Beyond detectable minimal residual disease in chronic lymphocytic leukemia.

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 Oncol

journal_title

Seminars in oncology

authors

Hillmen P

doi

10.1053/j.seminoncol.2006.01.026

subject

Has Abstract

pub_date

2006-04-01 00:00:00

pages

S23-8

issue

2 Suppl 5

eissn

0093-7754

issn

1532-8708

pii

S0093-7754(06)00058-3

journal_volume

33

pub_type

杂志文章,评审
  • The role of high-dose chemotherapy in patients with Hodgkin's disease and non-Hodgkin's lymphoma.

    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:

    authors: Laport GF,Williams SF

    更新日期:1998-08-01 00:00:00

  • The Bayesian basket design for genomic variant-driven phase II trials.

    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

    authors: Simon R,Geyer S,Subramanian J,Roychowdhury S

    更新日期:2016-02-01 00:00:00

  • Central nervous system disease in hematologic malignancies: historical perspective and practical applications.

    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

    authors: Pui CH,Thiel E

    更新日期:2009-08-01 00:00:00

  • Docetaxel (Taxotere) shows survival and quality-of-life benefits in the second-line treatment of non-small cell lung cancer: A review of two phase III trials.

    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:

    authors: Shepherd FA,Fossella FV,Lynch T,Armand JP,Rigas JR,Kris MG

    更新日期:2001-02-01 00:00:00

  • Colon cancer in older adults.

    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

    authors: Raftery L,Sanoff HK,Goldberg R

    更新日期:2008-12-01 00:00:00

  • Bladder cancer in Africa: update.

    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

    authors: el-Mawla NG,el-Bolkainy MN,Khaled HM

    更新日期:2001-04-01 00:00:00

  • Training and mentoring surgeons in lymphatic mapping.

    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

    authors: Wilke LG

    更新日期:2004-06-01 00:00:00

  • Common complications of advanced cancer.

    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:

    authors: Nelson KA,Walsh D,Abdullah O,McDonnell F,Homsi J,Komurcu S,LeGrand SB,Zhukovsky DS

    更新日期:2000-02-01 00:00:00

  • Role of surgery in the treatment of bilio-pancreatic cancer: the European experience.

    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

    authors: Pedrazzoli S,Pasquali C,Sperti C

    更新日期:2002-12-01 00:00:00

  • Palliative radiation therapy.

    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

    authors: Konski A,Feigenberg S,Chow E

    更新日期:2005-04-01 00:00:00

  • Immunotherapy with rituximab following high-dose therapy and autologous stem-cell transplantation for mantle cell lymphoma.

    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:

    authors: Mangel J,Buckstein R,Imrie K,Spaner D,Crump M,Tompkins K,Reis M,Perez-Ordonez B,Deodhare S,Romans R,Pennell N,Robinson JB,Hewitt K,Richardson P,Lima A,Pavlin P,Berinstein NL

    更新日期:2002-02-01 00:00:00

  • Hematopoietic growth factors in myelodysplastic syndromes.

    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

    authors: Steensma DP

    更新日期:2011-10-01 00:00:00

  • Ethical and legal aspects of cancer genetic testing.

    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

    authors: Offit K,Thom P

    更新日期:2007-10-01 00:00:00

  • Feasibility of amifostine administration in conjunction with high-dose rate brachytherapy.

    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

    authors: Dziuk T,Senzer N

    更新日期:2003-12-01 00:00:00

  • Results of treatment with an intensive combination induction regimen containing idarubicin in children with acute myeloblastic leukemia: preliminary report of the Argentine Group for Treatment of Acute Leukemia.

    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:

    authors: Sackmann-Muriel F,Fernández-Barbieri MA,Santarelli MT,Matus-Ridley M,Rosso A,Negri-Aranguren P,Cerutti I,Gomel M,Kvicala R

    更新日期:1993-12-01 00:00:00

  • Pathological and molecular evaluation of pancreatic neoplasms.

    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

    authors: Rishi A,Goggins M,Wood LD,Hruban RH

    更新日期:2015-02-01 00:00:00

  • Cutaneous manifestations of lung cancer.

    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

    authors: Owen CE

    更新日期:2016-06-01 00:00:00

  • Epidemiology and risk factors in pancreatic cancer.

    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:

    authors: Ahlgren JD

    更新日期:1996-04-01 00:00:00

  • The new staging system for cutaneous melanoma in the era of lymphatic mapping.

    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

    authors: Rousseau DL Jr,Gershenwald JE

    更新日期:2004-06-01 00:00:00

  • The role of bone marrow transplantation in the non-Hodgkin's lymphomas.

    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:

    authors: Williams SF

    更新日期:1990-02-01 00:00:00

  • Spirituality and healing.

    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

    authors: Torosian MH,Biddle VR

    更新日期:2005-04-01 00:00:00

  • High-dose ifosfamide in the treatment of advanced soft tissue sarcomas.

    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:

    authors: Tursz T

    更新日期:1996-06-01 00:00:00

  • CPT-11: clinical experience in phase I studies.

    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:

    authors: Armand JP

    更新日期:1996-02-01 00:00:00

  • Small cell carcinoma of the lung: cellular origin and relationship to other neoplasms.

    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:

    authors: Tischler AS

    更新日期:1978-09-01 00:00:00

  • Future directions in the chemotherapy of ovarian cancer.

    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:

    authors: Ozols RF

    更新日期:1997-10-01 00:00:00

  • Early studies of etoposide phosphate, a water-soluble prodrug.

    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:

    authors: Budman DR

    更新日期:1996-12-01 00:00:00

  • Complementary and alternative therapies in prostate cancer.

    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

    authors: Oh WK,Small EJ

    更新日期:2002-12-01 00:00:00

  • Pharmacology of oxaliplatin in solid tumor patients with hepatic dysfunction: a preliminary report of the National Cancer Institute Organ Dysfunction Working Group.

    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

    authors: Doroshow JH,Synold TW,Gandara D,Mani S,Remick SC,Mulkerin D,Hamilton A,Sharma S,Ramanathan RK,Lenz HJ,Graham M,Longmate J,Takimoto CH,Ivy P

    更新日期:2003-08-01 00:00:00

  • Etoposide plus ifosfamide plus cisplatin in the treatment of small cell lung cancer.

    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:

    authors: Sandler AB

    更新日期:1998-02-01 00:00:00

  • Carboplatin in combination with paclitaxel in advanced ovarian cancer: dose determination and pharmacokinetic and pharmacodynamic interactions.

    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:

    authors: Calvert AH,Boddy A,Bailey NP,Siddiqui N,Humphreys A,Hughes A,Robson L,Gumbrell L,Thomas H,Chapman F

    更新日期:1995-10-01 00:00:00