May 17, 2014 | by Kim Proescholdt
Hodgkin lymphoma, also known as Hodgkin disease, is a type of cancer that begins in lymphatic tissue, which includes the lymph nodes and other parts of the body's immune and blood-forming systems. It affects white blood cells, thus damaging the body’s ability to fight infection. In the United States, 6,000 to 7,000 new cases of Hodgkin lymphoma are diagnosed each year.
Although a diagnosis of Hodgkin lymphoma can be challenging, Robert Chen, M.D., assistant professor in the Department of Hematology & Hematopoietic Cell Transplantation at City of Hope, explains that recent advances in the diagnosis and treatment of the disease are giving patients the chance for a full recovery and long-term survival.
What is Hodgkin lymphoma?
Hodgkin lymphoma is one of the subtypes of lymphoma. Lymphoma arises out of lymphocytes, which are part of the white blood cells in the immune system. They are characterized by the presence of Reed-Sternberg cells when examined microscopically. The disease is considered curable, but a certain percentage of patients are refractory or relapsed to the primary treatment.
Are there any known causes of Hodgkin lymphoma? Also, who is most at risk?
This cancer primary occurs in two age groups – the first in young adulthood (ages 15 to 35), and the second in those over 55. Certain chemical and radiation exposures have been linked to Hodgkin lymphoma. Immunocompromised patients, such as patients with HIV or solid organ transplants, have been associated with having a higher risk. But in general, most patients do not have an identifiable risk factor.
What are the biggest or newest developments in treating Hodgkin lymphoma?
Fortunately, scientists continue to make major advances in Hodgkin lymphoma research. In August of 2011, the U.S. Food and Drug Administration (FDA) approved the drug brentuximab vedotin for patients with relapsed or refractory Hodgkin lymphoma. This is the first drug that has been FDA-approved for the specific treatment of Hodgkin lymphoma in the last 20+ years.
The drug’s approval is exciting because it is a new class of drug, an antibody-drug conjugate. It delivers a potent cytotoxic therapy directly into lymphoma cells expressing specific surface markers. This drug has a high overall response rate of 75 percent and is very well-tolerated. City of Hope was the leading institution on the pivotal trial that lead to the drug’s approval.
Researchers are also conducting clinical trials of advancing the use of brentuximab vedotin in earlier settings for the treatment of Hodgkin lymphoma. Several other biologic molecules are also under investigation at this time.
Where is the field going and what do you think will be accomplished in the next five or 10 years?
We continue to study the use of brentuximab vedotin either in combination or as a single agent in different treatment settings for Hodgkin lymphoma. We also are examining several other biologic agents. In general, the new drugs and combinations aim to improve the efficacy while reducing their side effects. We hope to achieve more cures and less long-term complication(s) in our long-term survivors.
Why did you choose this specialty? What inspires you to do the work you do?
What inspires and excites me about the hematology oncology field is the constant influx of knowledge and development of novel therapies. Advances in molecular biology, cellular biology and immunology, have led to new therapeutic strategies that were not available before. Survival rates have improved dramatically in a relatively short amount of time in the past 10 years in the field of hematology. It’s great to see research benefiting patients directly in front of my own eyes.
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Learn more about Hodgkin lymphoma research and treatment at City of Hope.