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Leukemia - Acute Lymphoblastic Leukemia
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Gleevec® Improves Outcomes of Children and Adolescents with Ph+ ALL (10/12/2009)
Researchers affiliated with Children’s Oncology Group (COG) have reported that the addition of long-term daily Gleevec® (imatinib mesylate) to high-dose chemotherapy improves event-free survival (EFS) in children and adolescents with Philadelphia chromosome positive (Ph+) acute lymphoblastic leukemia (ALL). The details of this study were published online on October 8, 2009.
Recent Results of Treating Childhood ALL Presented by Dutch Investigators (9/15/2009)
Researchers from the Netherlands have presented recent results of treating childhood acute lymphoblastic leukemia (ALL) that show continued improvement in outcomes with less toxicity. Details of this study appeared early online in Lancet Oncology on September 10, 2009.
Eliminating Preventive Radiation May Benefit Children with ALL (6/30/2009)
Researchers from the St. Jude Children’s Research Hospital have reported that children with acute lymphoblastic leukemia (ALL) who are treated with effective, risk-adjusted chemotherapy regimens have good outcomes and may safely be able to avoid preventive radiation therapy to the brain. These results were published in the New England Journal of Medicine.
Phase III Trial of Expanded Umbilical Cord Blood (StemEx®) for Treatment of Hematologic Malignancies Announced (6/17/2009)
Researchers from the University of Pittsburgh and Gamida Cell announced that the University of Pittsburgh would be participating in an international multicenter Phase III study of StemEx® for the treatment of hematologic malignancies. There are currently 15 U.S. centers and 11 centers in Europe and Israel participating in this study. This study is classified as a Phase III study but, because it is not randomized, patients will be compared to matched historical controls.
Early T-Cell Precursor Acute Lymphoblastic Leukemia in Children Has Poor Prognosis (2/18/2009)
Researchers from St Jude Children’s Research Hospital and researchers from Italy have reported that they have identified a subset of patients with T-cell acute lymphoblastic leukemia (ALL), called ETP-ALL, which connotes an extremely poor prognosis. The details of this study appeared in the February 2009 issue of Lancet Oncology.
The American Society of Clinical Oncology 2008: Highlights of Treatment of Hematological Malignancies (1/30/2009)
The 2008 annual meeting of the American Society of Clinical Oncology (ASCO), held in Chicago, Illinois, again revealed advances in the treatment of hematologic malignancies. Patients with chronic or acute leukemias, myelodysplastic syndromes, and myeloproliferative disorders continue to be presented with novel, effective options for the treatment of their diseases.
Developments in the Treatment of Acute Lymphoblastic Leukemia: Update from ASH 2008 (1/28/2009)
Several studies presented at the 2008 American Society of Hematology (ASH) meeting focused on improving the outcome of acute lymphoblastic leukemia (ALL) in children and adults.
Immediate Allogeneic Stem Cell Transplantation for Relapsed Adult ALL Successful (1/20/2009)
Researchers from Germany have reported that patients with relapsed acute lymphoblastic leukemia (ALL) who proceed directly to allogeneic stem cell transplant have better outcomes than patients who receive re-induction chemotherapy prior to transplantation. The details of this study appeared in the December 2008 issue of Bone Marrow Transplantation.
Good Results from Allogeneic Stem Cell Transplantation After Imatinib-based Induction for Ph+ ALL (12/19/2008)
Researchers from Japan have reported a three-year relapse-free survival of 53% for patients receiving an allogeneic stem cell transplant from related, unrelated, or cord blood donors in first complete remission (CR) for Philadelphia chromosome positive (Ph+) acute lymphoblastic leukemia (ALL). The details of this study were presented at the 50th annual meeting of the American Society of Hematology on December 8, 2008 in San Francisco.
Sprycel® Effective for First-line Therapy of Philadelphia Chromosome+ ALL (12/19/2008)
Two recent studies suggest that Sprycel® (dasatinib) is an effective agent for first-line therapy of Philadelphia chromosome positive (Ph+) acute lymphoblastic leukemia (ALL). The details of these two studies were presented at the 50th annual meeting of the American Society of Hematology on December 8, 2008 in San Francisco.
