Cancer Treatment Today

Cytogenetics are now routinely recommended for myelofibrosis. Guidelines (Reilly et al) indicate that beyond a routine bone marrow aspiration and biopsy, JAK2 V617F mutation screening should be carried out routinely in patients with primary myelofibrosis (PMF). Quantitative results are not required for clinical management.BCR-ABL1 rearrangement should be excluded in cases with atypical trephine biopsy features, or if the patient lacks a mutation

Shen transplanted from an immunologically different person, graft cells can attack the host's body. This is called Graft Versus Host Diseas*GVHD)e and remains a serious problem in transplantation.  One trial by Koreth and others found that Velcade was beneficial in GVHD; but his was a phase II trial other phase II trials are ongoing. Koreth treated 45 patients; 89% of patients who were treated had a one-locus and 11% of patients were treated with

Post-transplant lymphoproliferative disease (PTLD) remains a major complication after solid organ and allogeneic stem cell transplantation. It usually is caused by growth of lymphocytes infected with Epstein-Barr virus (EBV) in patients whose immune system is suppressed after transplantation to prevent rejection. Following titers and an individualized treatment plan including decreased immunosuppression and other agents should be chosen based on

GVHD is a serious complication of transplanting stem cells from a donor into a patient. These cells can attack the host. Calcineurin inhibitors, such as cyclosporine and tacrolimus,  are commonly used in the prophylaxis of GvHD. For full-intensity stem cell transplantation most centres use a combination of a calcineurin inhibitor, such as ciclosporin or tacrolimus, given in combination with methotrexate. Low-dose methotrexate was the first generally

The regimen of busulafan. fludarabine and thymogen has been very quickly adopted and now studies of it as a base for adding additonal drugs have been initiated. However, there is room for caution. Thymoglobulin added to busulfan and fludarabine to conditioning before an allogeneic stem cell transplant may reduce the incidence and severity of graft versus host disease, especially in matched unrelated graft, but it can potentially promote higher reapse

Both allogeneic(from another human) and autologous9from the self) hematopoietic cell transplant (HCT) recipients are at increased risk for a variety of infections based upon their past history and exposures, more so the allogeneic transplant recipients. The types of infections to which these hosts are most vulnerable can be roughly divided based upon their temporal relation to the transplantation: ?Preengraftment — less than three weeks ?Immediate

The ability to escalate therapy and then salvage with stem cells from a donor has been a boon for patients with many types of cancer and hematologic malignancies, making possible a chance of cures in previously hopeless situations. In addition to the ability to markedly escalate the aggressiveness of chemotherapy that can be salvaged with transplanted stem cells, these outside donor cells, if properly managed, can provide an anticancer or anti-

Stem cell Transplantation is the only curative therapy long term for Aplastic Anemia(AA). Before stem cells can be transfused, the marrow needs to be conditioned. In younger patients with Aplastic Anemia, the standard conditioning proposed by the Working Party(WPSAA) on AA is cyclophosphamide 50 mg/kg 32 × 4 + ATG. This regimen does not completely destroy the patient’s bone marrow and it is highly immunosuppressive in order prevent graft rejection

Acute Lymphocytic Leukemia(ALL) is the most common cancer diagnosed in children and represents almost 25% of cancers in children younger than 15 years. Complete remission of disease is now typically achieved with pediatric chemotherapy regimens in approximately 95% of children with ALL, with up to 85% long-term survival rates. Interestingly, recent studies appears to show that young adults with ALL do better with pediatric regimens and specifically

Pneumocystis carinii(PCP) infection remains a common complication of AIDS. NebuPent is indicated for prophylaxis of Pneumocystis Carinii  infections in HIV positive patients. There is precedent for using this drug or Bactrim for prophylaxis in other immuno-compromised states than AIDS. For example,the National Comprehensive Cancer Network (NCCN) guidelines on prevention and treatment of cancer-related infections consider CLL patients receiving purine