lymphoma-evidence

A tool that takes one patient's tumour genetics and gives the probability that it belongs to each of seven genetic groups, rather than sorting whole cohorts into clusters.

Every attempt to drop radiotherapy from early Hodgkin lymphoma on the strength of a clear scan has cost people their remission. Changing the chemotherapy as well is the next attempt.

A surgeon working in Uganda described a tumour of the jaw in children that nobody had named, and the pattern of where it occurred led, six years later, to the discovery of the first human cancer virus.

Repeating the SHINE design with a more selective targeted tablet gave another seventeen months before relapse, and again did not extend life.

Japanese researchers found an antigen in cells from a patient with an unusual leukaemia, then found antibodies to it in every one of 44 patients with that leukaemia and in a quarter of healthy adults where the disease clusters.

Starting with the most intensive Hodgkin chemotherapy and switching to the gentler standard once the scan cleared gave the same results with markedly less anaemia, low platelets and infection.

An intensive infusion chemotherapy schedule, widely believed to be better for aggressive lymphoma, was compared head to head with the standard and was not better, only harder to tolerate.

A German trial adding a targeted tablet to the reduced-dose chemotherapy used for older people with aggressive lymphoma, to see whether it delays relapse.

Three genetic classifications of the commonest aggressive lymphoma exist and none of them yet decides anyone's treatment. The trial that would change that has not been run.

The first CAR-T trial in slow-growing lymphoma: more than nine in ten responded and three quarters went into complete remission, with severe neurological events in about one in five.

In young women treated for Hodgkin lymphoma, breast cancer risk rose with the radiation dose to the breast, and fell when chemotherapy or radiation had stopped the ovaries working.

Adding a CD30-directed antibody-drug conjugate to a tablet-and-antibody pairing added about five months of median survival for heavily pretreated people with relapsed aggressive lymphoma.

Half of 2,524 people treated for Hodgkin lymphoma developed heart or valve disease within forty years, and the risk was still four to six times the general population's after thirty-five years.

Three ordinary laboratory stains, available in any hospital, were shown to sort lymphoma into the same two prognostic groups that an expensive gene-expression machine had found.

The first retrovirus found in people was isolated from the blood cells of a patient with a skin lymphoma, and turned out to cause a leukaemia endemic in southern Japan and the Caribbean.

A blood test read the genetic type of a lymphoma without a biopsy, detected disease left behind better than scans did, and spotted the change from a slow lymphoma into an aggressive one before it showed.

An intensive infusional chemotherapy regimen that many centres had adopted on single-arm evidence was no better than the standard when finally compared head to head, and was harder to tolerate.

In early Hodgkin lymphoma, switching to more intensive chemotherapy when the scan was still positive raised five-year freedom from progression from 77 to 91 per cent.

One in five people whose follicular lymphoma came back within two years of first treatment had half the five-year survival of everyone else, which is why that two-year mark now changes the plan.

A single infusion of a patient's own reprogrammed immune cells cleared follicular lymphoma completely in about seven out of ten people who had already been through several treatments.

A British and Nordic trial took chemotherapy out of first-line treatment for older people with mantle cell lymphoma and found the two-drug, chemotherapy-free combination worked better.

In early Hodgkin lymphoma, people whose scan was still positive after two rounds did much better on more intensive chemotherapy, and people whose scan was clear still needed their radiotherapy.

The first randomised trial of first-line drug treatment for MALT lymphoma: the combination of an old tablet and an antibody beat either alone on relapse, and nobody lived longer.

Several treatments now work without chemotherapy, but most are given until the disease comes back. Giving them for a fixed time and stopping is the version patients would choose.

Young people with early, low-risk aggressive lymphoma got two fewer rounds of chemotherapy and did just as well, with about a third fewer side effects recorded.

A trial testing whether a radiotherapy dose one sixth of the standard works as well for early follicular lymphoma when an antibody is given alongside it.

Young people with early, low-risk aggressive lymphoma did just as well with four rounds of chemotherapy as with six, and had roughly a quarter fewer side effects.

Sequencing 574 lymphomas found four genetic patterns that recur, two of which depend on a signalling route that an existing tablet can block.

Halving the chemotherapy and cutting the radiation dose by a third worked just as well for early Hodgkin lymphoma with favourable features, and caused fewer side effects.

Trying to spare people radiotherapy by using a clear scan after two rounds of chemotherapy cost them about seven in a hundred in disease control, so the radiotherapy stayed.

