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Treatment Options in Relapsed, Indolent Non-Hodgkin's Lymphoma

Summary & Participants

Whether relapsed or refractory, tune in to learn about treatments for indolent non-Hodgkin's lymphoma.

Medically Reviewed On: July 16, 2008

Webcast Transcript

JOHN LEONARD, MD: Hello, I'm Dr. John Leonard. I'm the clinical director of the Cornell Center for Lymphoma and Myeloma. We're going to talk today about the options faced by a patient when indolent or slow-growing non-Hodgkin's lymphoma returns or relapses.

Joining me today is my Cornell colleague, Dr. Morton Coleman. He's a clinical professor of medicine at the Weill Medical College of Cornell University. Rounding out our group today is Dr. Owen O'Connor. He's an oncologist with the Memorial Sloan-Kettering Cancer Center.

We're going today to talk about indolent lymphoma. Indolent lymphoma accounts for about a third of patients with lymphoma. The most common type of indolent lymphoma is follicular lymphoma. Patients often get their initial treatment, their disease response to treatment, and then at some point in time later the disease recurs or relapses.

And so the first question that comes up is the difference or the issue of relapse disease versus refractory disease. Dr. Coleman, how do we define that from the standpoint of classifying patients and their approach?

MORTON COLEMAN, MD: John, we usually refer to relapse as a term connoting a return of disease after the initial response. Refractory disease usually connotes a term which means that the disease never fully responded, either it progressed-and we call that progressive disease-or that the disease did not respond fully.

Very often, patients will respond in a complete manner. that's known as a complete remission. Those patients who come out of that sort of response is considered a relapse, whereas patients who don't fully respond, or where the disease continues to grow, those patients are considered to have refractory disease.

JOHN LEONARD, MD: So why is that an important distinction for a patient, as far as sorting out whether they responded and relapsed or whether the disease didn't respond at all?

MORTON COLEMAN, MD: It may have great relevance with regard to the sensitivity to therapy. Those patients who relapse tend to, from a complete remission, tend to be more sensitive to the subsequent therapy. It's more difficult to treat patients who have not fully responded or who have progressive disease. It probably connotes some form of resistance to treatment.

JOHN LEONARD, MD: One of the unusual things about indolent lymphoma as compared to other sorts of tumors is the fact that patients often don't need treatment, either at the time of diagnosis or at the time of relapse. And that can be a very complicated decision, as to deciding whether or not to initiate treatment or not.

Dr. O'Connor, how do you, as you approach your patients, how do you make that decision? What are some of the factors that you think about in deciding whether or not you need to start treatment for an individual patient?

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