Blood clots: What cancer patients need to know
Could You Be A Candidate For CAR T-Cell Therapy?
In 2017, the FDA approved a cutting-edge treatment for diffuse large B-cell lymphoma (DLBCL), the most common type of lymphoma. It's called chimeric antigen receptor T-cell therapy, or CAR T-cell therapy for short. It has been approved for people who have not been helped by other treatments for DLBCL. Could you be a candidate to receive this treatment? Let's take a look.
What Is CAR T-Cell Therapy?CAR T-cell therapy is an immunotherapy. That's a type of treatment that uses your body's immune system to fight your cancer. When you have this treatment, doctors remove white blood cells called T cells from your body. Scientists then alter the genes inside those T cells in order to transform them into cancer killers. When they return these cells to your body, they attack your cancer.
Why Might I Need CAR T-Cell Therapy?DLBCL is a potentially curable type of cancer. The standard treatment involves a combination of monoclonal antibody therapy and chemotherapy. About 60% of people with DLBCL do very well on this treatment. Some are considered cured. But 40% of patients will require some other form of treatment.
This second treatment often includes more chemotherapy. If your cancer responds to chemo, your doctor may combine that with a stem cell transplant (also called a bone marrow transplant) if you are healthy enough to tolerate the potential side effects of that treatment.
This second round of treatment also may fail to cure DLBCL. About half of those who have a transplant, for example, live an average of just 10 months after the procedure. That's where CAR T-cell therapy comes in.
Am I Eligible for CAR T-Cell Therapy?If you've already tried at least one or two kinds of treatment and you fall into one of the following two categories, you may be eligible to have CAR T-cell therapy:
You also must be healthy enough to have this treatment.
When Can I Get CAR T-Cell Therapy?The CAR T-cell therapies axicabtagene ciloleucel (Yescarta) and lisocabtagene maraleucel (Breyanzi) are sometimes used as a second-line treatment after a single round of chemotherapy or as a third-line treatment. You might get tisagenlecleucel (Kymriah) as a third-line treatment. In recent studies including people with aggressive B-cell lymphoma, those who received CAR T-cell therapy after just one round of chemotherapy lived longer without their lymphoma getting worse than those who received the standard treatment.
There are other benefits of CAR T-cell therapy as a second-line treatment. The treatment time is shorter, and with fewer aggressive chemotherapy treatments, recovery is also shorter and may be somewhat easier for some people.
What Can I Expect From CAR T-Cell Therapy?CAR T-cell therapy can be very effective. Some studies have shown that as many as 60% of people had a complete response to treatment. That means that after treatment, they had no signs of cancer. But about 60% of those who had benefited from CAR T-cell therapy at first saw their cancer return and progress after an average of 6 months.
Right now, experts don't know why some people do better than others on CAR T-cell therapy. That's a question they are working to solve in order to better determine who will benefit from this treatment.
In a 2021 study, for example, researchers found that the cancer cells in some lymphoma patients had transformed themselves from one type of cancer cell into another. That may have allowed them to avoid being targeted by the CAR T cells. Further research may allow scientists to overcome this hurdle and offer a treatment that's effective for more people with DLBCL.
Do I Need to Be Healthy Enough for CAR T-Cell Therapy?The side effects of CAR T-cell therapy can be serious and even life-threatening. The treatment will make your immune system less able to fight off infections. For this reason, your doctor may want you to be in good general health aside from your cancer to consider it as a treatment for you.
You may need to stay in the hospital for 1 to 2 weeks after treatment. For 30 days after treatment, you must remain within 2 hours of the hospital so that you can get there quickly if necessary. Also, you must have a caregiver with you at all times – 24 hours a day, 7 days a week – in order to watch you and arrange care if you become ill. Here are the most common side effects:
Cytokine release syndrome (CRS). CAR T cells trigger a buildup of cytokines, chemicals that help your immune system fight disease. This buildup can cause fevers, nausea, and other flu-like symptoms. But CRS also can be life-threatening. It can cause abnormal heartbeat (arrhythmia), cardiac arrest, organ failure, and other side effects that require intensive care right away.
Neurologic toxicities. This means that your treatment may impair your nervous system. Usually this is temporary or treatable. You may have speech problems, confusion, tremors, delirium, hallucinations, seizures, and loss of balance.
CAR T-cell therapy also can cause potentially severe allergic reactions (anaphylaxis). It may weaken your immune system and lower your blood cell counts, both of which increase your risk of infection.
How Can I Take Part in a Clinical Trial?A clinical trial can give you access to the latest, potentially lifesaving treatments and expert medical care before it's approved for the public. Clinical trials also help advance science and medicine. They do this by enlisting volunteers in studies that aim to determine whether a treatment in development is safe and effective.
In the United States right now, there are many ongoing or planned clinical trials focused on CAR T-cell therapy for DLBCL. Visit clinicaltrials.Gov to find a trial in your area.
