Winning Against Hematologic Malignancies

For more than a decade, Hoag Cancer Center has been the leader in Orange County in advancing the treatment of adult patients suffering from the various hematologic malignancies, including acute leukemias (myeloid and lymphoid), chronic myeloid leukemia (CML), chronic lymphocytic leukemia (CLL), Hodgkin’s Disease, Non-Hodgkin’s Lymphomas and multiple myeloma. Hoag physicians developed the first adult bone marrow transplant program in the County, and introduced the blockbuster treatment rituximab to the county in 1995, three years before it became commercially available.

Hoag’s comprehensive site-specific hematologic cancer program provides:

Higher than national figure survival rates
Highly skilled and specialized physicians
Treatment and Technology
- Minimally invasive surgery
- High-tech radiation therapy capabilities
- The latest in systemic therapy
Multidisciplinary Case Conference
Clinical Trials
Cancer Support Groups

Survival Rates

Hoag survival rates are higher than nationally for each of the various hematologic malignancies for which such data is available.

Non-Hodgkin’s Lymphoma

The most common of the hematologic malignancies are the Non-Hodgkin’s lymphomas (NHL), which collectively constitute the fifth most frequent cancer. Lymphomas typically start in the lymph glands but can spread throughout the body. The most efficacious treatments combine chemotherapy with monoclonal antibodies or other targeted therapies.

Hoag survival rates surpassed national rates in the latter part of the 1990s because of the early adoption of rituximab (Rituxan) combined with chemotherapy in treatment regimens at Hoag.

Hodgkin’s Disease

Hodgkin’s Disease, or Hodgkin’s lymphoma – another malignancy that starts in lymph glands but can spread throughout the body – is one of the most important diseases in the history of cancer care. It was one of the first cancers for which radiation therapy was found to cure many cases of early stage disease, and in the 1960s it became one of the first cancers to be cured by combinations of chemotherapy, even when the disease was spread throughout the body.

Relative five-year survival rates for Hodgkin’s disease have been high for many years. During the most recent era for which survival rates are available, the relative five-year survival rates for Hoag patients who were diagnosed with Hodgkin’s disease during 1996-2003 was 90 percent compared to 85 percent nationally.

Multiple Myeloma

Multiple myeloma is characterized by proliferation of plasma cells in the bone marrow. In recent years there have been tremendous improvements in the treatment of patients with multiple myeloma with the introduction of agents such as bortezomib, thalidomide and lenalidomide. Survival rates for Hoag myeloma patients are better than those observed nationally.

Acute lymphoid leukemia is more common in younger patients, and acute myeloid leukemia is more common in older patients. For acute adult leukemia, Hoag survival rates are higher for the two major age groups, as shown in the table below.

Chronic Lymphocytic Leukemia

Chronic Lymphocytic Leukemia (CLL) is a disease of small lymphocytes that build up in the blood stream and bone marrow, then in lymph glands and other organs in the body. There are now sensitive blood tests that can detect CLL at early stages. Recent advances with drugs such as the purine analogs (fludarabine, pentostatin and cladribine) have improved survival and are often combined with more traditional chemotherapy and newer monoclonal antibodies. Most patients live for five to 15 years after diagnosis. Hairy cell leukemia is a related entity that is especially responsive to the purine analogs.

Chronic Myeloid Leukemia (CML)

Chronic Myeloid Leukemia (CML), a hematologic malignancy, has also been important in the history of cancer treatment because it was one of the first for which a specific chromosome abnormality was identified (the Philadelphia chromosome translocation from chromosome 9 to 22). CML is also the first disease for which a biological agent (interferon) proved to be superior to chemotherapy for treatment and one of the first diseases for which a therapy targeted to the enzyme abnormality, which was created by the chromosome abnormality, is almost 100 percent effective. The oral agent Imatinib (Gleevec) has become the standard initial treatment for most patients, and produces responses in nearly 100 percent of patients. The treatment has dramatically changed the natural history of this disease.

Medical Staff Expertise

Hoag’s expert team of board-certified medical oncologists provide the latest in state-of-the-art therapy for patients with hematologic malignancies, other than bone marrow transplantation, which is referred to regional high volume centers.

As part of Hoag’s multidisciplinary approach to hematologic malignancies, the medical team conducts periodic cancer case conferences where experts from various disciplines gather together to review cases from every angle to ensure the latest knowledge in cancer treatment is applied.

