Pentostatin
Leukemia, Hairy Cell
Coformycin
Cladribine
Photopheresis
Ribonucleosides
Lymphoma, T-Cell
Lymphoma, T-Cell, Cutaneous
Antibiotics, Antineoplastic
Antibodies, Monoclonal, Murine-Derived
Leukemia, Lymphocytic, Chronic, B-Cell
Vidarabine
Blood Transfusion, Autologous
Sialic Acid Binding Ig-like Lectin 2
Drug Approval
United States Food and Drug Administration
Device Approval
Weekly administration of 2-chlorodeoxyadenosine in patients with hairy-cell leukemia is effective and reduces infectious complications. (1/179)
BACKGROUND AND OBJECTIVE: It has been widely demonstrated that one single 7-day course continuous infusion (c.i.) 2-chlorodeoxyadenosine (2-CdA) at a dose of 0.1 mg/kg daily is dramatically effective in inducing high and prolonged complete remission (CR) rates in patients with hairy-cell leukemia (HCL). However, 2-CdA administration often results in severe neutropenia and lymphocytopenia both responsible for the infectious complications observed in these patients. We previously reported preliminary data regarding the effectiveness and toxicity of a modified protocol of 2-CdA administration (0.15 mg/kg 2 hours infusion once a week for 6 courses) in 25 HCL patients. This treatment schedule produced a similar overall response rate compared to standard 2-CdA regimen and appeared to be followed by a lower incidence of infectious episodes. In the present study we report response rate and toxicity of weekly 2CdA administration in a larger cohort of patients and with a longer follow-up. DESIGN AND METHODS: In a group of HCL patients with a pronounced decrease in neutrophils count (< 1 x 10(9)/L), we modified the standard protocol (0.1 mg/kg daily x 7 days c.i.) by administering 2-CdA at a dose of 0.15 mg/kg 2 hours infusion once a week for 6 courses. Thirty HCL patients, 24 males and 6 females with a median age of 56 years (range 37-76), entered into this protocol. Seventeen out of 30 patients were at diagnosis while the remaining 13 had been previously treated with alpha-interferon (alpha-IFN) (7), or 2-CdA (4) or deoxycoformycin (DCF) (2). RESULTS: Overall, 22/30 (73%) patients achieved CR and 8 (27%) partial remission (PR) with a median duration of response at the time of writing of 35 months, ranging from 6 to 58 months. Five patients (1 CR and 4 PR) have so far progressed. The treatment was very well tolerated. Five out of 30 patients (16%) developed severe neutropenia (neutrophils < 0.5 x 10(9)/L) and only in two of them we did register an infectious complication which required treatment with systemic antibiotics and granulocyte colony-stimulating factor (G-CSF). INTERPRETATION AND CONCLUSIONS: In conclusion, we confirm that weekly administration of 2-CdA at a dose of 0.15 mg/kg for 6 courses appears to be very effective in HCL inducing a high CR rate, similar to that observed with daily c.i. administration. CR durability and relapse/progression rates are also comparable to standard 2-CdA schedule. Moreover this new regimen seems to be safer in pancytopenic patients, markedly reducing life-threatening infectious complications. (+info)Minimal residual disease in patients with hairy cell leukemia in complete remission treated with 2-chlorodeoxyadenosine or 2-deoxycoformycin and prediction of early relapse. (2/179)
The purine nucleoside analogues 2-chlorodeoxyadenosine (2-CdA) and 2'-deoxycoformycin (2'-DCF) induce complete remission (CR) in the majority of patients with hairy cell leukemia. However, minimal residual disease (MRD) has been detected in bone marrow core biopsies using immunohistochemical techniques in patients achieving CR by conventional criteria. This study was designed to compare the prevalence of MRD with each agent in patients in CR by using conventional criteria and the relapse-free survival for patients with and without MRD. Bone marrow biopsies from 39 patients treated with a single cycle of 2-CdA and 27 patients treated with multiple cycles of 2'-DCF were studied. The monoclonal antibodies anti-CD20, DBA.44, and anti-CD45RO were used to evaluate the paraffin-embedded bone marrow core biopsies for MRD. Five of 39 patients (13%) treated with 2-CdA had MRD, as compared to 7 of 27 patients (26%) treated with 2'-DCF (two-tailed P = 0.21). Relapse has occurred in two of the five patients with MRD after 2-CdA treatment and in four of the seven patients with MRD after 2'-DCF treatment. In total, 6 of the 12 patients (50%) with MRD have relapsed, whereas 3 of 54 patients (6%) without MRD have relapsed, and 2 patients have died without evidence of relapse. The estimated 4-year relapse-free survival among patients with MRD is 55% (+/- 15%, SE), compared to 88% (+/- 5%, SE) among patients without MRD (two-tailed P = 0.0023). The prevalence of MRD detected in a subset of patients in CR after either 2-CdA or 2'-DCF treatment did not differ significantly. However, the presence of MRD is associated with an increased risk of relapse. (+info)Pentostatin therapy of T-cell lymphomas with cutaneous manifestations. (3/179)