Everything To Know About Hodgkin's Lymphoma
Hodgkin's lymphoma is a type of cancer that affects the lymphatic system, including the lymph nodes. The cancer typically spreads from one lymph node to a neighboring one.
People with Hodgkin's lymphoma have Reed-Sternberg cells. These are abnormally large B lymphocytes that often have more than one nucleus. Doctors can identify these cells in lymph fluid under a microscope.
With treatment, Hodgkin's lymphoma has a high cure and survival rate.
This article looks at Hodgkin's lymphoma, including its symptoms, causes, treatment options, and outlook.
Not everyone with Hodgkin's lymphoma has symptoms. However, some people may experience signs that could point to this condition.
Swollen lymph nodesThe NHS states that the most common symptom of Hodgkin's lymphoma is a swollen lymph node under the skin. This often appears as a lump in the neck, armpit, or groin.
The lump may not hurt all the time, but it might hurt more after a person has drunk alcohol. This is possibly due to increased blood flow, nerve sensitivity, chemical reactions, or immune responses, though the exact reason for this remains unclear.
However, a swollen lymph node does not necessarily mean a person has cancer since lymph nodes often swell when the body is tackling an infection.
If the swollen lymph node hurts when a person touches it, it could be due to an infection. If this is the reason for the swelling, it will go down when the infection has healed.
However, when a lymph node swells for no apparent reason, and the swelling remains, it could indicate cancer.
Learn more about other causes of swollen lymph nodes.
Additional symptomsSometimes, swollen lymph nodes occur with other symptoms, such as coughing or difficulty breathing. This is because a swollen lymph node puts pressure on the chest.
Other symptoms some people may experience include:
Learn more about swollen lymph nodes in the chest.
Anyone can develop Hodgkin's lymphoma, which occurs when healthy cells divide and grow uncontrollably.
However, some factors can increase the risk of this condition, including:
Learn more here about EBV testing.
There is no known effective strategy for preventing Hodgkin's lymphoma or EBV, which increases the likelihood of developing this type of cancer.
Infection with HIV can increase a person's risk of Hodgkin's lymphoma. Ways to lower the risk of HIV include limiting intravenous drug use and avoiding sex without a condom or other barrier contraceptive.
Learn more here about the causes of HIV.
There are several factors doctors look at when staging Hodgkin's lymphoma:
Learn more about the four stages of lymphoma.
Bulky diseasePeople with bulky disease have stage 2 or higher cancer. They have tumors that are larger than 4 inches anywhere in the body or a tumor that is at least one-third as wide as the chest.
Doctors usually add an "X" to the stage to indicate bulky disease.
In lymphoma, bulky disease may mean a person requires more treatment.
A vs. BIn addition to a number, stages of cancer may also appear written with an "A" or "B."
A person may have B stage cancer if they experience:
If these symptoms are not present, the person has A-stage cancer.
TerminologyA person may hear a doctor use the following terms when discussing Hodgkin's lymphoma:
Learn more about recurrent lymphoma.
There are two major types of Hodgkin's lymphoma:
CHLAt least 90% of Hodgkin's lymphoma cases are CHL. This type of cancer occurs when B lymphocytes develop into a type of cancer called Reed-Sternberg cells.
There are four subtypes of CHL:
Learn more about Hodgkin's lymphoma in children.
Nodular lymphocyte predominant Hodgkin's lymphomaAbout 5% of Hodgkin's lymphoma cases are nodular lymphocyte predominant Hodgkin's lymphoma (NLPHL). This type of the condition causes a form of Reed-Sternberg cells called "popcorn" cells.
This slow-growing cancer often begins in the armpit and neck.
People of all ages can develop NLPHL. However, it is more common in males than in females.
Both Hodgkin's and non-Hodgkin's lymphoma affect the lymphatic system.
The main difference between these two types of cancer is that people with non-Hodgkin's lymphoma do not have Reed-Sternberg cells.
Non-Hodgkin's lymphoma is also more common than Hodgkin's lymphoma.
Learn more about Hodgkin's vs. Non-Hodgkin's lymphoma.
The 5-year survival rate for all stages of Hodgkin's lymphoma is 89%.
Survival rate refers to the number of people still alive for a specific after a particular diagnosis.
For example, a 5-year survival rate of 50% of people means that half of the people are still alive at least 5 years after diagnosis.
It is important to remember that these figures are estimates and are based on previous medical studies. Talk with your doctor about the outlook for your specific condition.
According to the NHS, most people who have survived 5 years with Hodgkin's lymphoma will recover.
However, many factors can affect a person's outlook and the intensity of the treatment they need, including:
Access to quality, evidence-based treatment could also affect a person's outlook.
Moreover, some people relapse after going into remission or do not respond to initial treatment. Data suggest about 30% of people with this type of cancer experience a relapse.
Learn more about the survival rates for Hodgkin's and non-Hodgkin's lymphoma.
A doctor may suspect lymphoma when a person has unexplained swollen lymph nodes.
A biopsy of the lymph node can test for cancer cells.
