Non-Hodgkin Lymphoma (Episode 508) of Second Opinion:

http://secondopinion-tv.org/secondopinion/episodes/nonhodgkinlymphoma/index.html
http://secondopinion-tv.org

"It's one of the fastest rising cancers in the United States.¹ It's the sixth most common cancer among males,² the fifth most common cancer among females² and accounts for about 6 percent of childhood cancers.³   In 2008, over 66,000 Americans will be diagnosed with it, and over 19,000 will die from it.⁴ It claimed the lives of Jacqueline Kennedy Onassis and King Hussein of Jordan.  It's non-Hodgkin lymphoma (NHL).

Like all cancers, lymphoma causes cells to abnormally reproduce, eventually causing tumors to grow.  There are both similarities and differences between the two main categories of lymphoma – Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL)." ....[Read more - click on the link above ]


¹ National Cancer Institute SEER Cancer Statistics Review
² Melissa Conrad Stöppler, MD and William C. Shiel Jr., MD, FACP, FACR, MedicineNet.com
³ Nemours Foundation, Jacksonville, FL
⁴ The Leukemia & Lymphoma Society


[Read more - click on the link above & watch a Webisode (on YouTube:...]

http://www.youtube.com/watch?v=nUo7VXo7vrY

Stephen H. Schneider - A big THANK YOU! Doctor Schneider.

http://news.stanford.edu/news/2010/july/schneider-071910.html
http://www.huffingtonpost.com/betsy-taylor/in-memory-of-climate-scie_b_653966.html

In Memory of Climate Scientist Stephen Schneider

By Betsy Taylor, The Huffington Post, July 21, 2010:

Stephen Schneider died on Monday. Losing Stephen is so hard. He was one of the few climate scientists I could call, ask for guidance, and cry with. He knew as much as anybody about the complex effects of global warming on glaciers, coral reefs, sea level rise and drought. Stephen was one of the world's most influential climate scientists, a Stanford professor, a physicist, and a leader among the scientists whose climate research earned a Nobel Peace Prize in 2007. [Click the link above to read more...]

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( A great read for Mantle Cell Lymphoma patients and their care-givers.)

Patient from Hell [,The]: How I Worked with my Doctors to get the Best of Modern Medicine and How you Can Too

http://search.barnesandnoble.com/The-Patient-from-Hell/Stephen-H-Schneider/e/9780738210780/?itm=26

http://www.amazon.com/Patient-Hell-Worked-Doctors-Medicine/dp/0738210781/ref=ntt_at_ep_dpi_1

[From Publishers Weekly:

Schneider, a climate scientist at Stanford and a MacArthur fellow, brought skills rooted in the uncertainty of his own field to bear on the treatments he received for mantle cell lymphoma, a rare condition for which treatments were relatively new. With his wife, Terry, also a scientist, he learned as much as possible about the protocol he had been assigned and read up on his oncologist, a leader in this type of cancer, Dr. Sandra Horning. Schneider gives a detailed account of the painful and otherwise unpleasant side effects of the chemotherapy, radiation and bone-marrow transplant he endured in a determined effort to arrest the disease. From the beginning, the author researched probabilities and outcomes and sought to modify decisions made by his physicians. Most importantly, after some resistance, Dr. Horning agreed to use Rituxan for Schneider as maintenance therapy to prolong his remission. Although the author's scientific language can be daunting, patients will relate to his arguments for the importance of patient advocates, individualization of treatments and the negative role bottom-line accounting plays in medical judgments made by HMOs. (Oct.)

Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved. --This text refers to the Hardcover edition.]

[Hardcover - © (2005) from Da Capo Press]

Books by Doctor Schneider - on Amazon:
http://www.amazon.com/Stephen-H.-Schneider/e/B001K8IXWS/ref=ntt_athr_dp_pel_pop_1

Hematopietic cell transplantation (HCT) brief Program History - from City of Hope

Hematopoietic cell transplantation (HCT) has become the standard of care for numerous life-threatening illnesses. Here, we present a brief history of this evolving therapy, both worldwide and at City of Hope.

http://www.cityofhope.org/patient_care/treatments/HCT/history/Pages/default.aspx
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Department of Hematology & Hematopoietic Cell Transplantation

City of Hope was one of the first medical centers in the nation to perform a successful bone marrow transplant (BMT) for leukemia, in 1976.