Dexamethasone Superior to Prednisone in Induction Regimen for Childhood ALL (12/9/2008)
Researchers affiliated with the European AIEOP-BFM ALL 2000 trial have reported that dexamethasone in the induction regimen for childhood acute lymphoblastic leukemia (ALL) reduces the relapse rate compared with prednisone. The details of this study were presented on December 7, 2008 at the annual meeting of the American Society of Hematology in San Francisco.
Intensive Hyper-CVAD Regimen for Older Patients with ALL Effective (10/2/2008)
Researchers from M. D. Anderson Cancer Center have reported that hyper-CVAD (hypofractionated Cytoxan® [cyclophosphamide], Oncovin® [vincristine], Adrimycin® [doxorubicin], and dexamethasone) alternated with high doses of methotrexate and Cytosar® (cytarabine) improves the complete remission rate and survival in elderly patients with acute lymphoblastic leukemia (ALL). The details of this study appeared in an early online publication of Cancer on August 20, 2008.
Survival Rates Improving in Childhood Hematologic Cancers (10/1/2008)
Researchers from Cornell University and Germany have reported that five- and 10-year survival rates in childhood hematalogic cancers have significantly improved in the United States since 1990. The details of this study were published in the September 17, 2008 issue of the Journal of the National Cancer Institute.
High Second Remission Rate for Children with Acute Lymphoblastic Leukemia (9/24/2008)
Researchers affiliated with the Children’s Cancer Study Group have reported an 81% second remission rate for children with acute lymphoblastic leukemia (ALL) in first marrow relapse. The details of this study appeared in the August 20, 2008 issue of the Journal of Clinical Oncology.
Improved Survival in Pediatric Leukemia Following Unrelated Bone Marrow but not Peripheral Blood Stem Cell Transplantation (9/17/2008)
Researchers affiliated with the National Marrow Donor Program (NMDP) have reported that children with leukemia have had remarkably better survivals in more recent years following unrelated bone marrow transplantation. There was no improvement, however, in children receiving unmodified peripheral blood stem cells. The details of this study appeared in the September 2008 issue of Biology of Blood and Marrow Transplantation.
Stronger Dose Intensity of Prolonged Post Induction Intensification Improves Outcomes in High-risk ALL (9/17/2008)
Researchers affiliated with the Children’s Oncology Study Group have reported, “Stronger intensity but not prolonged duration of PII [post induction intensification] improved outcome for patients with higher-risk ALL [acute lymphoblastic leukemia].” The details of this study were published in the March 1, 2008 issue of Blood.
Epratuzumab Has Significant Activity in Children with Relapsed ALL (9/16/2008)
Researchers from New York University have reported that epratuzumab alone or in combination with chemotherapy has significant activity in children with relapsed acute lymphoblastic leukemia (ALL). The details of this Phase II study appeared in the August, 2008 issue of the Journal of Clinical Oncology.
Will Intra-osseous Injection of Umbilical Cord Blood Reduce Graft Failures? (8/15/2008)
Researchers from Italy have reported that the injection of umbilical cord blood directly into the pelvic bones of patients with leukemia appears promising. These results were recently published in an early online publication of the Lancet Oncology on August 9, 2008.
Gleevec® Improves Outcomes of Philadelphia Chromosome Positive (Ph+) Childhood Acute Lymphoblastic Leukemia (ALL) (12/12/2007)
Researchers affiliated with Children’s Oncology Group (GOG) have reported that the addition of Gleevec® (imatinib mesylate) to high-dose chemotherapy improves event-free survival (EFS) in children with Philadelphia chromosome positive (Ph+) acute lymphoblastic leukemia (ALL). The details of this study were presented at the 2007 meeting of the American Society of Hematology (ASH), December 8-10, in Atlanta Georgia.
Tasigna® Effective for CML Patients with Gleevec® Resistance or Intolerance (11/13/2007)
Researchers involved in two international Phase II trials have reported that Tasigna (nilotinib) is highly effective for the treatment of patients with chronic myeloid leukemia (CML) who are resistant or intolerant to Gleevec®. The details of these studies appeared in the November 15, 2007 issue of Blood.
