Author: lymphomaprogram

Located on the Upper East Side of New York City, the Lymphoma Program at Weill Cornell Medical College/NewYork Presbyterian Hospital is internationally recognized for our efforts to enable patients with non-Hodgkin lymphoma, Hodgkin disease and related disorders to have the best possible clinical outcome, including cure when possible.

Can PET-CT Scans be used to Guide the Treatment of Advanced Hodgkin Lymphoma?

Lisa Roth, MD
Lisa Roth, MD

By Lisa Roth, MD

The New England Journal of Medicine recently published results from a study where researchers used positron-emission tomography-computed tomography (PET-CT) scans to guide treatment for patients with advanced Hodgkin lymphoma. The chemotherapy used to treat Hodgkin lymphoma can be associated with long-term health risks including toxicity in the lungs as a result of the chemotherapy agent bleomycin. Decreasing the risk of long-term toxicity is especially important in Hodgkin lymphoma where the majority of patients will be cured of their disease and their long term quality of life heavily factors into treatment decisions.

In this study patients were treated with 2 cycles of the chemotherapy regimen ABVD, which includes bleomycin. After 2 cycles of ABVD patients underwent a PET-CT scan. Patients who had a positive PET scan received more intensive therapy with the BEACOPP chemotherapy regimen. Patients who had a negative PET-CT were randomly assigned to continue treatment with ABVD or receive AVD, which does not include bleomycin. The outcomes of the ABVD and AVD groups were compared.

A total of 1,214 patients enrolled in this trial and the majority (83.7%) had a negative PET-CT after two cycles of ABVD. The statistical analysis comparing the group receiving ABVD with the group receiving AVD was designed to determine if AVD was not inferior to ABVD non-inferiority. Although the data fell just short of demonstrating non-inferiority, the difference in outcome between the AVD and ABVD groups was minimal (1.6%). Importantly, the risk of lung toxicity was higher in the group of patients who continued to receive ABVD.

This data suggests that omitting bleomycin in the treatment of patients with advanced Hodgkin lymphoma, who have a negative PET-CT after 2 cycles of ABVD, decreases the risk of lung toxicity without significantly increasing the risk of relapse.

Ask the Doctor: Dr. Richard Furman on the Latest Treatment Options for CLL/SLL

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Dr. Richard Furman, MD

Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) are cancers that affect the lymphocytes in the immune system. Essentially the same disease they are differentiated by the location in the body where they occur. CLL is found in the bloodstream, bone marrow, and sometimes the lymph node and spleen of patients, while SLL occurs in the lymph nodes of patients.

On Wednesday, September 21st at 6pm Director of the CLL Research Center, Dr. Richard Furman will give a presentation on currently available treatment options for patients with CLL/SLL. The presentation will be followed by a Q&A session. This presentation is part of the Lymphoma Research Foundation’s (LRF) “Ask the Doctor” program designed specifically for people affected by lymphoma, and seeks to provide the latest information on treatment. Online registration is available here.

The program includes:

  • Overview and Treatment Options for Chronic Lymphocytic Leukemia / Small Lymphocytic Lymphoma – ( CLL / SLL )
  • Research Updates
  • Question and Answer Session

This program is free-of-charge and dinner will be provided. Pre-registration is required.

Three Easy Ways to Register!

Call: 800-500-9976
Email:  mspellman@lymphoma.org
Web: Click here

Lymphoma Medicine is Precision Medicine: A Conversation with Dr. John Leonard

Last week, Dr. Leonard held a lecture to discuss how lymphoma medicine is precision medicine. Precision medicine treatment options are tailored to each patient’s specific genetic profile and medical history. With the availability of genomic sequencing tools, it is now feasible to profile a patient’s genome and locate the mutations that cause cancer.

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Dr. John Leonard

Each year more than 80,000 cases of lymphoma are reported, spanning over 100 different classifications. The majority of these are non-Hodgkin lymphomas. The most common forms of which are follicular lymphoma, diffuse large B-cell lymphoma (DLBCL), chronic lymphocytic lymphoma, and mantle cell lymphoma. Although these are all subtypes of the same disease, the variances in their biology require different treatment approaches.

To illustrate the effectiveness of precision medicine approaches in lymphoma, Dr. Leonard cited the treatment of DLBCL. For patients with DLBCL, the standard initial treatments are the chemotherapy combination R-CHOP and dose adjusted R-EPOCH. Around 70% of cases are cured with either of these two treatments, proving that chemotherapy is effective.

The other 30% of patients who do not respond to treatment proceed to 2nd and 3rd lines of therapy. For patients whose DLBCL returns, there is only a 20% survival rate. This low survival rate for patients with recurrent lymphoma and patients who do not respond to chemotherapy necessitates different approaches to treatment. This is not an abandonment of effective chemotherapy, but a way to tailor treatment more specifically to the patient’s individual tumor biology.

Precision medicine in lymphoma treatment involves targeting the “cancer cell-of-origin” in patients, or in other words, the genetic source of the cancer. Through gene expression profiling, we are able to determine distinct molecular subtypes. This could allow us to detect malignancies earlier on and offer better preventative treatment for individuals at risk of developing blood cancer. Continued advances in our understanding of the genome fuels the growth of precision medicine which already plays an important role in treating certain lymphomas.

Although precision medicine is a huge advancement for the treatment of lymphoma, there are still challenges. This includes weighing the effectiveness of drugs used in targeted therapy, developing tools to categorize the different lymphoma subtypes, cost, and patient participation. Because it is a still a growing field, many precision medicine goals are still in the early stages of development.

Stay tuned for the American Society of Hematology (ASH) annual meeting in November where Dr. Leonard will be presenting new research regarding lymphoma and precision medicine. If you would like to learn more about precision medicine at Weill Cornell Medicine visit the Englander Center for Precision Medicine website. If you are interested in learning about the new innovative treatment options at Weill Cornell Medicine visit our JCTO website listing our open clinical trials.