The chemotherapy drug, pentostatin shows moderate activity in persons with low grade recurrent T-cell lymphoid cancers in an advanced stage, report researchers in Europe.

T-cell lymphoid cancer, which may also be referred to as non-Hodgkin’s lymphoma, is considered to be a cancer of the lymph tissue, which is a part of the immune (infection fighting) system in the body. Lymph tissue is present in lymph nodes, bone marrow and lymph vessels which are present throughout the body. It is also present in organs such as the thymus, tonsils, and spleen. One of the main cells in the lymph system is the lymphocyte, of which there are two types: B and T-cells. Each of these cells has a very specific function in aiding the body to fight infection with T-cells being responsible for recognizing foreign cells, such as bacteria or viruses, and attacking them directly. T-cell lymphoid cancers are characterized by the excessive production of atypical T-cells. These cancerous cells can crowd lymph tissue causing suppression of normal formation and function of other cells normally found in this tissue. In addition, the cancerous T-cells are not able to perform their specific function in the defense against infection. Because T-cells can travel to virtually every place in the body through lymph fluid or blood, some T-cell lymphoid cancers may manifest in parts of the body besides lymph tissue, such as the skin or brain. While lymphoid type cancers are characterized by the type of lymphocyte involved, they are also further defined by the specific appearance of the affected cells as well as the grade of the disease (how fast it is likely to grow). These determinations are based on how cells look under a microscope. Low grade is considered to be the slowest growing and high grade is the fastest growing cancer.

The treatment options for low-grade lymphoid cancers depend on the specific type and stage (extent of disease in the body) of cancer, but may include: no therapy until symptoms appear, radiation therapy and/or chemotherapy. Following initial treatment, most patients have improved symptoms (i.e. shrinkage of tumor or a smaller percentage of cancer cells in the body), or may enter remission (no detectable cancer cells in the body). However, many patients with low-grade cancers have recurrence (the cancer returns). Because chemotherapy and radiation target and kill cells that are rapidly dividing, the slower dividing cancer cells characteristic in these low-grade cancers do not respond as effectively to modern treatments.

Researchers in Europe treated 92 patients with low grade, recurrent T-cell lymphoid cancers that were in an advanced stage, meaning the disease had spread from it’s original site to other places in the body. They were all treated with the chemotherapy drug pentostatin. The overall response rate to the drug was 21%. Patients with Sezary syndrome and mycosis fungoides (T-cell lymphoid cancers of the skin) showed the highest response rate at 30%. Infections were a common complication of treatment. From this study, researchers concluded that pentostatin was modestly active for the treatment of low-grade recurrent T-cell lymphoid cancers and speculated that higher doses would be needed to improve responses. Persons with a low grade, recurrent T lymphoid cancer may wish to talk with their doctor about the risks and benefits of the use of pentostatin or about the participation in clinical trials utilizing other promising new therapies. Two sources of information on ongoing clinical trials include clinical trials listing services provided by the National Cancer Institute (cancer.gov) and eCancerTrials.com. eCancertrials.com also performs personalized clinical trial searches on behalf of patients. (Seminars in Oncology, Vol 27, 2 supplement 5, pp 52-57, 2000).

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