Abstract:
:Lymphoproliferative disorders are characterized by the abnormal accumulation of aberrant lymphocytes, which frequently interfere with the processes associated with immunologic response and hematopoiesis. Chronic lymphocytic leukemia (CLL) has traditionally been considered indolent, with a prolonged clinical course. However, a large proportion of patients with CLL have severe symptoms, a poor prognosis, and often require more immediate treatment of their leukemia. Over the last 5 years, technology has transformed the approach to treating patients with CLL. Molecular markers are now available that characterize patients with poor-risk disease who may benefit from earlier or more aggressive therapeutic intervention. Biological markers have also been identified that assist in predicting responses to specific agents and may help select an effective therapeutic approach. The advent of more targeted monoclonal antibody therapies, used in combination with chemotherapy regimens or as monotherapy, has the potential to eradicate disease to a point of undetectability by the most sensitive tests available, thereby possibly extending the goal of therapy to include a cure. Because recent data have shown that achieving minimal residual disease (MRD) in the bone marrow is one of the most important factors in predicting duration of remission, MRD may be an appropriate therapeutic end point for patients with poor-risk CLL. The use of rituximab with the cytotoxic agents cyclophosphamide and fludarabine has achieved complete remission with no detectable CLL, as assessed by MRD techniques in a significant proportion of previously untreated and previously treated CLL patients. Monotherapy with alemtuzumab has also been shown to achieve a complete response with undetectable MRD in patients with relapsed/refractory disease. This article reviews recent advances in identifying patients who have poor-risk disease and explores the potential importance of MRD status as an outcome measure of CLL therapy.
journal_name
Semin Oncoljournal_title
Seminars in oncologyauthors
Hillmen Pdoi
10.1053/j.seminoncol.2006.01.026subject
Has Abstractpub_date
2006-04-01 00:00:00pages
S23-8issue
2 Suppl 5eissn
0093-7754issn
1532-8708pii
S0093-7754(06)00058-3journal_volume
33pub_type
杂志文章,评审abstract::Many patients with Hodgkin's and non-Hodgkin's lymphoma (NHL) can be cured today with combination chemotherapy and/or radiotherapy. However, for patients with suboptimal responses to initial therapy or for patients with refractory or relapsed disease, salvage therapy alone is usually inadequate to achieve long-term su...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1998-08-01 00:00:00
abstract::Basket clinical trials are a new category of early clinical trials in which a treatment is evaluated in a population of patients with tumors of various histologic types and primary sites selected for containing specific genomic abnormalities. The objective of such studies is generally to discover histologic types in w...
journal_title:Seminars in oncology
pub_type: 杂志文章
doi:10.1053/j.seminoncol.2016.01.002
更新日期:2016-02-01 00:00:00
abstract::Acute lymphoblastic leukemia (ALL) 5-year survival rates are approaching 90% in children and 50% in adults who are receiving contemporary risk-directed treatment protocols. Current efforts focus not only on further improving cure rate but also on patient quality of life. Hence, all protocols decrease or limit the use ...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2009.05.002
更新日期:2009-08-01 00:00:00
abstract::The potential benefits of docetaxel (Taxotere; Aventis, Antony, France) to patients with previously-treated non-small cell lung cancer have been evaluated in two prospective randomized phase III trials. In one study, patients with stage IIIB/IV non-small cell lung cancer who had failed previous cisplatin-based chemoth...
