Lymphoma is a group of cancers originating in the lymphatic system, which helps the body fight infection and disease.
For people who are diagnosed with lymphoma, the Toni Stephenson Lymphoma Center at City of Hope is one of the biggest and most successful treatment centers in the nation.
Because of our vast experience in treating patients with lymphoma, our specialists lead the field of hematopoietic cell transplantation (HCT) with excellent outcomes.
City of Hope physicians treat many types of lymphoma and may be able to treat rarer lymphomas that have not been formally classified.
Both Hodgkin lymphoma and Non-Hodgkin lymphoma and their subtypes.
Larry W. Kwak, M.D., Ph. D. is here to answer questions about Lymphona, its diagnoses and treatments.
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The Future of Lymphoma
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Learn more about Larry W. Kwak, M.D
Larry W. Kwak, M.D., Ph. D.
Larry W. Kwak, M.D., Ph.D., is the director for developmental therapeutics and translational research, director of the Toni Stephenson Lymphoma Center within the Hematologic Malignancies and Stem Cell Transplantation Institute and is endowed with the title of the Dr. Michael Friedman Professor in Translational Medicine. Dr. Kwak earned his undergraduate degree, medical doctorate and PhD from Northwestern University while also completing a research fellowship in tumor cell biology. Dr. Kwak’s postgraduate training also includes an internship and residency in internal medicine, followed by a clinical and research fellowship in medical oncology at Stanford University Medical Center.Learn more about Larry W. Kwak, M.D
Transcription:
The Future of Lymphoma
Melanie Cole (Host): For people who are diagnosed with lymphoma, the Tony Stevenson Lymphoma Center at City of Hope is one of the biggest and most successful treatment centers in the nation. Because of our vast experience in treating patients with lymphoma, the specialists lead the field in hematopoietic cell transplantation with excellent outcomes. My guest today is Dr. Larry Kwak. He’s the Director of the Tony Stevenson Lymphoma Center at City of Hope. Welcome to the show, Dr. Kwak. Tell us a little bit about lymphoma. People hear Non-Hodgkin’s and Hodgkin’s they don’t know what these mean. Give us a little working definition.
Dr. Larry Kwak (Guest): Certainly, I would be glad to Melanie. So, there are many different kinds of cancers that spread to lymph nodes but what lymphomas are, are cancers that actually arrive in the lymph nodes as the primary organ. So, when a patient comes to us with lymphoma this is a disease that is also different from more common solid cancers in that these are highly treatable. They’re very sensitive to most types of therapy--the conventional types including chemotherapy and radiation—and, in addition, now we have newer therapies and these lymphomas are proving to be very sensitive to these new therapies as well.
Melanie: So, this type of blood cancer, are there certain things that predispose us to these kinds of things? People hear about bone marrow transplants for blood cancers; for lymphoma. Are there certain risk factors for this?
Dr. Kwak: That’s a very good question. There are certain professions that have a higher risk for developing lymphoma such as farmers in the Midwest. We think that that’s due to pesticide exposures. Individuals in the hair dressing industry also have a slightly higher incidence of lymphoma probably due to the exposure to hair dyes. The majority of times, we actually have no idea what caused the lymphoma. It’s an active area of research and we’re trying to find out what hereditary, as well as exposure factors, might be involved.
Melanie: How would someone even know? Are there some symptoms that might arise that would tell you’ve got something going on systemically in your body that isn’t just affecting one organ? How would you know?
Dr. Kwak: Usually, lymphomas are primary tumors of the lymph glands and it’s quite common when there’s a small infection to have lymph node, say in your neck or in groin area enlarged. That’s the normal function of a lymph node. If a lymph node enlarges and it stays enlarged for more than just a few weeks, that’s how someone might know that they need to seek additional consultation to make sure it’s not a tumorous growth.
Melanie: Tell us about some of the treatments for lymphoma. Are these very aggressive? Are there a lot of side effects that go with lymphoma? What are some of the outcomes like?
Dr. Kwak: So, lymphomas are one of the real triumphs of medical oncology in this decade and what I mean by that is that virtually any type of lymphoma can be treated. There are actually several different types of lymphomas--some more aggressive than others. But, even the most aggressive types can now be addressed successfully with chemotherapy and, in some cases, stem cell transplantation. What’s particularly exciting is that we are developing a very robust pipeline of new drugs that are replacing chemotherapy in some cases with what we call targeted agents which are pills now. Just in the last couple years, there have been already three or four pills like this that have been approved by the FDA for treatment of lymphoma patients. These are, as I said, in some places replacing chemotherapy.
Melanie: That’s very exciting. Where do you see the future of lymphoma going? People hear these types of cancers, it’s very scary to get that diagnosis, Dr. Kwak. So, what do you want to say to give them hope from City of Hope about the future? What are you doing research-wise?
