Cancer Q&A: Feb 1, 2009

2/01/2009

Fishy links to multiple myeloma, NHL and leukemia

A blog reader, thank you!, sent me a study titled Dietary Fish Intake and Risk of Leukaemia, Multiple Myeloma, and Non-Hodgkin Lymphoma, published in “Cancer Epidemiology, Biomarkers & Prevention” in April 2004. The full study i...

A blog reader, thank you!, sent me a study titled Dietary Fish Intake and Risk of Leukaemia, Multiple Myeloma, and Non-Hodgkin Lymphoma, published in %26ldquo;Cancer Epidemiology, Biomarkers %26#38; Prevention%26rdquo; in April 2004. The full study is available online, so I won%26rsquo;t load the post up with details that you can read for yourself, right here: [...]

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Radioimmunotherapy for Non-Hodgkin's Lymphoma

ANNOUNCER: It's always exciting when medical research provides new treatment options. Such is the case with radioimmunotherapy for non-Hodgkin's lymphoma. Like traditional radiation therapy, this new technique uses radiation. But with radio...

ANNOUNCER: It's always exciting when medical research provides new treatment options. Such is the case with radioimmunotherapy for non-Hodgkin's lymphoma. Like traditional radiation therapy, this new technique uses radiation. But with radioimmunotherapy the radiation is not delivered externally through a beam, but in the form of medication containing special antibodies.

Normally, your immune system uses antibodies, which are proteins that circulate through the bloodstream and attack foreign substances. Today, science can artificially produce substances known as monoclonal antibodies, which are designed to target cancer cells. A radiation source is attached to these antibodies, providing an extra punch in destroying these cells.

RUSSELL SCHILDER, MD: Radioimmunotherapy is a more targeted way of delivering the radiation. It is usually bound to an antibody which is specific for the lymphoma and thus quickly distributes the radiation to the areas of interest and thus spares a lot of the normal tissue.

ANNOUNCER: Currently there are two medications, Zevalin and Bexxar, which are approved by the FDA for radioimmunotherapy. Both utilize the power of different radiation particles called isotopes

STEPHEN SCHUSTER, MD: Iodine-131 is the isotope that's used in the Bexxar antibody. Yttrium-90 is isotope that's used in the Zevalin antibody.

ANNOUNCER: The radioactive particles in Zevalin emit beta radiation, which travels over a relatively short distance. The radioactive particles in Bexxar give off beta and gamma radiation. The gamma radiation travels a longer distance.

STEPHANIE GREGORY, MD: Beta radiation has a short path length and doesn't penetrate deeply into tissue and outside of the body. Gamma radiation is not stopped by anything short of lead, so it passes straight through the body out into the external environment and actually hits whatever is in its pathway.

ANNOUNCER: Safety issues for those in close contact with the patient depend on which medication is administered.

RUSSELL SCHILDER, MD: Yttrium-90 source of radiation is a pure beta emitter so there's absolutely no radiation that escapes the body. The only instructions they really have is to wash their hands, clean up any spills of bodily fluids quickly, to not share utensils for three days, to use condoms during sexual relations for the first week, though it's recommended that birth control be used for up to a year. The other, if it's using iodine, as in I131, it is mostly a beta emitter but there's some gamma radiation and there are some slight differences depending on what state you live in as to the regulatory issues.

ANNOUNCER: Side effects for the patients themselves appear to be minimal.

STEPHEN SCHUSTER, MD: There's some lowering in the white count, platelet count. It's, in general, very mild. And rapidly reversible by the eighth week following treatment and has little clinical consequences. But nevertheless, patients need to be monitored carefully.

ANNOUNCER: A benefit from these types of radiation could be a "crossfire effect." Experts believe the radiation can attack not only the cells to which the radioactive antibody is attached, but also destroy adjacent tumor cells as well.

STEPHEN SCHUSTER, MD: The crossfire effect is the same for Bexxar and Zevalin in the sense that radiation is delivered over a distance from where the antibody's localized and will treat adjacent cells. The difference, however, is in the magnitude of the crossfire effect.

