What happens if high-grade lymphoma comes back?

Size: px
Start display at page:

Download "What happens if high-grade lymphoma comes back?"

Transcription

1 Freephone helpline What happens if high-grade non-hodgkin lymphoma comes back? Non-Hodgkin lymphoma is a cancer of the lymphatic system. There are many different types of non-hodgkin lymphoma. Some develop and grow slowly and these are described as 'low grade' or 'indolent'. Faster-growing non-hodgkin lymphomas are described as 'high grade' or 'aggressive'. This information sheet is for people with high-grade non-hodgkin lymphoma. High-grade non-hodgkin lymphoma is usually treated with chemotherapy and sometimes with radiotherapy too. Unfortunately, not everybody who is treated for high-grade non-hodgkin lymphoma will be cured by their first course of treatment. In some people the lymphoma will come back after the treatment initially seemed to work. This is called a 'relapse'. A smaller number of people will have high-grade non-hodgkin lymphoma that does not respond well to the first course of treatment. When this happens the lymphoma is described as being 'refractory'. In this information sheet we will look at some of the concerns that people in these situations might have: What does it mean if high-grade lymphoma comes back after treatment? (page 2) What does it mean if high-grade lymphoma does not respond well to the initial treatment? (page 2) Your feelings if the lymphoma hasn't gone away or has come back (page 2) What will happen next? (page 3) What treatments are available? (page 3) Where can I get more help and support? (page 5) We have more information about high-grade non-hodgkin lymphomas and about lymphoma treatments in general. Please ring our helpline ( ) or visit our website ( if you have questions that are not answered in this information sheet or if you would like further information on any aspect of your illness. 1/7

2 What does it mean if high-grade lymphoma comes back after treatment? Most people who have treatment for high-grade non-hodgkin lymphoma will go into complete remission. Complete remission means that the lymphoma has been very well controlled. Unfortunately, in some people who have been in complete remission, the lymphoma will come back or start to grow again. This is known as a relapse and people nearly always experience symptoms if this happens either the same symptoms they had before or new ones. Relapse is most likely to happen within 2 years of the end of your first course of treatment. The lymphoma might come back where it was before or it can affect another part of your body. Relapsed high-grade non-hodgkin lymphoma can be treated again. The treatments often work very well and it may still be possible for you to be cured. What does it mean if high-grade lymphoma does not respond well to the initial treatment? A small number of people with high-grade non-hodgkin lymphoma will not respond well to their first course of treatment. Lymphoma that does not go into remission with treatment is known as refractory lymphoma. If the initial treatment has not been as effective as hoped, other treatments may well work better and it is still possible for you to be cured. The treatments that are given for relapsed high-grade non-hodgkin lymphoma can often be used for refractory high-grade non-hodgkin lymphoma too (see pages 3 5). Your feelings if the lymphoma hasn't gone away or has come back Most people being treated for high-grade non-hodgkin lymphoma will hope that the treatment is going to cure them. It is therefore likely to be very disappointing and upsetting to be told that your lymphoma has not responded to the treatment or that it has come back. Everyone will have slightly different feelings when they hear this news. For many people it brings back the whole range of emotions they felt when they were first diagnosed. These emotions are no easier to cope with the second time round, even if the doctors feel that a cure is possible with further treatment and start to plan this with you. Once again, you will need to call on the people and resources you found helpful last time. It is vital to recognise that what you are feeling is natural and to ask for any help you need with the emotional side of your relapse. Our helpline staff are there for you at every stage of your lymphoma, so do ring them if you would like to talk about how you are feeling or if you want to know more about the emotional side of having lymphoma ( ). 2/7

3 What will happen next? If your lymphoma relapses or is refractory, your specialist will want to repeat some of the tests you had to start with, including blood tests and scans. You might have another biopsy. Your further treatment will depend on: which type of high-grade non-hodgkin lymphoma you have your symptoms and your test results your general health and fitness the treatment you had before and how well your lymphoma responded to it how well you coped with the treatment how long it is since you were treated (if your lymphoma has relapsed). Your treatment will be discussed by several expert doctors and nurse specialists at the multidisciplinary team (MDT) meeting. Do let your team know if you have any strong views about your treatment. When your doctor recommends a treatment for you, do not be afraid to ask why they feel it is the best treatment for you. What treatments are available? Chemotherapy Relapsed or refractory high-grade non-hodgkin lymphoma is most often treated with further chemotherapy. If you are fit enough, the chemotherapy you are offered will probably be stronger than your first treatment. This kind of treatment is often called 'salvage chemotherapy'. Once further chemotherapy has controlled the lymphoma again, you might then be offered high-dose chemotherapy and a stem cell transplant (see page 4). Your salvage chemotherapy is likely to contain some drugs that are new to you. Gemcitabine and the 'platinum' drugs (such as cisplatin) are quite commonly given to treat relapsed or refractory high-grade non-hodgkin lymphoma (in regimens such as DHAP or ICE for example). There are a number of different regimens and none of these have been shown to be better than any of the others, so different centres will use different salvage regimens. Often these treatments are given over a few days so you will need to be an inpatient. Your team will explain what the treatment will involve when and how it will be given and the side effects you might experience. As in the initial treatments, an antibody treatment might be included in the salvage regimen, for example rituximab for B-cell non-hodgkin lymphomas. Steroids are also commonly given as part of the treatment, usually in the form of prednisolone or dexamethasone. 3/7