People whose scan was clear after two rounds of the most intensive Hodgkin chemotherapy could stop after four rounds instead of six or eight, with the same disease control and far fewer severe infections.

A newer antibody against the same target as rituximab was tested in first-line treatment for the commonest aggressive lymphoma and did not work better, while causing more side effects.

The first trial to show that a chemotherapy-free first-line combination beats immunochemotherapy in older people with mantle cell lymphoma.

Adding a targeted tablet to first-line chemotherapy gave older people with mantle cell lymphoma about two and a half more years before relapse, without helping them live longer.

The first randomised trial of first-line drug treatment for MALT lymphoma found that combining an old tablet with an antibody delayed relapse better than either alone, without anyone living longer.

The only randomised trial ever run exclusively in the virus-driven T-cell leukaemia found an intensive Japanese regimen better than standard chemotherapy, at the cost of much more severe low blood counts.

The pivotal study of the second CAR-T cell product approved for adult lymphoma, which put about a third of people with no remaining options into a lasting remission.

Two years of a tablet after chemotherapy delayed relapse in older people with aggressive lymphoma but did not help them live longer.

The pivotal study of the third CAR-T product for lymphoma, built from a fixed one-to-one mix of two kinds of T cell, with severe immune side effects in only a small minority.

Three years of an antibody every two months after a stem cell transplant kept younger people with mantle cell lymphoma in remission longer and helped them live longer.

Everything known about the long-term cost of curing lymphoma comes from people treated decades ago with much larger radiation fields. Nobody knows the forty-year risks of what is given today.

Reading the whole genetic picture of 304 lymphomas, rather than one gene at a time, sorted them into five groups that arise by different routes and respond differently.

A large American trial testing whether a two-headed antibody that recruits the immune system should replace the standard antibody as the first treatment for slow-growing follicular lymphoma.

A European trial for a lymphoma that rarely gets its own study, testing a two-headed antibody with a tablet against the three combinations doctors currently choose between.

A newer antibody against the same target did not improve first-line treatment of the commonest aggressive lymphoma, although it had improved treatment of two other B-cell cancers.

Starting with the most intensive Hodgkin chemotherapy and switching to the gentler standard once the scan cleared gave the same disease control with far less anaemia, bleeding risk and infection.

People whose scan cleared after two rounds of the most intensive Hodgkin regimen could stop after four rounds instead of six or eight, halving severe infections with no loss of control.

An asparaginase-based regimen produced a response in four out of five people with an aggressive nasal lymphoma that resists ordinary chemotherapy, and nearly all of them developed dangerously low white cell counts.

A Nordic trial asking whether the antibody-drug conjugate that improved first-line treatment for younger patients also helps people in their eighties, who were barely represented in the original trial.

Adding an antibody-drug conjugate to a gentle outpatient chemotherapy pairing added about seven months of life for people with relapsed aggressive lymphoma who could not have a transplant.

Adding an antibody-drug conjugate to an outpatient chemotherapy pairing added seven months of median survival for people with relapsed aggressive lymphoma who could not have a transplant.

Trying to spare radiotherapy on the strength of a clear scan after two rounds of chemotherapy cost about seven people in a hundred their remission.

Two years of an antibody given every two months after chemotherapy more than doubled the time before follicular lymphoma came back, but after nine years the two groups were equally likely to be alive.

The first randomised trial asking whether older people with lymphoma of the brain do better with a short intensive course and a stem cell transplant than with the gentler long regimen that is standard in Germany.

An international trial asking whether swapping one old chemotherapy drug for a targeted antibody lets most people with early Hodgkin lymphoma avoid radiotherapy altogether.

Adult T-cell leukaemia has had one randomised trial, in 1998. Most T-cell lymphoma treatment rests on single-arm studies, and the diseases concentrated outside Europe and North America have the least evidence of all.

Adding a targeted tablet to standard first-line chemotherapy failed overall, helped people under 60 substantially, and harmed people over 60 by making them unable to finish the chemotherapy.

Adding six cycles of drug treatment after radiotherapy for early follicular lymphoma cut relapses outside the treated area and improved ten-year freedom from progression from 41 to 59 per cent.

Two years of a tablet taken after chemotherapy delayed relapse in older people with aggressive lymphoma but did not help them live longer, and caused low white cell counts in over half.

The best explanation for why one second-line CAR-T trial failed when two succeeded is how long the cells took to make. That interval is almost never a reported endpoint.