Hematologic Oncology

There have been significant advances in our understanding of the biology of acute myelogenous leukemia (AML), and to a lesser extent, in its treatment. Dr. Estey has provided an excellent overview of the current state of the clinical management of the disease. He has described both the standard therapeutic approaches, including allogeneic hematopoietic stem cell transplantation, as well as the role of investigational therapy. The present state of clinical research in AML is reviewed in some detail in the context of the broad clinical investigation of the disease at the M. D. Anderson Cancer Center. Dr. Estey makes a strong argument for the early consideration of investigational therapy, focusing on patients for whom "standard" therapy is demonstrably inadequate.

Therapeutic strategies are evolving for the treatment of patients with newly diagnosed acute myelogenous leukemia (AML), as well as for those with relapsed or refractory disease. Clinical and laboratory studies have demonstrated that AML is not a single disease, but a heterogeneous group of diseases with different clinical features and natural histories. There are variable responses to therapy depending on both the biologic characteristics of the disease and the clinical characteristics of the patient. Nevertheless, studies evaluating the outcomes of relatively large numbers of patients with newly diagnosed AML show that the majority still die of their disease.[1-3]

The treatment of patients with acute myelogenous leukemia (AML) ranges from palliative care only, to standard therapy, to investigational approaches. Acute myelogenous leukemia is, in fact, several different diseases, and the percentage of clinical responses varies with disease and prognostic subsets.

HOUSTON-The farnesyl transferase inhibitor R115777 (tipifarnib, also known as Zarnestra) produced an overall response rate of 33% in patients with chronic myelogenous leukemia (CML) and decreased splenomegaly in most patients with myelofibrosis, but was not effective in multiple myeloma, reported Deborah Thomas, MD, at the 43rd Annual Meeting of the American Society of Hematology. Dr. Thomas is assistant professor in the Department of Leukemia at The University of Texas M. D. Anderson Cancer Center in Houston.

ORLANDO-Patients with chronic myelogenous leukemia (CML) who have a complete cytogenetic response (CCgR) to interferon-alfa have a long survival, and low-risk patients have a projected 10-year survival of more than 80%, Francesca

ORLANDO, Florida-Updated data from two phase II trials show that imatinib mesylate (Gleevec, STI571) continues to improve response rates for patients with chronic myelogenous leukemia (CML) who did not respond to interferon therapy or are in blast crisis. With follow-up of 12 months or more, overall and complete response rates are proving to be durable and toxicities tolerable

ORLANDO-Imatinib mesylate (STI-571, Gleevec) is showing excellent results in newly diagnosed patients with chronic myelogenous leukemia (CML) in the early chronic phase, scientists reported at the 43rd Annual Meeting of the American

ORLANDO, Florida-Two phase I/II studies indicate that combination treatment with imatinib mesylate (Gleevec, also known as STI571) produces a high rate of hematologic response in patients in the chronic phase of chronic myelogenous leukemia (CML). Dose-limiting toxicities were mainly hematologic, and researchers advocate further studies were recommended to establish efficacy and recommended dosing.

MANNHEIM, Germany-Despite encouraging initial responses, patients with chronic myelogenous leukemia (CML) frequently become resistant in the advanced, or blast crisis, phase of the disease after initially responding to selective inhibition of the Bcr-Abl tyrosine kinase by imatinib (Gleevec, also known as STI571).

ROME-Best outcomes from donor lymphocyte infusion in chronic myelogenous leukemia (CML) occur when the first dose does not exceed 0.2 × 108 mononuclear cells/kg, Cesare Guglielmi, MD, reported in a presentation at the 43rd Annual Meeting of the American Society of Clinical Oncology.

MIAMI BEACH -The Bcr-Abl tyrosine kinase inhibitor PD173955 (PD17) binds to the target ATP binding pocket even more efficiently than STI-571 (imatinib mesylate, Gleevec). It shows 15 to 20 times greater efficacy in chronic myelogenous leukemia (CML) cell lines because it can bind to either open or closed activation loops.

Myeloproliferative disorders originate in the clonal expansion of a transformed pluripotential hematopoietic progenitor cell. This results in a group of syndromes that include polycythemia vera, essential thrombocythemia,

Myeloproliferative disorders originate in the clonal expansion of a transformed pluripotential hematopoietic progenitor cell. This results in a group of syndromes that include polycythemia vera, essential thrombocythemia,

SOUTH SAN FRANCISCO-The FDA has approved a supplemental biological license application (sBLA) for Rituxan (rituximab), the monoclonal antibody developed by Genentech, Inc. and IDEC Pharmaceuticals (San Diego) for treatment of patient with relapsed or refractory, low-grade or follicular, CD20-positive, B-cell non-Hodgkin’s lymphoma (NHL). The new product labeling includes re-treatment with rituximab after a prior course, initial treatment with eight weekly infusions instead of four, and treatment of bulky disease.