PURPOSE: To determine the side effects of and response to pentostatin in patients with T-cell lymphomas with cutaneous manifestations. PATIENTS AND METHODS: Pentostatin was administered to 28 patients who had relapsed cutaneous T-cell lymphoma or peripheral T-cell lymphoma with prominent cutaneous disease. The starting dose was between 3.75 to 5.0 mg/m(2)/d intravenous for 3 days every 3 weeks. RESULTS: Of the 24 patients assessable for response, 17 (71%) achieved a partial remission (46%) or complete remission (25%). The patients had a median number of three (range, one to 12) prior therapies. Of the 86 courses of pentostatin given, 39 were administered at doses of 5.0 mg/m(2)/d and 30 at doses of 3. 75 mg/m(2)/d. Dose escalation to 6.25 mg/m(2)/d was possible in only five courses, and toxicity necessitated dose reduction to 2.8 mg/m(2)/d in 12 courses. The most common side effects were granulocytopenia, nausea, and nonneutropenic fever. Most patients developed significant lowering of CD4 counts. Herpes zoster was seen within 1 year after pentostatin in five patients (19%). CONCLUSION: Pentostatin is an active agent in heavily pretreated T-cell lymphomas with cutaneous manifestations. (+info)Second malignancies as a consequence of nucleoside analog therapy for chronic lymphoid leukemias. (4/179)
PURPOSE: The nucleoside analogs fludarabine, 2'-deoxycoformycin (DCF), and 2-chlorodeoxyadenosine (CdA), commonly used in the treatment of patients with indolent lymphoid malignancies such as chronic lymphocytic leukemia (CLL) and hairy cell leukemia (HCL), are associated with myelosuppression and profound and prolonged immunosuppression. These complications raise the possibility of an increase in secondary malignancies in patients whose disease already places them at greater risk. The purpose of the present study was to assess the frequency of second tumors in patients with CLL who are treated with fludarabine and in patients with HCL who are treated with DCF and CdA. PATIENTS AND METHODS: We reviewed the long-term follow-up data for 2,014 patients treated on National Cancer Institute Group C protocols with fludarabine for relapsed and refractory CLL and with DCF and CdA for HCL using a Second Cancer Report. The numbers of observed and expected secondary tumors were compared. RESULTS: Median follow-up periods for the DCF (n = 409), fludarabine (n = 724), and CdA (n = 979) studies were 6.9, 7.4, and 5.1 years, respectively. The 111 malignancies were most commonly lymphoma (25 patients), prostate (19), lung (15), colorectal (nine), bladder (six), and breast (six), but also CNS, stomach, ovary, head and neck, melanoma, sarcoma, testicular, and myeloid leukemias. Compared with age-adjusted 1994 Surveillance and Epidemiology End-Results rates for the general population, the observed/expected frequencies for DCF, fludarabine, and CdA were 1.43 (95% confidence interval [CI], 0.93 to 2.10), 1.65 (95% CI, 1.04 to 2.47), and 1.50 (95% CI, 1.14 to 1.93), respectively, indicating a significant (at P =.05) increase in risk for patients treated on the latter two protocols compared with a normal population. However, these values are consistent with the increase already associated with these diseases. CONCLUSION: Despite their immunosuppression, nucleoside analogs can be safely administered to patients with CLL or HCL without a significantly increased risk of secondary malignancies. (+info)Pentostatin in T-cell malignancies--a phase II trial of the EORTC. Leukemia Cooperative Group. (5/179)
PURPOSE: Within this phase II EORTC trial, we have investigated the safety and efficacy of pentostatin in lymphoid malignancies. We have previously reported the results in T- and B-cell prolymphocytic leukemia, B-cell chronic lymphocytic leukemia (B-CLL) and hairy cell leukemia. This report focuses on the outcome in T-cell malignancies: T-CLL, Sezary syndrome (Sezary), mycosis fungoides (MF) and T-zone lymphoma (TZL). PATIENTS AND METHODS: Of the 92 patients with these diagnoses enrolled, 76 were evaluable for response and toxicity, i.e., 25 of 28 with T-CLL, 21 of 26 with Sezary, 22 of 26 with MF, and 8 of 12 with TZL. All patients had progressive and advanced disease. Pentostatin was administered at a dosage of 4 mg/m2 every week for the first 3 weeks, then 4 mg/m2 every 14 days for another 6 weeks, followed by maintenance therapy of 4 mg/m2 monthly for a maximum of 6 months. RESULTS: Response rates (complete and partial responses) in patients with Sezary (n = 22) or MF (n = 21) were 33% and 23%, respectively, and in patients with T-CLL (n = 21) or TZL (n = 8) 8% and 25%, respectively. Sixteen (21%) patients died during the first ten weeks of treatment: twelve of progressive disease, two of infectious complications with progressive disease, one of myocard infarction and one of renal failure related to administration of i.v. contrast. Major toxicity (grade 3-4) included infection in 11% of patients, nausea/vomiting in 4%, diarrhea in 3%. Hematologic toxicity was mild to non-existent. CONCLUSIONS: We conclude that pentostatin is active in Sezary and MF but showed marginal activity in T-CLL or TZL. Toxicities are mild to moderate at the dose schedule administered. Due to its relatively specific lympholytic effect and its favorable toxicity spectrum, pentostatin might be especially useful for the palliative treatment of T-cell malignancies. (+info)Adenosine-mediated killing of cultured epithelial cancer cells. (6/179)
