Remarkable therapeutic advances have been made in recent years, increasing the overall survival of patients with lymphoma worldwide
Lymphomas are a large group of tumors that affect our lymphatic system. There are basically two categories, Hodgkin’s lymphomas and non-Hodgkin’s lymphomas, and within the latter we have a hundred different subtypes. It’s important to keep in mind that, compared to other cancers, lymphomas are rare, so it’s important for patients to know what they are, how to identify and diagnose them, and what therapeutic options are currently available.
Lymphomas appear as a result of genetic changes in lymphocytes – the cells of the lymphatic system – and for reasons that are still unknown in most cases. The lymphatic system is a fundamental part of our immune system and consists of the lymph nodes, spleen, thymus and bone marrow. Lymphomas can occur in any of these locations, but they are usually diagnosed when an increase in the size of the lymph nodes is detected, usually not painful, in the neck, armpits, or groin. There are no symptoms or laboratory abnormalities specific to lymphomas. Patients often report that they are tired, and sometimes they also have a fever, weight loss, night sweats or general itching. The presence of these symptoms does not mean that the cause is lymphoma, but they are a reason to consult, especially if they persist.
Lymphomas can occur at any age, with a different pattern between non-Hodgkin’s lymphomas, whose incidence increases with age – half of patients with non-Hodgkin’s lymphomas are diagnosed after age 65 – and Hodgkin’s lymphomas , usually diagnosed between the ages of 20 and 35 and in those over 55 years of age.
The diagnosis of a lymphoma requires a biopsy of one of the affected nodes. The examination must be supplemented by analytical studies and an imaging test, and sometimes a bone marrow biopsy is required. It is very important to correctly identify the type of lymphoma as its treatment will be different and nowadays it is a matter of personalizing it as much as possible taking into account the type of lymphoma, the extent of the disease, the age and the individual characteristics of each patient.
From a therapeutic standpoint, remarkable therapeutic advances have been made in recent years, increasing the overall survival of patients with lymphoma around the world. Traditional chemotherapy and radiotherapy have been supplemented with different strategies, such as targeted therapies or immunotherapy. One of the great advances twenty years ago was the introduction of monoclonal antibodies, a basic form of immunotherapy consisting of proteins that target specific tumor antigens. More recently, strategies for cellular immunotherapy have been developed, either through the administration of bispecific antibodies – designed to bring our T lymphocytes into contact with tumor cells, thereby activating the immune response against lymphoma – or through CART therapy, in which genetically modified T lymphocytes specifically targeting tumor cells. The clinical application of this technique, which combines cell therapy and gene therapy, has been shown to be especially effective in lymphomas, multiple myeloma and acute lymphoblastic leukemia.
For lymphoma patients, the good news is that 14 hospitals in Spain have already been designated to administer CART drugs approved by the European and Spanish Medicines Agencies in adults. Even in our country, there are already three hospitals that have a cell therapy room to make CART medicines: the hospitals Clínic and Santa Creu i Sant Pau in Barcelona and the Navarra University Clinic in Pamplona.
The work conducted in collaboration with hospital research centers continues to increase the efficacy and safety of this type of therapy and reach new clinical indications, given the benefit that this type of medication has shown so far in patients with lymphoma, multiple myeloma and acute lymphoblastic leukemia .
This research should be carried out in the context of clinical trials in which the efficacy and safety of the different forms of cell therapy can be demonstrated in a controlled manner. Clinical trials, among other benefits, offer patients the opportunity to access this type of new therapy before it is approved and used in clinical practice, so it is currently important to consider this possibility before considering a therapeutic option, both in the first line as in the case of relapse of the disease.
Currently, we have dozens of clinical trials that we can offer to a lymphoma patient. When they are in our consultation, all specialists want to give them – without exception – the best therapeutic option for their health, and from these options we should never leave out the opportunity to participate in a clinical trial of safe and effective drugs.
Source: La Verdad