The CancerWeb Report, What's New In Cancer: July, 1996
Hematologic Malignancy

• Radioimmunotherapy for B-cell lymphoma - Although there has been tremendous progress in the treatment of non-Hodgkin's lymphoma, about half of patients with intermediate or high-grade disease are not cured by the deployment of the range of regimens comprising chemotherapy, chemoradiotherapy, and bone-marrow transplantation. Nearly all patients with the slow-growing low- grade lymphomas eventually relapse. There is need for new approaches, one of which, radioimmunotherapy using specific antibodies to direct the action of radioisotopes, is the subject of an article in the July, 1996 issue of the Journal of Clinical Oncology. Researchers from the University of Michigan at Ann Arbor, studied the effect of a monoclonal antibody to the CD20 B- lymphocyte antigen (anti-B1) labeled with radioiodine (131I) in 34 patients with B-cell lymphoma. Therapeutic doses between 34 and 161 mCi were given to 28 patients. They found that the limiting radiation dose was 75 cGy. Complete remissions were seen in 50% of treated patients and partial remissions in 28%. All 13 low-grade lymphoma patients responded, with a complete remission rate of 77%. Survival of those in complete remission exceeds 16.5 months with six in remission from 16 to 31 months after treatment. (Kaminski, J Clin Oncol 14:1974, 1996)

  ---

• Bone marrow transplantation and chemotherapy for multiple myeloma - Conventional chemotherapy gives less than a three-year median survival for patients with multiple myeloma. A multicenter trial undertaken in France claimed very good tumor response with a combination of high-dose chemotherapy (4-6 alternating cycles of VMCP and BVAP, high-dose melphalan, and total body irradiation) with autologous bone marrow transplantation and interferon alpha. The study, which was reported in the July 11, 1996 issue of the New England Journal of Medicine, described an 81% response rate, with 22% complete responses, for the combined therapy, versus 57% overall and only 5% complete responses for conventional chemotherapy (alternating cycles of VMCP and BVAP and interferon alpha). Overall estimated 5-year survival was 52% for the high- dose regimen and 12% for conventional-dose chemotherapy, with similar treatment-related mortality. (Attal, NEJ Med 335:91, 1996)