Re: [MOL] Mary Ellen! [00201] Medicine On Line


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Re: [MOL] Mary Ellen!



Mary Ellen:  I know this is a really hard time for you and your mother.  I
have gathered information regarding various  treatments for myleofibrosis.
In researching there are drugs that can be taken to lower your mother's
white cell counts.  I believe the most important thing is that your mother
is being treated at a full service cancer center and by a top doctor in this
perticular field of cancer.  Know that we are here for you and should you
have more questions, just ask.  We are not in the medical profession, just a
lot of expierence as we are either on the cancer journey, or connected to
the journey.  This is a very supportive forum and with the love and support
one receieves the freedom to rant, rave, cry and yes even laugh sometimes.
Warmly, your friend, lillian


Treatment

The use of chemotherapy, or anti-cancer drugs, usually in combinations of
two or more drugs, is largely responsible for the dramatic improvement in
managing leukemia and lymphoma. Approximately 40 different drugs are now
being used in the treatment of these diseases.

Lymphoma patients, and some patients with acute lymphocytic leukemia, also
can be treated with radiation therapy. Chemotherapy plus radiation may be
useful for select patients with lymphoma.

Bone marrow transplantation was introduced about 30 years and is now
standard therapy for selected patients with leukemia, lymphoma, and myeloma.
There are two major types of transplants: autologous and allogeneic.
Autologous transplantation uses the patient's own marrow. The marrow is
collected while the patient is in remission, and it is often treated with
chemotherapy agents or monoclonal antibodies before being given back. Such
procedures cleanse the marrow of the small proportion of leukemia and
lymphoma cells that might still be present. An allogeneic transplant uses
marrow from a normal donor, usually a brother or sister who has the same
tissue type. If a sibling is not available, a search of the National Marrow
Donor Program registry of tissue-typed volunteers could be made for a
matched unrelated donor.

Developed during the last 10 years, the technique of harvesting stem cells
from blood and from cord blood is making transplantation available for more
patients. Blood and cord blood transplants differ from marrow transplants
only in the source of the cells collected for transplant. Stem cells not
only reside in the marrow but circulate in the blood. Since blood as well as
marrow is a very good source of stem cells for transplantation, they can be
harvested from the blood of a donor, frozen and stored, and transplanted to
the patient. Stem cells circulate in large numbers in fetal blood also, and
can be recovered from umbilical cord blood after childbirth. The harvesting,
freezing and storing of "cord blood" has provided another source of stem
cells for transplantation.

Back to top.

New Approaches to Treatment

Several areas of research have resulted in new approaches to the treatment
of leukemia, lymphoma, and myeloma.

Several areas of research have resulted in new approaches to the treatment
of leukemia, lymphoma, and myeloma.

New Drug Development: Preliminary data on thalidomide for the treatment of
myeloma indicate that it can stop the progression of advanced myeloma in the
majority of patients. The FDA recently gave thalidomine (Thalomid), an
"orphan drug" designation, which clears the way for researchers to use and
evaluate thalidomide against myeloma and other cancers.

In the last decade, several very important new drugs or new uses for
existing drugs have greatly improved cure rates or remission duration for
some patients with leukemia.

              Use of interferon-alpha is an important advance in the
treatment of chronic myelogenous leukemia. Recent studies show that
combining interferon-alpha with other drugs, such as cytarabine, may lead to
further improvements in the treatment of the chronic phase of the disease.
Prolongation of the chronic phase has increased significantly in the last
decade as a result of interferon-alpha treatment.

              The treatment of hairy cell leukemia, an uncommon type of
chronic lymphocytic leukemia, has improved dramatically with the
introduction of the cladribine.

              The remission rate and duration of remission of acute
promyelocytic leukemia has been improved significantly with the introduction
of all-trans retinoic acid as a complement to chemotherapy.

Immunotherapy:This treatment is designed to enhance the ability of the
patient's immune system to suppress leukemia, lymphoma, or myeloma
progression, and to enhance the specificity of treatment to minimize toxic
effects on normal tissues. Three types of immunotherapy are being explored:
antibody treatment, immune cell administration, and vaccine development.


              Monoclonal antibodies are laboratory-produced proteins that
can be infused into an appropriate patient. Some antibodies can be made to
interact with a cell antigen and in so doing decrease the viability of the
tumor cell, leading to its death. These antibodies are sometimes called
"naked" in contrast to antibodies carrying a radioactive agent or a toxin to
kill the tumor cell to which they attach. Monoclonal antibodies are expected
to add to the arsenal of agents that can be used for the treatment of
lymphoma and leukemia patients. It is hoped that they can be added to
chemotherapy without producing many toxic side effects.


              In patients with chronic myelogenous leukemia who have
relapsed after stem cell transplantation, the infusion of donor lymphocytes
can re-induce remission. Patients with myeloma have also had remission
re-induced by donor lymphocytes. This type of treatment is being studied
intensively to learn more of the basis for this immune cell effect and to
expand it for use in other situations.

Reversal of Multidrug Resistance:The malignant cells of patients have
mechanisms that may allow them to escape the damaging effects of
chemotherapy agents. These cells are or become less responsiveness to
therapy. Approaches to reversing multidrug resistance are under study. For
example, a new agent, PSC 833, may decrease resistance to an important
chemotherapy drug used in leukemia. This agent is currently being tested in
patients with acute myelogenous leukemia and myeloma in the hope that it may
decrease drug resistance and increase the rate of response to therapy.

Gene Therapy: One approach is to use "antisense" agents that block the
encoding instructions of an oncogene so that it cannot direct the formation
of the corresponding oncoprotein that causes the cell to transform to a
malignant cell. In another approach, drugs are designed to interfere with
the oncoprotein and prevent its effect on the cell. In studies of gene
therapy for chronic myelogenous leukemia, researchers are trying to modify
an oncogene (BCR-ABL) that produces a protein that stimulates malignant cell
growth. Both approaches are being studied. These alternative treatment
strategies directly attack leukemic cells by shutting off the oncogene or
its product, the oncoprotein, and may have less toxicity on normal tissues.

Myelosuppresive Treatment


If you are overproducing blood cells, to minimize risk of complications,
some doctors will suggest trying chemotherapy such as Hydrea to control
platelets and white cell counts in patients whose marrow is overactive.
Other doctors believe that interferon is a better first line of treatment.
The problem with Hydrea is that it can depress the marrow and also increase
the risk of leukemia. However, its risks are lower than those associated
with older agents-i.e. alkylating agents such as chlorambucil or radioactive
phosphorus.

Anagrelide is a drug that lowers platelet counts. If high platelets are the
chief concern, this drug may be prescribed. It may be combined with other
drugs. Several ET patients in our mpd-net group have developed secondary
myelofibrosis while taking this drug. This is not considered chemotherapy
since anagrelide is not cytotoxic.




We invite you to take a look at our Album.
www.angelfire.com/sc/molangels/index.html

  ( Very informational, good tips, Molers pictures, art work and much
more....

----- Original Message -----
From: <MaryEllenSebelle@AOL.COM>
To: <mol-cancer@lists.meds.com>
Sent: Saturday, June 03, 2000 8:52 PM
Subject: [MOL] hi


>     my mom is in dire need of info for her co ndition..myleofibrosis(acute
> lukemia)stage..(white blood cells at 120.,000) count.  thank you
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