Those with relapsed and refractory peripheral T-cell lymphoma  -- a rare cancer -- now have the first treatment ever available for their disease. Folotyn (pralatrexate) was approved for this use just a few days ago by the FDA. This OK was based on the PROPEL trial, which showed early and newfound response in patients.  Of course, Folotyn is not without its side effects. Learn more by reading the FDA's news release on the approval.

Diffuse large B cell lymphoma (DLBCL) is one of the most common types of non-Hodgkin's lymphoma (NHL). It affects thousands of individuals worldwide. Apart from the stage of cancer and blood test results, several other factors like the age and fitness (often termed the 'performance status') of the patient can impact the outcomes of treatment with chemotherapy and radiation. See Prognostic factors for DLBCL.

Scientists at the US National Cancer Insitute in Bethesda carried out research to test if the different genes in the tumor could also predict treatment outcomes. In a pathbreaking study they tested multiple 'gene expression signatures' - a scientific term for patterns of genes that are expressed in the tumor, in more than 400 patients with DLBCL. They found that using 3 important gene patterns it was possible to predict different treatment outcomes after the same treatment in the same disease.

Their research is likely to prompt further research on this issue and help doctors predict how an individual is likely to respond to treatment, and whether different 'gene signatures' should be treated differently.

This is not the kind of news that Britons will be happy to hear.

A report on cancer survival that compares deaths from cancer in UK with 13 other countries in the rest of Europe has some definitely disconcerting news. The report is being presented at the launch of the National Awareness and Early Diagnosis Initiative (NAEDI), a part of Cancer Research, UK.

The report compared death rates for 39 cancers, including lymphomas, between UK and other European countries and has come to the conclusion that each year, nearly 11,000 deaths could be prevented in the UK if only their rates could match the European average.

This report should prompt the NHS to take measures for an earlier diagnosis and more effective treatments to meet the increasing threat of cancer in their population.

Most individuals with follicular lymphoma are diagnosed in an advanced stage, requiring chemotherapy for treatment. Although follicular lymphoma is a slowly growing disease, most patients who require chemotherapy eventually have their disease start growing back slowly within a year or two.

Zevalin is an agent that belongs to a class of treatment called Radioimmunotherapy. This kind of treatment combines radiation with monoclonal antibody treatment. Zevalin has been recently reported to benefit patients with follicular lymphoma when they relpase following chemotherapy. A recently reported trial that used Zevalin as a sort of consolidation treatment immediately after chemotherapy for follicular lymphoma has demonstrated excellent results. More than 75% of those who had a partial response to chemotherapy had a complete response after Zevalin. Disease progression after chemotherapy was delayed three times longer in those who had received Zevalin. All of these came at little or no excess of side-effects.

These encouraging results may result in a change of treatment policies and result in incorporation of Zevalin as a part of first line treatment of advanced stage follicular lymphoma whenever it is available.

The strangest stuff seem to increase risk of lymphoma.

A study from the Netherlands recently published in the Journal of the American Medical Association accidentally found an increased risk of anaplastic large cell lymphoma (ALCL), a rare form of non-Hodgkin's lymphoma (NHL) in women with silicone breast implants. The risk seemed to increase substantially compared to the general population. A woman with a silicone implant is 18 times more likely to get ALCL than someone who does not have an implant. The probable reason for tis risk is the body's immune response to the implant.

In spite of an increase in risk, the likelihood of getting ALCL is still pretty small. Only about one woman in 100,000 with silicone breast implants is likely to get ALCL.

What does this mean for someone contemplating a silicone breast implant? The actual risk of lymphoma is small enough not to practically deter anyone from getting an implant. However, it may be worthwhile to test this link further in order to better understand the connection between implant and lymphomas. Maybe silicone implants of the future can be modified to reduce the risk of developing lymphomas.

A recent report in a highly reputed journal on Cancer suggests that the socioeconomic status of an individual with NHL in the US can hamper healthcare delivery badly enough to affect his survival.

