Lymphoma/Myeloma/Leukemia

VDT-PACE for Myeloma – pro

There have been two previous Total Therapy studies for multiple myeloma (MM) at the Myeloma Institute for Research There have been two previous Total Therapy studies for multiple myeloma (MM) at the Myeloma Institute for Research and Therapy (MIRT): Total Therapy I (from 1989 through 1994) and Total Therapy II (from 1996 to 2004). TT II used VDT-PACE for 4 cycles. Results have shown that patients treated on these studies had better outcomes (meaning

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Primary CNS Lymphoma – pro

Primary nervous system lymphomas (PCNSL) are aggressive malignancies, exhibiting one of the worst prognoses among lymphomas. The best treatment modality for PCNSL has not yet been identified. A recent consensus reached an agreement that intrathecal chemotherapy can be left out if a sufficiently high dose of MTX is given intravenously. Moreover, many investigators are joining forces to optimize the collection of patient information and the performance

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Combined Rituxan and Campath for CLL – pro

Lay Summary: Combining two antibodies against CLL is being explored Rituximab, an anti-CD20 monoclonal antibody, has only recently provoked interest for the treatment of CLL. It is now widely used, both as a single agent and in combination with chemotehrapy. Alemtuzumab is a recombinant, fully humanized, monoclonal antibody against the CD52 antigen. Monotherapy with alemtuzumab has produced response rates of 33% to 53%, with a median duration of

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Second transplant for myeloma -autologous and allogeneic – pro

A single or tandem autologous transplant is considered medically necessary for multiple myeloma. Autologous followed by allogeneic transplants are being explored because autologous transplants are not curative while allogeneic salvage transplants might be curative. Autologous stem cell transplantation has emerged as standard therapy for patients with multiple myeloma, primarily as a result of randomized trials performed in France over the past decade.

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Bexxar – pro

Bexxar consists of a monoclonal antibody, tositumomab, linked to the radioactive isotope iodine iodine-131. The monoclonal antibody targets the CD20 antigen, which is found on the surface of mature B cells and B cell tumors. The Bexxar therapeutic regimen is administered in two steps: the dosimetric and therapeutic steps. Each step consists of a sequential infusion of tositumomab followed by iodine-131 (I 131) tositumomab. The therapeutic step is

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PET is the same as PET/CT for restaging lymphoma – pro

PET scanning has well recognized utility in staging and restaging lymphoma. It is now covered by CMS and recommended by recent literature. In regard to PET/CT, in a recent study, the addition of PET/CT to CT changed the management decisions in approximately a quarter of NHL and a third of HD patients, mostly in early disease stages. Thus, PET/CT performed as the initial staging procedure may well obviate the need for additional diagnostic CT in the

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DLI after relapse of AML – pro

Because of the large number of acute leukemia patients who relapse after alloBMT, there has been a substantial experience in the treatment of these patients with DLI. Using median doses of >/=108 T cells/kg, DLI alone induces complete remissions in 8% of patients with ALL and 22% of patients with acute myeloid leukemia (AML). When patients who receive chemotherapy prior to DLI are included, complete response rates are significantly higher, ranging

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Angioimmunoblastic lymphoma- stem cell transplant – pro

Angioimmunoblastic T-cell lymphoma (AILD) is considered a variety of T-cell lymphoma, which usually occurs in adults. Symptoms include generalized lymphadenopathy (enlarged lymph nodes) and increased antibody proteins in the blood (hypergammaglobinemia). Other symptoms are fever, skin rash and weight loss. It is classified under periphreal T-cell lymphomas. Characterized by clonal T-cell receptor gene rearrangement, this entity is managed like diffuse

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Biphosphonates for early myeloma – pro

There is increasing evidence that early treatment of smoldering myeloma with biphosphonates may e beneficial; however, the level of proof has nto yet reached the quality sufficient to change the guidelines or to modify existing coverage policies. The recently published American Society of Clinical Oncology clinical practice guidelines for the use of bisphosphonates (BPs) in multiple myeloma do not recommend use of these drugs in patients with monoclonal

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Revlimid for amyloidosis – pro

Treatment for systemic amyloidosis targets the aberrant plasma cell clone to prevent further synthesis and deposition of the amyloid protein. Conventional therapy usually combines oral melphalan with prednisone (MP), shown to yield higher response rates and longer survival than colchicine or prior therapies. A recent Phase II trial in 23 patients whose primary objective was hematologic response rate of single-agent lenalidomide in patients with primary

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