Danish researchers are reporting what appears to be a cure for a rare type of lymphoma that has been regarded as incurable until now.
A complex regimen that included immuno-chemotherapy produced a five-year, event-free survival rate of better than 60 percent in 159 people with mantle cell lymphoma, physicians at the Rigshospitalet in Copenhagen reported Sunday at the American Society of Haematology annual meeting, in Atlanta.
The cancer was treated with six cycles of immuno-chemotherapy, aimed at arousing the immune system, followed by high-dose chemotherapy with stem cell support. Of the 114 people who completed treatment, 72 percent were disease-free at five years.
Better long-term survival
The report is an outstanding example of the better long-term survival rates for various kinds of blood cancers such as lymphomas being reported at the meeting, said Dr Ruth Winter, a professor of haematology and oncology at Northwestern University in Chicago.
"All kinds of things are happening," Winter said. "These are exciting times for us all."
The advances being made "really represent a variety of different kind of approaches," Winter said, with no one thread running through the variety of trials being reported.
One piece of research represents something of a challenge to standard chemotherapy by successfully using high doses of steroids for multiple myeloma, said study author Dr S. Vincent Rajkumar, a professor of medicine at the Mayo Clinic in Rochester, Minn.
"There is a different philosophy in this trial," Rajkumar explained. "Less can be more. For years, we have used the highest possible dose of steroids for multiple myeloma, but they have been a source of major morbidity for patients. This is the first trial in which the intensity of steroids that are used has been studied in a randomised way."
Rajkumar and his colleagues used varying doses of the steroid dexamethasone along with lenalidomide, an agent that can modify and regulate action of the immune system, to treat 445 people with multiple myeloma. One-year survival was higher in the group getting lower doses of the steroid, "96 percent survival at one year, the highest reported in any study," he said. A reduction in damaging side effects was one reason for the improvement, he added.
May be used against other cancers
The approach is potentially applicable to other cancers, Rajkumar said. "As more and more drugs enter the picture, that kind of examination has to go on," he said. "As new drugs come along, can we adjust the dosage down?"
However, a study of 1,196 people treated for advanced Hodgkin's lymphoma at the University of Cologne in Germany indicated that high-dose treatment can sometimes be more effective. Patients treated with higher doses of varying chemotherapy regimens had better 10-year overall survival rates.
In another advance reported at the meeting, successful use of a form of radio-immunotherapy, using an anti-lymphoma antibody coupled with a radioactive isotope, against various forms of non-Hodgkin's lymphoma was reported by physicians at University Medical Centre Utrecht, the Netherlands.
A single infusion of the combination treatment tiuxetan, prolonged by two years the time period for which there were no signs or symptoms of the cancer. Some 60,000 new cases of non-Hodgkin's lymphoma are reported in the United States each year.
And physicians from the Hospital Avicenne in Paris reported that a new drug, azacitidine, was more effective than standard chemotherapy at prolonging survival among 358 patients with high-risk myelodysplastic syndromes (MDS), which currently have no cure other than bone marrow transplantation. - (Ed Edelson/HealthDay News)