China
Africa
Explore chapters and articles related to this topic
Genetic Manipulation of Human Marrow: Gene Transfer Using Retroviruses
Published in Adrian P. Gee, BONE MARROW PROCESSING and PURGING, 2020
Philip Hughes, R. Keith Humphries
Extension of such studies to bone marrow transplantation is now being considered in several centers. A clinical trial which is currently underway at our center involves the autologous transplant of “culture purged” marrow in the treatment of chronic myelogenous leukemia (CML). When marrow from most patients with CML is maintained in long-term culture, Philadelphia chromosome-positive progenitors gradually disappear, while normal progenitors can still be detected.42 The trial involves culturing CML marrow in long-term culture for 10 d, then reinfusing it after the patient has been treated. We are currently designing an addition to this protocol that would incorporate retroviral marking to the marrow during long-term culture. Such marking would enable us to ask questions concerning the purging procedure, such as, are normal cells post-transplant derived from the graft or the donor? If Philadelphia chromosome-positive cells reoccur in the patient, are they graft or donor-derived? Answers to these questionos could lead, for example, to more aggressive purging, or to improvements in the long-term culture protocol. Perhaps most importantly, from the gene transfer aspect, these studies could answer important questions concerning our ability to infect human stem cells and the appropriate conditions for doing so.
L
Published in Anton Sebastian, A Dictionary of the History of Medicine, 2018
Leukemia [Greek: leukos, white + haima, blood] Term used for the cellular disorder of blood was first coined by Rudolph Virchow (1821–1902) in 1845, and the first description was given by John Hughes Bennett (1812–1875) in the same year. Bennett later published a monograph on leucocythemia in 1852 in which he showed the microscopic blood picture in leukemia. Radioactive isotopes were employed for the first time in the treatment by John Hundale Lawrence (b 1904) and co-workers in 1939. See bone marrow transplant, chronic myeloid leukemia.
Future Prospects
Published in Tariq I Mughal, John M Goldman, Sabena T Mughal, Understanding Leukemias, Lymphomas, and Myelomas, 2017
Tariq I Mughal, John M Goldman, Sabena T Mughal
We now live firmly in the era of personalized cancer medicine. The past decade has witnessed colossal advances in our under-standing of the molecular abnormalities resulting in particular cancers and in the development of agents which could target these abnormalities. A landmark development was the identification of a small molecule designed to target the principal pathogenetic molecular target considered (then) to result in the chronic phase of chronic myeloid leukemia (CML). This development led to the availability of imatinib mesylate which results in a significant reduction of leukemia cells and a prolongation of survival for the majority of patients with CML. In the short space of time since imatinib was approved in 2001, several “next” generation of drugs with greater potency than imatinib have already entered the clinics. Moreover, it is truly remarkable how effectively the lessons learned from patients with CML have been applied to improve the outcomes of patients with diverse cancers, including common cancers, such as lung, breast, and colon. The speed at which this has occurred is staggering. Parenthetically on a lighter note, it would be difficult even for a supreme athlete such as Usain Bolt to keep up with this kind of pace!
Efficacy and safety of vemurafenib in Langerhans cell histiocytosis (LCH): A systematic review and meta-analysis
Published in Pediatric Hematology and Oncology, 2023
Debabrata Mohapatra, Aditya Kumar Gupta, Partha Haldar, Jagdish Prasad Meena, Pranay Tanwar, Rachna Seth
The clinical and hematological responses are usually rapid and occur at a median of 1–2 weeks, while the overall disease activity score (DAS) starts declining around four weeks. The documented radiological response usually occurs at a median of 5.25 months from the initiation of therapy. Despite these promising findings, some studies11,12 have highlighted the inability of vemurafenib therapy in completely eradicating the BRAF mutant clones from blood and marrow, irrespective of the excellent clinical-radiological response, even after six months of therapy. A load of these mutant clones correlates with the likelihood of disease relapse, and detectable BRAFV600E level precludes the ability to discontinue treatment confidently, even after sustained clinical-radiological response. This is in contrast to the emerging evidence of targeted therapy in other hematological malignancies like chronic myeloid leukemia (CML), where sustained deep molecular response usually precludes the likelihood of relapse in the majority.35
Utilizing the prognostic impact of minimal residual disease in treatment decisions for pediatric acute lymphoblastic leukemia
Published in Expert Review of Hematology, 2021
Francesco Ceppi, Frida Rizzati, Antonella Colombini, Valentino Conter, Giovanni Cazzaniga
Importantly, a significant number of patients had MRD levels higher by BCR-ABL1 than by IG/TR [60,61]. Whether a positivity for the BCR-ABL1 fusion with negativity for IG/TR corresponds to a predictor of relapse is clinically relevant, is still under debate. A study in 48 children with BCR-ABL1 positive ALL identified more than 20% of children with >1 log higher levels of BCR-ABL1 fusion than IG/TR rearrangement [61]. Cell sorting of the diagnostic material identified non-ALL B lymphocytes, T cells, and/or myeloid cells harboring the BCR-ABL1 fusion in patients with discrepant MRD results. These patients resemble a chronic myeloid leukemia (CML)-like disease that could benefit of early stem cell transplantation compared to lymphoid-only cases that better benefit from TKIs.
Recent advances in the combination delivery of drug for leukemia and other cancers
Published in Expert Opinion on Drug Delivery, 2020
Thikrayat Al-Attar, Sundararajan V. Madihally
Cancer treatment has gained tremendous attention due to its global impact. Statistically, 18.1 million new cases of cancer were diagnosed globally in 2018, of which, 9.6 million patients are expected to die [1]. Blood cancer accounts for almost 10-11% of new cancer cases in the US and Canada [2]. Approximately every 3 minutes, a person is diagnosed with blood cancer in the US, and almost 176,200 people in 2019 were expected to be diagnosed with leukemia, lymphoma, and myeloma. Chronic Myeloid (or Myelogenous) Leukemia (CML), a type of blood cancer, starts in the blood-forming cells of the bone marrow and invades the blood. Due to drug resistance in cancer, studies have shown that multi-drug treatment is more effective to induce the desired effect [3]. While introducing multiple drugs to treat cancer leads to undesired side effects, drug delivery techniques can be used to minimize off-target effects, and allow administration of higher doses.