Developments in fighting NHL
Dr Andy Haynes, Nottingham University Hospitals NHS Trust, UK
In the last 25 years there have been big improvements in the way we treat treat non-Hodgkin's lymphoma (NHL). We have learnt a great deal about the disease. We now know more about the different types of NHL and how to tell which type a patient has. We also have new ways of treating NHL, which allow us to fight the disease better than ever before.
One new technique that has helped us is called molecular profiling. To do this we take a sample of lymphoma cells from a patient and look at the genes in the cell. The genes can tell us about the type of NHL the patient has and also what is likely to happen to the cells in the future. This means we can give people the treatment that is the best one for them and their type of disease. Most importantly, it means that we can make sure people get the treatment that will give them the longest possible time without disease.
One of the most exciting ways that treatment of NHL has improved is with immunotherapy. We often give immunotherapy to patients in combination with chemotherapy, to make treatment more effective. The most common type of immunotherapy we use in NHL is called anti-CD20 monoclonal antibody treatment. This monoclonal antibody works because each dose contains millions of antibodies. The antibodies are specially designed to attach onto white blood cells, including the abnormal white blood cells that cause lymphoma. Once white blood cells have an antibody ‘tag', the patient's immune system sees them as foreign invaders and kills them. This means that treatment with an anti-CD20 monoclonal antibody is more selective than chemotherapy, destroying only white blood cells instead of all the cells in the body that are multiplying. Because of this, it does not have the same side effects as chemotherapy.
Research shows that when I give patients immunotherapy with chemotherapy, more of the patients with aggressive NHL will be cured than if they only had chemotherapy. Likewise, patients who have slow-growing, indolent NHL are likely to have a longer period of time without a relapse of the disease when treated with immunotherapy and chemotherapy together.
The future looks promising
New treatments and methods for diagnosing NHL are being developed all the time. As we learn more about NHL, the weapons we have to fight the disease can only increase.