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    Thursday, April 12, 2007

    Political Cancer: What kind of lymphoma does Fred Thompson have? All the news reports describe it as indolent. That's a description of its course. But is it the type? Let's ask Bill Frist:

    This morning Fred Thompson, my good friend and colleague of many years, made it known that he has slow-growing marginal zone lymphoma - a disease that has never made him physically ill and for which he has a good prognosis, according to his doctor.

    Could it be a this type of marginal zone lymphoma? Seems likely:

    Dr. Cheson said he first examined Mr. Thompson on April 7, 2005, about six months after the former senator had noticed a lump under his jaw. Pathologists at the National Institutes of Health ultimately determined that it was a marginal zone lymphoma, which is an unusual type of a common cancer and affects the immune system.

    Dr. Cheson said that he could have withheld any therapy for months because the cancer was slow-growing. But Mr. Thompson chose to receive radiation to the neck "because he did not want to have a visible lump in his neck given his high profile," Dr. Cheson said.

    When enlarged lymph nodes progressed in the groin and other areas, Mr. Thompson decided "he wanted to get the disease out of his system," Dr. Cheson said. So in April 2006, Dr. Cheson prescribed Rituxan, a recently developed form of antibody drug that produced "a complete remission."

    That would suggest a Stage III. We don't know if he had any symptoms that would help to categorize it further, but it's a less reassuring prognosis than what the news reports make it out to be. It isn't the most indolent of the indolent.

    (More on lymphoma.)


    posted by Sydney on 4/12/2007 10:59:00 PM 1 comments


    I also think the prognosis is somewhat guarded for the long-term, but given Mr. Thompson's age and his apparent excellent physical condition, I'd suspect that the disease would be manageable for years, if treated at all.

    Rituximab is an excellent drug; it is a biologic, and has few if any lasting side effects (infusion reactions can occur, but those are not of long-lasting duration).

    New agents are in clinical trials now, including a biologic similar to rituximab called Hu-Max, which is also a monoclonal antibody that attached to the CD20 receptor found on most mature B lymphocytes.

    I may be wrong, but I'd judge the risk to Mr. Thompson for the next four years to be acceptable to allow a political campaign and election.

    By Anonymous Anonymous, at 7:59 PM  

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