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DURHAM, North Carolina-Umbilical cord blood transplantation may be a viable option for adult patients with hematologic malignancies who do not have suitably matched donors as a source of stem cells, according to reports presented at the ASH meeting.

NEW ORLEANS-Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) may benefit from treatment with monoclonal antibody treatments directed against the CD20 and/or CD52 antigens, according to data presented at the ASH meeting. Increasing dosing frequency of rituximab (Rituxan) to three times per week produced responses in half of CLL/SLL patients treated in a phase I/II trial reported by John C. Byrd, MD, of the Hematology-Oncology Service at Walter Reed Army Medical Center, Washington, DC. In a separate study at M.D. Anderson Cancer Center in Houston, one-third of patients with CLL refractory to fludarabine (Fludara) responded to the anti-CD52 monoclonal antibody Campath-1H.

NANTES, France-High-dose chemotherapy followed by autologous peripheral blood stem cell transplantation (PBSCT) leads to better event-free survival and freedom from progression in people with intermediate and high-grade non-Hodgkin’s lymphomas (NHL) than does the standard therapy. That was conclusion of a randomized trial comparing autologous PBSCT with CHOP (cyclophosphamide, doxorubicin, Oncovin, prednisone) and reported by Noël Milpied, MD, of the Centre Hospitalier Regional et Universitaire de Nantes, at the ASH meeting.

NEW ORLEANS-Combining rituximab (Rituxan) with the conventional CHOP regimen can produce prolonged disease-free survival in low-grade lymphomas and can increase complete response (CR) rates to over 60% in patients with intermediate-grade or high-grade non-Hodgkin’s lymphoma (NHL). These results from two separate studies were reported at poster presentations at the American Society of Hematology (ASH) meeting.

ROCKVILLE, Maryland—The monoclonal antibody rituximab (Rituxan), which is directed against the CD20 antigen expressed in most B-cell malignancies, can be given repeatedly to patients with non-Hodgkin’s lymphoma (NHL) and may produce longer responses with retreatment. This unusual increase in response duration is in contrast to the ever-diminishing efficacy seen with repeated rounds of chemotherapy, researchers reported at the ASH meeting. The increase may indicate that some novel anti-tumor immune response is acting in addition to classic antibody-dependent, cell-mediated cytotoxicity (ADCC) in patients who respond to rituximab.

SEATTLE-A new chemotherapy agent called CMA-676 that specifically targets tumor cells led to remissions in 34% of patients with acute myeloid leukemia (AML) in relapse and was well tolerated. Eric Sievers, MD, of the Fred Hutchinson Cancer Research Center reported the results of the phase II trial at the ASH meeting.

NANTES, France-The anti-CD20 monoclonal antibody rituximab (Rituxan) produced a 69% overall response rate in patients with B-cell post-transplant lymphoproliferative disease (PTLD), according to a retrospective analysis presented at the ASH meeting by Noël Milpied, MD, of the Centre Hospitalier Regional et Universitaire de Nantes. The analysis also showed that rituximab is effective in both solid organ and bone marrow transplant recipients (see Table 1).

ROCHESTER, Minnesota-Adding a radioactive antibody aimed at the CD20 antigen to rituximab (Rituxan), a chimeric anti-CD-20 antibody, raised overall response rates to 80% and complete response rates to 21% in patients with relapsed or refractory B-cell non-Hodgkin’s lymphoma (NHL). Preliminary data from this multicenter trial was reported at the ASH meeting by Thomas E. Witzig, MD, of the Mayo Clinic.

At the beginning of the 1997 International Union AgainstCancer (UICC) conference in Kobe, Japan, the speakers invoked Buddhist imagery to inspire the audience to embrace cancer genetics in the “battle” against “the enemy.” Asura, a figure with

The article by Laheru and Jaffee offers an excellent summary of immunotherapies for gastrointestinal malignancies. Thoughtful descriptions of the antibody, cytokine, and cel- lular components of the immune system provide useful background information that facilitates an understanding of specific passive and active cancer immunotherapies. Immunotherapies that have demonstrated efficacy in colon cancer clinical trials, including levamisole (Ergamisol), passive monoclonal antibody vaccines, and bacillus Calmette- Guérin (BCG)–autologous tumor vaccines, are appropriately reviewed. In addition, novel approaches at varying stages of clinical testing are clearly summarized; these include the use of an anti-idiotypic antibody, genetically modified tumor and dendritic cells, recombinant protein, and viral and DNA vaccines. Some additional approaches, studies, and perspectives are also worthy of mention as a supplement to this review.

Primary central nervous system (CNS) lymphoma is a non-Hodgkin’s lymphoma restricted to the nervous system. The incidence of this lymphoma is rising in the immunocompetent population but may be decreasing in

The number of autologous periperal blood progenitor cell (PBPC) transplants performed annually has increased dramatically over the past decade. Autologous PBPC transplants have quickly moved from the exclusive province of the academic medical center to part of the armamentarium of the practicing community oncologist

Dr. Costabile presents a thorough review of the biological causes of erectile dysfunction after cancer treatment and of our current range of medical treatments to restore erections. I believe, however, that despite the technical progress made in understanding and remediating erectile dysfunction during the last 20 years, the majority of men who develop such problems following cancer treatment still do not resume a satisfying sex life.

