At the press conference on the afternoon of September 27, Dr. Tran Thanh Tung, Head of the Department of Hematology, Cho Ray Hospital, said that on July 6, 2022, the Department of Hematology, Cho Ray Hospital received patient O. with a diagnosis of relapsed follicular non-Hodgkin lymphoma resistant to many regimens.
Medical history showed that the patient discovered lymph nodes in the neck area, so he went to the doctor, and the diagnosis showed that it was lymphoma. At the first medical facility, the patient was treated with chemotherapy alone.
After 4 years, the patient relapsed twice and received chemotherapy, the disease still responded. In 2021, the patient relapsed for the third time, at this time the treatment was no longer responsive.
At Cho Ray Hospital, assessing this as a case of relapsed and resistant lymphoma, the treatment team decided to choose new treatment methods for the patient. Therefore, after consultation, the treatment team decided to simultaneously perform 2 techniques of myeloablative conditioning regimen with total body radiotherapy (TBI) to treat the patient.
Cho Ray Hospital doctors share at press conference
According to the treatment team, if the cancer cells are to be completely treated, the patient must first undergo chemotherapy to clear the cancer cells. Then, TBI is like a weapon that will wipe out the remaining cells hidden in the body. Finally, the patient will be transplanted with new blood cells and will be (cured) stably. Therefore, patient O. was treated with a treatment regimen of 3 consecutive days of total body radiation therapy, twice a day (morning and afternoon), each time lasting 35 - 40 minutes.
After treatment, the patient was monitored and underwent allogeneic stem cell transplantation. After 30 days of stem cell transplantation, the patient was assessed as having a successful transplant and was discharged from the hospital 45 days after transplantation.
Currently, after treatment, the patient's health is stable, he has gone to work and returned to his daily life.
TBI total body radiotherapy
Dr. Nguyen Tri Thuc, Director of Cho Ray Hospital, said that it can be said that with the pioneering role of simultaneously combining two advanced, specialized techniques to successfully treat patients with lymphoma, Cho Ray Hospital has opened up opportunities for cancer patients, because this method has fewer side effects, fewer complications and shorter hospital stays... In the future, it is hoped that there will be a combination between Cho Ray Hospital and hematology hospitals to increase the effectiveness of treatment for patients with leukemia, contributing to improving the quality of life for patients.
Dr. Le Tuan Anh, Director of the Oncology Center, Cho Ray Hospital, said that the reason for having to perform whole-body radiation therapy is because of the characteristics of lymphoma, cancer cells infiltrate the blood vessels, even in locations such as the testicles, cancer cells are difficult to find. Therefore, it is necessary to perform whole-body radiation therapy to help destroy cancer cells completely.
Doctor CK II Le Phuoc Dam, Department of Hematology, said that normally an allogeneic stem cell transplant ranges from 200 to 400 million VND. In this patient's case, the total cost was 270 million VND, of which insurance paid 170 million VND, and the patient only paid about 100 million VND.
In addition, applying the TBI method has few complications, the hospital stay is only 1.5 months, previously it usually took 2-3 months.
What is TBI?
Dr. Tran Thanh Tung said that TBI is a method that has been around since 1900 in the world and has been prescribed for cancer treatment since 1950. TBI is prescribed for the treatment of some cancers that are widespread throughout the body such as hematological cancers, acute leukemia or lymphoma with metastasis to many lymph nodes. TBI stands for Total Body Irradiation, which is whole body radiation therapy. With the advantage of radiation therapy at all locations in the body to control cancer cells, it helps to overcome some of the disadvantages of conventional chemotherapy.
Stem cell transplantation means taking stem blood cells and transfusing them to the patient. There are two methods: autotransplantation (taking the patient's own stem cells) and allogeneic transplantation (also known as allogeneic transplantation, which means taking stem cells from a person who is compatible with the patient and transfusing them to the patient). Patient O. relapsed and was resistant to treatment, so his own stem cells could not be taken because there were still cancer cells in his blood. Therefore, it was necessary to apply the allogeneic stem cell transplantation method. Fortunately, the patient's sister had suitable indicators and donated stem blood cells to patient O.
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