CHOP is a first-generation, combination-chemotherapy regimen consisting of cyclophosphamide, doxorubicin, vincristine, and prednisone that has cured approximately 30 percent of patients with advanced stages of intermediate-grade or high-grade non-Hodgkin's lymphoma in national cooperative-group trials.
A genetically reshaped human IgG1 monoclonal antibody (CAMPATH-1H) was used to treat two patients with non-Hodgkinlymphoma. Doses of 1-20 mg daily were given intravenously for up to 43 days. In both patients lymphoma cells were cleared from the blood and bone marrow and splenomegaly resolved. One patient had lymphadenopathy which also resolved. These effects were achieved without myelosuppression, and normal haemopoeisis was restored during the course of treatment, partially in one patient and completely in the other. No antiglobulin response was detected in either patient.
Estimated risks of NHL were elevated among men who had been farmers, 1.33 (1.03-1.7), forestry herbicide applicators, 4.80 (1.2-19.4), and for those potentially exposed to phenoxyherbicides in any occupation for 15 years or more during the period prior to 15 years before cancer diagnosis, 1.71 (1.04-2.8). Increased risks of NHL were also observed among those with occupational exposure to organochlorine insecticides, such as DDT [1.82 (1.04-3.2)] and organic solvents [1.35 (1.06-1.7)], and to other chemicals typically encountered in the agricultural, forestry, or wood products industries.
Even after accounting for the subtype of the disease and the stage at diagnosis, young adults were more likely to die compared with children and adolescents. A total of 87 percent of children and teens survived 24 months compared with 79 percent of young adults, and five-year survival rates were 85 percent for children and teens and 75 percent for young adults.
Non-Hodgkin lymphoma has grown from being a relatively uncommon disease to being the fifth most common cancer in the United States, nearly doubling in incidence since the early1970s, and increasing among women since 1991. According to the American Cancer Society, over 65,000 new cases of NHL are diagnosed annually.
Survival rates for NHL vary widely, depending on the lymphoma type, stage, age of the patient, and other variables. According to the American Cancer Society, the overall 5-year relative survival rate for patients with non-Hodgkin’s lymphoma is 63% and the 10-year relative survival rate is 51%. (The relative survival rate estimates the likelihood that a patient will survive a certain number years after diagnosis. It is calculated to exclude the likelihood of death from diseases other than the cancer.)
Symptoms of NHL can include swollen lymph nodes in the groin and neck, a swollen abdomen, itchy skin, and a group of symptoms called "B symptoms," which include drenching night sweats, fever, and weight loss, according to the American Cancer Society. If lymphoma starts in the brain, it may cause headaches and personality changes; and if lymphoma starts in the chest, it may cause coughing and difficulty breathing.
NHL accounts for approximately 60% of all lymphomas. In children, NHL occurs most frequently between the ages of 5 and 15 years, and males are affected more often than females. There is an increased incidence in children with immunodeficiency.
In 2011, about 662,789 people are living with lymphoma or are in remission (no sign of the disease). This number includes about 159,846 people with Hodgkin lymphoma and 502,943 people with NHL. Hodgkin lymphoma has characteristics that distinguish it from other diseases classified as lymphoma, including the presence of Reed-Sternberg cells. These are large, cancerous cells found in Hodgkin lymphoma tissues, named for the scientists who first identified them. Hodgkin lymphoma is one of the most curable forms of cancer.
In 1997, the Food and Drug Administration approved the first monoclonal antibody-based cancer treatment for non-Hodgkin’s lymphoma, a drug called Rituxan. Because it locks on to specific molecules on lymphoma cells, targeting them for destruction, and leaves innocent bystanders untouched, the new drug doesn’t cause the hair loss, nausea and other side effects associated with the more scattershot approach of conventional chemotherapy. Used in combination with chemotherapy, Rituxan improves the odds of inducing a long-lasting remission of cancer. Many doctors now use the drug as a first-line treatment for indolent non-Hodgkin’s lymphoma.