Protocols for Refractory Lymphomas:
CLL | Aggressive/Diffuse | CNS
Lymphoma | PMBCL | Follicular
| Hodgkins | Mantle Cell |
Marginal Zone/MALT
| T-cell | NHL Unspecified
| Low Counts and not Eligible for SCT
ALSO
SEE: About
Drug Resistance | Treatments
for Elderly | Eligibility Factors | Resources
Clinical Trials for Refractory Lymphomas
| Pipeline
Here
we provide resources for patients and professionals to use when searching
for information about treatment protocols that may help to overcome refractory disease - disease that is resistant, so far, to
treatment. The references within are not necessarily up-to-date - so
we have provided
Topic Searches of outside resources
to help you to locate new information published elsewhere.
It's most important to have expert guidance on
treatments
One important
goal for the patient is to understand the
risks of the disease and the potential risks
and benefits of the treatments under consideration. For
example, it can be appropriate - even essential - to use higher-risk aggressive
therapies to treat high-risk disease in order to potentially
eradicate the disease or produce a durable remission, but
only if there is at least some data to show the goal of treatment is
realistic for your diagnosis, and the risks are appropriate to your
general health, age, treatment history, etc..
Consult with at least one outside expert to obtain opinion and rationales about your
treatment options. Note: The rationales of experts can be
more useful to you than opinion, especially when you receive
different opinions from different experts.
Clinical
Trials? If the data for standard approaches specific to your
diagnosis are not strong, consideration of investigational
therapies becomes more reasonable. However, it does not follow
that investigational therapies will always be safer or more
effective than standard therapies. Therefore, you must read the
Informed Consent documents carefully and seek objective opinions and
the guidance of your treating physician. That said, you do not need
your physician's permission to review clinical trials, contact
clinical investigators, or participate in clinical trials.
However, it is best to ask the investigator of the study to consult
with your treating physician, and for you to consult independent
experts regarding the potential risks and benefits of the investigational
protocol you are considering. See Locating Experts in the
Field.
Questions you
might ask the doctors you consult
*
What is the most realistic goal of
treatment?
Cure? Durable remission?
Management with least toxicity? Pain relief? Other?
* What percentage of patients -
specific to my diagnosis, health, treatment history - have had a durable remission following
the approach you are recommending? What are the risks of
this treatment?
May I have a copy of the published data you
are basing the recommendation on?
* What is the prognosis for my diagnosis for management therapies
- using the least toxic therapies, as needed? Is this approach realistic for
my diagnosis and the clinical details and history of my
case?
* What protocols do you recommend and
what advantages do each have relative to other treatment
protocols?
* What investigational protocols do
you recommend, and why?
See Also: Clinical-trials-for-me?
PDF
-
Protocols for Refractory Lymphomas by Disease
Subtype
Note: This is a work in progress. We update this list in response to visitor inquires.
CLL- Relapsed / Refractory
(or SLL)
Treatment
Search
for relapsed CLL PubMed
| ASCO.org
Clinical
Trial Search for CNS lymphoma ClinicalTrials.gov
Also
see NHL - unspecified | PubMed
| ClinicalTrials.gov
Stem Cell Transplantation
Chemotherapy-based
protocols
-
Bendamustine ncbi.nlm.nih.gov
-
Nipent®/Cytoxan®/Rituxan® Shows
High Activity in Previously Treated CLL or Low-Grade NHL cancerconsultants.com
-
Treanda (Bendamustine) Full Prescribing information: FDA
as PDF file
-
Low-dose
fludarabine and cyclophosphamide in elderly patients with
B-cell chronic lymphocytic leukemia refractory to conventional
therapy.
Haematologica. 2000 Dec;85(12):1268-70. PMID:
11114133
-
Oxaliplatin, Fludarabine,
Cytarabine, and Rituxan combination therapy
in patients with Richter's syndrome or fludarabine-refractory CLL.
J Clin Oncol. 2008 Jan 10;26(2):196-203. PMID: 18182662
-
Rituximab with
Cladribine PMID: 16948126
The RC and RCC regimens were highly effective and well
tolerated modalities of treatment in
heavily pretreated patients
with indolent lymphoproliferative disorders.
