Recent progress in the treatment of acute lymphoblastic leukemia:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia, PA
Saunders
2009
|
| Schriftenreihe: | Hematology, oncology clinics of North America
23,5 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XVIII S., S. 949 - 1154 Ill., graph. Darst. |
| ISBN: | 9781437712278 1437712274 |
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Datensatz im Suchindex
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Titel: Recent progress in the treatment of acute lymphoblastic leukemia
Autor: Stock, Wendy
Jahr: 2009
Recent Progress in the Treatment of Acute Lymphoblastic Leukemia
Contents
Preface xi
Meir Wetzler and Wendy Stock
Monoclonal Antibody Therapy with Rituximab for Acute Lymphoblastic Leukemia 949
Deborah A. Thomas, Susan O'Brien, and Hagop M. Kantarjian
Significant advances have been achieved in the treatment of acute lym¬
phoblastic leukemia (ALL) with the incorporation of targeted therapy
agents. Targeting leukemia surface antigens with monoclonal antibodies
is another promising strategy. This article comprehensively reviews avail¬
able data regarding the use of rituximab for the treatment of Burkitt-type
leukemia/lymphoma and CD20-positive precursor B-cell ALL. The incor¬
poration of rituximab into frontline chemotherapy regimens for Burkitt-
type leukemia/lymphoma appears to improve outcome. Preliminary data
regarding the use of rituximab in frontline therapy for CD20- positive pre¬
cursor B-cell ALL suggest its use may also be beneficial, particularly for
the younger subsets.
Risk-adapted Treatment of Pediatric Acute Lymphoblastic Leukemia 973
Sima Jeha and Ching-Hon Pui
Optimal use of antileukemic agents and stringent application of risk-
directed therapy in clinical trials have resulted in steady improvement in
the outcome of children with acute lymphoblastic leukemia, with current
cure rates exceeding 80% in developed countries. The intensity of treat¬
ment varies substantially among subsets of patients, as therapy is de¬
signed to reduce acute and long-term toxicity in low-risk groups while
improving outcomes in poor risk groups by treatment intensification. Re¬
cent advances in genome-wide screening techniques, pharmacogenomic
studies, and development of molecular therapeutics are ushering in an era
of more refined personalized therapy.
Cytogenetics and Molecular Genetics of Acute Lymphoblastic Leukemia 991
Krzysztof Mrozek, David P. Harper, and Peter D. Apian
Acute lymphoblastic leukemia (ALL) is a malignant disease that often fea¬
tures nonrandom numerical or structural chromosome aberrations that
can be detected microscopically. The application of contemporary ge¬
nome-wide molecular analyses is revealing additional genetic alterations
that are not detectable cytogenetically. This article describes the cytoge-
netic methodology and summarizes major cytogenetic findings and their
clinical relevance in ALL The article provides a review of modern molecu¬
lar techniques and their application in the research on the genetics and
epigenetics of ALL.
vi Contents
Allogenic Hematopoietic Cell Transplantation for Acute Lymphoblastic
Leukemia in Adults 1011
Stephen J. Forman
Acute lymphoblastic leukemia (ALL) is a hematologic malignancy of the
bone marrow characterized by the rapid proliferation and subsequent ac¬
cumulation of immature lymphocytes. ALL accounts for 20% of all acute
leukemias that are seen in adults over the age of 20 years. In the past 2 de¬
cades, there has been substantial improvement in the understanding of the
molecular biology of the disease and in the management of adult patients
who have this disorder, including allogeneic transplantation This article re¬
views the biology of adult ALL, the relationship of specific disease charac¬
teristics to the natural history of the disease and the role of allogeneic
hematopoietic cell transplantation in the management of adult patients
with this disease.
Acute Lymphoblastic Leukemia in Adolescents and Young Adults 1033
Josep-Maria Ribera and Albert Oriol
Today, long-term survival is achieved in more than 80% of children 1 to 10
years old with acute lymphoblastic leukemia (ALL). However, cure rates for
adults and adolescents and young adults (AYA) with ALL remain relatively
low, at only 40% to 50%. Age is a continuous prognostic variable in ALL,
with no single age at which prognosis deteriorates markedly. Within child¬
hood ALL populations, older children have shown inferior outcomes,
whereas younger adults have shown superior outcomes among adult
ALL patients. The type of treatment (pediatric-based versus adult-based)
for AYA has recently been a matter of debate. In this article the biology
and treatment of ALL in AYA is reviewed.
Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia 1043
Farhad Ravandi and Partow Kebriaei
1 The Philadelphia (Ph) chromosome, a short chromosome 22, is the most
f frequent cytogenetic abnormality in adult patients with acute lymphoblas¬
tic leukemia (ALL). It occurs in approximately 20% to 30% of adults and in
about 5% of children with this disease. The incidence rises with age and
occurs in approximately 50% of patients older than 50 years. This article
reviews the treatment regimens for Ph+ ALL, including imatinib and sec¬
ond generation tyrosine kinase inhibitors (TKIs). The introduction of effec¬
tive TKIs in the treatment of Ph+ ALL has introduced several avenues of
research in a disease that was hitherto difficult to treat.
