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Research Shows Drug's Effectiveness in Battling a Usually Fatal Form of Leukemia

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April 09, 2001|THOMAS H. MAUGH II | TIMES MEDICAL WRITER

A normally fatal form of leukemia may finally have an effective treatment.

Chronic myelogenous leukemia, which affects an estimated 5,000 Americans a year, was the first distinct form of leukemia recognized, nearly 160 years ago, but it has been among the last to yield to therapy.

The best current treatment is the naturally occurring protein interferon alpha, but that drug must be injected and often produces severe side effects. Most patients also become resistant to its beneficial effects. The new drug, Glivec--also known as STI571--can be given as a once-daily pill, has few side effects and, so far, has not triggered resistance.

A team headed by Dr. Charles L. Sawyers of UCLA's Jonsson Cancer Center and Dr. Brian J. Druker of the Oregon Health Sciences University in Portland gave the drug to 54 patients with chronic myelogenous leukemia who were resistant to interferon. They reported in the April 5 issue of the New England Journal of Medicine (http://www.nejm.com) that the drug brought the white cell count back to normal--a sign of effectiveness--in 53 of the patients within four weeks.

A second paper by the team in the same journal looked at the effect of Glivec on patients whose tumor cells had mutated to the more quickly fatal form of the disease. They found that the drug produced tumor regression in about 70% of the patents, but that the effect was only transitory.

And in a third paper, Dr. George Demetri of the Dana-Farber Cancer Center in Boston and his colleagues reported on the use of Glivec to treat a woman with a rare and incurable form of gastrointestinal cancer called gastrointestinal stromal tumor, or GIST. GIST occurs in about 1,000 Americans per year, and fewer than 5% of victims respond to conventional chemotherapy.

Demetri used the drug on a 50-year-old woman whose GIST had spread to her liver and other sites in her abdomen. Six months after the study began, she showed a 70% decrease in the size of her eight largest tumors, six tumors had completely disappeared and no new tumors had arisen. The team is now using the drugs in other GIST patients as well.

Study Shows Vitamin D May Benefit MS Patients

A daily dose of 1,000 international units of vitamin D may be beneficial to patients with multiple sclerosis, according to researchers at Pennsylvania State University.

The dose produces changes in blood chemistry that indicate positive benefits for MS patients, according to Dr. Margherita Cantorna, but the therapy has not been continued long enough to determine what clinical benefits will result.

Cantorna began the study because of previous reports suggesting that sunlight may prevent MS. The disease is virtually unknown near the equator but increases in incidence with increasing latitude. One effect of sunlight is to catalyze the production of vitamin D by the skin.

Cantorna told an Orlando biology meeting last week that, in a study of 10 patients, the vitamin supplement doubled the amount of transforming growth factor beta-1, which is associated with remission and suppression of the immune response that causes MS. It also suppresses production of interleukin-2, which is associated with the cells that produce MS.

Female Smokers More at Risk for Bladder Cancer

Women who smoke are more likely to develop bladder cancer than men who smoke the same number of cigarettes, according to USC researchers.

Overall, smokers have about 2.5 times the risk of developing bladder cancer as do nonsmokers, but women have about twice the risk of men, according to Dr. J. Esteban Castelao and his colleagues.

Castelao's team studied 1,514 patients with bladder cancer in the Los Angeles area, comparing them with an equal number of closely matched people who did not have the malignancy. They reported in the April 4 Journal of the National Cancer Institute (http://jnci.oupjournals.org) that, the greater the number of cigarettes smoked, the higher the risk of bladder cancer. The risk was the same whether the cigarettes were filtered or unfiltered.

Tobacco smoke contains small quantities of 3- and 4-aminobiphenyls, which are believed to be the cause of bladder cancer in smokers. When the team analyzed blood samples from men and women smoking the same number of cigarettes daily, they found a higher level of the carcinogens in women.

Exposure to Bacterium May Ward off Allergies

Allergic diseases--including eczema, asthma and rhinitis--are becoming increasingly common in industrialized societies, and some researchers believe that the increase results from decreased exposure to bacteria during childhood. A few even speculate that deliberate exposure to certain beneficial bacteria could reverse that trend, and a new study seems to support that argument.

Dr. Marko Kalliomaki of Turku University in Finland studied the use of Lactobacillus GG, a so-called probiotic that has been shown to be safe at an early age and effective in the treatment of allergic inflammation and food allergy.

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