Because micromolar concentrations of adenosine (Ado) have been documented recently in the interstitial fluid of carcinomas growing in animals, we examined the effects of low concentrations of Ado on the growth of cultured human carcinoma cells. Ado alone had little effect upon cell growth. In the presence of one of a number of Ado deaminase (ADA) inhibitors, Ado led to significant growth inhibition of all cell lines tested. Similar effects were found when ATP, ADP, or AMP was substituted for Ado. Surprisingly, the ADA inhibitor coformycin (CF) had a much greater potentiating effect than did 2'-deoxycoformycin (DCF), although DCF is a more potent ADA inhibitor. The growth inhibition of the Ado/CF combination was not abrogated by pyrimidines or caffeine, a nonspecific Ado receptor blocker. Toxicity was prevented by the addition of the Ado transport inhibitor dipyridamole or the Ado kinase inhibitor 5'-amino 5'-deoxyadenosine. S-Adenosylhomocysteine hydrolase is not involved because neither homocysteine thiolactone nor an S-adenosylhomocysteine hydrolase inhibitor (adenosine dialdehyde) potentiated toxicity of the Ado/CF combination. Unexpectedly, substitution of 2'-deoxyadenosine (the toxic moiety in congenital ADA deficiency) for Ado, did not lead to equivalent toxicity. The Ado/CF combination inhibited DNA synthesis and brought about morphological changes consistent with apoptosis. Together, these findings indicate that the Ado-mediated killing proceeds via an intracellular route that requires the action of Ado kinase. The enhanced cofactor activity of CF may be attributable to its being a more potent inhibitor of AMP deaminase than is DCF. (+info)Antileukemic efficacy of 2-deoxycoformycin in monocytic leukemia cells. (7/179)
2'-Deoxycoformycin (dCF) as a single agent has been reported to be less effective against myeloid than against lymphoid malignancies in clinical trials. However, previous studies have shown that in the presence of 2'-deoxyadenosine (dAd), human monocytoid leukemia cell lines are much more sensitive to dCF with regard to the inhibition of cell proliferation. Thus, dCF might be useful for treating monocytoid leukemia with the aid of dAd analogs. The antiproliferative effects of dCF in combination with dAd or its derivatives were examined on normal and malignant blood and bone marrow cells. In the presence of 10 micromol/L dAd, the concentration of dCF required to inhibit the viability of primary monocytoid leukemia cells was much lower than that required to inhibit normal or non-monocytoid leukemic cells. Among the dAd analogs, 9-beta-D-arabinofuranosyladenine (AraA) was also effective in combination with dCF. Athymic nude mice were inoculated with human monocytoid leukemia U937 cells and treated with dCF or a dAd analog or both. Although dCF alone slightly but significantly prolonged the survival of mice inoculated with U937 cells, combined treatment with dCF and AraA markedly prolonged their survival. These data suggest that the combination of dCF and AraA may be useful for the clinical treatment of acute monocytic leukemia. (Blood. 2000;96:1512-1516) (+info)Long-term follow-up of remission duration, mortality, and second malignancies in hairy cell leukemia patients treated with pentostatin. (8/179)
The nucleoside analogue, pentostatin, has demonstrated high complete response rates and long relapse-free survival times in patients with hairy cell leukemia, a disease that historically had been unresponsive to treatment. Long-term data on duration of overall survival and relapse-free survival and incidence of subsequent malignancies with this agent are lacking. Patients completing the treatment phase of a randomized, intergroup study who received pentostatin as an initial treatment or who crossed over after failure of interferon alpha were followed for survival, relapse, and diagnosis of subsequent malignancies. Two hundred forty-one patients treated with pentostatin as initial therapy (n = 154) or who crossed over after failure of interferon alpha (n = 87) were followed for a median duration of 9.3 years. Estimated 5- and 10-year survival rates (95% confidence interval) for all patients combined were 90% (87%-94%) and 81% (75%-86%), respectively. In the 173 patients with a confirmed complete response to pentostatin treatment, 5- and 10-year relapse-free survival rates were 85% (80%-91%) and 67% (58%-76%), respectively. Survival curves for patients initially treated with pentostatin and those crossed over were similar. Only 2 of 40 deaths were attributed to hairy cell leukemia. The mortality rate and incidence of subsequent malignancies were not higher than expected in the general population. Pentostatin is a highly effective regimen for hairy cell leukemia that produces durable complete responses. Subsequent malignancies do not appear to be increased with pentostatin treatment. (+info)Pentostatin is a medication used in the treatment of certain types of cancer, including hairy cell leukemia and certain T-cell lymphomas. It is a type of drug called a purine nucleoside analog, which works by interfering with the production of DNA and RNA, the genetic material found in cells. This can help to stop the growth and multiplication of cancer cells.