Marqibo Gets Fast-Track Designation (8/31/2007)
Hana Biosciences has announced that their agent Marqibo has received fast-track designation by the United States Food and Drug Administration.
Umbilical Cord Blood Transplantation after a Reduced-Intensity Treatment Regimen: An Effective Strategy (7/12/2007)
Researchers from the University of Minnesota have reported a survival rate of almost 50% in adult patients with hematologic disease treated with umbilical cord blood transplantation following a regimen of Fludara® (fludarabine) and 200 cGy of total body irradiation (TBI). The details of this study appeared in an early on-line publication on June 13, 2007 in Blood.
Intravenous Oncaspar® Can be Safely Given to Adults with ALL (5/30/2007)
Researchers from the University of Southern California have reported that multiple doses of Oncaspar® (Peg-Asparaginase) can be given safely with minimal allergic reactions and no antibody formation in adults with adult lymphoblastic leukemia (ALL). The details of this study were published in the April 1, 2007 issue of Blood.
Atovaquone Effective Prophylaxis for Pneumocystis carinii Pneumonia in Children (4/10/2007)
Researchers from St Jude Children’s Research Center have reported that atovaquone (Mepron®, Malarone®) is effective prophylaxis against Pneumocystis carinii in children with leukemia. The details of this study appeared in the April 15, 2007 issue of Cancer.
Intravenous Oncaspar® Safe and Effective in Children with ALL (1/5/2007)
Researchers from the Dana-Farber Cancer Center have reported that Oncaspar® (peg-asparaginase) can be safely given intravenously (IV) to children with acute lymphoblastic leukemia (ALL). The details of this study were reported at the December 2006 meeting of the American Society of Hematology.
Intravenous Oncaspar® is Well Tolerated in Adults with ALL (1/4/2007)
Researchers from the University of Southern California have reported that multiple doses of Oncaspar® (Peg-Asparaginase) can be given safely with minimal allergic reactions and no antibody formation in adults with adult lymphoblastic leukemia (ALL). The details of this study were presented at the December 2006 meeting of the American Society of Hematology.
Allogeneic Stem Cell Transplant: Best Option for Younger Adults with ALL (12/13/2006)
A combined MRC/ECOG study has confirmed that an allogeneic stem cell transplant in first complete remission is the best option for patients with standard and high risk adult acute lymphoblastic leukemia (ALL) who were 65 years of age or younger. The details of this large cooperative study were presented at the December 2006 meeting of the American Society of Hematology.
Mercaptopurine Confirmed Preferable to Thioguanine for Childhood ALL (10/17/2006)
Researchers affiliated with the U.K. Medical Research Council’s ALL97 trial have reported that maintenance 6-thioguanine (6-TG) causes excess toxicity and no overall benefit compared to 6-mercaptopurine (6-MP) in childhood acute lymphoblastic leukemia (ALL).
Alternating Chemotherapy and Gleevec® Effective for Elderly with Philadelphia-Positive ALL (8/30/2006)
Researchers from France affiliated with the Group for Research in Adult Acute Lymphoblastic Leukemia have reported that Gleevec (imatinib) and methylprednisone alternated with chemotherapy improve outcomes of elderly patients with Philadelphia-chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL).
Dasatinib (SprycelTM) Active in Gleevec®-Resistant CML and ALL (6/28/2006)
Researchers from UCLA and the M.D. Anderson Cancer Center have reported that a new kinase inhibitor, Dasatinib (BMS-354825), has significant activity in patients with Philadelphia chromosome positive chronic myeloid leukemia (CML) or acute lymphoblastic leukemia (ALL) who have disease resistant to Gleevec (imatinib mesylate). The details of this phase I-II study appeared in the June 15, 2006, issue of the New England Journal of Medicine .
High Dose Gleevec® and Low-Dose Chemotherapy Effective for Relapsed PH Positive Acute Lymphoblastic Leukemia (3/17/2006)
Researchers from France have reported that high-dose Gleevec (imatinib) combined with vincristine and dexamethasone produced complete remissions (CR) in 28 of 30 patients with Philadelphia chromosome positive (PH+) acute lymphoblastic leukemia (ALL or lymphoid blast crisis of chronic myeloid leukemia (CML).
