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Yu Yuanbin, chief physician of the Department of Oncology and Hematology of Yadong Memorial Hospital, and Dr. Li Xinxue of the Department of Hematology of the Department of Internal Medicine of National Cheng Kung University Hospital analyze the treatment guidelines for diagnosed diffuse large B-cell lymphoma. (Taken from the post)
"Many people are shocked when they are unexpectedly diagnosed with diffuse large B-cell lymphoma (DLBCL), and even want to give up treatment, but in fact, most patients can achieve excellent treatment results after receiving first-line chemotherapy!" Dr. Yu Yuanbin, director of the Department of Oncology and Hematology of Yadong Memorial Hospital, said, "One day in the clinic, An elderly patient in his seventies had stage IV diffuse large B-cell lymphoma when he was diagnosed. The cancer cells had invaded the liver. His family initially had a negative attitude and did not want treatment. Fortunately, he received standard chemotherapy with the encouragement of the medical team. The result was an excellent response. After completing the course of treatment, the liver tumor completely disappeared. There has been no recurrence after five years of follow-up. "
"Patients who have poor response to first-line or second-line treatment or have relapsed do not need to be overly anxious. Nowadays, CAR-T cell immunotherapy is also available, and forward-looking strategies such as collecting T cells in advance can be used to cope with the ever-changing cancer treatment." Dr. Li Xinxue, Department of Hematology, Department of Internal Medicine, Chengda Hospital mentioned, "There is a patient in his clinic who was treated with standard chemotherapy. Unfortunately, he relapsed after 2 years, but considering that his body condition was still good and there was a high chance of relapse, we collected healthy T cells from the patient in advance and stored them in a frozen manner before entering the second line of chemotherapy. This was like buying an extra insurance policy for the patient. If he still relapsed after the second line of chemotherapy, he could complete the CAR-T cell immunotherapy faster and seize the golden treatment time.
Please read on...
Diffuse large B-cell lymphoma has a violent course and should not be regarded as aging or fatigue.
Non-Hodgkin's lymphoma is a life-threatening blood cancer, and about 50% of them are highly malignant "diffuse large B-cell lymphoma". Dr. Yu Yuanbin pointed out that the disease most commonly occurs between the ages of 50 and 60, but it can also occur between the ages of 20 and 90. Abnormal proliferation of lymphocytes weakens the immune system. The most common early symptom is abnormally swollen lymph nodes in the neck, groin, or armpits.
Patients with diffuse large B-cell lymphoma may experience non-specific symptoms such as "fever, swelling, itching, sweating, coughing, and weight loss", which can easily be confused with aging fatigue, and the public should not make any mistakes on their own. Dr. Yu Yuanbin reminded that the most correct concept is: as long as you find abnormally swollen lymph nodes or other unusual symptoms that "continue" and have not healed, you should seek medical examination immediately.
Patients with diffuse large B-cell lymphoma may experience non-specific symptoms such as fever, swelling, itching, sweating, coughing, and weight loss. As long as you find abnormally swollen lymph nodes or other unusual symptoms that persist and do not heal, you should seek medical examination immediately. (Taken from the post)
Early treatment can help increase the cure rate!
The current standard course of treatment for diffuse large B-cell lymphoma is "R-CHOP", which combines anti-CD20 monoclonal antibody-targeted drugs with four chemotherapy drugs. Dr. Yu Yuanbin explained that early-stage patients require three to four courses of treatment combined with radiotherapy, while late-stage patients usually require six courses.
Diffuse large B-cell lymphoma responds excellently to drugs, and on average up to 60% of patients can be cured. Faced with a high cure rate, one must not hide the disease and avoid medical treatment or seek folk remedies in an attempt to "recover well and come back again." Physical weakness is the cause of cancer. Delaying regular treatment and waiting for organ damage will cause the patient to recover. Instead, he will miss the golden period and greatly reduce the success rate of treatment.
Diffuse large B-cell lymphoma responds excellently to drugs, and on average up to 60% of patients can be cured. (Taken from the post)
Don’t panic if recurrence occurs, CAR-T cell immunotherapy relay rescue
Despite the excellent results of first-line treatment, about 30% to 40% of patients still face poor response to treatment or relapse. Dr. Li Xinxue said that in the past, second- and third-line treatments for relapsed and refractory patients required high-intensity chemotherapy or stem cell transplantation, which placed a greater burden on older patients or patients with multiple comorbidities. Fortunately, with the advancement of medical technology in recent years, new weapons such as CAR-T cell immunotherapy and bispecific antibodies have been introduced one after another. Taiwan currently has CAR-T cell immunotherapy covered by health insurance, which provides a new cure opportunity for patients who have failed two-line treatments or relapsed after transplantation, or even those who cannot withstand high-intensity chemotherapy.