Pentostatin is given intravenously (through an IV) in a healthcare setting, such as a hospital or clinic. It is usually administered on a schedule of every other week. Common side effects of pentostatin include nausea, vomiting, diarrhea, and loss of appetite. It can also cause more serious side effects, such as low blood cell counts, infections, and liver problems.
It's important to note that this is a medical definition of the drug and its use, and it should not be used as a substitute for professional medical advice. If you have any questions about pentostatin or your treatment, it is best to speak with your healthcare provider.
Adenosine deaminase inhibitors are a class of medications that work by blocking the action of the enzyme adenosine deaminase. This enzyme is responsible for breaking down adenosine, a chemical in the body that helps regulate the immune system and is involved in the inflammatory response.
By inhibiting the activity of adenosine deaminase, these medications can increase the levels of adenosine in the body. This can be useful in certain medical conditions where reducing inflammation is important. For example, adenosine deaminase inhibitors are sometimes used to treat rheumatoid arthritis, a chronic autoimmune disease characterized by inflammation and damage to the joints.
One common adenosine deaminase inhibitor is called deoxycoformycin (also known as pentostatin). This medication is typically given intravenously and is used to treat hairy cell leukemia, a rare type of cancer that affects white blood cells.
It's important to note that adenosine deaminase inhibitors can have serious side effects, including suppression of the immune system, which can make people more susceptible to infections. They should only be used under the close supervision of a healthcare provider.
Hairy cell leukemia (HCL) is a rare, slow-growing type of cancer in which the bone marrow makes too many B cells (a type of white blood cell). These excess B cells are often referred to as "hairy cells" because they look abnormal under the microscope, with fine projections or "hair-like" cytoplasmic protrusions.
In HCL, these abnormal B cells can build up in the bone marrow and spleen, causing both of them to enlarge. The accumulation of hairy cells in the bone marrow can crowd out healthy blood cells, leading to a shortage of red blood cells (anemia), platelets (thrombocytopenia), and normal white blood cells (leukopenia). This can result in fatigue, increased risk of infection, and easy bruising or bleeding.
HCL is typically an indolent disease, meaning that it progresses slowly over time. However, some cases may require treatment to manage symptoms and prevent complications. Treatment options for HCL include chemotherapy, immunotherapy, targeted therapy, and stem cell transplantation. Regular follow-up with a healthcare provider is essential to monitor the disease's progression and adjust treatment plans as needed.
Coformycin is an antimetabolite antibiotic, which means it interferes with the growth of bacteria by inhibiting the synthesis of nucleic acids, the genetic material of bacteria. It is derived from Streptomyces coelicolor and is used primarily in research to study bacterial metabolism.
Coformycin is a potent inhibitor of bacterial enzyme adenosine deaminase, which is involved in purine biosynthesis. By inhibiting this enzyme, Coformycin prevents the bacteria from synthesizing the building blocks needed to make DNA and RNA, thereby inhibiting their growth.
Coformycin has not been approved for use as a therapeutic drug in humans or animals due to its narrow spectrum of activity and potential toxicity. However, it is still used in research settings to study bacterial metabolism and the mechanisms of antibiotic resistance.
Cladribine is a medication used in the treatment of certain types of cancer and multiple sclerosis. It is a type of drug called a purine nucleoside analog, which means it interferes with the production of DNA and RNA, the genetic material of cells. This can help to stop the growth and multiplication of abnormal cells in the body.
In cancer treatment, cladribine is used to treat hairy cell leukemia and certain types of lymphoma. In multiple sclerosis, it is used to reduce the frequency of relapses and slow down the progression of disability. Cladribine works by selectively targeting and depleting certain white blood cells called lymphocytes, which are thought to play a role in the immune response that damages the nervous system in multiple sclerosis.
Cladribine is usually given as an injection into a vein or under the skin, and it may be given on its own or in combination with other medications. Common side effects of cladribine include nausea, vomiting, diarrhea, and weakness. It can also lower the body's ability to fight infections, so patients may need to take precautions to avoid infection while receiving treatment. Cladribine should be used with caution in people with a history of certain medical conditions, such as liver or kidney disease, and it should not be used during pregnancy or breastfeeding.
Extracorporeal photopheresis (ECP) is a medical treatment that involves the separation of peripheral blood mononuclear cells, which are then exposed to photoactivation. This process is repeated in multiple sessions and is used primarily in the management of cutaneous T-cell lymphoma (CTCL), as well as for the prevention of organ rejection in transplant patients. The exposure to photoactivation leads to the induction of apoptosis, or programmed cell death, in the affected cells, which can help to reduce inflammation and modulate the immune response. ECP is typically administered in an outpatient setting and has been shown to be a safe and effective treatment option for many patients with CTCL.
Ribonucleosides are organic compounds that consist of a nucleoside bound to a ribose sugar. Nucleosides are formed when a nitrogenous base (such as adenine, guanine, uracil, cytosine, or thymine) is attached to a sugar molecule (either ribose or deoxyribose) via a beta-glycosidic bond. In the case of ribonucleosides, the sugar component is D-ribose. Ribonucleosides play important roles in various biological processes, particularly in the storage, transfer, and expression of genetic information within cells. When ribonucleosides are phosphorylated, they become the building blocks of RNA (ribonucleic acid), a crucial biomolecule involved in protein synthesis and other cellular functions. Examples of ribonucleosides include adenosine, guanosine, uridine, cytidine, and inosine.
