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Alert Number 191

Steroid-Campath Combinations: A Sledgehammer To Be Used Wisely

Date: August 31, 2006

Contrary to the conventional wisdom of just a few years ago, one size does not fit all when it comes to CLL therapy. The soft-glove approach may be the right tack for some varieties of CLL, whereas going in hard and fast and not giving the cancer a chance to adapt may be the right thing to do for others.

Deletions or mutations in the important cancer controlling p53 gene predict for an aggressive variety of CLL. What is the best way to treat it? When should therapy start? What are the pros and cons? CLL Topics is proud to present an article by Dr. Andrew Pettitt, CLL expert and Consultant Hematologist at the Royal Liverpool University Hospital, on this important subject. PC and I had the pleasure of meeting Dr. Pettitt on our recent trip to the UK, and since then we have corresponded extensively with this physician, researcher, and teacher, someone who is right up there on my very short list of good guys. I think you will find his article on the use of Campath + HDMP very interesting: Steroid-Campath Combinations: A Sledgehammer To Be Used Wisely.

The tough news is that many indolent varieties of CLL gradually become more aggressive over time and as a result of chemotherapy. “p53 deletions or mutations are present in about 5% of newly diagnosed CLL patients, about 10-15% of patients requiring first-line therapy and up to a half of patients who are resistant to fludarabine-based chemotherapy” says Dr. Pettitt. Bottom line, as we travel down this CLL path, many of us are going to have to learn to deal with this p53-deleted variety of CLL. This article is an excellent place to start learning about your options.

Please join me in thanking Dr. Pettitt for taking the time to write this article for publication on CLL Topics.

Be well,


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