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.
Recent articles in left column more or less in alphabetical order classified
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Stem cell transplantation for lymphoma: stem cell transplantation (allogeneic) in relapsed non-Hodgkin gives 43% five-year disease-free survival and overall 5 year survival 48%, from Phase II study of 44 patients with relapsed aggressive non-Hodgkin. This new study confirms earlier studies from 2002 and 2005 with same positive results. Update November 27, 2010
November 27, 2010: New study shows that an allogeneic stem cell transplant (using stem cells from donors) in recent years shows improved results in survival and adverse events and study below confirms 2005. Click on regular - overview and then underneath stem cell transplants in alphabetical list.
October 10, 2005: Source: Br J Haematol. 2005 Oct; 131 (2) :223-30.
Still a stem cell transplant after a relapse of non-Hodgkin's, even if the patient has become resistant to chemotherapy, a treatment appears to be that long can cause life extension. The 5-year disease-free survival was 43% and overall 5-year survival was 48% after the stem cell. The unusually large number of people, by the progression of their disease become incurable and in fact not statistically many more years of life would thus benefited from these stem cell transplantation. But it's also a risky procedure because 25% dies within one year as a direct consequence of the disease or treatment. Especially the risk of repulsion - Grade III-IV acute graft-versus-host disease (GVHD) - is a frequent side effect occurred in these stem cell transplantation. Yet a remarkable study. For those in good physical condition and such does a lot with nutrition and supplementation would ever be a really good opportunity for long-term non-Hodgkin's survival. Oi to read the brief abstract of the study and ask your doctor if necessary through the full study report. The study was a follow-up of 16 years so is a reliable time to reach these conclusions may be reached. Under this recent study, an extended abstract of a 2002 study by the same positive and dramatic results show, even for patients with relapsed non-Hodgkin.
Allogeneic haematopoietic cell transplantation vote for relapsed and refractory aggressive non-Hodgkin lymphoma *. Histology
Doocey RT, Toze CL, Connors JM, Nevill TJ, Gascoyne RD, Barnett MJ, Forrest DL, Hogge DE, Lavoie JC, Nantel SH, Shepherd JD, Sutherland HJ, Voss NJ, Smith CA, Song KW.
Division of Hematology, Leukemia / Bone Marrow Transplant Program of British Columbia, The Vancouver Hospital and Health Science Centre, Vancouver, BC, Canada.
Summary Forty-four Patients with relapsed or refractory aggressive Histology Non-Hodgkin's lymphoma (NHL) (diffuse large B cell, n = 23; peripheral T cells, n = 5; Transformed B cell, n = 16) proceeded to allogeneic stem cell transplantation (allo-SCT) Between 1987 and 2003. Median age at transplant was 40 years (range 19-56 years). At the time of transplants, 35 chemo-sensitive and nine Were Were chemorefractory. Thirty-three patiënten had matched sibling donors and 11 had Unrelated donors. Forty-two patients (95%) Received radiation-based conditioning regimens. Event-free survival (EFS) and overall survival (OS) at 5 years was 43% [95% confidence interval (CI) 27-58%] and 48% (95% CI: 32-63%) respectively. Treatment-related mortality was 25% at 1 year. Grade III-IV acute graft-versus-host disease (GVHD) was the only variable significantly affects OS and EFS, and had a negative impact. Chronic GVHD did not Influence survival. Lymphoma relapse <12 months after initial therapy predicted for Increased Risk of relapse post-transplant (P = 0.02). Patients with lymphoma chemorefractory Were Not at Increased Risk of relapse (P = 0.20) with four of nine Patients Remaining alive without disease 12-103 months post-transplant. In Conclusion, allo-SCT for relapsed or refractory aggressive NHL Histology results in long-term EFS and OS of 40-50%. Patients with can-chemorefractory disease have a durable remission post-transplant.
PMID: 16197454 [PubMed - in process]
Ann Oncol. January 2002, 13 (1) :135-9.
Comment in:
Ann Oncol. September 2002, 13 (9): 1507.
Allogeneic hematopoetic cell transplantation vote for Patient with relapsed or refractory lymphomas: comparison of high-dose conditioning Conventional versus fludarabine-based reduced-intensity regimens.
Bertz H, ILLERHAUS G, Veelken H, Finke J.
Albert Ludwigs University Medical Center Freiburg, Department of Haematology and Oncology, Germany.
BACKGROUND: Allogeneic hematopoetic cell transplantation vote (alloHSCT) HAS Curative potential for poor risk lymphoma patiënten due to the graft-versus-lymphoma effect. High non-relapse mortality with Conventional high-dose conditioning indicates the necessity for less toxic transplant strategies.
PATIENT AND METHODS: Between 1992 and 1999, 25 patients [median age 37 (20-60) years] with relapsed or refractory non-Hodgkin's lymphoma (NHL, n = 20) or Hodgkin's disease (HD, n = 5) Received an alloHSCT in our institution. Patients Were grafted from HLA matched (17) or mismatched (2) related, or matched Unrelated donor (MUD) (6). NHL histological subtypes Were lymphoblastic (6), high grade B / T-cell lymphomas (5), follicular (3), mantle cell (2) and CLL immunocytic, panniculitic composite lymphoma and T-NHL in one patient EACH. Received Patients had a median of four (range three to six) before alloHSCT differentiation therapies, and 10 patients had relapsedafter high-dose chemotherapy and autologous (9) or allogeneic (1) HSCT. Remission status prior to allogeneic SCT was CR1 (1), CR2 (1), relapse (11), partial remission (5) or primary refractory induction failure (7). Conventional myeloablative conditioning (cc) regimens contained total body Irradiation 12 Gy (5), busulfan 16 mg / kg (7) or BCNU/VP16 (1). Twelve patiënten Received Reduced-intensity conditioning (ric) regimens with fludarabine (FLU) plus alkylates agents. Graft-versus-host disease prophylaxis consisted of cyclosporin A + / - prednisone or methotrexate. Six Patients Received Also anti-T lymphocyte globulin.
RESULTS: Twenty-four patiënten engrafted. Best response after alloHSCT was complete remission in 16 of all patients [64%: 95% confidence interval (CI) 44% to 84%] and in 16 of 22 evaluable patients (73%, 95% CI 53% to 93%) partial remission in three of 25 (12%), and no change in three of 25 (12%) patients. Early death prevented response evaluation in three of 25 patients. Non-relapse mortality was 54% (95% CI 15% to 78%) in patients after cc and 17% (95% CI 0% to 41%) after FLU-based RIC (P = 0.03). Six Patients died due to progressive disease or relapse. Four Patients with HD died, three in complete remission due to non-relapse mortality and one with progressive disease. Eleven of 25 patients are alive with a median follow up of 618 days (range 383-2815), with an overall survival of 44% (95% CI 23% to 65%) at 1 year for ALL patients, while eight or 12 ( 67%: 95% CI 35% to 98%) patients are alive after ric compared with three of 13 (23%, 95% CI 0% to 50%) after cc (P <0.02).
CONCLUSIONS: AlloHSCT induces high rates of complete remission in advanced lymphoma patient, even When The tumor had relapsed after autologous HSCT. It Should Be Considered EARLIER as part of the therapeutic options in poor risk patients to Avoid non-relapse mortality associated with extensification pretreatment. Our novel Reduced conditioning regimens show promising results, Especially in Heavily pretreated patient, and ImproveGhana survival after allogeneic transplantation.
Publication Types:
Clinical Trial
PMID: 11863095 [PubMed - indexed for MEDLINE]
