Mayo Clinic Comprehensive Cancer Center hematologist and oncologist
Jose (J.C.) C. Villasboas Bisneto, M.D., discusses follicular lymphoma and other indolent B-cell non-Hodgkin’s lymphomas. For many of these slow-growing diseases, cure is not the goal. Rather, a patient's care team must remain flexible and nimble in the treatment plan to manage the disease.
Dr. Villasboas aims to take a collaborative approach with his patients' care teams at home to ensure long-term disease management with the most advanced therapies. Examples include immunotherapies such as CAR-T cell therapy, which is already approved by the FDA for patients with relapsed follicular lymphoma.
when we're looking at a biopsy of a patient suspected to have lymphoma and we see that these cells are mostly of a small size usually found in aggregates that sometimes respect the distribution of follicles, that's why the name follicular lymphoma. The vast majority of the patients will have a B cell lineage, non Hodgkin lymphoma or be NHL inside that category, I normally divide that between aggressive B cell, non hodgkin lymphomas and indolent or slow growing B cell, non hodgkin lymphomas and inside that group this low growing kind is where we find follicle lymphomas and other indolent B cell non hodgkin lymphomas. Any time that you see a case of lymphoma, I would recommend that you have that case reviewed by a center with no experience in treating this particular type of cancer. Once you give that label of, you know, the lymphoma diagnosis in the subtype that typically dictates everything else you do from that point onward for most cases of follicle lymphoma, cure is not the goal. The goal is disease control. With some exceptions. For example, if you do see a case of follicular lymphoma that is localized to one or two lymph nodes in one specific area, There is a chance, not 100% but a fair chance of cure with radiation therapy, most patients will present with more than one lymph node area or multiple areas or even involvement of you know, lymph nodes, both sides of the diaphragm the spleen and bone marrow and in those cases, I typically tell the patient that we're going to try to control this and there are great tools to achieve that. I am personally excited about anything related to using the immune system and this includes not only car T cell therapy and that's actually already approved for patients with relapse for legal lymphoma, but we're testing now new variations of cellular therapy, different types of car T cells, looking at different targets. And I expect this will be very useful and exciting for patients with lymphoma. This disease is a multifaceted disease. It has different behaviors and biology at different times and requires that we be flexible and nimble in terms of going to and from different treatments and having that access to. A multidisciplinary team definitely is in the benefit of the patient patients who are traveling to be here obviously would like to go back home. I'll practice very collegial practice working hand in hand with the local providers. I see a patient I reviewed the case, I confirmed the diagnosis, I confirmed this stage and then I design a treatment plan keeping in mind that the patient wants to return home