Hematologic Oncology

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.

High-dose therapy with hematopoietic progenitor-cell transplantation plays a key role in the treatment of Hodgkin’s disease and the non-Hodgkin’s lymphomas. First and foremost, transplantation is used as a salvage treatment for those who relapse or do not achieve a complete remission with first-line chemotherapy. Carefully selected patients with poor prognostic features may benefit from the incorporation of high-dose therapy and transplant into their initial treatment programs. Despite a myriad of trials, many pivotal questions regarding the appropriate application of high-dose therapy with transplantation to the lymphoid malignancies remain unsettled, including the role of allogeneic transplantation and the optimal timing of transplant for patients with poor prognostic indicators. Phase III studies are required to address these issues; these trials will demand the active commitment of concerned transplanters and referring hematologists and oncologists. Although autologous transplantation has been the preferred approach for the majority of patient subgroups, new approaches to allogeneic transplantation that have diminished toxicity may pave the way for a greater role for allogeneic grafting in the lymphoid diseases. [ONCOLOGY 13(12):1635-1645, 1999]

Data published in a recent issue of Blood suggest that valspodar (Amdray), a multidrug resistance modulator being developed by Novartis Pharmaceuticals Corporation, may show promise in treating certain patients with acute myelogenous leukemia

The combination of fludarabine and mitoxantrone (FM) has been shown to be an effective regimen for indolent lymphoma (J

MIAMI BEACH-Long-term follow-up of 23 patients with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) in first complete remission showed a relatively low relapse rate at 3 years when treated with allogeneic bone marrow transplant from HLA-matched siblings, D.S. Snyder, MD, reported at the American Society of Hematology (ASH) annual meeting.

TUCSON-Cyclosporine (Sandimmune) significantly reduces resistance to daunorubicin (Cerubidine), prolongs the duration of remission, and improves overall survival of patients with high-risk acute myelogenous leukemia (AML), Alan F. List, MD, of the University of Arizona, said at the ASH meeting. Dr. List’s observations were based on a randomized trial conducted with the Southwest Oncology Group.

SEATTLE-Preliminary phase II data show that CMA-676, an engineered human anti-CD33 antibody linked to calicheamicin, a potent cytotoxic agent, produced an objective response in 10 of 23 patients (43%) with acute myelogenous leukemia in first relapse after initial chemotherapy. Six responders went on to allogeneic bone marrow transplant.

CHICAGO-A cost analysis of the use of G-CSF (Neupogen) in elderly patients undergoing intensive chemotherapy for acute myelogenous leukemia (AML) showed the agent to be almost cost neutral, Tammy J. Stinson, MS, said at a poster session of the American Society of Hematology annual meeting.

GOTEBORG, Sweden-A postconsolidation regimen of low-dose interleukin-2 (IL-2) and the investigational agent histamine dihydrochloride (Maxamine) appears to increase leukemia-free survival in acute myelogenous leukemia (AML) patients in remission, Bo I. Nilsson, MD, PhD, reported at an ASH poster session.

Chronic myelogenous leukemia (CML) is a myeloproliferative disorder that follows a characteristic clinical course in which a chronic phase of variable duration precedes an accelerated, and ultimately blastic, phase,

GAITHERSBURG, Md-The Oncologic Drugs Advisory Committee (ODAC) has unanimously recommended the approval of Busulfex Injection (busulfan, Orphan Medical) in combination with other chemotherapeutic agents and/or radiation as a conditioning regimen prior to hematopoietic progenitor cell transplantation-but only in chronic myelogenous leukemia (CML).

Chronic myelogenous leukemia (CML) is an intriguing disease for reasons that point to important biological differences between this and other types of leukemia:

Individualizing the dosage of cancer chemotherapy can increase survival rates for children with acute lymphoblastic leukemia (ALL) without causing excessive toxicity, according to a recent study published in The New England Journal of Medicine.

SAN DIEGO-Up to 80% of newly diagnosed elderly acute myelogenous leukemia (AML) patients overexpress P-glycoprotein (P-gp), leading to multidrug resistance and a poor prognosis, said Dr. P. Sonneveld, University Hospital, Rotterdam, in a presentation at the American Society of Hematology (ASH) annual meeting.

ASH-Patients with chronic myelogenous leukemia (CML) who are eligible for transplant but lack a matched sibling donor should begin their search for an unrelated donor as soon as possible after diagnosis, A. James Morton, MD, said at the plenary session of the annual meeting of the American Society of Hematology (ASH) in San Diego.

Drs. Enright and McGlave succinctly review the biology of chronic myelogenous leukemia (CML) and highlight the therapeutic role of allogeneic stem-cell transplantation. Two points, however, warrant further discussion. The first is that a regimen containing interferon-alfa (Intron A, Roferon-A) is optimal front-line therapy for the great majority of CML patients.[1] The second is that use of an interferon-alfa-based regimen prior to allogeneic stem-cell transplantation does not adversely affect post-transplant mortality, morbidity, or anti-CML efficacy.

ASCO--Treatment with an investigational immunoconjugate, CMA-676, safely induced remissions in some patients with refractory or relapsed acute myelogenous leukemia (AML), Eric L. Sievers, MD, said in his poster presentation of the preliminary results at the American Society of Clinical Oncology annual meeting.

ORLANDO--Final results of a phase III trial show that monotherapy with IDEC-C2B8, a new chimeric monoclonal antibody being developed by IDEC Pharmaceuticals and Genentech, pro-duces favorable response rates in patients with relapsed low-grade or follicular non-Hodgkin's lymphoma (NHL).

ORLANDO--Combination therapy utilizing interferon alfa-2b (Intron A) and cytarabine is associated with improved cytogenetic response and survival over interferon alone in patients with chronic myelogenous leukemia (CML), a French study, presented at the 38th Annual Meeting of the American Society of Hematology (ASH), has shown.

ORLANDO--A preparative regimen employing a radiolabeled monoclonal antibody (MoAb), coupled with busulfan (Myleran) and cyclophosphamide (Cytoxan, Neosar), yielded a low relapse rate in patients with acute myelogenous leukemia (AML) undergoing bone marrow transplantation (BMT) while in first remission.

Leukemia Society of America (LSA) scientist Dr. Brian Druker has described a drug that may be useful for combatting chronic myelogenous leukemia (CML). The new drug may be able to target leukemia cells, a much sought-after approach to cancer treatment.

Responding to the need for more efficacious and less toxic treatments for chronic myelogenous leukemia (CML), researchers at the University of Pennsylvania are exploring a novel form of gene therapy. By interfering with the transmission of a crucial message, they hope to prevent malignant cell growth without affecting normal hematopoietic cells.

Following unmodified allogeneic bone marrow transplantation (BMT), up to 60% of patients with chronic myelogenous leukemia (CML) will relapse. The management of relapsed CML has proven especially difficult, because cytotoxic drugs and interferon-alfa (Intron A, Roferon-A) seldom cure the disease, and a second bone marrow transplant is associated with high mortality.