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The fifth leading cause of cancer in the United States, lymphoma is made up of more than 40 rare and highly diverse diseases that target the body's lymphatic system. Lymphomas include both one of the fastest growing cancers — Burkitt's lymphoma, which can double in size in as little as a day — and one of the slowest, chronic lymphocytic leukemia (CLL).

While all lymphoma types can be cured or managed as a chronic disease, its complexity and variation do not allow for a one-size-fits-all treatment approach. Instead, it necessitates highly specialized and individualized approaches.

With a dozen new therapies in development — one of the largest portfolios of lymphoma drugs under development anywhere — the Herbert Irving Comprehensive Cancer Center of NewYork-Presbyterian Hospital and Columbia University Medical Center is meeting this challenge with highly effective new treatments for the disease, giving hope to the more than one million lymphoma patients worldwide.

In 2006, NewYork-Presbyterian/Columbia recruited Dr. Owen A. O'Connor, one of the world's top lymphoma researchers, to lead its Lymphoid Development and Malignancy Program, and direct more than 25 full-time scientists and physician scientists.

"By increasing the number and quality of treatment options for lymphoma patients, we are improving their chances for survival. This is especially critical for patients who haven't responded to standard therapies," says Dr. O'Connor, who is also chief of the Lymphoma Service at NewYork-Presbyterian/Columbia and associate professor of medicine at Columbia University College of Physicians and Surgeons.

One of the most promising new therapies is PDX (pralatrexate) for T-cell lymphoma — among the most fatal forms of the disease. PDX was developed by a team of researchers at Memorial Sloan-Kettering Cancer Center (MSKCC), including Dr. O'Connor, while at Sloan-Kettering. The researchers identified unique activity of PDX in patients with T-cell lymphoma. Dr. O'Connor has continued studying PDX at the Herbert Irving Comprehensive Cancer Center and is the principle investigator of an international clinical trial of PDX for patients with aggressive T-cell lymphoma.

The drug is uniquely designed to camouflage itself as a folic acid, which allows it to be absorbed by the tumor, where it attacks the cancer. The therapy has been shown effective in 54 percent of patients who did not respond to other treatments. PDX is now being evaluated around the world, and if its activity is confirmed, it may get regulatory approval some time next year.

"Our hope is that the national multi-center clinical trial that is currently underway to evaluate this drug will result in an improved treatment option for patients," says Dr. O'Connor.

Researchers are also exploring novel lymphoma treatments that are not chemotherapies. These include drugs targeting Bcl-6, a gene cloned by Dr. Riccardo Dalla-Favera in 1993, and an enzyme known as histone deacetylase. Work by Dr. Dalla-Favera has shown that drugs affecting these two targets will markedly synergize with conventional chemotherapy, and may lower the amount of chemotherapy necessary to achieve remission.

"We are very excited about the promise of these new therapies. Our lymphoma program includes some of the nation's brightest scientists working together to translate laboratory discoveries into improved treatment options for patients," says Dr. Dalla-Favera, who is director of the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian/Columbia, director of the Institute of Cancer Genetics at Columbia University Medical Center and Uris Professor of Pathology and Genetics & Development at Columbia University College of Physicians and Surgeons.

Investigators at NewYork-Presbyterian/Columbia also collaborate with colleagues at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, including Dr. John Leonard.

For more information about lymphoma treatments, contact the Herbert Irving Comprehensive Cancer Center at 212-305-3653.

Lymphoma

Lymphoma is a type of cancer that originates in lymphocytes, a type of white blood cell in the vertebrate immune system. The most common type of lymphoma, non-Hodgkin's lymphoma (NHL) includes B-cell lymphoma and T-cell lymphomas. Since the early 1970s, incidence rates of NHL have nearly doubled. The overall five-year survival rate is only 59 percent. Hodgkin's lymphoma (HL), also known as Hodgkin's disease, is a less common form of lymphoma that arises from an abnormal lymphocyte. The overall five-year survival rate is 85 percent. HL occurs mainly in young adults, with a peak occurrence between ages 16 and 34. Older patients, especially those over age 55, may also develop the disease. Treatments for lymphoma may include radiation therapy, chemotherapy, immunotherapy and bone-marrow or peripheral blood transplants.

Herbert Irving Comprehensive Cancer Center

The Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center and NewYork-Presbyterian Hospital encompasses pre-clinical and clinical research, treatment, prevention and education efforts in cancer. The Cancer Center was initially funded by the NCI in 1972 and became a National Cancer Institute (NCI)–designated comprehensive cancer center in 1979. The designation recognizes the Center's collaborative environment and expertise in harnessing translational research to bridge scientific discovery to clinical delivery, with the ultimate goal of successfully introducing novel diagnostic, therapeutic and preventive approaches to cancer. For more information, visit www.hiccc.columbia.edu.

NewYork-Presbyterian Hospital

NewYork-Presbyterian Hospital, based in New York City, is the nation's largest not-for-profit, non-sectarian hospital, with 2,242 beds. The Hospital has nearly a million patient visits in a year, including more than 230,000 visits to its emergency departments — more than any other area hospital. NewYork-Presbyterian provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine at five major centers: NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, Morgan Stanley Children's Hospital of NewYork-Presbyterian, NewYork-Presbyterian Hospital/Allen Pavilion and NewYork-Presbyterian Hospital/Westchester Division. One of the largest and most comprehensive health-care institutions in the world, the Hospital is committed to excellence in patient care, research, education and community service. It ranks sixth in U.S.News & World Report's guide to "America's Best Hospitals," ranks first on New York magazine's "Best Hospitals" survey, has the greatest number of physicians listed in New York magazine's "Best Doctors" issue, and is included among Solucient's top 15 major teaching hospitals. The Hospital's mortality rates are among the lowest for heart attack and heart failure in the country, according to a 2007 U.S. Department of Health and Human Services (HHS) report card. The Hospital has academic affiliations with two of the nation's leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons.

Columbia University Medical Center

Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians & Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia’s College of Physicians & Surgeons was the first institution in the country to grant the M.D. degree. Among the most selective medical schools in the country, the school is home to the largest medical research enterprise in New York State and one of the largest in the country. For more information, please visit www.cumc.columbia.edu.