Wednesday, June 13, 2007

Senator's Thompson's Diagnosis explained based on info available

Common Subtypes of Marginal Zone Lymphomas:
There are three distinct forms (Harris et al, 1999) of marginal zone lymphomas:
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MALT (Extranodal)
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Nodal (Monocytoid B-cell Lymphoma) I believe this is what Senator Thompson has
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Splenic (Spleen)
 
"Malignant monocytoid B-cell proliferations in a lymph node have been classified as monocytoid B-cell lymphomas (MBCL), which are now called nodal marginal-zone B-cell lymphoma (MZL) in the World Health Organization (WHO) classification." 1
"Clinically, nodal MZL is a more aggressive disease. Patients with nodal MZL present with more advance disease (71%) and BM involvement (28%), and have a corresponding poor prognosis with a 5-year overall survival rate of 56% and a failure-free survival rate of only 28%. Histologic transformation to a higher-grade lymphoma occurs in more than 20% of cases. In ~70% of nodal MZL, there is no involvement of spleen or extranodal sites. Because conventional chemotherapy is not curative, patients are managed with expectant observation followed by combined chemotherapy." - cancer.med.umich.edu
  1. Nodal monocytoid B-cell lymphoma (nodal marginal-zone B-cell lymphoma). Semin Hematol. 1999 Apr;36(2):128-38. Review. PMID: 10319381 - PubMed
  2. Detailed: Marginal zone-related neoplasms of splenic and nodal origin - PDF
  3. Marginal zone-related neoplasms of splenic and nodal origin.
    Haematologica. 2003 Jan;88(1):80-93. Review.
    PMID: 12551831 | Related articles
Diagram showing lymphatic system
Diagram showing lymphatic system

Senator Thompson is stated to have had a lump in his Jaw that was bothering him.  From my previous post and CNN
  • Bruce D. Cheson, head of hematology in the division of hematology/oncology at Georgetown University Hospital in Washington. 
  • The diagnosis was made late in 2004, when Thompson sought treatment for a 3.5 centimeter by 4 centimeter (roughly one inch by 1½ inch) lump under his left jaw and the biopsy came back positive, Cheson said.
  • Thompson was initially treated with radiation to his neck, "merely because it was bothersome to him to have a lump there."
  • "The indolent, or slow-growing lymphomas are very treatable, but rarely if ever curable," Cheson said. "Therefore, his likelihood of recurring is high, but this may not happen for a number of years."
Lymphoma is a disease in which either T- or B-lymphocytes, (but Senator Thomspon has a B-Cell type) grow in an uncontrolled way and cause various parts of the lymphatic system to enlarge or stop working effectively.
There are more than 20 different types of non-Hodgkin lymphoma but Thompspm has Nodal marginal zone B-cell lymphoma which is very rare, making up about 1% of all cases of non-Hodgkin lymphoma. It used to be called monocytoid B-cell lymphoma and is a cancer of the B-lymphocytes. It can occur in middle age or in older people. It is slightly more common in women than men.
 
"Clinically, nodal MZL is a more aggressive disease. Patients with nodal MZL present with more advance disease (71%) and BM involvement (28%), and have a corresponding poor prognosis with a 5-year overall survival rate of 56% and a failure-free survival rate of only 28%.
 
Now the good Senator received Rituxan, a new Monoclonal Antibody Therapy, or cells engineered to hunt down the cancer by recognizing an antigen on the cancerous cell's surface and kills it without doing the harm to surrounding tissue. Older chemotherapy treatments use agents that harm surrounding tissue.  The 5 year surviblity are not available yet for the newer treatment Senator Thompson received.  God's Speed new dad, good actor & Senator now Presidential Candidate for the USA. 


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