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Less toxic therapy for indolent lymphomas could replace R-CHOP
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The results of a Phase III clinical trial presented at the American Society of Hematology meeting could have a significant impact on first-line therapy for indolent lymphomas.
Currently, the standard first-line therapy for Follicular Lymphoma, Mantle Cell Lymphoma and other indolent lymphomas is the combination chemotherapy regimen known as R-CHOP (Rituxan + cyclophosphamide, daunorubicin, vincristine, prednisone), but findings published at this weekend's American Society of Hematology meeting suggest that Rituxan's more ideal partner is bendamustine (Treanda).
Ultimately, overall response rates in the study for Rituxan + CHOP (91.3%) and for Rituxan + bendamustine (92.7%) were practically the same, but the latter therapy is significantly less toxic, speciflcally in two high-grade hematologic toxicities:
- Leukocytopenia: Rituxan + bendamustine (12.1%), Rituxan + CHOP (38.2%)
- Neutropenia: Rituxan + bendamustine (10.7%), Rituxan + CHOP (46.5%)
The trial was carried out at University Hospital in Giessen, Germany and is already being called "potentially practice-changing". However, until published in a peer-reviewed journal, its conclusions are considered preliminary only.
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Where does the removal of the
Where does the removal of the spleen ever fall into these studies. I never see that option discussed.
When the spleen is removed, do you not then need the chemo?
Do these treatments slow down the groth of the cancer in the bone marrow?
Have you hade splenetic marginal zone b cell lymphoma that is indolent, with an enlarged spleen, anemia, a low red blodd cell count, and bone marrow involvment?