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Specific Patient Situations

Leukemia Insights - Summer 2007

The understanding of specific alterations is allowing the development of targeted clinical trials in MDS. Several MDACC studies meet this criteria:

2006-0293: The activity of lenalidomide is well accepted in patients with low and intermediate-1 risk MDS, but it is not known whether it is also active in patients with higher risk disease and a chromosome 5 alteration. This is being tested now in patients with intermediate-2 or high-risk scores. The results of this study will have implications for the treatment of patients with chromosome 5 and AML or high-risk MDS.

2005-0913: Deregulated immune responses may have a role in the pathogenesis of MDS. Pilot studies by MDACC investigators indicated that a vaccine against PR1 in HLA-A2 patients had activity in patients with advanced leukemia. We are now studying the activity of these vaccines in patients with low or intermediate-1 risk disease. This study just opened at M. D. Anderson Cancer Center and offers the possibility of potentially active therapy with minimal toxicity.

2005-0115: Patients with hypocellular MDS constitute a distinct group of patients for whom treatment with ATG may be beneficial. We are conducting a study combining rabbit ATG, cyclosporine, and growth factors for patients with aplastic anemia or hypocellular MDS. This is a group of patients whose treatment is especially complex.

2004-0468: Finally, it is not known whether there is cross-resistance between the two hypomethylating agents vidaza and dacogen. We are conducting a study with dacogen for patients that have failed vidaza therapy that will provide insights into this important question.

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