How To Choose the Best Treatment Option When Indolent NHL Returns

" Hello I'm Dr. John Leonard and the clinical director of the one now -- lymphoma and -- We're going to talk today. About how patient with England slow growing not -- Omar the I'd among treatment up when the disease could learn to relax."

" Letting me today is -- Cornell colleague doctor -- home."

" Practical and a clinical for her mad at the Weill medical college of Cornell universe. Are joining me zucker I don't know can't. He's on collar with a memorial Sloan Kettering cancer and are today with a brief review of the treatment option. Shall within. A little lymphoma hodgkin's lymphoma overall. -- He's been all that can recur. And our whole array of treatment options and can be very complicated choosing between chemotherapy. Without a map."

" Radioactive antibodies like Evelyn and -- star and -- transplant. Practical when you've seen over. Hundred years they kind of in the major impact -- map made in the east and traditionally patients were treated with chemotherapy. Now. Now we use -- lab with chemotherapy. Now there's a whole group of -- and getting treated with her and -- so what's what a -- He is appropriate hurt or to treatment whether it's -- and Abalone and how do you like to give it and that sort of --"

" They can really tolerate the talks and remarkably well. One lead particularly good property of the toxin is that it does not impact on Merrill function. And sometimes we can just get away your dad I can live with news and -- and -- simple. We take it once a week or for a week and given on the office and that era there's very little to contend. The big debate now in medical circles as well taken to respond to -- those patients in particular who have just slowly -- and disease. Well he's taken should be maintained that we -- on not. I think the current trend is tilting toward maintaining these -- although the jury is that a lot of."

" And city advantages doctorate on Armenians for an avenue are you obviously that he's come back to get treatment."

" What's the trade all they're they're down I'd your experience far ends of the convenience did you think it works well. What about -- that."

" Post reports suggested there's a lot of controversy in the medical community today about the merits of using -- talks to map on the maintenance schedule versus using it. On an as needed a and the current data -- suggests that using an army maintenance tight schedule on a very well prescribed regimen for example at least six months. On main -- victory -- benefit. But there's still a lot of clinical trials. Ongoing exploring the -- and then more."

" Morning and I think I think there's a very complicated area and one and plot that paint and should know about speak about -- and I don't think there's a clear cut answer. One and in other major areas -- that -- out is the radio in you know with USDA approved drugs Evelyn back our. There are a number of scenarios. That those agents can be very useful for doctor Coleman what's been you're dealing with when these drugs particularly will now focus again -- hasten slowly progressing disease may be. Not a lot of therapy in the past. -- and look at -- and there is an option of that group."

" If there's one clean that I make -- I -- that you keep going you greeted -- with -- to use that earlier rather than later. The chances of being successful with this particular therapy as far greater if -- early on and the treatment Steve rather than waiting on the page and they had. Multiple thirteen. And I think that -- in -- our team is that it therapy that's pretty completed within a couple of weeks so is extremely convenient for the patient. Also -- aren't that -- who -- on radio and a third inning game that came as -- responding. Very well or greater when used early on that you -- sponsors are very durable and -- and so they have very convenient way to meet people. There is total direct thirtieth I stood in short and very often the -- and so prolonged anchored in many many many many years."

" There radium therapy is one option and challenges among the different treatment options that we have this particular group at me and with the -- relatively. And it relatively early in the quarter there are some issues that potential long term -- our text on the bone marrow but in general I think these are not a major promote hate and that's something that patients need to keep in mind and and speak about what exactly."

" When does extraordinarily nice things about ready therapies that means -- patent on the radio and you know European -- They did not respond previously the plain ordinary what we call monochrome with them -- and also that we've seen excellent response and in Pickens who seem to be resistant to chemotherapy. -- district as a whole -- about new modality. Treatment qualities they can. Again and it did something that we need -- need more experience with but at least that current experiences is that it is a very useful and very simple treatment --"

" That's a good segue to our other kind of major category. In that group and then."

" Media had a number prior treatment maybe they've worked at the beginning pretty well but I no longer working well maybe the patient has that number bombs but it doesn't last very long one strategy. In some cases as to what talent and health plans doctor Coleman what sorts of hate and -- resistant disease or multiply relapse CI guess with -- he's been back several times where do you think about a talent and so."

" Well I do use -- and so transplant usually when I get -- sense of good taste of the disease is beginning to increase. That the disease is becoming more -- and I have had very good experience could use our colleges and plantation in patients where right -- the disease is transforming. Into a more aggressive form of the seats would carry Auckland and deliberately killing all one may do. And those symptoms -- feel that are out there and let it could be all really almost virtually light -- it. But in addition radio in -- Turkey has been used now in case is over practically disease -- of the date has not responded to chemotherapy. I think that perhaps maybe we could find for the audience Slovenian prime McConnell and -- body -- what we mean by radio immunotherapy. We talk about it and we're talking about a monoclonal antibody that is -- biologic agent that directed specifically. Through the -- so that -- there's a particular. And accused of radio in the therapy we all headed monoclonal antibody directed against Olympic title one home seller the case may be. But in this case -- during the war and that is the radio isotope. And we have double means of killing the tumor that is you can killer of a monoclonal antibody -- Al. All we can kill the tumor by the use of radio in. And the nice thing about it is there's that the radiation itself had not certainly been hit by the Monica but nobody else but we were hurt -- fire back. So we do have the option -- disease picking up paste they can who seems to be developed and a certain amount of -- to chemotherapy are. Simple monoclonal we talk some therapy and those two rockin' in particular are really -- therapy and I'll tell them well transplant. There's also an option of course of -- can make and we and we don't that we probably many transplant -- so all. Many transplant when he don't get it taken so heavily with Emo but depend on the -- to -- You do that does -- with at greater risk we have new -- that they. Resistance."

" Anger and very good summary and that you often find. That -- Considering those two options -- more intense -- a transplanted radium therapy option in the resistant senate and."

" Certainly having something like radium therapy with -- back -- that has a -- in the intends to graduate certainly makes -- appealing in many particularly. The elderly. Well thank you very much I think that that's and hopefully help people better understand their treatment --"

" If they relapse in England once and not hunt them."

" Joining me today from my colleague doctor Morton Coleman and doctor -- I'm Dr. John Leonard thank you very much for being -- it and we hate it now live in an."