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LYMPHOMA FOUNDATION NEWSLETTERSSEEKING SOLUTIONS TO SERIOUS LATE OCCURRING COMPLICATIONS OF RADIATION THERAPY Use of the radiation therapy to a 'mantle field' was responsible for effectively limiting the chances of early relapses and helped introduce long survival in many patients with Hodgkin's disease. Now it is understood that this treatment has its own unique limitations.
”ABVD chemotherapy alone is as effective as ABVD plus radiation therapy in early-stage Hodgkin disease; thus, the majority of patients are curable without being exposed to the life-long, life-threatening risks of therapeutic radiation.” ¨ Because the use of Radiation therapy may not be stopped but only modified it will continue to be a significant risk factor for the development of coronary heart disease. Therefore cardiologists and oncologists should unite to consider and initiate a study of the value of adding long term use of a statin to the radiation treatment. ¨ Advise the American College of Cardiology (ACC) and the American Heart Association (AHA) that radiation therapy to the chest and neck in lymphoma patients should be added as a serious risk factor for the development of acute coronary syndromes and stroke and the already treated surviving patients post-radiation should consider starting statin medication and be sure to lower the LDL cholesterol levels to the lowest levels now expected to achieve the best results. In this regard an Editorial appeared in the Journal of the American Medical Association entitled JAMA. November 16, 2005;Volume 294:page 2492 “… patients should know their cholesterol numbers, for both LDL-C and HDL-C, to enable them to see how much lowering is needed to reach targets of an LDL-C level of less than 100 mg/dL for patients with risk factors or less than 70 mg/dL for patients with heart disease … any drug treatment should be taken together with an appropriate diet and exercise program to lower cholesterol and overall vascular risk. … The amount of LDL-C lowering with diet is only in the range of 7% to 12%. Clearly, diet is a central part of the treatment, but to get the benefits of very low cholesterol levels, drug treatment is often necessary. ...Optimal use of diet and appropriate use of medications will dramatically reduce the risk of MI, stroke, and death from heart disease. These new data should help motivate any patients who have been hesitating about treating their cholesterol to talk with their physician to get the benefits of intensive cholesterol lowering” And... in the August 2, 2005 issue of the Annals of Internal Medicine of the American College of Physicians Dr. John V.L. Sheffield and Dr. Eric B. Larson reviewed data regarding Cardiovascular Disease and Statin Use and they noted the following:
ATTENTION ALL LYMPHOMA PATIENTS AND ALL PERSONS —- BE INFORMED AND INFORM YOUR PHYSICIANS AND YOUR FRIENDS ABOUT THE DATA REGARDING ‘STATIN’ ANTI-CHOLESTEROL MEDICATION and THE ROLE OF MAMMOGRAPHY TO ACHIEVE AN EARLY DIAGNOSIS OF BREAST CANCER —- GO TO THE ‘HEART' AND ‘BREAST CANCER’ PAGES OF THE LYMPHOMA FOUNDATION WEBSITE TO REVIEW THIS INFORMATION
UNIVERSITY OF UTAH — HEMATOLOGY DIVISION — SCHOOL OF MEDICINE— DUKE
UNIVERSITY MEDICAL CENTER — DURHAM, NORTH CAROLINA
YALE
UNIVERSITY CANCER CENTER — NEW HAVEN, CONNECTICUT
CORNELL NEW
YORK-PRESBYTERIAN HOSPITALS — NEW YORK, NEW YORK
MEMORIAL SLOAN KETTERING CANCER CENTER —NEW YORK, NEW YORK SUMMARIES OF RESEARCH IN PROGRESS Monoclonal antibody, Anti-sense BC-2 and Bortezomib therapy JOHN P. LEONARD, M.D., Joan and Sanford Weill Medical College of Cornell University “The assistance of the Lymphoma Foundation [will] be used to support the following efforts at our center in very meaningful ways…” “Novel initial therapies for aggressive lymphoma. We continue to explore ways to improve outcomes with chemotherapy, particularly combinations of CHOP chemotherapy and rituximab along with agents such as Bcl-2 antisense, idiotype vaccines, and bortezomib (Velcade). Trials with these are ongoing, and initial phase I results of the CHOP-R-Velcade study have been submitted to ASH. We are excited about these preliminary findings, and the support from the Lymphoma Foundation will help us to continue this trial as well as to conduct correlative studies on tumor tissue that will allow us to characterize tumors from the molecular standpoint in the patients on the study. We also plan additional future trials with other novel agents.” “Further assessment of the anti-CD22 antibody epratuzumab and other antibodies in B-cell malignancies. We continue to study this agent, with which we have demonstrated evidence of clinical activity and manageable toxicity. We are evaluating patients treated with single-agent epratuzumab, repeated courses (at relapse) as well as in combination with rituximab. Substantial numbers of these patients remain in remission years later (initial results from one study recently reported in the JCO). Our initial efforts are encouraging in this regard, and we are currently conducting a pilot study in lymphoplasmacytic lymphoma (which highly expresses CD22). We are also attempting to identify clinical, laboratory, and pathologic parameters, which may correlate with response and therefore allow us to better target appropriate patient populations. Further trials in combination with CHOP-R and with rituximab are being planned. Additionally, we are currently conducting phase I studies with anti-CD40 and anti-interleukin 6 monoclonal antibodies.” Is there a genetic (inherited) component that protects against the development of cancer? KENNETH OFFIT, M.D., MPH, Memorial Sloan Kettering Cancer Center: As a result of the “genetic revolution” it is now possible to look for genetic variations between individuals and to learn if these are associated with disease. The goal of one aspect of our genetic research at the Memorial Sloan Kettering Cancer Center has been to use “whole genome” technologies to look for genetic markers that will predict resistance to disease in the elderly. Our initial research paper soon to be published demonstrated that it is possible to do “whole genome” analysis to “rediscover” known genes. As preliminary data we performed low density genomic scans and we have been able to resolve two significant regions: one on chromosome 12 and one on chromosome 22 that may be associated with the resistance to breast cancer in this elderly population. As we continue our research we hope to better map these regions and to discover other genetic regions that confer cancer resistance in the elderly. How is
cell senescence (aging) controlled
THE DILEMMA POSED IN CHOOSING TREATMENT OF ‘LOW GRADE’ FOLLICULAR LYMPHOMAS
New
approaches to treatment are being studied in order to secure the much needed
improved longer-term survival.
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