Lymphoma in the News: Routine Surveillance PET/CT Scans Prone to False Positives

By Peter Martin, MD

There are few guidelines on how best to follow patients in complete remission after chemotherapy for lymphoma. Most experts agree that routine visits to the doctor are worthwhile. The question of routine imaging, however, is less clear. Historically, routine chest x-rays were replaced by CT scans under the assumption that more information was better. We are facing a similar shift in paradigm as many patients now undergo routine PET/CT imaging.

A recent study published in the journal Leukemia & Lymphoma found that only 21% of positive surveillance PET/CT scans represented actual relapse; i.e., 79% of patients with scans that were read as positive had not relapsed. Patients with false-positive scans therefore underwent additional scanning and invasive biopsies with no benefit. Moreover, the scans added over $8000 per patient to the cost of follow up. A related study performed at Weill Cornell Medical College found that routine scanning was associated with significant anxiety and even post-traumatic stress disorder.

Until there is better evidence to guide decisions regarding routine surveillance, it is important to talk with your doctor. Ask about the pros and cons as they apply to you personally. Try to agree on a plan that is acceptable to both of you.

Lymphoma in the News: Anaplastic Large Cell Lymphoma and Breast Implants

By Peter Martin, MD

Several news sources recently reported that women with breast implants may be at increased risk of developing a rare form of non-Hodgkin lymphoma called anaplastic large cell lymphoma (ALCL). These reports are based on recent studies that suggest an association between ALCL and breast implants. In order to adequately understand the recent reports, it is important to have some background information.

ALCL is an uncommon form of T-cell lymphoma and it has at least three different subtypes: 1) Systemic ALK-positive ALCL; 2) Systemic ALK-negative ALCL; and 3) Primary cutaneous CD30-positive ALCL. This latter form typically caries an excellent prognosis and is usually managed with locally directed therapy; i.e., surgery or radiation but not chemotherapy. Continue reading “Lymphoma in the News: Anaplastic Large Cell Lymphoma and Breast Implants”

Follicular Lymphoma Clinical Trial

Combination Veltuzumab (Anti-CD20) and Fractionated 90Y- Epratuzumab (Anti-CD22) Radioimmunotherapy in Patients with Follicular Lymphoma

Update: this study is closed to enrollment. 

Monoclonal antibodies can fight lymphoma by binding to proteins expressed on lymphoma cells and either directly killing or inducing the immune system to kill the tumor cells.

With radioimmunotherapy, the antibody is labeled with a radioactive molecule, allowing directed delivery of radiation to the lymphoma.  Radioimmunotherapy is effective in follicular lymphoma, but immune reactions against the radiolabeled antibody have limited the utility of this approach.

In this study, we are evaluating the combination of an unlabeled antibody to one lymphoma-associated protein (CD20) with a radio-labeled antibody to a different lymphoma-associated protein (CD22), in hopes of improving responses. The antibodies are modified to minimize immune responses, and both antibodies will be given in repeated doses in order to increase the total amount of drug administered while limiting side effects.

Eligibility:

  • Follicular lymphoma
  • No more than 2 prior systemic treatments for non-Hodgkin’s lymphoma
  • Detailed eligibility discussed when you contact the study team

For more information, contact June Greenberg, RN at (212) 746-2651 or jdg2002@med.cornell.edu.

Click here to view all lymphoma clinical trials at Weill Cornell Medical Center.