Novel / Targeted Therapies
See
also Pipeline
Return to top
CNS Lymphoma
Treatment
Search
for relapsed CNS lymphoma PubMed
| ASCO.org
Clinical
Trial Search for CNS lymphoma ClinicalTrials.gov
See
also Pipeline
.gif) |
Salvage Therapy With Temozolomide in Patient With Primary
Brain Lymphoma
http://bit.ly/bH3IgR
Temozolomide-based
Clinical trials:
http://bit.ly/cTcM0O
Temozolomide as salvage treatment in primary brain
lymphomas
http://bit.ly/biziKd
|
|
|
Intensive Chemotherapy Followed by Hematopoietic Stem-Cell Rescue for Refractory and Recurrent Primary CNS and Intraocular Lymphoma: Societe Francaise de Greffe de Moelle Osseuse-Therapie
Cellulaire. J Clin Oncol. 2008 Apr 14; PMID: 18413641
|
Primary Mediastinal B cell
Lymphoma (PMBCL)
See
also Pipeline
Return to top
Aggressive (such as Diffuse Large B Cell) -
refractory / primary refractory
Also
see NHL - unspecified | PubMed
| ClinicalTrials.gov
Treatment
Search for relapsed aggressive lymphoma PubMed
| ASCO.org
Clinical
Trial Search for relapsed aggressive / DLBCL lymphoma
ClinicalTrials.gov
/ ClinicalTrials.gov
Stem Cell Transplant (SCT) for relapsed aggressive
lymphoma
-
Topic
Search
-
Autologous
SCT: The International Prognostic Index predicts for outcome
following autologous stem cell transplantation in patients with
relapsed and primary refractory intermediate-grade lymphoma. Bone
Marrow Transplant. 1999 Mar;23(6):561-7. PMID:
10217186 | Related
articles
-
Concurrent
high-dose Rituxan before and after
autologous stem-cell transplantation
PMID:
15800314
Chemotherapy-based
protocols
|
|
Bendamustine
(Treanda) Topic
Search |
|
|
Bendamustine
(Treanda) is effective in relapsed or refractory aggressive
non-Hodgkin’s lymphoma cancerconsultants.com |
|
|
High-Dose Celecoxib
and Metronomic
"Low-dose" Cyclophosphamide clinicalcancerresearch |
|
|
Cyclophosphamide, Cytarabine
and Methotrexate Regimen Followed
by Stem Cell Transplantation cancerconsultants.com |
|
|
NEW
Dose-adjusted EPOCH jco.ascopubs.org
(June 2008) |
|
|
Gallium nitrate,
Rituxan and Dexamethasone ASCO
2006 |
|
|
Gemcitabine, Ifosfamide, Oxaliplatin and Rituximab
(R-GIFOX) ASH2005 |
|
|
Efficacy
and safety of gemcitabine, carboplatin, dexamethasone,
and rituximab http://www.ncbi.nlm.nih.gov/pubmed/20578815
|
|
|
High-Dose Celecoxib and
Metronomic
"Low-dose" Cyclophosphamide
clinicalcancerresearch |
|
|
ICE: Ifosfamide,
carboplatin, etoposide PMID
12736224
| Abstracts |
|
|
ICE +
Rituxan
PMID:
14739217 |
Related articles
| Free
full text - Bloodjournal.org |
|
|
Ifosfamide,
Epirubicin and Etoposide (IEV)
PMID:
15370212 |
|
|
Metronomic
chemotherapy (low/continuous dosing). Topic
Search |
|
|
Mitoxantrone,
carboplatin, cytosine arabinoside, and methylprednisolone followed
by
autologous peripheral blood stem cell transplantation (MiCMA):
[effective]
PMID:
16419074 |
|
|
Pixantrone
Pixantrone: A New Agent with Activity in Non-Hodgkin's Lymphoma
cancerpublications.com
ClinicalTrials.gov
Pixantrone Combination Regimen Produces High Rates of Complete
Remission
for Patients With Aggressive NHL Who Fail CHOP Therapy
Docguide.com
|
|
|
R-GEMOX Rituxan, gemcitabine, and
oxaliplatin
Medscape |
|
|
Sequential
Doxorubicin and Topotecan in relapsed/refractory aggressive
Burkitt's
/ DLBCL:
Results of CALGB 59906.