The radiation travels 1 to 2 mm in distance with Bexxar, where it travels 5 to 10 mm with Zevalin. So the area of crossfire is greater with Zevalin than with Bexxar.

ANNOUNCER: The results for both of these medications are very promising.

STEPHANIE GREGORY, MD: A complete response with Bexxar is a median duration of three years, and there are patients with complete responses out to eight years with Bexxar. We don't have as long follow-up with Zevalin, but the complete responders are out two years with Zevalin, and they do have complete responders who are out four years at the present time.

ANNOUNCER: Both therapies are delivered through a vein and generally require several visits over a period of time lasting one to two weeks. Balancing the administration of these unique treatments requires a coordinated effort between a team of skilled experts.

STEPHANIE GREGORY, MD: We often say that it's a multi-disciplinary approach between the oncologist, the nuclear medicine physician or the radiation therapist, and certainly a nursing staff.

STEPHEN SCHUSTER, MD: I don't know that there are many more people involved in radioimmunotherapy than in other cancer therapies. It's just that there is new people or different people that are on the scene.

ANNOUNCER: Many feel radioimmunotherapy holds new hope for patients with non-Hodgkin's lymphoma.

STEPHANIE GREGORY, MD: The future of targeted therapy is very bright. We are going to see more and more combinations of targeted therapy.

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BRCA1 mutations in cancer stem cells

BRCA1 mutations are the most common cause of hereditary breast cancer and germline mutations carriers have a greatly increased lifetime incidence of breast and ovarian cancer. However, the molecular mechanisms responsible for this tissue-sp...

A new study published in PNAS may explain why women with a mutation in the BRCA1 gene face up to an 85 percent lifetime risk of breast cancer.

The study, in mice and in human breast cancer cells, found that BRCA1 is involved in the stem cells differentiating into other breast tissue cells. When BRCA1 is missing, the stem cells tend to accumulate unregulated and develop into cancer. Researchers detected clusters of expanded stem cells in breast tissue isolated from women carrying BRCA1 mutations, and found that women with these expanded stem cells had a particularly high chance of developing breast cancer ( via ).

%26ldquo;If larger studies confirm these findings, it could potentially lead to a test to identify BRCA1 carriers at particularly high risk of developing breast cancer. This might help them and their physicians make a more informed decision about preventative measures such as prophylactic mastectomy,%26rdquo; says senior study author.

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Fishy links to multiple myeloma, NHL and leukemia

The danger of cell phones, laptop computers, electromagnetic fields

In this video Brian Clement speaks about the dangers of cell phones, laptop computers and electromagnetic fields in general. It’s part of the raw food lecture Brian and Anna Maria Clement gave in Amsterdam, March 2008.

Be careful with cell phones. It’s best not to use them at all. If you do need one, don’t have it close to your body, but in a handbag or so. Use an earphone and a BioPro to protect your brains. In your car, use a car system, if you can afford it.

People don’t realize, but children get cell phones at a younger and younger age.

Research in Sweden has shown that kids, who use cell phones double their chance of getting blastic types of brain tumors by the time they are 20.

In Russia they did a study on 150 thousand children. They found that children below 16 who use cell phones on a regular basis up to one hour a week, between 21 and 28 years old get a 37 times higher incidence of brain cancer.

The same is true for laptop computers. Never put them on your nap.

Children get ovarian and testicle cancer nowadays, because of laptop computers. Imagine, you stick a high power radioactive battery on your penis or vagina. What do you think is going to happen?

Wall sockets are similar. They radiate about 2 square feet. Place your bed in a save place, if possible.

We don%26acute;t realize, but electromagnetic fields are everywhere around us nowadays. Keep them away from your body as much as possible.

Realize that cell phones, Ipods, BlackBerrie’s and laptop computers take away all your contemplative time. You are constantly stimulated from the outside.

Everybody needs this contemplative time. At the end it all comes back to you, self love and self respect.

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Decreased T-cell reactivity to Epstein-Barr virus-infected lymphoblastoid cell lines in multiple sclerosis

The cause of MS is not known but many factors are implicated including possibly viruses. The authors investigated immunity to Epstein-Barr virus in people with MS and found fewer immune cells, suggesting that it might somehow be involved.

authors: Pender MP, Csurhes PA, Lenarczyk A, Pfluger CM, Burrows SR

source: J Neurol Neurosurg Psychiatry. 2008 Nov 17. [Epub ahead of print]

The University of Queensland, Australia.

