Thursday, June 14, 2007

Senator Thompson's Non-Hodgkins Lymphoma Prognosis improved greatly with Monoclonal Therapy

Upon more research I found that the Washington Post reported on April 12, 2007 from a French Study that only 4 of 46 Patients treated with Rituxan(Rituximab) had died and 15% were still in remission after seven years. This means that 85% have had recurrences but must be doing well. In addition Senator Thompson had Radiation Therapy, which may also help him in his fight against Non-Hodgkins Marginal Zone Lymphoma. The more recent study I found was published here in the USA in 2006 and is from MD Anderson in Houston(see article at bottom). This study revealed a 95-100% remission rate ofver at least 3 year. Things are looking good for Senator Thompson in the Lymphoma Department because of this new Monclonal Therapy, Rituxan!
Here I have excerpted the WaPo article from 4-12-2007

Thompson's physician, Bruce D. Cheson of Georgetown University Hospital, said the former senator's lymphoma was diagnosed after he noticed a painless lump under the left side of his jaw in October 2004.

The lump turned out to be an enlarged lymph node, which when biopsied contained marginal zone B-cell lymphoma, a relatively rare form that accounts for about 10 percent of all lymphomas diagnosed in the United States.
Thompson initially got only radiation therapy on the site of the original lump. When several other nodes became enlarged a few months later, however, he opted to have treatment with rituximab, an antibody that targets B-cells to be killed by the immune system.

Thompson's lymphoma was slow-growing and he had no symptoms when diagnosed, which are both good prognostic signs, said Cheson, who is the head of hematology at Georgetown.

"His prognosis is excellent. We have patients out for years, leading totally normal lives, doing whatever they want, including running for president."
The longest study evaluating the usefulness of rituximab as sole initial therapy for lymphoma's similar to Thompson's looked at the experience of 46 French patients. Seven years after treatment, four had died. Fifteen percent of the group were still in remission, with no evidence of disease, which is Thompson's current state. The average time until disease recurred was two years.

Cancer. 2006;107:125-35
  • Outcomes in patients with splenic marginal zone lymphoma and marginal zone lymphoma treated with rituximab with or without chemotherapy or chemotherapy alone
    Apostolia M. Tsimberidou, MD, PhD 1 *, Daniel Catovsky, MD 2, Ellen Schlette, MD 3, Susan O'Brien, MD 1, William G. Wierda, MD, PhD 1§, Hagop Kantarjian, MD 1, Guillermo Garcia-Manero, MD 1, Sijin Wen, MS 4, Kim-Anh Do, PhD 4, Susan Lerner, MS 1, Michael J. Keating, MB, BS 1
    1Department of Leukemia, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
    2Institute of Cancer Research, London, United Kingdom
    3Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
    4Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
    email: Apostolia M. Tsimberidou (

  • *Correspondence to Apostolia M. Tsimberidou, Department of Leukemia, Unit 428, The University of Texas, M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030
  • Fax: (713) 794-4297
    Dr. O'Brien was a consultant for Berlex Laboratories, Inc., and Genentech.
    §Dr. Wierda has performed contract work for Berlex Laboratories, Inc., and X-cyte Therapies, Inc.
    Dr. Keating was a consultant and a member of the Speakers Bureau for Berlex Laboratories, Inc., and Genentech.

  • Keywords
  • splenic marginal zone lymphoma • lymphoma • splenic • rituximab • splenectomy
  • Abstract

    The optimal management of patients with splenic marginal zone lymphoma/marginal zone lymphoma (SMZL) is controversial. The objective of this retrospective study was to compare the outcomes of patients with SMZL who received treatment with rituximab, rituximab plus chemotherapy, or chemotherapy alone.

    The Leukemia Service database was searched for patients with splenic lymphoma who were registered between May 1995 and October 2004. The indications for treatment were the same as those used for patients with chronic lymphocytic leukemia.

    SMZL was confirmed in 70 patients. The median age was 64 years. The median number of CD20 molecules per cell was 69 × 103. Forty-three patients required systemic therapy; rituximab in 26 patients, chemotherapy plus rituximab in 6 patients, and chemotherapy alone in 11 patients. Ten additional patients underwent splenectomy, and 17 patients were in the observation group. The overall response rates were 88% with rituximab, 83% with rituximab plus chemotherapy, and 55% with chemotherapy alone; the 3-year survival rates were 95%, 100%, and 55%, respectively. The 3-year failure-free survival (FFS) rates were 86%, 100%, and 45% in the rituximab, rituximab plus chemotherapy, and chemotherapy alone groups, respectively. Rituximab treatments resulted in longer survival and FFS compared with chemotherapy. Rituximab alone resulted in disappearance of splenomegaly in 92% of patients and normalization of absolute lymphocyte counts. In univariate analysis, younger age and rituximab-based therapy were predictive of longer FFS.

    Rituximab with or without chemotherapy was found to have major activity in patients with SMZL. These results may be associated with high levels of cellular CD20 antigen sites. Rituximab should be the treatment of choice, at least in older patients with SMZL who have comorbid diseases. Cancer 2006. © 2006 American Cancer Society.


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