Vol.54 No.3 May 2006
Recent development of chemotherapy for hematological malignancies
Division of Hematology and Oncology, Department of Internal Medicine,
Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, Japan
Abstract
Hematological malignancies are presently classified into leukemia, malignant lymphoma and multiple myeloma, and leukemia or malignant lymphoma are furtherly subtyped. Among recent development of treatment strategies against these diseases, treatments for chronic myelogenous leukemia (CML), acute promyelocytic leukemia (APL), diffuse large B-cell lymphoma (DLBCL) or multiple myeloma (MM) need to be highlighted. In the treatment of CML, use of inhibitor for tyrosine kinase, which deeply relates the cause of disease, drastically improved the response rate including genetic alterations and long-term survival, even potentially affecting the indication of allogeneic stem cell transplantation for CML. In APL, strong impact in therapeutic outcome have been achieved by the combination with all-trans retinoic acid, the agent targeting fusion-gene caused by specific chromosome translocation of the disease and anthracycline. In DLBCL, CHOP (cyclophosphamide, adriamycin, vincristine, and prednisolone) had been long evaluated as the standard therapy for DLBCL. However, when CHOP is combined with rituximab, a human/mouse chimera antibodies against human CD20 which is expressed more than 95% of human B-cell lymphoma, have shown statically superior therapeutic effects to CHOP alone in CR rate, disease-free survival rate and survival rate. As for MM, in addition to high dose chemotherapy with autologous stem cell transplantation, recent development in use of thalidomide or proteasome inhibitor, each possesses the novel actions of mechanisms, had brought this field to a new era.
Key word
hematological malignancy, chemotherapy, chronic myelogenous leukemia, diffuse large B-cell lymphoma
Received
August 26, 2005
Accepted
April 3, 2006
Jpn. J. Chemother. 54 (3): 221-226, 2006
