Over the past 40 years, major therapeutic advances have dramatically improved survival rates for patients with hematologic malignancies, yielding overall 5-year survival rates of 83% for Hodgkin lymphoma, 68% for non-Hodgkin lymphoma, 54% for leukemia, and 43% for myeloma across all age groups in the United States.1 Experts with University of Minnesota Cancer Care continue their work toward furthering an improved survival rate and quality of life for these patients. Two recent trials show promise in this treatment area. One employs a novel immunotoxin for refractory B-cell malignancies, and another tests the use of an expanded pool of donors for patients receiving allogeneic blood or marrow transplantations as a therapy for lymphoma.
Researchers at Masonic Cancer Center, University of Minnesota have recently completed a phase 1 study of a novel immunotoxin called DT2219. This immunotoxin fuses the active domain of diphtheria toxin with monoclonal antibodies targeting human CD19 and CD22 proteins on the surface of malignant B-cells.2 (See Figure 1.) In the study, 1 cycle of DT2219 was administered to 25 patients with relapsed/refractory B-cell lymphoma or leukemia.3 Treatment was well tolerated. Although the trial was only designed to test the safety of the immunotoxin, the study team was excited to see that some achieved major responses, one of which was a complete response. (See case study.) Based on these results, a phase 2 study exploring the efficacy and safety of multiple cycles of DT2219 is now enrolling.
In allogeneic blood or marrow transplantation (alloBMT) as a treatment for lymphoma, donors and recipients are precisely matched to ensure that they both share exactly the same proteins at 8 critical locations in the human leukocyte antigen (HLA) complex. Mismatches between patient and donor increase the risk of graft-versus-host disease, with a greater number of mismatches leading to a greater level of risk. Unfortunately, only about 50% of searches identify a suitable, matched donor for patients of European ancestry, and match rates are far lower for patients of other ethnic backgrounds.4
The team recently investigated alloBMT success rates in cases where the donor and patient had an HLA match at only 7 out of 8 locations (“7/8 match”).5 They found that the 3-year overall survival rate of patients who received a partially matched transplantation using umbilical cord blood or adult blood or marrow was comparable to that of patients who received a perfect matched donor graft. Further studies are ongoing to confirm and extend this exciting new treatment option for patients with lymphoma who lack a closely matched donor.
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To schedule a cancer consultation, referral or appointment: 855-486-7226
We understand that many of our patients live long distances from University of Minnesota Medical Center. To minimize travel difficulties and lost time from school or work, we are committed to partnering with the patient’s referring provider and other local providers. Some patients can be initially discussed over the phone in collaboration with the referring provider. We aim to expedite the process so that, in one trip to the Twin Cities, patients can be assessed and also complete surgery, if required. In many cases, care after discharge can also be provided locally.
The Cancer Care Outreach Program is designed to provide education and facilitate knowledge sharing between our team and the medical community.
To schedule a physician meeting or to visit our facility, contact Melinda Arvold, Oncology Outreach Manager. Phone: 612-867-3411; email: email@example.com.
An 80-year-old woman with refractory chronic lymphocytic leukemia experienced a 40% reduction in tumor size after treatment with a novel immunotoxin. At 15-months follow-up, the patient remains in partial remission.Continue reading