T-cell lymphoma is a type of cancer that affects the T-cells, which are a specific type of white blood cell responsible for immune function. These lymphomas develop from mature T-cells and can be classified into various subtypes based on their clinical and pathological features.
T-cell lymphomas can arise in many different organs, including the lymph nodes, skin, and other soft tissues. They often present with symptoms such as enlarged lymph nodes, fever, night sweats, and weight loss. The diagnosis of T-cell lymphoma typically involves a biopsy of the affected tissue, followed by immunophenotyping and genetic analysis to determine the specific subtype.
Treatment for T-cell lymphomas may include chemotherapy, radiation therapy, immunotherapy, or stem cell transplantation, depending on the stage and aggressiveness of the disease. The prognosis for T-cell lymphoma varies widely depending on the subtype and individual patient factors.
Cutaneous T-cell lymphoma (CTCL) is a type of cancer that affects T-cells, a specific group of white blood cells called lymphocytes. These cells play a crucial role in the body's immune system and help protect against infection and disease. In CTCL, the T-cells become malignant and accumulate in the skin, leading to various skin symptoms and lesions.
CTCL is a subtype of non-Hodgkin lymphoma (NHL), which refers to a group of cancers that originate from lymphocytes. Within NHL, CTCL is categorized as a type of extranodal lymphoma since it primarily involves organs or tissues outside the lymphatic system, in this case, the skin.
The two most common subtypes of CTCL are mycosis fungoides and Sézary syndrome:
1. Mycosis fungoides (MF): This is the more prevalent form of CTCL, characterized by patches, plaques, or tumors on the skin. The lesions may be scaly, itchy, or change in size, shape, and color over time. MF usually progresses slowly, with early-stage disease often confined to the skin for several years before spreading to lymph nodes or other organs.
2. Sézary syndrome (SS): This is a more aggressive form of CTCL that involves not only the skin but also the blood and lymph nodes. SS is characterized by the presence of malignant T-cells, known as Sézary cells, in the peripheral blood. Patients with SS typically have generalized erythroderma (reddening and scaling of the entire body), pruritus (severe itching), lymphadenopathy (swollen lymph nodes), and alopecia (hair loss).
The diagnosis of CTCL usually involves a combination of clinical examination, skin biopsy, and immunophenotyping to identify the malignant T-cells. Treatment options depend on the stage and subtype of the disease and may include topical therapies, phototherapy, systemic medications, or targeted therapies.
Antibiotics are a type of medication used to treat infections caused by bacteria. They work by either killing the bacteria or inhibiting their growth.
Antineoplastics, also known as chemotherapeutic agents, are a class of drugs used to treat cancer. These medications target and destroy rapidly dividing cells, such as cancer cells, although they can also affect other quickly dividing cells in the body, such as those in the hair follicles or digestive tract, which can lead to side effects.
Antibiotics and antineoplastics are two different classes of drugs with distinct mechanisms of action and uses. It is important to use them appropriately and under the guidance of a healthcare professional.
Leukemia, T-cell is a type of cancer that affects the T-cells or T-lymphocytes, which are a type of white blood cells responsible for cell-mediated immunity. It is characterized by an excessive and uncontrolled production of abnormal T-cells in the bone marrow, leading to the displacement of healthy cells and impairing the body's ability to fight infections and regulate immune responses.
T-cell leukemia can be acute or chronic, depending on the rate at which the disease progresses. Acute T-cell leukemia progresses rapidly, while chronic T-cell leukemia has a slower course of progression. Symptoms may include fatigue, fever, frequent infections, weight loss, easy bruising or bleeding, and swollen lymph nodes. Treatment typically involves chemotherapy, radiation therapy, stem cell transplantation, or targeted therapy, depending on the type and stage of the disease.
Monoclonal murine-derived antibodies are a type of laboratory-produced antibody that is identical in structure, having been derived from a single clone of cells. These antibodies are created using mouse cells and are therefore composed entirely of mouse immune proteins. They are designed to bind specifically to a particular target protein or antigen, making them useful tools for research, diagnostic testing, and therapeutic applications.
Monoclonal antibodies offer several advantages over polyclonal antibodies (which are derived from multiple clones of cells and can recognize multiple epitopes on an antigen). Monoclonal antibodies have a consistent and uniform structure, making them more reliable for research and diagnostic purposes. They also have higher specificity and affinity for their target antigens, allowing for more sensitive detection and measurement.
However, there are some limitations to using monoclonal murine-derived antibodies in therapeutic applications. Because they are composed entirely of mouse proteins, they can elicit an immune response in humans, leading to the production of human anti-mouse antibodies (HAMA) that can neutralize their effectiveness. To overcome this limitation, researchers have developed chimeric and humanized monoclonal antibodies that incorporate human protein sequences, reducing the risk of an immune response.
Chronic lymphocytic leukemia (CLL) is a type of cancer that starts from cells that become certain white blood cells (called lymphocytes) in the bone marrow. The cancer (leukemia) cells start in the bone marrow but then go into the blood.