Leuk
Lymphoma. 2006 Aug;47(8):1511-7.
PMID:
16966261 |
Novel /
Targeted therapies for aggressive lymphomas
See
also Pipeline
|
|
Radioimmunotherapy
|
|
|
Rituxan for aggressive non-Hodgkin's lymphomas relapsing after or refractory to
auto SCT
PMID:
12416894
|
Return to top
Follicular lymphoma - Refractory / Transformed
Also
see NHL unspecified
Treatment
Search for relapsed follicular lymphoma Topic
Search | ASCO.org
Treatment
Search for transformed follicular lymphoma Topic
Search | ASCO.org
Clinical
Trial Search for relapsed follicular lymphoma ClinicalTrials.gov
Clinical
Trial Search for relapsed follicular lymphoma ClinicalTrials.gov
Stem Cell Transplantation
(SCT)
Allogeneic type (from
donor) Topic
Search | PAL
-
Non-Myeloablative
(mini) Topic
Search
"non-myeloablative" means pretreatment (conditioning
phase of treatment) that has lower
toxicity and does not ablate
(kill off) the myeloid cells in the marrow. Often called a
mini-transplant. "Allogeneic" means from a donor,
in this case an HLA-identical sibling.
"Hematopoietic" means the process of forming blood cells
from stem cells in the bone marrow.
Autologous
cell transplantation PubMed
abstracts | Topic
Search | PAL
Radioimmunotherapy
-
Radioimmunotherapy
(Bexxar or Zevalin)
-
Bexxar
High-dose radioimmunotherapy (Bexxar) versus conventional
high-dose therapy and autologous hematopoietic stem cell
transplantation for relapsed follicular non-Hodgkin's lymphoma: a
multivariable cohort analysis. Blood. 2003 May 15 PMID: 12750161
PubMed
| Abstracts
| PAL
-
Bexxar for
transformed fNHL Topic
Search
-
Bexxar
in Patients With Relapsed or Refractory Indolent Non-Hodgkin's
Lymphoma:
Australian Multicenter Phase II Clinical Study. J Clin
Oncol. 2006 Aug 28; PMID:
16940276
-
Radioimmunotherapy of relapsed non-Hodgkin's lymphoma with
Zevalin, Review. PMID: 10541376
Zevalin
for transformed fNHL
Chemotherapy-based
protocols
-
New R-DHAOx -
95% (21 of 22) relapsed follicular lymphomas patients
realize durable remissions
http://bit.ly/6VASEB
-
Bendamustine Plus
Rituxan PMID:
15908650
Patient's story-
Bendamustine overcomes refractory nhl
-
Bendamustine
Topic
Search
A recent study of the drug bendamustine shows it
gives patients with advanced lymphoma
an option when other
treatments fail. According to Oncologist Jonathan Friedberg,
M.D.
of the University of Rochester, 70 percent of the patients in a
trial study had
good responses to the treatment. He says 35
percent even went into remission.
-
Fludarabine Related
abstracts | Topic
Search
-
Metronomic
chemotherapy (low/continuous dosing). Topic
Search
-
Phase II study of paclitaxel
and estramustine in patients with recurrent and refractory NHL
Cancer. 2004 Sep 28 PMID:
15455357
-
Bortezomib (Velcade) With Standard Chemotherapy for Relapsed or
Refractory
Follicular Lymphoma ClinicalTrials.gov
The purpose of this study is to evaluate the effectiveness and
safety of combining bortezomib (Velcade) with rituximab,
fludarabine, mitoxantrone, and dexamethasone in treating patients
with follicular cell lymphoma.