Total Lymphoid Irradiation Reduces Incidence of Acute Graft-Versus Host Disease in Allogeneic Stem Cell Recipients (9/30/2005)
Researchers from Stanford University have reported that allogeneic stem cell transplantation following a conditioning regimen of low-dose total lymphoid irradiation (TLI) and anti-thymocyte globulin (ATG) results in a low incidence of acute graft-versus host disease (GVHD) and a good survival in patients with lymphoid malignancies and acute myeloid leukemia.
Increased Exposure to Infection Decreases Incidence of Childhood Acute Lymphoblastic Leukemia (6/1/2005)
Researchers affiliated with the United Kingdom Childhood Cancer Study (UKCCS) have reported that day care in infancy decreases the risk of childhood acute lymphoblastic leukemia (ALL).
Are Two Umbilical Cord Blood (UCB) Units Better Than One for Transplantation? (2/15/2005)
Researchers from the University of Minnesota have reported that “transplantation of 2 partially HLA-matched UCB is safe and may overcome the cell-dose barrier that limits the use of UCB in many adults and adolescents.” The details of this report appeared in the February 1, 2005 issue of Blood.
Clolar™ Approved for Pediatric ALL (1/18/2005)
The Food and Drug Administration (FDA) recently approved Clolar™ (clofarabine) for the treatment of pediatric acute lymphoblastic leukemia (ALL). Clolar™ is indicated for patients aged 1 to 21 years who have received at least 2 prior treatment regimens.
Umbilical Cord Blood: Acceptable Source of Stem Cells for Adult Transplants (12/2/2004)
Two articles in the November 25, 2004 issue of the New England Journal of Medicine report the outcomes of 248 umbilical cord blood transplants in adults with acute leukemia. Both studies conclude that cord blood transplants are an acceptable source of stem cells for adults with leukemia who lack a suitable related or unrelated donor of stem cells.
Improved Outcome of Children with ALL with Less Intensive Treatment (11/4/2004)
Researchers from St. Jude Children’s Research Hospital have reported their latest results of adaptive treatment of children with ALL. They report 5-year and 8-year event-free survivals of 80.8% and 78.6%, respectively. The details of this study were reported in the November 1, 2004 issue of Blood.
Gleevec® is Safe and Effective for Children with Philadelphia Chromosome-Positive Leukemia (11/3/2004)
Researchers affiliated with Children’s Oncology Group have reported that Gleevec® (imatinib mesylate) is safe and effective in children with PH+ leukemias when administered in doses comparable to those administered to adults. The details of this study appeared in the November 1, 2004 issue of Blood.
Unrelated and Related Donor Stem Cell Transplants Produce Similar Outcomes for Adult ALL (7/21/2004)
Researchers affiliated with the European Bone Marrow Transplant (EBMT) Registry have reported that, for adults with acute lymphoid leukemia (ALL) in first remission, stem cell transplants from unrelated donors result in similar outcomes to those observed following related allogeneic stem cell transplants. These results were published in the July 15, 2004 issue of the Journal of Clinical Oncology.
Gene Profiling for Acute Lymphoblastic Leukemia (ALL) Can Predict Outcome (2/26/2004)
The status of gene profiling in ALL was reviewed by Dr. Bernard Fine in a plenary session of the International Bone Marrow Transplant Registry/American Association for Blood and Marrow Transplant (IBMTR/ASBMT) tandem meetings in Orlando Florida, February 13-17, 2004.
Thalidomide Effective for Myelofibrosis with Myeloid Metaplasia (2/17/2004)
Researchers from Italy have reported that patients with myelofibrosis with myeloid metaplasia (MMM) significantly benefit from low-dose thalidomide treatment. The details of this study were published in the February 3, 2004 issue of the
Journal of Clinical Oncology.
