Progress in Understanding DNA Changes in Lymphoma

Marco A. Ruiz, MD, GRACE Faculty
Malignant Hematology


Progress in understanding DNA changes in lymphoma has already provided improved and highly sensitive tests for detecting this disease. Such tests can identify lymphoma cells based on changes such as chromosome translocations or rearrangements or specific gene mutations. Some of these tests are already in use, and others are being developed. They may be used to:

  • Detect lymphoma cells in a biopsy sample
  • Determine what type of lymphoma a person has
  • Help determine if a lymphoma is likely to grow and spread, even within a certain subtype of lymphoma
  • Help figure out if a certain treatment is likely to be helpful Help determine if a lymphoma has been destroyed by treatment and if a relapse is likely

 

Many new chemotherapy drugs are being studied in clinical trials. In recent years, these studies have led to the approval of drugs such as bendamustine (Treanda) and pralatrexate (Folotyn) for use against certain types of lymphoma. Other studies are looking at new ways to combine drugs using different doses or different sequences of drugs.

 

Bone Marrow Transplant treatment options

 

Researchers continue to improve bone marrow and peripheral blood stem cell transplant methods, including new ways to collect these cells before the transplant.
Autologous transplants (which use stem cells from the patient rather than from another person) have the risk of reintroducing lymphoma cells back into the patient after treatment. Researchers are testing new and improved ways to remove the last traces of lymphoma cells from the stem cells before they are returned to the patient. Some of the new monoclonal antibodies developed for treating lymphoma may help remove these remaining cells.
A lot of research is focusing on eliminating graft-versus-host disease in allogeneic (donor) transplants. This work revolves around altering the transplanted T-cells so that they will not react with the recipient’s normal cells but still kill the lymphoma cells.
Researchers are also studying the effectiveness of non-myeloablative (reduced-intensity) stem cell transplants in people with lymphoma. This approach may allow more people to benefit from stem cell transplants.

 

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