Facing the challenge of possible recurrence, planning in advance is the key to improving the prognosis. Dr. Li Xinxue explained that chemical drug treatment and the oppression of tumor cells will put pressure on the immune system in the body. As the number of treatment lines increases, the number and activity of T cells will also decrease. Therefore, if doctors assess that a patient has a higher risk of relapse after second-line treatment, it is strongly recommended to pre-collect and freeze healthy T cells before starting second-line chemotherapy, when the patient's physical condition is ideal and has not been affected by excessive drugs. This not only ensures the quality of immune cells, but also significantly saves waiting time when treatment is needed in the future.
Are there any problems with collecting frozen T cells early? Doctors explain common myths in detail
In response to the concerns of many patients about collecting cells in advance, it shows that there is no need to worry about common myths such as freezing will reduce activity or accidentally collecting cancer cells. Today's cryopreservation technology is extremely rigorous. Cells are stored in liquid nitrogen at minus 150 degrees Celsius for up to 30 months, and they can still maintain excellent activity after thawing. In addition, the probability of lymphoma cells entering the peripheral blood is extremely low. Even if a very small amount is mixed in, they will be directly eliminated by activated T cells during the CAR-T preparation process. The safety has been confirmed by a large number of clinical studies, so patients can rest assured.
Dr. Li Xinxue explained that in order to ensure that the cell collection process is smooth and safe, the medical team will in principle arrange for the patient to be hospitalized. To collect T cells, a double-lumen venous catheter is placed to draw out peripheral blood, and the mononuclear cells are separated through a machine, and the remaining red blood cells and platelets are immediately returned to the body. The process may be accompanied by mild numbness or cramping in the hands and feet, and the medical team will closely monitor it.
To collect T cells, a double-lumen venous catheter is placed to draw out peripheral blood, and the mononuclear cells are separated through a machine, and the remaining red blood cells and platelets are immediately returned to the body. The process may be accompanied by mild numbness or cramping in the hands and feet, and the medical team will closely monitor it. (Taken from the post)
The treatment weapons for diffuse large B-cell lymphoma are quite diverse, from first-line targeted chemotherapy to late-line CAR-T cell immunotherapy, and health insurance coverage is gradually becoming more popular. Patients are encouraged to actively discuss treatment strategies with doctors and take the initiative to help achieve a better prognosis!
Organize notes in key points
● Patients with diffuse large B-cell lymphoma may experience non-specific symptoms such as "fever, swelling, itching, sweating, coughing, and weight loss", which can easily be confused with aging fatigue. The most correct concept is: as long as you find abnormally swollen lymph nodes or other unusual symptoms that "continue" and do not heal, you should seek medical examination immediately.
● Diffuse large B-cell lymphoma responds well to drugs, and on average up to 60% of patients can be cured. Faced with a high cure rate, one must not hide the disease and avoid medical treatment or seek folk remedies in an attempt to "recover well and come back again." Delaying formal treatment until the organs are damaged before turning around will miss the golden period and significantly reduce the success rate of treatment.
● For relapsed and refractory patients, second- and third-line treatments require high-intensity chemotherapy or stem cell transplantation, which places a greater burden on older patients or patients with multiple comorbidities. Fortunately, new weapons such as bispecific antibodies and CAR-T cell immunotherapy have emerged one after another. Taiwan currently has CAR-T treatment covered by health insurance, which provides a new cure opportunity for patients who have failed two-line treatments or relapsed after transplantation, or even those who cannot withstand high-intensity chemotherapy.
● If the doctor assesses that the patient has a higher risk of relapse after second-line treatment, it is strongly recommended to pre-collect and freeze healthy T cells before starting second-line chemotherapy, when the patient's physical condition is ideal and has not been affected by excessive drugs. This not only ensures the quality of immune cells, but also significantly saves waiting time when treatment is needed in the future.
This article is reprinted with permission from [Care Online] Don’t panic if you are diagnosed with diffuse large B-cell lymphoma (DLBCL)! CAR-T cell immunotherapy provides patients with disease control and hope for cure, graphic analysis by expert doctors
