lymphoma treatment | Treatment of non-hodgkiniens Lymphoma

Treatment of non-hodgkiniens Lymphoma




The non Hodgkin lymphoma is a cancer that is treatable but can not be cured with current treatments. The arrival of new monoclonal antibodies associated with chemotherapy has changed management and continues to improve. The point with the PR. Gilles rooms, hematologist in Lyon.

Doctissimo: What is the treatment for non-Hodgkin Lymphoma?

PR. Gilles rooms: Classically, the treatment of lymphoma appealed to radiotherapy which today is virtually abandoned, except in very special cases.

Chemotherapy that cured many patients and that is still used today. And for a 10-15 years, immunotherapy which was initially represented by interferon and mainly represented today by monoclonal antibodies, which are synthetic molecules that are similar to our own antibodies that are made for example to defend themselves against infectious diseases, but who are here, specifically directed against the disease cells.

So today, most of the treatment will depend on the combination of chemotherapy to a monoclonal antibody. These monoclonal antibodies are unfortunately available only in B lymphomas, which still represent 85% of lymphomas, but it is an important tool.

Doctissimo: What is the contribution of these monoclonal antibodies?

PR. Gilles rooms: These monoclonal antibodies have appeared at the end of the 1990s and spread in the 2000s. The main is rituximab, an antibody directed against the CD20 Antigen. They formed a therapeutic revolution since this has led to significant progress, to cure more patients. It is estimated that about 15 to 20% of additional patients could be cured, see their life expectancy improved through the use of this monoclonal antibody. For a decade, all the figures confirm the clinical trials which demonstrated the effectiveness of this treatment.

Doctissimo: What is the best supported of the lymphomas?

PR. Gilles rooms: Support effective for lymphoma: is a good diagnosis, a good record, a multidisciplinary team of imaging, diagnosis and doctors Hematologists or onco-Hematologists, then this is the choice of therapeutic by adjusting the intensity and the type of chemotherapy in the diagnosis of lymphomas and its different forms and the association to a monoclonal antibody which can be used either in combination with chemotherapy - it is the most frequent case-, in rare cases alone and then sometimes and now more and more often in maintenance treatment after chemotherapy to improve the results achieved by it.

Doctissimo: Is this maintenance treatment a new concept?

PR. Gilles rooms: The treatment in hematology is not be a new concept because it was used with the chemotherapy drugs he long ago but it was toxic. The advantage of monoclonal antibodies, is in maintenance, are not so toxic. They are associated with a small additional risk of infection, but a risk of banal infection which can be controlled with antibiotics treatment. This spread for about 5 years, it is used in relapse in the major types of indolent lymphomas, lymphomas of the coat, follicular lymphomas, and there are currently ongoing studies to clarify their place in the first line, which the results should be known in the coming months. And we know that the trend in these studies is positive.

Doctissimo: Will this maintenance treatment delay the recidivism or cure patients?

PR. Gilles rooms: Maintenance therapy is mainly used in the treatment of indolent lymphomas, low-grade lymphomas, as today, unfortunately, we don't heal. Maybe with new treatments, we'll get a lot of patients who survive for a long time and who perhaps are cured, because only at age 60, live 25 years even with lymphoma, if he's still there at 85 years old, it's probably be cured. However today it is delaying the onset of a relapse of the disease, of a resurgence of the disease which will require a new cytotoxic treatment.

Story of David Bême and Florence Lemaire, December 9, 2009