B Cell Lymphoma: 5月 2012

2012年5月31日星期四

Under-Treatment of Lymphoma and the Risks of Relapse

The treatment of lymphoma comprises a wide variety of immunosuppressant medications as well as a series of specific cancer therapies. Patients with lymphoma are often prescribed combination treatments, receiving carefully established doses of cancer medications according to age, gender and more important, the type of lymphoma and its stage of progression. In order to maximize the potency of the treatment and reduce the risks of relapse, doctors need to take in consideration all these previously mentioned aspects when deciding upon the appropriate dose of medications.

If patients are administered lymphoma medications in the wrong dose, the treatment will either fail to accomplish its expected action (in case of under-dosage) or generate severe temporary or even permanent side-effects (in case of over-dosage). Choosing the most appropriate drugs and deciding the perfect individual dose for each patient with lymphoma is a very challenging and time-consuming task for doctors. However, if this protocol is not followed correctly, the existing treatment of lymphoma can produce a series of undesired results.

Recent medical studies have revealed that the under-treatment of lymphoma is a very common phenomenon in hospitals, clinics and other medical establishments nationwide. Under-treatment of lymphoma has been recently identified as a significant cause of relapse among lymphoma sufferers. Due to the fact that repeated treatments often fail to control the progression of lymphoma in relapsed cases, it is very important to establish the appropriate dose of medications and decide upon the right duration of the specific treatment in the first place. Although the doses of lymphoma medications can be slightly adjusted over the period of administration, under-treatment of lymphoma should be avoided at all costs.

According to oncologists, patients who suffer from aggressively progressing Non-Hodgkin's Lymphoma should receive the specific chemotherapeutic treatment in precise doses and without delay in order to prevent relapse. Although rapidly progressing Non-Hodgkin's Lymphoma is considered to a severe, life-threatening disease, the existing forms of treatment and therapies can successfully reverse the malignant effects of the lymphoma cancer on the body and slow down the progression rate of the disease.

Paradoxically, fast progressing Non-Hodgkin's Lymphoma subtypes, as well as Hodgkin's Disease are more curable than slower progressing lymphomas. The phenomenon is explained by the increased potency of existing chemotherapeutical drugs in fighting against rapidly dividing malignant cells. However, despite the high curability of these varieties of lymphoma, it is imperative to prescribe the specific course of treatment in the right doses in order to obtain the best results. If the treatment is delayed, prematurely stopped or prescribed in the wrong doses, the risks of relapse are considerably increased and the afflicted patients rarely respond to re-treatment.

Recent studies conducted in randomly chosen medical establishments nationwide have revealed very disturbing facts regarding the treatment of lymphoma patients: around 50 percent of patients with highly curable forms of lymphoma cancers receive considerable dose reductions during chemotherapy. Thus, the chances of long-term survival for this category of patients are substantially reduced, despite the curable nature of their disease. Researchers have stated that it is imperative for cancer specialists to avoid under-treatment for patients with curable forms of lymphoma and that future treatments should be optimized in order to minimize the risks of relapse.

The initially decided doses of medications shouldn't be reduced unless the patients with lymphoma are confronted with severe side-effects. According to medical researchers, less than 5 percent of all lymphoma cases actually require ulterior changes in dosage; the other 95 percent of cases should receive the specific treatment in the same dose until the disease is completely overcome.

So, if you want to find out more about cutaneous t cell lymphoma or even about cutaneous t cell lymphoma please visit this link http://www.lymphoma-center.com/

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Diagnosing and Treating Cutaneous T-cell lymphoma

Cutaneous T-cell lymphoma first affects the skin and then spreads to other parts of the body, like internal organs. The signs of the disease are itchy dark patches on the skin that progressively transform into mushroom shaped tumors, that is why the disease is also known as Mycosis Fungoides.

A particular form of the cutaneous T-cell lymphoma is the Sézary syndrome. Signs of this disease are: an overall redness of the skin, small bumpy tumors, and the skin is atrophic. At physical examination doctors see that the lymph nodes have swollen and discover an increased number of malign lymphocytes.

Cutaneous T-cell lymphoma is not the same thing with adult T-cell leukemia or peripheral T-cell lymphomas. These are more aggressive skin affections and require different treatment.

Generally, patients go to the doctor because they have an itchy red skin zone that bothers them for some time. If the disease has already spread outside the skin, the patient might feel its lymph nodes swollen.

Because mistaken cutaneous T-cell lymphoma with other skin diseases is quite easily, doctors prefer to perform a tissue biopsy, meaning that they remove the suspected tissue and analyze it in the laboratory to see if there is cancer present and in what stage of evolvement it is. For staging the disease they use that TNM classification: from T1 to T4- the spread of the tumors on the skin; N0 to N3- the involvement of the lymph nodes; M1 or not M0 if there are metastases present or not. Biopsy is the most accurate way of diagnosing cutaneous T-cell lymphoma that is why all doctors must request it when suspecting such a disease.

When studying the tissue there can be seen abnormal cells, and by performing a Southern blot analysis there will be observed changes of the gene that encodes the T-cell receptors.

The treatment will be adjusted depending on the affection's evolution. There can be used chemotherapy, ultraviolet 'A' light exposure and total skin electron beam radiation if metastases are present.

Chemotherapy tries to stop cancerous cells from growing or dividing. There can be used oral drugs or drugs injected into the vein or muscle that will reach the cancer cells by entering the bloodstream, and is called systemic chemotherapy. Another type of chemotherapy is the regional chemotherapy when the chemotherapy is placed directly into the cancerous area.

Also, a patient can participate at a clinical trial where treatment with multiple agent chemotherapy is done.

So, if you want to find out more about mantle cell lymphoma or even about non hodgkins lymphoma please visit this link http://www.lymphoma-center.com

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Lymphoma and Breast Implants

In January 2011, articles were published in major US newspapers about the association of lymphoma and breast implants. This is called anaplastic large cell lymphoma (ALCL), an extremely rare type of malignancy. Approximately 1 in 500,000 women is diagnosed with ALCL (anywhere in the body) in the United States each year. Only 3 in 100 million women per year in the US are diagnosed with ALCL in the breast. Breast ALCL has been most often identified in patients undergoing implant revision operations. There are now about 60 case reports of ALCL in women with breast implants worldwide. The total number of implants worldwide is estimated to be between 5-10 million. Based on these numbers, for women with breast implants, the estimation is that one out of 125,000 would develop breast ALCL. To put things in perspective, in the same women, the rate of breast cancer is one out of seven.

According to the FDA (Food and Drug Administration), women with breast implants may have a very small but increased risk of developing this disease in the scar capsule adjacent to the implant. Fortunately, it does not appear that this lymphoma occurs in the breast tissue itself. So far, it is not possible to identify a type of implant (silicone versus saline) or a reason for implant (breast cancer reconstruction versus aesthetic augmentation) associated with a smaller or greater risk. Currently (February 2011), the recommendations are as follows:

1) In women without any abnormal signs or symptoms, breast implants should not be removed due to fear of lymphoma.

