Methotrexate and cyclosporine versus cyclosporine alone for prophylaxis of graft-versus-host disease in patients given HLA-identical marrow grafts for leukemia: long-term follow-up of a controlled trial

Article Abstract:

Often there is a reaction between donor cells and patient cells when leukemia victims receive bone marrow transplants. This reaction can produce a life threatening condition, graft-versus-host disease (GVHD). One study examines the degree and severity of GVHD in bone marrow transplant patients who received their graft from a closely matched brother or sister. The patients received either an immunosuppressive drug, cyclosporine, or a combined treatment of cyclosporine and a common anticancer drug, methotrexate. Patients treated with the combined therapy had a reduction in both the incidence and severity of GVHD, and the treatment did produce an increased rate of early survival. The combined treatment did not cause impairment or loss of the transplanted marrow, nor did it affect white blood cell production and rate of entrance into the blood. However, at three years the improvement in survival was only better in patients with chronic myelocytic leukemia. Patients with nonlymphoblastic leukemia who received an early increase in survival rate with the combined treatment, experienced an increased rate of the return of their cancer.

Testing, Prevention, Methotrexate

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Influence of acute and chronic graft-versus-host disease on relapse and survival after bone marrow transplantation from HLA-identical siblings as treatment of acute and chronic leukemia

Article Abstract:

Patients with leukemia are sometimes treated with a combined therapy of anticancer drugs and radiation to destroy their bone marrow cells in the hope of eliminating their cancer. Without receiving a new source of bone marrow the treatment would be fatal. Transplantation requires that both the donor of the marrow and the patient have close tissue types. With few exception's this match can never be exact. Therefore, there is always some reaction between the donated cells and the patient's own tissue. This reaction can produce a life threatening condition, graft-versus-host disease (GVHD). A study examining the relationship of GVHD to recurrence of cancer in 1,202 subjects with various leukemias showed that patients receiving transplants in advanced stages of certain types of leukemia with acute or chronic GVHD had an increased chance of survival because the GVHD was associated with a durable antileukemic effect. Patients early in their disease with ANL or CML (in a chronic phase) had a reduced rate of survival if GVHD occurred.

Patient outcomes, Mortality

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Very low dose alpha-2b interferon for the treatment of hairy cell leukemia

Article Abstract:

Alpha-2b interferon has been highly effective in the treatment of patients with a particular form of hairy cell leukemia (HCL), but mild, flu-like side effects have been noted. Interferon is produced naturally by certain white blood cells in response to virus infection of the presence of foreign nucleic acids. The efficacy of treating patients with a lower dose of interferon alpha-2b was studied. In this study, 17 patients who had previously undergone interferon treatment were given alpha-2b interferon at a reduced dose level, which, although it induced few side effects, proved inadequate for treatment. Nonetheless, the advantages of reduced toxicity should encourage further research into low doses of interferon for the maintenance of remission in HCL.

Health aspects, Research, Drug therapy, Interferon, Immunotherapy

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