OBJECTIVE: To investigate T-cell and antibody immunity to Epstein-Barr virus (EBV) in multiple sclerosis (MS).

%26raquo; Read More

Suggestions, Comments and/or Questions are always appreciated.. - Thank you
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Epstein-Barr Virus (EBV)

The mad scientist/researcher is coming out again in me....this personality overtakes and consumes my thoughts for hours or even days at a time.This is just my own personal rant.....so beware!I noticed in my last set of bloodwork that I have...

The mad scientist/researcher is coming out again in me....this personality overtakes and consumes my thoughts for hours or even days at a time. This is just my own personal rant.....so beware!

I noticed in my last set of bloodwork that I have an elevated EBV titer of 7.6. I didn't have a clue to what this was....so I brought out my husbands old medical books. Turns out this is the virus that causes Mononucleosis. Did I have Mono or did I have it in past??? I did more research and found out that people with Sjogrens Syndrome tend to have an elvated EBV titer. Interesting....

Then I stumbled across a few studies that were trying to come to the conclusion that EBV may cause Sjogrens Syndrome and it does say that there is evidence indirectly.

The virus infects the immune B cells and multiplies in the salivary glands and surface tissues of the nasal and throat passages. After the initial infection, the virus remains dormant in the host's body, that is, exists without being infective. EBV can stimulate the production of autoantibodies, which are abnormal immune proteins directed against the body's own tissues and cells. Various lines of evidence suggest that EBV may be involved in the development of two autoimmune disorders, rheumatoid arthritis and Sjogren's syndrome.

Hmmmm....I am just wondering.

Anyone have anything to add to this? I wonder if there are any current studies going on about EBV and Sjogrens or other autoimmune disorders.....

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Lung tumor, brain tumor, metastatic liver cancer

The metastatic liver, stomach, brain and lung cancer story you read below could well be from your next door neighbour. And maybe all you knew was "that he was terribly sick" and "had been rushed to the hospital more than once". But you don&...

brain tumor

The metastatic liver, stomach, brain and lung cancer story you read below could well be from your next door neighbour.

And maybe all you knew was %26#34;that he was terribly sick%26#34; and %26#34;had been rushed to the hospital more than once%26#34;. But you don%26rsquo;t even have a clue how %26#34;terrible%26#34; terrible can get %26hellip;

Or you receive the announcement that your neighbour has passed away surrounded by his family battling a long lasting disease%26hellip;

We all heard about Ted Kennedy%26rsquo;s brain tumor and we saw him waving after coming out of the hospital and endorsing Obama, as if it%26rsquo;s all business as usual.

Images like this let us forget that cancer is a killer and that nothing looks like it seems once you or your loved one gets diagnosed with cancer.

That%26rsquo;s exactly what Sylvia points out when she commented at Please pray for Kathy%26rsquo;s liver metastasis:

I always used to hear cancer stories from other people.
But until you experience this on a personal level
you don not really grasp how terrible this disease is.

Sylvia%26rsquo;s brother passed away from cancer before his 40th birthday%26hellip;

Sylvia%26rsquo;s cancer story

Thanks for sharing Sylvia, our prayers, love and hugs go to you. Like you, father%26rsquo;s passing away from metastatic liver cancer is all but a closed chapter%26hellip;

My brother Heron went to the ER on 7/6/2008 for a severe headache.

He was diagnosed with a brain tumor.

A brain tumor that had developed from a tumor in the lung.

He had just turned 39 on 7/3/2008.

He went through brain surgery on 7/10/2008.

From there on cat scans , mri, radiation therapy to the brain area and more tests.

They found more cancer in the stomach as well as his liver.

He had one session of chemotherapy and never recuperated from it.

He passed on 9/2/2008.

I always used to hear cancer stories from other people. But until you experience this on a personal level you don not really grasp how terrible this disease is.

I still have not come to terms with my brothers death and how could he of died so quickly.

