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Summary & Participants

Whether relapsed or refractory, tune in to learn about treatments for indolent non-Hodgkin's lymphoma.

Medically Reviewed On: July 16, 2008

Webcast Transcript

OWEN O'CONNOR, MD: Well, typically it requires a close interaction with the patient and getting a sense from them on the kind of symptoms they have that might be disease related. So probably one of the first decision points would be to try to decipher what symptoms the patient may be experiencing that are disease-related.

In addition, there are other features of the disease that one might take into consideration, including the size of the disease. So, for example, patients that have bulky disease might be patients you'd want to treat sooner rather than later. And certainly, patients who have a trend toward slowly progressive disease might be patients in whom you'd rather treat when the disease volumes are typically a little bit smaller.

The other important reason for treating patients would pertain to vital organ compromise. So if patients had, for example, a lot of disease in the bone marrow with low hemoglobin counts and low blood cell counts, that might be a good reason to try to treat the disease to allow the normal blood cells to recover.

MORTON COLEMAN, MD: I would like to add that while we try to be very scientific about making a decision on when to initiate therapy, clearly judgment is called for, and the physician has to put together all of these various factors which Dr. O'Connor had mentioned in deciding when to initiate treatment.

JOHN LEONARD, MD: One of the things that I like to do is to try to monitor the patient over time, because I think the pace of the disease or the . . .so you can get a sense of whether it's rapidly progressive or whether it's slowly progressive, in which case you might be more comfortable watching for a while.

Patients often ask, is there a size cutoff when my disease . . . when a lymph node gets to a certain number value of centimeters in size? Is that an absolute determinant of when you would treat me? Do you all use any kind of size cutoff in that, or is it just part of the whole picture of when you see a patient? Mort?

MORTON COLEMAN, MD: Yeah, I think it's really part of the whole picture. Clearly, there is a judgment call here, and knowing your patient is very important. When you sense the pace of the disease getting more aggressive, when you decide that the bulk is more than the patient should be carrying around, those are the factors that go into knowing your patient and making the right judgment call.

JOHN LEONARD, MD: I think another major issue is symptoms, and certainly, if patients are symptomatic from their disease, that would be a reason to initiate treatment. Owen, what are the some of the symptoms that you look at, or typically tell your patients to watch out for, as a potential sign of their disease progressing and potentially needing treatment?

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