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New therapy prevents dangerous side effect for lymphoma patients
December 10, 2008SAN FRANCISCO - Patients respond well to a new three-drug combination for indolent B cell lymphoma that also spares them prolonged, potentially lethal, suppression of blood production in the bone marrow, researchers at The University of Texas M. D. Anderson Cancer Center report today at the 50th annual meeting of the American Society of Hematology.
Pentostatin, cyclophosphamide and rituximab together are providing the same remission rate as other combinations but with minimal long-term bone marrow suppression, said study presenter Felipe Samaniego, M.D., associate professor in M. D. Anderson's Department of Lymphoma and Melanoma.
Myelosuppression leads to production of fewer red blood cells, white blood cells and platelets. When prolonged, it can lead to myelodysplastic syndrome, which comprises several conditions that cause potentially lethal insufficient blood production.
"The worst outcome of long-term myelosuppression for indolent B cell lymphoma patients is myelodysplastic syndrome," Samaniego said. "In this study, out of 80 patients, none developed MDS."
And 77 of 80 (96 percent) experienced either complete remission or unconfirmed complete remission. Some did have low blood counts, but all were short-term. Overall, the combination is well-tolerated, the research team reported.
Prolonged myelosuppression also makes treatment much more difficult if a patient's lymphoma recurs, Samaniego said. "Patients treated with myelosuppressing agents have a difficult time tolerating another round of chemotherapy if their lymphoma comes back."
Indolent B cell lymphomas comprise follicular lymphoma, small lymphocytic lymphoma, and marginal zone lymphoma. These slow-growing but potentially lethal cancers are the most common form of non-Hodgkin lymphoma.
Samaniego and colleagues have been testing new drug combinations against indolent B cell lymphoma that reduce myelosuppression.
Two years ago, a combination of fludarabine, mitoxantrone and dexamethasone with rituximab and interferon alpha reduced the incidence of MDS to 4 percent of patients, down from a historical rate of around 10 percent.
The key ingredient in pushing the MDS rate to zero, Samaniego says, was substitution of fludarabine with pentostatin. Both are nucleoside analogs, which interfere with DNA reproduction, and target lymphoid cells, making them attractive drugs for lymphomas.
Earlier research indicated that pentostatin is less toxic to bone marrow than other members of this drug class.
"The PCR combination is a very promising therapy for indolent B cell lymphoma," Samaniego said.
University of Texas M. D. Anderson Cancer Center
"The worst outcome of long-term myelosuppression for indolent B cell lymphoma patients is myelodysplastic syndrome," Samaniego said. "In this study, out of 80 patients, none developed MDS."
And 77 of 80 (96 percent) experienced either complete remission or unconfirmed complete remission. Some did have low blood counts, but all were short-term. Overall, the combination is well-tolerated, the research team reported.
Prolonged myelosuppression also makes treatment much more difficult if a patient's lymphoma recurs, Samaniego said. "Patients treated with myelosuppressing agents have a difficult time tolerating another round of chemotherapy if their lymphoma comes back."
Indolent B cell lymphomas comprise follicular lymphoma, small lymphocytic lymphoma, and marginal zone lymphoma. These slow-growing but potentially lethal cancers are the most common form of non-Hodgkin lymphoma.
Samaniego and colleagues have been testing new drug combinations against indolent B cell lymphoma that reduce myelosuppression.
Two years ago, a combination of fludarabine, mitoxantrone and dexamethasone with rituximab and interferon alpha reduced the incidence of MDS to 4 percent of patients, down from a historical rate of around 10 percent.
The key ingredient in pushing the MDS rate to zero, Samaniego says, was substitution of fludarabine with pentostatin. Both are nucleoside analogs, which interfere with DNA reproduction, and target lymphoid cells, making them attractive drugs for lymphomas.
Earlier research indicated that pentostatin is less toxic to bone marrow than other members of this drug class.
"The PCR combination is a very promising therapy for indolent B cell lymphoma," Samaniego said.
University of Texas M. D. Anderson Cancer Center
Lymphoma Current Events and Lymphoma News RSSDrugs to treat anemia in cancer patients linked to thromboembolism
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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.
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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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