WASHINGTON-A new evaluation of existing scientific studies has found "limited or suggestive" evidence to link servicemen’s wartime exposures to herbicides in Vietnam with the development of acute myelogenous leukemia (AML) in their children. However, the Institute of Medicine (IOM) committee that reported the finding emphasized that the evidence for the association is not conclusive.

WASHINGTON -The Food and Drug Administration, acting with dispatch, has approved the marketing of Gleevec (imatinib mesylate, Novartis) for the treatment of chronic myeloid leukemia (CML). The agency granted the drug priority review and orphan drug status, and approved it under the FDA’s "accelerated approval" regulations less than 3 months after the sponsor submitted its marketing request.

SAN FRANCISCO-Patients with acute myeloid leukemia (AML) in first relapse who achieve remission with the antibody gemtuzumab ozogamicin (Mylotarg) before undergoing stem cell transplantation have prolonged disease-free survival, according to research presented at the 42nd Annual Meeting of the American Society of Hematology (ASH).

NEW YORK-The promise of molecularly targeted therapies has been validated in chronic myelogenous leukemia (CML), Brian J. Druker, MD, of Oregon Health Sciences University, Portland, said at the Chemotherapy Foundation Symposium XVIII. "This disease has provided an ideal opportunity to test the concept that drugs targeted against a tumor-specific abnormality will have therapeutic utility," he said.

SAN FRANCISCO-Patients receiving monoclonal antibody-targeted chemotherapy with gemtuzumab ozo-gamicin (Mylotarg) rather than conventional combination chemotherapy for first relapse of acute myelogenous leukemia (AML) are more likely to be treated as outpatients, resulting in considerable cost savings, according to a study from Fred Hutchinson Cancer Research Center and Wyeth-Ayerst Research.

SAN FRANCISCO-Results of a phase II, open-label, multicenter study show that the investigational agent STI571 holds promise for many patients with Philadelphia chromosome-positive (Ph+) chronic myelogenous leukemia (CML) whose disease has proved resistant to interferon therapy.

Over the past 2 decades, our understanding of the pathobiological events underlying chronic myelogenous leukemia (CML) has grown. At the same time, effective transplant and nontransplant treatment approaches to

Over the past 2 decades, our understanding of the pathobiological events underlying chronic myelogenous leukemia (CML) has grown. At the same time, effective transplant and nontransplant treatment approaches to

Over the past 2 decades, our understanding of the pathobiological events underlying chronic myelogenous leukemia (CML) has grown. At the same time, effective transplant and nontransplant treatment approaches to

ASCO-STI-571, an investigational drug that has high activity in benign-phase chronic myelogenous leukemia (CML), also produces significant hematologic responses in patients with advanced-stage CML or acute forms of leukemia, Moshe Talpaz, MD, said at the 36th annual meeting of the American Society of Clinical Oncology (ASCO) in New Orleans.

ASCO-Mylotarg (gemtuzumab ozogamicin) has received FDA approval for treatment of CD33-positive acute myelogenous leukemia (AML) in patients age 60 and older in first relapse who are poor candidates for cytotoxic therapy. The agent, manufactured by Wyeth-Ayerst, was approved as an orphan drug.

CMA-676 (gemtuzumab zogamicin) is an antibody-targeted chemotherapeutic agent consisting of a humanized anti-CD33 antibody linked to calicheamicin, a potent cytotoxic

One important future direction for rituximab (Rituxan) is to expand its therapeutic role into other CD-positive disorders. Rituximab induces responses in up to one-third of patients with relapsed or refractory aggressive non-Hodgkin's lymphoma

PORTLAND, Oregon-A rationally designed drug now known as STI 571 is both effective and well tolerated in treating certain leukemia patients that have not responded to other therapies. The results of two phase I clinical trials using STI 571 for chronic myelogenous leukemia (CML) and acute lymphoblastic leukemia (ALL) were reported by Brian Druker, MD, of the Oregon Health Sciences University in Portland, at the ASH meeting. The trials were conducted in collaboration with M.D. Anderson Cancer Center in Houston, Novartis Pharmaceuticals in East Hanover, New Jersey, and the University of California at Los Angeles.

NEW YORK-Acute myelogenous leukemia (AML) is an aggressive disease. But improved diagnosis with cytogenetic examinations and other special studies have made it possible to select the most effective induction therapy, Frederick R. Appelbaum, MD, told patients at a teleconference sponsored by Cancer Care Inc. and the Leukemia Society of America.

NEW ORLEANS-STI 571, an investigational drug for the treatment of chronic myelogenous leukemia (CML), produced complete hematologic responses in all patients receiving higher doses, according to preliminary analysis of phase I data presented at the 41st Annual Meeting of the American Society of Hematology (ASH) (see illustration ). All participants had failed interferon-alfa therapy.