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Gleevec® Treatment of Philadelphia Chromosome-Positive ALL Buys Time for Donor Search (12/12/2003)
Philadelphia chromosome-positive acute lymphoblastic leukemia (ALL) represents 40% of ALL cases in patients over the age of 40 years. For adults with Philadelphia chromosome-positive ALL, survival at 3 years does not exceed 20% in most studies. Most cooperative groups have ongoing studies designed to improve the outcome of such patients. Most studies are based on the observation that recipients of allogeneic transplant from related or unrelated donors have improved survivals and up to 40%-50% of patients are long-term survivors. The outcomes for autologous stem cell transplants have not been clearly superior to intensive consolidation therapy without stem cell support but may be improved for the subset that achieves PCR negativity allowing the collection of leukemia-free stem cells.
Zarnestra™, a Farnesyl Transferase Inhibitor, Active in AML (12/10/2003)
Two multicenter US clinical trials have established Zarnestra™ as an active agent for the treatment of acute myeloid leukemia (AML). Zarnestra™ has been evaluated in patients with refractory AML
1 and in elderly or high-risk patients with untreated AML.
2 The results of these 2 phase II clinical trials were presented at the 45th annual meeting of the American Society of Hematology in December 2003.
Thioguanine No More Effective and More Toxic than Mercaptopurine for Maintenance Therapy of ALL (10/15/2003)
German researchers have determined that mercaptopurine remains the maintenance therapy of choice for children with acute lymphoblastic leukemia (ALL). The results of this clinical trial were published in the October 15, 2003 issue of
Blood.
Anti-Angiogenesis Agent, SU5416, May Have Activity in Acute Myeloid Leukemia (10/13/2003)
Researchers from Germany and Switzerland have reported that SU5416, an inhibitor of vascular endothelial growth factor (VEGF), has single agent activity in patients with refractory acute myeloid leukemia (AML). The results of this study were published in the October 15, 2003 issue of
Blood.
Molecular Studies Show Superiority of Gleevec® Over Interferon for Treatment of CML (10/9/2003)
Researchers affiliated with the International Randomised Study of Interferon versus STI571 (IRIS) Study Group reported that patients receiving Gleevec® had a higher rate of complete cytogenetic remissions and a higher proportion of patients achieving at least a 3 log reduction in BCR-ABL transcript levels by 12 months of treatment. Since there were no recurrences reported in the group with at least a 3 log reduction, the researchers propose that “a reduction in BCR-ABL transcript levels of at least 3 log be used to define a major cytogenetic response.”
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Long-Term Outcomes from Childhood ALL Affected by Irradiation (8/14/2003)
Researchers from St. Jude Children’s Research Hospital have reported that children with ALL who have not received radiation to the brain have normal long-term survival while irradiation is associated with the development of second neoplasms, a slight excess in mortality, and an increased unemployment rate. These findings were published in the August 14, 2003 issue of the
New England Journal of Medicine.
Unrelated Stem Cell Transplants Effective for Children with Poor Risk ALL in Second CR (5/14/2003)
German and Austrian researchers report that unrelated donor transplants result in a 44% survival rate in children with acute lymphoblastic leukemia (ALL) in second complete remission (CR) with poor risk factors versus 0% following conventional chemotherapy. For children with good risk factors there was no advantage of transplants over conventional chemotherapy. These results were reported in the May 15, 2003 issue of
Blood.
Second Malignancies Are Frequent After Stem Cell Transplants (4/11/2003)
A study of second malignancies in children receiving stem cell transplants revealed that the risk of post-transplant malignancies, especially solid tumors, continues to increase even 20 years after transplant, necessitating long-term close follow-up for these patients. These results were reported by researchers from the University of Minnesota in the April 1, 2003 issue of the
Journal of Clinical Oncology.
Gleevec Found to Be Effective for Idiopathic Hypereosinophyllic Syndrome (4/1/2003)
Recently, it was reported that some patients with idiopathic hypereosinophilic syndrome responded to Gleevec. This multicenter study also determined the molecular basis of the defect in one patient. They found that one patient had a complex chromosomal abnormality related to chromosome 4q12. These results were published in the March 27, 2003 issue of the
New England Journal of Medicine.
