Immunotherapy

Follicular Lymphoma

Lymphoma occurs when cells of the immune system called lymphocytes, a type of white blood cell, grow and multiply uncontrollably. These cancerous lymphocytes can travel to many parts of the body and form a mass called a tumor. Two main types of lymphocytes develop into lymphomas: B lymphocytes (B-cells) and T lymphocytes (T-cells). Follicular lymphoma is a B-cell lymphoma and is the most common indolent (slow-growing) form of non-Hodgkin lymphoma (NHL).

Follicular lymphoma usually begins in the lymph nodes and can spread into the blood and bone marrow (soft, spongy tissue in the center of some bones) or other organs. For Stage I and early Stage II follicular lymphoma, radiation therapy is often recommended to target the lymph nodes affected by the lymphoma and the surrounding area. Other treatment options include immunotherapy, chemotherapy or both.

Follicular lymphoma grows slowly, so your doctors may recommend “watchful waiting” instead of beginning treatment right away if you are otherwise healthy and the lymphoma is not causing any symptoms or problems with other organs.

Immunotherapy combined with chemotherapy is the most common treatment for more advanced Stage II, Stage III and Stage IV disease. One of the first immunotherapies approved for follicular lymphoma was a type of interferon, which is a cytokine. Cytokines act primarily by communicating between the various cells of the body’s immune system. It is classified as a biologic response modifier (BRM). Immunotherapy drugs may be used alone if chemotherapy cannot be tolerated. Additionally, if some lymph nodes are very large from the lymphoma, radiation therapy may be used to reduce symptoms.

If follicular lymphoma does not respond to treatment or returns after treatment, your doctor may recommend other types or combinations of immunotherapy, chemotherapy, targeted therapy or stem cell transplantation. These therapies may be FDA-approved or part of a clinical trial.

Current follicular lymphoma clinical trials are designed to investigate treatment strategies to increase the remission rate or cure the disease. Results from clinical trials of Stage III disease show promise for a personalized vaccine to treat follicular lymphoma; the patient’s own cancer cells are mixed with immune cells as well as agents to stimulate the immune system. The immune cells learn to recognize the cancer cells as foreign and are then used in the vaccine together with an agent that stimulates the immune system. Once the vaccine is given, the immune cells recognize and fight cancer cells that may be in the body. Ask your doctor if you are a candidate for clinical trials.

 

FDA-Approved Immunotherapies for Follicular Lymphoma
As of 10/26/2016
ibritumomab tiuxetan (Zevalin)
interferon alfa-2b (Intron A)
obinutuzumab (Gazyva)

Additional Resources

 

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