Long-term Outcomes in Survivors of Childhood Acute Lymphoblastic Leukemia 1065
Paul C. Nathan, Karen Wasilewski-Masker, and Laura A. Janzen
Cure rates for childhood acute lymphoblastic leukemia (ALL) now exceed
80%. Consequently, there is a growing population of survivors of child¬
hood ALL who are at risk for developing late sequelae of their cancer
Contents vii
therapy. The risk of developing a late effect of therapy is particularly high in
those survivors treated with cranial radiation or hematopoietic stem cell
transplantation; however, most children who survive after treatment in
the current era are expected to live normal lives with minimal or no long-
term morbidity. In this article, the more common, serious late effects of
ALL therapy are reviewed, the treatment exposures that predispose
some survivors to their development are discussed, and the need for
life-long risk-based medical care for all survivors of childhood ALL is
emphasized.
Role of Minimal Residual Disease Monitoring in Adult and Pediatric Acute
Lymphoblastic Leukemia 1083
Dario Campana
Assays that measure minimal residual disease (MRD) can determine the
response to treatment in patients with acute lymphoblastic leukemia
(ALL) much more precisely than morphologic screening of bone marrow
smears. The clinical significance of MRD, detected by flow cytometry or
polymerase chain reaction-based methods in childhood ALL, has been
established. Hence, MRD is being used in several clinical trials to adjust
treatment intensity. Similar findings have been gathered in adult patients
with ALL, making MRD one of the most powerful and informative parame¬
ters to guide clinical management. This article discusses practical issues
related to MRD methodologies and the evidence supporting the use of
MRD for risk assignment in clinical trials.
Looking Toward the Future: Novel Strategies Based on Molecular Pathogenesis
of Acute Lymphoblastic Leukemia 1099
Syed A. Abutalib, Meir Wetzler, and Wendy Stock
There has been exponential growth in our understanding of the pathobio-
logy of acute lymphoblastic leukemia (ALL) leading to the discovery of new
prognostic markers and potential new treatment strategies. The inferior
treatment outcome observed in adults with ALL in comparison with chil¬
dren with ALL means that new therapeutic approaches are required, pref¬
erably based on novel molecular insights. In this concluding article, the
important themes that have been discussed in earlier articles are reviewed.
Looking toward the future, the authors highlight several of the new thera¬
peutic agents and discuss some of the recently described molecular ge¬
netic aberrations that might serve as therapeutic targets for future drug
development.
Nelarabine for theTreatment of Patients with Relapsed or RefractoryT-cell Acute
Lymphoblastic Leukemia or Lymphoblastic Lymphoma 1121
Daniel J. DeAngelo
Nelarabine (506U78) is a soluble prodrug of 9- Darabinofuranosylguanine
(ara-G), a deoxyguanosine derivative. Nelarabine has significant activity
in patients with T-cell acute lymphoblastic leukemia (T-AIL) and
viii Contents
lymphoma (T-LBL). Principal toxicity is grade 3 or 4 neutropenia and
thrombocytopenia. Neurologic toxicity with Guillain-Barre syndrome, de¬
pressed level of consciousness, and peripheral neuropathy are concerning
side effects. Nelarabine is well tolerated and has significant antitumor ac¬
tivity in T-ALL and T-LBL. Nelarabine was approved by the Food and Drug
Administration for patients with T-ALL/LBL who failed at least two prior
regimens. Nelarabine is being explored in children and will be explored
in the near future in adults with newly diagnosed T-ALL.
Recent Progress in the Treatment of Acute Lymphoblastic Leukemia: Clofarabine 1137
Sima Jeha
Significant progress in the treatment of acute lymphoblastic leukemia
(ALL) has been achieved through more effective use of established drugs
in risk-adapted treatment regimens. As we are reaching the limits of opti¬
mizing current treatment strategies, new therapeutic targets are being
identified, and novel formulation of older drugs are being explored. Clo¬
farabine is a novel purine analog approved in 2005 for treating children
in second or greater ALL relapse. Ongoing trials are studying the benefits
of clofarabine combinations in less heavily pretreated patients, and the use
of different dose schedules in a variety of hematologic malignancies.
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| title | Recent progress in the treatment of acute lymphoblastic leukemia |
| title_auth | Recent progress in the treatment of acute lymphoblastic leukemia |
| title_exact_search | Recent progress in the treatment of acute lymphoblastic leukemia |
| title_full | Recent progress in the treatment of acute lymphoblastic leukemia guest ed. Wendy Stock ... |
| title_fullStr | Recent progress in the treatment of acute lymphoblastic leukemia guest ed. Wendy Stock ... |
| title_full_unstemmed | Recent progress in the treatment of acute lymphoblastic leukemia guest ed. Wendy Stock ... |
| title_short | Recent progress in the treatment of acute lymphoblastic leukemia |
| title_sort | recent progress in the treatment of acute lymphoblastic leukemia |
| topic | Lymphoblastic leukemia in children Precursor Cell Lymphoblastic Leukemia-Lymphoma therapy Akute lymphatische Leukämie (DE-588)4221958-9 gnd Therapie (DE-588)4059798-2 gnd |
| topic_facet | Lymphoblastic leukemia in children Precursor Cell Lymphoblastic Leukemia-Lymphoma therapy Akute lymphatische Leukämie Therapie |
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