Lymphoma. Hodgkinlymfomen and non-Hodgkin's disease

Information on current developments in both regular and alternative or complementary treatments and resources for lymphoma - non-Hodgkin's lymphoma and Hodgkin's disease at all stages.

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Chemo and effect in mantle-cell lymphoma: An approach first a single dose of Rituximab plus cyclophosphamide, vincristine, doxorubicin and dexamethasone (hyper-CVAD) followed by Rituximab plus high-dose methotrexate, cytarabine, high durable remissions observed in new patients with an aggressive form of mantle cell lymphoma. But the side effects and disease-related mortality was high with this approach.

September 14, 2005: Source: J Clin Oncol. 6 September 2005;

With an approach first a single dose of Rituximab plus cyclophosphamide, vincristine, doxorubicin and dexamethasone (hyper-CVAD) followed by Rituximab plus high-dose methotrexate, cytarabine, high durable remissions observed in new patients, so had not been treated with an aggressive form of mantle cell lymphoma. A disease-free period of three years was 82% of the patients responding to treatment achieved. However, especially in people over 65 years, adverse events and disease-related deaths is so large that this approach by the investigators is not recommended for this patient group. What is striking is that a whopping 10% of all participating patients died from the effects of treatment, even though some of them achieved remission of their cancer. Especially haematological side effects (blood disorders) were severe and frequent with this approach. Here is the abstract of this phase II study of 97 newly-diagnosed mantle-cell lymphoma patients.

High Rate of Durable remission After Treatment of Newly Diagnosed Aggressive Mantle-Cell Lymphoma With Rituximab Plus Hyper-CVAD Alternating With Rituximab Plus High-Dose Methotrexate and Cytarabine.

Romaguera JE, Fayad L, Rodriguez MA, Broglio KR, Hagemeister FB, Pro B, McLaughlin P, Younes A, Samaniego F, Goy A, Sarris AH, Dang NH, Wang M, Beasley V, Medeiros LJ, Katz RL, Gagneja H , Samuels BI, Smith TL, Cabanillas FF.

Departments of Lymphoma / Myeloma, Biostatistics, Cytopathology, Hematopathology, Gastroenterology, and Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX.

PURPOSE: To determining the response, failure-free survival (FFS) and overall survival rates and toxicity of rituximab plus an intensive chemotherapy regimen in Patients with Previously untreated aggressive mantle cell lymphoma (MCL).

PATIENT AND METHODS: This was a prospective phase II trial of rituximab plus Fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (hyper-CVAD; Considered one cycle) alternating 21 days everytime with rituximab plus high-dose methotrexate-cytarabine (Considered one cycle) for a total of six to eight cycles.

RESULTS: Of 97 assessable patient, 97% responded, and Achieved a 87% complete response (CR) or CR UNCONFIRMED. With a median follow-up time or 40 months, the 3-year FFS and overall survival rates Were 64% and 82%, respectively, without a plateau in the curves. For the subgroup of Patients
CONCLUSION: Rituximab plus hyper-CVAD alternating with rituximab plus high-dose methotrexate and cytarabine is effective in untreated aggressive MCL. Toxicity is significant but expected. Because Of The Shorter FFS competitor with significant toxicity in Patients More Than 65 Years of Age, this regimen is not recommended as standard therapy for this age subgroup. Larger prospective randomized studies are Needed to define the role of this regimen in the treatment of lymphoma patient compared with Existing and New treatment modalities.

PMID: 16145068 [PubMed - as supp song by publisher]