Management of Chronic Lymphocytic Leukemia

Han, Tao; Kanti, R.

doi:10.1016/s0889-8588(18)30496-9

Cited by 10 publications

(5 citation statements)

References 49 publications

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“…Several authors have reported palliative benefits of splenic irradiation in patients with CLL, CML, polycythemia vera, and myelofibrosis. [3][4][5][6][7] In spite of the well-established palliative effects of splenic irradiation in myeloproliferative disorders, there is concern among some physicians regarding its potential toxicity. Wilson and Johnson reported severe hematologic toxicity after splenic irradiation in six of 20 patients with CML; five of these patients died.…”

Section: Discussionmentioning

confidence: 99%

Splenic irradiation in the palliation of patients with lymphoproliferative and myeloproliferative disorders

Paulino

Reddy

1996

Am J Hosp Palliat Care

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Splenic irradiation is effective in the short-term palliation of splenomegaly and pain and may be most useful in the subset of patients with a life expectancy of less than one year. Terminally ill patients with splenomegaly secondary to lymphoproliferative or myeloproliferative disorders may benefit from splenic irradiation to minimize pain and pressure symptoms in addition to possible reduction of narcotic use.

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Section: Discussionmentioning

confidence: 99%

Splenic irradiation in the palliation of patients with lymphoproliferative and myeloproliferative disorders

Paulino

Reddy

1996

Am J Hosp Palliat Care

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“…Nitrogen mustards were the earliest and most extensively studied DNA interstrand cross-linking agents [19], but only a few members of these compounds, such as melphalan and chlorambucil, are used in clinical cancer chemotherapy today [20][21][22][23]. Due to their high inert chemical activity, they can bind covalently to the nucleophilic sites of biomolecules.…”

Section: Introductionmentioning

confidence: 99%

The allylic 7-ketone at the steroidal skeleton is crucial for the antileukemic potency of chlorambucil’s active metabolite steroidal esters

et al. 2004

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We have investigated the role of the allylic 7-ketone in oxidized Delta5-steroids on antileukemic activity. We synthesized and studied a series of oxidized and non-oxidized steroidal esters of p-N,N-bis(2-chloroethyl)aminophenylacetic acid (PHE), chlorambucil's active metabolite. In a comparative study of these 7-keto derivatives, on a molecular basis, regarding their ability to induce sister chromatid exchanges (SCEs) and to inhibit cell proliferation in normal human lymphocytes in vitro, the results with these 7-keto derivatives, on a molecular basis, correlated well with their antileukemic potency against leukemia P388- and L1210-bearing mice, which proved to be significantly increased compared to that of the non-oxidized derivatives. Our results indicate that the role of the steroidal skeleton it is not only for the transportation of the alkylating agent into the cell, but also contributes directly to the mechanism of antileukemic action, by an as-yet unknown way. The main conclusion from this study is that the existence of the allylic 7-keto group in the skeleton of the Delta5-steroidal esters impressively enhances their antileukemic activity, while the toxicity remains at clinically acceptable levels, suggesting that this structural modification should be further investigated.

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“…CLL is no exception to this, as clinicians and researchers work to understand how to best manage these often indolent yet cautionary neoplasms. [4][5][6] Prior studies have examined the potential benefits of leukapheresis as a therapeutic option in CLL patients. These findings note mixed conclusions.…”

Section: Discussionmentioning

confidence: 99%

“…Newer options including monoclonal antibodies and immunomodulation now exist as alternatives to historical options of chemotherapy, radiation, splenectomy, and leukapheresis. CLL is no exception to this, as clinicians and researchers work to understand how to best manage these often indolent yet cautionary neoplasms 4‐6 …”

Section: Discussionmentioning

confidence: 99%

Therapeutic leukocytapheresis for leukostasis in chronic lymphocytic leukemia: A case report and literature review

Auen

Renavikar

Habib

et al. 2023

J of Clinical Apheresis

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Chronic lymphocytic leukemia (CLL) is a clonal mature B‐cell neoplasm with a typically indolent clinical course. Though most clinicians follow these neoplasms through observation alone, an aggressive transformation to prolymphocytic leukemia, diffuse large‐B‐cell lymphoma (Richter transformation) or classical Hodgkin lymphoma requires immediate attention. We present a case of extreme leukocytosis (>1 million/μL) in a previously diagnosed CLL patient. Due to symptomatic leukostasis, she was started on cytoreductive therapies including leukocytapheresis. After three rounds of leukocytapheresis (LCP) and concurrent chemotherapy, her white blood cell count decreased from a maximum 1262 × 103/μL to 574 × 103/μL. To our knowledge, CLL with symptomatic leukostasis that required therapeutic LCP is rarely reported in literature. We propose that therapeutic LCP is of value in such rare, yet dangerous settings like our case.

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Management of Chronic Lymphocytic Leukemia

Cited by 10 publications

References 49 publications

Splenic irradiation in the palliation of patients with lymphoproliferative and myeloproliferative disorders

Splenic irradiation in the palliation of patients with lymphoproliferative and myeloproliferative disorders

The allylic 7-ketone at the steroidal skeleton is crucial for the antileukemic potency of chlorambucil’s active metabolite steroidal esters

Therapeutic leukocytapheresis for leukostasis in chronic lymphocytic leukemia: A case report and literature review

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