Posted by rob on April 28, 2010 under Uncategorized | 
In this study, the biological activity of 16 LCRCs to a chronic myelogenous leukemia cell line, K562, was evaluated. As a result, two compounds, 2-(4-butoxyphenyl)-5-(4-hydroxyphenyl)pyrimidine (compound 7) and 2-{4-(4-hexyloxyphenyl)phenyl}-5-hydroxypyrimidine (compound 9) showed marked growth suppression of K562 cells at muM range. These compounds are similar in structure with a core of three aromatic rings including a pyrimidine ring and residues of one alkyl chain and one hydroxide on either side. In addition, only compound 7 induced the activation of p38 mitogen-activated protein kinase and c-Jun N-terminal kinase, and apoptosis of K562 cells. The contrasting results between compounds 7 and 9 indicate different mechanisms to suppress the cell proliferation between the two compounds. T…
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Abstract: Imatinib mesylate is used with increasing frequency and duration for the treatment of chronic myelogenous leukemia (CML), gastrointestinal stromal tumor (GIST), and other neoplastic conditions. Although muscular complaints are common, elevations of creatine kinase (CK) are listed as (Source: Leukemia Research)
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In this study, we found
that the CD34+ subpopulation in the CML cell line K562 had a higher expression of SOD1 than that in the CD34 negative cells.
Knockdown of SOD1 in CD34+ cells had no significant effects on cell survival and growth, while it sensitized the CD34+ cells
to imatinib therapy. N-acetyl-L cysteine (NAC) blocked the pro-apoptotic effects of SOD1 knockdown, suggesting the antioxidant
effects of SOD1 was essential for the resistance of CD34+ cells to imatinib therapy. In summary, our results suggest that
antagonizing the enhanced endogenous antioxidant activity in leukemia stem cells sheds lights on CML therapy.
Content Type Journal ArticleCategory Original PaperDOI 10.1007/s12032-010-9529-9Authors
Li Liu, Fourth Military Medical University Department of Hematology…
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Posted by rob on April 17, 2010 under Uncategorized |
CXCR4 in Clinical Hematology.
Curr Top Microbiol Immunol. 2010 Apr 14;
Authors: Calandra G, Bridger G, Fricker S
Pharmacological manipulation of CXCR4 has proven clinically useful for mobilization of stem and progenitor cells and in several preclinical models of disease. It is a key component in the localization of leukocytes and stem cells. For patients with multiple myeloma and non-Hodgkin’s Lymphoma, treatment with plerixafor, an inhibitor of CXCL12 binding to CXCR4, plus G-CSF mobilizes stem cells for autologous transplantation to a greater degree than the treatment with G-CSF alone, and in some cases when patients could not be mobilized with cytokines, chemotherapy, or the combination. Stem cells from healthy donors mobilized with single agent plerixafor have been used for allogeneic transplantation in acute myelogenous leukemia (AML) patients, although this is still in the early phase of clinical development. Plerixafor is also undergoing evaluation to mobilize tumor cells in patients with AML and chronic lymphocytic leukemia (CLL) to enhance the effectiveness of chemotherapy regimens. Plerixafor’s effect on neutrophils may also restore circulating neutrophil counts to normal levels in patients with chronic neutropenias such as in WHIMs syndrome. Other areas where inhibition of CXCR4 may be useful based upon preclinical or clinical data include peripheral vascular disease, autoimmune diseases such as rheumatoid arthritis, pulmonary inflammation, and HIV.
PMID: 20397073 [PubMed - as supplied by publisher]
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K562/GM-CSF immunotherapy reduces tumor burden in chronic myeloid leukemia patients with residual disease on imatinib mesylate.
Clin Cancer Res. 2010 Jan 1;16(1):338-47
Authors: Smith BD, Kasamon YL, Kowalski J, Gocke C, Murphy K, Miller CB, Garrett-Mayer E, Tsai HL, Qin L, Chia C, Biedrzycki B, Harding TC, Tu GH, Jones R, Hege K, Levitsky HI
PURPOSE: Chronic myeloid leukemia (CML) can be responsive to T-cell-mediated immunity. K562/granulocyte macrophage-colony stimulating factor (GM-CSF) is a GM-CSF producing vaccine derived from a CML cell line that expresses several CML-associated antigens. A pilot study was developed to determine if K562/GM-CSF immunotherapy could improve clinical responses to imatinib mesylate (IM) in patients with chronic myeloid leukemia. EXPERIMENTAL DESIGN: Patients with chronic phase CML who achieved at least a major cytogeneic response but remained with persistent, measurable disease despite one or more years on imatinib mesylate were eligible. Each was given a series of four vaccines administered in three-week intervals, with or without topical imiquimod, while remaining on a stable dose of imatinib mesylate. CML disease burden was measured serially before and after vaccination. RESULTS: Nineteen patients were vaccinated, with a median duration of previous imatinib mesylate therapy of 37 (13-53) months. Mean PCR measurements of BCR-ABL for the group declined significantly following the vaccines (P = 0.03). Thirteen patients had a progressive decline in disease burden, 8 of whom had increasing disease burden before vaccination. Twelve patients achieved their lowest tumor burden measurements to date following vaccine, including seven subjects who became PCR-undetectable. CONCLUSIONS: K562/GM-CSF vaccine appears to improve molecular responses in patients on imatinib mesylate, including achieving complete molecular remissions, despite long durations of previous imatinib mesylate therapy.
