Re: can't believe it... best wishes to him


"Mark Stahl" <stahl@xxxxxxxxxxxxxxxxxxx> wrote in message
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"Larry Lee" <larry@xxxxxxxxx> wrote in message
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"Mark Stahl" <stahl@xxxxxxxxxxxxxxxxxxx> wrote in message
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"Jim Tiberio" <jimtiberio@xxxxxxxxxxx> wrote in message
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I just caught this on the CT news. Supposedly treatable, get well soon
kid!


I think that's just a carefully worded media statement. "Treatable"...
well, most cancers are technically "treatable" in one way or another,
particularly given his age. The question is what stage, grade, etc.
and are the results expected to be favorable or not.

Either way, he's looking at a long, hard road, and I wish him the best.
Cure rates aren't the best for this type of lymphoma, although 5 year
survival rates are pretty good.

Actually, cure rates for this type of lymphoma are excellent, especially
in contrast to other forms of cancer.
Really? I can't get up to date at home. I tried doing an mdconsult
search,

Pubmed's easier, I think...

but most of what I found, including e-medicine, cites a 70-80% 5 year
survival but only a 50% cure rate with CHOP and rituximab.. +/- I think
radiation.

It all depends on what markers are expressed. The most important being
anaplastic lymphoma kinase (ALK).

From a 2006 review (Jacobson 2006):
A French series contained a subset of patients with ALCL treated with
three cycles of ACVBP (doxorubicin, cyclophosphamide, vindesine,
bleomycin, prednisone) chemotherapy followed by a consolidation phase with
high-dose methotrexate, ifosfamide, etoposide, asparaginase, and
cytosine-arabinoside or eight cycles of m-BACOD (methotrexate, bleomycin,
cyclophosphamide, vincristine, dexamethasone) [71]. The CR rate was 69%
for the T-cell subtype and 64% for the null subtype with an estimated
5-year OS rate of 63.2%. No stratification was performed based upon ALK
expression.

In an Italian series that stratified patients by ALK expression, the
overall response rate (ORR) for ALK+ patients was 92.3% (77.3% achieved a
CR), whereas the ORR in ALK- patients was 84%, with only 56% achieving a
CR [3]. Unfortunately, the chemotherapy regimens used were heterogeneous
and not reported in the paper. The percentage of patients receiving
consolidative radiotherapy also was not reported.

("CR" is "complete response", which is basically total remission)

So, depending on exactly what is going on, we can estimate somewhere
between 56 and 92% CR, with a very high ORR. That's "good", I'd say,
although I'm on the research side and not the clinical side these days.


All that stuff makes my head spin though. all starts sounding the same
after a while. it's like memorizing the signal characteristics of brain
neoplasms.

I totally feel your pain.
Thanks, I appreciate that! It's always good to learn as much as possible
about these things, although I'm on the imaging side. Although, there's
more than enough there to keep me occupied, as I'm finding out...


.

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