4 For people who are less fit, gentler chemotherapy, but using different drugs from those used initially, may be offered. The aim of this treatment would be to ease any symptoms and control the lymphoma for a while. This kind of treatment is not likely to cure the lymphoma. If you would like to know more about chemotherapy, how it is given and its possible side effects, please ring our helpline ( ) or visit our website ( Radiotherapy Radiotherapy is sometimes used after chemotherapy to treat areas where the lymph nodes were very large (known as bulky disease ). It cannot usually be given again to an area that has already been treated with radiotherapy. If the lymphoma comes back in just one part of the body, where radiotherapy has not been given before, it can be given to that area. If possible, though, your doctors will probably still want to give you chemotherapy first. High-dose chemotherapy and stem cell transplant If your lymphoma has been controlled by more chemotherapy and you are fit enough, you may be offered high-dose chemotherapy and a stem cell transplant. This form of treatment takes several weeks to complete, and for some of that time you will need to stay in hospital. Stem cells are special cells from the bone marrow that can make normal blood cells. A stem cell transplant is a treatment which allows very high doses of anti-lymphoma therapy to be given to you. It is a way of replenishing your healthy bone marrow stem cells after this intensive treatment. When you have a stem cell transplant you first have high doses of chemotherapy (and sometimes also radiotherapy). This treatment causes so much damage to your bone marrow that it might never recover by itself. Instead it is rescued (helped to recover) by the stem cells that are transplanted into you. The stem cells are put back into your bloodstream, just like a blood transfusion. They then settle in your bone marrow where they start to grow and make new blood cells. Stem cell transplants for high-grade non-hodgkin lymphoma are usually autologous. This means that the stem cells used are your own. They are collected, usually after one of your cycles of chemotherapy, and kept frozen until they are needed. If your response to the salvage chemotherapy regimen was good, this will increase the chance that an autologous stem cell transplant will keep the lymphoma in remission for a long period of time. Less often, stem cells from a donor are used this is known as an allogeneic transplant. Allogeneic transplants offer the chance of cure in some people, but they are a very intense form of therapy. Most allogeneic stem cell transplants for lymphoma now use reduced-intensity conditioning (sometimes shortened to RIC or known as a 'mini-transplant'). This means that less treatment is given before the transplant. Although this makes the treatment safer than other allogeneic transplants, it is still not suitable for everyone. 4/7

5 If your high-grade non-hodgkin lymphoma relapses after an autologous stem cell transplant, you might be treated with an allogeneic stem cell transplant. Alternatively, you might be offered treatment with a newer drug (see below). Stem cell transplants carry lots of risks as well as benefits, especially if they are allogeneic. If your doctors are thinking about this form of treatment for you, they will talk to you in detail about it. Please ring our helpline ( ) if you want to talk to someone about stem cell transplants. We also have information about transplants that the helpline can send you. The information can also be downloaded from our website ( New drugs used to treat relapsed high-grade lymphoma New drugs to treat lymphoma are becoming available all the time. Some of these drugs may work differently from chemotherapy because they target biological pathways in the lymphoma cells. They are often described as 'novel agents'. These new drugs have often been used in other lymphomas or blood cancers already, but it might not be known how well they work in your particular type of lymphoma or when a lymphoma needs further treatment. You may therefore be offered one of these newer treatments as part of a clinical trial. In fact, this is often the only way that people can receive one of these drugs. Examples of drugs that are being studied as treatments for relapsed and refractory high-grade lymphomas include brentuximab vedotin (Adcetris ), romidepsin (Istodax ), lenalidomide (Revlimid ), temsirolimus (Torisel ), bortezomib (Velcade ) and ibrutinib. They might be given alone or in combination with other treatments (such as chemotherapy drugs). Taking part in a trial is entirely voluntary and you can always opt to have the standard treatment if you prefer. If you are interested in taking part in a trial, ask your specialist if there might be a suitable one for you. Please ring our helpline ( ) if you would like to talk to someone about taking part in a clinical trial. We produce a booklet on clinical trials please ring the helpline or see our website ( if you would like to receive a copy. Where can I get more help and support? Finding out that the lymphoma hasn't responded to treatment or that it has come back and then having to face another course of treatment is very difficult for most people. You and your loved ones may well need to ask for more help and support at this time. Your hospital team will be able to tell you what to expect from any treatment that is planned. Finding out about your treatment and what is involved, especially if your team is suggesting that you have a transplant, can often help you prepare. 5/7

6 Talking about any concerns you may have is more important than ever at this time. You may be able to talk to your clinical nurse specialist or GP. Some people find that counselling is helpful. Our helpline staff are always happy to listen too and may be able to put you in touch with a 'buddy' someone who has been through the same sort of treatment as you. Please ring our helpline ( ) if you would like to talk to someone about how you are feeling about your lymphoma or if you would like to be put in touch with a Lymphoma Association buddy. Other possible sources of help Maggie s Centres Drop-in centres offer free, comprehensive support for anyone affected by cancer (also online) enquiries@maggiescentres.org British Association for Counselling and Psychotherapy Provides a register of accredited counsellors throughout the UK bacp@bacp.co.uk Macmillan Cancer Support Provides practical, medical, emotional and financial support to people living with cancer (Monday Friday, 9am 8pm) Acknowledgement We are grateful to Dr Paul Fields, consultant haematologist at Guy's and St Thomas' NHS Foundation Trust, London for reviewing this information. We also wish to thank all those people affected by lymphoma who have helped us develop our information. Selected references The full list of references is available on request. Please contact us via (publications@lymphomas.org.uk) or telephone if you would like a copy. Ghielmini, et al. and the panel members of the 1st ESMO Consensus Conference on Malignant Lymphoma. ESMO Guidelines consensus conference on malignant lymphoma 2011: diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL) and chronic lymphocytic leukemia (CLL). Annals of Oncology, : Tilly H, et al. and the ESMO Guidelines Working Group. Diffuse large B-cell lymphoma (DLBCL): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, (Suppl 7): vii78 vii82. Linch D. Today s treatment of diffuse large B-cell lymphoma in adults. Hematology Education: the education program for the Annual Congress of the European Hematology Association, : /7