PMID: 20048335 [PubMed - indexed for MEDLINE]
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Targeted therapies have made their way into clinical practice during the past decade. They have caused a major impact on the survival of cancer patients in many areas of clinical oncology and hematology. Indeed, in some hematologic malignancies, such as chronic myelogenous leukemia or non-Hodgkin’s lymphomas, biologicals and antibodies specifically designed to target tumour-specific proteins have revolutionized treatment standards. In solid tumours, new drugs targeting EGF- or VEGF- receptors are now approved and are entering clinical practise for treatment of colon, lung, kidney and other cancers, either alone or in combination with conventional treatment approaches.Recent data have now shown that molecular targeted therapy might display efficacy in patients with head and neck squamous ce…
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Posted by rob on April 10, 2010 under Uncategorized |
Conclusion
With these similar outcomes observed in older patients, we conclude that older age alone should not be considered a contraindication to HCT. (Source: Journal of Clinical Oncology)
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Hairy enhancer of split 1 (Hes1) is a basic helix-loop-helix transcriptional repressor that affects differentiation and often helps maintain cells in an immature state in various tissues. Here we show that retroviral expression of Hes1 immortalizes common myeloid progenitors (CMPs) and granulocyte-macrophage progenitors (GMPs) in the presence of interleukin-3, conferring permanent replating capability on these cells. Whereas these cells did not develop myeloproliferative neoplasms when intravenously administered to irradiated mice, the combination of Hes1 and BCR-ABL in CMPs and GMPs caused acute leukemia resembling blast crisis of chronic myelogenous leukemia (CML), resulting in rapid death of the recipient mice. On the other hand, BCR-ABL alone caused CML-like disease when expressed in c…
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Authors: A Puissant, M Dufies, S Raynaud, J-P Cassuto
& P Auberger (Source: Leukemia)
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Authors: Li W, Hongli Z, Xuedong S, Tieqiang L, Mei G, Guangxian L, Qiyun S, Jianhui Q, Danhong W, Changlin Y, Kaixun H, Zheng D, Huisheng A
Clinical studies have shown that NST has better therapeutic results with chronic myelogenous leukemia (CML) than acute leukemia (AL), but whether the generation of graft-versus-leukemia (GVL) effects is different between AL and CML patients early after NST has not yet been studied, so we used a pentamer-staining technique in combination with ICCS to detect WT1(+)CD8(+)CTL/WT1(+)Tc1 and WT1(+)Th1 cells in these two groups of patients. Results showed that the emergence time of WT1(+)CD(8) (+)CTL/WT1(+)Tc1 cells after NST in AL patients was similar to that in CML patients (P = 0.58), while the emergence time of WT1(+)Th1 cells after NST in AL patient…
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Imatinib 400 mg daily is the standard treatment for patients with chronic myelogenous leukemia (CML). The safety and efficacy of imatinib in CML patients with pre-existing liver and/or renal dysfunction has not been analyzed.The authors analyzed the outcome of 259 patients with early chronic phase CML treated with imatinib (starting dose 400 mg in 50, 800 mg in 209). Pre-existing liver and/or renal dysfunction was seen in 38 (15%) and 11 (4%) patients, respectively.Dose reductions were required in 91 (43%) of 210 patients with normal organ function, compared with 8 (73%) of 11 (P = .065) with renal dysfunction, and 19 (50%) of 38 (P = .271) with liver dysfunction. Grade 3-4 hematologic toxicities including anemia (29%, 10%, and 7% of patients with renal dysfunction, liver dysfunction, and …
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Clinical profiles of 7 patients with chronic myelogenous leukemia or Philadelphia chromosome-positive acute lymphoblastic leukemia treated with dasatinib.