Dr. Kwak: Well, I’m really pleased to have joined City of Hope just in the last five months and one of the things I find most exciting here is the very focused research going on, particularly in blood cancers including lymphomas. Particularly, the new areas here, in addition to those targeted agents and the pills that I just described, is what we call immune therapies. These are a new class of therapies or drugs that are designed to harness the patient’s own immune system. This idea has been around for 20 or 30 years but it’s just now that we at City of Hope and, actually, around the country are also beginning to see successes with these types of immune therapies. One example of this success is what we call CAR T-Cells. The term “CAR” refers to chimeric antigen receptor. What that means is that we’re able to take the immune cells, the T-Cells from the patient’s own body, and to genetically modify them, manipulate them, in the test tube to be more specific for the cancer cell; for the lymphoma cell in this case. After that manipulation, which only take a couple weeks, then we infuse them back into the patient and they seek out and destroy lymphoma cells. This is a therapy that clearly works. It has now graduated from academic laboratories such as at City of Hope and have now made their way into pharmaceutical companies. This is a therapy that everyone is very excited about. Again, some of the very early work started here at City of Hope and is the basis for some of the companies out there. This is an approach that I think is going to revolutionize the treatment of lymphoma. Again, moving to a softer biologic approach rather than toxic chemotherapy with all its side effects.
Melanie: What do you want people to know about those side effects and treatments and things that are going on as far as how long? I know it’s individual with each patient, Dr. Kwak. I know that. But when they think of something that is systemic, they don’t think you can go in and target one single spot, what do you tell them about Non-Hodgkin’s and Hodgkin’s Lymphoma to help give them some hope that this can be dealt with?
Dr. Kwak: Particularly for what we call “low-grade lymphomas” which make up about half of all lymphomas, what I tell my patients is that our therapy has progressed to such a stage that we can actually just keep the tumor at bay. I tell my patients to think about these low-grade lymphomas as more like chronic diseases like high blood pressure which we can’t actually cure either but we can manage high blood pressure quite effectively with pills. Low-grade lymphoma is evolving very rapidly into that same strategy where we can periodically treat patients with the pills when they need it and then the disease goes back into remission. While many types of common cancers like breast cancer or colon cancer, it’s a very serious situation once the tumor has escaped outside of the organ of origin, in the case of the lymphomas, these are tumors that are often in multiple lymph nodes in multiple parts of the body but they can be managed quite successfully, as I just described, treating them as a chronic disease. So, even now, there are many patients with low-grade lymphomas who will die of something else and not the lymphoma.
Melanie: Why should patients come to City of Hope for their care?
Dr. Kwak: I believe City of Hope has a really unique ingredient of what we call research driven patient care. What that means is that we are not only practicing the standard of care here but we’re also inventing it. For this reason, patients get early exposure to the idealist treatments which will one day become standard of care.
Melanie: It’s great information. Thank you so much, Dr. Kwak. You’re listening to City of Hope Radio. For more information you can go to cityofhope.org. That’s cityofhope.org. This is Melanie Cole. Thanks so much for listening.
The Future of Lymphoma
Melanie Cole (Host): For people who are diagnosed with lymphoma, the Tony Stevenson Lymphoma Center at City of Hope is one of the biggest and most successful treatment centers in the nation. Because of our vast experience in treating patients with lymphoma, the specialists lead the field in hematopoietic cell transplantation with excellent outcomes. My guest today is Dr. Larry Kwak. He’s the Director of the Tony Stevenson Lymphoma Center at City of Hope. Welcome to the show, Dr. Kwak. Tell us a little bit about lymphoma. People hear Non-Hodgkin’s and Hodgkin’s they don’t know what these mean. Give us a little working definition.
Dr. Larry Kwak (Guest): Certainly, I would be glad to Melanie. So, there are many different kinds of cancers that spread to lymph nodes but what lymphomas are, are cancers that actually arrive in the lymph nodes as the primary organ. So, when a patient comes to us with lymphoma this is a disease that is also different from more common solid cancers in that these are highly treatable. They’re very sensitive to most types of therapy--the conventional types including chemotherapy and radiation—and, in addition, now we have newer therapies and these lymphomas are proving to be very sensitive to these new therapies as well.
Melanie: So, this type of blood cancer, are there certain things that predispose us to these kinds of things? People hear about bone marrow transplants for blood cancers; for lymphoma. Are there certain risk factors for this?
Dr. Kwak: That’s a very good question. There are certain professions that have a higher risk for developing lymphoma such as farmers in the Midwest. We think that that’s due to pesticide exposures. Individuals in the hair dressing industry also have a slightly higher incidence of lymphoma probably due to the exposure to hair dyes. The majority of times, we actually have no idea what caused the lymphoma. It’s an active area of research and we’re trying to find out what hereditary, as well as exposure factors, might be involved.