7 Murawski N, Pfreundschuh M. New drugs for aggressive B-cell and T-cell lymphomas. Lancet, : Dearden CE, et al. Guidelines for the management of mature T-cell and NK-cell neoplasms (excluding cutaneous T-cell lymphomas). British Journal of Haematology, : Updated August Available at: com/documents/t_nhl_guideline_3_8_13_updated_with_changes_accepted_v1_ rg.pdf (accessed 15 January 2014). Dunleavy K, et al. New strategies in peripheral T-cell lymphoma: understanding tumor biology and developing novel therapies. Clinical Cancer Research, : How we can help you We provide: a Freephone helpline providing information and emotional support (9am 6pm Mondays Thursdays; 9am 5pm Fridays) or information@lymphomas.org.uk booklets and other information about lymphoma (free of charge) a website with forums the opportunity to be put in touch with others affected by lymphoma through our buddy scheme a nationwide network of lymphoma support groups. How you can help us We continually strive to improve our information resources for people affected by lymphoma and we would be interested in any feedback you might have. Please visit or publications@lymphomas.org.uk if you have any comments. Alternatively please phone our helpline on We make every effort to ensure that the information we provide is accurate but it should not be relied upon to reflect the current state of medical research, which is constantly changing. If you are concerned about your health, you should consult your doctor. The Lymphoma Association cannot accept liability for any loss or damage resulting from any inaccuracy in this information or third party information such as information on websites which we link to. Please see our website ( for more information about how we produce our information. Lymphoma Association PO Box 386, Aylesbury, Bucks, HP20 2GA Registered charity no Produced: February 2014 Next planned review: /7

Who is affected by HCL and what causes it?

Who is affected by HCL and what causes it? Freephone helpline 0808 808 5555 information@lymphomas.org.uk www.lymphomas.org.uk Hairy cell leukaemia Hairy cell leukaemia (HCL) is a rare and very distinctive cancer of blood cells called B lymphocytes

More information

Treatment of low-grade non-hodgkin lymphoma

Treatment of low-grade non-hodgkin lymphoma Produced 28.02.2011 Due for revision 28.02.2013 Treatment of low-grade non-hodgkin lymphoma Lymphomas are described as low grade if the cells appear to be dividing slowly. There are several kinds of low-grade

More information

Follicular lymphoma. What is follicular lymphoma? Freephone helpline 0808 808 5555 information@lymphomas.org.uk www.lymphomas.org.

Follicular lymphoma. What is follicular lymphoma? Freephone helpline 0808 808 5555 information@lymphomas.org.uk www.lymphomas.org. Freephone helpline 0808 808 5555 information@lymphomas.org.uk www.lymphomas.org.uk is a cancer of the lymphatic system, a type of non-hodgkin lymphoma. Even though more than 12,000 people are diagnosed

More information

Leukaemia and lymphoma what s the difference?

Leukaemia and lymphoma what s the difference? Freephone helpline 0808 808 5555 information@lymphomas.org.uk www.lymphomas.org.uk Leukaemia and lymphoma what s the difference? This is a difficult question to answer simply but it is one that is often

More information

Lauren Berger: Why is it so important for patients to get an accurate diagnosis of their blood cancer subtype?

Lauren Berger: Why is it so important for patients to get an accurate diagnosis of their blood cancer subtype? Hello, I m Lauren Berger and I m the Senior Director of Patient Services Programs at The Leukemia & Lymphoma Society. I m pleased to welcome Dr. Rebecca Elstrom. Dr. Elstrom is an Assistant Professor in

More information

Treatment of colon cancer

Treatment of colon cancer Treatment of colon cancer This information is an extract from the booklet, Understanding colon cancer. You may find the full booklet helpful. We can send you a copy free see page 5. Contents How treatment

More information

What is a Stem Cell Transplantation?

What is a Stem Cell Transplantation? What is a Stem Cell Transplantation? Guest Expert: Stuart, MD Associate Professor, Medical Oncology www.wnpr.org www.yalecancercenter.org Welcome to Yale Cancer Center Answers with Drs. Ed and Ken. I am

More information

How do I find the best place to get treatment for my lymphoma?

How do I find the best place to get treatment for my lymphoma? Produced November 2010 Next revision due November 2012 How do I find the best place to get treatment for my lymphoma? Introduction Fortunately this is not a question that patients with cancers of the blood

More information

Many people with non-hodgkin lymphoma have found an educational support group helpful. Support

Many people with non-hodgkin lymphoma have found an educational support group helpful. Support Track 2: Treatment Options [Narrator] Many people with non-hodgkin lymphoma have found an educational support group helpful. Support groups take many forms: some meet the needs of people with all kinds

More information

Mantle Cell Lymphoma Understanding Your Treatment Options

Mantle Cell Lymphoma Understanding Your Treatment Options New Developments in Mantle Cell Lymphoma John P. Leonard, M.D. Richard T. Silver Distinguished Professor of Hematology and Medical Oncology Associate Dean for Clinical Research Vice Chairman, Department

More information

It can be devastating to be diagnosed with a cancer like multiple myeloma. But there are treatments that can help you live longer and feel better.

It can be devastating to be diagnosed with a cancer like multiple myeloma. But there are treatments that can help you live longer and feel better. Patient information from the BMJ Group It can be devastating to be diagnosed with a cancer like multiple myeloma. But there are treatments that can help you live longer and feel better. What is multiple

More information

Hodgkin Lymphoma Disease Specific Biology and Treatment Options. John Kuruvilla

Hodgkin Lymphoma Disease Specific Biology and Treatment Options. John Kuruvilla Hodgkin Lymphoma Disease Specific Biology and Treatment Options John Kuruvilla My Disclaimer This is where I work Objectives Pathobiology what makes HL different Diagnosis Staging Treatment Philosophy

More information

Lymphomas after organ transplantation

Lymphomas after organ transplantation Produced 21.03.2011 Revision due 21.03.2011 Lymphomas after organ transplantation People who have undergone an organ transplant are more at risk of developing lymphoma known as post-transplant lymphoproliferative

