radioimmunotherapy for the treatment of non-Hodgkin's Lymphomas. Section 1 - deals with the definition and the explanation of cancer, and how it affects the human body. Cancer is the way in which the cells that are always dividing and reproducing within the body, when there is a change in the orderly and organized method in which this takes place, react to the change by multiplying constantly and unabatedly, due to which there would be a lump formed in the region where the cells are deposited. This results in the formation of a so-called 'tumor'. This tumor can either be benign, meaning that it is non-cancerous, and malignant, meaning that it is in fact cancerous. Since it is a well-documented fact that cancer is not a disease with one single symptom and mode of treatment, this inevitably means that it can affect any part of the body, and the treatment for this disease would have to be based on the part of the body that has been afflicted with the cancer.

Non-Hodgkin's lymphoma is the type of cancer that affects the lymphatic system that comprises the immune system of the human body. When this type of cancer is to be treated with any results, a combination therapy is what works best. The traditional CHOPS, that is, a treatment that is a chemotherapy combination comprising of cyclophosphamide, doxorubicin, Oncovin®, and prednisone, was the method of treatment that had been used until recently. It was after intensive research began to be conducted into more effective and better treatment methods that the treatment regimens of Zevalin and Bexxar were evolved. Zevalin combines cell targeting and cell killing in one package, and this is achieved through a combination of a monoclonal antibody that targets a cell, and a radioactive particle or in other words, a 'radioisotope', called 'yttrium-90' that kills a cell. This mode of treatment is a part of the radioimmunotherapy methods that are being researched today, when the practitioners of Nuclear Medicine use radioisotopes as part of the treatment regimens followed for non-Hodgkin's lymphoma treatment.

Bexxar is another similar method of treatment wherein Iodine-131, which is basically a radiation emitting form of iodine. Bexxar treatment is in essence a dual-action therapy that combines the ability and the capacity of a monoclonal antibody; which in this case is tositumomab, to target the cytotoxic tumor that is present within the body of the patient who is suffering from the dreaded disease, cancer, with the therapeutic action and the potential of radiation, in this case, iodine 131, which is generally administered as a patient-specific dosage. Yet another similar mode of treatment for this dreaded disease is the 'Lutetium 177' or the 'lu-177', a radioisotope, and it is hoped that this would help to create the first successful radiopharmaceutical for the treatment of solid tumors. It works by emitting low-level beta energy, and the great benefit of using the Lutetium 177 is that it emits gamma radiation, and this facilitates its use for the purpose of imaging as well as for therapy. All these ideas and concepts will be discussed in this paper.

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List of Illustrations

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Illustration -1 shows the normal cells of the body and those that form a tumor.

Illustration -2 shows Immune System Structures


What actually is Cancer, and in what way does it affect the human body? The various organs and the tissues of the human body are made up of small and tiny so-called 'building blocks' that are referred to as 'cells'. Though there are in fact numerous different types of cells within the body, all the cells reproduce in the same way, and this means that when a particular set of cells become old and start to die, then new cells take their place and replaces all the older cells. Generally, this process of reproduction of cells is an extremely ordered and very controlled process, but if there is any small problem with the process, then the cells would continue to multiply and reproduce unabatedly, and this would inevitably result in the formation of a lump which is also called a 'tumor'. By nature, these tumors can be either malignant or benign.

When the tumor is found to be malignant, then it will be called 'cancerous'. Whereas in a benign tumor, the cells will not spread to various other parts of the body, in a malignant tumor, the cells will spread to any other part of the body, uncontrollably, and this is how the cancer spreads within the human body. However, it is also true that when the tumor is benign, the cells may multiply on the same site, and this will lead to various other problems, wherein the tumor may start to press and exert pressure on the surrounding organs, but this is not cancer. Cancer is a disease where it can be said that it is not one single disease with certain specific symptoms and single treatment and where it will only affect certain specific parts of the body. It is a disease that may affect any part of the human body, and each type of cancer has its own name and its own mode of treatment. (What is Cancer?)

Illustration -1

Illustration 1 shows the normal cells of the body and those that form a tumor.

(What is Cancer?)


Non-Hodgkin's Lymphomas are a type of cancer that affects the lymphatic system of the human body, the lymphatic system comprising the immune system of the body. The immune system is made up of several organs such as the bone marrow, the spleen, the thymus and also an entire network of lymph nodes found throughout the body, that are connected with a complicated system of lymphatic vessels. The lymphatic system provides the natural immunity system or the body's natural defense system against the various diseases that we are prone to. When the cancerous cells attack the lymphatic system of the body, then this is referred to as the Non-Hodgkin's Lymphoma. There are in essence two different types of lymphoma, these being 'Hodgkin's Disease', named after the person who first discovered and named it, Dr. Hodgkin, and the other being 'Non Hodgkin's lymphoma', of which there are at present nearly 20 different types. (What are non-Hodgkin's Lymphomas?)

It is, however, extremely difficult to distinguish between the two different types of lymphomas, and this can only be accomplished when the cells are examined under a microscope. Generally, the presence of a cell called 'Reed-Sternberg' will be present in the cells of a Hodgkin's disease affected patient, and the absence of this particular cell would signify that the patient is suffering from a Non-Hodgkin's Lymphoma. There are 20 different types of Non-Hodgkin's Lymphoma, and each has its own different characteristics and behavior within the body. When the multiplication and division of cells within the body goes awry for any reason whatsoever, then there will be too many immature and undeveloped white blood cells either within the bone marrow or within the blood itself, or a lump or a tumor may start to develop in any one of the numerous lymph nodes in the body. In the same part of the fight against infection, lymphocytes have the function of moving around the body, and this means that lymphoma cells would travel through the lymphatic system to get to the different lymph nodes in the other parts of the body. These cells may also travel through the blood stream of the body, and in this way they would be carried to other organs, and when these cells reach a new area they may start to divide at that spot and this means that a new tumor will be formed at that site soon. (What are non-Hodgkin's Lymphomas?)

The twenty different types of non-Hodgkin's Lymphomas have different appearances when examined under a microscope; have different types of proteins on the surfaces of the cells, have different rates of growth, and are to be treated differently. Some of the main types of non-Hodgkin's Lymphomas are divided into B-Cell lymphomas, and T-Cell lymphomas. Some of the B-Cell lymphomas are: B-Cell Prolymphocytic, Follicular, Mantle cell, Diffuse Large B-Cell, Burkitt's, Splenic Marginal zone, and so on. Some of the T-Cell lymphomas are: Adult T-Cell, Skin Lymphomas, Hepatosplenic T-Cell, Enteropathy type T-Cell, and Extra nodal Natural Killer T-cell, nasal type. Another type of non-Hodgkin's Lymphomas is that which is either related to AIDS, or that which is related to the central nervous system. (Types of non-Hodgkin's Lymphomas)

Illustration -2

Illustration -2 shows Immune System Structures

Immune System Structures:

Medical Encyclopedia)

When a patient who is suffering from the symptoms of any of the different types of non-Hodgkin's Lymphomas is to be treated, there are today plenty of choices and the patient may be able to make an educated choice of treatment for his won benefit. One such traditionally used method of treatment is called 'CHOPS', or, in other words, a treatment that is a…