Adolescents with Acute Lymphoblastic Leukemia Have Better Survivals When Treated on Pediatric Rather Than Adult Protocols (3/3/2003)
Adolescents, ages 15 to 20, with acute lymphoblastic leukemia (ALL), are treated on either pediatric or adult protocols. The main difference between pediatric and adult protocols is dose intensity. As a generality, pediatric protocols for ALL involve higher doses of drugs administered over a shorter period of time. There have been few analyses of the impact of protocol choice on the outcome of adolescents with ALL. In the March 1, 2003 issue of the
Journal of Clinical Oncology, French researchers report that survival of adolescent patients with ALL was improved if they received treatment on pediatric protocols.
Genasense™, an Inhibitor of Bcl-2, has Clinical Activity for the Treatment of Refractory Acute Leukemia (1/13/2003)
Bcl-2 is a potent inhibitor of apoptosis which is a cause of cell death. Overexpression of this protein in patients with leukemia is associated with resistance to chemotherapy. The Bcl-2 antisense oligonucleotide, Genasense™ down-regulates Bcl-2 and has been investigated in several hematological malignances where Bcl-2 has been implicated in disease resistance. In vitro studies have suggested that Genasense™ can down-regulate Bcl-2 activity and inhibit cell viability. Thus, the targeting of Bcl-2 was a potential strategy for treatment of leukemia. Investigators from Ohio State University, University of Chicago, the National Cancer Institute and Genta, Inc. reported the results of treatment of patients with refractory leukemia with Genasense™ in the January 15, 2003 issue of
Blood.
Parental Medications Can Affect The Incidence of Acute Lymphoblastic Leukemia in Offspring (10/7/2002)
Childhood acute lymphoblastic leukemia (ALL) is the most frequent cancer in children in all cultures. The etiology of childhood ALL is unknown, but some researchers suspect that fetal exposure to carcinogens could play a role. It has been shown in other studies that maternal use of folic acid is associated with a lower incidence of ALL. An increased incidence of ALL has been observed in children whose mothers are anemic. However, little is known about fetal exposure to other agents such as mind altering drugs like amphetamines (present in diet pills) and marijuana. The effect of paternal drug use on ALL has also not been explored.
Peripheral Blood Monitoring for Minimal Residual Disease Can Provide Useful Information in Children with Acute Lymphoblastic Leukemia (9/19/2002)
The usual method for monitoring of minimal residual disease in patients with leukemia is to perform sophisticated tests including PCR on bone marrow samples. Many patients who have a normal bone marrow on examination by light microscopy will have leukemia detected by more precise techniques. The detection of minimal residual disease is usually associated with relapse unless further treatment is given. In children, frequent bone marrow examinations can be traumatic and sometimes have to be done under heavy sedation or anesthesia. Researchers at St Jude Children's Research Hospital have compared the results on blood and bone marrow testing for minimal disease in children with acute lymphoblastic leukemia (ALL). They found that peripheral blood tests correlated with bone marrow tests for T-cell ALL but not for B-cell ALL. Surprisingly, they found that children with minimal disease in the peripheral blood but not the bone marrow had a very poor outcome. They reported these results in the September 18, 2002 issue of
Blood.
Allogeneic Stem Cell Transplantation in First Remission is Current Best Approach for Adults with Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia (9/19/2002)
Philadelphia chromosome-positive acute lymphoblastic leukemia (ALL) represents 40% of ALL cases in patients over the age of 40 years. For adults with Philadelphia chromosome-positive ALL, survival at 3 years does not exceed 20% in most studies. Most cooperative groups have ongoing studies designed to improve the outcome of such patients. Most studies are based on the observation that recipients of allogeneic transplant from related or unrelated donors have improved survivals with up to 40%-50% of patients being long-term survivors. The outcomes for autologous stem cell transplants have not been clearly superior to intensive consolidation therapy without stem cell support. Researchers in France have reported a confirmation of these observations in 154 adults with Philadelphia chromosome-positive ALL and their results were published in the September 18, 2002 issue of
Blood.
The Administration of Growth Hormone Increases Height in Children with Acute Lymphoblastic Leukemia (ALL) (7/24/2002)
Children who become long-term survivors from ALL often have poor growth and development including short stature. The reasons for this are multifactorial and can include premature closing of the epipiseal plates and damage to endocrine organs. It is clear that some children have a specific decrease in the levels of growth hormone. There have been several studies that have suggested that administering growth hormone to children who have completed therapy for ALL improves growth and development. The administration of growth hormone can also improve muscle and cardiac function, increase bone mineral density and normalize serum lipid concentrations, resulting in an improved quality of life in deficient individuals.
