Intense chemotherapy wards off recurrence in half of mantle cell lymphoma patients after seven years

December 10, 2008

SAN FRANCISCO - More than half of younger mantle cell lymphoma patients who received an intensive regimen of chemotherapy as frontline treatment remain in remission seven years later, researchers at The University of Texas M. D. Anderson Cancer Center report today at the 50th annual meeting of the American Society of Hematology.

Among patients 65 or younger, 52 percent survived without disease recurrence at a median of seven years of follow-up, said first author Jorge Romaguera, M.D., professor in M. D. Anderson's Department of Lymphoma and Myeloma. Overall survival for this subgroup was 68 percent.

"There is some disagreement about whether these younger patients should receive a bone marrow transplant as frontline therapy rather than chemotherapy," Romaguera said. "Our results with chemotherapy are as good as any transplant data. We don't believe a transplant is necessary as a first treatment in newly diagnosed mantle cell lymphoma."

Mantle cell lymphoma is one of the most lethal versions of non-Hodgkin lymphoma. Romaguera and colleagues have followed 97 patients for up to nine years who received rituximab plus a combination of chemotherapies known as hyperCVAD, alternated with rituximab plus high-dose methotrexate/cytarabine in 6-8 cycles.

Out of those patients, 87 percent achieved either a complete response or unconfirmed complete response after six cycles. Of 65 patients who were 65 or younger, 30 relapsed. Of 32 patients older than 65, a total of 23 relapsed.

Overall survival for the entire group, including all ages up to 80 years, was 60 percent; 43 percent were at failure-free survival, with no recurrence of the disease, at seven years of median follow-up.

Survival is about the same for patients who undergo stem cell transplantation, Romaguera said. No randomized studies between the chemotherapy regimen, stem cell transplants or the chemotherapy plus stem cell transplant have been done.

About 3,500 new cases of mantle cell lymphoma are diagnosed in the United States annually. The average age of diagnosis is the mid-sixties and median survival is about four years.