More information

Other treatments for chronic myeloid leukaemia

Other treatments for chronic myeloid leukaemia Other treatments for chronic myeloid leukaemia This information is an extract from the booklet Understanding chronic myeloid leukaemia. You may find the full booklet helpful. We can send you a copy free

More information

Breast Cancer Questions to Ask

Breast Cancer Questions to Ask Ask about your medicines for primary (early) breast cancer Questions to help you get the best from your drug treatments Ask about your medicines for primary (early) breast cancer This guide is to help

More information

Narrator: Transplants using stem cells from the blood, bone marrow or umbilical cord blood

Narrator: Transplants using stem cells from the blood, bone marrow or umbilical cord blood [Track 2: What Is a Transplant?] Narrator: Transplants using stem cells from the blood, bone marrow or umbilical cord blood can be an effective treatment for people with blood cancers such as leukemia,

More information

Corporate Medical Policy

Corporate Medical Policy Corporate Medical Policy Hematopoietic Stem-Cell Transplantation for CLL and SLL File Name: Origination: Last CAP Review: Next CAP Review: Last Review: hematopoietic_stem-cell_transplantation_for_cll_and_sll

More information

I was just diagnosed, so my doctor and I are deciding on treatment. My doctor said there are several

I was just diagnosed, so my doctor and I are deciding on treatment. My doctor said there are several Track 3: Goals of therapy I was just diagnosed, so my doctor and I are deciding on treatment. My doctor said there are several factors she ll use to decide what s best for me. Let s talk about making treatment

More information

Lymphoma and palliative care services

Lymphoma and palliative care services Produced 2010 Next revision due 2012 Lymphoma and palliative care services Introduction Despite improvements in treatment, many people with lymphoma will not be cured. Death and dying are things that people

More information

The Lymphoma Guide Information for Patients and Caregivers

The Lymphoma Guide Information for Patients and Caregivers The Lymphoma Guide Information for Patients and Caregivers Ashton, lymphoma survivor This publication was supported in part by grants from Revised 2013 A Message From John Walter President and CEO of The

More information

Mantle Cell Lymphoma and New Treatments on the Horizon

Mantle Cell Lymphoma and New Treatments on the Horizon MANTLE CELL LYMPHOMA Mantle Cell Lymphoma and New Treatments on the Horizon Presented by James Armitage, MD University of Nebraska Medical Center Pierluigi Porcu, MD The Ohio State University Comprehensive

More information

State-of-the-Art Treatment for Lymphoma December 19, 2007 Guests: David Maloney, M.D., Ph.D Hosted by Andrew Schorr INTRODUCTION

State-of-the-Art Treatment for Lymphoma December 19, 2007 Guests: David Maloney, M.D., Ph.D Hosted by Andrew Schorr INTRODUCTION State-of-the-Art Treatment for Lymphoma December 19, 2007 Guests: David Maloney, M.D., Ph.D Hosted by Andrew Schorr Please remember the opinions expressed on Patient Power are not necessarily the views

More information

CHAPTER 26 LATE BREAKING DEVELOPMENTS: IMPACT OF ANTI-CD20 MONOCLONAL ANTIBODIES ON LYMPHOMA THERAPY

CHAPTER 26 LATE BREAKING DEVELOPMENTS: IMPACT OF ANTI-CD20 MONOCLONAL ANTIBODIES ON LYMPHOMA THERAPY CHAPTER 26 LATE BREAKING DEVELOPMENTS: IMPACT OF ANTI-CD20 MONOCLONAL ANTIBODIES ON LYMPHOMA THERAPY 26.1 Introduction rituximab Subsequent to the completion of drafts for the guidelines earlier in 2004,

More information

T-cell lymphomas. What are T-cell lymphomas? Freephone helpline 0808 808 5555 information@lymphomas.org.uk www.lymphomas.org.uk. What are T cells?

T-cell lymphomas. What are T-cell lymphomas? Freephone helpline 0808 808 5555 information@lymphomas.org.uk www.lymphomas.org.uk. What are T cells? Freephone helpline 0808 808 5555 information@lymphomas.org.uk www.lymphomas.org.uk are cancers of the lymphatic system, which is part of the body's immune system. They belong to a group of cancers called

More information

RADIATION THERAPY FOR LYMPHOMA. Facts to Help Patients Make an Informed Decision TARGETING CANCER CARE AMERICAN SOCIETY FOR RADIATION ONCOLOGY

RADIATION THERAPY FOR LYMPHOMA. Facts to Help Patients Make an Informed Decision TARGETING CANCER CARE AMERICAN SOCIETY FOR RADIATION ONCOLOGY RADIATION THERAPY FOR Facts to Help Patients Make an Informed Decision TARGETING CANCER CARE AMERICAN SOCIETY FOR RADIATION ONCOLOGY FACTS ABOUT The lymphatic system is a network of tiny vessels extending

More information

A guide to prostate cancer clinical trials

A guide to prostate cancer clinical trials 1 A guide to prostate cancer clinical trials In this fact sheet: What is a clinical trial? Why are trials done? What are trials looking into at the moment? How are clinical trials done? Should I take part

More information

Infosheet. Allogeneic stem cell transplantation in myeloma. What is the principle behind stem cell transplantation?

Infosheet. Allogeneic stem cell transplantation in myeloma. What is the principle behind stem cell transplantation? Infosheet Allogeneic stem cell transplantation in myeloma High-dose therapy and autologous stem cell transplantation is currently the first-line treatment standard of care for younger/fitter myeloma patients.