Rinsho Ketsueki. 2010 Mar;51(3):181-8
Authors: Hoshino T, Tahara K, Miyawaki K, Hatsumi N, Takada S, Miyawaki S, Sakura T
We retrospectively analyzed the clinical outcome of dasatinib in 7 patients with chronic myelogenous leukemia (CML) or Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) resistant or intolerant to imatinib. Three patients with chronic phase CML and two patients with Ph+ALL achieved major molecular response, however, two CML patients in accelerated phase (AP)/blast crisis (BC), did not. Grade>/=3 pancytopenia was seen in four patients. Among these, two AP/BC-CML patients required interruption/or dose reduction of dasatinib. As for nonhematologic adverse events, pleural effusion was seen in one patient and cytomegalovirus (CMV) colitis was observed in two patients. No patients who had been intolerant to imatinib experienced the same nonhematologic toxicity following treatment with dasatinib. We identified three patients who developed peripheral lymphocytosis, identified as natural killer cells or cytotoxic T-cells based on their large granular lymphocyte (LGL) morphologies and immunophenotypic profiles, out of six patients receiving dasatinib therapy. All three cases that developed LGL lymphocytosis achieved optimal molecular response, two of the patients, however, had pleural effusion and CMV colitis, respectively. Dasatinib inhibits off-target kinases, which may result in unexpected drug responses.
PMID: 20379112 [PubMed - in process]
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Kaposi’s sarcoma in a patient treated with imatinib mesylate for chronic myeloid leukemia.
Clin Ther. 2009 Nov;31(11):2565-9
Authors: Campione E, Diluvio L, Paternò EJ, Di Marcantonio D, Francesconi A, Terrinoni A, Orlandi A, Chimenti S
BACKGROUND: Chronic myeloid leukemia (CML) is a myeloproliferative disorder primarily characterized by the presence of the Philadelphia chromosome resulting from a reciprocal translocation between the long arms of chromosomes 9 and 22. This translocation determines a fusion gene, bcr-abl, which encodes a constitutively active protein, tyrosine kinase, resulting in decreased apoptosis, defective adhesion, and genomic instability in transformed cells. The tyrosine kinase activity and its effects represent a potential pharmacologic target of tyrosine kinase inhibitors, such as imatinib. Flare of Kaposi’s sarcoma (KS) is well described in immunosuppressed patients treated with corticosteroids and rituximab, but has not yet been reported during treatment with imatinib. OBJECTIVE: We report a case of cutaneous KS lesions in a patient affected by CML treated with imatinib. CASE SUMMARY: A 61-year-old white male patient (weight, 90 kg) was diagnosed with CML in March 2006 at the Division of Hematology, University of Rome “Tor Vergata,” Rome, Italy. He was treated with imatinib 400 mg/d, which improved his general condition with few adverse effects. After 12 months of treatment, molecular biology showed an important reduction in the peripheral blood of the fusion oncoprotein bcr-abl p210-b3a2. However, at the same time, multiple cutaneous violaceous papular-nodular lesions appeared on his left forearm. A punch biopsy showed the presence of KS, whereas a polymerase chain reaction assay documented the presence of human herpes virus type 8 (HHV8) DNA in the skin lesion. Serologic HIV was negative and HHV8 viremia was under the limit of quantitation of the assay. Total body computed tomography scan did not reveal any mucosal or visceral lesion. CONCLUSIONS: We present a case of a patient with CML who developed KS 12 months after starting treatment with imatinib 400 mg/d. The mechanism behind the development of the cutaneous lesions is unclear, and could have either a casual clinical association or be related to the study drug. According to the Naranjo adverse drug reaction probability scale, the development of KS in this case was probably associated with the imatinib treatment (score, 5-8).
PMID: 20110001 [PubMed - indexed for MEDLINE]
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Posted by rob on April 4, 2010 under Uncategorized |
Donor-directed human leukocyte antigen (HLA)–specific allo-antibodies (DSAs) cause graft failure in animal models of hematopoietic stem cell transplantation (HCT). Archived pretransplantation sera from graft failure patients (n = 37) and a matched case-control cohort (n = 78) were tested to evaluate the role of DSAs in unrelated donor HCT. Controls were matched for disease, disease status, graft type, patient age, and transplantation year. Patients had acute myeloid leukemia, acute lymphoblastic leukemia, chronic myelogenous leukemia, or myelodysplastic syndrome; 98% received myeloablative conditioning regimens 100% received T-replete grafts, 97% received marrow, 95% HLA-mismatched, and 97% received calcineurin-based graft-versus-host disease prophylaxis. Among the 37 failed transpla…
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Point mutations in the phosphorylation domain of the Bcr-Abl fusion oncogene give rise to drug resistance in chronic myelogenous leukemia… (Source: Proceedings of the National Academy of Sciences)
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[Direct costs of pharmacotherapy for acute leukemia at a Regional Hospital in Chile.]
