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aCentre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; bUniversity of Southern California, Los Angeles, CA, USA; cHôpital Saint-Louis, Paris, France; dRush University Medical Center, Chicago, IL, USA
Key Words. Non-Hodgkin's lymphoma • Radioimmunotherapy • Anti-CD20 antibody • PET/CT imaging • Complete response
Correspondence: Angelika Bischof Delaloye, M.D., Department of Nuclear Medicine, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland. Telephone: 41-21-314-43-46/47; Fax: 41-21-314-43-49; e-mail: Angelika.BischofDelaloye{at}chuv.ch
Received March 27, 2009; accepted for publication June 1, 2009.
Disclosures: Angelika Bischof Delaloye: Consultant/advisory role: Bayer Schering Pharma AG; Peter S. Conti: Honoraria: Bayer; Christian Gisselbrecht: Research funding/contracted research: Bayer Schering Pharma; Stephanie A. Gregory: Honoraria: GlaxoSmithKline, Genentech.
The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the independent peer reviewers.
An expert panel of 44 physicians (including hemato-oncologists, radiologists, and nuclear medicine physicians) recently met at the 6th International Workshop on Nuclear Oncology, which was held April 17–19, 2008. The scientific committee who chaired this workshop, alongside the distinguished faculty who presented data at this meeting, have prepared this supplement to summarize and explore the emerging data and changing protocols for the diagnosis and treatment of non-Hodgkin's lymphoma (NHL) and discuss the evolving role of radioimmunotherapy (RIT) in the treatment of such malignancies.
NHL encompasses a number of different B-cell lymphomas that can be separated into two groups: aggressive, such as diffuse large B-cell lymphoma and mantle cell lymphoma; and indolent, such as follicular lymphoma (FL) [1, 2]. There are a number of treatment options for NHL depending on the nature of the disease and the health of the patient; therefore, it is important to individualize the therapy for the patient (Fig. 1). The first article of this supplement, entitled "Harnessing the energy: Development of radioimmunotherapy for patients with non-Hodgkin's lymphoma," focuses on this issue [3]. Because of the intensive nature of some of the regimens for NHL, such as high-dose chemotherapy, it is important to balance the benefit of providing therapy with patient quality of life.
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Patient selection for therapy is facilitated by imaging technology, specifically 18F-fluoro-2-deoxyglucose positron emission tomography (PET) and computed tomography (CT). There is an expanding role for PET/CT in the diagnosis, staging, and evaluation of response to therapy [8–11]. In the third article, entitled "Expert opinions on positron emission tomography and computed tomography imaging in lymphoma," Dominique Delbeke et al. [12] discuss the new guidelines for staging and response criteria of NHL and provide expert opinion on how best to standardize the use of PET/CT for making therapy decisions.
Historically, the only curative option for eligible patients with NHL has been stem cell transplantation (SCT); however, this treatment option is usually combined with a highly toxic, myeloablative regimen of high-dose chemotherapy and/or total-body irradiation [13]. Because older patients make up the majority of the NHL population and may not be able to withstand these toxicities, and because some patients may still relapse as a result of incomplete eradication of residual disease [14], there is a need for a new approach to myeloablative therapy that is both effective and well tolerated. The final article, "Radioimmunotherapy for stem cell transplantation in non-Hodgkin's lymphoma: In pursuit of a complete response," outlines the RIT studies that have investigated its use in this setting so far [15]. These data suggest that the use of RIT alone or in combination with chemotherapy in this setting can improve clinical outcome, with no added toxicity for patients undergoing SCT therapy.
In this rapidly evolving field, we hope that you find the expert opinion presented in this supplement informative and useful in your clinical practice.
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AUTHOR CONTRIBUTIONS |
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 Top Author Contributions References |
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Provision of study materials or patients: Christian Gisselbrecht, Stephanie A. Gregory
Collection/assembly of data: Peter S. Conti, Christian Gisselbrecht
Data analysis and interpretation: Peter S. Conti, Christian Gisselbrecht
Manuscript writing: Angelika Bischof Delaloye, Peter S. Conti, Christian Gisselbrecht, Stephanie A. Gregory
Final approval of manuscript: Angelika Bischof Delaloye, Peter S. Conti, Christian Gisselbrecht, Stephanie A. Gregory
The authors take full responsibility for the scope, direction, and content of the manuscript and have approved the submitted manuscript. They would like to thank Lynda Chang, Ph.D., at Complete Health Vizion for her assistance in the preparation and revision of the draft manuscript, based on detailed discussion and feedback from all the authors. Editorial assistance was supported by a grant from Bayer HealthCare Pharmaceuticals.
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REFERENCES |
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TopAuthor ContributionsReferences |
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60 years) with non-Hodgkin's lymphoma: Comparison with patients <60 years treated within the same protocol. Bone Marrow Transplant 2000;26:737–741.[CrossRef][Medline]
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