Intensive Chemotherapy Prolongs Remission of Mantle Cell Lymphoma
In a study of intensive chemotherapy for mantle cell lymphoma, more than half of patients 65 or younger were still in remission after seven years. These results were presented at the 50th Annual Meeting of the American Society of Hematology.
Non-Hodgkin?s lymphoma (NHL) is a form of cancer that begins in the cells of the lymph system. The lymph system includes the spleen, thymus, tonsils, bone marrow, lymph nodes, and circulating immune cells. The main cells in the lymph system are lymphocytes, which exist in two forms: B and T-cells. Each of these cells has a specific function in fighting infection.
NHL is characterized by the excessive accumulation of atypical (cancerous) lymphocytes. These lymphocytes can crowd the lymph system and suppress the formation and function of other immune and blood cells. NHL is categorized by the type of lymphocyte it involves and by the rate at which the cancer grows; both are determined by the cells? appearance under a microscope.
Mantle cell lymphoma is a fast-growing type of B-cell non-Hodgkin?s lymphoma. It accounts for roughly 6% of all NHL diagnoses in the United States.
Combination chemotherapy is commonly used in the treatment of mantle cell lymphoma. To explore the effectiveness of an intensive chemotherapy regimen, researchers at the M. D. Anderson Cancer Center conducted a study among 97 patients.
Treatment consisted of Rituxan? (rituximab) plus a chemotherapy regimen known as hyperCVAD (fractionated cyclophosphamide, doxorubicin, vincristine, and dexamethasone) alternated with Rituxan plus high-dose methotrexate and cytarabine.
- 87% of patients had a complete disappearance of detectable cancer after six cycles of treatment.
- Among patients 65 or younger, 52% remained free of cancer recurrence after a median of seven years of follow-up. Recurrence rates were higher among older patients.
- Overall survival for patients 65 or younger was 68%.
In a prepared statement, the lead investigator of the study, Dr. Jorge Romaguera, noted that survival in this study was generally similar to survival following stem cell transplantation. He went on to say, ?There is some disagreement about whether these younger patients should receive a bone marrow transplant as frontline therapy rather than chemotherapy. Our results with chemotherapy are as good as any transplant data. We don’t believe a transplant is necessary as a first treatment in newly diagnosed mantle cell lymphoma.?
The results of this study suggest that intensive chemotherapy effectively delays cancer recurrence in younger patients with mantle cell lymphoma.
Reference:?Romaguera J, Fayad L, Rodriguez A et al. Rituximab (R) + Hypercvad alternating with R-methotrexate/cytarabine after 9 years: continued high rate of failure-free survival in untreated mantle cell lymphoma (MCL). Presented at the 50th Annual Meeting of the American Society of Hematology, San Francisco, CA, December 6-9, 2008. Abstract 833.
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