Elitek® Approved by FDA for Tumor Lysis Syndrome (7/19/2002)
The Food and Drug Administration has approved Elitek™ (rasburicase) for pediatric patients at a high risk of developing tumor lysis syndrome from treatment of their cancer. Elitek™ is a genetically engineered enzyme that breaks down uric acid so by-products can be safely excreted through the kidneys.
Rapidity of Blast Clearance From Bone Marrow is Main Predictor of Treatment Failure for Children with Acute Lymphoblastic Leukemia (ALL) (6/24/2002)
Failure of children with ALL to achieve a complete remission promptly has been associated with a poor outcome. Identifying children with a high risk of relapse is important because they can be put on more aggressive protocols, while good-risk patients can be spared the more intensive treatment and its associated side effects. Two reports in the July 2002 issue of
Blood help to better classify such poor-risk patients and emphasize the importance of persistent leukemia cells following induction.
Maintenance Therapy for Childhood AML Associated with Poor Survival Compared to No Maintenance (6/17/2002)
Children with AML have a high remission rate, but the majority of patients will ultimately relapse. The best post induction therapy is probably allogeneic transplantation for children who have suitable donors. For the remainder of patients, it has not been clear if they benefit from prolonged chemotherapy maintenance after consolidation. French researchers have reported that prolonged maintenance therapy in children with AML may be detrimental in that it is associated with poor salvage rates and survivals. They reported their findings in the June 12 issue of the
Journal of Clinical Oncology.
Prolonged Maintenance Therapy for Acute Myeloid Leukemia has a Renewed Interest (6/10/2002)
Over the past decade or two, maintenance chemotherapy for patients with acute myeloid leukemia (AML) who achieve a complete remission (CR) has been abandoned in favor of intensive consolidation. However, the issue of benefit from long-term maintenance was raised at the 2002 Annual Meeting of the American Society of Clinical Oncology.
Shortened Intensive Chemotherapy May Improve Outcomes of Patients with Low and Intermediate-Risk Acute Lymphoblastic Leukemia (6/5/2002)
Adult patients with low and intermediate-risk ALL have an approximate 35% cure rate with current chemotherapy, which has included cranial radiation and high doses of anthracyclines. Cranial radiation and high-dose anthracycline treatment can be associated with severe side effects. At the University of California at San Francisco, researchers have focused their attention on improving the outcomes of adult patients with ALL by decreasing the total amount of anthracyclines administered and omitting cranial radiation. They published their results in the May 15 issue of the
Journal of Clinical Oncology.
Stem Cell Transplants from Unrelated Donors Effective for Children With Acute Lymphoblastic Leukemia (ALL) in Second Remission (4/30/2002)
Results from a recent analysis by the International Bone Marrow Transplant Registry (IBMTR) recently published in
Blood indicate that unrelated stem cell transplants produce similar results as related in children with acute lymphoblastic leukemia (ALL) in second remission.
Abnormal Magnetic Resonance Images (MRI) of Femoral Marrow May Predict Relapses in Patients with Acute Myeloid Leukemia (AML) in First Complete Remission (CR) (4/18/2002)
Patients with AML who achieve a CR can be cured or are destined to relapse. Prediction of those who are destined to relapse would allow for other interventions such as stem cell transplantation. Some of the factors predictive of outcome include: requiring more than one course of chemotherapy to achieve CR or adverse cytogenetics. Once remission has been achieved, persistence of cytogenetic abnormalities predict for relapse. However, other more easily performed tests are desirable.
E coli-Asparaginase Superior to Erwinia-Asparaginase (4/10/2002)
The European Organisation for Research and Treatment of Cancer, Children's Leukemia Group (EORTC-CLG) have reported that E coli-Asparaginase results in better survival of children with ALL than Erwinia-Asparaginase. These results were published in the April 15 issue of the journal
Blood.
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