Chronic Lymphocytic Leukemia

Source: www.ncbi.nlm.nih.gov --- 4 days ago
Related Articles A genome-wide association study identifies six susceptibility loci for Chronic Lymphocytic Leukemia. Nat Genet. 2008 Aug 31; Authors: Di Bernardo MC, Crowther-Swanepoel D, Broderick P, Webb E, Sellick G, Wild R, Sullivan K, Vijayakrishnan J, Wang Y, Pittman AM, Sunter NJ, Hall AG, Dyer MJ, Matutes E, Dearden C, Mainou-Fowler T, Jackson GH, Summerfield G, Harris RJ, Pettitt AR, Hillmen P, Allsup DJ, Bailey JR, Pratt G, Pepper C, Fegan C, Allan JM, Catovsky D, Houlston RS We conducted a genome-wide association study of 299,983 tagging SNPs for Chronic Lymphocytic Leukemia (CLL) and performed validation in two additional series totaling 1,529 cases and 3,115 controls. We identified six previously unreported CLL risk loci at 2q13 (rs17483466; P = 2.36 x 10(-10)), 2q37.1 (rs13397985, SP140; P = 5.40 x 10(-10)), 6p25.3 (rs872071, IRF4; P = 1.91 x 10(-20)), 11q24.1 (rs735665; P = 3.78 x 10(-12)), 15q23 (rs7176508; P = 4.54 x 10(-12)) and 19q13.32 (rs11083846, PRKD2; P = 3.96 x 10(-9)). These data provide the first evidence for the existence of common, low-penetrance susceptibility to a hematological malignancy and new insights into disease causation in CLL. PMID: 18758461 [PubMed - as supplied by publisher] ...

Source: www.ncbi.nlm.nih.gov --- 4 days ago
Related Articles Early treatment of high-risk Chronic Lymphocytic Leukemia with alemtuzumab and rituximab. Cancer. 2008 Aug 29; Authors: Zent CS, Call TG, Shanafelt TD, Tschumper RC, Jelinek DF, Bowen DA, Secreto CR, Laplant BR, Kabat BF, Kay NE BACKGROUND.: Patients with Chronic Lymphocytic Leukemia (CLL) usually are treated only for progressive disease. However, the discovery of biologic predictors of a high risk of disease progression, together with the development of newer, more targeted therapies, could change this paradigm. In this phase 2 study, the authors tested the safety and efficacy of early treatment for patients with high-risk CLL using alemtuzumab and rituximab. METHODS.: Patients were eligible for treatment if they were 1) previously untreated, 2) had no National Cancer Institute-Working Group 1996 criteria for treatment, and 3) had at least 1 marker of high-risk disease 17p13-, 11q22-, or a combination of unmutated IgVH and CD38+/ZAP70+). Treatment consisted of subcutaneous alemtuzumab (initial dose escalation followed by 30 mg on Monday, Wednesday, and Friday for 4 weeks) and intravenous rituximab (375 mg/m(2) per week x4 doses). All patients received Pneumocystis pneumonia and herpes virus prophylaxis and were monitored for cytomegalovirus reactivation. RESULTS.: Twenty-seven of 30 patients (90%) responded to therapy with 11 (37%) complete responses (CRs). Five patients (17%) patients who had a CR had no detectable m ...

Source: www.ncbi.nlm.nih.gov --- 4 days ago
Related Articles Bendamustine in Chronic Lymphocytic Leukemia and Refractory Lymphoma. Semin Hematol. 2008 Jul;45S2:S7-S10 Authors: Rummel MJ Bendamustine is a water-soluble, bifunctional chemotherapeutic agent with characteristics of both an alkylator and a purine analog. Bendamustine combined with rituximab in vitro shows synergistic effects against various Leukemia and lymphoma cell lines. Clinical trials supporting these results show that bendamustine plus rituximab is highly effective in relapsed and refractory patients with indolent lymphoma. The results have been found in rituximab-naive, rituximab-pretreated, and rituximab-refractory patients with excellent response rates and toxicity profiles. Bendamustine is effective both with rituximab and as a monotherapy in rituximab-refractory patients. Interim results from a phase III, randomized trial comparing bendamustine and rituximab to a standard CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) and rituximab regimen suggest that combination bendamustine and rituximab may provide a viable alternative for treatment of many indolent lymphomas. PMID: 18760709 [PubMed - as supplied by publisher] ...