In CLL, the leukemia cells often build up slowly. Many people don't have any symptoms for at least a few years. But over time, the cells can spread to other parts of the body, including the lymph nodes, liver, and spleen.
The "B-cell" part of the name refers to the fact that the cancer starts in a type of white blood cell called a B lymphocyte or B cell. The "chronic" part means that this leukemia usually progresses more slowly than other types of leukemia.
It's important to note that chronic lymphocytic leukemia is different from chronic myelogenous leukemia (CML). Although both are cancers of the white blood cells, they start in different types of white blood cells and progress differently.
Vidarabine is an antiviral medication used to treat herpes simplex infections, particularly severe cases such as herpes encephalitis (inflammation of the brain caused by the herpes simplex virus). It works by interfering with the DNA replication of the virus.
In medical terms, vidarabine is a nucleoside analogue that is phosphorylated intracellularly to the active form, vidarabine triphosphate. This compound inhibits viral DNA polymerase and incorporates into viral DNA, causing termination of viral DNA synthesis.
Vidarabine was previously used as an injectable medication but has largely been replaced by more modern antiviral drugs such as acyclovir due to its greater efficacy and lower toxicity.
Splenomegaly is a medical term that refers to an enlargement or expansion of the spleen beyond its normal size. The spleen is a vital organ located in the upper left quadrant of the abdomen, behind the stomach and below the diaphragm. It plays a crucial role in filtering the blood, fighting infections, and storing red and white blood cells and platelets.
Splenomegaly can occur due to various underlying medical conditions, including infections, liver diseases, blood disorders, cancer, and inflammatory diseases. The enlarged spleen may put pressure on surrounding organs, causing discomfort or pain in the abdomen, and it may also lead to a decrease in red and white blood cells and platelets, increasing the risk of anemia, infections, and bleeding.
The diagnosis of splenomegaly typically involves a physical examination, medical history, and imaging tests such as ultrasound, CT scan, or MRI. Treatment depends on the underlying cause and may include medications, surgery, or other interventions to manage the underlying condition.
Autologous blood transfusion is a medical procedure in which a patient receives their own blood that has been collected and stored prior to surgery or a medical treatment that may cause significant blood loss. The blood is drawn from the patient, typically in the days or weeks leading up to the scheduled procedure, and then stored until it is needed during or after the surgery.
The primary advantage of autologous blood transfusion is that it eliminates the risk of transfusion reactions, infectious disease transmission, and immunomodulation associated with allogeneic (donor) blood transfusions. However, not all patients are candidates for this type of transfusion due to various factors such as medical conditions, low hemoglobin levels, or insufficient time to collect and store the blood before the procedure.
Autologous blood transfusion can be performed using several methods, including preoperative blood donation, acute normovolemic hemodilution, intraoperative cell salvage, and postoperative blood collection. The choice of method depends on various factors, such as the patient's medical condition, the type and extent of surgery, and the availability of resources.
In summary, autologous blood transfusion is a safe and effective way to reduce the need for allogeneic blood transfusions during or after surgical procedures, but it may not be suitable for all patients.
Methylprednisolone is a synthetic glucocorticoid drug, which is a class of hormones that naturally occur in the body and are produced by the adrenal gland. It is often used to treat various medical conditions such as inflammation, allergies, and autoimmune disorders. Methylprednisolone works by reducing the activity of the immune system, which helps to reduce symptoms such as swelling, pain, and redness.
Methylprednisolone is available in several forms, including tablets, oral suspension, and injectable solutions. It may be used for short-term or long-term treatment, depending on the condition being treated. Common side effects of methylprednisolone include increased appetite, weight gain, insomnia, mood changes, and increased susceptibility to infections. Long-term use of methylprednisolone can lead to more serious side effects such as osteoporosis, cataracts, and adrenal suppression.
It is important to note that methylprednisolone should be used under the close supervision of a healthcare provider, as it can cause serious side effects if not used properly. The dosage and duration of treatment will depend on various factors such as the patient's age, weight, medical history, and the condition being treated.
Siglec-2, also known as CD22, is a type of cell surface protein that belongs to the sialic acid-binding immunoglobulin-like lectins (Siglecs) family. It is primarily expressed on mature B cells and plays a crucial role in regulating B cell activation and function. Siglec-2 recognizes and binds to sialic acid residues on glycoproteins and gangliosides, which are sugars that are attached to proteins and lipids on the surface of cells. This binding can lead to inhibitory signals that dampen B cell activation and help prevent autoimmunity. Siglec-2 has also been implicated in the regulation of B cell migration and adhesion.
"Drug approval" is the process by which a regulatory agency, such as the US Food and Drug Administration (FDA), grants formal authorization for a pharmaceutical company to market and sell a drug for a specific medical condition. The approval process is based on rigorous evaluation of clinical trial data to ensure that the drug is safe and effective for its intended use.
The FDA's approval process typically involves several stages, including preclinical testing in the lab and animal studies, followed by three phases of clinical trials in human subjects. The first phase tests the safety of the drug in a small group of healthy volunteers, while the second and third phases test the drug's efficacy and side effects in larger groups of patients with the medical condition for which the drug is intended.