He survived less than two months once he was diagnosed.

He is terribly missed.

My prayers and thoughts go out to everyone out there who has experienced this.

Technorati Tags: brain cancer, brain tumor, cancer story, Liver Cancer, Lung Cancer, Metastatic Liver Cancer, stomach cancer

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Connie Arnold's Non-Hodgkins Lymphoma Survivor Story

Here is my friend Connie Arnold's amazing story about her recovery. Don't forget about Connie's class tomorrow!"In January of 2004, I was diagnosed with Non-Hodgkin Lymphoma, an aggressive large B-cell cancer. This is a cancer that develops...

Connie arnold

Here is my friend Connie Arnold's amazing story about her recovery. Don't forget about Connie's class tomorrow!

%26quot;In January of 2004, I was diagnosed with Non-Hodgkin Lymphoma, an aggressive large B-cell cancer. This is a cancer that develops in the lymphatic system. I was told this cancer could spread to almost any part of my body, including the liver, bone marrow and spleen.

When I heard the word cancer, I felt numb with disbelief and a paralyzing fear. The upcoming weeks were filled with tests and more tests.

As fate would have it, I learned about the macrobiotic lifestyle, a natural approach to health and sickness. %26quot;Macro%26quot; means long or great, %26quot;biotics%26quot; means life. An M.D. I knew who had a holistic approach to medicine explained that macrobiotics is an alkalizing way of eating when cancer patients are known to have an acidic condition in their bodies. I started practicing in January of 2004, eating fresh whole foods brimming with health-supporting qualities.

Three doctors' opinions prescribed 4 to 8 months of aggressive chemotherapy and 6 or more radiation treatments. The doctors urged me to start this treatment immediately. I decided not to do the chemotherapy or radiation and continued on the macrobiotic path. The most difficult part of my decision was to look at my husband and children's eyes and see the fear and disbelief. I knew in my heart it was the right choice for me. Over 4 1/2 years later, ongoing medical tests have found no evidence of cancer in my body. I thank God every day for my health and macrobiotics. Should you be looking for better health or facing serious illness, I encourage you to explore the possibilities.

Since I started the macrobiotic lifestyle, I have attended the %26quot;Way To Health%26quot; week as well as Levels 1, 2, 3 (currently enrolled in Level 4) at the Kushi Institute (in Becket, Mass.) to further my studies and understanding of the energetics of food and macrobiotic healing. My goal is to become a macrobiotic counselor and help others in the same situation I was once in.

I am teaching cooking classes in groups or private sessions by appointment. For more information, call me at (207) 247-5146.%26quot;

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Bone-marrow transplantation fails to halt intrathecal lymphocyte activation in multiple sclerosis

PubMed - Sept 2008

Mondria T, Lamers CH, te Boekhorst PA, Gratama JW, Hintzen RQ.
Department of Neurology, Erasmus University Medical School, Erasmus MC, 3000 CA Rotterdam, The Netherlands.

BACKGROUND: Given the presumed key role for autoreactive lymphocytes in multiple sclerosis (MS), treatment strategies have been developed to ablate lymphocyte activity. Intrathecal lymphocyte activation can be measured by CSF-soluble(s)CD27.

OBJECTIVE: To determine the effect of maximum whole-body immune ablation on two different markers that detect lymphocyte activation in CSF-oligoclonal IgG bands and levels of CSF-sCD27.

%26raquo; Read More

Leaving comments is a great way to get others involved with the topic. Please feel free to leave your comment(s) for any of the postings found on this blog.
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Fine Needle Biopsy, Sounds Scarier Than it Is

I am not sure where to start on this because I can't assume everyone out there knows what a thyroid nodule is to begin with. We all have a thyroid, (if you have never had it removed) and it does a whole lot of things for our body. It stimul...

I am not sure where to start on this because I can't assume everyone out there knows what a thyroid nodule is to begin with. We all have a thyroid, (if you have never had it removed) and it does a whole lot of things for our body. It stimulates our metabolism, which is why people who are very skinny or very heavy can be said to have a thyroid issue. It does run in my family.

