Monoclonal antibody therapy in the treatment of non-Hodgkin lymphoma.

Abstract

MONOCLONAL ANTIBODIES ARE revolutionizing the treatment of many illnesses. Some patients with coronary artery disease, Crohn disease, solid organ transplants, rheumatoid arthritis, or cancer have already experienced benefits from these engineered proteins. Monoclonal antibodies typically either harness the patient’s own immune system to fight disease or suppress an errant immune system. The TABLE lists the monoclonal antibodies currently approved by the Food and Drug Administration (FDA); more than 50 others are in active clinical trials around the world. Monoclonal antibodies are currently used by cardiologists, gastroenterologists, nephrologists, and rheumatologists as well as oncologists. In this article, we focus on the use of monoclonal antibodies for the treatment of patients with non-Hodgkin lymphoma (NHL). An estimated 56000 people in the United States will develop NHL this year leading to more than 26000 deaths. Non-Hodgkin lymphomas range from slow-growing follicular lymphomas (historically grouped as low-grade NHL) to more aggressive large-cell lymphomas (intermediateto high-grade NHL). Patients with either indolent or fast-growing lymphomas may achieve remissions with conventional chemotherapy, but most eventually succumb to their disease. Monoclonal antibodies are used to treat both follicular and large-cell lymphomas using a variety of approaches. These approaches include using antibodies alone, linking antibodies with cellular toxins or radioisotopes, and combining antibodies with standard chemotherapy.