New Drug Treatments Offer Hope to Leukemia Patients

13 minutes ago   Health - HealthDay 
 

By Dennis Thompson
HealthDay Reporter 

TUESDAY, Sept. 28 (HealthDayNews) -- Scientists call them "molecularly 
targeted" drugs, and they represent a remarkable gain in the war against 
blood cancers.


Leukemia, lymphoma and myeloma are some of the rarest yet most deadly forms 
of cancer. They account for only 2 percent to 3 percent of all cancers, but 
cause 10 percent of all cancer deaths, said Alan Kinniburgh, vice president 
of research for the Leukemia & Lymphoma Society.


These so-called "liquid cancers" cannot be surgically removed and up until 
recently have been treated with radiation and chemotherapy.


But promising new therapies all involve "molecularly targeted" drugs that 
disrupt the spread of cancer by honing in on specific mechanical processes 
that cancer cells to grow.


These breakthrough treatments merit attention in September, which is 
Leukemia & Lymphoma Awareness Month.


Kinniburgh foresees a day when these new drugs will work together to halt 
blood cancers, "all hitting the same target, but hitting the target in 
different ways so the target can't escape being killed."


An estimated 106,000 Americans were diagnosed with leukemia, lymphoma or 
myeloma last year, according to estimates by the National Cancer Institute 
(news - web sites). Another 57,500 people died from one of the diseases.


The diseases each begin with one damaged cell that turns cancerous, 
explained Hildy Dillon, vice president of patient services for the Leukemia 
& Lymphoma Society.


"They are usually the result of an acquired genetic injury to the DNA of a 
single cell, which then becomes malignant and starts to reproduce," Dillon 
said.


The blood cancers interfere with the production of healthy blood cells, 
Dillon said.


If red blood cells are affected, the person initially suffers from anemia 
and fatigue. If white blood cells are stricken, the patient initially 
suffers a high risk of infection. And since the cancers affect blood's 
ability to clot, patients also suffer unexplained bruises.


If left untreated -- or detected too late -- the blood cancers will kill.


The biggest recent leukemia breakthrough involved the drug Gleevec, which 
inhibits an enzyme that pushes cells to reproduce uncontrollably. The drug, 
which gained U.S. Food and Drug Administration (news - web sites) approval 
in 2001, has been stunningly successful in treating people with chronic 
myeloid leukemia, often returning patients' blood cell counts to near normal 
within three or four weeks.


Building on the success of Gleevec are three other new therapies that hold 
promise, Kinniburgh said.


The first involves clofarabine, a drug that disrupts DNA replication in 
cancer cells. The drug has been found in clinical trials to put about one-
quarter of acute lymphoblastic leukemia (ALL) patients and acute myeloid 
leukemia (AML) patients into remission when other treatments have failed, 
Kinniburgh said.


"That provides extra time for a patient to undergo a bone marrow or stem-
cell transplant," he said. "That's going to save children's lives." The drug 
is awaiting FDA (news - web sites) approval.


Another set of drugs undergoing clinical trials are FLT-3 inhibitors, which 
can disrupt cellular communications that spur cancer growth. Again, about 
one-quarter of patients with acute myeloid leukemia respond to the drugs, 
but those who do respond show an 80 percent to 90 percent reduction of 
cancer cells in the blood, Kinniburgh said.

  
The third drug, which Kinniburgh calls "Son of Gleevec," is an ABL-kinase 
inhibitor that targets cancer cell mutations that escape treatment with 
Gleevec. The drug, BMS-354825, is being tested in patients with chronic 
myelogenous leukemia whose bodies are resistant to Gleevec.

Doctors generally don't know what causes blood cancers. Benzene, smoking, 
radiation and the Epstein-Barr virus have all been linked to the diseases, 
but most of the time physicians have no idea why a specific person has 
contracted a blood cancer.

"Most often, there really isn't a known cause," Dillon said. "These are not 
diseases that can be prevented."

There also are multiple types of each of the diseases, which can make it 
tough for doctors to know how to proceed, Dillon said.

"The challenge is to determine the type of blood cancer a person has because 
the treatments are designed very specifically," she said. "They're beginning 
to be able to really target the specific mechanics of each of these 
different types of cancer.

Leukemia involves cancer of the bone marrow and blood cells, and strikes 
about 30,600 Americans each year. Another 21,900 die from the disease 
annually.

Lymphomas are malignancies of the lymphocites, a type of white blood cell. 
This is the most common blood cancer, afflicting 61,000 people a year and 
killing 24,700.

Myeloma affects the plasma cells, or white blood cells found primarily in 
the bone marrow. About 14,600 people are diagnosed with this disease each 
year, and another 10,900 die. 

Leukemia has a five-year survival rate of 44 percent. Lymphoma has a 52 
percent survival rate, and myeloma has a 28 percent survival rate.

Kinniburgh said all of the new drug treatments could ultimately be used in 
concert to specifically target different blood cancers, no matter how rare 
or obscure.

"With several of these agents hitting each other's cross-resistance, it's 
certainly very likely we may be able to treat all patients without radiation 
or chemotherapy," he said. "At some point the goal and the dream would be 
the drugs could be withdrawn from the patients and they would go on in 
remission."




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