January 15, 2008 - So, How Good Are the Odds?

A treatment that sounds rather similar to the one I was discussing with Dr. Donato and Dr. Feldman during my visit to Hackensack University Medical Center has just made the news. (“Gentler Chemotherapy Before Stem Cell Transplant Causes Long-term Remission Of Follicular Lymphoma, Study Suggests,” ScienceDaily, January 3, 2008.)

“Treating relapsed follicular lymphoma patients with a milder chemotherapy regimen before they receive a blood stem cell transplant from a donor resulted in long-term complete remission for 45 of 47 patients in a clinical trial, researchers at The University of Texas M. D. Anderson Cancer Center report at the 49th annual meeting of the American Society of Hematology.

The two patients who had relapsed after the treatment regained a complete response after additional therapy.

‘Our results show that this approach may actually be curative of follicular lymphoma,’ says lead author Issa Khouri, M.D., professor in M. D. Anderson’s Department of Stem Cell Transplantation. ‘No other treatments produce this type of response.’”

So, it seems that the “incurable” follicular lymphoma I now have may be curable after all. I recall hearing both Dr. Donato and Dr. Feldman use the words “potentially curative” when I spoke with them. This study gives a little more oomph to that word “potentially.”

Getting the cure, though – if, indeed, it is a cure – is not a simple matter. Stem-cell transplants are grueling in and of themselves, and they carry with them a certain risk of fatality (10-15%, according to Dr. Feldman). All my doctors are agreed that, in the absence of symptoms, there’s simply no reason for me to run that kind of risk. Better to keep on with “watch and wait,” and think about such treatments only later, at such time as my situation may have become more dire. Then, 10-15% may not seem like such a large, imposing number as it now appears.

Of course, new lymphoma treatments are emerging at a furious rate. Who knows if, by then, there may not be other treatments that are just as effective as stem-cell transplants, but without the drawbacks?

The jury’s still out on this new way of doing stem-cell transplants, however. 45 out of 47 does sound like pretty good odds, but – given the long-term nature of the disease – those 45 people have still not been tracked long enough for the researchers to be absolutely certain.

The results are promising, though. Very promising.

It’s getting to those results that’s the problem.

So, I wait and hope. What more can I do?