Diagnosis and Treatment of Non-Hodgkin's Lymphoma
Non-Hodgkin’s lymphoma is a group of diseases that includes any kind of lymphoma that is not considered Hodgkin’s disease.
In general, non-Hodgkin’s lymphomas are cancers that arise in the lymphatic cells (a type of white blood cell) in the immune system, and account for about 60 percent of all cases of lymphomas. All in all, there are about 30 different types of non-Hodgkin’s lymphoma that affect more than 54,000 people each year in the United States.
Non-Hodgkin's lymphoma is one of the more common childhood cancers. Information about Non-Hodgkin’s lymphoma in children can be found at the Lucile Packard Children’s Hospital, which has excellent programs and physicians.
Stanford: A Center of Lymphoma Excellence
The dedicated cores of individuals in the Cancer Center's lymphoma program have pioneered the real advances that are available to patients today and that are outlined below.
Physicians in our Lymphoma Program are routinely awarded and recognized for their contributions to the field and this year will be specifically profiled in US News & World Report’s “America’s Best Hospitals” issue. As a recognized center of excellence, we routinely treat thousands of lymphoma patients each year.
Rituxan: A Revolution in Lymphoma Treatment, Discovered at Stanford
The development of the monoclonal anti-CD20 antibody rituximab has changed the treatment of B-cell non-Hodgkin's lymphoma worldwide.
Stanford Cancer Center physicians and researchers discovered the therapeutic effects of this antibody and have been instrumental in developing its many applications.
Some of the earliest trials of rituximab were carried out by Cancer Center physicians, meaning that their patients had early access to this groundbreaking treatment.
Genetics
Stanford researchers were some of the earliest pioneers in sequencing the human genome and developing methods to more rapidly identify genetic differences between people with different diseases.
Today, our doctors continue to lead the field and apply this technology to cancer. For example, researchers at the Cancer Center have identified a set of six genes that may predict response to treatment in patients with diffuse large B cell lymphoma (DLBCL), the most common form of non-Hodgkin's lymphoma.
This finding could result in the first gene-based screen to identify people who need the most aggressive therapy. When you are treated by physicians at the Cancer Center, you may have access to this kind of predictive genetic screening through ongoing clinical studies in both DLBCL and follicular lymphoma.
A Wide Range of Expertise
Cancer Center lymphoma specialists have expertise treating a wide range of non-Hodgkin’s lymphomas, including:
- Mycosis fungoides – a rare form of indolent T-cell lymphoma that affects the skin.
- Sézary syndrome – a form of mycosis fungoides that involves the blood as well as the skin.
- Aggressive B-cell lymphomas
- AIDS-related B-cell lymphomas – a group of specific lymphomas that often respond differently to treatment in AIDS patients than they do in other patients.
- Burkitt’s lymphoma – a type of lymphoma that often results from a genetic alteration of the MYC gene.
- Diffuse large B-cell lymphoma – a common form of lymphoma that can affect adults and children.
- Mantle cell lymphoma – a type of lymphoma that often results from a genetic alteration of the BCL-1 gene.
- Indolent B-cell lymphomas
- Follicular lymphoma – a common form of lymphoma that often results from a genetic alteration of the BCL-2 gene.
- Marginal zone lymphoma (gastric MALT and non-gastric MALT) – gastric MALT can be caused by chronic infection with the stomach bacteria H. pylori; non-gastric MALT most commonly occurs in the lung, salivary gland, thyroid gland, skin and around the eye.
- Small lymphocytic lymphoma – a type of lymphoma that is very similar to chronic lymphocytic leukemia.
- Waldenström/lymphoplamsacytoid lymphoma – a rare type of lymphoma that causes the blood to thicken; tends to occur in older adults.
- T-Cell lymphomas
- Peripheral T-cell lymphoma – an unpredictable form of lymphoma that often has an aggressive behavior.
- Lymphoblastic lymphoma – a type of leukemia/lymphoma that is more common in children than adults
A World Leader in Cutaneous Lymphoma
The Cutaneous Lymphoma Clinic at Stanford is a major referral center for patients with lymphomas that affect the skin such as
- mycosis fungoides
- other cutaneous T-cell lymphomas
- cutaneous B-cell lymphomas.
Stanford's 35-year experience in mycosis fungoides is internationally recognized, and the patient database of over 600 patients is the largest single-center resource for vertical data analysis. The multidisciplinary Cutaneous Lymphoma Clinic meets weekly and is jointly directed by the Departments of Dermatology and Radiation Oncology.
Treatment Expertise
When you are being treated for cancer you want a physician who is familiar with your particular disease. Yet because many forms of non-Hodgkin’s lymphoma are rare it can be difficult to find a doctor who has treated patients with the disease.
Our specialists at the Cancer Center not only treat non-Hodgkin’s lymphoma, but are considered world-leaders in the field and offer the most advanced diagnostic technologies and treatments available today.
Advanced Therapies
Cancer Center physicians commonly treat non-Hodgkin’s lymphoma with chemotherapy and radiation therapy, but also offer advanced therapies for patients who will benefit from them. These state-of-the-art treatments include
- blood and marrow transplants
- peripheral blood stem cell transplants
- immunotherapy like rituximab
- radioimmunotherapy like Zevalin and Bexxar
- experimental treatments through clinical trials.
Ongoing Clinical Trials
Cancer Center innovators don’t rest on their laurels. Today, just one of their many innovative avenues of research and clinical trials includes:
- developing a vaccine to treat follicular non-Hodgkin’s lymphoma that is customized for each patient by basing the vaccine on the unique signature of each lymphoma tumor.
- conducting a Phase I-II trial of humanized anti-CD3 antibody infusion therapy for patients with T-cell lymphomas
- a preclinical phase study of T-cell receptor vaccines for T-cell malignancies.
Trial Administration