If the results of these studies demonstrate that the drug is safe and effective, the pharmaceutical company can submit a New Drug Application (NDA) or Biologics License Application (BLA) to the FDA for review. The application includes data from the clinical trials, as well as information about the manufacturing process, labeling, and proposed use of the drug.
The FDA reviews the application and may seek input from independent experts before making a decision on whether to approve the drug. If approved, the drug can be marketed and sold to patients with the medical condition for which it was approved. The FDA continues to monitor the safety and efficacy of approved drugs after they reach the market to ensure that they remain safe and effective for their intended use.
The United States Food and Drug Administration (FDA) is a federal government agency responsible for protecting public health by ensuring the safety, efficacy, and security of human and veterinary drugs, biological products, medical devices, our country's food supply, cosmetics, and products that emit radiation. The FDA also provides guidance on the proper use of these products, and enforces laws and regulations related to them. It is part of the Department of Health and Human Services (HHS).
"Device approval" is a term used to describe the process by which a medical device is determined to be safe and effective for use in patients by regulatory authorities, such as the U.S. Food and Drug Administration (FDA). The approval process typically involves a rigorous evaluation of the device's design, performance, and safety data, as well as a review of the manufacturer's quality systems and labeling.
The FDA's Center for Devices and Radiological Health (CDRH) is responsible for regulating medical devices in the United States. The CDRH uses a risk-based classification system to determine the level of regulatory control needed for each device. Class I devices are considered low risk, Class II devices are moderate risk, and Class III devices are high risk.
For Class III devices, which include life-sustaining or life-supporting devices, as well as those that present a potential unreasonable risk of illness or injury, the approval process typically involves a premarket approval (PMA) application. This requires the submission of comprehensive scientific evidence to demonstrate the safety and effectiveness of the device.
For Class II devices, which include moderate-risk devices such as infusion pumps and powered wheelchairs, the approval process may involve a premarket notification (510(k)) submission. This requires the manufacturer to demonstrate that their device is substantially equivalent to a predicate device that is already legally marketed in the United States.
Once a medical device has been approved for marketing, the FDA continues to monitor its safety and effectiveness through post-market surveillance programs. Manufacturers are required to report any adverse events or product problems to the FDA, and the agency may take regulatory action if necessary to protect public health.
Pentostatin
1,3-Diazepine
Hairy cell leukemia
Chemotherapy
Adenosine deaminase
Graft-versus-host disease
Leukemia
Purine analogue
ATC code L01
National Cancer Institute
List of drugs: Pb-Pe
Ira Pastan
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Fludarabine4
- Pentostatin and Fludarabine. (freezingblue.com)
- In a clinical investigation using fludarabine in combination with pentostatin (deoxycoformycin) for the treatment of refractory chronic lymphocytic leukemia (CLL), there was an unacceptably high incidence of fatal pulmonary toxicity. (guidelinecentral.com)
- Therefore, the use of fludarabine in combination with pentostatin is not recommended. (guidelinecentral.com)
- K.L. Bourantas Following the administration of the human anti-CD20 monoclonal antibody IDEC-C2B8 (rituximab), a 31-year-old woman with B- prolymphocytic leukemia , who had been resistant to CHOP, fludarabine, pentostatin and 2-CdA. (karger.com)
Deoxycoformycin4
- Pentostatin (or deoxycoformycin, trade name Nipent, manufactured by SuperGen) is an anticancer chemotherapeutic drug. (wikipedia.org)
- Deoxycoformycin(DCF)/Pentostatin is a T-cell cytotoxic drug with previously reported responses in lymphoid malignancies but larger studies are needed. (knowcancer.com)
- Overall responses (OR) of participants with lymphoid malignancies to Deoxycoformycin (DCF)/Pentostatin defined as Complete Response (CR) and Partial Response (PR). (knowcancer.com)
- Pentostatin (deoxycoformycin), is one of a number of purine analogues. (johnshopkins.edu)
Rituximab8
- The PCR (pentostatin, cyclophosphamide, and rituximab) regimen is given every 21 d with growth factor support and ID prophylaxis. (medscape.com)
- Randomized Phase II Trial of Rituximab with Either Pentostatin or Bendamustine for Multiply Relapsed or Refractory Hairy Cell Leukemia (NCI-10-C-0025). (cancer.gov)
- Although the hairy cells that remain after cladribine or pentostatin treatment are essentially always CD20 positive, only a minority of patients respond to rituximab therapy alone. (cancer.gov)
- However, combinations of rituximab and either cladribine or pentostatin seem to be highly effective in nearly all patients. (cancer.gov)
- Dr. Kreitman is currently directing a randomized clinical trial of rituximab with cladribine in newly diagnosed (untreated) patients and patients who have had only one prior course of cladribine, but no prospective trial has yet evaluated rituximab with pentostatin in patients with hairy cell leukemia. (cancer.gov)
