Chronic Lymphocytic Leukemia

Rituxan for Variant Hairy Cell Leukemia – pro

Recent literature suggests that a subgroup of Hairy Cell Leukemia(NCL), sometimes called Variant Hairy Cell Leukemia(HCL-V)l  my in fact be a different disease not related to HCL at all and which my respond to rituximab to a much higher extent than common Hairy Cell does. It is thought that this variant is what used to be called Leukemic Reticuloendotheliosis in the past. It is an uncommon disorder accounting for approximately 0.4% of chronic lymphoid

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PET for lymphomas – pro

Although CT remains the gold standard for the staging and follow-up of malignant lymphomas, 18F-FDG PET has a potential role in accurately staging disease and in predicting response to therapy. This role has the potential to affect both the initial choice of chemotherapy and the decision to alter management based on the initial response to therapy . PET performed early in a chemotherapeutic regimen has demonstrated a role in identifying patients

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Fludara and Cytoxan for Chronic Lymphocytic Leukemia – pro

Fludarabine is highly effective in the treatment of chronic lymphocytic leukemia, producing higher response rates than alkylating agents such as chlorambucil alone. Fludarabine is used in various combinations with cyclophosphamide, mitoxantrone, dexamethasone and rituximab in the treatment of indolent non-Hodgkins lymphomas and CLL. According to an article published in The Lancet, the chemotherapy combination consisting of Fludara® (fludarabine)

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Maintenance Rituxan – pro

Lay Summary: Maintenance rituximab is becoming more common although questions remain about its benefit for DLBCL. The impact of maintenance treatment with rituximab on overall survival is one of the most important open questions for patients with indolent non-Hodgkin lymphoma. Recent randomized trials performed by the German Low Grade Lymphoma Study Group (GLSG) and by the EORTC demonstrated the superiority of rituximab maintenance after immunochemotherapy

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Revlimid for Chronic lymphocytic leukemia – pro

Lay Summary: Revlimid is promising for CLL. Revlimid is an orally administered derivative of thalidomide, which is a very active agent for the treatment of multiple myeloma but has serious side effects, especially thromboembolism. Revlimid is reported to have less toxicity than thalidomide but retains antimyeloma effects. Revlimid has recently been approved by the FDA for review of treatment of myelodysplastic syndromes (MDS) wih a 5q- mutation and

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Transformed follicular lymphoma – pro

Lay Summary: Transplants for transformed follicular lymphoma are supported by follicular lymphoma (transformed) guidelines of the NCCN. There is trial evidence supporting this approach. Takvorian and colleagues (1987) studied 49 patients with either high-grade (n = 29), intermediate-grade (n =14) or low-grade (n = 6) lymphoma. All patients were considered to have a poor prognosis either due to relapse (n = 41) or poor prognostic factors (n = 8).

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Allogeneic transplant for CLL – pro

Patients with low-grade non-Hodgkin's lymphoma (NHL) and CLL have a median survival of 4-8 years from diagnosis and a cause-specific survival of about 10 years. Allogeneic transplantation has been increasingly utilized in patients with lymphoid malignancies but is associated with high toxicity. Recently, reduced-intensity conditioning regimens have shown encouraging results, attributed to graft-versus-lymphoma effects. The use of recently introduced

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PCR regimen for CLL – pro

Lay Summary: Purine analogues and the PCR regimen are effective in CLL. When purine analogs were first introduced in the treatment ofpatients with CLL, the issue of whether or not these agentsshowed cross-resistance was a matter of extensive debate. Thecurrent notion is that cross-resistance does exist. However,pentostatin combined with cyclophosphamide has been reportedto produce responses (77% including one CR) in a small seriesof 13 patients who

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AVN944 – pro

Lay Summary: AVN-944 is reviewed. AVN-944 is an inhibitor of inosine monophosphate dehydrogenase (IMPDH), an enzyme that catalyzes the rate-limiting step in guanine nucleotide synthesis, and induces apoptosis in malignant hematopoietic cell lines in vitro. Pre-clinical studies showed that AVN944 is a highly specific inhibitor of IMPDH, suppresses pools of GTP, and in cultured cells has a selective growth inhibition effect on cancer cells vs. normal

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Rituximab induced neutropenia – pro

Neutropenia has been well reported with Rituxan in CLL. In these reports it ws usually associated with agressive regimens that incorpoorted Rituxan. The use of intensive primary chemotherapy regimen was a risk factor. Neutropenia was generally self-limited and not associated with severe infections. I did not find any reports of using G-CSF to treat this condition and in the absence of dicumented infection, it may not be of any benefit. Since an immunologic

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