What Are Common Follicular Lymphoma Treatment Side Effects?
What might follicular lymphoma patients experience for treatment side effects? Expert Dr. Brad Kahl from Washington University School of Medicine discusses common treatment side effects that patients might experience, some methods for dealing with side effects, and other precautions to help ensure optimal patient care.
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Transcript:
Lisa Hatfield:
What are the common side effects of the recommended treatments in newer therapies? And a really important question. Are there long-term side effects that I should be aware of or that a patient should be aware of?
Dr. Brad Kahl:
Yeah, the side effects are going to be different for all the different new agents that I mentioned. With the bispecific monoclonal antibodies, there’s a little bit of risk for something called cytokine release syndrome. When you’re first starting on the drug, sometimes the drugs are really potent at activating the patient’s immune system. And as that immune system is getting revved up, the immune system will release chemicals or cytokines, which can give you fevers and make you feel like you have the flu. It’s just your immune system responding.
And so that’s something that we have to watch for as we’re starting a bispecific, that’s usually a short-term problem. And it’s usually pretty easily managed with steroids or other drugs that can tamp down the immune system. And then once you’re past that risk for cytokine release syndrome, the bispecifics usually go pretty smooth, but the bispecifics do deplete your body of healthy B cells in addition to the follicular lymphoma cells.
So they do weaken the patient’s immune system some, and I’d say that’s the biggest risk that we have to worry about in patients getting a lot of these different treatments is just what it does to your immune system. And so we’re always telling patients to call us if you get a fever, infections in a patient on treatment can become a big deal. And that’s why we want those phone calls so we can figure out if you need to get seen, if you need to go to an emergency room, if we need to start on broad spectrum antibiotics immediately, if we need to bring in for fancy testing, because sometimes people can get kind of oddball or rare infections.
So infections, infections, infections are the things we worry about the most with most of the treatments that we give to people with relapsed follicular lymphoma. That’s true of the CAR T-cell products, cytokine release syndrome. We also have to worry about some neurologic toxicity that can happen if that happens, that’s going to occur while the patient’s in the hospital with us getting those treatments. But again, these drugs will deplete the immune system for months and months, maybe even a year, maybe longer. So we have to just be super careful about infections in patients getting these different treatments that I mentioned today.
