Recent advances in the treatment of lymphomas

Malignant lymphoma is a common neoplasm and some are potentially curable if appropriate therapy is given. The use of the monoclonal anti-CD20 antibody rituximab in the management of follicular lymphoma has improved the outcome of patients. Rituximab and chemotherapy combination is now standard in the initial treatment of advanced-stage follicular lymphoma. Furthermore, rituximab maintenance therapy has also been shown to prolong progression-free survival in first clinical remission as well as in relapse following salvage therapy. In addition to rituximab, the use of purine analogue fludarabine in follicular lymphoma has also been shown to enhance the response rate. On the other hand, chemotherapy designed for the treatment of B-cell lymphoma is generally ineffective for NK/T-cell lymphoma, a highly malignant lymphoma that is prevalent in Asian countries. Recently, preliminary results from international study and our local centre have shown that the SMILE regimen (comprising dexamethasone, methotrexate, ifosphamide, L-asparaginase and etoposide) is very effective and would potentially improve the survival of patients with NK/T-cell lymphoma.