Radioimmunotherapy
Return to top
Hodgkin's Lymphoma - Refractory
/ Relapsed
Treatment
Search for relapsed HL PubMed
| ASCO.org
Clinical
Trial Search for relapsed HL ClinicalTrials.gov
Return to top
Also
see NHL - unspecified | PubMed
| ClinicalTrials.gov
Treatment
Search for relapsed MCL PubMed
| ASCO.org
Clinical
Trial Search for relapsed MCL ClinicalTrials.gov
Stem Cell
transplants (SCT)
Allogeneic SCT
-
Topic
Search | PAL
-
Non-Myeloablative
(mini) Topic
Search
"non-myeloablative" means pretreatment (conditioning
phase of treatment) that has lower toxicity
and does not ablate
(kill off) the myeloid cells in the marrow. Often called a
mini-transplant.
"Allogeneic" means from a donor,
in this case an HLA-identical sibling.
"Hematopoietic" means
the process of forming blood cells
from stem cells in the bone marrow.
Allogeneic stem cell
transplantation for mantle cell lymphoma--does it deserve a
better look?
Leuk Lymphoma. 2005 Feb;46(2):217-23. PMID:
15621804
Autologous SCT
-
Topic
Search | PubMed
abstracts | PAL
-
Bexxar,
High Dose with SCT High-Dose Iodine-131-Labeled Rituxan
and Autologous Stem
Cell Support Produces Long Lasting Effects in
Patients with Mantle Cell Lymphoma Failing
Conventional Autologous
Transplants cancerconsultants.com
Chemotherapy-based
protocols for relapsed MCL
-
Bendamustine Plus
Rituxan in Mantle Cell and Low-Grade Non-Hodgkin's Lymphoma.
J Clin Oncol. 2005 May 20;23(15):3383-9. PMID:
15908650
-
Gemcitabine and
Oxaliplatinum an effective regimen in a patient with
progressive refractory
MCL Leuk Lymphoma. 2004
Jun;45(6):1289-91. PMID:
15360015 | Related
articles
-
High (95%) Response
Rates in Relapsed/Refractory Mantle Cell Lymphoma after R-HCVAD
Alternating with R-Methotrexate/Cytarabine (R-M-A). Session
Type: Poster Session 650-II ASH
2005
Targeted / Novel
Therapies
Treatment
Search Web
See also Pipeline
-
NEW:
Oral Inhibitor of Syk - Fostamatinib Disodium (FosD)
http://ash.confex.com/ash/2008/webprogram/Paper5094.html
-
BMS 247550
ASCO
2005 | Clinical
trial | Topic
Search
The
epothilones are a new class of natural products.
CCI-779 Single-agent CCI-779 has substantial anti-tumor activity in relapsed MCL. This study
demonstrates that agents, which selectively target cellular pathways dysregulated in MCL cells
can produce therapeutic benefit. The high response rate warrants further studies of this agent in MCL,
but the high incidence of hematologic toxicity suggests that a lower dose should be explored.
CCI-779 at 25mg is currently being evaluated in MCL through an NCCTG trial
Abstract #129
appears in Blood, Volume 104, issue 11, November 16, 2004
Also see: Clinical
Trial -
*
-
Maintenance
therapy with Rituxan PMID:
16946304
-
Radioimmunotherapy
for MCL
-
Revlimid
(lenalidomide)
-
Targeting
Angiogenesis in Mantle Cell Lymphoma
-
Velcade (Bortezomib)
Return to top
Marginal Zone (MZL) / MALT - Richter's - Refractory /
Transformed
Treatment
Search for relapsed MZL PubMed
| ASCO.org
Treatment
Search for Richter's (transformed) MZLPubMed
| ASCO.org
Also
see NHL - unspecified | PubMed
| ClinicalTrials.gov
Stem Cell Transplantation
(SCT)
Chemotherapy-based
[protocols for MZL
Novel /
Targeted therapies
See also Pipeline
Radioimmunotherapy
(Bexxar / Zevalin)
Return to top
T-cell - refractory /
relapsed
Treatment Search for relapsed T-cell lymphoma PubMed
| ASCO.org
Clinical
Trials Search: ClinicalTrials.gov
See also Pipeline
Also
see NHL - unspecified | PubMed
| ClinicalTrials.gov
Stem Cell
transplants (SCT)
Allogeneic SCT
Chemotherapy-based
protocols
Targeted
/ Novel Treatments
 |
Effective treatment of a case of
refractory mycosis fungoides with imatinib (Gleevec).