Source: www.ncbi.nlm.nih.gov --- 2 days ago
Related Articles Epigenetic Dysregulation of the Wnt Signaling Pathway in Chronic Lymphocytic Leukemia (CLL). J Clin Pathol. 2008 Sep 2; Authors: Chim C, Pang R, Liang R Wnt signaling has recently been implicated in the pathogenesis of cancer. We studied the activity of Wnt signaling in peripheral blood CLL lymphocytes, and the methylation status of seven soluble Wnt antagonists including WIF1, DKK3, APC, SFRP1, SFRP2, SFRP4 and SFRP5 by methylation-specific PCR in the peripheral blood CLL lymphocytes and bone marrow samples of CLL patients at diagnosis. In the peripheral blood CLL lymphocytes, constitutive activation of Wnt signaling was detected, associated with hypermethylation of the soluble Wnt inhibitors. In the diagnostic CLL marrow samples, methylation of the seven genes was detected in up to 36.4%. Moreover, twenty-three (52.3%) patients had methylation of at least one of these 7 genes, of whom 14 (60.8%) had methylation of two or more Wnt inhibitors. Apart from an association of advanced age with DKK3 methylation, there was no association of gene hypermethylation with either clinical characteristics (including age, gender, lymphocyte count at diagnosis, Rai stage and poor-risk karyotype) or survival. In conclusion, Wnt signaling is constitutively activated in CLL B-lymphocytes in association with methylation of multiple soluble Wnt antagonists. Methylation of these soluble Wnt antagonists, occasionally multiple genes, in prim ...

Source: www.ncbi.nlm.nih.gov --- 32 days ago
Related Articles Calorimetric study as a potential test for choosing treatment of B-cell Chronic Lymphocytic Leukemia. Leuk Res. 2008 Aug 1; Authors: Rogalinska M, Goralski P, Wozniak K, Bednarek JD, Blonski JZ, Robak T, Piekarski H, Hanausek M, Walaszek Z, Kilianska ZM Differential scanning calorimetry (DSC) and complementary techniques were utilized to evaluate the sensitivity of B-cell Chronic Lymphocytic Leukemia (B-CLL) cell samples in vitro exposed to cladribine or fludarabine in combination with mafosfamide. Mafosfamide, the active in vitro form of cyclophosphamide with both purine analogs produced the cytotoxic effect on mononuclear cell probes, however, to a different degree. Our results indicated that higher sensitivity of examined leukemic cell samples to the used drug combinations was usually accompanied by a marked decrease or even a complete loss of thermal transition at 95+/-3 degrees C in DSC scans of nuclear preparations as well as by more significant reduction of cell viability, higher extent of DNA damage estimated by the comet assay and by dropping/disappearance of anti-apoptotic protein Mcl-1 in comparison with untreated cells. We have also observed that the reduction of transition at 95+/-3 degrees C in thermal scans of nuclear preparations isolated from blood of B-CLL randomized patients who showed response to cladribine or fludarabine combined with cyclophosphamide, i.e., CC and FC, respectively, corresponded wi ...

Source: www.ncbi.nlm.nih.gov --- 32 days ago
Related Articles Concurrent B-cell Chronic Lymphocytic Leukemia and multiple myeloma treated successfully with lenalidomide. Leuk Res. 2008 Aug 1; Authors: Srinivasan S, Schiffer CA The occurrence of multiple myeloma and Chronic Lymphocytic Leukemia in the same patient is very uncommon. The immunomodulatory agent lenalidomide has been shown to have high response rates in multiple myeloma and appears to be quite active in advanced CLL. We report two patients with concurrent CLL and MM who were both treated successfully with lenalidomide. PMID: 18676017 [PubMed - as supplied by publisher] ...

Source: www.ncbi.nlm.nih.gov --- 26 days ago
Related Articles Miller-Fisher syndrome associated with Chronic Lymphocytic Leukemia. Neurol India. 2008 Apr-Jun;56(2):198-200 Authors: Aki Z, Aksoy O, Sucak G, Kuruoglu R, Yagci M Chronic Lymphocytic Leukemia (CLL) is a frequent hematological malignancy, with meningeal or peripheral nerve infiltrations being the most commonly encountered neurological complications. In this report, we describe a CLL patient with Miller-Fisher syndrome (MFS) who responded to immune modulation with plasmapheresis. A 47-year-old man diagnosed as B-cell CLL admitted with neutropenic fever. He complained of diplopia and numbness of both arms. Neurological examination revealed a bilateral external ophthalmoplegia, dysphagia, dysarthria, mild shoulder girdle muscle weakness and gait ataxia, accompanied by absent tendon reflexes. Nerve conduction studies were indicative of a predominantly axonal sensori-motor peripheral neuropathy. This association of CLL with MFS had not been previously reported in the literature. PMID: 18688150 [PubMed - in process] ...

