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Double Hit Lymphoma Palliative Chemo Option

mimosagirl
Posts: 9
Joined: Jan 2018

 

Can anyone help evaluate the recommendation for palliative chemo for double hit lymphoma using rituxan and oral lenalidomide?  My Dad is deconditioned and weak.  He is 81.  I literally cannot find anything on this regimen with regard to double hit.  I see info on follicular and mantle.  Tyring to evaluate comfort care v this option.   Any input or thoughts are welcome!  The double hit cancer progressed on DA R EPOCH so it was stopped after three rounds. 

 

https://www.chemoexperts.com/rituximab-rituxan-lenalidomide-revlimid-b-cell-lymphoma.html

po18guy
Posts: 880
Joined: Nov 2011

Sometimes, the center makes all the difference in the world.

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ShadyGuy
Posts: 303
Joined: Jan 2017

Except that my father-in law has been on it for multiple myeloma for 12 years and is still doing well at 89 . It is an oral medication derived from thalidomide, right? Good luck.

po18guy
Posts: 880
Joined: Nov 2011

So called "salvage regimens" need a more acceptable name, IMO. Lenolidamide certainly has some toxicity, but is apparently in trial for NHL and has been used against Multiple Myeloma. As to the suggested regimen, at this point it is worth trying on principle, as the gold standard of R-EPOCH was not effective. There is a chance that it will be less effective, but also a reasonable chance that it will be more effective. Another drug that might possibly be considered alone or in combo is Arzerra (Ofatumumab), a drug in the class of Rituxan, but reputedly more potent and with a similar side effect profile. 

Have they performed genomic profiling on the tumor cells? This can lead to a more customized treatment that would hopefully be less toxic and more effective.

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illead
Posts: 812
Joined: Aug 2012

My husband was diagnosed in ‘11 With Mantle Cell, he has relapsed 3 times, twice this year. We saw an expert of MCL at MD Anderson in Houston. He put him on Lenalidomide (Revlimid) and Rituxan infusion 1/ mo. he was pretty ill by that time but was back in remission after 2 mos. His dr. feels he will be in remission for a long time.  That was in Dec and he is doing very well, some side effects but tolerable.  We also have a friend with multiple myeloma who is taking leno for first line treatment and is in remission and doing well with no side effects. So I think your dad should respond well. Our dr in Houston is world renown for work with mcl and all the inroads they have made with it is now being used for most other types of lymphoma. So it sounds like your dad is in very good hands.

My best to your dad, you and your family,

Becky

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