Posttransplantation Management Strategies for Patients with Lymphoma
Non-Hodgkin lymphoma (NHL) is the 8th most common cancer in men and the 11th most frequent cancer in women worldwide. In the United States, NHL is the most common hematopoietic neoplasm.The National Cancer Institute (NCI) estimates that in 2014 there were 70,800 new cases of NHL in the US and some 18,990 deaths. NHLs are a group of lymphoproliferative malignancies with differing patterns of presentation and responses to treatment. These tumors characteristically originate in the lymphoid tissues and may result from genetic alterations or damage to the cells related to infection, immunosuppression, or chronic inflammation. Hodgkin lymphoma (HL) is less common than NHL. The NCI estimates that in 2014 there were 9,190 new cases of HL in the US and some 1,180 deaths.
Treatment for lymphoma depends on the histologic type, stage, and grade. In asymptomatic patients with indolent forms of advanced NHL, treatment may be deferred until the patient becomes symptomatic. Frequent and careful observation is required in these patients to monitor possible disease progression. To assist practitioners, standardized guidelines for treatment and response assessment have been suggested.
Traditional therapies for lymphoma may include radiation therapy; rituximab standalone therapy;combination therapy of rituximab, cyclophosphamide, hydoxydaunorubicin, vincristine, and prednisone (R-CHOP) with or without radiotherapy (IF-XRT); lenalidomide; ibritumomab tiuxetan; and tositumomab. In addition, several new therapies are being investigated as standalone options and in combination with existing treatment regimens. These include: alisertib, bendamustine hydrochloride, brentuximab vedotin, and lenalidomide.
The National Cancer Institute recommends bone marrow transplantation (BMT) as the treatment of choice for patients whose lymphoma has relapsed. Data suggest that approximately 20% to 40% of patients will have a long-term disease-free status following BMT. The NCI notes that in general, re-treatment with standard agents rarely produces a cure in patients with relapsed/refractory lymphoma, though several salvage chemotherapy regimens are available and trials are underway on emerging therapeutic options.
This activity is based on a live symposium where leading experts discussed the role of BMT; current and emerging treatment strategies for patients with relapsed/refractory lymphoma following transplantation;and the post transplantation management strategies for patients with lymphoma.
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of The Medical College of Wisconsin and Carden Jennings Publishing. The Medical College of Wisconsin is accredited by the ACCME to provide continuing medical education for physicians.
AMA Credit Designation Statement
The Medical College of Wisconsin designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Hours of Participation for Allied Health Care Professionals: The Medical College of Wisconsin designates this activity for up to 1.0 hours of participation for continuing education for allied health professionals.
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views ofthe Medical College of Wisconsin, Carden Jennings Publishing, or Seattle Genetics. Before prescribing any medication, physicians should consult primary references and full prescribing information. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. Further, participants should appraise the information presented critically, and are encouraged to consult appropriate resources for any product or device mentioned in this program.
This activity was supported by an unrestricted educational grant from Seattle Genetics.
This activity has been developed and is intended for transplant specialists, oncologists, hematologists, and other healthcare professionals involved in the treatment of patients with lymphoma.
Upon completion of the program, participants should be able to:
- Discuss the established role and controversies in bone marrow transplantation and post transplantation management of patients with lymphoma
- Review the current treatment strategies and expected outcomes for patients with relapsed/refractory lymphoma following transplantation
- Evaluate recent safety and efficacy data from clinical trials of new post-transplant treatment strategies for lymphoma
CJP Medical Communications Disclosure
The employees of CJP Medical Communications have no financial relationships to disclose.
Consistent with the current Accreditation Councilfor Continuing Medical Education policy, the CME Provider must be able to show that everyone who is in a position to control the content of an individual educational activity has disclosed all relevant financialrelationships. The CME Provider has a mechanism in place to identify and resolve any conflicts of interest discovered in the disclosure process. The presenting faculty members have all made the proper disclosures, and the following relationships are relevant:
Jack W. Hsu, MD, has no relevant financial relationships to disclose.
John R. Wingard, MD, has no relevant financialrelationships to disclose.
Owen O’Connor, MD, PhD, discloses that he has received honoraria/consulting fees from Mundipharma,
Acetylon Pharmaceuticals, Inc., Celgene,Spectrum, and Millennium.
Ajay K. Gopal, MD, discloses that he has received honoraria/consulting fees from Millennium, American College of Physicians, Pfizer; Seattle Genetics,Gilead Sciences, and the National Marrow Donor Program.
He also has received research grants from the National Institutes of Health; Lymphoma Research Foundation, Leukemia and Lymphoma Society, CLL Topics, Merck, Seattle Genetics, GlaxoSmithKline, Janssen, Bristol-Myers Squibb, Gilead Sciences, PiramalHealthcare, Teva USA, Pfizer, Spectrum, Eli Lilly, Biogen Idec, Biomarin, Millennium, and Abbott.
Robert J. Soiffer, MD discloses that he has received honoraria/consulting fees from Jazz Pharma, GlaxoSmithKline, and Boehringer Ingelheim.
- 1.00 AMA PRA Category 1 Credit(s)™AMA PRA Category 1 Credit(s)™
- 1.00 Hours of ParticipationHours of Participation credit.