Source: www.ncbi.nlm.nih.gov --- 14 days ago
Related Articles [Treatment of Chronic Lymphocytic Leukemia with regimen of fludarabine, cyclophosphamide and rituximab.] Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2008 Aug;16(4):938-42 Authors: Gu WJ, Xu W, Qian SX, Wu YJ, Hong M, Chen LJ, Wu HX, Lu H, Qiu HX, Li JY In order to evaluate the effecicney of rituximab combined with fludarabine, cyclophosphamide and rituximab (FCR) regimen for Chronic Lymphocytic Leukemia (CLL). Five patients with CLL were treated with FCR regimen for 2 - 6 courses. FCR regimen included fludarabine 25 mg/m(2) via intraveneous drip at day 2 - 4, cyclophosphamide 250 mg/m(2) via intraveneous drip at day 2 - 4 and rituximab 375 mg/m(2) via intraveneous drip at day 1. Courses were repeated every 4 weeks. Minimal residual disease (MRD) was determined by multiparametic flow cytometry. The results showed that three patiens achieved complete remission, 2 patients achieved partial remission. MRD was negative in two patiens. In conclusion, FCR is an effective therapeutic regimen for treating CLL patients and is worth to be used in clinic. PMID: 18718095 [PubMed - in process] ...

Source: www.ncbi.nlm.nih.gov --- 32 days ago
Related Articles Investigation of an NQO1 polymorphism as a possible risk and prognostic factor for Chronic Lymphocytic Leukemia. Leuk Res. 2008 Aug 1; Authors: Begleiter A, Hewitt D, Gibson SB, Johnston JB NAD(P)H:quinoneoxidoreductase 1 (NQO1) inhibits some cancers and increases p53 and apoptosis in cells. Due to an inactivating polymorphism, 10% of humans have no NQO1 activity. A case:control study suggested that Chronic Lymphocytic Leukemia (CLL) patients may have an increased incidence of the NQO1 null genotype compared with controls. NQO1 genotype did not correlate with various CLL prognostic factors, but we observed a trend toward lower drug response in patients with the NQO1 null genotype. Inhibiting NQO1 activity decreased p53 levels and drug induced apoptosis in CLL cells. These results raise the possibility that the NQO1 polymorphism may be a risk factor for CLL and a predictor of response to chemotherapy. PMID: 18676018 [PubMed - as supplied by publisher] ...

Source: www.ncbi.nlm.nih.gov --- 24 days ago
Related Articles Characterization of regulatory T cells in patients with B-cell Chronic Lymphocytic Leukemia. Oncol Rep. 2008 Sep;20(3):677-82 Authors: Giannopoulos K, Schmitt M, Kowal M, Wlasiuk P, Bojarska-Junak A, Chen J, Rolinski J, Dmoszynska A The status of the immune system of patients with B-cell Chronic Lymphocytic Leukemia (B-CLL) is not yet sufficiently characterized. Clinically, B-CLL patients present immunodeficiency increasing along with disease progression and signs of autoimmunity. In the current study, we evaluated the expression of FOXP3 in CD4+CD25hi T regulatory lymphocytes (Treg) and their influence on immune response against tumor and viral antigens in the complex system of peripheral blood mononuclear cells. In 80 B-CLL patients, the frequency of Treg (CD4+CD25hi FOXP3+) cells was significantly higher in B-CLL patients when compared to healthy volunteers (HV) and increased with the progression of the disease (median: 8.24% in stage A, 11.24% in stage B and 12.57% in stage C according to the Binet classification). The frequency of Treg showed no correlation with prognostic markers such as ZAP-70, CD38 and HLA-G. Notably, Treg frequency correlated with serum levels of TNF (r(2)=0.45, p=0.001). T-cell immune responses against epitopes derived from the tumor-associated antigens survivin, fibromodulin and RHAMM as well as from the influenza matrix protein were evaluated. Functionally, higher frequencies of Treg corre ...

