Improved Outcome for Relapsed Non-Hodgkin's Lymphoma

Contact: Alicia Kim
(212) 639-3573

NEW TREATMENT OFFERS IMPROVED OUTCOME FOR PATIENTS WITH RELAPSED NON-HODGKIN'S LYMPHOMA

NEW YORK, December 1, 1999 - Each year 15,000 patients with the most common type of non-Hodgkin's lymphoma (NHL) will relapse and require life-saving treatment. Now, researchers at Memorial Sloan-Kettering Cancer Center have shown that a new combination treatment increases the number of patients who can receive potentially curative bone marrow transplantation.

The treatment, called ICE, combines three chemotherapies (ifosfamide, carboplatin, etoposide). It was found to significantly improve the tumor response rate and reduce toxicities in patients with relapsed, aggressive NHL. In addition, the ICE regimen enables more stem cells to be harvested, therefore increasing eligibility of patients for a lifesaving transplant, according to a study published in this month's Journal of Clinical Oncology and presented at the American Society of Hematology Meeting in New Orleans this week.

The ICE trial demonstrated a significant reduction of tumor size in less time, with a greater response rate compared to standard therapy. In addition, there were no treatment-related deaths, clearly demonstrating a substantial improvement in outcome.

"The ICE regimen represents a significant advance in lymphoma management," according to Dr. Craig Moskowitz, of the Lymphoma Service, Division of Hematologic Oncology at Memorial Sloan-Kettering Cancer Center and the study's lead investigator. "We believe that the data support the use of ICE as the standard treatment prior to transplant in patients with lymphoma."

Non-Hodgkin's lymphoma is currently the fifth most common cancer in the U.S. and is the only malignancy, other than melanoma, that is on the rise. NHL is a cancer of the lymphatic system. The lymphocytes (white blood cells) begin to divide too rapidly and grow without any order or control, possibly forming tumors and spreading to other parts of the body via the lymphatic system. Lymphomas can be found anywhere in the body. NHL generally occurs in individuals between the ages of 30 and 70 and effects men and women equally. In 1999, there were an estimated 64,000 new cases of NHL.

Stem cells transplant with high dose chemotherapy (also referred to as bone marrow transplant) is the most successful way to treat relapsed patients. However, current standard therapy can result in poor stem cell harvest and excessive toxicity. In this study, patients received a short course of ICE chemotherapy with G-CSF (a growth factor used to increase production of the white blood cells).

Despite the poor prognosis of patients in the ICE treatment program, 73 percent of the 163 patients in this study received all three cycles of ICE. Of those who received all three cycles, 91 percent demonstrated a major response and 81 percent underwent high-dose therapy and transplant. Only patients who achieved a major response were eligible for transplant.

"To date, this is the largest clinical trial for relapsed lymphoma patients. This study is important because there was a response to treatment in a very sick group of patients, many of whom were excluded from previous studies." said Dr. Moskowitz. "For the first time, the ICE treatment program offers an effective option for patients with relapsed, aggressive non-Hodgkin's lymphoma."

Memorial Sloan-Kettering Cancer Center is the world's oldest and largest private institution devoted to prevention, patient care, research, and education in cancer. Throughout its long distinguished history, the Center has played a leadership role in defining the standard of care for patients with cancer. In 1999, Memorial Sloan-Kettering was named the nation's best cancer care center for the seventh consecutive year by U.S. News & World Report.

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