The treatment and outcomes of more than 13000 Medicare beneficiaries affected by NHL were analyzed at the University of Texas. The results showed that those in the lowest socioeconomic strata were less likely to receive chemotherapy and radiation, the two most important treatments for lymphomas. They were also less likely to be cured or live as long as those receiving treatment.

Other factors may also disadvantage those who are less educated or poor. They could be diagnosed late, in a more advanced stage of lymphoma. They would also be less likely to be compliant for the entire duration of treatmen, due to a relative lack of insurance funding.

It's not an equal world. However, it would certainly help if lack of financial resources did not affect one's chances of getting quality treatments for cancer.

Get more details about this study here

A Finnish study has recently reported that the chances of developing cancers increase significantly after liver transplantation. The risk in transplant recipients is 2.6 times the average risk in the population, and results in about 1 in 6 recipients developing a cancer during their lifetime. The risk is higher for younger individuals receiving liver transplants.

Non-Hodgkin's Lymphoma (NHL) is one of two cancers (along with skin cancer) that shows the highest risk after liver transplantation. The increased risk for NHL after transplants is well known. Read the article on Post-transplant NHL. This study reinforces this fact, and the need to keep a close watch on transplant recipients so that cancers can be detected early enough for the best results with treatment.

Recently published research from the Memorial Sloan Kettering Cancer Center in New York suggests that high doses of Vitamin C may interfere with the action of chemotherapy on cancer cells.

One of the ways that chemo acts on cells is by 'oxidative' damage - by producing an abnormal oxygen atom that damages cells. Vitamin C is a natural 'anti-oxidant' and protects the body from this kind of damage caused by a number of common environmantal pollutants. This makes them work at cross purposes.

The results of this study demonstrate a 30-70% reduction in the cell-killing effects of chemo when higher than normal concentration of Vit C was present in blood. What was surprising in this study was the fact that Vit C seemed to reduce the effects of all kinds of commonly used chemo drugs (whether or not they cause 'oxidative' damage). This effect of Vit C is produced at the same blood concentrations that are reached in the body after Vit C supplementation.

Although this study was performed on animals, the findings are important for us as well. Vit C supplementation is quite common among cancer patients - often without any medical reason. It would be a real cause for concern if this were to reduce the action of chemo drugs and have a detrimental effect on outcomes.

So, perhaps it's better to just take a good diet of fruits and vegetables and stay off your Vit C pills while on chemo.

Ever wondered why new treatments for your cancer takes so long to get discovered and then finally become available for use?

New drugs and treatments aren't discovered in a day. They are the products of years (even decades) of expensive and painstaking research and development. Today drugs are first modelled using sophisticated computer programs. Only a few of hundreds of promising molecules are found suitable for research on animals. After it is found safe in animals, a drug goes in 3 different phases of trials in humans. These trials involve testing the drug for safety (phase I), then for efficacy (phase II) and finally a comparison against standard treatments to tests whether it provides any advantage (phase III). See the page on clinical trials. Only when it has clearly passes all these hurdles can a drug receive approval for marketing.

If this seems unnecessary and time consuming, remember that new drugs that are not appropriately tested can be a disaster with potentially dangerous consequences for any user. Surely, you don't want to be one of them.

The addition of Epratuzumab (marketed as LymphoCide) to the standard R-CHOP regimen in diffuse large B-cell lymphoma (DLBCL) may be a promising idea in the treatment of this lymphoma.

Epratuzumab is a monoclonal antibody directed against the CD22 molecule on the surface of white blood cells (WBC) - blood cells that are transformed by this cancer. Read more about Epratuzumab...

A study published last week from Researchers at the Mayo Clinic and the University of Wisconsin demonstrates that if Epratuzumab is added to the standard R-CHOP chemotherapy it leads to exciting results. The disease disappeared completely in 56% of their patients, and another 38% had considerable reduction in disease. With these promising results it may not be long before this new drug combination is formally tested against standard chemotherapy to see if there is a worthwhile improvement.