Ash 2008 - Platelets, Non-Hodgkins & Discontinuing Gleevec

[Guest guest]

Fresh off the press from ASH. 12/7/08

December 6, 2008 (San Francisco, California) - The dose of platelets given by

transfusion to cancer patients who become thrombocytopenic can be halved without

increasing the risk of bleeding, according to the results of a large study

reported here at the American Society of Hematology (ASH) 50th Annual Meeting

and Exposition. Several experts have predicted that this finding will change

clinical practice.

http://www.medscape.com/viewarticle/584896?sssdmh=dm1.411795 & src=nlconfnews & spon\

=7 & uac=

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Novel Therapy for B Cell Non-Hodgkins Lymphoma 1/207/08 (ASH)

An investigational drug with a novel mechanism of action has shown promising

activity in leukemia and lymphoma patients who were resistant to other therapies

in a phase 2 study highlighted here at the American Society of Hematology (ASH)

50th Annual Meeting and Exposition. Fostamatinib disodium is the first drug to

target the protein spleen tyrosine kinase (SYK), and is under development by

Rigel Pharmaceuticals, Inc.

http://www.medscape.com/viewarticle/584896?sssdmh=dm1.411795 & src=nlconfnews & spon\

=7 & uac=

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December 8, 2008 (San Francisco, California) - For some patients with chronic

myeloid leukemia (CML), it might be possible to discontinue imatinib mesylate

(Gleevec) after they have achieved a complete molecular remission. Research

presented here at the American Society of Hematology (ASH) 50th Annual Meeting

and Exposition confirmed the results of a pilot study that demonstrated that

remission can be sustained after imatinib is discontinued, particularly in

patients who have been pretreated with interferon.

http://www.medscape.com/viewarticle/584961?sssdmh=dm1.411795 & src=nlconfnews & spon\

=7 & uac=

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Advances in Leukemia treatment:

A. Dasatinib 100 mg orally once daily is equal in efficacy to 140 mg daily, 70

mg twice daily, or 50 mg twice daily. It is also associated with a lower

side-effect profile (including fewer pleural effusions and less

myelosuppression) than other dosing schedules for patients with CML resistant to

or intolerant of imatinib.[24]

B. The use of dasatinib 100 mg daily in patients with newly diagnosed CML

leads to a very high rate of complete cytogenetic and molecular responses at 12

months, based on a 31-patient trial conducted at MD Cancer Center.[25]

C. Both nilotinib (which is associated with longer follow-up at this point)

and bosutinib are potent, well-tolerated bcr-abl inhibitors that lead to a high

(about 55%) rate of major cytogenetic responses at 6 months in patients with

imatinib-intolerant or -refractory CML.[26,27]

The choice of which kinase inhibitor to use in patients with CML ultimately may

depend on such issues as cost and side-effect profile.

http://www.medscape.com/viewarticle/562638

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Nilotinib Therapeutic class: ANTINEOPLASTIC AGENTS

St. s Wort causes decreased effect of nilotinib.

Contraindicated Drug Combination:

Clearly contraindicated in all cases and should not be dispensed or administered

to the same patient:

See link for all drug/drug interactions:

http://www.medscape.com/druginfo/dosage?drugid=149533 & drugname=Nilotinib+Oral & mo\

notype=default

Most Severe Adverse Effects:

Anorexia, Arthralgia, Constipation, Diarrhea, Disorder of Electrolytes, Fatigue,

Fever, Flushing, Headache Disorder, Hyperbilirubinemia, Hyperglycemia,

Hyperkalemia, Hypertension, Hypocalcemia, Hypokalemia, Hypomagnesemia,

Hyponatremia, Leukopenia, Nausea, Neutropenic Disorder, Pain, Palpitations,

Pancytopenia, Pharyngitis, Prolonged QT Interval, Pruritus of Skin, Skin Rash,

Thrombocytopenic Disorder, Vertigo, Vomiting

See above link for all other side effects which are less severe.

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Most frequent side effects for Gleevec:

Most Frequent:

Abdominal Pain with Cramps, Anemia, Ascites, Back Pain, Body Fluid Retention,

Chills, Cramps, Diarrhea, Dizziness, Edema, Eye Tearing, Fever, Flatulence,

Gastrointestinal Hemorrhage, Hemorrhage, Insomnia, Myalgia, Nausea, Neutropenic

Disorder, Pericardial Effusion, Pleural Effusions, Pulmonary Edema, Skin Rash,

Thrombocytopenic Disorder, Upper Respiratory Infection, Vomiting. Web site is

same as the above information.

FYI,

Lottie