Huntington Beach resident Virginia Gallup, pictured above, is a life master—the highest ranking bestowed by the American Contract Bridge League. These days, however, her greatest challenge isn’t an opposing bridge team, but a rare form of cancer called mantle cell lymphoma.
In January 2000, the 83-year-old retired school teacher came down with a serious respiratory illness. When she visited the emergency department at Orange Coast Memorial, doctors gave her a physical exam, complete with blood tests and other assessments. Her problem was diagnosed as pleurisy—an inflammation of the chest-cavity lining. Soon after, Virginia was admitted to the hospital, where specialized treatment put her on the road to recovery almost immediately.
But the next day, an Orange Coast Memorial cancer specialist visited with some shocking news that was unrelated to pleurisy. “Tests showed I had non-Hodgkin’s lymphoma, a type of cancer involving my white blood cells,” recounts Virginia.
Further testing followed over the next few days. “Since there are more than 30 types of non-Hodgkin’s lymphoma, it’s important to identify the exact form of the disease,” says Glen Justice, M.D., medical director of the MemorialCare Cancer Center at Orange Coast. “The number and location of other organs that are affected also determines the treatment process.”
The results revealed that Virginia had an aggressive form of lymphoma called mantle cell cancer. The disease involves specific types of white blood cells called B lymphocytes, which are found in the mantle zone—or outer edge—of lymph nodes.
“B lymphocytes play a critical role in the workings of the immune system, fighting viruses and bacteria that constantly invade the body,” says Dr. Justice. The cells are made in the bone marrow and stored in the lymph nodes—small, bean-shaped structures in the neck, under the arms, at the elbows and in the chest, abdomen and groin. Suspended in a fluid called lymph, B lymphocytes and other disease-fighting cells are carried throughout the body by a network of lymphatic vessels.
To combat the disease, Virginia began a course of chemotherapy called CHOP. Consisting of a special combination of four drugs, it resulted in a remission within several months. “Since mantle cell cancer is not currently curable, the goal is to improve and sustain the quality and duration of remissions,” explains Dr. Justice.
Since she first began therapy, Virginia has undergone additional rounds of CHOP in the hospital’s state-of-the-art infusion center, followed by a new drug called rituximab. Rituximab works by attaching itself to diseased mantle cells, marking them for destruction by the body’s immune system. Most recently, she began an experimental drug called Revlimid, which is undergoing clinical trials. It belongs to a new class of medications believed to affect the biological pathways in malignant mantle cells. “I’m quite positive about my treatment,” says Virginia. “Very few patients have access to the up-to-date treatment I’m getting.” Orange Coast Memorial oncologists are currently involved in more than 40 of the world’s most promising clinical trials, giving patients access to drugs not widely available elsewhere.