Typically, a doctor will cut out the entire lymph node for testing. They may also insert a needle into the lymph node and remove some fluid.
If a doctor diagnoses someone with a lymphoma, they may recommend a bone marrow biopsy. This procedure involves inserting a needle into the bone to see whether the cancer has spread to the bone marrow.
Learn more here about bone marrow cancer.
Hodgkin's lymphoma can spread quickly throughout the body. However, it is one of the most treatable types of cancer.
Treatment will depend on disease staging and other risk factors. For example, people with bulky advanced stage CHL do not respond well to radiation, so a doctor may advise against it.
In general, treatment options include:
Learn more about Hodgkin's lymphoma and treatment options.
What is the survival rate of Hodgkin's lymphoma?The 5-year survival rate for all stages of Hodgkin's lymphoma is 89%.
What are the first signs of Hodgkin's lymphoma?Typically, the first sign of Hodgkin's lymphoma is a swelling in the neck, armpit, or groin. Other symptoms include night sweats, fever, and a persistent cough.
How curable is Hodgkin's lymphoma?Hodgkin's lymphoma is one of the most easily treated types of cancer. Most people who have survived 5 years with Hodgkin's lymphoma will likely be cured.
Is Hodgkin's lymphoma a serious cancer?Hodgkin's lymphoma is a relatively aggressive cancer and can spread quickly through the body. It is a serious cancer but is also one of the most easily treated types of cancer.
Hodgkin's lymphoma is a type of cancer that affects the lymphatic system. It has a high remission rate, and most people with this condition survive.
Survival rates are best in people who receive an early diagnosis. Therefore, it is important to contact a doctor as soon as possible for any unexplained changes in a lymph node or other symptoms of infection or illness.
Understanding Lymphocyte Levels In Lymphoma: Uses And Significance
Doctors monitor lymphocyte and other blood cell levels to predict how your lymphoma will progress. Low lymphocyte counts may suggest that cancer has spread to your bone marrow, or it can be a side effect of treatments.
Lymphoma is a group of cancers that develop in your lymphocytes. These white blood cells are found inside your lymph nodes and other parts of your lymph system. Cancerous lymphocytes replicate uncontrollably and can crowd out healthy blood cells.
Doctors don't use the results of blood tests to diagnose lymphoma, but they can use them to:
Read on to learn more about the role that lymphocyte monitoring plays in diagnosing and treating lymphoma.
Blood tests aren't used to diagnose lymphoma, but they're important for monitoring your disease. You'll likely receive blood tests throughout your diagnosis and during your treatment to assess your:
People with lymphoma have high levels of abnormal lymphocytes that replicate quickly. These abnormal cells don't function properly and can crowd out healthy lymphocytes and other blood cells.
Lower blood cell counts are responsible for many of the characteristic symptoms of lymphoma such as easy bruising and fatigue.
A higher-than-normal level of lymphocytes in your blood suggests you may have blood cancer, but it can also be a sign of some other conditions such as an active infection.
The normal range of lymphocytes can vary between laboratories since laboratories may have different ways to measure your sample. Here's a general idea of what's considered a higher or lower lymphocyte count than average.
Young children typically have higher lymphocyte counts than adults. A doctor may consider your child's lymphocyte count low if it's fewer than 2,000/μL.
When examining your blood cell counts, doctors also often look at the breakdown of your total white blood cell count. This test is called a white cell differential test, and it's often ordered as part of a complete blood count.
The typical percentages in a normal blood sample are:
Lymphocytes and other blood cells are produced in stem cells in your bone marrow. A low lymphocyte count is generally associated with a less favorable outlook since lymphocytes help your body monitor and destroy cancer cells.
In a 2019 study, low lymphocyte count trended toward worse survival in people with aggressive non-Hodgkin's lymphoma but didn't reach statistical significance (meaning the association between low lymphocyte counts and poorer survival rates could be attributed to chance or other random factors).
Researchers in this study reported the following survival rates:
Low blood cell counts can suggest that the cancer has spread to your bone marrow. Special stem cells in your bone marrow produce new blood cells.
Low blood cell counts can also be a side effect of some lymphoma treatments such as chemotherapy. Usually, your blood cell levels return to normal once treatment is finished.
If your cancer treatment is causing your low blood cell count, a doctor may adjust your dose. Blood transfusions are used to help increase your blood cell counts. Immunoglobulin replacement therapy administered through an intravenous (IV) line or injections may help support your immune system.
A high lymphocyte count can be a sign that you have lymphoma, but it can also be a sign of other conditions such as an active infection.
Factors other than lymphoma that can increase your white blood cell count include:
Lymphoma starts in a type of white blood cell called lymphocytes. Doctors often monitor lymphocyte and other blood cell counts during the diagnosis and treatment of lymphoma.
Knowing your lymphocyte count isn't enough to diagnose lymphoma, but it can help doctors predict how your cancer may progress and help determine your best treatment options.
Having a lower-than-normal lymphocyte count is generally associated with a less favorable outlook.
Comments
Post a Comment