Blood Podcast Aggressive non-Hodgkin lymphoma: defining and managing high-risk subsets
Jun 19, 2025
Dr. Mark Roschewski, a clinical investigator at the National Cancer Institute, Dr. Grzegorz Nowakowski from Mayo Clinic, and Dr. Neha Mehta-Shah, an associate professor at Washington University, discuss aggressive non-Hodgkin lymphoma. They highlight the importance of identifying high-risk patients for tailored treatments. The conversation delves into the unique challenges of lymphomas in immune-privileged sites and innovative therapies like BTK inhibitors. They also touch on new options like Polar-RCHIP and the promise of circulating tumor DNA in clinical trials.
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Unique Immune-Privileged Lymphomas
- Immune-privileged large B-cell lymphomas include malignancies in the eyes, brain, and testes.
- These tumors avoid the immune system and standard treatments, needing distinct diagnostic and therapeutic approaches.
Biology of Immune-Privileged Lymphomas
- Immune-privileged lymphomas share biology linked to activated B-cell origin and immune escape mechanisms.
- They often show chronic active B-cell receptor signaling, sensitive to Bruton's tyrosine kinase inhibitors.
Therapeutic Strategies for Sanctuary Sites
- Consider therapies that penetrate sanctuary sites like brain and testes for immune-privileged lymphomas.
- BTK inhibitors, immunomodulatory agents, and PD-1 inhibitors show promising efficacy in these tumors.