ASH

This year's ASH (American Society of Hematology) conference will take place December 10-13 in San Diego, and the abstracts and press releases for some of the sessions have been popping up in the last couple of weeks.

The conference brings together researchers and practioners in hematology. Hematology is, of course, the study of blood diseases, and a good chunk of the ASH conference is devoted to lymphomas. It's exciting to see what goes on every year with new treatments, updates on clinical trials for treatments that have been around for a while, and other interesting research related to lymphoma, and especially (for me) to Follicular NHL.

I'll write about some of the more interesting abstracts over the next few weeks (though you're free to search the abstracts yourself on the ASH conference homepage).

The first one on my list: research that says a mini-Stem Cell Transplant may cure some Follicular NHL.

The paper is titled "Nonmyeloablative Allogeneic Stem Cell Transplantation with/ or without 90yttrium Ibritumomab Tiuxetan (90YIT) Is Curative for Relapsed Follicular Lymphoma: Median 9 Year Follow-up Results."  Here's my translation:

Researchers have been working for a while on determining if a mini-STC can be a cure for fNHL. With a Stem Cell Transplant, heavy duty chemo is given to essentially wipe out a patient's immune system. This is necessary for fNHL because the immune system is unfortunately the source of the cancer. After the heavy chemo, the body will restore the immune system in about 30 days, but this leaves the patient open to (potentially deadly) infections. To help the patient, stem cells (which will grow into blood cells) are injected back into the patient after the chemo does its job, keeping things in check until the immune system is restored. Sometimes the patient's own cells are removed and then put back (this is called an autogeneic STC); sometimes a matching donor's cells are put in (this is an autogeneic STC). There's also a variation called a mini-STC, which involves less harsh conditioning (the step that wipes out the immune system). Mini-STCs are easier on the patient, but potentially less effective.

In this study, the researchers report a follow-up on mini-allogeneic STC's. The conditioning agent was a chemo combo of Fludarabine (a faurly common chemo aget for several types of NHL), cyclophosphamide (another common chemo agent),and rituximab (or Rituxan, my old pal the monoclonal antibody). In an updated version of the trial, some patients were given Zevalin (the RadioImmuno Therapy agent) instead of Rituxan. After 10 years, the Lymphoma-free Overall Survival for the Rituxan group was 82%, and the Progression-Free Survival was 76%.  Pretty dang good for a group of fNHL patients. The group that had the Zevalin had a 2 year check up, and their OS and PFS rates were 88% and 85%, about the same as the 2 year rates for the first group.

The researchers' conclusion: "Nonmyeloablative allogeneic transplant can induce complete responses lasting over a decade in the majority of patients with relapsed follicular lymphoma. The addition 90YIT to the regimen appears to be particularly effective in relapsed refractory patients."

In other words: this might be a cure for some patients.

Not for all, so don't get excited. STCs have long been a cure for some patients. I think the significance here is that the mini-STC seems to do the job, too: much easier on the patient, and still very effective.

Just the first bit of good news from ASH -- at least the first to be reported in this blog. I'm sure it won't be the last, though.