Immune System

DLI for T cell leukemia and lymphoma – pro

Donor lymphocyte infusions are designed to awaken some degree of graft versus host reaction, which contains within it also the graft versus disease effect. It is a modality that can be used after allogeneic transplantation to treat relapse by "awakening" an immune response. . Almost all work on DLI was in B cell leukemias and lymphomas.  How it affects T cell malignancies is not well studied and most of what is known was in Adult T-Cell leukami/Lymphoma.

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Topical cidofovir in immunocompromised patients – pro

VISTIDE (cidofovir) is indicated for the treatment of CMV retinitis in patients with acquired immunodeficiency syndrome (AIDS). The FDA says: "THE SAFETY AND EFFICACY OF VISTIDE (cidofovir) HAVE NOT BEEN ESTABLISHED FOR TREATMENT OF OTHER CMV INFECTIONS (SUCH AS PNEUMONITIS OR GASTROENTERITIS), CONGENITAL OR NEONATAL CMV DISEASE, OR CMV DISEASE IN NON-HIV-INFECTED INDIVIDUALS." It is a nephrotoxoc drug and cannot be administered to people with kidney

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Leukine for Melanoma – pro

Lay Summary: Leukine is being explored for treating melanoma. A phase II trial and a phase III trial were recently reported. Leukine (granulocyte macrophage colony stimulating factor, GM-CSF, Sargramostim), which is approved for marketing for hematopoietic reconstitution and reversal of chemo induced neutropenia, also has activity as a macrophage activator. It has been reported that Leukine stimulates peripheral blood monocytes in vitro to become

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Followup of Resected Gastric Cancer – pro

Patients with early gastric cancer have an excellent prognosis after appropriate treatment, with a high survival rate and a low rate of recurrence.There are no guidelines as to how to follow gastric cancer. A recent review concluded: " Early detection of asymptomatic gastric cancer recurrence did not improve overall survival of patients with recurrence after curative resection. Until development of more effective treatment for this disease, close

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PET for FUO – pro

The best way to approach this situation is as PET being done for fever of unknown origin. There is little evidence of recurrent lymphoma. The bone marrow has 2% of cells that may be monoclonal and no Fever of unknown origin (FUO) is among the most difficult medical puzzles to solve.PET appears to have a very high negative predictive value in ruling out inflammatory causes of fever.If positive, PET can direct attention to rareas of fartehr workup

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Rituxan for Gullain-Barre Syndrome – pro

Guillain-Barré syndrome is a disorder in which the body's immune system attacks part of the peripheral nervous system. Symptoms include varying degrees of weakness or tingling sensations in the legs. Sometimes, the weakness and abnormal sensations spread to the arms and upper body and progress to paralysis. There is no known cure for Guillain-Barré syndrome, but therapies can lessen the severity of the illness and accelerate the recovery in most

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Rituxan: Prevention of Post-transplant Lymphoproliferative Disorders – pro

Anti-CD20 (Rituximab) is a humanised monoclonocal antibody directed against the specific CD20 antigens found on B lymphocytes plasma membrane. It has been approved by the FDA for the treatment of lymphoma and post-transplant lymphoproliferative diseases. The rationale for using Rituxan for treating EBV infections is that it can destroy B cells and thus "dampen" T-cell response caused by immune dysregulation. After bone marrow transplantation (BMT)

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Chronic Lyme Disease Treatment – pro

Treatment of Lyme disease is the subject of much controversy and has been subjected to legal action. The most controversial issue is empiric treatment of patients with symptoms that remain after a one month course of antibiotics. Many patients continue to complain of various hard to characterize symptoms and some physicians advocate continued antibiotic treatment and report that it helps. The Infectious Diseases Society of America IDSA) issued guidelines

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Tamiflu for Prophylaxis – pro

Most guidelines for pre-exposure prophylaxis of influenza in patients with cancer and on chemotherapy suffice with recommending vaccination. Some mention antiviral prophylaxis. Patients with active malignant disease are at higher risk for upper respiratory tract infection due to influenza, parainfluenza or respiratory syncycial virus (RSV). Although response to vaccination with the attenuated influenza vaccine in patients on chemotherapy is highly

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Cyclosporin for ITP – pro

There are patients with refractory autoimmune thrombocytopenia do not respond to standard therapy with high-dose corticosteroids, WinRHO, Rituxan, IVGG, and splenectomy. Cyclosporin is useful for some patients who occasionally respond to it. There are many published case reports of its effectiveness. It is recommended for refractory cases in standard reviews. Since very few pateints are this refractory, prospective studies are not possible but cyclosporine

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