Document Detail


Novel agents and strategies for treatment of p53-defective chronic lymphocytic leukemia.
MedLine Citation:
PMID:  17707839     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Chronic lymphocytic leukemia (CLL) is a common leukemia with a highly variable natural history. A subset of patients with high-risk CLL rapidly progress to develop symptomatic disease requiring treatment. Over-represented in this group are those who have a deletion of 17p13.1, the chromosomal location of the tumor suppressor gene P53. Of all prognostic factors examined in CLL, del(17p13.1) has a superior predictive value for poor response to conventional therapy. In this article we review the current published data on prognostic factors relevant to treatment in CLL. We next provide therapeutic recommendations for patients with del(17p13.1) that are available to oncologists in general practice. Chemoimmunotherapy, alemtuzumab, or high-dose corticosteroids are all effective as initial therapy for these patients, but progression is generally rapid. If allogeneic immune therapy is to be considered, it should be approached as part of initial or first salvage therapy. The investigational agent flavopiridol has also demonstrated clinical activity in this subset of patients. Identification of small molecules and new treatment approaches for patients with del(17p13.1) is a major focus of several investigators. Selection of therapy based on high-risk genomic features represents an appropriate treatment approach supported by currently available published data.
Authors:
Michael R Grever; David M Lucas; Amy J Johnson; John C Byrd
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Best practice & research. Clinical haematology     Volume:  20     ISSN:  1521-6926     ISO Abbreviation:  Best Pract Res Clin Haematol     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-08-20     Completed Date:  2007-10-26     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  101120659     Medline TA:  Best Pract Res Clin Haematol     Country:  England    
Other Details:
Languages:  eng     Pagination:  545-56     Citation Subset:  IM    
Affiliation:
Division of Hematology-Oncology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA. michael.grever@osumc.edu
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / therapeutic use
Antibodies, Monoclonal / therapeutic use
Antibodies, Monoclonal, Humanized
Antibodies, Neoplasm / therapeutic use
Apoptosis / drug effects
CD40 Ligand / therapeutic use
Chromosomes, Human, Pair 17
Combined Modality Therapy
Flavonoids / therapeutic use
Gene Deletion
Humans
Leukemia, Lymphocytic, Chronic, B-Cell / therapy*
Middle Aged
Piperidines / therapeutic use
Tumor Suppressor Protein p53 / deficiency*
Grant Support
ID/Acronym/Agency:
P01 CA81534-02/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/Antibodies, Neoplasm; 0/Flavonoids; 0/Piperidines; 0/Tumor Suppressor Protein p53; 147205-72-9/CD40 Ligand; 3A189DH42V/alemtuzumab; 45AD6X575G/alvocidib

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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