study in this week's issue of THE LANCET.
Chemotherapy (single or aggressive combination therapy) does not cure advanced stage low-grade non-Hodgkin lymphomas, even when combined with radiotherapy. On behalf of the British National Lymphoma Investigation, Kirit Ardeshna from the Mount Vernon Cancer Centre, Northwood, UK, and colleagues compared administration of immediate chemotherapy (chlorambucil) with a policy of delaying chemotherapy until clinical progression necessitated its use, in patients with asymptomatic advanced-stage, low-grade non-Hodgkin lymphoma.
309 patients were recruited from 44 UK centres between 1981 and 1990. Half the patients were randomised to receive immediate chemotherapy with oral chlorambucil (10 mg per day); the other half were randomised to an initial policy of 'wait and see', with chemotherapy delayed until disease progression. Local radiotherapy was given to both groups if lymph nodes showed evidence of disease.
The Average follow-up of patients was 16 years, and patients randomised to a 'wait and see' policy required chemotherapy after an average of two and a half years. There was no difference in overall survival (around six years) and survival specific to non-Hodgkin lymphoma (around nine years) between the two groups. People in the 'wait and see' group had around a 20% chance of not requiring chemotherapy after 10 years; this was doubled to 40% of people not requiring chemotherapy for patients over 70 years of age.
Kirit Ardeshna comments: "An initial policy of watchful waiting in patients with asymptomatic, advanced stage low-grade non-Hodgkin lymphoma is appropriate, especially in patients aged over 70 years."
Lancet
The Average follow-up of patients was 16 years, and patients randomised to a 'wait and see' policy required chemotherapy after an average of two and a half years. There was no difference in overall survival (around six years) and survival specific to non-Hodgkin lymphoma (around nine years) between the two groups. People in the 'wait and see' group had around a 20% chance of not requiring chemotherapy after 10 years; this was doubled to 40% of people not requiring chemotherapy for patients over 70 years of age.
Kirit Ardeshna comments: "An initial policy of watchful waiting in patients with asymptomatic, advanced stage low-grade non-Hodgkin lymphoma is appropriate, especially in patients aged over 70 years."
Lancet
Lymphoma Current Events and Lymphoma News RSSDrugs to treat anemia in cancer patients linked to thromboembolism
Medications frequently given to cancer patients to reduce their risk of anemia are associated with an increased risk of deep vein thrombosis or pulmonary embolism, according to new research led by Dawn Hershman, M.D, M.S., co-director of the breast cancer program at the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian Hospital/Columbia University Medical Center.
Researchers find new way to attack inflammation in Graves' eye disease
A small group of patients with severe Graves' eye disease experienced rapid improvement of their symptoms - and improved vision - following treatment with the drug rituximab.
Approved lymphoma drug shows promise in early tests against bone cancer
A drug already approved for the treatment of lymphoma may also slow the growth of the most deadly bone cancer in children and teens, according to an early-stage study published online today in the International Journal of Cancer.
Immunotherapy demonstrates long-term success in treating lymphoma
Targeted immunotherapy has been an attractive new therapeutic area for a number of cancers because it has the potential to destroy tumor cells without damaging surrounding normal tissue. New study results demonstrate high success rates using specialized white blood cells to prevent or treat lymphoma associated with the Epstein-Barr virus (EBV-lymphoma) in patients who have received a hematopoietic stem cell transplant (HSCT).
Exercise is good medicine for lymphoma patients
A healthy dose of exercise is good medicine, even for lymphoma patients receiving chemotherapy, University of Alberta researchers have found.
Childhood cancer survivors experience suicidal thoughts decades after diagnosis
Adult survivors of childhood cancer have an increased risk for suicidal thoughts, even decades after their cancer treatments ended, according to a study led by Dana-Farber Cancer Institute scientists.
New therapy for vasculitis will help patients avoid infertility and cancer
Researchers have identified that Rituxan, a drug previously approved for the treatment of non-Hodgkin's B cell lymphoma and rheumatoid arthritis, can treat severe ANCA-associated vasculitis as effectively as cyclophosphamide, the current standard therapy.
Studying cancer in pet dogs to find new treatments for human patients
A team of scientists at the National Cancer Institute (NCI) in Bethesda, USA, says that studying pet dogs with cancer could yield valuable information on how to diagnose and treat human cancers.
Scientists identify genetic cause of previously undefined primary immune deficiency disease
Researchers at the National Institutes of Health have identified a genetic mutation that accounts for a perplexing condition found in people with an inherited immunodeficiency.
Certain cancers more common among HIV patients than non-HIV patients
Researchers at UT Southwestern Medical Center have found that non-AIDS-defining malignancies such as anal and lung cancer have become more prevalent among HIV-infected patients than non-HIV patients since the introduction of anti-retroviral therapies in the mid-1990s.
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