2) No screening for lymphoma in breast implant patients who do not have symptoms. This is because reported cases of breast ALCL had manifestations of chronic fluid pocket (seroma), pain, lumps, swelling, or asymmetry. Chronic seroma is persistent and recurring, and should be distinguished from post-surgical seromas that commonly happen immediately after breast surgery. Furthermore, there is no yet identified reliable method to screen for breast ALCL in a non-invasive fashion.

3) If there is suspicion of breast ALCL, the plastic surgeon should collect fresh seroma fluid and representative portions of the capsule (scar around the implant) at the time of surgery and send for pathology tests. Diagnostic evaluation should include cytological evaluation of seroma fluid with Wright Giemsa stained smears and cell block immunohistochemistry testing for cluster of differentiation (CD) and Anaplastic Lymphoma Kinase (ALK) markers.

4) If breast ALCL is confirmed, the implant and the capsule around it should be removed. The patient should be referred to a multi-disciplinary care team with surgical, radiation and medical oncology expertise. Because this type of malignancy is so rare, there is no defined consensus treatment regimen for the population at large. Therapy should be individualized, and may include further surgery, radiation and chemotherapy.

Mai Brooks

Dr. Mai Brooks is a surgical oncologist/general surgeon, with expertise in early detection and prevention of cancer. More at http://www.drbrooksmd.com, http://thecancerexperience.wordpress.com.

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2012年5月30日星期三

What is Burkitt's Lymphoma?

Burkitt's lymphoma is a type of aggressive B-cell lymphoma. This condition is most commonly observed in young people and divided into three types:

- Endemic - this is commonly seen in children living in Africa. Usually, this type of Burkitt's lymphoma affects the facial bones such as the jaw, the intestines such as the distal ileum and cecum. Other abdominal parts such as the ovaries and kidneys can also be affected.

- Sporadic/Non-African - found outside of Africa and affects the same parts as that of the endemic variety.

- Immunodeficiency associated - this type of Burkitt's lymphoma is usually seen in HIV patients or patients taking immune-suppressive drugs,

Along with the stated associated factors, Burkitt's lymphoma is highly connected with Epstein-Barr virus and malaria. The virus creates a mutation inside the B-cells, a type of lymphocyte found in the immune system. Exposure to malaria weakens the cells' resistance to the effects of the virus, making it one of the predominant forms of Non-Hodgkin's lymphoma in African children.

Usually, swollen lymph nodes are seen in the neck area that quickly spread in other lymph nodes via lymphatic circulation. The nodes are more than 10 cm in size, and can cause obstruction and deformity. The nodes are rubbery and non-tender. Being an aggressive type of NHL, Burkitt's lymphoma can easily spread through the nervous system and can cause weakness and paralysis. Other symptoms include fatigue, loss of appetite, night sweats, unexplained fever and weight loss. Malignancies in certain body parts can compromise organ function. For example, if a lymphoma is located at the spleen, anemia can result for the capacity of the spleen to store red blood cells has been affected.

Cure of Burkitt's lymphoma usually includes chemotherapy agents such as cytoxan, oncovin, and methotrexate. Aggressive therapy often shows promising effects on children, but close monitoring of the renal system is required. This system can be damaged both by the chemotherapeutic agents and onset of tumor lysis syndrome. The main goal of treatment is to prevent to prevent the disease from spreading further into the nervous system. When proper treatment is given, survival rate 90% guaranteed. It is important to undergo treatment once Burkitt's lymphoma is confirmed for this condition gets worse rapidly and life threatening.

Need to learn more about Lymphoma? Be sure to check out Lymphoma Symptoms which contains in-depth information on Burkitt's Lymphoma symptoms, causes, treatment and much more.

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Lymphocytes And Lymphomas Classification

A disease of white blood cells called lymphocytes take to lymphoma, a complex cancer that is often confusing for patients and doctors as well. Its understanding must be completed after the good perception of the terms normal lymphocytes and lymphoma (malignant) lymphocytes and their classification.

Fighting infections, this is the thing that white blood cells, called normal lymphocytes, do. Lymphocytes are divided in B lymphocytes and T lymphocytes, each one of them with different responsibilities. When discovering an infection B cells become plasma cells and secrete antibodies which stick to the infected cells. The other white cells will eliminate the antibodies and the infected particles (also known as antigens) as soon as they recognize it.

T cells can also attack antigens, combat viruses and tumor cells, but they do not secrete antibodies like B cells, their responsibility being resumed at body immunity.

The numerous T and B lymphocytes go through the body in search of antigens to combat. The B and T cells recognize different antigens and when meeting one, lymphocytes divide rapidly and their number increases.

After dividing, the T and B lymphocytes form groups and may cause lymph nodes to enlarge.

Identical lymphocytes form a cell population. These cells, in any way they divide, slowly or rapidly, can cause lymph nodes to enlarge. Unlike normal lymphocytes, lymphoma (malignant) lymphocytes do not mature normally remaining at the stage of development.

In the last decades our questions about lymphoma were answered differently. Science could offer us irrelevant classifications of lymphoma. From 10 to 10 years approximately we receive more and more answers, more detailed and always in change. Lymphoma classification has a strong connection with lymphocyte tumors classification. The last known classification uses the lymphoma cells morphology, phenotype and genotype to determine the type of lymphoma.

The morphology means how malignant lymphocytes look under the microscope. The type of lymphoma lymphocyte can be determined only in labs and refer to unique characteristics. The genotype refers also to a unique characteristic, the DNA of the malignant lymphocytes. Only after these classification tests the diagnosis of lymphoma can be certified.

Just like lymphocytes, lymphomas are divided into two groups: Hodgkin's disease and Non-Hodgkin's Lymphoma. The first group, Hodgkin's disease, not as common as the second one, is composed of cells known as Reed-Sternberg cells, and a mixture of infected particles. This disease affects young adults, unlike the Non-Hodgkin's Lymphoma that it's often discovered at people over 60, but fortunately it's curable in most of the cases.

For more resources about lymphoma or even about lymphoma cancer please review this page http://www.lymphoma-center.com/lymphoma-cancer.htm

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Mantle Cell Lymphoma-An Indolent Or An Aggressive Disease?

Mantle cell lymphoma is a non-Hodgkin's lymphoma type of cancer and it represents affection of the lymphatic system. The lymphatic system, as part of the immune system, helps fighting against infections or foreign particles. The lymph drains through lymph vessels, a network of tubular channels, into the bloodstream and accumulates in lymphocytes. The lymphocytes or the white blood cells are divided in two groups: the B cells or the B lymphocytes and the T cells or lymphocytes, and can be located not only in the lymph nodes, but in the lymphoid tissue too.

B lymphocytes search the organism for infections or foreign bodies. When something wrong is found B cells transform into plasma cells and secrete antibodies to neutralize the infection. This is the moment when T cells get to do their job. Once neutralized by the B cells the infection or foreign body is destroyed by the T lymphocytes.

