By Matt Kalaycio

The Cleveland hospital beginning, OH. textual content covers information regarding new biologic treatments and offers the healthcare professional with sensible facts for treating sufferers with leukemia. Discusses such remedies as arsenic trioxide, P-glycoprotein inhibitors, and interleukins. additionally covers genetic code adjustments. DNLM: Leukemia, treatment.

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Rituximab has also been tested against lymphoid leukemias with CD20 expression. 1. B-Cell Chronic Lymphocytic Leukemia B-cell chronic lymphocytic leukemia (B-CLL) is a clonal neoplasm of mature lymphocytes expressing a unique immunophenotype characterized by coexpression of CD5, CD19, and CD23. CD20 is also expressed but only at low levels (19). In early trials of rituximab for low-grade lymphomas, patients with small lymphocytic leukemia (SLL), the nodal equivalent of B-CLL, were included. However, in contrast to the high response rates noted in follicular lym- 32 Kalaycio phomas with standard doses of rituximab, patients with relapsed SLL achieved remission rates of no more than 15% (18).

Blood 1995;85:3302–3312. 27. Nieda M, Nicol A, Kikuchi A, et al. Dendritic cells stimulate the expansion of bcr-abl specific CD8+ T cells with cytotoxic activity against leukemic cells from patients with chronic myeloid leukemia. Blood 1998;91:977–983. 28. Krijanovski O, Hill G, Cooke K, et al. Keratinocyte growth factor separates graft-versus-leukemia effects from graft-versus-host disease. Blood 1999;94:825–831. 29. Jiang Y, Barrett A, Goldman J, Mavroudis D. Association of natural killer cell immune recovery with a graft-versus-leukemia effect independent of graft-versus-host disease following allogeneic bone marrow transplantation.

One would then infuse donor hematopoietic cells and rely entirely on the GVT effect to generate a tumor response. This is the fundamental concept of nonmyeloablative (“mini”) allogeneic transplantation. To summarize, the rationale is straightforward: 1. Some malignancies will not be cured by high-dose chemotherapy. 2. Some malignancies may be cured by the GVT effect. 3. If so, a minimal BMT preparative regimen would be desirable to prevent graft rejection and minimize toxicity. 4. Once the donor cells engraft, a GVT effect will hopefully result, leading to a clinical remission.

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