journal_title:Seminars in oncology
pub_type: 杂志文章
doi:
更新日期:2001-02-01 00:00:00
abstract::Colorectal cancer (CRC) is a common malignancy in the elderly. Randomized trials have demonstrated that adjuvant and palliative chemotherapy for CRC improves survival and quality of life. Unfortunately, there is a lack of evidence-based data about elderly patients to guide decisions regarding therapy. Clinical trials ...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2008.08.004
更新日期:2008-12-01 00:00:00
abstract::Carcinoma of the bladder is the most prevalent cancer in Egypt and in most African countries. At the National Cancer Institute (NCI), Cairo, it constitutes 30.3% of all cancers. The median age at diagnosis is 46 years, with a male preponderance of 5:1. Whether in Egypt or other African countries such as Sudan, Kenya, ...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/sonc.2001.21961
更新日期:2001-04-01 00:00:00
abstract::Intraoperative lymphatic mapping and selective lymphadenectomy for solid malignancies is a novel technique, having been introduced into surgical practice in the last 12 years. Dissemination of this technique among surgeons has followed a course similar to that found with the introduction of new laparoscopic techniques...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2004.03.005
更新日期:2004-06-01 00:00:00
abstract::Complications due to cancer and its treatment are common and increase in incidence and severity as the disease progresses. Central nervous system complications affect 15% to 20% of patients, and up to 75% have bone metastases at some point during the disease process. Endocrine abnormalities include hypercalcemia, adre...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:2000-02-01 00:00:00
abstract::Pancreatic cancer is the eighth most common cancer in Europe, accounting for 4.1% of cancer deaths in men and 4.8% in women. Standardized pancreatoduodenectomy and left pancreatectomy are the gold standard for routine surgical treatment of pancreatic cancer. Total pancreatectomy should be reserved for positive pancrea...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/sonc.2002.37379
更新日期:2002-12-01 00:00:00
abstract::Radiation is an effective modality to aid in symptom management of patients with metastatic disease. The type and duration of treatment depends on the Karnofsky performance status (KPS) of the patient and type and status of the cancer. Abbreviated treatment regimens may be favored in this patient population. They prov...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2004.11.013
更新日期:2005-04-01 00:00:00
abstract::Advanced-stage mantle cell lymphoma (MCL) is a disease for which no curative treatment strategy exists. Results with standard combination chemotherapy, with or without an anthracycline, are disappointing, and new and better therapies are needed. High-dose therapy and autologous stem-cell transplantation (ASCT) have be...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章,评审
doi:
更新日期:2002-02-01 00:00:00
abstract::Hematopoietic growth factors (HGFs) continue to be the most widely prescribed class of medications for patients with myelodysplastic syndromes (MDS), despite the advent of disease-modifying therapies for MDS (eg, azacitidine, decitabine, and lenalidomide) and the current absence of an MDS-specific US Food and Drug Adm...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2011.04.014
更新日期:2011-10-01 00:00:00
abstract::As a result of the increasing effectiveness of cancer screening and preventive interventions, ethical issues, as well as legal liabilities, are increasingly associated with cancer genetic testing. These issues include the possible "duty to warn" relatives of inherited cancer risk, the appropriateness of testing of chi...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2007.07.007
更新日期:2007-10-01 00:00:00
abstract::This ongoing study was initiated to determine the feasibility of administering amifostine (Ethyol, WR-2721; MedImmune, Inc, Gaithersburg, MD) with monomodal high-dose rate (mHDR) brachytherapy and to assess the tolerability and side effects of this combination. To date, 18 patients suitable for prostate implant brachy...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2003.11.010
更新日期:2003-12-01 00:00:00
abstract::In April 1990, the Argentine Group for Treatment of Acute Leukemia began a multicenter trial for the treatment of previously untreated acute myeloblastic leukemia patients who were under 21 years of age. Initial treatment consisted of an 8-day induction phase with cytarabine together with idarubicin on days 3 to 5 and...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章,多中心研究
doi:
更新日期:1993-12-01 00:00:00
abstract::Pancreatic neoplasms are morphologically and genetically heterogeneous and include a wide variety of tumors ranging from benign to malignant with an extremely poor clinical outcome. Our understanding of these pancreatic neoplasms has improved significantly with recent advances in cancer sequencing. Awareness of molecu...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2014.12.004
更新日期:2015-02-01 00:00:00
abstract::Skin findings can serve as a clue to internal disease. In this article, cutaneous manifestations of underlying lung malignancy are reviewed. Paraneoplastic dermatoses are rare, but when recognized early, can lead to early diagnosis of an underlying neoplasm. Malignancy-associated dermatoses comprise a broad group of h...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2016.02.025
更新日期:2016-06-01 00:00:00
abstract::Pancreatic cancer is one of the most lethal neoplasms. Incidence in the United States has remained fairly stable over the past 25 years, with about 25,000 cases annually. Almost 100% of cases are fatal. Incidence in the developed world parallels that in the United States. Incidence in undeveloped nations is lower but ...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1996-04-01 00:00:00
abstract::In 2002, the American Joint Committee on Cancer (AJCC) revised the staging system for cutaneous melanoma on the basis of a survival analysis of important melanoma prognostic factors. Features of the revised system include new strata for primary tumor thickness, incorporation of primary tumor ulceration as an important...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2004.03.018
更新日期:2004-06-01 00:00:00
abstract::In a significant fraction of patients with NHL, disease develops that is resistant to conventional chemotherapy. Experience using high-dose chemotherapy, with or without TBI, and BMT is expanding. Remissions can be achieved in many patients with refractory NHL in particular those patients with tumors that are still ch...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1990-02-01 00:00:00
abstract::Spirituality can exert a tremendous impact on ones health and promote recovery from trauma and illness, including cancer. Throughout the history of mankind, spirituality and religion have played a major role in healing a variety of physical and mental illnesses. Cancer is one of the most devastating illnesses, as it a...