While moving through the lymphatic system, the lymph is filtered by the lymph nodes. Lymph nodes are located in various regions in our body such as neck, armpit, chest and groin and even abdomen, and have the mission to destroy antigens.

From the two categories of lymphoma that we know, mantle cell lymphoma is a non-Hodgkin's disease, being a result of weakness from the immunity system. By dividing, slowly or rapidly, the malignant cells form a numerous population that enlarges the lymph nodes. Mantle cell lymphomas symptoms are different from a case to another, and are strictly related to the stage of disease, sex and age of the patient.

MCL is a B cell lymphoma that develops in the zone of the lymph nodes and it is a form of non-Hodgkin's disease caused by the malignant B lymphocytes.

Mantle cell lymphoma is considered as being a two stage disease. In cases when lymphomas divide slowly the diagnosis is low grade disease, but in cases when the malignant cells divide rapidly the diagnosis is set as high grade lymphoma, in urgent need of proper treatment. Because of this classification of the mantle cell lymphoma, specialists have doubts about where to situate this lymphoma, along with indolent or aggressive diseases.

Mantle cell lymphoma affects especially men that are over 50. Fewer than 33% of the patients are women.

MCL symptoms are pretty much alike to the other lymphomas symptoms. The immune system is getting weaker and from this time towards, problems occur. In early stage the enlargement of lymph nodes is one of the most common symptoms just like anemia and in final stages neurological problems appear.

For more resources about lymphoma or even about non hodgkins lymphoma please review this page http://www.lymphoma-center.com/non-hodgkins-lymphoma.htm

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2012年5月29日星期二

Ocular Lymphoma - A Major Indicator of Brain Involvement in Patients with Non-Hodgkin's Lymphoma

Ocular lymphoma, also referred to as intraocular large cell lymphoma, is a subtype of Non-Hodgkin's Lymphoma that primarily affects the central nervous system. The incidence of ocular lymphoma among the global population has known a pronounced decrease since 1960, although paradoxically it has slightly increased in the last few years. Although there isn't enough evidence to support this theory, medical scientists believe that the recently increased incidence of the disease is mainly caused by prolonged treatments with immuno-suppressing drugs. However, in the absence of conclusive findings, this supposition has been disregarded by most oncologists.

Ocular lymphoma has the highest incidence among the male gender, and predominantly affects people with ages over 50. The categories considered to present the highest risk of developing this subtype of lymphoma are patients diagnosed with AIDS, patients who have suffered complicated surgeries and persons with native impairments of the immune system - especially people affected by the Wiskott-Aldrich syndrome. The implication of lymphoma at ocular level generally occurs in the incipient stages of the disease at brain level. Recent studies have revealed that in the majority of cases, ocular symptoms precede the occurrence of symptoms at the central nervous system level.

Patients diagnosed with Non-Hogkin's Lymphoma at the level of the central nervous system may either present with intracranial nodules, meningeal or periventricular lesions, retinal affections or localized spinal malignant excrescences. Ocular lymphoma generally produces symptoms such as decreased vision, and inflammation of the eye. Despite the fact that ocular lymphoma may cause serious decreases in visual acuity and pronounced inflammation, pain is a rare symptom of this variety of lymphoma. Ocular lymphoma may at first affect only one eye, affecting both eyes in later stages of disease. Although this lymphoma subtype can be overcome with the aid of existing treatments, its occurrence often announces the occurrence of serious impairments at brain level, problems that are more difficult to cure. Thus, ocular lymphoma can be considered a major indicator for Non-Hodgkin's Lymphoma at brain level, allowing doctors to timely intervene in order to minimize the development of further complications.

Patients with suspected ocular lymphoma need to go through a series of neurological investigations. The presence of symptoms such as headache, reduced vision, poor concentration, confusion or memory loss, corroborated with clinical signs of ocular lymphoma clearly point to involvement of the central nervous system in the disease. In order to slow down the progression of the lymphoma and to reduce the risks of complications, doctors often prescribe a series of medication treatments and therapies. Radiation therapy is generally recommended to patients with ocular lymphoma and in more severe cases, this form of therapy is combined with chemotherapeutic drugs.

So, if you want to find out more about non hodgkins lymphoma or even about mantle cell lymphoma please visit this link http://www.lymphoma-center.com/

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Treating Non-Hodgkin lymphoma

Until now, patients suffering of Non-Hodgkin lymphoma were treated with chemotherapy and radiation. In some of the cases the treatment was useful but in most patients treatment was very toxic and did not lead to a cure. The scientists are trying to find a better treatment that will not have such toxic effects on the organism.

Scientists have tested the "Monoclonal-antibody-based" therapy and the conclusions were promising. An antibody is a substance created by the human immune system to fight against foreign germs, viruses and bacterium. Each antibody is designed to recognize a specific target (antigen). When the antibody and the antigen get connected, the immune system is alerted and so it is ready to fight with the foreign substance.

Monoclonal antibodies are made in a laboratory and are all the same and are designed to fight only one type of foreign substance like tumors.

Until now scientists have tested antibodies created by a mouse model, a human model and chimeric (half mouse, half human) and they want to see which one is the most effective against cancer.

Most of the patients diagnosed with Non-Hodgkin lymphoma are affected by tumors made out of B-cell lymphocytes, and so, monoclonal antibodies are designed to fight these modified B-cells that create tumors.

During tests, a toxic substance designed to kill cancerous cells has been attached to the antibody in order to reach these cells. Also, radio-labeled antibodies were tested to see if they can improve the radiation therapy. The radio-labeled antibodies are nor suitable in the therapy of those who have bone marrow cancer because radiation could cause hematological toxicity.

Since tests begun the only monoclonal antibody approved to be used was Rituxan. The treatment is followed once a week, for a month and the drug is given intravenously. Rituxan does not give such unbearable side effects like radiation or chemotherapy does; its side effects are only chills, fever or shakes. The radio-labeled combination has been tested too and the anti-tumor effects are quite remarkable. The side effects seamed to be manageable.

Bexxar is another monoclonal antibody that is being tested but is not yet approved for Non-Hodgkin lymphoma. It has a radioactive iodine molecule attached to, and also binds to the surface of B-cells. Side effects are similar to those caused by Rituxan, but the patient is advised to take an oral iodine supplement in order to protect its thyroid from any damage caused by radioactive iodine. Bexxar has been tested on low-grade NHL and one third of the patients had a complete remission, and 70% responded well to the treatment.

It is possible for the patient to develop an immune response against the antibody because this is a foreign substance too, but such cases are rare and appear mostly in the patients that did not have chemotherapy and have a less affected immune system.

Oncolym is another monoclonal antibody that is being tested. Results recommend it for a more aggressive form of NHL.

Before replacing the standard treatment, monoclonal antibodies have to be tested more and secure doses must be established for preventing other damages to install in the human body.

