Clinical Lymphoma and Myeloma最新文献_第8页

Nonmyeloablative Allogeneic Stem Cell Transplantation for Chronic Myelogenous Leukemia in the Imatinib Era 非清髓性异基因干细胞移植治疗伊马替尼时代的慢性骨髓性白血病

Clinical Lymphoma and Myeloma Pub Date : 2009-09-01 DOI: 10.3816/CLM.2009.s.021

Richard Champlin, Marcos de Lima, Partow Kebriaei, Gabriela Rondon, Tobi Fisher, Elias Jabbour, Jorge E. Cortés, Hagop Kantarjian, Paolo Anderlini, Amin Alousi, Chitra Hosing, Elizabeth Shpall, Uday Popat, Muzaffar Qazilbash, Borje Andersson, Sergio Giralt

{"title":"Nonmyeloablative Allogeneic Stem Cell Transplantation for Chronic Myelogenous Leukemia in the Imatinib Era","authors":"Richard Champlin, Marcos de Lima, Partow Kebriaei, Gabriela Rondon, Tobi Fisher, Elias Jabbour, Jorge E. Cortés, Hagop Kantarjian, Paolo Anderlini, Amin Alousi, Chitra Hosing, Elizabeth Shpall, Uday Popat, Muzaffar Qazilbash, Borje Andersson, Sergio Giralt","doi":"10.3816/CLM.2009.s.021","DOIUrl":"10.3816/CLM.2009.s.021","url":null,"abstract":"<div><p>Allogeneic stem cell transplantation (ASCT) is a potentially curative treatment for patients with chronic myelogenous leukemia (CML) and was previously considered the preferred treatment for newly diagnosed CML. The success of imatinib has changed treatment recommendations, and allogeneic transplants are now reserved for imatinib treatment failures. Previous imatinib treatment does not compromise the results of ASCT, but patients with overt transformed disease have poor results. It is unclear whether patients whose disease is considered to have failed imatinib should be referred immediately for ASCT or receive treatment with a second-generation tyrosine kinase inhibitors (TKI). Patients whose disease fails 2 TKIs should receive ASCT if possible. Nonmyeloablative preparative regimens reduce the toxicity and treatment-related mortality associated with the transplantation procedure and allow transplantations to be performed in older and medically infirm patients. This approach, including posttransplantation treatment with TKIs and donor lymphocyte infusion, produces a high fraction of durable molecular complete remissions.</p></div>","PeriodicalId":100272,"journal":{"name":"Clinical Lymphoma and Myeloma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3816/CLM.2009.s.021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10584209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 15

JAK2 Inhibitors: A Reality? A Hope? JAK2抑制剂:现实?一个希望?

Clinical Lymphoma and Myeloma Pub Date : 2009-09-01 DOI: 10.3816/CLM.2009.s.033

Effrosyni Apostolidou, Hagop M. Kantarjian, Srdan Verstovsek

{"title":"JAK2 Inhibitors: A Reality? A Hope?","authors":"Effrosyni Apostolidou, Hagop M. Kantarjian, Srdan Verstovsek","doi":"10.3816/CLM.2009.s.033","DOIUrl":"10.3816/CLM.2009.s.033","url":null,"abstract":"<div><p>Myelofibrosis (MF; primary or post–polycythemia vera/essential thrombocythemia) carries the worst prognosis among BCR-ABL–negative myeloproliferative neoplasms (MPNs). Stem cell transplantation is the only curative approach but is hampered by significant nonrelapse mortality. Thus, effective, targeted therapies are needed. A mutated Janus kinase 2 (JAK2) gene (JAK2<sup>V617F</sup>), found in a significant portion of patients with MPN, results in increased JAK2 tyrosine kinase activity, leading to clonal proliferation; several small molecules inhibit the growth of hematopoietic colonies harboring JAK2<sup>V617</sup>. Several JAK2 inhibitors have reached the clinical trial stage and are reviewed here. The most developed among them is INCB018424, which has demonstrated noteworthy clinical activity, with a rapid and profound reduction in splenomegaly and associated improvement in constitutional symptoms in MF patients receiving 10–25 mg orally twice daily, continuously. Thrombocytopenia (reversible) was the most common adverse event, seen in 30% of patients treated with 25 mg twice daily but not with 10 mg twice daily. Interestingly, INCB018424 was equally active in patients with and without JAK2 mutation. Other JAK2 inhibitors are less developed but show a similar type of clinical benefit. Conclusively, JAK2 inhibitors, particularly INCB018424, are clinically active in MF and are well tolerated. Whether they have an effect on the natural course of MF in treated patients remains to be elucidated.</p></div>","PeriodicalId":100272,"journal":{"name":"Clinical Lymphoma and Myeloma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3816/CLM.2009.s.033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10584207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11

Advances in Stem Cell Transplantation: Making it Better and Safer 干细胞移植的进展:使其更好和更安全

