Dr. Lauren Pinter-Brown, a nationally recognized lymphoma expert, treats patients, coordinates lymphoma clinical research and mentors fellows and junior faculty.
“The reason I am at UC Irvine is to help develop a state-of-the-art lymphoma program for this area, so that patients have more treatment options, close to home,” she says.
We asked her a few questions about research and treatment:
What is lymphoma?
It’s the most common type of blood cancer, with more than 100,000 new lymphoma cases diagnosed annually. It forms in the bone marrow or the lymphatic system when white blood cells called B-lymphocytes (B-cells) or T-lymphocytes (T-cells) grow and multiply uncontrollably.
These lymphocytes can travel to many parts of the body and form a tumor, including in the lymph nodes, spleen, bone marrow, or other organs.
Hodgkin and non-Hodgkin lymphoma are the two main forms of lymphoma.
According to the Lymphoma Research Foundation, common symptoms are similar to many other illnesses, such as a cold, the flu, or another respiratory illness, but won’t go away, such as:
- Chills, fever, and night sweats
- Painless swelling of lymph nodes, itching
- Unexplained weight loss, lack of energy
Most people who have these non-specific symptoms will not have lymphoma. It is important for anyone who has persistent symptoms to see a doctor to make sure that lymphoma is not present.
What is the state of lymphoma research?
The progress in lymphoma research is amazing. When I was a fellow in the 1980s, there were very few drugs available in all of oncology.
The big breakthrough in lymphoma came in 1998 with the discovery of Rituximab, a monoclonal antibody. It is primarily used to treat non-Hodgkin lymphoma or in combination with other drugs to treat chronic lymphocytic leukemia. A monoclonal antibody is a type of immunotherapy that helps the patient’s immune system fight specific cancer cells, like lymphoma.
Research is moving faster and faster and showing great promise.
Most of the research advances in treatment are in B-cell and Hodgkin lymphoma which account for 85 percent of lymphoma patients, and includes clinical trials that genetically modify the patient’s own T-cells to fight the cancer cells.
I treat all lymphoma patients, and what works well for B-cell and Hodgkin does not work so well for T-cell non-Hodgkin lymphomas.
The field is wide open to find tools and novel treatments, better drugs and combinations that work for T-cell non-Hodgkin lymphomas.
What is the goal of lymphoma research today?
The goal, when we are not able to cure lymphoma, is to manage it as a chronic condition. There are more than 70 types of lymphoma, and many are highly treatable, but there are certain types that are not curable by conventional therapies.
These are patients who will be in remission for a period of time and then relapse, so there is a whole population in need of an effective way to control their condition for as long as possible.
Lymphoma requires a different approach from so called “solid” or organ cancers. Unlike solid organ tumors that can be cut out, such as breast or prostate cancer, lymphoma is not confined to one location. It is a systemic disorder because lymphocytes, the cells responsible for lymphoma, travel through the blood stream by their nature.
In place of studying specific drugs for the treatment of certain lymphomas, we are now just as often looking at the pathways and mechanisms that the lymphoma cells use to live and are trying to interrupt this, no matter the type of lymphoma. This is a big paradigm shift.
What is the future of lymphoma research?
We want to be at the point where we don’t rely on chemo, because of its side effects, for treatment. Drug-based treatments that are not chemotherapy, which is toxic, are more tolerable and specific for the cancer cell.
For example, my elderly and debilitated patients better tolerate bortezomib, a drug that damages a cancer’s cell structure but is not toxic.
Research and clinical trials are key in achieving this goal, but when conducting a clinical trial, it’s important to remember that each patient is not just a subject, but a person diagnosed with a condition called lymphoma. They are people, with other medical and social issues that must be addressed, and we, the doctors, must treat the whole person.