Rev Med Chil. 2009 Dec;137(12):1553-60
Authors: Molina F, Schramm C, Ruiz G
Background: In Chile, leukemia is one of the diseases whose treatment is guaranteed by a special law called AUGE (universal access and explicit guaranties). Therefore, the knowledge of its treatment costs is of utmost importance. Aim: To determine and to characterize the direct costs of pharmacotherapy for leukemia at a regional hospital in Chile. Material and methods: Data were retrospectively obtained from electronic and manual records of the hospital for all patients treated for leukemia between 2003 and 2006. Patients were classified into four groups: pediatric and adult patients treated for acute lymphocytic leukemia (ALL children and ALL adults, respectively), and pediatric and adult patients treated for acute myelogenous leukemia (AML children and AML adults, respectively). Results: Total accumulated costs of pharmacotherapy for acute leukemia between 2003 and 2006 were 304,724,845 Chilean pesos (USD 574,952). The higher total or per patient costs, were generated by drugs for chemotherapy compared to other required medications. The exception were AML children, where support drugs, such as antimicrobials, ant emetic drugs and colony stimulating factors, generated the higher costs per patient. Among ALL adults, AML children and AML adults, the costs were concentrated in the first 6 months of treatment. NO children followed this tendency concentrating the costs between the seventh and twenty-fourth months. Conclusions: Annual costs of pharmacotherapy per patient for acute leukemia in this regional hospital were approximately USD 4,717. Chemotherapy was the item with the greatest impact on cost.
PMID: 20361130 [PubMed - in process]
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Exploiting the mevalonate pathway to distinguish statin-sensitive multiple myeloma.
Blood. 2010 Apr 1;
Authors: Clendening JW, Pandyra A, Li Z, Boutros PC, Martirosyan A, Lehner R, Jurisica I, Trudel S, Penn LZ
Statin inhibitors, used to control hypercholesterolemia, trigger apoptosis of hematolological tumor cells and therefore have immediate potential as anti-cancer agents. Evaluations of statins in acute myelogenous leukemia and multiple myeloma have shown statin efficacy is mixed, with only a subset of tumor cells being highly responsive. Our goal was to distinguish molecular features of statin-sensitive and -insensitive myeloma cells and gain insight into potential predictive markers. We show that dysregulation of the mevalonate pathway is a key determinant of sensitivity to statin-induced apoptosis in multiple myeloma. In sensitive cells, the classic feedback response to statin exposure is lost. This results in deficient up-regulation of two isoforms of hydroxymethylglutaryl coenzyme A reductase, the rate limiting enzyme of the mevalonate pathway, and hydroxymethylglutaryl coenzyme A synthase 1. To ascertain the clinical utility of these findings we demonstrate that a subset of primary myeloma cells is sensitive to statins and that monitoring dysregulation of the mevalonate pathway may distinguish these cancers. We also show statins are highly effective and well tolerated in an orthotopic model of myeloma using cells harboring this dysregulation. This determinant of sensitivity further provides molecular rationale for the significant therapeutic index of statins on these tumor cells.
PMID: 20360469 [PubMed - as supplied by publisher]
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Kinase domain mutations and responses to dose escalation in chronic myeloid leukemia resistant to standard dose imatinib mesylate.
Leuk Lymphoma. 2010 Jan;51(1):79-84
Authors: Rajappa S, Mallavarapu KM, Gundeti S, Roshnipaul T, Jacob RT, Digumarti R
We studied kinase domain (KD) mutations, response to dose escalation, event free survival (EFS), and overall survival (OS) of 90 patients with chronic phase CML who were resistant to imatinib mesylate (IM) 400 mg. IM was escalated to 800 mg daily. There were 65 patients with hematologic failure and 25 with cytogenetic failure. Median duration on IM at resistance detection was 18 months (range, 3-48). Twenty nine (32.2%) patients had KD mutations. Of the 29, the most common were T315I in nine (31.2%) and G250E in eight (27.6%). No clinical or laboratory factor predicted for mutation detection. Of 90 patients, 50 (55.5%) achieved a complete hematologic response and 35 (39%) a major cytogenetic response. At a median of 18 months (range 3-40), 35 patients (39%) are event free and 84 (93%) are alive. The 2 year EFS and OS were 34% and 93%, respectively. The projected 2 year EFS was superior for patients with cytogenetic failure compared to those with hematologic failures (73 vs. 22%, p = 0.0001). Dose decreases were necessary in 16 (18%) and interruptions in 31 (34%). KD mutations were detected in a third of patients with T315I being the most common. IM dose escalation can induce sustained responses in patients with cytogenetic failures.
PMID: 20055659 [PubMed - indexed for MEDLINE]
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