follicular lymphoma | Lymphoma: less relapses with maintenance treatment

Lymphoma: less relapses with maintenance treatment

 
Lymphoma: cancer unknown
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Cancer of the lymphatic system
Lymphomas: from diagnosis to everyday life
Support for lymphomas
Among lymphomas, follicular lymphoma is the 2nd most common lymphoma. His support is based on the combination of chemotherapy and antibodies rituximab monoclonal. But she is facing a significant number of relapses after a few years. A problem that could be solved by maintenance treatment with rituximab.

Lymphoma lymphoma are cancerous tumors that develop from lymphocytes, which are the cells that defend the immunity and who usually sit in the lymph nodes. The 6 month treatment is today based on the combination of chemotherapy and rituximab infusions.

Lymphoma: half of patients relapse after 3 to 5 years
Obtained by genetic engineering, rituximab (Mabthera®) is a monoclonal antibody. These molecules mimic natural antibodies and are able to bind to specific receptors located on the surface of a cancer cell (in this case, the receiver CD - 20). Once attached, this antibody is able to destroy or to induce an immune response of the body.

This targeted therapy is associated with chemotherapy for a most effective synergistic effect.

The life expectancy of patients is close to 15 years. This support is facing a big problem: nearly half of patients relapse after 3 to 5 years.

Halve the number of relapses
Could support benefit from a maintenance treatment able to avoid or delay relapse? An international study of the lymphomas of the adult study group (GELA) and driven by Gilles Salles, hematologist at the Lyons CHU, has tested the benefits of an infusion of rituximab in maintenance treatment, every two months during the two years that following the initial treatment of follicular lymphoma. As of 2009, Prof. Gilles rooms evoked the hopes raised by this work at the Congress of the American Society of Hematology.

In total, 225 services were mobilised and 1019 patients enrolled in 25 countries. A total 505 patients received the rituximab in maintenance treatment, and 513 no treatment. After 2 years, 74.9 percent of treated patients did not relapse compared with 57.6% in the control group, a reduction of almost half of the number of relapses. The use of rituximab in maintenance treatment increases the hope of life without sign of disease, regardless of age and sex. According to the preliminary data, the overall life expectancy has not improved. Finally, there is a slight increase in the side effects (especially infectious 37% of patients with rituximab in maintenance compared to 24% for others, including 26 patients with infections considered serious).

But overall, the maintenance treatment seems to have little negative effect on the quality of life of patients. Most can even return to their professional activity at the end of maintenance therapy. At the Lyons CHU, this maintenance therapy is prescribed for all patients treated for follicular lymphoma. It tends to spread to the whole of France hospitals.