Why it is important to predict which lymphoma patients may relapse early

30 Jun

After analyzing data on hundreds of cases, researchers suggest that 2 years –

rather than the more common 5 years for many cancer patients – might be a more practical

survival goal for patients with a type of non-Hodgkin lymphoma called follicular


man feeling lymph nodes in neck
Follicular lymphoma develops when the body makes abnormal B-lymphocytes, which build up in lymph nodes.

Early relapse should be carefully considered when oncologists and patients make decisions about treatment, concludes a team led by Carla Casulo, oncologist and assistant

professor of Medicine at the University of Rochester, NY, writing in the Journal of

Clinical Oncology.

While most follicular lymphoma patients can expect to live 20 years, a distinct group of

around 1 in 5 patients consistently experiences a return of the blood cancer within 2 years

of receiving even the most up-to-date treatment.

The study is the first to confirm that this group is likely to experience poor

survival – 50% of these patients die within 5 years.

Prof. Casulo says these early relapsing patients may have a disease with distinctly

different biology, and notes:

“Through research we have confirmed that all relapsed patients are not equal, and

therefore should not be approached the same at diagnosis nor at the time of relapse in

terms of therapies.”

Gene-expression profiling ‘will be important to understand high-risk group’

The researchers came to their conclusions after analyzing data from 588 patients with

stage 2-4 follicular lymphoma. They also confirmed their findings in an independent patient


Prof. Casulo says it is critical to predict which follicular lymphoma patients are

likely to relapse early, and:

“We believe that targeted sequencing or gene-expression profiling will be

important to understanding how to improve the outcomes of this group.”

The National Cancer Institute is starting to develop clinical trials for this high-risk,

early-relapsing group of patients.

Lymphomas – cancers of the lymphatic system – are divided into Hodgkin lymphoma and

non-Hodgkin lymphoma, of which follicular lymphoma is the second most common.

Follicular lymphoma develops when the body makes abnormal B-lymphocytes – a type of

white blood cell. The affected cells accumulate in lymph nodes.

In the US, around 15,000 people a year are affected by follicular lymphoma.

You can find out more about investigational treatments for all types of lymphoma,

including follicular lymphoma, that are currently being evaluated at cancer treatment

centers nationwide, from the Lymphoma Research Foundation’s clinical trials information service.

In December 2014, Medical News Today reported how a team of researchers had

identified some early gene changes that precede blood

cancer. They suggested their findings could open new ways to research blood cancers and

identify high-risk groups.

Written by Catharine Paddock PhD