Saturday, March 26, 2011

March 26, 2011 – New Follicular Lymphoma Treatment Guidelines

Here are a couple of big changes in standard treatment guidelines for follicular NHL. According to the National Comprehensive Cancer Network, Rituxan plus Bendamustine (a single chemotherapy agent) is evidently replacing R-CHOP, the cocktail of Rituxan plus four chemotherapy agents I received, as the standard, first-line treatment. Bendamustine is more easily tolerated and doesn’t typically lead to alopecia (hair loss).

There’s also a change in the NCCN-recommended treatment for relapsed follicular lymphoma: Rituxan maintenance and chemotherapy followed by radioimmunotherapy.

If I were presenting as a newly-diagnosed NHL patient today, I don’t know if this new first protocol would apply to me; nor do I know, were my NHL to come back with a vengeance, if the second option would be what Dr. Lerner would order up. That’s because my initial diagnosis was not follicular, but diffuse-mixed-large-and-small-cell. The small-cell type I now have has many similarities to follicular lymphoma, but it isn’t exactly the same.

Still, it leads me to wonder if this news story is significant for any treatment I may one day need.

It’s interesting for me to hear that both Rituxan maintenance (that’s Rituxan administered not only along with chemotherapy, but also on its own, as a monthly maintenance infusion over a couple of years) and radioimmunotherapy (Bexxar or Zevalin) are moving up in the medical world. I've written about both of these in the past, as I've become aware of discussions about their possible usefulness. Now these treatments seem to have moved to the head of the pack - at least for follicular lymphoma.


Anonymous said...



Carl said...

Thanks so much!

Anonymous said...



sinus surgery Los Angeles said...

Good to know for the medicine with chemotherapy for the cancer affected.There is research and more findings for cure of the disease.I am sure it is going to get easier with time.

Anonymous said...

Hi there,
I was diagnosed with follicullar lymphoma Oct 2010 and have just completed 6 months of bendamustine and rituxan.
My scans at 3 months were positive and I am hoping that my upcoming scans will show continued success. I will be moving to rituxan maintence therapy which is expected to last 2 years---
Cancer, I've discovered, is a little like being on a cruise you didn't want to take-the ship has set sail and other than jumping ship-you're stuck with an intinery that may bring you to some experiences you would rather do without.....
I hope you fare well--Boston Mary

alan coates said...

hi carl,
i have just been diagnosed with follicular lymphoma and also starting a blog documenting my journey and also researching alternative methods of treating my cancer. I was wondering if you were able to post your story on my blog and any other helpful information.
kind regards
alan coates

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