Source: www.ncbi.nlm.nih.gov --- 26 days ago
Related Articles Monoclonal B-cell lymphocytosis and Chronic Lymphocytic Leukemia. N Engl J Med. 2008 Aug 7;359(6):575-83 Authors: Rawstron AC, Bennett FL, O'Connor SJ, Kwok M, Fenton JA, Plummer M, de Tute R, Owen RG, Richards SJ, Jack AS, Hillmen P BACKGROUND: A diagnosis of Chronic Lymphocytic Leukemia (CLL) requires a count of over 5000 circulating CLL-phenotype cells per cubic millimeter. Asymptomatic persons with fewer CLL-phenotype cells have monoclonal B-cell lymphocytosis (MBL). The goal of this study was to investigate the relation between MBL and CLL. METHODS: We investigated 1520 subjects who were 62 to 80 years of age with a normal blood count and 2228 subjects with lymphocytosis (>4000 lymphocytes per cubic millimeter) for the presence of MBL, using flow cytometry. Monoclonal B cells were further characterized by means of cytogenetic and molecular analyses. A representative cohort of 185 subjects with CLL-phenotype MBL and lymphocytosis were monitored for a median of 6.7 years (range, 0.2 to 11.8). RESULTS: Monoclonal CLL-phenotype B cells were detected in 5.1% of subjects (78 of 1520) with a normal blood count and 13.9% (309 of 2228) with lymphocytosis. CLL-phenotype MBL had a frequency of 13q14 deletion and trisomy 12 similar to that of CLL and showed a skewed repertoire of the immunoglobulin heavy variable group (IGHV) genes. Among 185 subjects presenting with lymphocytosis, progressive lymphocytosis occurred in 51 (2 ...

Source: www.ncbi.nlm.nih.gov --- 29 days ago
Related Articles Management of infections in patients with Chronic Lymphocytic Leukemia treated with alemtuzumab. Ann Hematol. 2008 Aug 6; Authors: Elter T, Vehreschild JJ, Gribben J, Cornely OA, Engert A, Hallek M Infection is a significant cause of morbidity and death in patients with Chronic Lymphocytic Leukemia (CLL). Increased infectious events may arise from the multiple courses of immunosuppressive therapy and progressive deterioration of a patient's immune system over the course of disease. The humanized, anti-CD52 monoclonal antibody alemtuzumab (Campath or Campath-1H) has shown notable activity for both untreated and fludarabine-refractory CLL. The antibody not only targets malignant cells but also affects normal, healthy immune cells. The cumulative effects of the malignancy and successive courses of treatments adversely impinge on a patient's defense response to certain bacterial, fungal, and viral infections. In this review article, we provide an overview of common infectious events associated with alemtuzumab therapy in CLL. We also discuss recommendations for effectively monitoring and managing infections in CLL patients. PMID: 18682948 [PubMed - as supplied by publisher] ...

Source: www.ncbi.nlm.nih.gov --- 34 days ago
Related Articles Combined molecular biological and molecular cytogenetic analysis of genomic changes in 146 patients with B-cell Chronic Lymphocytic Leukemia. Neoplasma. 2008;55(5):400-8 Authors: A B, L P, L B, L H, J T, P B, E C, J S, J K, M T, J B, Z Z, K M Interphase fluorescence in situ hybridization was used to detect common deletions in B-CLL patients as well as trisomy 12 and aberrations of IgH gene complex at 14q32.33 where we evaluated not only translocation-like signal pattern but also deletions. 120 (82%) patients showed genetic changes - del(13)(q14) 95 (62%), deletion of ATM gene 22 (15%), deletion of p53 gene 25 (17%) and trisomy 12 was proved in 18 (12%) cases. IgH rearrangements were detected in 45 (31%), split of the signals in 11 (8%), deletion of 3 segment flanking IgH gene in 5 (3%) and deletions of variable segment in 29 (20%) patients. Although deletions of 3 segment flanking IgH gene complex are supposed to have an adverse prognostic impact and the genetic background of variable segment deletions is believed to be most probably physiological, we assumed a detailed mapping of the 14q32.33 region will be needed to unravel these mysteries. Key words: B-CLL; I-FISH; IgH gene complex deletions; prognosis. PMID: 18665750 [PubMed - in process] ...