So, if you want to find out more about lymphoma or even about cutaneous t cell lymphoma please visit this link http://www.lymphoma-center.com

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2012年5月28日星期一

All You Need To Know About Cutaneous T-Cell Lymphoma

This type of lymphoma first affects the skin and then spreads to other parts of the body. The signs of the disease are itchy dark patches on the skin that progressively transform into mushroom shaped tumors.

In this type of cancer, the white blood cells are responsible for the disease. The T-lymphocytes (T-helper cells) develop in an uncontrollable way and infiltrate into the epidermal layer of the skin, and cause lesions mostly situated in the trunk. After some time the lesions transform into palpable plaques with defined edges and then into mushroom shaped tumors. In the end, the tumor progresses into the lymph nodes and then spreads to other parts of the body. The internal organs are affected in 20-30% of the patients who have this disease.

The disease affects mostly men than women, at the age of 55 or 60; annually the new cases discovered in US are more than 500 and there are registered 100-200 deaths. The cutaneous T-cell lymphoma is considered to be a rare affection, in US, the annual incidence being of about .29 cases per 100,000 persons.

Scientist first suspected that pesticides and chemicals caused the disease, but after performing researches they believe that a virus leads to cutaneous T-cell lymphoma. This hypothesis is still not 100% confirmed.

Generally patients go to the doctor because they have an itchy red skin zone that bothers them for some time. If the disease has already spread outside the skin, the patient might feel its lymph nodes swollen.

Usually, the itchy skin patches can be easily mistaken for other skin diseases, like eczema, psoriasis, and contact dermatitis. Doctors prescribe a corticosteroid treatment and in some cases the skin lesions respond favorably to it, so the patient carries this disease a few years more until the real affection is discovered; then it is too late to treat it.

If a doctor is inspired to perform a biopsy of the affected area he might diagnose the disease earlier and treatment could be rapidly instituted. When studying the tissue there can be seen abnormal cells, and by performing a Southern blot analysis there will be observed changes of the gene that encodes the T-cell receptors. Biopsy is the most accurate way of diagnosing cutaneous T-cell lymphoma that is why all doctors must request it when suspecting such a disease.

So, if you want to find out more about symptoms of lymphoma or even about lymphoma cancer please visit this link http://www.lymphoma-center.com

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The Target Of The Treatment In Non-Hodgkin's Lymphoma

Nowadays, cancer is one of the most serious problems in medicine.Specialists try to discover new treatments. In clinics, the patients with cancer that start a new treatment are closely followed. Physicians determine the optimal dose which have the minimal side effects and offers the most numerous chances of survival. Because doctors make often adjustments, the treatment given to the patients does not always match with the treatment that studies found it to be the most effective. That's why sometimes people receiving the treatment doesn't feel very well, even if that treatment is supposed to save their life. If the patients have to get chemotherapy it is very important to respect the recommended doses and schedule, and it is also important to know the reasons why this rules are not respected.

There are a lot of cases when different types of cancer, like breast cancer or even the Non- Hodgkin's lymphoma, are not correctly treated and it is not given the appropriate supportive therapy. It was proved that if those patients were treated appropriately and the treatment guidelines were followed, they would have a good chance of survival and possible cure.

The Non- Hodgkin's lymphoma is a very aggressive type of cancer or the most common type of lymphoma. In lymphomas are affected the lymph glands and nodes that are anywhere in the body. So this kind of cancer can occur everywhere in the body. There is also a Hodgkin's disease that can often occur in younger patients. The incidence of the Non- Hodgkin's lymphoma is bigger in older patients, most frequently around age 60, but latest it can occur in younger people too. There is no explanation why this is one of the cancers that affects more and more individuals over the last 20 years.

Even if it is a very aggressive form of cancer it is very responsive in treatment and potentially curable cancer, which is a resemblance with the Hodgkin's disease. An appropriate treatment can give the patients the chance to be cured and to live a normal life. This is justified for more than half of the patients.

So it was proved that the aggressive disease is more responsive to treatment which is a kind of a paradox which can be seen in many forms of rapidly growing cancers. The cells in this cancers are rapidly dividing, but they tend to be more responsive to treatment. The scientific explanation for this phenomenon is that the chemotherapy drugs are most active against rapidly growing cells.

The whole treatment in Non- Hodgkin's lymphoma can last for about four to five months. If there is an early stage disease, the patient may get a shorter course of chemotherapy. This method must be combined with radiation therapy to the affected area. Because the cancerous cells may be anywhere in the body the biggest part of the patients with cancer needs to be treated systemically with chemotherapy. Chemotherapy is a combination of four or five drugs. The whole treatment program can run over a period of about four to five months.

Even if this form of cancer is a curable one, there are people with Non-Hodgkin's lymphoma who being under-treated.

This under- treatment means a substantial dose reductions or treatment delays during their chemotherapy. This is one of the reasons why some of this patients presents side effects and they don't get cured. It was proved in clinical trials that patients who receive the appropriate treatment do better than patients whose treatment is compromised by reducing the doses or not respecting the schedule. So the chances of long-term survival and cure are influenced by the way the treatments are being given.

There are some situations when reductions in doses of the treatment are unavoidable. This happens when there are older patients, or patients with a higher stage of disease, patients who aren't able to care for themselves. in this circumstances the treatment have to be delayed too.

The best moment to give the appropriate treatment are the early stages of the disease. Preventative care is very important. Specifically treatment to boost low white blood cell counts caused by chemotherapy, are more likely to receive the dose on time and to receive fuller dose intensity than those patients who didn't receive these agents. There many reasons,not only cancer, for which patients received these medications from the beginning.

Another cause of under- treatment is the situations when the patient doesn't tolerate the chemotherapy the way it was expected to be. So it increases the concern about side effects. There are situations when the reduction in dose of the treatment is established from the very beginning, before the patient had received any kind of treatment. This is a conscious decision of the doctor who consult the patient and gets to the conclusion that he won't tolerate the chemotherapy well. Other reductions in doses of the treatment occurs after starting therapy, because of the side effects. In this case reducing the dose is a strategy to reduce the side effects of treatment. This has negative results because it is very sure that to this patients the disease will come back months or years later.

Supportive care is very important. Older patients, patients who have more intensive symptoms from their disease or a higher stage of disease, need a type of a more aggressive supportive care. If they are supported in a right way it is also recommended to be treated the same as younger patients are. This increases their chances to be cured.When giving the supportive care it is important to analyze the risk factors. This are the patient's age that can easily lead to more side effects or in the most cases determine the physician to reduce the doses or schedule of the treatment, even before starting it. Giving the right supportive care enables the patients at a higher risk to receive the full treatment.

Supportive care helps physicians and patients with cancer to control nausea, vomiting and infections that can result because of the low white blood cell count. These are one of the most common side effects of the toxicity of the chemotherapy. Supportive care includes treatments that can improve the blood counts and also reduce the risk of infection. So if the patients seem not to tolerate the chemotherapy well, it is recommended to use the supportive care and not to modify the doses and schedule in treatment. This way the patient will be allowed to go through the full program.

