This is a summary of an article, written by Dr Daryl Tan, that was featured in The Straits Times, June 2013.


Lymphoma, a type of blood cancer, can be broadly classified into two variants – the indolent type, which is usually slow-growing, not immediately life-threatening but incurable; and the aggressive type, which grows rapidly and can be life-threatening if not treated early, but is potentially curable.

Mantle cell lymphoma is a rare entity that has the worst traits of both variants. It is both aggressive and incurable. The average survival period of a patient with this disease back then was three years. The standard care back then was conventional chemotherapy, followed by stem cell transplantation. Conventional chemotherapy can result in indiscriminate killing of innocent bystander cells in addition to cancer cells.

Major Breakthrough

Doctors were beginning to witness major breakthroughs in the treatment of blood cancer. Chronic myeloid leukemia, a type of terminal cancer where patients’ average survival period was three to four years, was converted overnight to a chronic disease akin to diabetes with the introduction of a pill. The survival period of patients with multiple myeloma, a cousin of lymphoma, was doubled with the advent of new drugs. These improvements were predicated on scientists unraveling the mechanisms that make these types of cancer tick, and developing targeted drugs to disrupt these processes.

Although mantle cell lymphoma physically manifests as a solid tumour, and appears differently from other kinds of blood cancer, it closely resembles multiple myeloma which is a liquid. There were signs that a drug called bortezomib, which revolutionized the treatment of myeloma, could also be effective in mantle cell lymphoma.

New Drugs Improve Prognosis

Currently, in the treatment of blood cancer, the line between terminal disease and potential curability is getting blurred with the barrage of new targeted drugs. Hence the prognosis of a disease such as mantle cell lymphoma keeps improving with time. It is now apparent that a doctor is only as good as his therapeutic armamentarium, or the medicine, equipment and techniques available to a medical practitioner. Availing patients of novel drugs through clinical trials and collaborations with the industry is the key to improving patients’ outcomes.

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