journal_title:Seminars in oncology
pub_type: 杂志文章
doi:10.1053/j.seminoncol.2004.11.017
更新日期:2005-04-01 00:00:00
abstract::Ifosfamide, an oxazaphosphorine analogue, is now commonly used in first-line anthracycline-containing regimens for advanced soft tissue sarcomas, based on its demonstrated single-agent activity in previously treated patients. At the Institut Gustave-Roussy, we performed a phase II study of high-dose ifosfamide without...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章
doi:
更新日期:1996-06-01 00:00:00
abstract::Phase I studies of CPT-11 (irinotecan) have been conducted in Europe, the United States, and Japan to determine the maximum tolerated dose (MTD) and the most appropriate intravenous administration schedule for further evaluation in phase II investigations. Diarrhea and/or neutropenia were the major dose-limiting toxic...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1996-02-01 00:00:00
abstract::Many small cell carcinomas share morphological and physiological characteristics with normal and neoplastic cells of Pearse's APUD series, including pulmonary APUD cells and pulmonary carcinoid tumors. There is very likely more than one type of APUD cell in the lung, and conclusions that small cell carcinomas and carc...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1978-09-01 00:00:00
abstract::Clinical research in the treatment of epithelial ovarian cancer has entered a new phase. A pivotal Gynecologic Oncology Group study demonstrated that paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) plus cisplatin was superior to the previous standard therapy of cyclophosphamide plus cisplatin. Confirma...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1997-10-01 00:00:00
abstract::Etoposide phosphate (Etopophos; Bristol-Myers Squibb Company, Princeton, NJ) is a water-soluble prodrug of etoposide that is converted in vivo by endogenous phosphatases to the active drug etoposide. This conversion process is efficient and not saturable in humans at doses between 50 and 1,600 mg/m2. The resultant eto...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1996-12-01 00:00:00
abstract::Complementary and alternative therapies are used with increasing frequency in men with prostate cancer. However, little is known about the efficacy of such therapies for this cancer. While epidemiological data support the association between intake of certain micronutrients with development of prostate cancer, there e...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/sonc.2002.50007
更新日期:2002-12-01 00:00:00
abstract::Oxaliplatin, which was recently approved by the US Food and Drug Administration for the treatment of advanced colorectal cancer, is often administered to patients with altered liver function caused by hepatic metastases. Because of the absence of data on the clearance of oxaliplatin in patients with liver dysfunction,...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/s0093-7754(03)00400-7
更新日期:2003-08-01 00:00:00
abstract::Approximately 25% of all lung cancer cases diagnosed in 1993 were due to small cell lung cancer (SCLC). Approximately one third of all SCLC patients present with limited disease. Efforts to improve treatment results for patients with limited-stage SCLC include two recent meta-analyses of combined-modality treatment in...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1998-02-01 00:00:00
abstract::Data from various phase I/II studies of carboplatin in combination with paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) have suggested that the degree of thrombocytopenia seen is less than that expected when carboplatin is given alone. However, some studies also have suggested that the area under the p...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章
doi:
更新日期:1995-10-01 00:00:00