There are different kinds of treatments available and it is very important for the patients recently diagnosed Non- Hodgkin's lymphoma to ask an oncologist about the side effects of those treatments and what can be done to diminish and to prevent them. It is very important for this patients to get the full treatment and to know that the target is to minimize side effects and to increase the effects of the appropriate treatment.

For more resources about lymphoma please review http://www.lymphoma-center.com/mantle-cell-lymphoma.htm or http://www.lymphoma-center.com/cutaneous-t-cell-lymphoma.htm

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Types of Lymphoma and Their Characteristics

Lymphoma refers to a form of tumor caused by the immune system, involving abnormal activity of lymphocytes, body cells that belong to the lymphatic system. Lymphocytes are born at the level of the bone marrow and their primary role inside the body is to identify antigens (foreign bodies that are malignant to the organism) and to trigger the action of the immune system, telling it to attack the discovered antigens. However, in the case of patients with lymphoma, the cells of the lymphatic system become compromised and begin to act like cancer cells. Thus, the occurrence of lymphoma is primarily determined by inappropriate activity of the lymphatic system, lymphocytes multiplying at abnormally fast rates and accumulating in different regions of the body.

There are two distinctive types of lymphatic cells involved in causing the occurrence of lymphoma: "B" lymphocytes and 'T' lymphocytes (commonly referred to as B cells and T cells). The main action of B cells is to create antibodies, a type of proteins that fight against antigens. The T cells (born at the level of the thymus gland) help the activity of the B cells, sustaining and enhancing their action.

According to the type of cells involved in causing the disease and the rate of progression, there are multiple forms of lymphoma. The main two types of lymphoma are: Hodgkin's Lymphoma (also referred to as Hodgkin's Disease) and Non-Hodgkin's Lymphoma. These two main types can be further classified in multiple subtypes. Hodgkin's Lymphoma is characterized by the implication of the so-called "double-eyed cells" in causing the disease. All other varieties of lymphoma that don't share this feature are known as Non-Hodgkin's Lymphomas. Non-Hodgkin's Lymphoma comprises over 25 subtypes, classified according to the speed of progression and the seriousness of the disease. Various subtypes of lymphoma involve genetic abnormalities that carry the name of primary mutations. Some of these mutations are responsible for triggering the disease, while others are responsible for sustaining its progression.

A very common subtype of lymphoma is follicular lymphoma. This variety of lymphoma is slow progressing and alternates between periods of remission and periods of relapse. In the majority of cases, follicular lymphoma is caused by a specific genetic mutation that affects the B lymphocytes. The mutation causes an overproduction of the BCL2 protein, a type of protein that stimulates an excessive accumulation of B cells, which begin to act like cancerous cells.

Another common subtype of Non-Hodgkin's Lymphoma is diffuse large cell lymphoma. This variety progresses faster and it can also originate from a slower progressing lymphoma subtype. Diffuse cell lymphoma requires immediate treatment; otherwise, the disease can become life-threatening in a very short amount of time. The most efficient form of treatment consists in chemotherapy. Although most patients with diffuse cell lymphoma experience relapse, a second course of strong chemotherapy is usually effective in curing relapsed cases.

Burkitt's lymphoma is a rapidly evolving lymphoma subtype that occurs due to a unique genetic anomaly. This variety of lymphoma requires immediate medical intervention and involves a poor patient life expectancy. When chemotherapy is not sufficient for treating patients with Burkitt's lymphoma, combination treatments with immunosupressants can help ameliorate its symptoms and slow its progression rate.

Unlike B-cell lymphomas, T-cell lymphomas are rare and account for about 20 percent of cases of all Non-Hodgkin's Lymphoma in general. T-cell lymphomas are rapidly progressing and often involve the body skin. Along with Hodgkin's Disease, T-cell lymphoma raises serious issues in diagnosis and treatment. This is due to the poor understanding of the causes and evolution of the disease, medical scientists lacking conclusive medical data. However, medical scientists hope to unveil the exact origins and the pattern of evolution characteristic to Non-Hodgkin's T-cell lymphoma and Hodgkin's Disease in order to develop an efficient treatment in the near future.

So, if you want to find out more about lymphoma cancer or even about symptoms of lymphoma please visit this link http://www.lymphoma-center.com

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2012年5月27日星期日

What is Mantle Cell Lymphoma?

Mantle cell lymphoma is a subtype of B-cell or B-Lymphocyte lymphoma categorized under Non-Hodgkin's lymphoma. This type of lymphoma is due to a malignant transformation of the B-cells. These B-cells are part of the immune system and responsible for destroying microorganisms that invade the body. The disease got its name for the malignant B-cells are often found in the mantle zone of the lymph node. Under morphological studies, this would present as a non-aggressive type of lymphoma. However, mantle cell lymphoma is an aggressive type of B-cell lymphoma and the malignancy can spread quickly in the body.

Mantle cell lymphoma is a rare-type of Non-Hodgkin's lymphoma. Comprising about 7% of the patients belonging in this category, it is commonly found in age groups above 60 years old. This type of lymphoma is manifested by swollen, non-tender lymph nodes located in the throat, and can involve other nodes such as the ones located near the collar bone, the armpits, chests, and groin. The malignant cells can also metastasize in the spleen and liver, giving the sensation of a full, distended abdomen. Fatigue in this condition is due to anemia because of spleen and bone marrow involvement may also be observed, as well as unexplained fever and weight loss. Gastric symptoms such as nausea and vomiting can also be observed.

Treatment for mantle cell lymphoma is given depending on the current stage of malignancy and metastasis. Rituximab is used to help the immune system look for the malignant cells and destroy them, with the help of Interferon given as an immune system booster. R-CHOP in combination with Rituximab and a steroid is commonly given as a form of chemotherapy that aims in destroying the cancer cells. In Stage I and Stage II phase it is treated with a local radiation therapy with or without the aid of chemotherapeutic agents. To help the body recover, stem cell therapy such as bone marrow transplant is done as an aggressive form of treatment when the disease is at the later stage.

Research is still being conducted on ways to treat mantle cell lymphoma without suffering from too much side effects. The MCL Consortium is a group of physicians dedicated to battling this disease. Their website has mantle cell lymphoma resources for researchers and patients designed to help people understand this malignancy as well as group together patients and survivors to form a support group.

Need to learn more about Lymphoma? Be sure to check out Lymphoma Symptoms which contains in-depth information on Mantle Cell Lymphoma symptoms, causes, treatment and much more.

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What is Cutaneous Lymphoma?

Cutaneous lymphoma is a type of Non-Hodgkin's lymphoma involving the lymphocytes within the skin, specifically T-cells and B-Cells. This is a rare type of Non-Hodgkin's lymphoma where the tumor growths are seen mostly as numerous lumps beneath the skin's surface and not in just a lymph node.

