Sylvester Comprehensive Cancer Center

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José Recio, Lymphoma

José Recio, Lymphoma

"The medical team at Sylvester has been exceptional. I was fortunate to have found the best, and I doubt there is any better."

Unique Protocol Gives Patient New Lease On Life

For several weeks in the fall of 2005, José Recio began experiencing recurring night sweats. Even so, the 60-year-old Portuguese entrepreneur, a 24-year resident of Luanda, Angola, Africa, wasn’t particularly worried.

Assuming his symptoms were that of malaria, a disease that is prevalent in Africa and one he had contracted before, he went to a local clinic to get properly checked and diagnosed for the mosquito-born illness. Surprisingly, the results came back negative.

“The medical team at Sylvester has been exceptional. I was fortunate to have found the best, and I doubt there is any better.”Days later, while receiving physiotherapy for a knee problem, he casually mentioned his sweating episodes to a physician/friend, who quickly insisted he get a medical check up to pinpoint the problem. During that check up, doctors noticed Recio had an abnormally enlarged spleen. Based on this information, he traveled to South Africa to undergo a comprehensive medical exam.

The results were shocking. Recio had an uncommon form of lymphoma known as mantle cell lymphoma, which accounts for about six percent of non-Hodgkin’s lymphoma in the United States (about 3,300 new cases a year), according to the Leukemia and Lymphoma Society. Recio was dumbfounded but quickly transformed his initial shock into action.

“The treatment that was suggested to me in South Africa was conventional chemotherapy,” recalls Recio. “But before undergoing any treatment, and with the help of a physician/friend in South Africa, I decided to do some research of my own and contacted Memorial Sloan-Kettering Cancer Center in New York. Since I have a house in Miami (Recio often travels to South Florida for business), they recommended I contact the best researcher for this type of lymphoma, Dr. Izidore Losses at the University of Miami Sylvester Comprehensive Cancer Center.”

That’s because Lossos, associate professor of medicine, Division of Hematology-Oncology, University of Miami Leonard M. Miller School of Medicine and director of the Sylvester lymphoma Program, designed an innovative and promising new protocol, which was initiated in Miami about three years ago. That’s when official clinical trials began on 12 patients, including Recio.

Although the results still are considered preliminary, the unique trial has proven amazingly successful. The combination and intensity of the drugs administered is part of the reason. The trial uses eight medications (standard chemotherapy typically uses a combination of four to five drugs), which are given at a high dose and at “dose-dense” intensity—when the chemotherapy treatments are administered on a condensed schedule, reducing the interval between successive doses.

“We don’t wait a certain amount of time for the patient to recover. As we see the counts improving, patients can receive chemo. So patients can receive chemo every two weeks; it just depends on their bone marrow—and treatment is completed in four months. So it’s very intense,” says Lossos, who was recently elected to the American Society of Clinical Investigation.

Another modification, which is believed to have improved patients’ outcomes, is the addition of the drug thalidomide, an immunomodulator that affects not only tumor cells but also the micro-environment where the tumor cells grow. The first stage of treatment affects the tumor and the second stage affects the cells that support the tumor.

Since the clinical trial was started the response rate in patients has been 100 percent. In contrast to previous trials, all patients who finished the therapy are in complete remission—and there has been no significant relapse. This response rate is better than anything that has been reported so far, explains Lossos.

“When Mr. Recio came to me, his lymphoma was very advanced,” recalls Lossos. “He had an enlarged spleen that weighed about five to six kilos (approximately 11 pounds} and a very disseminated disease—everything was involved. He had a leukemic stage when malignant cells are present not only in the bone marrow, but also in peripheral blood.”
Luckily, Recio had not received any prior treatment for his cancer and so was eligible and placed on the protocol. Individuals are eligible for the clinical trial if they have mantle cell lymphoma, do not have HIV/AIDS, have not received any previous treatment for their cancer, and have no central nervous system involvement.

Since the treatment is so intensive and patients must be monitored closely, Recio was hospitalized for approximately ten weeks to administer the four cycles of medications. Today, all of Lossos’ patients, including Recio, have shown no signs or symptoms of cancer after completing the various cycles of medications.

“My rapport with Dr. Lossos has been excellent,” says Recio. “In my case, aggressive chemotherapy was used in an attempt to achieve improved cure rates without the requirement of a transplant. Today, tests indicate that my lymphoma is in complete remission.”

Recio admits that many factors contributed to his amazing recovery. “I attribute my resilience to few words, faith in God, and a phenomenal support network of family, friends, and my doctor, Dr. Lossos, who gave me the strength to see this through,” he says.

Recio now takes an oral form of thalidomide daily as a form of maintenance treatment. Although the drug’s potential side effects include dizziness, peripheral neuropathy (where patients develop a tingling sensation in their toes or a numbness in the hands), and constipation, Recio has tolerated the drug well and reports no major side effects.

Recio now travels to Miami every three months where imaging studies (PET and CT scans) are performed. Soon, these will be scheduled every six months and then just once a year. To better monitor his condition between checkups, Recio and Lossos communicate by email and telephone.

“The medical team at Sylvester has been exceptional,” adds Recio. “I was fortunate to have found the best, and I doubt there is any better. Researchers like Dr. Lossos, who dedicate themselves to finding solutions so that people like me can move on with living life, are unique. I am deeply grateful to him for both his support and medical expertise.”

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