Br J Haematol.
2006 May;133(4):353. No abstract available. PMID:
16643439
|
|
HuMax-CD4 Phase II cutaneous T-cell lymphoma
(CTCL) studies - 55% of Higher Dose
Patients Achieve a Clinical
Response in Primary Indication prnewswire
Apr 2004 |
ONTAK
(Denileukin diftitox) for refractory T-cell lymphomas Topic
Search
Denileukin diftitox (Ontak) for
relapsed/refractory T-cell non-Hodgkin lymphoma interscience.wiley.com
-
Forodesine
HCl active single oral agent for advanced refractory CTCL abstracts2view.com
Forodesine is a rationally designed, potent inhibitor of purine
nucleoside phosphorylase (PNP)
-
NEW
-
Histone deacetylase (HDAC) inhibitors:
Topic
Search
-
NEW:
Phase 2 Data for Romidepsin Showing Durable
Response in Refractory
CTCL businesswire.com
"Romidepsin is a novel, cyclic peptide, pan-HDAC
inhibitor under investigation for
hematologic malignancies"
-
Phase II Trial of Oral Vorinostat
(Suberoylanilide Hydroxamic Acid, SAHA) for
Refractory Cutaneous
T-cell Lymphoma (CTCL). Blood. 2006 Sep 7; PMID:
16960145 | Related
articles
-
Lenalidomide / Revlimid (investigational)
PubMed
articles | ClinicalTrials.gov
A potent immune modulating agent.
-
Pralatrexate, a novel class
of antifol PMID:
17910632
All four patients with T-cell lymphoma (TCL) achieved a
complete remission. Patients with
B-cell lymphoma achieved stable
disease at best. For each TCL patient, the response
was more
durable than their best response with chemotherapy. This early
experience is
the first to document this unique activity of
pralatrexate in TCL.
Return to top
Non-Hodgkin's Lymphoma (NHL) - unspecified
Clinical
Trials Search: ClinicalTrials.gov
-
Stem
Cell transplant (SCT)
-
Tandem autotransplant
as first-line consolidative
treatment in poor-risk aggressive lymphoma: a pilot study of 36
patients. Ann Oncol. 2001 Dec;12(12):1749-55. PMID: 11843254
PubMed
| Abstracts
Long-term
survival of patients with resistant lymphoma treated with
tandem stem cell transplant.
Leuk Lymphoma. 2005 Mar;46(3):405-14. PMID:
15621831 | Related
articles
-
Allogeneic Hematopoietic Transplantation Topic
Search | PAL
-
Autologous
cell transplantation PubMed
abstracts | Topic
Search | PAL
-
Radioimmunotherapy
(Bexxar / Zevalin)
Chemotherapy-based
protocols
-
Bendamustine
(Treanda) Topic
Search
-
Rituximab
combined with cladribine or with cladribine and
cyclophosphamide in heavily pretreated patients with indolent
lymphoproliferative disorders and mantle cell lymphoma.
Cancer. 2006 Aug 31; PMID: 16948126
The RC and RCC regimens were highly effective and well
tolerated modalities of treatment in heavily pretreated patients
with indolent lymphoproliferative disorders.
-
DHAP
Topic
Search
-
Eloxatin®
Topic
Search
-
EPOCH
Topic
Search
-
ESHAP Topic
Search
-
Fludarabine &
Cyclophosphamide: Topic
Search
-
FPD-R
Preliminary Results of a Phase I/II Trial of BBR-2778 (Pixantrone)
in Combination with Fludarabine, Dexamethasone, and Rituximab
(FPD-R) in the Treatment of Patients with Relapsed/Refractory
Indolent Non-Hodgkin's Lymphoma (NHL). Session Type: Poster
Session 478-I ASH
2004
-
Gemcitabine, cisplatin
and methylprednisolone chemotherapy (GEM-P) is an effective
regimen in patients with poor prognostic primary progressive or
multiply relapsed Hodgkin's and non-Hodgkin's lymphoma.