My doctor discovered the thyroid nodules upon physical examination and I thought it explained the pressure I was having in my throat. I still think it might explain for some of the pressure. I can now visibly see one of the lumps in my neck. Some can't tell but if you look closely it sometimes appears as though I have an Adam's apple. UGH. I hate it and part of me just wants it gone but for that to happen we'd have to get rid of the thyroid which is functionally properly. That's not an ideal thing to do. We do have to watch for thyroid cancers since I already have four nodules and now I have had radiation to that area.

Anyway, long story short, they decided the first time to biopsy my thyroid nodules to make sure they were not cancerous. This is all before my cancer diagnosis of Hodgkin's. Since I have four nodules I got around 7 to 8 sticks. They put the needle into a nodule with a sonogram to guide it. It's not like a shot though. They don't just go in and then pull out the needle. No. They put the needle in and wiggle it around to get a good sample. The pain wasn't as bad as I thought though. The wiggling around was a little painful but mostly I felt pressure and like if I swallowed, I would swallow the needle. Obviously I wouldn't but it still felt like it. I ended up with a band aid. It was not too traumatic but anytime someone wants to poke you in the neck repeatedly with a needle you get a little scared. The second time was the day they actually did find the tumor. They ran a series of tests one being another fine needle biopsy which I used no anesthesia for this time around. I had realized that shot hurt worse than the others combined so I opted for none. It was again uncomfortable and scary but not too bad. They got nothing but blood though. They got no good samples and then on the sonogram she saw the tumor. So, I think she was pretty sure something else was wrong anyway. So, that is a fine needle biopsy in a nutshell. If you have other questions ask. I have no problem answering what I can.

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Treating Follicular Non-Hodgkin's Lymphoma

ALEXANDRA LEVINE, MD: Follicular lymphoma is not unusual at all in the United States. It is a disease that is associated with long survival, even though we cannot traditionally cure it today.MORTON COLEMAN, MD: It tends to be a disease more...

ALEXANDRA LEVINE, MD: Follicular lymphoma is not unusual at all in the United States. It is a disease that is associated with long survival, even though we cannot traditionally cure it today.

MORTON COLEMAN, MD: It tends to be a disease more of the elderly than of the young, but it is possible to see it in patients 30 and 40 years old.

ANNOUNCER: Twenty-two percent of all non-Hodgkin's lymphoma is classified as follicular lymphoma. It develops from malignant B-lymphocytes or B-cells and is usually of the indolent type.

MORTON COLEMAN, MD: Follicular lymphoma tends to be very indolent, very lazy. Sometimes, we don't even treat the disease. Certainly initially, we are willing to watch the patient to see what happens.

ANNOUNCER: When a patient begins to experience symptoms, such as fatigue, loss of appetite, weight loss or lymph node swelling many doctors may begin treatment.

MORTON COLEMAN, MD: We have a wide range of treatments for follicular lymphoma. Some of the treatment options are chemotherapy; immunotherapy, primarily monoclonal antibody therapy, although there are experimental use of vaccines now in patients.

ANNOUNCER: Monoclonal antibodies target proteins on the surface of lymphoma cells.

DAVID FISHER, MD: I think the most important drug is a drug called Rituxan. It's a manmade antibody that binds to a protein on the lymphocytes called CD20.

ALEXANDRA LEVINE, MD: Once that attachment occurs, the antibody attaching to the lymphoma cell, that whole complex goes to the spleen. And in the spleen, that complex is removed by a cell in the spleen and it is literally digested or destroyed.

ANNOUNCER: Rituximab can be used by itself or in combination with chemotherapy.

DAVID FISHER, MD: There are a number of studies now that show, by adding Rituxan to the chemotherapy, it can work much better.

ALEXANDRA LEVINE, MD: The side effects of rituximab are very interesting because they're different from the usual side effects of chemotherapy.

DAVID FISHER, MD: The main side effect is an allergic-type reaction. Fever, chill, or an asthmatic-type reaction or tightness in the throat.

ALEXANDRA LEVINE, MD: We will treat the patient to try to prevent those symptoms when the antibody is given for the first time. So we will use drugs to prevent fever, drugs to prevent allergy or rashes.

ANNOUNCER: These symptoms usually don't re-occur after the first treatment.