Clinical Lymphoma and Myeloma Pub Date : 2009-09-01 DOI: 10.3816/CLM.2009.s.026

Sergio Giralt

引用次数: 3

High-Risk Childhood Acute Lymphoblastic Leukemia 高危儿童急性淋巴细胞白血病

Clinical Lymphoma and Myeloma Pub Date : 2009-09-01 DOI: 10.3816/CLM.2009.s.016

Deepa Bhojwani , Scott C. Howard , Ching-Hon Pui

{"title":"High-Risk Childhood Acute Lymphoblastic Leukemia","authors":"Deepa Bhojwani , Scott C. Howard , Ching-Hon Pui","doi":"10.3816/CLM.2009.s.016","DOIUrl":"10.3816/CLM.2009.s.016","url":null,"abstract":"<div><p>Although most children with acute lymphoblastic leukemia (ALL) are cured, certain subsets have a high risk of relapse. Relapse risk can be predicted by early response to therapy, clinical and pharmacogenetic features of the host, and genetic characteristics of leukemic cells. Though early treatment response can be assessed by the peripheral blast cell count after 1 week of single-agent glucocorticoid treatment or percent of bone marrow blasts by morphology after 1 or 2 weeks of multiagent induction treatment, determination of minimal residual disease by polymerase chain reaction (PCR) or flow cytometry after 2 to 6 weeks of induction is the most precise and useful measure. Augmented therapy has improved outcome for the poor responders to initial treatment. Infants with mixed-lineage leukemia (MLL)–rearranged ALL comprise a very poor-risk group wherein further intensification of chemotherapy causes significant toxicity. Hybrid protocols incorporating drugs effective for acute myeloid leukemia could improve survival, a strategy being tested in international trials. Studies on the biology of MLL-induced leukemogenesis have prompted the development of novel targeted agents, currently under evaluation in clinical trials. Short-term outcomes of patients with Philadelphia chromosome (Ph)–positive ALL have improved significantly by adding tyrosine kinase inhibitors to standard chemotherapy regimens. New agents and methods to overcome resistance are under investigation, and allogeneic stem cell transplantation is recommended for certain subsets of patients, for example those with Ph<sup>+</sup> and T-cell ALL with poor early response. Genome-wide interrogation of leukemic cell genetic abnormalities and germline genetic variations promise to identify new molecular targets for therapy.</p></div>","PeriodicalId":100272,"journal":{"name":"Clinical Lymphoma and Myeloma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3816/CLM.2009.s.016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40034196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 66

Transplantations in Adult Acute Lymphoblastic Leukemia–Grounds for Optimism? 成人急性淋巴细胞白血病的移植:乐观的理由?

Clinical Lymphoma and Myeloma Pub Date : 2009-09-01 DOI: 10.3816/CLM.2009.s.014

Anthony H. Goldstone

引用次数: 0

Acute Myeloid Leukemia Complicating Multiple Myeloma: A Case Successfully Treated With Etoposide, Thioguanine, and Cytarabine 急性髓性白血病合并多发性骨髓瘤:依托泊苷、硫鸟嘌呤和阿糖胞苷成功治疗一例

Clinical Lymphoma and Myeloma Pub Date : 2009-08-01 DOI: 10.3816/CLM.2009.n.066

Alev Akyol Erikci, Ahmet Ozturk, Emre Tekgunduz, Ozkan Sayan

{"title":"Acute Myeloid Leukemia Complicating Multiple Myeloma: A Case Successfully Treated With Etoposide, Thioguanine, and Cytarabine","authors":"Alev Akyol Erikci, Ahmet Ozturk, Emre Tekgunduz, Ozkan Sayan","doi":"10.3816/CLM.2009.n.066","DOIUrl":"10.3816/CLM.2009.n.066","url":null,"abstract":"<div><h3>Background</h3><p>The association of acute leukemia and multiple myeloma (MM) has been usually described not only as a complication of chemotherapy but also in the absence of chemotherapy or together at the time of diagnosis. Such leukemias are typically acute myeloid leukemia (AML). The myelomonocytic subtype is particularly found.</p></div><div><h3>Case Report</h3><p>We report a case of a 68-year-old female who developed AML 2 years after the diagnosis of light chain (κ) myeloma. She had been treated with oral melphalan and prednisone for MM. The patient was treated with an anthracycline-lacking therapy consisting of etoposide 120 mg/m<sup>2</sup>, thioguanine 100 mg/m<sup>2</sup> orally twice daily on 1-5 days, and cytarabine 40 mg/m<sup>2</sup> subcutaneously on day 1 (ETC) because of poor cardiac performance.</p></div><div><h3>Conclusion</h3><p>Following ETC therapy our particular patient has been in complete hematologic remission for 29 months. This therapy might be a safe alternative in secondary leukemia especially for elderly patients.</p></div>","PeriodicalId":100272,"journal":{"name":"Clinical Lymphoma and Myeloma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3816/CLM.2009.n.066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28371609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

Arterial Thrombosis With Immunomodulatory Derivatives in the Treatment of Multiple Myeloma: A Single-Center Case Series and Review of the Literature 动脉血栓与免疫调节衍生物治疗多发性骨髓瘤:单中心病例系列和文献综述

Clinical Lymphoma and Myeloma Pub Date : 2009-08-01 DOI: 10.3816/CLM.2009.n.063

Mike G. Martin, Ravi Vij

引用次数: 7

Successful Completion of Pregnancy in a Patient With Chronic Myeloid Leukemia Without Active Intervention: A Case Report and Review of the Literature 慢性髓性白血病患者在没有积极干预的情况下成功完成妊娠:一例报告和文献回顾

Clinical Lymphoma and Myeloma Pub Date : 2009-08-01 DOI: 10.3816/CLM.2009.n.064

Suzanne Cole, Hagop Kantarjian, Patricia Ault, Jorge E. Cortés

引用次数: 47

Selected Phase III Trials in Multiple Myeloma With Study Start 2008 and 2009 选择多发性骨髓瘤III期试验，研究开始于2008和2009年

Clinical Lymphoma and Myeloma Pub Date : 2009-08-01 DOI: 10.1016/S1557-9190(11)70013-0

引用次数: 0

Remission Induction With Lenalidomide Alone in a Patient With Previously Untreated Plasmablastic Myeloma: A Case Report 单独使用来那度胺诱导未治疗浆母细胞骨髓瘤患者缓解:1例报告

Clinical Lymphoma and Myeloma Pub Date : 2009-08-01 DOI: 10.3816/CLM.2009.n.065

Taimur Sher , Kena C. Miller , Kelvin Lee , Asher Chanan-Khan

引用次数: 14