diagnosis and treatment of lymphomas
Lymphomas are one of the main lines of research in which the Clínica Universidad de Navarra participates.
The responsibility for the treatment of patients with chronically lymphoproliferative syndromes and lymphomas lies with the Department of Haematology, which coordinates all activities directed towards the treatment and prevention of the complications of the disease.
We offer a multidisciplinary approach for the diagnosis and prognosis of the disease. In terms of treatment effectiveness, the overall therapeutic consideration of the disease plays a fundamental role; in other words, not just the treatment that each patient will require at the time of diagnosis but also the treatment they might need in the future when faced with potential relapses.
The Clínica’s Departments of Haematology and Oncology have developed a comprehensive healthcare programme, which includes all aspects related to the diagnosis, prognosis and treatment of the disease, for patients with chronic lymphoproliferative syndromes.
A number of patients with lymphoma are susceptible to treatment with radiation therapy. The Clínica's Department of Radiation Oncology has the linear accelerators needed to administer this treatment.
Its mechanism of action is based on direct and indirect DNA cell damage, which causes functional and/or structural abnormalities and, ultimately, cell death.
Outpatient chemotherapy is the specific treatment for lymphoma.
The selection of the most appropriate chemotherapy will depend on the size of the tumour, lymph node involvement, the presence of distant metastases, previous treatments, the tumour subtype, age, comorbidity, the patient’s functional status and the potential toxicities.
The chemotherapy is administered, in most cases, at the Outpatient Centre, which allows for extended treatments without the need for hospitalisation, with the resulting convenience for the patient.
It is a systemic treatment in which one or more combined anticancer drugs are administered.
Its objective is to destroy the tumour cells in order to reduce the disease, using a considerable variety of drugs. A single drug can be used, but, in general, the therapy is more effective when certain combinations are used.
The objective of this procedure is to generate cells that restore the function of the bone marrow.
Haematopoietic progenitor transplantation or bone marrow transplantation is employed for the following conditions:
- Neoplastic diseases (malignant tumours).
- Diseases with impaired bone marrow function (blood cell producer).
- Immune system diseases.
- In a number of congenital metabolic disorders.
Haematopoietic progenitor cells are obtained from bone marrow. Currently, they are mostly extracted from the blood and occasionally from the umbilical cord and placenta. These cells are found in the interior of the bone marrow (especially from the hip, vertebrae and ribs) but occasionally increase in number in the blood circulating blood and can therefore also be obtained from the veins.
Monoclonal antibodies, a revolutionary treatment against lymphomas.
The application of monoclonal antibodies is one of the treatments that has most revolutionised the therapy for lymphomas. It consists of proteins directed against other proteins on the surface of the tumour cells (antigens) and therefore represents a much more specific treatment against the tumour. The treatment is often combined with chemotherapy.
At the Clínica Universidad de Navarra, this treatment has been jointly administered with chemotherapy to more than a hundred patients, and its use has raised the response rate achieved with just chemotherapy by a significant percentage.
The most widely used antibody is anti-CD20, which binds to lymphoid cells and induces their destruction. Furthermore, in coordination with the Department of Nuclear Medicine, we have begun to use other types of monoclonal antibodies that add (to the effectiveness of anti-CD20) the action of a radioactive isotope to which they are attached.
A clinical trial with vaccines that do not cause rejection or increase toxicity
Its objective is to generate an immune reaction in patients whose disease is in its first stages or in patients whose disease is in remission.
This technique is in clinical studies to determine its effectiveness with follicular lymphoma. After administering the first phase of conventional treatment with R-CHOP chemotherapy, the disease typically goes into partial or full remission.
Chemotherapy is administered for six months using a 1-month treatment cycle. Patients who are candidates for participating in the clinical trial are those diagnosed with follicular lymphoma who are not undergoing or have not undergone chemotherapy and, in this case, present partial or full remission.
The increased incidence of follicular lymphoma occurs mainly in the elderly. This is one of the main reasons for investigating a treatment that boosts the effectiveness of conventional therapies against this disease but which do not increase its toxicity.
Among other advantages, the new treatment with lymphocytes from the patient does not cause rejection and does not increase the toxicity.
Los linfomas son una de las líneas fundamentales de investigación en Hematología en las que participa la Clínica conjuntamente con el Centro de Investigación Médica Aplicada (CIMA).
• Potenciar el registro de los casos de linfoma en registros nacionales e internacionales.
• Continuar con el desarrollo del banco de muestras de tejido.
• Caracterizar las rutas moleculares esenciales durante la transformación de los linfomas más frecuentes.
• Definir estrategias terapéuticas selectivas y eficaces.
• Explorar mecanismos de respuesta y resistencia terapéutica.
• Explorar distintas terapias mediante la promoción y participación en ensayos clínicos.