Melanie: How would someone even know? Are there some symptoms that might arise that would tell you’ve got something going on systemically in your body that isn’t just affecting one organ? How would you know?
Dr. Kwak: Usually, lymphomas are primary tumors of the lymph glands and it’s quite common when there’s a small infection to have lymph node, say in your neck or in groin area enlarged. That’s the normal function of a lymph node. If a lymph node enlarges and it stays enlarged for more than just a few weeks, that’s how someone might know that they need to seek additional consultation to make sure it’s not a tumorous growth.
Melanie: Tell us about some of the treatments for lymphoma. Are these very aggressive? Are there a lot of side effects that go with lymphoma? What are some of the outcomes like?
Dr. Kwak: So, lymphomas are one of the real triumphs of medical oncology in this decade and what I mean by that is that virtually any type of lymphoma can be treated. There are actually several different types of lymphomas--some more aggressive than others. But, even the most aggressive types can now be addressed successfully with chemotherapy and, in some cases, stem cell transplantation. What’s particularly exciting is that we are developing a very robust pipeline of new drugs that are replacing chemotherapy in some cases with what we call targeted agents which are pills now. Just in the last couple years, there have been already three or four pills like this that have been approved by the FDA for treatment of lymphoma patients. These are, as I said, in some places replacing chemotherapy.
Melanie: That’s very exciting. Where do you see the future of lymphoma going? People hear these types of cancers, it’s very scary to get that diagnosis, Dr. Kwak. So, what do you want to say to give them hope from City of Hope about the future? What are you doing research-wise?
Dr. Kwak: Well, I’m really pleased to have joined City of Hope just in the last five months and one of the things I find most exciting here is the very focused research going on, particularly in blood cancers including lymphomas. Particularly, the new areas here, in addition to those targeted agents and the pills that I just described, is what we call immune therapies. These are a new class of therapies or drugs that are designed to harness the patient’s own immune system. This idea has been around for 20 or 30 years but it’s just now that we at City of Hope and, actually, around the country are also beginning to see successes with these types of immune therapies. One example of this success is what we call CAR T-Cells. The term “CAR” refers to chimeric antigen receptor. What that means is that we’re able to take the immune cells, the T-Cells from the patient’s own body, and to genetically modify them, manipulate them, in the test tube to be more specific for the cancer cell; for the lymphoma cell in this case. After that manipulation, which only take a couple weeks, then we infuse them back into the patient and they seek out and destroy lymphoma cells. This is a therapy that clearly works. It has now graduated from academic laboratories such as at City of Hope and have now made their way into pharmaceutical companies. This is a therapy that everyone is very excited about. Again, some of the very early work started here at City of Hope and is the basis for some of the companies out there. This is an approach that I think is going to revolutionize the treatment of lymphoma. Again, moving to a softer biologic approach rather than toxic chemotherapy with all its side effects.
Melanie: What do you want people to know about those side effects and treatments and things that are going on as far as how long? I know it’s individual with each patient, Dr. Kwak. I know that. But when they think of something that is systemic, they don’t think you can go in and target one single spot, what do you tell them about Non-Hodgkin’s and Hodgkin’s Lymphoma to help give them some hope that this can be dealt with?
Dr. Kwak: Particularly for what we call “low-grade lymphomas” which make up about half of all lymphomas, what I tell my patients is that our therapy has progressed to such a stage that we can actually just keep the tumor at bay. I tell my patients to think about these low-grade lymphomas as more like chronic diseases like high blood pressure which we can’t actually cure either but we can manage high blood pressure quite effectively with pills. Low-grade lymphoma is evolving very rapidly into that same strategy where we can periodically treat patients with the pills when they need it and then the disease goes back into remission. While many types of common cancers like breast cancer or colon cancer, it’s a very serious situation once the tumor has escaped outside of the organ of origin, in the case of the lymphomas, these are tumors that are often in multiple lymph nodes in multiple parts of the body but they can be managed quite successfully, as I just described, treating them as a chronic disease. So, even now, there are many patients with low-grade lymphomas who will die of something else and not the lymphoma.
Melanie: Why should patients come to City of Hope for their care?
Dr. Kwak: I believe City of Hope has a really unique ingredient of what we call research driven patient care. What that means is that we are not only practicing the standard of care here but we’re also inventing it. For this reason, patients get early exposure to the idealist treatments which will one day become standard of care.
Melanie: It’s great information. Thank you so much, Dr. Kwak. You’re listening to City of Hope Radio. For more information you can go to cityofhope.org. That’s cityofhope.org. This is Melanie Cole. Thanks so much for listening.