WHO: What Else Have You Done to Non-Hodgkin Lymphoma — And Why?

Peter W. Marks, MD, PhD

For those of us who have been exposed to the Rappaport Classification, the Working Formulation, or the Revised European American Lymphoma Classification schemes, the World Health Organization (WHO) classification of non-Hodgkin lymphoma (NHL) may represent yet another set of initials attached to a complex mix of diseases. However, as we learn more about the molecular abnormalities present in the various NHL sub-types, the importance of continued revision in classification, with its implications for treatment, becomes clear.

There will be a variety of opportunities to learn more about the biology and treatment of NHL at this year’s annual meeting. Dr. Elaine Jaffe from the National Cancer Institute will lead off the Education Program Session that will take place today from 9:30 to 11:00 a.m. and again Sunday from 7:30 to 9:00 a.m. in Conference Auditorium ABC of the Ernest N. Morial Convention Center. She will discuss implications of the WHO classification scheme for clinical practice, including in situ neoplasia, age-related conditions, and a new classification scheme for aggressive lymphomas. Dr. Steven Bernstein from the University of Rochester will then discuss the challenges involved in managing transformed lymphomas. Finally, Dr. Martin Dreyling of the University of Munich, Germany will discuss the management of mantle-cell lymphoma. Mantle-cell lymphoma is particularly challenging, as outcomes remain poor and there is considerable controversy about optimal management, including ongoing debate about the best conventional chemotherapy regimen and how to integrate stem cell transplantation.

In today’s Poster Session from 5:30 to 7:30 p.m. in Hall E, there will be further opportunity to learn more about the biology, pathophysiology, and prognosis of NHL, with numerous posters on pathways involved and prognostic factors identified. On Sunday, from 4:30 to 6:00 p.m. in room E-1, the Oral Session on clinicopathological correlations in NHL will cover a variety of laboratory and radiographic data that appear to predict prognosis. Following this from 6:00 to 8:00 p.m. in Hall E, the second Poster Session will include posters that focus on the biology underlying NHL. On Monday, there will be continued coverage of the biology of NHL focusing on lymphoma cell biology in an Oral Session from 7:00 to 8:30 a.m. in room E-1 followed by another session in this same room from 10:30 a.m. to 12:00 noon focusing on genetic factors in lymphoma, and in the same room again (perhaps you want to stay seated!) from 2:45 to 4:15 p.m. on the biology and prognosis of diffuse large B-cell lymphoma.

For those whose interests lean toward therapy, there are also a variety of sessions. For example, there will be an Oral Session held Sunday from 4:30 to 6:00 p.m. in rooms 208-210 of the Ernest N. Morial Convention Center on lymphoma chemotherapy using PET strategies and therapy adapted to special populations such as those with post-transplant lymphoproliferative disorder. You will need to choose between this session and a simultaneously held Oral Session in rooms R02-R05, where uncommon lymphomas and supportive care will be discussed. Other sessions will take place on Monday as noted in the 2009 Program Book.

Dr. Marks indicated no relevant conflicts of interest.

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