In this interview Dr. Armitage discusses his early career and what led him to specialize in the treatment of lymphoma, and shares his thoughts on the future of cancer treatment.
James O. Armitage, MD
Our heads hit the pillow later at night as the complexity of treating DLBCL increases, but we are well rested on account of the progress that is being made.
The role of transplant in MCL is in clinical evolution. Up-front high-dose therapy and autologous stem cell transplant remains an attractive option for those with chemosensitive disease regardless of the induction regimen chosen, whereas this approach in the relapsed or refractory setting has not yielded long-term disease-free intervals.
In a new series, beginning this month and running into early 2014, experts on five “unusual dysproteinemias” will share their insights into diagnosis and management.
The current standard therapies for chronic lymphocytic leukemia do not prevent Richter's transformation from occurring. If we are fortunate, new treatments will realize the hope that this usually fatal complication of chronic lymphocytic leukemia might be avoided.
Observations made in the study of the leukemias have contributed to our understanding of malignancy in general and to our ability to treat cancer patients with drugs.
While ONCOLOGY has continued to evolve along with the field of oncology—for example, it now addresses critical issues of science and socioeconomics—it has remained true to the founding principles. Perhaps largely for this reason, the journal continues to be widely read across the entire oncology community.
Twenty-five years ago, the journal ONCOLOGY came into being. At that time patients with B- and T-cell lymphomas were lumped together in clinical trials, and mantle cell lymphoma, MALT lymphoma, and many subtypes of the peripheral T-cell lymphomas were not recognized as specific entities.
Anemia is a widely prevalent complication among cancer patients. At the time of diagnosis, 30% to 40% of patients with non-Hodgkin lymphoma or Hodgkin lymphoma and up to 70% of patients with multiple myeloma are anemic; rates are higher among persons with myelodysplastic syndromes. Among patients with solid cancers or lymphomas, up to half develop anemia following chemotherapy. For almost 2 decades, erythropoiesis-stimulating agents (ESAs) were the primary treatment for cancer-related anemia. However, reassessments of benefits and risks of ESAs for cancer-associated anemia have occurred internationally. We reviewed guidelines and notifications from regulatory agencies and manufacturers, reimbursement policies, and utilization for ESAs in the cancer and chronic kidney disease settings within the United States, Europe, and Canada. In 2008 the US Food and Drug Administration (FDA) restricted ESAs from cancer patients seeking cure. Reimbursement is limited to hemoglobin levels
Our ability to treat patients with B-cell lymphomas has improved dramatically over the past few decades. Today the majority of patients with diffuse large B-cell lymphoma are cured, the survival of patients with low-grade follicular lymphoma is improving (ie, some estimates have the average survival more than doubling), most patients with Hodgkin lymphoma (also a B-cell lymphoma) are cured, most patients with Burkitt lymphoma are cured, and our ability to diagnose and treat patients with the various marginal zone lymphomas has improved considerably.