The lumps formed beneath the skin cutaneous lymphoma are due to a collection of the malignant cells in the skin. In an attempt to purge the system of the mutated cells, the body pushes the clustered malignant cells towards the surface of the skin. The most common type of cutaneous lymphoma is the cutaneous T-cell lymphoma. The disease manifests itself in several stages:

* Pre-tumor stage - the skin is presented with raised, red patches that appear on the breasts or buttocks and somewhat mimics the appearance of other skin conditions such as eczema or psoriasis.

* Plaque stage - the patches are now irregularly shaped and can appear anywhere in the body. Hair loss in the affected skin area is also noted, and can be permanent if the condition is not treated.

* Tumor stage - the incidence of people progressing to this stag is quite small. The plaques can now form lumps and even ulcerate. Lymph nodes are also affected. The liver, lungs, and spleen is also at risk of being affected by the cutaneous lymphoma, but the cases are quite rare.

* Sezary syndrome - this is when the malignancy has spread and covers a large skin area. The malignant cells have also metastasized in the blood stream. Some patients have no plaques or tumors, but the entire integumentary system may be swollen, red and sore (l'homme rouge). The skin can also manifest desquamation or peeling off of skin.

Cutaneous lymphoma of T-cell origin is treated through a specific or a combination of treatment modalities that can range from topical or local to systemic. PUVA treatment is a combination of psoralen and UVA. After taking psoralen, the patient enters an enclosed room where rays of UVA is applied on the skin. However, extra care must be given for it is known that exposure to UV rays can predispose a person to skin cancer. Radiation therapy and chemotherapy is also done to help cure cutaneous lymphoma.

Cutaneous lymphoma can be hard to deal with for it can cause some severe changes in your appearance. A support group can help you combat the disease both in its physical and psychological aspects. Talk to your friends and family during hard times, and ask your doctor to refer you to a cancer support group to help you understand and cope with the effects of cutaneous lymphoma.

Need to learn more about Lymphoma? Be sure to check out Lymphoma Symptoms which contains in-depth information on Cutaneous Lymphoma, symptoms, causes, treatment and much more.

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2012年5月26日星期六

General Things About Mantle Cell Lymphoma

Lymphoma is a type of cancer that affects the lymph nodes and is known as cancer of the lymphoid tissue. We know two categories of lymphomas: Hodgkin's lymphoma and non-Hodgkin's lymphoma.

We are going to talk about a rare type of non-Hodgkin's lymphoma, mantle cell lymphoma. This type of cancer can be defined as an enlargement of the population of malignant lymphoid cells, happening in the area of the lymph nodes and tissues. These cells have an unusual structure being considered as mutant cells because of their lack of development. Maturing improperly these cells become cancerous.

The lymphatic system helps the body to fight against infections or foreign particles. When the white cells are mature they seek for infections through the body. There are two types of white cells in the lymphatic system, the B cells and the T cells. Once an infection is found by the B cells, the second type of white cells, the T ones come to destroy it. This is how the immune system works.

Lymphomas are cancerous cells from the lymphatic system. The non-Hodgkin's lymphomas that occur in the lymphatic system include follicular lymphomas, Burkitt's lymphomas which are non-cleaved lymphomas, MALT lymphomas which are lymphomas from the marginal sides of the tissues, small and large cell lymphomas, and the subject of discussion, the mantle cell lymphomas (MCL).

The classification of the mantle cell lymphomas separates them into three categories: mantle zone type MCL cells, nodular type and immature (blastic) type. Diagnoses, in most of the cases, refer to mixed mantle or nodular type MCL.

The mantle cell lymphoma is a great concern, many specialists debating over this subject. Some consider it intermediate while others say that mantle cell lymphoma is a low-grade cancer because of its slow development. Both of these sides come with arguments based on studies and both sides are right. Patients suffering of blastic type MCL have less chances of survival comparing to the other MCL patients, because in these cases cancer spreads faster.

Persons suffering of mantle cell lymphoma are rarely under 50 and women represent a little more than a quarter in the patients number.

It's not easy to say if a patient suffers of mantle cell lymphoma. Some believe that an immunologic test is required for a correct diagnosis.

Treatment is prescript by specialists, because each case is unique and is related to many factors like age, sex and especially stage of disease.

For more resources about lymphoma or even about mantle cell lymphoma please review this page http://www.lymphoma-center.com/mantle-cell-lymphoma.htm

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Treatment Options for Mantle Cell Lymphoma

A rare form of the Non-Hodgkin disease is the Mantle cell lymphoma. This disease is quite dangerous because its tumor grows very fast and ends up affecting most of the organs.

Generally, people are diagnosed with mantle cell lymphoma only when the disease has affected more organs and so, treating them is a little bit difficult because several areas of the body must be treated in the same time. The most indicated treatment in this case is chemotherapy.

Chemotherapy tries to stop cancerous cells from growing or dividing. There can be used oral drugs or drugs injected into the vein or muscle that will reach the cancer cells by entering the bloodstream, and is called systemic chemotherapy. In mantle cell lymphoma doctors use a combination of four drugs administered in a single day and then repeated every 3 weeks for 6 times.

In most of the cases, mantle cell lymphoma therapy is not useful and even if the response to the treatment seemed to be good, the disease comes back very often. In preventing this, doctors have used different drug combinations and the most successful was one treatment used in leukemia too. This treatment is unbearable for many of the patients due to its side effects, and doctors will not recommend this drug combination if they feel that the patient will not tolerate the treatment.

In most cases, after chemotherapy is done, stem cells previously taken from the patient's blood or bone marrow or from a donor will be thawed and replaced through an infusion, in order to restore the body's blood cells destroyed by the chemotherapy.

Biological therapy has proved to be useful in treating many forms of lymphoma, and it uses monoclonal antibodies. These antibodies are made from an immune system cell and are designed to seek and destroy all the substances that can help cancer cells to grow and develop. One of the monoclonal antibodies used in treating Non-Hodgkin lymphoma is Rituximab. This antibody could be used in treating mantle cell lymphoma too.

There have been developed some new drugs but they are still under tests in clinical trials. Bortezomib is one of them and using it seems to lead to the death of cancer cells.

Using radiation therapy proved to be inefficient because it did not lead to a remarkably extinction of the cancer cells and it only weakened the human organism.

Until now there is no cure for this disease and no certain effective treatment. In order to discover a useful therapy, doctors will encourage you to join a clinical trial and help them improve the medical treatment of this terrible disease.

So, if you want to find out more about cutaneous t cell lymphoma or even about cutaneous t cell lymphoma please visit this link http://www.lymphoma-center.com/

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Hodgkin's Lymphoma Vs Non-Hodgkin's Lymphoma

My introduction to lymphoma came one, quiet July afternoon in 2008 as I was sitting at my desk at work. My husband called. He had been feeling poorly for the last couple of weeks while we were on vacation and had just been to see the doctor.

"The doctor said I've got one of three things," he calmly reported. "But the only one I can remember is lymphoma." He went on to say that he was calling from a hospital bed where he had a few things stuck in and on him. (Before I lost control of my thoughts, I was reminded of an incident two years earlier. Then, my husband had left me a voice mail. The message went something like this: "My appendix burst. I'm in the hospital. You can stop by if you want to.")