- Bendamustine's mechanism of action is different from those of cladribine and pentostatin, and it is known to act synergistically with rituximab in lymphoma cells. (cancer.gov)
- In this trial, patients with hairy cell leukemia who have not responded to initial chemotherapy followed by second-line treatment with rituximab, or who have relapsed following two courses of chemotherapy, will be randomly assigned to receive rituximab combined with either pentostatin or bendamustine. (cancer.gov)
- So it makes sense to use rituximab along with pentostatin as a comparator to bendamustine and rituximab for patients with multiply relapsed or refractory disease. (cancer.gov)
Cladribine7
- Pentostatin , another chemotherapy drug in the same class as cladribine, is also effective against this cancer. (cancer.gov)
- However, most patients and doctors prefer cladribine because the typical course of treatment lasts 5-7 days as opposed to 3-6 months or longer with pentostatin. (cancer.gov)
- Cladribine and pentostatin have different mechanisms of action, but they both produce high rates of complete remission and have similar toxicity. (cancer.gov)
- Although responses to cladribine and pentostatin can last years or even decades, these drugs do not appear to cure most patients. (cancer.gov)
- The majority of these patients will have received only cladribine, but because pentostatin works differently, some patients with disease that is refractory to cladribine may be sensitive to pentostatin. (cancer.gov)
- Treatment, when clinically indicated, starts with monotherapy with one of the purine nucleoside analogs, cladribine or pentostatin. (fda.gov)
- Upon recurrence, the malignancy may again be sensitive to treatment with cladribine or pentostatin, although subsequent remissions tend to be less durable. (fda.gov)
Hairy cell leu1
- Pentostatin is used to treat hairy cell leukemia. (wikipedia.org)
Graft-versus-1
- Additionally, pentostatin has been used to treat steroid-refractory acute and chronic graft-versus-host disease. (wikipedia.org)
Chemotherapy1
- This is a dose banded chemotherapy product specification for Pentostatin pre-filled syringes, for use by procurement teams to ensure the NHS will purchase standard, ready made products across the NHS in England. (england.nhs.uk)
Chronic lymphocy1
- Pentostatin is also used in chronic lymphocytic leukemia (CLL) patients who have relapsed. (wikipedia.org)
Fludara1
- Fludara may interact with pentostatin. (rxlist.com)
Clinical1
- Pentostatin is one of the agents being examined in a randomised Phase II study of initial therapy for GVHD by the NIH sponsored Clinical Trials Network. (johnshopkins.edu)
Refractory1
- note = "Funding Information: Several other trials of pentostatin for treatment of steroid refractory chronic GVHD are currently ongoing. (johnshopkins.edu)
Give1
- DON'T give with pentostatin! (freezingblue.com)
Nipent8
- Pentostatin (or deoxycoformycin, trade name Nipent, manufactured by SuperGen) is an anticancer chemotherapeutic drug. (wikipedia.org)
- sure to mention adenosine deaminase inhibitors such as pentostatin (Nipent). (nih.gov)
- Pentostatin (Nipent) in the treatment of chronic lymphocyte leukemia and hairy cell leukemia. (nih.gov)
- We've researched the best available deals for Pentostatin (Generic Nipent). (internetdrugcoupons.com)
- Save on Pentostatin (Generic Nipent) today! (internetdrugcoupons.com)
- Browse the free discounts and coupons below to reduce the price of Pentostatin (Generic Nipent) at your local pharmacy. (internetdrugcoupons.com)
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- Nipent may also be referred to by its drug name, pentostatin. (myleukemiateam.com)
Adenosine deaminase3
- Comment: Pentostatin is a potent inhibitor of adenosine deaminase (pegademase). (medscape.com)
- Pentostatin inhibits adenosine deaminase, resulting in deoxyadenosine and deoxyadenosine 5+-triphosphate accumulation that may inhibit DNA or RNA synthesis, causing cell death. (medscape.com)
- The adenosine deaminase (ADA) inhibitor, Pentostatin (2'-deoxycoformycin), was developed in the 1970s and was introduced to treat HCL in late 1980s [ 5 ]. (longdom.org)
Cyclophosphamide1
- The first symptoms of PML appeared immediately following the last of five cycles of rituximab, cyclophosphamide and pentostatin. (nih.gov)
Purine2
Chronic2
- Additionally, pentostatin has been used to treat steroid-refractory acute and chronic graft-versus-host disease. (wikipedia.org)
- Pentostatin is also used in chronic lymphocytic leukemia (CLL) patients who have relapsed. (wikipedia.org)
Injection1
- It is important for you to tell your doctor how you are feeling during your treatment with pentostatin injection. (medlineplus.gov)
Acute1
- Pentostatin is associated with a low rate of serum enzyme elevations during therapy and has been linked to rare instances of severe acute liver injury with jaundice. (nih.gov)
Powder1
- Pentostatin comes as a powder to be mixed with liquid and injected intravenously (into a vein) over 5 minutes or infused intravenously over 20 to 30 minutes by a doctor or nurse in a medical facility. (medlineplus.gov)
Treatment1
- The length of treatment depends on how well your body responds to treatment with pentostatin. (medlineplus.gov)
Drug1
- Anesthesia Central , anesth.unboundmedicine.com/anesthesia/view/Davis-Drug-Guide/51596/all/pentostatin. (unboundmedicine.com)