Br J Haematol. 2003 Mar;120(6):970-7 PMID:
12648066 | Abstracts
-
Gemcitabine +
Rituxan: a therapeutic option for elderly or frail
patients with aggressive non Hodgkin's lymphoma? Leuk Lymphoma.
2005 Jan;46(1):71-5. PMID:
15621783
-
Irinotecan in
Relapsed or Refractory Non-Hodgkin’s Lymphomas, Vol 16, No 8, Suppl 7 (August 2002)
cancernetwork.com
-
Metronomic
chemotherapy (low/continuous dosing). Topic
Search
-
Liposomal
vincristine (Onco TSC) in relapsed non-Hodgkin's lymphomas: early results of
an ongoing phase II trial.
Ann Oncol. 2000 Jan;11(1):69-72. PMID: 10690390 PubMed
| Abstracts
-
Multiple cycles [continuous
dose] aggressive chemotherapy prior to autologous peripheral stem
cell transplantation for lymphoma. Aust N Z
J Med. 1997 Jun;27(3):323-9. PMID: 9227818 PubMed
| Abstracts
-
Oxaliplatin
treatment in heavily pretreated patients with non-Hodgkin's
lymphoma.
Leuk Lymphoma. 2005 Oct;46(10):1437-40 PMID:
16252433
-
Paclitaxel: Phase II
study of paclitaxel in combination with mitoxantrone and
ifosfamide/mesna for patients with relapsed or refractory
non-Hodgkin's lymphoma after failure to cytarabine/cisplatin
combination. Invest New Drugs. 1999;17(2):187-92.
PMID: 10638491 PubMed
| Abstracts
-
Pixantrone
Pixantrone: A New Agent with Activity in Non-Hodgkin's Lymphoma cancerpublications.com
ClinicalTrials.gov
-
Pixantrone (BR
2778):
Alternative to Doxorubicin? - Might have similar activity against
aggressive lymphomas as doxorubicin, with less cardio toxicity
Abstracts
|
Clinical trials
-
Rituximab,
gemcitabine and oxaliplatin: an effective salvage regimen for
patients with relapsed or
refractory B-cell lymphoma not candidates for high-dose therapy.
Ann Oncol. 2007 May 11; PMID:
17496309
-
Rituximab-EPOCH - an Effective Salvage Regime for Relapsed,
Refractory, or Transformed B-Cell Lymphoma. Results of a Phase II
Study. Year: 2001
Abstract No: 1157
-
Sensitization
of ara-C-resistant lymphoma cells by a SATE pronucleotide
analogue. Int J Cancer. 2003 Oct 20;107(1):149-54.
PMID:
12925971 | Abstracts
-
Trofosfamide
(palliative/elderly) as a salvage treatment with low toxicity in
malignant lymphoma. A phase II study. Eur J Cancer. 1997
Mar;33(3):500-2. PMID: 9155539 PubMed
| Abstracts
-
Novel / Targeted
therapies
BMS 247550
ASCO
2005 | Clinical
trial | Topic
Search -
Elsamitrucin
Topic
Search
-
Radiofrequency
ablation of lymphoma.
Blood. 2006 Feb 15;107(4):1624-6. Epub 2005 Oct 27 PMID:
16254135 | PAL
-
*
TOPIC SEARCH
Mechanisms PubMed
TOPIC SEARCH Outcome data Medscape |
PubMed
TOPIC SEARCH
Safety or Toxicity PubMed
-
Promising
Results For Patients With Aggressive, Recurrent Non-Hodgkin
Lymphoma Using New Oral Drug (tipifarnib) sciencedaily.com
"We were pleased with the results of this study because it
demonstrates that tipifarnib has some single-agent activity in
this aggressive tumor group," says Dr. Witzig. "Now we
need to combine it with other effective agents to further enhance
the activity for our patients."
