Lymphomas not hodgkiniens: major advances
No hodgkiniens lymphomas: lymphomas not hodgkiniens major advances: major advances
DR
The treatment of lymphomas, cancers of the blood rising, been progress. The Pr Gilles rooms made the point.
Paris Match. What is Lymphoma (LY)?
PR Gilles rooms. It is a cancer that develops from lymphocytes, the cells of our immune system. There are more than 60 different subtypes. Schematically, we distinguish the LY of Hodgkin's disease, common in young adults, the LY so-called no hodgkiniens (NHL) that can appear at any age and who are either aggressive, quickly threatening the life, is "indolent" slow many years of evolution.
What is the frequency of the LY in France?
There are more than 12,000 new cases per year (5% of all cancers), figure that has doubled in twenty-five years and continues to increase, affecting more men than women. A cause or known to be driving factors are often ignored. The possible role of a virus (Infectious Mononucleosis, hepatitis B or C), bacteria (Helicobacter pylori), pesticides, or even a possible family plot, is sometimes referred to.
We cure more than 60 percent of patients
What are the most frequent NHL and how is it diagnosed?
1. the diffuse large cell, aggressive, B is the most common (35% of the NHL). It begins in a lymph node that grows in a few weeks, palpable in the neck, groin, armpit, or deep elsewhere and the origin of atypical signs (abdominal pain, cough,...); It can also develop in any organ of the body (stomach, lung, brain...). 2. the follicular (20% of the NHL) is the most common form of indolent LY. Initially, it's the discreet increase of a ganglion, which can go unnoticed for many years. Fatigue, weight loss, unexplained fever, night sweats may accompany all types of NHL. A scanner will identify the lymph nodes and/or bodies met, which may be the subject of a sample (biopsy) for analysis under a microscope and confirmation of the diagnosis. A Pet scan (imaging of active) will specify the spread of the disease in the body. It will also analyse the bone marrow puncture (myelogram) or by biopsy (more informative yet).
What is the standard treatment of the LY large cell and its results?
It is based on chemotherapy (associated immunotherapy with monoclonal antibodies made in the laboratory to specifically target malignant cells), generally issued every three weeks for six months. It heals more than 60% of the patients. Relapses may occur, leading to repeated chemotherapy or to use more aggressive methods (blood stem cell transplant). The healing is so rare, but in these resistant forms, a revolutionary treatment could change.
What is it?
It is through advanced biotechnology to turn healthy cells (LS) of the patient in lymphocytes killers of lymphomas (called CAR - T cells). The LS are taken from the blood of the subject (Apheresis), genetically manipulated in the laboratory to target a protein specific to cancer cells and re-injected by intravenous patient: they multiply so up to a thousand times, then attack their target, which is the malignant cells. In a few days or weeks (at the price of reversible side effects), the tumour cast is spectacular: certainly incomplete in half of the patients, but complete after six months at 30 to 40 percent of them and in a sustainable way, it seems. This new approach could eventually apply to all LY.
Read also. Targeted therapies and cancer: positive balance sheets
And for the follicular LY?
A medical surveillance sometimes enough. Otherwise, we used a monoclonal antibody (rituximab) with or without chemotherapy. A prolonged administration of rituximab (an injection every two or three months for two years) increases the length of remissions. Most patients can live well without recurrence for at least ten years, or even more. Other monoclonal antibodies and promising products can boost immunity (lenalidomide) are to study, and this in addition to the hopes raised by the CAR - T cells.
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