Today, City of Hope leads the field of hematopoietic cell transplantation (HCT) as one of the world’s largest and most successful transplant centers with more than 9,300 transplants performed to date.

We combine important research discoveries with superior clinical techniques to provide the most advanced treatments for leukemia, lymphoma, multiple myeloma, myelodysplasia and other blood disorders. City of Hope physicians are nationally recognized experts in the care of patients with these disorders.

We also provide new options for patients contemplating HCT – options which may make transplants possible for those who might not have previously been considered good transplant candidates.

These strengths have resulted in improved treatment outcomes, with longer disease-free survival, increased cure rates and fewer complications from treatment.

http://www.cityofhope.org/patient_care/treatments/HCT/Pages/default.aspx
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Lymphoma SPORE (Specialized Program of Research Excellence)

Stephen, J. Forman, M.D.
Principal Investigator
Andrew Raubitschek, M.D.
Co- Principal Investigator

The overall goal of the City of Hope Lymphoma Specialized Program of Research Excellence (SPORE) is to develop translational studies to improve the detection and therapy of Hodgkin’s and non-Hodgkin’s Lymphoma. This grant consists of four translational research projects and five cores developing novel approaches that are derived from molecular and immunologic studies of T-cell and antibody based therapies. An important theme of the translational studies in this grant is to develop lymphoma therapies that will reduce toxicities associated with current treatment regimens for Hodgkin’s and non-Hodgkin’s Lymphoma which can then be translated to the older patient population.

This Lymphoma SPORE also supports a Developmental Research Program and a Career Development Program to foster the advancement of pilot translational research projects and young investigators focused on lymphoma.

Read more about SPORE projects at City of Hope:
[Click here:Lymphoma SPORE]

Stem Cell Transplants - info: from Cancer Treatment Centers of America

Autologous Stem Cell Transplants
http://www.cancercenter.com/video/treatments-technology/stem-cell-transplants/autologous

This video details autologous stem cell transplants and offers insightful animations of the procedure.

In an autologous stem cell transplant, you are your own donor. Your peripheral blood stem cells are taken from you, frozen until needed, then given back to you after you have received high doses of radiation therapy, chemotherapy, or both, to destroy cancer cells.

"An autologous stem cell transplant removes your bone marrow stem cells so that you can be given larger doses of chemotherapy and radiation. Following therapy, your unharmed stem cells are returned…"

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Autologous Process -

What is it?

In an autologous stem cell transplant, you are your own donor. Your bone marrow or peripheral blood stem cells are taken from you (harvested), frozen until needed, then given back to you (transplanted) after you have received high doses of chemotherapy, radiation therapy, or both, to destroy your cancer cells. At Cancer Treatment Centers of America (CTCA), the majority of autologous transplants are performed using peripheral blood stem cells; the remaining use bone marrow stem cells or a combination of the two.

Indications
Autologous transplants are available for the following diseases:
•Acute myelogenous leukemia, in complete remission
•Acute lymphoblastic leukemia, in complete remission
•Relapsed or primary refractory Hodgkin’s disease
•Relapsed, low-, intermediate- or high-grade non-Hodgkin’s lymphoma
•Standard risk multiple myeloma
•Selected patients with metastatic breast cancer
•Relapsed germ-cell/testicular tumors
•Primary amyloidosis

The first step

The first step is to obtain sufficient stem cells for transplant. Currently, stem cells are mostly obtained from the blood stream (peripheral blood stem cells). In order to move stem cells from the bone marrow to the blood stream, a mobilization treatment is done. You will either receive daily injections of a growth factor for four days, followed by daily stem cell collections, or you will receive moderately high-dose chemotherapy, followed by daily injections of a growth factor. In the latter case, collections will not start until 10-14 days after the chemotherapy.

