Diffuse large B cell lymphoma (DLBCL) is one of the most common types of non-Hodgkin's lymphoma (NHL). It affects thousands of individuals worldwide. Apart from the stage of cancer and blood test results, several other factors like the age and fitness (often termed the 'performance status') of the patient can impact the outcomes of treatment with chemotherapy and radiation. See Prognostic factors for DLBCL.

Scientists at the US National Cancer Insitute in Bethesda carried out research to test if the different genes in the tumor could also predict treatment outcomes. In a pathbreaking study they tested multiple 'gene expression signatures' - a scientific term for patterns of genes that are expressed in the tumor, in more than 400 patients with DLBCL. They found that using 3 important gene patterns it was possible to predict different treatment outcomes after the same treatment in the same disease.

Their research is likely to prompt further research on this issue and help doctors predict how an individual is likely to respond to treatment, and whether different 'gene signatures' should be treated differently.

This is not the kind of news that Britons will be happy to hear.

A report on cancer survival that compares deaths from cancer in UK with 13 other countries in the rest of Europe has some definitely disconcerting news. The report is being presented at the launch of the National Awareness and Early Diagnosis Initiative (NAEDI), a part of Cancer Research, UK.

The report compared death rates for 39 cancers, including lymphomas, between UK and other European countries and has come to the conclusion that each year, nearly 11,000 deaths could be prevented in the UK if only their rates could match the European average.

This report should prompt the NHS to take measures for an earlier diagnosis and more effective treatments to meet the increasing threat of cancer in their population.

Most individuals with follicular lymphoma are diagnosed in an advanced stage, requiring chemotherapy for treatment. Although follicular lymphoma is a slowly growing disease, most patients who require chemotherapy eventually have their disease start growing back slowly within a year or two.

Zevalin is an agent that belongs to a class of treatment called Radioimmunotherapy. This kind of treatment combines radiation with monoclonal antibody treatment. Zevalin has been recently reported to benefit patients with follicular lymphoma when they relpase following chemotherapy. A recently reported trial that used Zevalin as a sort of consolidation treatment immediately after chemotherapy for follicular lymphoma has demonstrated excellent results. More than 75% of those who had a partial response to chemotherapy had a complete response after Zevalin. Disease progression after chemotherapy was delayed three times longer in those who had received Zevalin. All of these came at little or no excess of side-effects.

These encouraging results may result in a change of treatment policies and result in incorporation of Zevalin as a part of first line treatment of advanced stage follicular lymphoma whenever it is available.

The strangest stuff seem to increase risk of lymphoma.

A study from the Netherlands recently published in the Journal of the American Medical Association accidentally found an increased risk of anaplastic large cell lymphoma (ALCL), a rare form of non-Hodgkin's lymphoma (NHL) in women with silicone breast implants. The risk seemed to increase substantially compared to the general population. A woman with a silicone implant is 18 times more likely to get ALCL than someone who does not have an implant. The probable reason for tis risk is the body's immune response to the implant.

In spite of an increase in risk, the likelihood of getting ALCL is still pretty small. Only about one woman in 100,000 with silicone breast implants is likely to get ALCL.

What does this mean for someone contemplating a silicone breast implant? The actual risk of lymphoma is small enough not to practically deter anyone from getting an implant. However, it may be worthwhile to test this link further in order to better understand the connection between implant and lymphomas. Maybe silicone implants of the future can be modified to reduce the risk of developing lymphomas.