ALEXANDRA LEVINE, MD: The average survival of patients with indolent or low grade lymphoma has been stable ever since the 1960s. And now with these new antibodies and so forth for the first time in 40 years, or approaching 50 years for the first time, we are seeing a statistically improved, prolonged survival in those patients.

ANNOUNCER: Doctors may also treat patients with radioimmunotherapies like Zevalin and Bexxar to deliver radioactivity directly to the tumor cells.

MORTON COLEMAN, MD: We tag a radioisotope onto the monoclonal antibody, that's pretty much like saying if you wanna make sure you can shoot down that plane, you'll not only hit it with the missile, but you'll attach an explosive.

ALEXANDRA LEVINE, MD: Some of the recent data suggests that as many as 70 percent of patients who have not responded to the antibody alone will respond very nicely to the radioimmunotherapy.

MORTON COLEMAN, MD: If patients don't respond to these "more conventional approaches," then we can also consider the patient for transplantation and we have several options with transplantation.

DAVID FISHER, MD: One approach that's being used for quite some time now is stem cell transplant, using high doses of chemotherapy that require receiving your own stem cells back to recover your blood counts or using donor stem cells. And I think donor stem cells are very interesting, because it's giving a new immune system to the patient and that allows the immune system to go on and attack the lymphoma for years and can be very effective.

ANNOUNCER: Researchers are continuing to study new therapies for the treatment of follicular lymphoma.

ALEXANDRA LEVINE, MD: Just because it cannot be cured today does not mean that it won't be cured tomorrow, and with all of the exciting advances being made right now, this is a very important time for patients with follicular lymphoma.

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Testing Vaccines for Non-Hodgkin's Lymphoma

ANNOUNCER: There are times when medicine offers up hope for an advance that might change the course of a disease. Such is the case with Non-Hodgkin's Lymphoma and a new vaccine therapy which Doctors hope can prolong remissions and extend su...

ANNOUNCER: There are times when medicine offers up hope for an advance that might change the course of a disease. Such is the case with Non-Hodgkin's Lymphoma and a new vaccine therapy which Doctors hope can prolong remissions and extend survival.

RONALD LEVY, MD: Chemotherapy and radiation therapy. The standard treatments can make the tumor shrink, can make it go away, but it's temporary and it eventually does come back. And this vaccine (we hope) will keep it from coming back.

ANNOUNCER: Non-Hodgkin's Lymphoma, a cancer of the immune system, is particularly suited to a vaccine.

DAVID FISHER, MD: We know that antibodies attack things and help us with our immune system. Everyone's lymphoma has a specific antibody, because all the cells are produced as a clone, they're all the same, because they're cancer cells. We call that antibody idiotype.

And every patient has a unique idiotype. You have to sort of put a flag on those cells and help the body recognize that those are indeed unwanted cells. We can take tumor cells, we can pull out the idiotype antibody, we can purify it and we can give it back to the patient to work as an immune booster, sort of like a vaccine.

RONALD LEVY, MD: It's kind of like using the immune system to go after the immune system. It's fighting fire with fire in a sense

ANNOUNCER: What's innovative about this approach - personalized immunotherapy - is that that the vaccine will be individualized - made for each patient from his or her own tumor cells.

RONALD LEVY, MD: The vaccine is custom-made for each person, from their own tumor. And it's only usable in that one person. So it's made from their tumor, from their own tumor cell and it's given back to them and they're the only one that can benefit from this vaccine that's made from their own tumor

ANNOUNCER: For any new therapy, a series of trials must be done.

DAVID FISHER, MD: Phase I is where we give a drug and we just look to see if it's safe. Phase II is we start to use the drug with a dose that we think that is safe based on the phase I trials and look to see is there any evidence of activity.

ANNOUNCER: Several Phase II trials of vaccine immunotherapy are ongoing. Results from completed Phase II trials were very promising.

RONALD LEVY, MD: We saw from those phase II trials that patients can make an immune response against their own tumor, and that they can stay in remission a long time, and that it's even better if they make that immune response. Not all of them make an immune response, the ones who do, have an exceedingly long time staying in remission and staying alive.

