Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0338671 (Steroids)
 9,479 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There is general agreement that patients with advanced chronic lymphocytic leukemia (CLL) should be treated if they develop anemia or thrombocytopenia. The combination of chlorambucil (CLB) and prednisone is often used for first-line therapy of these patients, but compared to monotherapy with CLB, no difference in survival could be demonstrated. Steroids should be generally reserved, therefore, for the management of complications such as hemolytic anemia and thrombocytopenia or other autoimmune manifestations. CLB can still be considered standard therapy for advanced CLL, since polychemotherapy protocols as well as newer agents such as fludarabine have failed to show an improvement in survival compared to CLB. However, the results regarding response and survival of the CLB-treated patients seem to depend on dosage intensity and treatment duration. Biological response modifiers such as interferons, interleukins, and monoclonal antibodies have not improved responses or remission duration. Because experiences with CLL patients are limited, the indications and procedure of bone marrow transplantation are not yet clear. However, since results of current treatment protocols are unsatisfactory, regardless of age, patients should be involved in clinical studies that address the question whether high-dose CLB, fludarabine or the combination of fludarabine with other active agents can improve patients' outcome. In addition, autologous and allogeneic bone marrow transplantation as a consolidation therapy is under study and might be a step towards a potential cure of this disease.
Leukemia 1997 Apr
PMID:First-line therapy of advanced chronic lymphocytic leukemia. 917 32

A series of analogs of 1,25-dihydroxyergocalciferol (1-4) was synthesized and screened for their antiproliferative activity in vitro. The structure of new analogs was designed based on biological activity of the previously obtained side-chain modified analogs of vitamin D(2) and D(3). The analogs were obtained by the Julia olefination of C(22)-vitamin D sulfone 11 with side-chain aldehyde 15. The analogs were tested for their antiproliferative activity against the cells of human breast cancer lines T47D and MCF7 as well as human and mouse leukemia lines, HL-60 and WEHI-3, respectively. Analog 2 (PRI-1907) showed the strongest antiproliferative activity out of the present series of analogs of 1,25-dihydroxyvitamin D(2) with the mono homologated and double unsaturated side chain. The activity of 2 was 3-150 times stronger, depending on the cell line, than that of 1,25-dihydroxycholecalciferol (calcitriol), used as standard.
Steroids 2002 Aug
PMID:Synthesis and antiproliferative activity of side-chain unsaturated and homologated analogs of 1,25-dihydroxyvitamin D(2). (24E)-(1S)-24-Dehydro-24a-homo-1,25-dihydroxyergocalciferol and congeners. 1212 91

Autoimmune hemolytic anemia (AIHA) is a well known complication of chronic lymphocytic leukemia (CLL). Steroids are the first line of treatment and there are limited effective treatment options for steroid refractory AIHA of CLL. Rituximab, an active agent against B cell malignancies, has also been noted to be active in certain autoimmune hematologic disorders. We used a combination of rituximab, cyclophosphamide and dexamethasone (RCD) in eight CLL patients with steroid refractory AIHA. Rituximab was given at a dose of 375 mg/m(2) i.v. on day 1 (D-1). Cyclophosphamide was given at a dose of 750 mg/m(2) on D-2. Twelve mg of dexamethasone was given i.v. on D-1, D-2 and orally from D-3 to D-7. Cycles were repeated every 4 weeks till the best response. Response in AIHA was evaluated by frequent blood counts and Coombs test. All eight patients achieved a remission of their AIHA. Median pretreatment hemoglobin was 8.3 g/dl and post-treatment hemoglobin was 14.3 g/dl. Five patients converted to Coombs negative after RCD. Median duration of response was 13 months (7-23+). Retreatment with RCD was also effective in achieving a response on relapse of AIHA. Our results indicate that a rituximab-based combination regimen (RCD) is highly effective in treating steroid refractory AIHA of CLL.
Leukemia 2002 Oct
PMID:Rituximab-based chemotherapy for steroid-refractory autoimmune hemolytic anemia of chronic lymphocytic leukemia. 1235 62