Collection process

Following mobilization, your white cells and platelets may be very low, and you are at significant risk for infection and bleeding. Collections will be done with an apheresis machine, which is a blood separator. The same machine is used to obtain platelets or plasma at blood centers. You will be connected to the machine through a large-bore catheter, which will be inserted prior to the mobilization chemotherapy. Each collection takes 3-5 hours. Side effects are rare and mostly minor. One to five collections daily are necessary to obtain sufficient stem cells. Each collection will be checked for its stem cell content, and once the threshold goal is reached, the collection process is stopped and the stem cells are frozen and kept in a freezer.


Transplantation

Once sufficient stem cells have been collected, you are ready for the start of the actual transplant therapy. Depending upon your cancer type, either a combination of total body irradiation (TBI) and chemotherapy or a combination of chemotherapy agents are given. Your physician will discuss with you which drugs will be used, and give you a calendar outlining precisely which drugs will be given and when. Many additional drugs will be administered during the days of radiation and chemotherapy. Some are meant to prevent nausea from chemotherapy, some to prevent infections, others to prevent complications from the chemotherapy drugs. Many of the drugs are given to you by mouth, while some are given to you through your vein. You will also receive lots of fluid through your central line to help cleanse your system as quickly as possible.

Two days after the last chemotherapy, your stem cells will be re-infused. After collection, the stem cells were stored in bags in liquid nitrogen to keep them viable. Now they will be thawed at the bedside in a water bath, until they are liquid again. Then the stem cells will be slowly injected with a syringe into your central line. The process lasts 15-30 minutes. Some patients may experience side effects to DMSO (a chemical added to the stem cells to prevent damage during freezing), including but not limited to, nausea and/or shortness of breath.

After the re-infusion of stem cells, it takes about 10-14 days before the first white cells re- appear. In the meantime, the old blood cells will start dying off, and you may be prone to infections and bleeding. Typically, patients will need transfusions of platelets and red cells. Once the white cells and platelets re-appear, they mostly return rapidly to the normal range. Transfusions are usually only needed in the first 2-3 weeks after transplant.

The mobilization phase usually takes place as an outpatient. The actual transplant phase can be done either as an outpatient or as an inpatient. Depending on the availability of a caregiver, your own preferences, and insurance issues, outpatient or inpatient treatment will be recommended.

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A Look at Stem Cell Transplants
http://www.cancercenter.com/video/treatments-technology/stem-cell-transplants/mini-transplant

Using detailed medical illustrations and narration, this video provides an insightful introduction to stem cell transplants. It briefly covers what to expect before, during and after a stem cell transplant.

Included are overviews of autologous and allogeneic stem cell transplants. The video also explains “minitransplants,” which may be a treatment option for some cancer patients.

"When traditional stem cell transplantation is not an option, Cancer Treatment Centers of America may offer a nonmyeloablative or minitransplant. In a minitransplant, lower doses of chemotherapy drugs are used. This lower dosage makes conditioning more tolerable and suppresses your immune system to allow donor engraftment…"

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Allogeneic Stem Cell Transplants
http://www.cancercenter.com/video/treatments-technology/stem-cell-transplants/allogeneic

This video provides extensive details on allogeneic stem cell transplants.

With allogeneic stem cell transplants, a donor provides the healthy stem cells to be transplanted into your body. Family members, oftentimes siblings, are the best matches for donating stem cells for this particular type of transplant.

"In an allogeneic stem cell transplant, your bone marrow is replaced with new healthy stem cells from another person. Stem cells are special parent cells that develop into blood cells and immune cells…"

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Related Links:

◦Learn More About the Autologous Process
http://www.cancercenter.com/stem-cell/stem-cell-autologous.cfm
◦Learn About the Allogeneic Process
http://www.cancercenter.com/stem-cell/stem-cell-allogeneic.cfm
◦Stem Cell Treatment By Disease Type
http://www.cancercenter.com/stem-cell/stem-cell-treatment-disease-type.cfm
◦CTCA at Midwestern Regional Medical Center
http://www.cancercenter.com/midwestern-hospital.cfm