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Chemoimmunotherapy has been the most significant step in recent years to improving overall survival (OS) and progression-free survival (PFS) rates in patients with diffuse large B-cell lymphoma ­(DLBCL).[1] Despite this major therapeutic advance, a significant proportion of patients will relapse or remain refractory to initial chemoimmunotherapy. The pivotal PARMA trial confirmed the place of high-dose chemotherapy and autologous stem cell transplant (ASCT) as the optimum salvage treatment.

According to published statistics, in 2008 approximately 66,120 new cases of non-Hodgkin lymphoma (NHL) were diagnosed and 19,160 lymphoma patients died from their disease despite currently available treatment.[1] Diffuse large B-cell lymphoma (DLBCL), the most common type of B-cell NHL, has an aggressive clinical course and, as demonstrated by gene-profiling studies, can be further divided into subgroups with distinct biologic characteristics and prognoses.[2]

Sargramostim (Leukine) paired with a patient-specific immunotherapy mitumprotimut-T (Specifid), failed to reduce time to remission in patients with CD20+ follicular lymphoma following therapy with rituximab (Rituxan), according to the highly anticipated results of a phase III clinical trial.

Cephalon, Inc, announced that the US Food and Drug Administration (FDA) has approved injectable bendamustine hydrochloride (Treanda) for the treatment of patients with indolent B-cell non-Hodgkin lymphoma (NHL) that has progressed during or within 6 months of treatment with rituximab (Rituxan) or a rituximab-containing regimen. The data supporting the FDA approval show that bendamustine is effective, has a tolerable side effect profile in patients with indolent NHL, and that treatment results in a high durable response rate. In March of this year, bendamustine received approval for the treatment of patients with chronic lymphocytic leukemia, the most common form of leukemia in the United States.

Burkitt lymphoma (BL) is a unique B-cell lymphoma characterized by a high proliferation rate and cytogenetic changes related to c-myc proto-oncogene overexpression. Burkitt lymphoma is a highly aggressive B-cell lymphoma that is most frequently seen in children and young adults in endemic areas.

CHICAGO-Increasing the dose density of rituximab in the R-CHOP-14 regimen yields better rituximab (Rituxan) pharmacokinetics and improved clinical outcomes among older adults with high-risk diffuse large B-cell lymphoma (DLBCL), reported lead investigator Michael G.M. Pfreundschuh, MD.

An analysis of 2,459 mantle cell lymphoma patients diagnosed from 1992 (when the disease was first recognized as a separate type of lymphoma) to 2004 showed that men were more than twice as likely to be diagnosed as women, Caucasians had the highest risk of all ethnic groups, and people aged 70 to 79 were more likely to be diagnosed than all other age groups (Cancer, published online July 7, 2008, DOI: 10.1002/cncr.23608).

CHICAGO-Ongoing trials are still clarifying the optimal approach to management after induction therapy for non-Hodgkin’s follicular lymphoma. In the meantime, patients and physicians are left to ponder whether maintenance rituximab (Rituxan) should be used routinely in all cases. Leading researchers in hematology debated this topic in an education session at ASCO 2008.

Chronic myelogeneous leukemia (CML) is a biologically unique neoplasm resulting from a mutation producing a single abnormal protein that induces unregulated proliferation of myelopoiesis. Imatinib mesylate (Gleevec) profoundly inhibits the chimeric bcr/abl tyrosine kinase, and has dramatically improved the outlook for patients with CML in chronic phase.

Long-term results of a German randomized trial suggest that a novel escalated-dose regimen may replace the current chemotherapy standard of care for treatment of advanced-stage Hodgkin lymphoma. Volker Diehl, MD, of the University of Cologne, Germany, presented 10-year follow-up data on behalf of the German Hodgkin Study Group at ASH 2007 (abstract 211).

Among Ph+ chronic myelogenous leukemia patients in accelerated phase with imatinib (Gleevec) resistance or intolerance, treatment with nilotinib (Tasigna) rapidly produced significant responses and was generally well tolerated in an open-label pivotal phase II study

Study results presented at ASH 2007 showed efficacy of the novel tyrosine kinase inhibitor dasatinib (Sprycel) in imatinib (Gleevec) resistant or intolerant chronic myelogenous leukemia patients in chronic, accelerated, and blast phase