Zevalin (Ibritumomab Tiuxetan) is a novel treatment of lymphoma called radioimmunotherapy. A radiation emitting molecule is attached to a monoclonal antibody that seeks out and binds to cancer cells of lymphoma. The radiation kills the cancer cells to which the drug attaches. This enables the drug to target cancer cells without killing normal body cells that are often damaged by conventional chemo and radiation.

Zevalin had earlier shown great promise in the treatment of some non-Hodgkin's lymphomas (NHL) at relapse after standard first-line treatments with chemo and radiation. In many countries of the world, it is approved for second line treatment for follicular (low grade) b-cell lymphomas. Now, based on some very exciting evidence from a large trial, the European Commission has granted approval for using Zevalin in the first-line treatment as a consolidation therapy after standard chemo in follicular lymphomas.

This multinational European study (FIT study) tested the use of a single dose of Zevalin as an additional or consolidation treatment after the completion of standard chemotherapy regimens. The trial showed that this treatment increased the duration of disease control from an average of 1 year to about 3 years. These exciting results have spurred a new wave of excitement regarding Zevalin, a drug which was facing a troubled future and nearly becoming financially non-viable for its manufacturer.

Angioimmunoblastic T-cell lymphoma (AITL) is an uncommon type of non-Hodgkin's lymphoma (NHL). This T-cell lymphoma has several distinctive features that set it apart from the more common types of NHL. Most patients first complain of a rash over the body that causes intense itching. They also commonly have joint pains as well as blood abnormalities. These features are very uncommon in other lymphomas, and occur due to the overactivation of the immune system that regulates the normal body response to infections. Angioimmunoblastic lymphoma is also a fast growing lymphoma that frequently spreads to different body organs like the liver, spleen and bone marrow.

To find out more about this lymphoma read the article Angioimmunoblastic T-cell lymphoma.

Statins are lipid lowering drugs - very effective for reducing the high cholesterol and triglycerides in your blood. Worldwide, hundreds of thousands of individuals are on statins. Not only are statins useful in lowering the fats in the blood and reducing the chances of a heart attack or a stroke, they are also being actively investigated as a tool in other areas of medicine - including cancer.

This news is however not a positive one. In one of the many lab studies that are investigating how statins may act on cancer cells, it has been found that these drugs may alter the CD20 molecule that acts as a target for the drug Rituximab. Rituximab is a monoclonal antibody drug that has improved outcomes in a range of non-Hodgkin's lymphomas, including diffuse large B-cell lymphoma and follicular lymphoma. By altering the CD20 molecule, it may reduce the binding of the drug to the cancer cell and result in a diminished effect.

Though this is only a lab study in rats, the effects on humans may be similar. Many individuals may be taking statins while on cancer treatment. The consequences on using both these drugs together will now have to be investigated in humans. The scientific world is watching.

Lymphoma is a cancer of lymph cells - a type of cells that are present in the blood and lymph nodes and protect the body from infections. Most lymphomas arise from lymph nodes, though they can arise from practically any organ in the body - including the stomach, brain, testes, skin and bones.

Lymphoma starting from a bone is quite uncommon, though they are known to happen. This condition is different from bone invasion by lymphoma that starts from lymph nodes lying close to the bone, and from bone marrow involvement by any type of lymphoma. In primary bone lymphoma, the disease starts in a bone and is often present only in that bone. Though rare, these lymphomas can be usually cured with a combination of chemotherapy and radiation.

Are lymphoma treatment results getting any better with all the medical research that is going on? The answer seems to be yes. A recenly published analysis of changes in treatment outcomes in non-Hodgkin's lymphoma (NHL) between 1990 and 2004 in the US shows a very encouraging improvement in survival rates.

There is a 16% improvement in survival at both 5 and 10 years after diagnosis, and the improvement has occurred in almost all age groups, NHL types and in both males and females. This is extremely special, because few other cancers, if any, can boast of such an improvement in a span of just over a decade.

What has led to this improvement? There are no clear answers, but two important advances may have had a large impact. The first is the introduction of monoclonal antibodies (like rituximab) in the treatment of some common types of NHL. The other is advances made in the treatment of HIV infection, that contributes to the development of several types of NHL. No matter what the exact reasons are, the news is definitely a cause of cheer.

Your treatment is over and you visit your oncologist for a checkup. He examines you and finds no disease left. He orders a CT scan - and there in one corner lies a small lymph node that turns your joy into fear. Is there some lymphoma left in my body?