More information

-Examination of key pipeline candidates with in-depth clinical and commercial profiles of Phase III candidates

-Examination of key pipeline candidates with in-depth clinical and commercial profiles of Phase III candidates Brochure More information from http://www.researchandmarkets.com/reports/1215469/ Pipeline Insight: Lymphomas, Multiple Myeloma & Myelodysplastic Syndromes - Optimization of clinical practice creates opportunities

More information

Corporate Medical Policy

Corporate Medical Policy Corporate Medical Policy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: hematopoietic_stem-cell_transplantation_for_epithelial_ovarian_cancer 2/2001 11/2015 11/2016 11/2015 Description

More information

亞 東 紀 念 醫 院 Follicular Lymphoma 臨 床 指 引

亞 東 紀 念 醫 院 Follicular Lymphoma 臨 床 指 引 前 言 : 惡 性 淋 巴 瘤 ( 或 簡 稱 淋 巴 癌 ) 乃 由 體 內 淋 巴 系 統 包 括 淋 巴 細 胞 淋 巴 管 淋 巴 腺 及 一 些 淋 巴 器 官 或 組 織 如 脾 臟 胸 腺 及 扁 桃 腺 等 所 長 出 的 惡 性 腫 瘤 依 腫 瘤 病 理 組 織 型 態 的 不 同 可 分 為 何 杰 金 氏 淋 巴 瘤 (Hodgkin s disease) 與 非 何 杰 金

More information

The Treatment of Leukemia

The Treatment of Leukemia The Treatment of Leukemia Guest Expert: Peter, MD Associate Professor of Hematology Director, Yale Cancer Center Leukemia Program www.wnpr.org www.yalecancercenter.org Hi, I am Bruce Barber and welcome

More information

Locally advanced prostate cancer

Locally advanced prostate cancer Diagnosis Specialist Nurses 0800 074 8383 prostatecanceruk.org 1 Locally advanced prostate cancer In this fact sheet: What is locally advanced prostate cancer? How is locally advanced prostate cancer diagnosed?

More information

Chemotherapy for head and neck cancers

Chemotherapy for head and neck cancers Chemotherapy for head and neck cancers This information is from the booklet Understanding head and neck cancers. You may find the full booklet helpful. We can send you a free copy see page 7. Contents

More information

IF AT FIRST YOU DON T SUCCEED: TRIAL, TRIAL AGAIN

IF AT FIRST YOU DON T SUCCEED: TRIAL, TRIAL AGAIN + IF AT FIRST YOU DON T SUCCEED: TRIAL, TRIAL AGAIN Rena Buckstein MD FRCPC Head Hematology Site Group Sunnybrook Odette Cancer Center (OCC) Head of Hematology Clinical Trials Group at OCC + Outline Start

More information

Information Pathway. The emotional impact of a myeloma diagnosis. Coping with a diagnosis of myeloma

Information Pathway. The emotional impact of a myeloma diagnosis. Coping with a diagnosis of myeloma Information Pathway Myeloma UK Broughton House 31 Dunedin Street Edinburgh EH7 4JG Tel: + 44 (0) 131 557 3332 Fax: + 44 (0) 131 557 9785 Myeloma Infoline 0800 980 3332 www.myeloma.org.uk Charity No. SC

More information

Guidelines for the Management of Chronic Lymphocytic Leukaemia (CLL)

Guidelines for the Management of Chronic Lymphocytic Leukaemia (CLL) Guidelines for the Management of Chronic Lymphocytic Leukaemia (CLL) Version History Version Date Summary of Change/Process 2.0 08.05.08 Endorsed by the Governance Committee 2.1 16.02.11 Circulated at

More information

Coping with chemotherapy

Coping with chemotherapy This information is an extract from the booklet Understanding chemotherapy. You may find the full booklet helpful. We can send you a copy free see page 11. Contents Feelings and emotions How you can help

More information

Peripheral T-Cell Lymphoma Facts

Peripheral T-Cell Lymphoma Facts Peripheral T-Cell Lymphoma Facts No. 25 in a series providing the latest information for patients, caregivers and healthcare professionals www.lls.org Information Specialist: 800.955.4572 Highlights l

More information

Hormonal therapy for advanced prostate cancer

Hormonal therapy for advanced prostate cancer Hormonal therapy for advanced prostate cancer This information is an extract from the booklet Understanding advanced (metastatic) prostate cancer. You may find the full booklet helpful. We can send you

More information

Mantle Cell Lymphoma Understanding Your Treatment Options

Mantle Cell Lymphoma Understanding Your Treatment Options WELCOME AND INTRODUCTIONS Operator Greetings and welcome to the Mantle Cell Lymphoma (MCL), Understanding Your Treatment Options telephone and Web education program. It is now my pleasure to introduce

More information

Cutaneous Lymphoma FAST FACTS

Cutaneous Lymphoma FAST FACTS Cutaneous Lymphoma FAST FACTS What is Cutaneous Lymphoma? Cutaneous lymphomas are types of non-hodgkin s lymphomas (NHL) that originate in the lymphocytes (white blood cells). Unlike most other types of

More information

PROTOCOLS FOR TREATMENT OF MALIGNANT LYMPHOMA

PROTOCOLS FOR TREATMENT OF MALIGNANT LYMPHOMA 2012 1 31,, PROTOCOLS FOR TREATMENT OF MALIGNANT LYMPHOMA Version 1.0 2012 DIVISION OF HAEMATOLOGY / ONCOLOGY DEPARTMENT OF MEDICINE KAOHSING VETERAN GENERAL HOSPTIAL General Guide Diagnosis 1.Adequate

More information

The faecal occult blood (FOB) test

The faecal occult blood (FOB) test The faecal occult blood (FOB) test This information is an extract from the booklet, Understanding bowel cancer screening. You may find the full booklet helpful. We can send you a copy free see page 6.

More information

Advanced prostate cancer

Advanced prostate cancer Diagnosis Helpline 0800 074 8383 prostatecanceruk.org 1 Advanced prostate cancer In this fact sheet: What is advanced (metastatic) prostate cancer? What tests are used to diagnose advanced prostate cancer?

