Speciality
Spotlight

 




 


Oncology


 

 





Chronic
Leukemia

 

  • Tura
    S, for the Italian Cooperative Study Group on Chronic
    Myeloid Leukemia [Bologna Univ, Italy; Udine Univ,
    Italy; ravenna Hosp, Italy; et al]

    Long-term Follow-up of the
    Italian Trial of Interferon –
    a
    Versus Conventional Chemotherapy in Chronic Myeloid
    Leukemia

    Blood
    92: 1541-1548, 1998


     

    Interferon
    a
    has been shown to induce a cytogenetic responses in
    patients with chronic myeloid leukemia [ CML].

     

    This study compares interferon-
    a
    and conventional chemotherapy in patients with CML and
    its long term effects.

     

    Interferon-a
    treatment confirms a significant to survival advantage
    on long term, as compared with conventional
    chemotherapy, however most of these survivors were
    classified as low risks. 
    This study also documents safety and efficacy of
    long term interferon-
    a
    therapy on the patients cytogenetic response. 
    Significant numbers of patients attained complete
    cytogenetic response after two years of IFN therapy. The
    editor comments that once the patient is started on IFN-
    a
    therapy they should continue on therapy as long as
    clinical activity and patient tolerability are
    maintained.

     

  • Hasford
    J, Pfirrmann M, Hehlmann R, et al [Univ of Munich;
    Universitat Heidelberg, Mannheim, Germany; Western Gen
    Hosp, Edinburgh, Scotland; et al]

    A
    New Prognostic Score for Survival of Patients with
    Chronic Myeloid Leukemia Treated with Interferon Alfa

    J
    Natl Cancer Inst 90: 850-858, 1998


     

    Interferon
    a
    is one the standard therapies for patients with CML.This
    study is meta – analysis to establish a reliable
    prognostic scoring system for estimating survival
    a.
    The newly developed scoring system included patient age,
    spleen size, blast count, platelet count, eosinophil
    count and basophil count.
    Three distinct group low, intermediate and high
    risk with proportional median survival could be
    identified.

     

    The
    editor comments that major disadvantage of this study is
    its non prospective nature.

      

  • Weiss RB, Freiman J, Kweder SL, et al [ Georgetown Univ, Washington, DC; Walter Reed Army Med Ctr, Washington, DC; Food and Drug Administration, Rockville, Md; et al]

    Hemolytic Anemia After Fludarabine Therapy for Chronic Lymphocytic Leukemia

    J Clin Oncol 16: 1885-1889, 1998

      

    This study documents a rare, life-threatening toxicity hemolytic anemia [HA] reported after fludarabine therapy in patients with CLL. In most of the patients HA developed within first three courses of fludarabine. 29% of patients who develop HA died of HA related complications. The HA was severe and fatal especially in patients retreated with fludarabine after a previous HA episode. The disordered immune regulation [depletion of CD4+ T cells, ] is believed to be the cause of HA rather than direct cytotoxicity of fludarabine.

       

  • Mahon FX, Faberes C, Pueyo S, et al (Centre Hospitalier Universitaire de Bordeaux, Pessac, France; Universite Victor Segalen, Bordeaux, France)

    Response at Three Months Is a Good Predictive Factor for Newly Diagnosed Chronic Myeloid Leukemia Patients Treated by Recombinant Interferon-a

    Blood 92: 4059-4065, 1998

      

    This study of 116 patients of CML (newly diagnosed) who received IFN-a. 50 patients had a major cytogenetic response (MCR). 37 had a complete cytogenetic response (CCR). The overall estimated 5-year survival was 68%. The most important factor associated with survival was MCR and CCR. Hematologic and cytogenetic response in high rate were possible when IFN-a would be administered in dose that lead to myelosuppression and CHR and MCR within 3 months may be useful in determination of patients response to IFN-a and its subsequent long term use.

      


 

 



 

 

Speciality Spotlight

 

 

Chronic Leukemia
 

  • Tura S, for the Italian Cooperative Study Group on Chronic Myeloid Leukemia [Bologna Univ, Italy; Udine Univ, Italy; ravenna Hosp, Italy; et al]
    Long-term Follow-up of the Italian Trial of Interferon –a Versus Conventional Chemotherapy in Chronic Myeloid Leukemia
    Blood 92: 1541-1548, 1998
     
    Interferon a has been shown to induce a cytogenetic responses in patients with chronic myeloid leukemia [ CML].
     
    This study compares interferon-
    a and conventional chemotherapy in patients with CML and its long term effects.
     
    Interferon-a treatment confirms a significant to survival advantage on long term, as compared with conventional chemotherapy, however most of these survivors were classified as low risks.  This study also documents safety and efficacy of long term interferon-a therapy on the patients cytogenetic response.  Significant numbers of patients attained complete cytogenetic response after two years of IFN therapy. The editor comments that once the patient is started on IFN-a therapy they should continue on therapy as long as clinical activity and patient tolerability are maintained.
     

  • Hasford J, Pfirrmann M, Hehlmann R, et al [Univ of Munich; Universitat Heidelberg, Mannheim, Germany; Western Gen Hosp, Edinburgh, Scotland; et al]
    A New Prognostic Score for Survival of Patients with Chronic Myeloid Leukemia Treated with Interferon Alfa
    J Natl Cancer Inst 90: 850-858, 1998
     
    Interferon a is one the standard therapies for patients with CML.This study is meta – analysis to establish a reliable prognostic scoring system for estimating survival a. The newly developed scoring system included patient age, spleen size, blast count, platelet count, eosinophil count and basophil count. Three distinct group low, intermediate and high risk with proportional median survival could be identified.
     
    The editor comments that major disadvantage of this study is its non prospective nature.
      

  • Weiss RB, Freiman J, Kweder SL, et al [ Georgetown Univ, Washington, DC; Walter Reed Army Med Ctr, Washington, DC; Food and Drug Administration, Rockville, Md; et al]
    Hemolytic Anemia After Fludarabine Therapy for Chronic Lymphocytic Leukemia
    J Clin Oncol 16: 1885-1889, 1998
      
    This study documents a rare, life-threatening toxicity hemolytic anemia [HA] reported after fludarabine therapy in patients with CLL. In most of the patients HA developed within first three courses of fludarabine. 29% of patients who develop HA died of HA related complications. The HA was severe and fatal especially in patients retreated with fludarabine after a previous HA episode. The disordered immune regulation [depletion of CD4+ T cells, ] is believed to be the cause of HA rather than direct cytotoxicity of fludarabine.
       

  • Mahon FX, Faberes C, Pueyo S, et al (Centre Hospitalier Universitaire de Bordeaux, Pessac, France; Universite Victor Segalen, Bordeaux, France)
    Response at Three Months Is a Good Predictive Factor for Newly Diagnosed Chronic Myeloid Leukemia Patients Treated by Recombinant Interferon-a
    Blood 92: 4059-4065, 1998
      
    This study of 116 patients of CML (newly diagnosed) who received IFN-a. 50 patients had a major cytogenetic response (MCR). 37 had a complete cytogenetic response (CCR). The overall estimated 5-year survival was 68%. The most important factor associated with survival was MCR and CCR. Hematologic and cytogenetic response in high rate were possible when IFN-a would be administered in dose that lead to myelosuppression and CHR and MCR within 3 months may be useful in determination of patients response to IFN-a and its subsequent long term use.
      

 

 

 

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