Molecular genetic advances in chronic myelogenous leukemia

Article Abstract:

Chronic myelogenous leukemia is a malignant and often fatal disease of the blood-cell-forming elements of the bone, and is characterized by an overproduction of white blood cells. The cause of the disease on the molecular level has eluded medical researchers, but recent advances in genetic research may uncover the origin of this disease. This type of leukemia is associated with an abnormality of chromosome 21, called the "Philadelphia chromosome", which is a genetic marker of the disease. Many variations of this chromosome exist, but they all share a common feature. One genetic element, called the Abelson proto-oncogene (ABL), the function of which is unknown, is moved (translocated) from a part of chromosome nine to a region on chromosome 22 called the breakpoint cluster region (BCR). In more than 99 percent of patients with chronic myelogenous leukemia, who have the Philadelphia chromosome, the breakpoint on chromosome 22 is in a very small region of DNA. As a result of this translocation, a different type of messenger RNA is produced. This new type of messenger RNA leads to the formation of an enzyme that has the ability to phosphorylate the amino acid tyrosine. Recently, a number of methods have been developed that allow the BCR-ABL translocation to be detected as a way of diagnosing chronic myelogenous leukemia. One method, called the polymerase chain reaction, permits the accurate detection of one leukemic cell per 10,000 normal cells and can be used to assess the progression of the disease, and the effectiveness of treatment. It is possible that this disease could be prevented by the insertion of genetic elements that prevent the BCR-ABL translocation from occurring. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Causes of, Genetic aspects, Molecular genetics, Myeloblastic leukemia, editorial, Nonlymphoid leukemia, Myeloid leukemia

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Cost-effectiveness of interferon-alpha and conventional chemotherapy in chronic myelogenous leukemia

Article Abstract:

Interferon-alpha appears to be cost-effective as a primary treatment for chronic myelogenous leukemia (CML) when compared with hydroxyurea. Hydroxyurea is inexpensive, of low toxicity, and can be taken orally, but rarely cures CML. Interferon-alpha is expensive, toxic, and must be injected, but occasionally produces cures. An analysis of data from four studies revealed that the average length of survival was 69 months with interferon-alpha and 58 months with hydroxyurea therapy. Although more expensive and toxic, interferon-alpha therapy proved to be more cost-effective even when quality of life was taken into account.

Chemotherapy, Chronic myeloid leukemia, Hydroxyurea

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Cost-effectiveness of 6 and 12 months of interferon-alpha therapy for chronic hepatitis C

Article Abstract:

Six months of therapy with interferon-alpha may be more cost effective than 12 months for patients with chronic hepatitis C. A decision analysis using hypothetical patients with chronic hepatitis C examined the clinical and economic outcomes of four age-specific groups either not treated, treated for 6 months, or treated for 12 months with interferon-alpha. Treatment was found to be cost effective in all groups except those older than 60 years of age. Patients with aggressive disease initially responding to treatment are more cost-effectively treated with the 12-month regimen.

Usage, Drug therapy, Hepatitis C, Cost benefit analysis

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