Additionally, Hoag’s expert medical staff is complemented by its highly trained team of certified oncology nurses. Dedicated to delivering patient-centered care, Hoag’s nursing staff ranks high among the nation’s top nurses, as validated by Hoag’s designation as a Magnet™ hospital by the American Nurses Credentialing Center.

Hoag-Affiliated Experts in Hematologic Malignancies

Obtaining your cancer care from a medical team that treats a high volume of patients with your specific cancer type has its advantages – namely, successful patient outcomes. Studies show that physicians who treat large numbers of patients with a specific disease achieve better patient outcomes.

Hoag physicians treat and manage more kidney cancer patients than any other facility in Orange County. Hoag’s expert medical team and long tradition of high survival rates are just two reasons why patients diagnosed at Hoag remain at Hoag for treatment. During 2005-2006 the Hoag medical oncologists who saw the highest numbers of patients with newly diagnosed hematologic malignancies were Drs. Mahdavi, Fong and Vandermolen.

Diagnostics

Hoag’s state-of-the-art diagnostic services give patients convenient access to a full spectrum of technologies that enable doctors to pinpoint the nature and extent of the disease – and the best treatment plan for each individual patient.

Hoag’s sophisticated imaging technology and expert radiologists provide an essential component of service. Detailed images of the tumor site, contours and dimensions help physicians determine an accurate diagnosis and develop an effective treatment plan. Hoag offers leading-edge, minimally invasive technology that allows physicians to evaluate the presence of cancer, which has spread beyond the original site.

Some of the advanced imaging techniques at Hoag include:

PET Scanning (Positron Emission Tomography) with CT/PET fusion capability
Computerized Tomographic (CT) scanning, including spiral CT
Magnetic Resonance Imaging (MRI) with the ability to add spectroscopy for localizing tumor

Treatment/Technology

Hoag Cancer Center’s expert medical team works together to determine the best course of treatment for each individual patient.

Surgery

Although hematologic malignancies are almost always systemic in nature, surgeons sometimes have an important role in the diagnosis of lymphoma and Hodgkin’s disease. Whenever possible, Hoag surgeons use minimally invasive techniques to minimize the effects of surgery.

Radiation Oncology

Radiation therapy is an important component of early stage lymphoma and Hodgkin’s Disease. Hoag Cancer Center’s radiation oncology program is yet another example of the center’s commitment to excellence in treatment. The entire first floor of the cancer center is dedicated to radiation oncology, where its highly specialized team of medical experts delivers the latest in state-of-the-art radiation therapy to patients.

The most progressive options available for patients include:

It’s important to note that Hoag’s radiation oncology program offers a full spectrum of leading-edge radiation treatment options. For a complete list of radiation oncology services, please click here.

Systemic Therapy

Systemic therapy is the most important component of care for patients with hematologic malignancies. Chemotherapy, monoclonal antibodies and a variety of oral therapies are used to treat these various disorders. During 2005-2006 the Hoag medical oncologists who saw the highest numbers of patients with newly diagnosed hematologic malignancies were Drs. Mahdavi, Fong and Vandermolen.

Multidisciplinary Case Conference

Hoag’s multidisciplinary hematology case conferences provide collaborative care planning for patients with hematologic malignancies. This periodic cancer case conference brings together a multidisciplinary team of hematologists, medical oncologists, radiation oncologists, radiologists, pathologists, nurses and support staff to review cases from every angle to ensure the latest knowledge in cancer treatment is applied.

Clinical Trials

Hoag Cancer Center has a long history of participation in innovative clinical trials for hematologic malignancies. This includes pivotal trials with monoclonal antibodies and radioimmunotherapy for lymphoma, and high dose chemotherapy with stem cell rescue for lymphoma, leukemia and multiple myeloma. To learn more about Hoag Cancer Center’s Clinical Trials Department and available trials, please click here.

Family and Friends Cancer Support Group

This support group provides a unique forum in which patients are able to share concerns and learn more about cancer and its treatment. Designed for cancer patients and their support persons, this group focuses on sharing information and mutual support. The group meets the second Tuesday of each month from 5:30-7:00 p.m. in Hoag Cancer Center Conference Room A. To view Hoag Cancer Center’s Monthly Events Calendar, please click here.

Hereditary Cancer

For information about Hoag’s Hereditary Cancer Program click here or call 949/764-5764.

Cancer Education

To learn more about hematologic malignancies, please visit the National Cancer Institute Website.

Patient Stories

This area is currently under development.

Newly diagnosed with a hematologic malignancy?

Looking for information about hematologic malignancy treatment?

We can help! Call 949/7-CANCER

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