16 New approaches to follicular lymphona

With conventional therapy, follicular Iymphona remains incurable for most patients. An experimental approach is therefore justified.Recognition of the association between follicular Iymphona and the (14;18) translocation and the possibility of detecting residual disease at the molecular level using the polymerase chain reaction (PCR), have led to the concept of ‘molecular remission’.Several new approaches, some of which have been reported to result in ‘molecular remission’ eg. the chimaeric antibody antti-CD20 and the combination Fludarabine, Mitoxantrone and Dexamethasone are currently being evaluated at SBH. These and other treatment options, including high dose treatment (Cyclophosphamide + total body irradiation) supported by autologous haemopoietic progenitor cells, radio-labelled anti-CD20 and the nonmyeloablative regimen comprising Fladarabine and Cyclophosphamide supported by allogeneic bone marrow transplantation will be discussed

16 New approaches to follicular lymphona

With conventional therapy, follicular Iymphona remains incurable for most patients. An experimental approach is therefore justified.Recognition of the association between follicular Iymphona and the (14;18) translocation and the possibility of detecting residual disease at the molecular level using the polymerase chain reaction (PCR), have led to the concept of ‘molecular remission’.Several new approaches, some of which have been reported to result in ‘molecular remission’ eg. the chimaeric antibody antti-CD20 and the combination Fludarabine, Mitoxantrone and Dexamethasone are currently being evaluated at SBH. These and other treatment options, including high dose treatment (Cyclophosphamide + total body irradiation) supported by autologous haemopoietic progenitor cells, radio-labelled anti-CD20 and the nonmyeloablative regimen comprising Fladarabine and Cyclophosphamide supported by allogeneic bone marrow transplantation will be discussed

A randomized controlled trial to evaluate the role of interferon as initial and maintenance therapy in patients with follicular lymphoma

The purpose of this study was to evaluate the role of interferon as initial and maintenance therapy in patients with newly diagnosed follicular lymphoma. Between 1984 and 1994, 204 patients with newly diagnosed Stage III or Stage IV follicular lymphoma were randomized to receive either, Chlorambucil (CB): 10 mg daily for 6 weeks, followed by a 2-week interval, with 3 subsequent 2-week treatment periods at the same dose, separated by 2-week intervals, or, CB given concurrently with interferon (IFN). IFN was given at a dose of 3 × 106units thrice weekly, subcutaneously, throughout the 18-week treatment period. Responding patients were subsequently randomized to receive maintenance IFN at the dose and schedule described above, or to expectant management. The overall response rate was 161/204 (78%), complete remission being achieved in 24% of patients. Neither the addition of IFN to the initial treatment, nor the use of maintenance IFN influenced response rate, remission duration or survival. This study was undertaken to determine whether IFN, given in combination with, and then subsequent to, CB would alter the clinical course of patients with follicular lymphoma. Disappointingly, this objective was not achieved, no advantage having been demonstrated for the addition of IFN. © 2001 Cancer Research Campaign http://www.bjcancer.co