University of Texas M. D. Anderson Cancer Center

---

---

	Living with Lymphoma: A Patient's Guide by Elizabeth M. Adler (Author) When neurobiologist Elizabeth M. Adler was diagnosed with non-Hodgkin lymphoma, she learned everything she could about the disease, both to cope with the emotional stress of being diagnosed and to make sure she made the best possible decisions for her treatment. In Living with Lymphoma, she combines her knowledge of lymphoma—both scientific and personal—with the desire to help other patients come to grips with this complex, and often baffling, disease. Adler thoroughly explains the disease, describing the many different kinds of Hodgkin and non-Hodgkin lymphoma, the wide range of symptoms, and the various treatment options available. Convinced that understanding lymphoma's biological basis will help patients make better treatment decisions, Adler explains basic cell biology and how...
	100 Questions & Answers About Lymphoma, Second Edition by Peter Holman (Author) EMPOWER YOURSELF! Written by oncology experts with over 20 years of experience, 100 Questions and Answers About Lymphoma, Second Edition provides authoritative answers to your questions on lymphoma. Featuring the information you need in one concise, easy-to-read volume, 100 Questions and Answers About Lymphoma, Second Edition is an invaluable resource for newly diagnosed patients, survivors, friends or relatives of either. Now, in its Second Edition, this newly updated text features information on the latest, cutting-edge treatments and medication, Hodgkin s and Non-Hodgkin s lymphoma, natural killer cells, T-cell lymphoma, autoimmune diseases, and much more! Comprehensive, insightful, compact, 100 Questions and Answers About Lymphoma, Second Edition is an essential guide for anyone...
	Johns Hopkins Patients' Guide to Lymphoma by Aditya Bardia (Author), Eric Seifter (Author) Johns Hopkins Patients' Guide to Lymphoma is a concise, easy-to-follow how to guide that puts you on the path to wellness by explaining lymphoma treatment from start to finish. It guides you through the overwhelming maze of treatment decisions, simplifies the complicated schedule that lies ahead, and performs the task of putting together your plan of care in layman's terms. Empower yourself with accurate, understandable information that will give you the ability to confidently participate in the decision making about your care and treatment.
	My Secret Lymphoma by Hanratty, Philip This book is one patient’s sometimes humorous account of living with and being treated for cancer which he likens to having a mistress. Headaches that began in June of 2009 were not diagnosed as Diffuse Large B-Cell Lymphoma until mid December. Given odds of 50/50 by his oncologist he describes the tests, bone marrow biopsies and treatments which included six cycles of R-CHOP, four spinal infusions with other drugs and, while in remission, three 28-day cycles of Revlimid (AKA Lenalidomide). Starting with the R-CHOP treatments he describes the day to day side effects of chemotherapy and his attempts to deal with them. The remainder of the book describes the aftermath of treatment which lasts much longer than one would normally expect.
	Non-Hodgkin Lymphomas by James O. Armitage (Editor), Peter M. Mauch (Editor), Nancy Lee Harris (Editor), Bertrand Coiffier (Editor), Riccardo Dalla-Favera (Editor) Thoroughly updated for its Second Edition, Non-Hodgkin Lymphomas is the definitive textbook on the biology, diagnosis, staging, and treatment of all forms of non-Hodgkin lymphomas. With backgrounds in medical and radiation oncology, molecular biology, and pathology, the editors and contributors provide an international, multidisciplinary approach to the topic. This edition is the first text using the new World Health Organization classification of non-Hodgkin lymphomas. The book offers complete coverage of the most current techniques for diagnosis, staging, and treatment, the approach to specific types of lymphoma, and special problems common to the management of patients with these disorders. A companion Website includes the fully searchable text and downloadable...
	Medifocus Guidebook on: Non-Hodgkin's Lymphoma by Medifocus.com (Author), Elliot Jacob PhD. (Editor) The MediFocus Guidebook on Non-Hodgkin's Lymphoma is the most comprehensive, up-to-date source of information available. You will get answers to your questions, including risk factors of Non-Hodgkin's Lymphoma, standard and alternative treatment options, leading doctors, hospitals and medical centers that specialize in Non-Hodgkin's Lymphoma, results of the latest clinical trials, support groups and additional resources, and promising new treatments on the horizon. This one of a kind Guidebook offers answers to your critical health questions including the latest treatments, clinical trials, and expert research; high quality, professional level information you can trust and understand culled from the latest peer-reviewed journals; and a unique resource to find leading experts,...
	What You Need To Know About: Non- Hodgkin Lymphoma This booklet is about non-Hodgkin lymphoma, a cancer that starts in the immune system. Non-Hodgkin lymphoma is also called NHL. Each year, more than 63,000 Americans learn they have non-Hodgkin lymphoma. This booklet tells about diagnosis, treatment, and supportive care. Learning about the medical care for people with lymphoma can help you take an active part in making choices about your own care.
	Extranodal Lymphomas: Expert Consult - Online and Print, 1e by Judith A. Ferry MD (Author) Extranodal Lymphomas is a practical, easy-to-use guide that helps you accurately diagnose even the most challenging cases. Dr. Judith Ferry and leaders in the field present their expertise to fill the need for a highly-illustrated, authoritative reference that keeps you up to date on histologic, immunophenotypic, genetic, and clinical features, along with risk factors and current nomenclature. This comprehensive resource also features access to the fully searchable text and a downloadable image library online at www.expertconsult.com so you'll have convenient access to everything you need for effective diagnostic decision making.Access the fully searchable text online at www.expertconsult.com, along with a downloadable image bank. See specimens as they appear through the microscope with...
	Skin Lymphoma: The Illustrated Guide by Lorenzo Cerroni (Author), Kevin Gatter (Author), Kerl Helmut (Author) Skin lymphomas are relatively rare and can be easily misdiagnosed as psoriasis or dermatitis. These lymphomas can be fatal. Consequently, those in training in dermatology and pathology need to have a good understanding of the clinical presentations and the pathological correlates of this challenging disease.This updated edition provides:A full-colour illustrated text and atlas that combines pathology with clinical features and treatmentupdated nomenclature according to WHO/EORTC and WHO classificationsImages to expand the diagnostic potentialCases to enhance the scope for teaching and learning
	Understanding Leukemias, Lymphomas and Myelomas by Tariq I. Mughal (Author), Tariq Mughal (Author), John Goldman (Author), John M. Goldman (Author), Sabena T. Mughal (Author), Sabena Mughal (Author) A brand-new edition of the bestselling guide to hematologic malignancies. An international team of contributors come together to present all clinically relevant aspects of leukemias, lymphomas, and myelomas. Using clear terminology, the book discusses salient features, diagnostic procedures, prognosis, and treatments for these cancers. Following on the successful steps of the first edition, this Second Edition covers: various types of leukemias, lymphomas, and myelomas utilizing stem cell transplantation side-effects of various treatments future prospects for leukemia, lymphoma, and myeloma targeted therapies and history of the cancers information and support sources for...