ANNOUNCER: The vaccines in the completed Phase II trials are now in phase III trials, the final step before a drug is approved. One Phase III trial is sponsored by a company named Genitope and a second, by the National Cancer Institute.

RONALD LEVY, MD: We have some people getting the vaccine that's made from their own tumor, and some people getting something that looks and feels like the vaccine but doesn't contain the ingredients from their own tumor. And we're comparing these two groups to each other. We're trying to prove that it actually keeps the lymphoma from coming back and keeps people living longer.

ANNOUNCER: Patients are still being recruited for these trials, but only certain patients are eligible.

DAVID FISHER, MD: The current trials are looking at patients with newly diagnosed follicular lymphoma. We're looking at patients who are newly diagnosed, so that they haven't been sort of beaten up with the chemotherapy and they have a good immune system.

RONALD LEVY, MD: We also like to have the tumor down to the minimum, so the tumor is not damaging the immune system.

ANNOUNCER: Two Phase II trials are looking at combining two immunotherapies, an antibody, called Rituxan, with the idiotype vaccine. This is an option for patients who don't respond as well as they might to the chemotherapy, who relapse, or even as their first treatment.

RONALD LEVY, MD: For the people who have what we call an inadequate response to chemotherapy (their tumors shrink not enough or they shrink not long enough and come back again) -- give all those patients Rituxan as a second treatment to get their tumors to shrink, and then to give them the vaccine.

ANNOUNCER: For patients in the Phase III trials, treatment follows a standard plan with an important addition.

DAVID FISHER, MD: We do require a biopsy of fresh tissue either a surgical biopsy or a needle biopsy. We do go through chemotherapy after that and the chemotherapy is standard and routine and it's the same you'd receive even if you weren't on the trial.

RONALD LEVY, MD: We allow a period of recovery from the chemotherapy for the immune system to recover before we start the vaccine.

DAVID FISHER, MD: The vaccinations are given as a shot under the skin like a diabetic gives himself insulin and it's been very well tolerated.

In addition, patients take a drug called GM-CSF as a shot under the skin for four days after each vaccination. This helps stimulate the immune response.

ANNOUNCER: The side effects from the vaccine itself are minimal.

DAVID FISHER, MD: You can sometimes get some redness, some swelling around the sites of the injections. Some people have had some flu-like symptoms, sort of muscle aches, low-grade fevers. Otherwise, they've been well tolerated.

Once the vaccinations are done, we follow patients, which is the standard of what we would do with patients who were receiving chemotherapy watch for any signs of recurrent disease, but without any further therapies.

ANNOUNCER: Yet taking part in the trial doesn't mean abandoning other therapies if the disease returns.

DAVID FISHER, MD: The question is: Does receiving the vaccine close any doors down the line? And it doesn't. So once the disease does show evidence of coming back, if it does, patients can receive any other therapy that they would if they hadn't received the vaccine.

ANNOUNCER: There are also exciting possibilities about combining the vaccine with other therapies and using it on a more wide spread basis.

RONALD LEVY, MD: We would love to be able to combine an active vaccine with a monoclonal antibody treatment, such as Rituxan or other monoclonal antibodies that are being developed. We'd love to try it in other kinds of B-cell lymphomas and T-cell lymphomas. There's no reason this couldn't also be used with aggressive lymphomas or what we call intermediate-grade lymphomas. There's no reason it couldn't be used after bone-marrow transplantation. There's no reason it couldn't be used as the first treatment, instead of chemotherapy.

ANNOUNCER: The development of this vaccine may have far reaching implications and the trials to test it are the first step in making these customized vaccines a reality for all patients.

DAVID FISHER, MD: We know, with chemotherapy, that people tend to have their disease come back. So why not try something that may turn the tables and keep the disease away longer or perhaps eradicate it and what could be better than a drug that's designed to attack my specific lymphoma, my own protein on the surface of the cell? Hopefully, this will pay -- will pay off in the future. Time will tell.

ANNOUNCER: For more information on the Clinical Trials of Idiotype Vaccine in Non-Hodgkin's Lymphoma, visit the Lymphoma Research Foundation website at www.Lymphoma.org.

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