This is a summary of an article featuring Dr Daryl Tan in CNA, Aug 2024.
Image credit: Freepik.com
Blood cancer is a prevalent disease suffered by millions worldwide. These cancers include widely recognised forms such as lymphoma, myeloma and leukaemia. Lymphoma, a cancer where infection-fighting white blood cells (lymphocytes) undergo malignant changes and form tumours, is particularly common. Dr Daryl Tan, a haematologist from the Clinic For Lymphoma, Myeloma And Blood Disorders at Mount Elizabeth Novena Hospital, explained that several risk factors like age, gender and infection exposure can contribute to the development of Lymphoma. He noted that most lymphoma cases are diagnosed in patients above 60 due to the increased likelihood of genetic mutations accumulating with age. Additionally, individuals with weakened immune systems from autoimmune diseases, or on prescription of immunosuppressive drugs face a higher risk of developing lymphoma.
Lymphoma Risk Factors, Signs and Symptoms
Men are more likely to develop certain types of lymphoma compared to women. In particular, diffuse large B-cell lymphoma (DLBCL), an aggressive form of the disease, is more common in men. According to Dr Tan, potential contributing factors include hormonal differences, genetic predisposition, varying environmental exposures between genders and subtle variations in immune system function. DLBCL affects the lymph nodes, symptoms include: –
- Unexplained fevers
- Fatigue
- Coughs
- Swollen lymph nodes in the neck, groin or armpits
Diagnosis for the disease could potentially be delayed as patients may ignore the signs or attribute them to other causes like the flu. “DLBCL can also present with less obvious B-symptoms,” shared Dr Tan. “These encompass unexplained weight loss, night sweats and itching, which are often mistaken for an infection.” He urges anyone experiencing these symptoms to consult a doctor for further investigation.
Treating Diffuse Large B-cell Lymphoma (DLBCL)
“The primary objectives of DLBCL treatment are to alleviate symptoms, achieve or extend remission, and enhance patients’ quality of life. Whenever possible, to strive for curative therapy, aiming to completely eliminate the disease,” said Dr. Tan. Several treatment options are available for DLBCL patients, with the frontline approach being chemoimmunotherapy. This approach combines chemotherapy to destroy or slow the growth of cancer cells with immunotherapy to strengthen the immune system’s ability to combat cancer. For DLBCL patients who experience relapse or resistance to frontline treatment, second-line treatments are available, often involving high-dose chemotherapy followed by a bone marrow transplant. This procedure involves infusing the patient’s bone marrow with either their own or donor-filtered stem cells to encourage the production of healthy blood cells.
Advances in Blood Cancer Treatment Options
“Recent advances in CAR T-cell therapy have significantly improved treatment options for blood cancer, especially in managing treatment-resistant and early-relapse DLBCL after initial therapy,” said Dr. Tan. CAR T-cell therapy modifies a patient’s T-cells, a type of white blood cell crucial for immune response, to target and attack lymphoma cells. These T-cells are collected, genetically engineered in a lab, and reintroduced into the patient’s bloodstream to fight the cancer. Studies show this therapy offers lasting benefits, with shorter treatment times and less need for further therapy in responsive patients.
Emotional Challenges of Lymphoma
According to Dr Tan, beyond the physical challenges of lymphoma and its treatment, patients often experience emotions such as anxiety, sadness and anger, as well as worry about relapse. He emphasises the need for a strong support network of family, friends and healthcare providers who can help patients stay resilient. Prioritise rest, nutritious food and gentle movement whenever possible,” he advised. Dr Tan believes that more approvals for CAR T-cell therapies will follow with the rapid development of the field in Singapore for the treatment of several types of blood cancer, including DLBCL and B-cell acute lymphoblastic leukaemia.
About Dr. Daryl Tan
Dr. Daryl Tan is an experienced haematologist specialising in the treatment of various blood cancers, including lymphoma, multiple myeloma, leukaemia, and myeloproliferative neoplasms. With extensive expertise in diagnosing and managing bleeding disorders and other general haematological conditions, Dr. Tan is well-versed in advanced treatments such as chemotherapy, targeted therapy, and immunotherapy for lymphoma patients.