Source: www.ncbi.nlm.nih.gov --- 19 days ago
Related Articles Fc receptor-like 1-5 molecules are similarly expressed in progressive and indolent clinical subtypes of B-cell Chronic Lymphocytic Leukemia. Int J Cancer. 2008 Aug 14; Authors: Kazemi T, Asgarian-Omran H, Hojjat-Farsangi M, Shabani M, Memarian A, Sharifian RA, Razavi SM, Jeddi-Tehrani M, Rabbani H, Shokri F Fc receptor-like (FCRL) 1-5 molecules are exclusively expressed in B-cells and have recently been considered as potential targets for immunotherapy of B-cell malignancies. In this study, the expression pattern of FCRL1-5 molecules was investigated in Iranian patients with B-cell Chronic Lymphocytic Leukemia (B-CLL). Our RT-PCR results have demonstrated that all FCRL molecules, except FCRL4, were expressed in the vast majority of the patients with B-CLL. However, comparison of the relative mRNA expression levels of FCRL between B-CLL (n = 86) and elderly normal subjects (n = 10) revealed significantly lower expression levels of FCRL1 (p < 0.0001), FCRL3 (p = 0.01) and FCRL4 (p = 0.002), but not FCRL2 or FCRL5, in cases with B-CLL. No significant differences were observed between the indolent and progressive subtypes of patients with B-CLL. Comparison between the mutated and unmutated subtypes revealed a significantly higher expression level of FCRL3 (p = 0.017) in patients with mutated CLL. Surface and intracytoplasmic expression of FCRL1, 2, 4 and 5 in leukemic cells of 12 patients by flow cytometry revealed similar ...

Source: www.ncbi.nlm.nih.gov --- 14 days ago
Related Articles Bilateral infiltrative disease of the extraocular muscles: a rare clinical presentation of early stage Chronic Lymphocytic Leukemia. Orbit. 2008;27(4):293-5 Authors: Ramkissoon YD, Lee RW, Malik R, Hsuan JD, Potts MJ Orbital involvement in Chronic Lymphocytic Leukemia (CLL) is highly unusual and most commonly involves hemorrhage or soft tissue infiltration in advanced disease. We report a case of rapid onset bilateral orbital muscle infiltration as the presenting feature of early stage CLL. In addition, we demonstrate clinico-pathological correlation with an identical Chronic B-cell Lymphocytic infiltrate in both orbit and bone marrow, with good response of the orbital disease to local radiotherapy. PMID: 18716967 [PubMed - in process] ...

Source: www.ncbi.nlm.nih.gov --- 16 days ago
Related Articles Allogeneic Hematopoietic Stem-Cell Transplantation for Chronic Lymphocytic Leukemia With 17p Deletion: A Retrospective European Group for Blood and Marrow Transplantation Analysis. J Clin Oncol. 2008 Aug 18; Authors: Schetelig J, van Biezen A, Brand R, Caballero D, Martino R, Itala M, García-Marco JA, Volin L, Schmitz N, Schwerdtfeger R, Ganser A, Onida F, Mohr B, Stilgenbauer S, Bornhäuser M, de Witte T, Dreger P PURPOSE: Patients with Chronic Lymphocytic Leukemia (CLL) and 17p deletion (17p-) have a poor prognosis. Although allogeneic hematopoietic stem-cell transplantation (HCT) has the potential to cure patients with advanced CLL, it is not known whether this holds true for patients with 17p- CLL. PATIENTS AND METHODS: Baseline data from patients, for whom information on the presence of 17p- CLL was available, were downloaded from the European Group for Blood and Marrow Transplantation database. Additional information on the course of CLL and follow-up was collected with a questionnaire. RESULTS: A total of 44 patients with 17p- CLL received allogeneic HCT between March 1995 and July 2006 from a matched sibling (n = 24) or an alternative donor (n = 20). 17p- CLL had been diagnosed by fluorescent in situ hybridization in 82% of patients and by conventional banding in 18% of patients. The median age was 54 years. Before HCT, a median of three lines of chemotherapy had been administered. At HCT, 53% of patients were ...