Primary central nervous system (CNS) lymphoma is a non-Hodgkin’s lymphoma restricted to the nervous system. The incidence of this lymphoma is rising in the immunocompetent population but may be decreasing in patients

Erectile dysfunction is a common occurrence as men age. Approximately 20% of men over the age of 50 years report difficulty in achieving or maintaining an erection, and as many as 60% of men age 70 and older suffer from erectile dysfunction.[1]

Primary central nervous system (CNS) lymphoma is a non-Hodgkin’s lymphoma restricted to the nervous system. The incidence of this lymphoma is rising in the immunocompetent population but may be decreasing in patients

Laheru and Jaffee review the potential role of tumor vaccines in the management of gastrointestinal (GI) malignancies, which represent the leading cause of cancer death and are believed to be poorly immunogenic. The authors carefully review the questions and controversies surrounding currently available immunotherapeutic strategies and describe ongoing clinical protocols using tumor vaccine therapy, a few of which deserve special comment.

Primary central nervous system (CNS) lymphoma is a non-Hodgkin’s lymphoma restricted to the nervous system. The incidence of this lymphoma is rising in the immunocompetent population but may be decreasing in patients

Intensive outpatient care is rapidly becoming the primary mode of care for selected patients undergoing high-dose chemotherapy with autologous peripheral blood stem cell (PBSC) transplantation. Although the traditional inpatient model of care may still be necessary for high-risk patients, published data suggest that outpatient care is safe and feasible during or after administration of high-dose chemotherapy and autologous PBSC transplant. Blood and marrow transplant (BMT) centers have developed programs to provide more outpatient care under three basic models: an early discharge model, a delayed admission model, and a comprehensive, or total, outpatient model. This review will describe these models of care and address the elements necessary for the development of an outpatient BMT program, including patient selection, staff development, and patient and caregiver education. Available supportive care strategies to facilitate outpatient care will also be highlighted.

NEW ORLEANS-Prolonged hospitalization and toxic effects have limited the use of peripheral blood stem cell transplants for hematologic malignancies to younger, fitter patients. But a new nonmyeloablative approach may allow otherwise-excluded patients to also benefit, according to two studies presented at the American Society of Hematology meeting.

NEW YORK—Ezra Greenspan, MD, has been at the helm of the Chemotherapy Foundation since its founding in 1968. At its 17th annual symposium, in what he termed an “op-ed” piece, Dr. Greenspan, clinical professor of medicine, Mt. Sinai School of Medicine, highlighted what he considers the “blind spots and halos” in adult solid tumor chemotherapy.”

WASHINGTON—Three cancer specialists offered a more optimistic view for the future of lung cancer patients during a congressional briefing. Despite the disease’s “dismal” 5-year survival statistics, advances in genetics, a new screening technique, and treatment improvements promise earlier diagnosis and prolonged life for some patients, they said.

WASHINGTON-The Cancer Research Foundation of America (CRFA) honored a member of Congress, a journalist, and an antitobacco crusader with its 1999 FrontLine Awards.

Patients with chronic myelogenous leukemia (CML) are finding new hope in an experimental oral agent developed by Oregon Health Sciences University researcher Brian Druker, MD, in collaboration with scientists at Novartis Pharmaceuticals. Early clinical trials are producing dramatic results with minimal side effects.

CLEVELAND-Communicating bad news is an essential part of end-of-life care as well as an important skill in all areas of medicine. Although many physicians feel unprepared to deliver bad news, it is a skill that can be learned and improved, said Donna S. Zhukovsky, MD, director of the Cancer Pain Clinic in the Palliative Medicine Program, Cleveland Clinic Foundation.

CHICAGO-A new ultrasound technology that amasses as much as nine times more information than conventional ultrasound provides greater detail in characterizing breast lesions and also allows real-time tracking of the entire path of the breast biopsy needle, Jacques Souquet, PhD, senior vice president and chief technology officer at ATL Ultrasound (Bothell, Washington), said in an interview with ONI.

 RESEARCH TRIANGLE PARK, NC—The National Toxicology Program is considering an NCI request that it do toxicity studies of four herbal products and a substance found in vegetables: aloe vera, used in cosmetics and as a dietary supplement; ginseng, promoted to increase vigor; kava kava, sold as a mood elevator; milk thistle, believed by some to prevent cancer and protect the liver; and indole-3-carbinol, which occurs in cruciferous

Despite recent decreases in sexual risk behaviors among high school students nationwide, human immunodeficiency virus (HIV) infection was the seventh leading cause of death for persons ages 15 to 24 years in the United States during 1997. To determine whether the prevalence of HIV-related sexual risk behaviors among high school students also has decreased in certain urban areas heavily affected by the epidemic, the Centers for Disease Control (CDC) analyzed data from the Youth Risk Behavior Surveys (YRBS) conducted in 1991, 1993, 1995, and 1997 in eight large-city school districts: Boston, Massachusetts; Chicago, Illinois; Dallas, Texas; Fort Lauderdale, Florida; Jersey City, New Jersey; Miami, Florida; Philadelphia, Pennsylvania; and San Diego, California. This report summarizes the results of this analysis, which indicate that, from 1991 to 1997, the percentage of high school students engaging in HIV-related sexual risk behaviors decreased in some US cities.

Each year, cigarette smoking causes an estimated 430,000 deaths in the United States. In addition, the health risks for smoking cigars, which include mouth, throat, and lung cancers, are well documented. This report summarizes the findings from the 1998 Behavioral Risk Factor Surveillance System (BRFSS) on the prevalence of current cigarette and cigar smoking in the 50 states and the District of Columbia. The findings indicate that state-specific cigarette smoking prevalence among adults ³ 18 years old varied twofold and having ever smoked a cigar (ie, ever cigar smoking) varied nearly fourfold.

CLEVELAND-Primary care physicians and their patients should make advance care planning part of their routine office visits. This is the message of the Education of Physicians in End-of-Life Care (EPEC) program, developed by the American Medical Association in conjunction with the Robert Wood Johnson Foundation.