Our life plummeted into the realm of conscious uncertainty. Non-medical people, we searched all over the Internet, talked to family, friends, friends of friends, doctors, etc., to find out everything we could about this kind of cancer.

Soon enough, we were reminded of the danger of Internet searches. There is almost too much information -- a lot of it is downright scary and some of it is ultimately inaccurate. Even without really understanding my husband's current condition, we were already contemplating the worst possible outcome.

Types of Lymphoma

There are two main types of lymphoma -- Hodgkin's Lymphoma (also called Hodgkin's Disease) and Non-Hodgkin's Lymphoma. Both types develop in the lymphocytes, white blood cells that are an important part of the body's immune system. The two types have similarities, but there are definite distinctions.

Lymphocytes have two main cell types: B cells or T cells. With lymphoma, either the B cell or the T cell becomes abnormal; the first abnormal cell quickly divides and then subsequent abnormal cells divide, encroaching upon and destroying other lymphatic cells. And, while lymphoma originates in the body's lymphatic system, Hodgkin's Lymphoma and Non-Hodgkin's Lymphoma can spread to bone marrow and other organs such as the liver and spleen.

Symptoms and Signs

My spouse had been complaining about aching, swollen lumps in his neck. He had also been having night sweats and fever. These are typical symptoms for both Hodgkin's Lymphoma and Non-Hodgkin's Lymphoma. Other symptoms include breathing problems, fatigue, itching, unexplained weight loss, and swollen lumps in the armpits and/or groin.

The doctors told us it was not uncommon for either type of cancer to appear in adults in their 50's, but, typically, Hodgkin's Lymphoma appears in children and young adults. In contrast, the risk for developing Non-Hodgkin's Lymphoma increases with age and typically appears between the ages of 40 and 70.

My husband, a seemingly healthy man who watched his diet and regularly exercised, was in his early 50's.

Diagnosis

After several tests, there was little doubt that my husband had lymphoma, but in order to treat it, the doctors needed to know exactly what type it was.

There are several diagnostic techniques used, either alone or in combination, to make the diagnosis between Hodgkin's Lymphoma and Non-Hodgkin's Lymphoma. These include blood tests, thorough physical examinations, biopsies of bone marrow, and chest x-rays. The definitive test, however, is the tissue biopsy of part or all of an affected lymph node.

The hospital did a biopsy of one of the lumps on his neck on a Friday. The results would not be available until early the next week. So, it was back to the Internet to see what else we could learn and worry about. Meanwhile, my spouse was suffering and more painful lumps were fast appearing. Overwhelmed with both too much general and too little specific information, we waited for news from the lab.

Under the microscope, the presence of an abnormal B cell called the Reed-Sternberg cell, a particular kind of lymphocyte, indicates Hodgkin's Lymphoma. Diagnosis is not as easy for Non-Hodgkin's Lymphoma; there are over 30 different types of Non-Hodgkin's Lymphoma which include various types of cells and cell markers.

Finally, on Monday, we learned we were dealing with Anaplastic T cell Non-Hodgkin's Lymphoma. At last, we knew the enemy.

Treatment

Now that we knew the type of cancer, we had all the usual questions about treatment. Chemo? Radiation? How long? How much?

Like all cancers, lymphoma is characterized by stages which define the extent or severity of the cancer, and treatment differs depending on the cell type and stage. Treatment for Hodgkin's Lymphoma can include radiotherapy, chemotherapy or a combination of the two. Stem cell or blood marrow transplantation can be recommended in more severe cases. Non-Hodgkin's Lymphoma is typically treated with chemotherapy; on rare occasions, radiation alone or in combination with chemotherapy is utilized.

The type and severity of lymphoma determine the response to any particular treatment. Other treatments for lymphoma can include radioimmunotherapy or immunotherapy alone; surgery is rarely a treatment option.

In my spouse's case, he had Stage III (of I to IV with IV being the most severe) of an aggressive type of Non-Hodgkin's Lymphoma. That meant hitting him hard and fast with chemotherapy. They began it almost immediately. The first treatment was excruciating and weakened him, but it provided great results. After a week, he was released with a treatment plan that included five additional chemotherapy sessions.

As we left the hospital, I remember watching my husband - stooped over, thinner by 30-some pounds, frail and weak - as he carefully got into the car in the parking lot. I wondered whether he would ever return to his vibrant, irreverent self.

Statistics for New Cases and Deaths

In 2008, my spouse was one of the estimated 74,340 people to be diagnosed with lymphoma. In that same year, it was estimated that 20,150 people with lymphoma would die. Staggering statistics that we couldn't seem to comprehend at the time.

The American Cancer Society's Facts & Figures 2010 lists the expected new cases and estimated deaths for men and women in the U.S. for 2010 for lymphoma as follows:

Estimated New Cancers (2010)

Hodgkin's Lymphoma - 8,490
Non-Hodgkin's Lymphoma - 65,540

Estimated Cancer Deaths (2010)

Hodgkin's Lymphoma - 1,320
Non-Hodgkin's Lymphoma - 20,210

Prognosis

According to the American Cancer Society, the 5-year survival rate for Hodgkin's Lymphoma is 85%; the 10-year survival rate is 81%. It is much tougher to pin down survival rates for Non-Hodgkin's Lymphoma. Prognosis varies depending on the type of Non-Hodgkin's Lymphoma, as well as other factors including the stage, the cell type, blood counts, other medical problems, etc.

Since his last chemotherapy treatment in November 2008, my husband's periodic scans have been clean and his prognosis is excellent. He's back to his old self, with only two visible scars (one from the biopsy and the other marking the location of the port used to administer chemotherapy), the scans, and doctor's appointments to remind us that life is tenuous.

While I continue to scour information about both types of lymphoma, my husband rarely, if ever, speaks about it, although he is conscientious about his scans. Looking back, the most angst-filled time during the entire ordeal was while we were waiting for the final diagnosis. After all, looking at the facts and figures, it would seem Hodgkin's Lymphoma might be the 'preferred' disease, but it was not that simple. It was never necessarily that we thought one type of lymphoma was more 'optimistic' than the other; we just desperately needed to know for treatment purposes. Besides, I believe there are too many other factors involved in survival, i.e., the severity, the treatment, response to treatment, etc., that overshadow any mere numbers linked to a particular type of disease. In fact, I honestly believe the most important factor is the patient's attitude.

In my husband's case, he just had lymphoma - didn't matter which to him. He just wanted to put it behind him. He went back to work as soon as he could and worked around his chemotherapy, taking little time off. He did not let cancer stop him, he did not let it define him and, unless he told you, you would never know.

Linda R. Prior is a freelance writer with over 25 years of writing experience. Find her at http://www.lindarprior.com.