-
TRM-1 (TRAIL-R1 monoclonal antibody) in Subjects with
Relapsed or Refractory NHL
Condition: Lymphoma, Non-Hodgkin clinicaltrials.gov
-
Velcade
approved for Multiple Myeloma will be available off label to
patients with NHL Abstracts
-
YM155,
a novel survivin suppressant, administered by 168 hour
continuous infusion to patients with advanced solid tumors. asco.org
2006
Two pts with chemotherapy refractory intermediate grade NHL had
marked reduction of lymph nodes including one that was durable (PR
reviewed independently). This pt went onto BMT and was in
remission at the time of this submission.
Return to top
Lymphoma with low blood counts, and not eligible
for SCT
Probably the most difficult circumstance is when
your bone marrow function is low and you cannot tolerate treatment
with the majority of agents for lymphoma. The following
agents and protocols were selected because they may be less harsh
to immune function. This list is a work in progress, and is
by no means complete. Please discuss with your doctors.
Rituxan
Interferon-alpha -
Denileukin diftitox (Ontak)
Phase II study of denileukin diftitox for relapsed/refractory B-Cell non-Hodgkin's lymphoma.
J Clin Oncol. 2004 Oct 15;22(20):4095-102. Epub 2004 Sep 7. PMID: 15353540
T-cell
therapy, if your doctor judges you can tolerate CVP as pretreatment (Fred Hutch)
clinicaltrials.gov -
Velcade
approved for Multiple Myeloma will be available off label to
patients with NHL Abstracts
-
Bortezomib
(Velcade) and Rituximab in Treating Patients With Non-Hodgkin's Lymphoma
clinicaltrials.gov
Return to top
Resources
Primary Chemo-Refractory Follicular Lymphoma: Treatment Approaches Post-BMT Author: Myron Czuczman, MD
cmelink.com
-
Current Therapies in the Treatment of Non-Hodgkin's
Lymphoma: Chemotherapy
Richard I. Fisher, MD Medscape
(free login req.) - * Comprehensive *
-
Sequencing of Therapies for Low-Grade Lymphomas
cancercare.org
Presenter: Peter Rosen, MD, Professor of Medicine, UCLA School of
Medicine, Department of
Hematology and Oncology, Los Angeles, CA.
-
Treatment of Persistent Lymphoma? - Response from Joseph A.
Sparano, MD, 10/23/2001
Medscape
(free login req.)
-
-
Treatments of NHL (flowcharts) - MDACC
PDF
| PDF-Help
-
About
Transformation PAL
Return to top
Common Treatment Eligibility Factors
Be aware that one or more of the
following may determine eligibility for some treatment
protocols. We recommend that you take an inventory of the
following in order to make it easier to identify appropriate treatment
protocols when consulting your doctor, outside experts, or
investigators of investigational therapies.
-
Diagnosis -
lymphoma subtype (including phenotype markers, such as CD20, CD19,
etc.)
-
Treatment history
- specific prior therapies or treatment types - may be required,
or may exclude
-
Bone marrow involvement
with lymphoma (greater than 25% bilaterally for Bexxar/Zevalin)
-
Bone marrow (Hematopoietic)
function - measured by hemoglobin, lymphocytes,
platelets, neutrophils
-
Co morbidities
- other conditions, such as heart (cardiovascular) disease, HIV,
Hepatitis B/C, and other infections
-
Kidney (Renal) function
- measured by creatinine
-
Liver (Hepatic) function
- measured by bilirubin, AST and ALT
-
Lungs (Pulmonary)
function - measured by a variety of tests or
observation
-
Neurological
- such as history of seizures, CNS involvement
-
Patient characteristics
- age, gender,
life expectancy, pregnancy status
-
Performance status
- as measured by Karnofsky standards
Return to top
About Drug Resistance
Potential methods to circumvent blocks in
apoptosis in lymphomas.
Curr Opin Oncol. 2002 Sep;14(5):490-503. Review.
PMID: 12192267 PubMed
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