Source: www.ncbi.nlm.nih.gov --- 26 days ago
Related Articles Whole-Genome Scanning by Array Comparative Genomic Hybridization as a Clinical Tool for Risk Assessment in Chronic Lymphocytic Leukemia. J Mol Diagn. 2008 Aug 7; Authors: Gunn SR, Mohammed MS, Gorre ME, Cotter PD, Kim J, Bahler DW, Preobrazhensky SN, Higgins RA, Bolla AR, Ismail SH, de Jong D, Eldering E, van Oers MH, Mellink CH, Keating MJ, Schlette EJ, Abruzzo LV, Robetorye RS Array-based comparative genomic hybridization (array CGH) provides a powerful method for simultaneous genome-wide scanning and prognostic marker assessment in Chronic Lymphocytic Leukemia (CLL). In the current study, commercially available bacterial artificial chromosome and oligonucleotide array CGH platforms were used to identify chromosomal alterations of prognostic significance in 174 CLL cases. Tumor genomes were initially analyzed by bacterial artificial chromosome array CGH followed by confirmation and breakpoint mapping using oligonucleotide arrays. Genomic changes involving loci currently interrogated by fluorescence in situ hybridization (FISH) panels were detected in 155 cases (89%) at expected frequencies: 13q14 loss (47%), trisomy 12 (13%), 11q loss (11%), 6q loss (7.5%), and 17p loss (4.6%). Genomic instability was the second most commonly identified alteration of prognostic significance with three or more alterations involving loci not interrogated by FISH panels identified in 37 CLL cases (21%). A subset of 48 CLL cases analyze ...

Source: www.ncbi.nlm.nih.gov --- 20 days ago
The impact of trisomy 12, retinoblastoma gene and P53 in prognosis of B-cell Chronic Lymphocytic Leukemia. Hematology. 2008 Jun;13(3):147-53 Authors: AbdelSalam M, El Sissy A, Samra MA, Ibrahim S, El Markaby D, Gadallah F PURPOSE: Routine cytogenetic analysis frequently fails to identify an abnormal clone in B-cell Lymphocytic leukaemia (B-CLL) due to poor response to mitogen stimulation. Fluorescence in situ hybridization (FISH) suggest that chromosomal abnormalities occur more frequently, most commonly trisomy 12, retinoblastoma gene deletion (Rb1 gene) and P53 gene deletion. PATIENTS AND METHODS: 30 patients with B-CLL were enrolled in the trial from two centers in Cairo, Egypt during the period May 2000 to January 2002. Karyotyping and FISH assessment for possible chromosomal abnormalities (trisomy 12, Rb1 gene and P53 gene) were done at initial diagnosis. Results of cytogenetic abnormalities were correlated with clinical picture and survival. RESULTS: The median age was 57.4 years (range 40-75). Karyotyping technique showed that no metaphase could be detected in 30%, metaphase with normal karyotyping was observed in 63% and cytogenetic abnormalities were detected in two cases (one trisomy 12 and one deletion in chromosome 13). FISH examination of interphase and metaphase nuclei revealed cytogenetic abnormalities in 15 cases (50%), trisomy 12 in 9 (30%), Rb1 gene deletion in 5 (17%) and P53 gene deletion in 3. At diagnosis, patien ...

Source: www.ncbi.nlm.nih.gov --- 6 days ago
Related Articles Rituximab in combination with high-dose methylprednisolone for the treatment of fludarabine refractory high-risk Chronic Lymphocytic Leukemia. Leukemia. 2008 Aug 28; Authors: Castro JE, Sandoval-Sus JD, Bole J, Rassenti L, Kipps TJ We examined the clinical response of fludarabine-refractory CLL patients treated with high-dose methylprednisolone (HDMP) and rituximab. Fourteen patients were treated with three cycles of rituximab (375 mg/m(2) weekly for 4 weeks) in combination with HDMP (1 gm/m(2) daily for 5 days). All patients were refractory to fludarabine and 86% had high-risk disease by the modified Rai classification. In all, 79% of the patients had CLL cells that expressed ZAP-70 and three patients had poor prognostic cytogenetics. The overall response rate was 93% and the complete remission rate was 36%. The median time-to-progression was 15 months and the median time-to-next treatment was 22 months. Median survival has not been reached after a median follow up of 40 months. Four patients have died of progressive disease. Patients tolerated the treatment well and serious adverse events were rare. This allowed patients to receive all planned treatments on schedule with no dose modifications. All but one patient responded to treatment and the overall survival and time-to-progression were superior to those of other published salvage regimens.Leukemia advance online publication, 28 August 2008; doi:10.1038/leu.2008.2 ...

Source: www.medscape.com --- 3 days ago
Variation at all 6 genetic loci may increase disease risk by a factor of 8. Medscape Medical News ...