More information

Non-Hodgkin Lymphoma. Understanding your diagnosis

Non-Hodgkin Lymphoma. Understanding your diagnosis Non-Hodgkin Lymphoma Understanding your diagnosis Non-Hodgkin Lymphoma Understanding your diagnosis When you first hear that you have cancer, you may feel alone and afraid. You may be overwhelmed by the

More information

Stem Cell Transplantation

Stem Cell Transplantation Harmony Behavioral Health, Inc. Harmony Behavioral Health of Florida, Inc. Harmony Health Plan of Illinois, Inc. HealthEase of Florida, Inc. Ohana Health Plan, a plan offered by WellCare Health Insurance

More information

MALIGNANT LYMPHOMAS. Dr. Olga Vujovic (Updated August 2010)

MALIGNANT LYMPHOMAS. Dr. Olga Vujovic (Updated August 2010) MALIGNANT LYMPHOMAS Dr. Olga Vujovic (Updated August 2010) Malignant lymphomas consist of Hodgkin and non-hodgkin lymphomas. The current management of these diseases involves a multi-disciplinary approach.

More information

Chemotherapy for non-small cell lung cancer

Chemotherapy for non-small cell lung cancer Chemotherapy for non-small cell lung cancer This information is an extract from the booklet Understanding lung cancer. You may find the full booklet helpful. We can send you a free copy see page 3. Contents

More information

Asymptomatic or smoldering myeloma with no symptoms and slow growing cancer cells

Asymptomatic or smoldering myeloma with no symptoms and slow growing cancer cells ESSENTIALS Multiple Myeloma Diagnosed with Multiple Myeloma? It s important to understand everything you can about your diagnosis, possible treatments, and places to go for support and care. Cancer is

More information

High-grade non-hodgkin lymphoma (NHL) Patient information

High-grade non-hodgkin lymphoma (NHL) Patient information High-grade non-hodgkin lymphoma (NHL) Patient information My details This is a place to put important information about you, your condition and key contacts. Name and hospital number My NHS number My condition

More information

Bone Marrow Transplantation and Peripheral Blood Stem Cell Transplantation: Questions and Answers. Key Points

Bone Marrow Transplantation and Peripheral Blood Stem Cell Transplantation: Questions and Answers. Key Points CANCER FACTS N a t i o n a l C a n c e r I n s t i t u t e N a t i o n a l I n s t i t u t e s o f H e a l t h D e p a r t m e n t o f H e a l t h a n d H u m a n S e r v i c e s Bone Marrow Transplantation

More information

Clinical trials. Patient information. For anyone affected by blood cancer. bloodwise.org.uk

Clinical trials. Patient information. For anyone affected by blood cancer. bloodwise.org.uk Clinical trials For anyone affected by blood cancer bloodwise.org.uk Patient information A note about this booklet This booklet has been produced by Bloodwise, the new name for Leukaemia & Lymphoma Research.

More information

Tubular breast cancer

Tubular breast cancer Tubular breast cancer This booklet is for people who would like more information about tubular breast cancer. It describes what tubular breast cancer is, its symptoms, how a diagnosis is made and the possible

More information

What is non-hodgkin lymphoma, how is it treated, and what is the unmet need?

What is non-hodgkin lymphoma, how is it treated, and what is the unmet need? What is non-hodgkin lymphoma, how is it treated, and what is the unmet need? Tim Illidge BSc PhD MRCP FRCR FRCPath Institute of Cancer Sciences, University of Manchester Manchester Cancer Research Centre,

More information

Metastatic Melanoma What You Need to Know

Metastatic Melanoma What You Need to Know ESSENTIALS Metastatic Melanoma Metastatic Melanoma What You Need to Know If you have metastatic melanoma, you may feel as though your life has been turned upside down. It s a serious disease, but patients

More information

Non-Hodgkin s lymphomas (NHLs) are a

Non-Hodgkin s lymphomas (NHLs) are a Oncology 33 Non-Hodgkin s lymphoma in the elderly The incidence of non-hodgkin s lymphoma (NHL) is increasing, and this increase is even more rapid in the older population. Although treatment of NHL in

More information

The Blood Cancer Twice As Likely To Affect African Americans: Multiple Myeloma

The Blood Cancer Twice As Likely To Affect African Americans: Multiple Myeloma The Blood Cancer Twice As Likely To Affect African Americans: Multiple Myeloma 11 th Annual National Leadership Summit on Health Disparities Innovation Towards Reducing Disparities Congressional Black

More information

RADIATION THERAPY FOR BRAIN METASTASES. Facts to Help Patients Make an Informed Decision TARGETING CANCER CARE AMERICAN SOCIETY FOR RADIATION ONCOLOGY

RADIATION THERAPY FOR BRAIN METASTASES. Facts to Help Patients Make an Informed Decision TARGETING CANCER CARE AMERICAN SOCIETY FOR RADIATION ONCOLOGY RADIATION THERAPY FOR BRAIN METASTASES Facts to Help Patients Make an Informed Decision TARGETING CANCER CARE AMERICAN SOCIETY FOR RADIATION ONCOLOGY FACTS ABOUT BRAIN METASTASIS Brain metastases are clusters

More information

Advanced prostate cancer

Advanced prostate cancer 1 Advanced prostate cancer In this fact sheet: What is advanced (metastatic) prostate cancer? What tests are used to diagnose advanced prostate cancer? What do my test results mean? What are my treatment

More information

Interesting Case Series. Periorbital Richter Syndrome

Interesting Case Series. Periorbital Richter Syndrome Interesting Case Series Periorbital Richter Syndrome MarkGorman,MRCS,MSc, a Julia Ruston, MRCS, b and Sarath Vennam, BMBS a a Division of Plastic Surgery, Royal Devon and Exeter Hospital, Exeter, Devon,

More information

Invasive lobular breast cancer

Invasive lobular breast cancer Invasive lobular breast cancer This booklet is about invasive lobular breast cancer. It describes what invasive lobular breast cancer is, the symptoms, how it s diagnosed and possible treatments. Diagnosed