It is not uncommon to find a few lymph nodes left behind when a CT scan is done after completing treatment. CT scans show up nodes that are larger than usual and calls them abnormal. Very often, these nodes may not have disease at all. Till a few years back there was no really good way to find out for sure.

Now PET scans have an answer. PET scans are similar to CT scans, but show up areas of the body where disease activity is taking place. Since cancer cells grow faster than the normal cells of the body, they light up on a PET scan. This is very useful, because it can tell you that even though some lymph nodes are enlarged, they don't have any disease left. (See PET Scans for Assessment of Treatment Response).

A PET-CT machine goes a step further. In a single machine it has both PET and CT scanners. The 2 sets of scans than then be accurately overlaid on each other and compared. It makes it easy to pinpoint whether a suspicious area on the CT has active lymphoma or not. Because of its advantages, a PET-CT scan may become the best scan to do for assessing response to lymphoma treatment.

Rheumatoid arthritis (RA) is a common joint disease that results in severe joint pain and deformity. This disease is related to the immune system that protects the body from infections. Some of the drugs used for severe RA act against the immune system of the body. There has been a suspicion among physicians that these drugs may increase the risk of developing cancers of the blood and lymph system, including lymphoma.

A large study in Quebec, Canada evaluated the risk of blood cancers (leukemias) and lymphoma among nearly 24,000 individuals with RA who receive drugs against the immune system. They found that the risk of developing lymphomas very definitely increased and the risk was mainly with the use of the cyclophosphamide - a drug used both for RA and many cancers. The use of cyclophosphamide approximately doubled the risk of getting lymphomas.

Though not many individuals with RA develop lymphomas, and cyclophosphamide is often of great benefit in this disease, it is a risk worth keeping in mind when treating rheumatoid arthritis.

Young individuals (less than 30 years of age) with Hodgkin's lymphoma treated with radiation to the chest are at increased risk of second cancers, including breast cancer.

Breast cancer screening can detect this cancer early and make a difference in the treatment and outcome of the disease. Screening commonly involves doing an annual breast checkup with a doctor (clinical examination) and an X-ray of the breast (called a mammogram).

However, doctors from the Massachusetts General Hospital have found in a recent study that an annual mammogram may not be enough for Hodgkin's lymphoma survivors. In their study on patients with Hodgkin's treated with radiation to the chest, they found that a high percentage of those who went on to get breast cancer had normal screening mammo reports. They suggest that since survivors of Hodgkin's lymphoma are at high risk for developing breast cancer, it may be worthwhile to additionally do an MRI scan to detect some very early lesions that the mammo cannot catch.

A study from Europe, published in Jan 2008, investigated the risk of having a premature menopause among women treated with chemotherapy for Hodgkin’s lymphoma. In the group of 600 women who were a part of the study, it was found that nearly half had the likelihood of developing menopause before the age of 40. That is a 12-fold higher risk compared to the general population.

It is well known that certain chemo drugs can suppress the follicles in the ovary that mature every month and cause menstrual periods. This study showed that two drugs belonging to the group of chemo drugs called ‘alkylating agents' – procarbazine and cyclophosphamide (especially the former) – were the most likely culprits for this. Unfortunately both these drugs are very effective against Hodgkin’s and a part of the best chemo regimens against the disease. Chemotherapy is the most effective treatment of Hodgkin’s lymphoma and cures the majority of patients with this disease, even when the disease is advanced.

It seems that till the time safer drugs are found that produce results just as good as these agents, thousands of women with Hodgkin’s will just have to accept the risk of a premature menopause and its effects on their body and health.

A large batch of defective Duragesic (Fentanyl) patches sold by PriCara and generic versions of fentanyl sold by Sandoz and ALZA in the US and Canada have been found to have a manufacturing defect and are being withdrawn from the market. These are 25mcg/hr patches and all have a date of expiry on or before December 2009.

Fentanyl is a very powerful and effective painkiller used for controlling longstanding severe pain. Thousands of individuals, especially cancer patients, need to use fentanyl patches that are stuck to the skin and provide pain relief for 3 days.

These defective patches have a cut alongside the drug reservoir that may result in the drug leaking out into the pouch and coming in direct contact with the skin. This may result in a drug overdosage that may cause severe side effects including respiratory depression and even death.

To find out more about this issue read the FDA news article on this topic.