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Leukemia & Lymphoma

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New Treatments for Non-Hodgkin's Lymphoma

The rate of non-Hodgkin's lymphoma has nearly doubled since the 1970s, but advances in treatments are offering new hope.

Antibody Therapy for Non-Hodgkin's Lymphoma continued...

Their hunch was right: People with certain lymphomas treated with a combination of chemotherapy and Rituxan do better and live longer, regardless of the disease's stage.

As a result, leading medical centers have adopted Rituxan as part of standard treatment for most non-Hodgkin's lymphomas.

"In practice, we see improvements in all of them," Felipe Samaniego, MD, a medical oncologist at The University of Texas M.D. Anderson Cancer Center, tells WebMD.

For practicing academic oncologists today "it's an exciting time," says Oliver Press, MD, oncologist at University of Washington and director of the Lymphoma Research Foundation Advisory Board. "It's gratifying to see the antibody therapies gain a major role and give a great benefit to patients."

Benefits like fewer side effects than traditional chemotherapy. That's because, unlike standard chemotherapy, which is toxic to normal body cells, Rituxan targets only lymphoma cells.

"Antibodies are much gentler on patients," says Press. "[Rituxan] is very mild chemotherapy. You don't get the infections, toxicity, or drop in blood counts" of conventional chemotherapy.

However, there is the potential for rare but serious reactions, such as breathing or heart problems, during or shortly after Rituxan is infused into the body.

Radioimmunotherapy: Raising the Odds of Remission

In 2002, new versions of monoclonal antibodies arrived. Called "radioimmunotherapy," or RIT, they combine a radioactive substance with the antibody, increasing its killing power against tumor cells.

These new letters in the alphabet soup of chemotherapy show immense promise in improving and possibly prolonging life with NHL.

As with Rituxan, the FDA approved two radioimmunotherapy agents for treatment of relapsed or resistant follicular lymphoma:

  • Zevalin
  • Bexxar

Some oncologists believe radioimmunotherapy drugs hold even more promise than Rituxan. One 2002 study published in the Journal of Clinical Oncology found that 30% of the patients using Zevalin had a complete remission of their disease with no trace of the cancer present, compared with only 16% of those taking Rituxan.

After a complete response, lymphoma is more likely to stay under control longer.

And the less often chemotherapy is used to control lymphoma, the better, says Gregory. "More chemotherapy treatments can actually damage the bone marrow," causing long-term complications.

"Think of conventional chemotherapy as a gun with six bullets in it," says O'Connor. "If we spread out the time between treatments, you can save those bullets for a rainy day."

Each treatment for Rituxan and the radioimmunotherapies is complete in one to two weeks. There is no hair loss, nausea, or vomiting, although the radioimmunotherapies often cause a drop in blood counts.

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