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Cover Story:
Leukemia/Lymphoma

"This is an exciting time in the treatment of lymphoma."

Dear Dr. Wilson,

I am writing to express our family's deepest and heartfelt appreciation for the life-saving care you and your team provided for our son, Patrick …

I don't know how widely it is known that you save lives at the National Cancer Institute—offering hope and treatment to people like Patrick who have run out of options. I will never forget what it was like to have you and Dr. Jaffe respond with such compassionate expertise to our desperate call for help. Were it not for the quick action you took in diagnosing and then treating his PCNS Lymphoma, Patrick would not now be rebuilding his life with a healthy future ahead of him.

With heartfelt thanksgiving,
Tim

The National Cancer Institute's Dr. Wyndham Wilson and a team of colleagues are discovering complexities of lymphoma that may help lead to cures.

Wyndham Wilson, M.D., Ph.D., has seen a lot in the war on cancer. For 25 years, the lymphoma specialist at the National Cancer Institute (NCI) has cared for lymphoma sufferers, tailoring treatments to each patient's cancer. He also served as a consultant for Sen. Arlen Specter in his fight against lymphoma. (See interview with Sen. Specter on page 6.)

A decade ago, he teamed with two other NCI scientists to advance the treatments, strategies, and therapies used to combat the devastating disease. He is head of the Lymphoma Therapeutics Section of the Center for Cancer Research (CCR) Metabolism Branch. His NCI research partners are Elaine S. Jaffe, M.D., and Louis Staudt, M.D., Ph.D.

"The partnership is very strong because we're very different," says Dr. Staudt. "I'm a dyed-in-the-wool molecular biologist. A decade ago, I started reading about lymphoma. It seemed to be crying out for some molecular insights."

Classifying the Danger

First described by Thomas Hodgkin in 1832, lymphoma is the most common type of blood cancer in the United States. The disease forms when infection-fighting cells in blood grow out of control. These diseased cells spread through vessels called lymph nodes. For decades, the scientific community believed there were only a few types of lymphoma. They appeared to differ by the size of the cells and if the cells clumped together. Doctors were baffled why patients who seemed to have the same type of cancer under the microscope responded differently to similar treatments.

The genius of the three NCI colleagues combined to solve the mystery and create a new way to classify lymphomas. Now, the medical world has a much clearer understanding of the complexity of lymphoma.

"We now know that there are many different types of lymphoma," says Dr. Wilson. "Currently, we have identified about 60 different types. Putting lymphomas into reasonable groups has been at the core of diagnosis and optimal treatment. On a global level, the classification system has been our most important advance in lymphoma research."

Lymphomas are now classified by the way abnormal molecules within cancer cells control their survival and the way they multiply. This helps determine the kind of treatment a patient will receive and provides insight into how the patient is responding to therapy.

"We have to be very creative and careful to prioritize drugs and to test them to see which works best where."

Knowledge is the Best Medicine

To decide the best course of action for a patient, Dr. Wilson continues to rely on his colleagues in the lab. He sends samples of diseased cells to the CCR lab to be analyzed. This helps him choose the best medication for each patient, indicates the best time for treatments, and sheds light on the patient's response.

According to Dr. Wilson, this type of medical research bridges the gap between medical professionals and basic scientific research conducted in a lab. "These types of 'translational studies' help us to select very thoughtfully chosen, targeted, designer drugs. We have to be very creative and careful to prioritize drugs and to test them to see which works best where," he says. "This is an exciting time in the treatment of lymphoma."

Summer 2008 Issue: Volume 3 Number 3 Page 9