RE: High Dose Rituxan Restores Immunoglobulins

[Guest guest]

Does anyone have a layman's understanding of what this report is stating?

Are the Serum Globlins normally reported as part of a Liver Function Blood

test?

Regards

_____

From: [mailto: ] On

Behalf Of Ann

Sent: 10 January 2008 04:37

Subject: High Dose Rituxan Restores Immunoglobulins

Serum globulins as marker of immune restoration after treatment with

high-dose rituximab for chronic lymphocytic leukemia.

Doru T andrescu and H Wiernik

Med Oncol, January 5, 2008; . Abstract

Comprehensive Cancer Center, Our Lady of Mercy Medical Center, New

York Medical College, 600 East 233rd Street, Bronx, NY, 10466, USA,

mddoruhotmail (DOT) <mailto:mddoru%40hotmail.com> com.

An important biological alteration in chronic lymphocytic leukemia

(CLL) is the dysregulation of immunoglobulin production, as a

consequence of complex and yet incompletely understood interactions

between plasma cells and the neoplastic B-cell clone. As a result,

most patients develop severe hypogammaglobulinemia during the course

of the disease. Fourteen patients were analyzed retrospectively for

changes in globulins produced by antineoplastic treatments. During

maximum response to fludarabine, chlorambucil, and overall rituximab,

the mean levels of globulins were 2.500, 2.752, and 3.018 g/dl. The

mean increase in globulins during clinical response to individual

treatments compared to pre-treatment values were 0.050 g/dl for

fludarabine, 0.302 g/dl for chlorambucil, 0.267 g/dl for low-dose

rituximab, and 0.346 g/dl for high-dose rituximab. Overall, treatment

with rituximab produced an average increase in globulins at clinical

response of 11.6%, which increased further to 17.3% at maximum

clinical response. Serum globulins increased significantly compared

with pre-treatment values at maximum clinical response to rituximab

overall (P = 0.001) and high-dose rituximab (P = 0.001), but no

statistical significance occurred in the cases of fludarabine (P =

0.5), chlorambucil/prednisone (P = 0.14), and low-dose rituximab (P =

0.07). Serum globulins levels correlate with disease status (complete

responders versus partial responders and stable disease groups), but

not with peripheral neoplastic load. Therefore, although rituximab is

efficient in decreasing the tumor burden, additional mechanisms may

be involved in relieving suppressive effects on immunoglobulin-

producing cells, which especially manifest at high doses of the

agent. Use of high doses of rituximab in CLL can avoid T-cell

dysfunction and neutropenia, and is associated with humoral

immunorestorative effects.

PMID: 18176848

[Guest guest]

Serum globulins refer to proteins in the blood; the

one we are most familiar with are the immunoglobulins

such as IgG, IgA, etc. These are antibody complexes.

Here is an explanation (I didn't read through it, but

it seems accurate):

http://en.wikipedia.org/wiki/Immunoglobulin

All CLL patients by definition have an impaired immune

system. For an unknown reason, the cancer cells

somehow depress the immune system to a great extent.

This article logically looks at immune system recovery

after treatment with three CLL drugs, fludarabine,

rituximab, and chlorambucil.

Rituximab seems to show the best result in terms of

immune system reconstitution after treatment.

--- " @charitydalek " <robert@...>

wrote:

> Does anyone have a layman's understanding of what

> this report is stating?

> Are the Serum Globlins normally reported as part of

> a Liver Function Blood

> test?

>

>

>

> Regards

>

>

>

>

>

> _____

>

> From:

> [mailto: ] On

> Behalf Of Ann

> Sent: 10 January 2008 04:37

>

> Subject: High Dose Rituxan Restores

> Immunoglobulins

>

>

>

> Serum globulins as marker of immune restoration

> after treatment with

> high-dose rituximab for chronic lymphocytic

> leukemia.

> Doru T andrescu and H Wiernik

> Med Oncol, January 5, 2008; . Abstract

>

> Comprehensive Cancer Center, Our Lady of Mercy

> Medical Center, New

> York Medical College, 600 East 233rd Street, Bronx,

> NY, 10466, USA,

> mddoruhotmail (DOT) <mailto:mddoru%40hotmail.com> com.

>

> An important biological alteration in chronic

> lymphocytic leukemia

> (CLL) is the dysregulation of immunoglobulin

> production, as a

> consequence of complex and yet incompletely

> understood interactions

> between plasma cells and the neoplastic B-cell

> clone. As a result,

> most patients develop severe hypogammaglobulinemia

> during the course

> of the disease. Fourteen patients were analyzed

> retrospectively for

> changes in globulins produced by antineoplastic

> treatments. During

> maximum response to fludarabine, chlorambucil, and

> overall rituximab,

> the mean levels of globulins were 2.500, 2.752, and

> 3.018 g/dl. The

> mean increase in globulins during clinical response

> to individual

> treatments compared to pre-treatment values were

> 0.050 g/dl for

> fludarabine, 0.302 g/dl for chlorambucil, 0.267 g/dl

> for low-dose

> rituximab, and 0.346 g/dl for high-dose rituximab.

> Overall, treatment

> with rituximab produced an average increase in

> globulins at clinical

> response of 11.6%, which increased further to 17.3%

> at maximum

> clinical response. Serum globulins increased

> significantly compared

> with pre-treatment values at maximum clinical

> response to rituximab

> overall (P = 0.001) and high-dose rituximab (P =

> 0.001), but no

> statistical significance occurred in the cases of

> fludarabine (P =

> 0.5), chlorambucil/prednisone (P = 0.14), and

> low-dose rituximab (P =

> 0.07). Serum globulins levels correlate with disease

> status (complete

> responders versus partial responders and stable

> disease groups), but

> not with peripheral neoplastic load. Therefore,

> although rituximab is

> efficient in decreasing the tumor burden, additional

> mechanisms may

> be involved in relieving suppressive effects on

> immunoglobulin-

> producing cells, which especially manifest at high

> doses of the

> agent. Use of high doses of rituximab in CLL can

> avoid T-cell

> dysfunction and neutropenia, and is associated with

> humoral

> immunorestorative effects.

> PMID: 18176848

>

>

>

>

>

>

>

> [Non-text portions of this message have been

> removed]

>

>

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