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DNA analysis (i.e., molecular genetics) can be used in evaluating lung cancer, and can reliably separate lung tumors into their morphologic categories of squamous, large cell, small cell, and adenocarcinoma. Gene expression profiling (GEP) may have even more utility in the assessment of patients with non-small cell lung cancers (NSCLCs) and similar histology.

Several investigators have attempted to subclassify these tumors by correlating GEP patterns with clinicopathologic variables.

A series that included 41 lung adenocarcinomas identified three prognostically separate subgroups. The genes involved in this classification included thyroid transcription factor, hepsin, cathepsin L, vascular endothelial growth factor C (VEGF-C), and the intercellular adhesion molecule-1 (ICAM-1).

In another report of 139 lung adenocarcinomas defined four distinct subclasses. Tumors expressing neuroendocrine-type genes had a significantly less favorable survival than those lacking such characteristics. The genes that defined the neuroendocrine cluster adenocarcinomas included dopa decarboxylase, achaete-scute homolog 1, and the serine protease kallikrein 11.

Others used GEP to predict outcome from surgery in 67 patients with resected stage I adenocarcinoma. A specific group of genes distinguished high-risk from lower risk groups, with significantly different survival. Among the 50 genes comprising the risk index were erbB2, VEGF, S100P, cytokeratin 7 and 18, and fas-associated death domain protein.

In another series of 125 patients from Taiwan with surgically resected NSCLC, 16 genes were identified that correlated with increased or decreased survival. Further RT-PCR validation assay confirmed the microarray findings and showed that survival was significantly associated with five of the 16 genes (DUSP6, MMD, STAT1, ERBB3, and LCK). The five-gene signature was further validated in microarray data from patients of Western population and was an independent predictor of recurrence and overall survival for patients with surgical resection of NSCLC without any adjuvant therapy. This GEP profile is being used to select high risk patients for adjuvant chemotherapy in prospective clinical trials.

Lymphoma - Gene expression profiling (GEP) by means of DNA microarrays is an evolving approach to classification, diagnosis, and prognostication of Non-Hodgkin's Lymphoma (NHL).

As an example, diffuse large B-cell lymphoma (DLBCL) is a clinically heterogeneous disease in which approximately 40 percent of patients with advanced stage disease respond well to combination chemotherapy and are long-term survivors. Using GEP, DLBCL has been subclassified into three distinct molecular subgroups, germinal center B-cell-like (GCB), activated B-cell-like (ABC), and other (type 3), that appear to be derived from different stages of B-cell differentiation, utilize different oncogenic mechanisms, and differ clinically in their ability to be cured by multiagent chemotherapy.

Patients whose tumors express genes characteristic of germinal center B cells (GCB) have a significantly better outcome from chemotherapy than those whose gene expression is more typical of activated B cells (ABC). In one series for example, a clustering algorithm applied to 58 patients with DLBCL receiving cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) chemotherapy separated patients into two groups with very different five-year overall survival rates (70 versus 12 percent).

Although most of the early studies used fresh frozen tissue sections, similar results have been reported with GEP performed on formalin-fixed, paraffin-embedded material. No formal head-to-head comparisons of GEP from fresh versus archived materials have yet been performed.

GEP has also been used to develop a more precise molecular diagnosis of primary mediastinal B-cell lymphoma, a clinically unfavorable entity that cannot be reliably distinguished from other types of diffuse large B-cell lymphoma. These tumors do poorly with CHOP chemotherapy alone and may need more aggressive therapy than used for standard DLBCL.

Finally, GEP has the potential to reveal new therapeutic molecular targets. As an example, the ABC subtype of DLBCL is characterized by constitutive activation of the nuclear factor kappaB (NF-kappaB) signaling pathway; interference with this pathway selectively kills these lymphoma cells. The ubiquitin-proteasomal pathway and the NF-kappaB axis are intimately involved in the control of apoptosis. Inhibitors of this pathway (eg, proteasome inhibitors) can induce apoptosis in human leukemia cells that ectopically express the antiapoptotic protein Bcl-2. One such agent, the synthetic dipeptide boronic acid bortezomib, is a potent promoter of apoptosis in several human tumor cell types.

Summary - The rapidly evolving field of DNA microarray analysis and gene expression profiling has wide-ranging implications for the molecular classification of tumors, refinement of prognostic estimates, and prediction of response to therapy. Despite its exciting potential and significant recent advances, this field remains relatively new, and it is premature to conclude that microarray data can be used as a sole means of classifying cancers or predicting outcomes of treatment.

Among the specific challenges that must be met are the need for larger studies with appropriate validation, standardization of methods and establishment of guidelines for the conduct and reporting of studies, and the formation of repositories and registries where research institutions may deposit data for comparison with independent works involving the same malignant disorder. Finally, DNA microarray-based tests must demonstrate utility in prospectively designed clinical trials before this technology is considered a routine part of clinical evaluation. These studies may eventually establish a new treatment paradigm in personalized cancer therapy in the future.

Dr. Richard Graydon, http://www.medauthor.com, trained as an Oncologist, holding both M.D. and PhD degrees, andspecializes in molecular genetics and cancer research. His education and experience have provided him analytical and clinical skills for keen insight into diagnosis, treatment, and care of cancer patients. See http://www.medauthor.com for further information

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B Cell Lymphoma

2012年5月31日星期四

Under-Treatment of Lymphoma and the Risks of Relapse

Diagnosing and Treating Cutaneous T-cell lymphoma

Lymphoma and Breast Implants

2012年5月30日星期三

What is Burkitt's Lymphoma?

Lymphocytes And Lymphomas Classification

Mantle Cell Lymphoma-An Indolent Or An Aggressive Disease?

2012年5月29日星期二

Ocular Lymphoma - A Major Indicator of Brain Involvement in Patients with Non-Hodgkin's Lymphoma

Treating Non-Hodgkin lymphoma

2012年5月28日星期一

All You Need To Know About Cutaneous T-Cell Lymphoma

The Target Of The Treatment In Non-Hodgkin's Lymphoma

Types of Lymphoma and Their Characteristics

2012年5月27日星期日

What is Mantle Cell Lymphoma?

What is Cutaneous Lymphoma?

2012年5月26日星期六

General Things About Mantle Cell Lymphoma

Treatment Options for Mantle Cell Lymphoma

Hodgkin's Lymphoma Vs Non-Hodgkin's Lymphoma

2012年5月25日星期五

What You Need to Know About Lymphoma

Mantle Cell Lymphoma Prognosis - Is There a New Cure?

Monoclonal Antibody - Alternatives for Treating Non-Hodgkin's Lymphoma

2012年5月24日星期四

Cutaneous T-cell Lymphoma Facts Revealed

Characteristics of Hodgkin's Lymphoma

2012年5月23日星期三

Hodgkin's Lymphoma, The White Cell Cancer

Non-Hodgkin's Lymphoma - What Increases Your Risk?

What are the Symptoms of Lymphoma?

2012年5月22日星期二

Lung Cancer and Lymphoma - DNA Analysis and Molecular Genetics

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