More information

Chemotherapy for pancreatic

Chemotherapy for pancreatic Chemotherapy for pancreatic cancer 1 Chemotherapy for pancreatic cancer This information is from the booklet Understanding pancreatic cancer. You may find the full booklet helpful. We can send you a free

More information

An overview of CLL care and treatment. Dr Dean Smith Haematology Consultant City Hospital Nottingham

An overview of CLL care and treatment. Dr Dean Smith Haematology Consultant City Hospital Nottingham An overview of CLL care and treatment Dr Dean Smith Haematology Consultant City Hospital Nottingham What is CLL? CLL (Chronic Lymphocytic Leukaemia) is a type of cancer in which the bone marrow makes too

More information

About chemotherapy for lung cancer

About chemotherapy for lung cancer About chemotherapy for lung cancer This information is about chemotherapy for lung cancer. There are sections on What is chemotherapy? Chemotherapy for small cell lung cancer Chemotherapy for non-small

More information

Lymphoma. Starting Point. Diagnosed with Lymphoma?

Lymphoma. Starting Point. Diagnosed with Lymphoma? ESSENTIALS Lymphoma Diagnosed with Lymphoma? It s important to understand everything you can about your diagnosis, treatment options, and places to go for support. This will help you make treatment decisions

More information

Low grade non-hodgkin Lymphoma

Low grade non-hodgkin Lymphoma Low grade non-hodgkin Lymphoma www.lymphomas.org.uk The knowledge to challenge lymphatic cancers The Lymphoma Association provides: freephone helpline emotional support for those affected by lymphomas

More information

Phasel clinical trials:

Phasel clinical trials: Phasel clinical trials: what are they all about? Information for people wanting to know more about early clinical trials in cancer, Belfast City Hospital NORTHERN IRELAND CANCER TRIALS CENTRE Introduction

More information

Treating Melanoma S kin Cancer A Quick Guide

Treating Melanoma S kin Cancer A Quick Guide Treating Melanoma Skin Cancer A Quick Guide Contents This is a brief summary of the information on Treating melanoma skin cancer from our website. You will find more detailed information on the website.

More information

Guidelines for the Management of Follicular Lymphoma

Guidelines for the Management of Follicular Lymphoma Guidelines for the Management of Follicular Lymphoma Scope The following guidance for first- and second-line therapy applies to follicular lymphoma histological grades 1, 2 and 3a according to the World

More information

OVARIAN CANCER TREATMENT

OVARIAN CANCER TREATMENT OVARIAN CANCER TREATMENT Cancer Care Pathways Directorate Tailored Information in Cancer Care (TICC) Sir Anthony Mamo Oncology Centre National Cancer Plan May 2015 Contents About this booklet 1 The Ovaries

More information

Localised prostate cancer

Localised prostate cancer Diagnosis Specialist Nurses 0800 074 8383 prostatecanceruk.org 1 Localised prostate cancer In this fact sheet: What is localised prostate cancer? How is localised prostate cancer diagnosed? What do my

More information

Latest News in Blood Cancer Research

Latest News in Blood Cancer Research ASH 2009 REPORT Latest News in Blood Cancer Research Highlights from the 2009 Annual Meeting of the American Society of Hematology Editor David H. Henry, MD, FACP Pennsylvania Hospital Philadelphia, Pennsylvania

More information

Background Information Myeloma

Background Information Myeloma Myeloma FAST FACTS Myeloma, also known as multiple myeloma, is a type of cancer that develops from plasma cells which originate in the bone marrow 1 Myeloma is the second most common type of blood cancer

More information

Talking With Your Doctor About Multiple Myeloma: A guide to making the most of your healthcare visits

Talking With Your Doctor About Multiple Myeloma: A guide to making the most of your healthcare visits There s a lot to think about and many important decisions to make when you or someone you care for has multiple myeloma. It s important to have an ongoing conversation with your healthcare team throughout

More information

How treatment is planned Giving your consent The benefits and disadvantages of treatment Second opinion

How treatment is planned Giving your consent The benefits and disadvantages of treatment Second opinion Treatment overview for lung cancer This information is an extract from the booklet Understanding lung cancer. You may find the full booklet helpful. We can send you a free copy see page 5. Contents How

More information

Pediatric Stem Cell Transplantation

Pediatric Stem Cell Transplantation Pediatric Stem Cell Transplantation Guest Expert: Deborah Chirnomas Assistant Professor of Pediatrics at Yale School of Medicine and Director of the Pediatric Bone Marrow Transplant Program at Smilow Cancer

More information

Blood-Forming Stem Cell Transplants

Blood-Forming Stem Cell Transplants Blood-Forming Stem Cell Transplants What are bone marrow and hematopoietic stem cells? Bone marrow is the soft, sponge-like material found inside bones. It contains immature cells known as hematopoietic

More information

Phyllodes tumours: borderline malignant and malignant

Phyllodes tumours: borderline malignant and malignant Phyllodes tumours: borderline malignant and malignant This booklet is for people who would like more information on borderline malignant or malignant phyllodes tumours. It describes what they are, the

More information

The role of the Specialist Nurse Practitioner for Late Effects Information for patients

The role of the Specialist Nurse Practitioner for Late Effects Information for patients Oxford University Hospitals NHS Trust The role of the Specialist Nurse Practitioner for Late Effects Information for patients This leaflet describes the role of the Specialist Nurse Practitioner for Late

More information

University College Hospital. Metastatic spinal cord compression (MSCC) information for patients at risk of developing MSCC.

