Lymphomas are divided into two large groups of diseases referred to as non-Hodgkin's lymphoma (NHL) and Hodgkin's disease (sometimes called Hodgkin lymphoma). Each year, there are approximately 74,000 cases of lymphoma diagnosed in the United States. What makes lymphoma sometimes challenging to manage is the fact that it is not one, but 65 different diseases, each with its own unique clinical behavior and frequently requiring its own specific treatment.
The two most common forms of non-Hodgkin’s lymphoma, diffuse large B-cell lymphoma and follicular lymphoma, comprise almost half of all lymphoma cases. Hodgkin lymphoma accounts for 11.5 percent of cases. Each of the remaining subtypes of lymphoma are generally very rare, affecting less than 1,000 to 3,000 patients each year in the U.S.
These “rare" forms of lymphoma include diseases such as mantle cell lymphoma, small lymphocytic lymphoma, chronic lymphocytic leukemia, marginal zone lymphoma, peripheral T-cell lymphoma, and cutaneous T-cell lymphoma, to name a few. The rarity of these subtypes makes it especially important for patients to find physicians and institutions that specialize in the care of these diseases -- places that have the experience to manage each and every subtype of lymphoma.
Today, with the development of more effective therapies and treatment regimens, more patients with lymphoma are surviving the disease. Yet much remains to be understood about lymphomas in order to make continued advances against these diseases.
The NYU Cancer Institute features internationally recognized basic science and clinical investigators who collaborate to enhance the understanding of lymphomas and to develop new drugs. The program has four major goals:
- To offer internationally recognized care for patients with all lymphoproliferative cancers by bringing together people from multiple disciplines, including oncologists, nurses (including research nurses), clinical trial managers, basic scientists, and clinical researchers who are collaborating on the medical treatment and scientific aspects of lymphomas, immunotherapies, bone marrow transplantation, radiation therapy, and the epidemiology of the disease.
- To define new research areas with the potential to have the highest impact on patient care, particularly translational efforts that transport research findings from the laboratory to the patient and back to the lab. Elucidation of the molecular underpinnings of lymphoma development (also called "lymphomagenesis") is leading to the identification of novel targets for innovative drug development. The program at the NYUCI brings together not only clinical and basic science investigators focusing on lymphoma, but also chemists, molecular biologists, and specialists in bioinformatics and computational biology.
- To discover and develop the newest drugs capable of targeting and killing lymphoma at its genetic roots. Investigators at the NYUCI have patented new agents for lymphoma, and successfully led their development around the world from their earliest stages of development all the way to their approval by the U.S. Food and Drug Administration. Because of this highly specialized expertise, the NYUCI has one of the most robust clinical research portfolios dedicated to lymphoma in the world, with over 20 clinical trials assessing emerging agents for the care of patients with lymphoma.
- To provide a venue for medical students, fellows, and visiting physicians to gain focused expertise and learning experiences related to their understanding and treatment of lymphoma.
Examples of the focused services offered at the NYUCI for the treatment of lymphomas include:
T- Cell Lymphomas
T-cell lymphomas are a challenging group of over 20 diseases. They have their own unique biology that makes it difficult to diagnose and treat these diseases. The rarity and heterogeneity of these diseases make it especially important for patients suffering from these disorders to seek care at specialized centers where pathologists and physicians have experience treating these diseases, and can provide the best possible care to these patients to improve their survival and quality of life.
Physicians at the NYUCI have specialized expertise in the treatment of challenging T-cell lymphomas and have helped to develop several of the approved treatments for these diseases. Patients with T-cell lymphomas have benefited from the recent approval of several new targeted therapies for this disease that were not available as little as one to two years ago, including vorinostat (Zolinza®), pralatrexate (FolotynTM), and romidepsin (Istodax®), based on efforts by the physician-scientists now at NYUCI. These drugs are being evaluated in combination with each other and with other anticancer drugs to maximize their effectiveness. Scientists are continuing to study the biology of T-cell lymphomas in an effort to identify new therapeutic targets and improve treatment outcomes.
Stem Cell Transplantation
Bone marrow transplantation is an important tool in the treatment of patients with lymphoma and other hematological malignancies, and may be the only curative option for patients whose disease has relapsed after initial therapy. The NYUCI has offered "autologous" bone marrow transplantation for over a decade. This approach involves the harvesting of a person's own stem cells before intensive chemotherapy treatment, followed by re-administration of these stem cells after therapy is completed to repopulate the bone marrow and blood systems.
We are directing the development of a state-of-the-art bone marrow transplant program at the NYUCI in which patients can receive bone marrow stem cells from a donor other than themselves, such as a sibling, a matched unrelated donor, or from umbilical cord blood -- a strategy referred to as "allogeneic stem cell transplantation." This unit will allow eligible patients to receive this therapy at the NYUCI instead of having to be referred to an outside facility, enabling them to benefit from the expertise and research efforts of our experienced team of clinicians, scientists, and nurses. This unit will also be integrated into the research activities of the overall lymphoma program to provide novel therapeutic options to our patients.