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Stronger therapy better for AML with normal genetics

COLUMBUS, Ohio New research is helping select which therapies improve the chances of remission in the largest category of people affected by acute myeloid leukemia (AML) those whose cancer cells have normal-looking chromosomes.

The findings suggest that people receiving more intense therapies are more likely to enter remission and to remain there longer than those receiving lower-dose therapies.

The study was published online Nov. 8 by the Journal of Clinical Oncology.

The Cancer and Leukemia Group B (CALGB) study was initiated by researchers at the Ohio State University Comprehensive Cancer Center Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSU CCC-James). It is part of a larger CALGB cytogenetic trial chaired by Clara D. Bloomfield, professor of internal medicine and the William G. Pace III Professor in Cancer Research, OSU Cancer Scholar and senior adviser to the OSU cancer program.

Unexpectedly, the current study also found that patients who had an enlarged spleen at the time of their initial treatment were less likely to enter remission. AML patients are in remission when leukemic cells are not microscopically detectable among their bone-marrow cells.

"These preliminary findings raise the question of whether additional treatment directed specifically to the spleen might improve remission rates," says first author Sherif S. Farag, assistant professor of internal medicine and a medical oncologist with the OSU CCC-James. "At this point, this is just a hypothesis that needs to be tested, but it may be that the spleen is a sanctuary site for leukemic cells and needs separate treatment."

A diagnosis of AML routinely includes studying patients' leukemic cells for chromosome damage, a process known as cytogenetic analysis. The information helps determine the best therapy and a patient's chance of remission and cure. But 40 percent of AML patients have leukemic cells wit
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Contact: Darrell E. Ward
Ward-15@medctr.osu.edu
614-293-3737
Ohio State University
29-Nov-2004


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