University College Hospital. Metastatic spinal cord compression (MSCC) information for patients at risk of developing MSCC. University College Hospital Metastatic spinal cord compression (MSCC) information for patients at risk of developing MSCC Cancer Services 2 If you would like this document in another language or format,

More information

Bendamustine for the fourth-line treatment of multiple myeloma

Bendamustine for the fourth-line treatment of multiple myeloma LONDON CANCER NEW DRUGS GROUP RAPID REVIEW Bendamustine for the fourth-line treatment of multiple myeloma Contents Summary 1 Background 2 Epidemiology 3 Cost 6 References 7 Summary There is no standard

More information

Aggressive lymphomas. Michael Crump Princess Margaret Hospital

Aggressive lymphomas. Michael Crump Princess Margaret Hospital Aggressive lymphomas Michael Crump Princess Margaret Hospital What are the aggressive lymphomas? Diffuse large B cell Mediastinal large B cell Anaplastic large cell Burkitt lymphoma (transformed lymphoma:

More information

ACUTE MYELOID LEUKEMIA (AML),

ACUTE MYELOID LEUKEMIA (AML), 1 ACUTE MYELOID LEUKEMIA (AML), ALSO KNOWN AS ACUTE MYELOGENOUS LEUKEMIA WHAT IS CANCER? The body is made up of hundreds of millions of living cells. Normal body cells grow, divide, and die in an orderly

More information

Graft-versus-host disease (GvHD)

Graft-versus-host disease (GvHD) Graft-versus-host disease (GvHD) This information is an extract from the booklet Understanding donor stem cell (allogeneic) transplants. You may find the full booklet helpful. We can send you a free copy

More information

Malignant Lymphomas and Plasma Cell Myeloma

Malignant Lymphomas and Plasma Cell Myeloma Malignant Lymphomas and Plasma Cell Myeloma Dr. Bruce F. Burns Dept. of Pathology and Lab Medicine Overview definitions - lymphoma lymphoproliferative disorder plasma cell myeloma pathogenesis - translocations

More information

Lumbar Puncture Procedure and Intrathecal Chemotherapy Explained

Lumbar Puncture Procedure and Intrathecal Chemotherapy Explained Lumbar Puncture Procedure and Intrathecal Chemotherapy Explained Patient Information Introduction This leaflet tells you about the procedures known as lumbar puncture and intrathecal chemotherapy. We hope

More information

Outline of thesis and future perspectives.

Outline of thesis and future perspectives. Outline of thesis and future perspectives. This thesis is divided into two different sections. The B- section involves reviews and studies on B- cell non- Hodgkin lymphoma [NHL] and radioimmunotherapy

More information

Lymphoma. Measurability of Quality Performance Indicators Version 2.0

Lymphoma. Measurability of Quality Performance Indicators Version 2.0 Lymphoma Measurability of Quality Performance Indicators Version 2.0 To be read in conjunction with: Lymphoma Clinical Quality Performance Indicators (September 2013) Lymphoma Data Definitions V2.0 (September

More information

METASTASES TO THE BONE

METASTASES TO THE BONE RADIATION THERAPY FOR METASTASES TO THE BONE Facts to Help Patients Make an Informed Decision TARGETING CANCER CARE AMERICAN SOCIETY FOR RADIATION ONCOLOGY WHAT ARE BONE METASTASES? Cancer that starts

More information

Deciding whether to become a parent

Deciding whether to become a parent Deciding whether to become a parent This information is an extract from the booklet, Relationships, sex and fertility for young people affected by cancer. You may find the full booklet helpful. We can

More information

Acute myeloid leukaemia (AML) in children

Acute myeloid leukaemia (AML) in children 1 61.02 Acute myeloid leukaemia (AML) in children AML can affect children of any age, and girls and boys are equally affected. Leukaemia Acute myeloid leukaemia (AML) FAB classification of AML Causes of

More information

FDA approves Rituxan/MabThera for first-line maintenance use in follicular lymphoma

FDA approves Rituxan/MabThera for first-line maintenance use in follicular lymphoma Media Release Basel, 31 January 2011 FDA approves Rituxan/MabThera for first-line maintenance use in follicular lymphoma Approval provides option that improves the length of time people with incurable

More information

Perspectives on Recent Non-Hodgkin s Lymphoma (NHL) Data

Perspectives on Recent Non-Hodgkin s Lymphoma (NHL) Data Perspectives on Recent Non-Hodgkin s Lymphoma (NHL) Data Summary Article James O. Armitage, MD Presented through a strategic collaboration by A series of 5 expert interviews were conducted, focusing on

More information

CLL. Handheld record. Stockport NHS foundation trust

CLL. Handheld record. Stockport NHS foundation trust CLL 2015 Handheld record Contains- Patient information booklet, details of haematology clinic assessment and ongoing clinical assessment at GP surgery Stockport NHS foundation trust You have been diagnosed

More information

Collaboration to collect Autologous transplant outcomes in Lymphoma and Myeloma (CALM) Additional Questionnaire (MED C) INCLUSION CRITERIA CALM STUDY

Collaboration to collect Autologous transplant outcomes in Lymphoma and Myeloma (CALM) Additional Questionnaire (MED C) INCLUSION CRITERIA CALM STUDY Additional Questionnaire (MED C) CALM study Inclusion period: 01/01/2008 to 31/12/2011 PATIENT REGISTRATION FORM Disease Diagnosis Lymphoma S Non Hodgkin Lymphoma (NHL) Mature B-cell neoplasm Follicular

More information

If you have been taking a Parkinson s drug that contains levodopa,

If you have been taking a Parkinson s drug that contains levodopa, Symptoms and lifestyle Wearing off and involuntary movements (dyskinesia) If you have been taking a Parkinson s drug that contains levodopa, for example co-beneldopa or co-careldopa, for some time, you

More information

Multiple Myeloma Understanding your diagnosis

Multiple Myeloma Understanding your diagnosis Multiple Myeloma Understanding your diagnosis Multiple Myeloma Understanding your diagnosis When you first hear that you have cancer you may feel alone and afraid. You may be overwhelmed by the large amount

More information

STEM CELL TRANSPLANTS

STEM CELL TRANSPLANTS UAMS Information on STEM CELL TRANSPLANTS What is a Stem Cell Transplant? A stem cell transplant is an infusion of stem cells following high-dose chemotherapy. The infused cells effectively rescue the

More information