Duvelisib was effective in reducing disease symptoms and improving QOL in this population of patients. Further research into its toxicity profile and its potential role in treating CLL are warranted.
The number of people affected by leukemia, lymphocytic, acute, l1 was estimated at 2.4 million in 2010, up from 1.6 million in 1990. In 2010, more than 443,000 Americans were living with chronic myeloid leukemia (CML) and 312,000 with CML in 2015. In 2016, about 47,500 people were living with feline leukemia virus (FeLV), about 20,000 with canine leukemia virus (CaLV), and about 15,000 with equine leukemia virus (EuLV). Cancer Prevention and Control. 2016 Feb 21;52(6):335–39.
The data suggest that EBV infection, with involvement of NK/T cells and T helper cells, may be strongly associated with primary and secondary AML, whereas other infections, including HTLV 1, may be risk factors for a subset of cases.
A complete blood count with differential shows white blood cells, red blood cells, platelets, and hematocrit. Lymphocytes and monocytes are found below normal levels. Reducing the number of white blood cells in the bloodstream increases the amount of platelets in the bloodstream, while increasing red blood cell counts increases the amount of hemoglobin. It is important to remember that bone marrow is shrinking over time and becoming less productive because of aging. Bone marrow failure is most commonly seen in people with chronic illness. The bone marrow may stop producing blood cells altogether. Blood tests for dipstick protein is also helpful in diagnosing leukemia.
Duvelisib was well tolerated and may have therapeutic potential in two of the Phase I clinical studies. Additional clinical studies are warranted in order to determine optimal dosing of this compound.
Data from a recent study provides evidence that marrow [transplant](https://www.withpower.com/clinical-tri[als](https://www.withpower.com/clinical-trials/als)/transplant)ation may be an effective therapy for most patients with AML/MDS. The overall survival rates observed In a recent study are comparable with those reported in the literature. We believe that these results support the use of hematopoietic stem cell transplantation as a therapeutic tool in the treatment of AML/MDS. We also think that further investigations of the role of transplanted bone marrow in the therapy of MDS are necessary.
Duvelisib is a potent and selective inhibitor of both BCR-ABL1 and PI3K/AKT signaling and has been shown to effectively inhibit cell growth and stimulate apoptosis in vitro and in vivo. Duvelisib was recently approved by the US Food and Drug Administration for relapsed or refractory chronic myeloid leukemia (CML), Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL), and Ph+ relapsed or refractory follicular lymphoma (FL); it is currently being investigated in combination with other agents for use in chemotherapy-naive adult B-cell chronic lymphocytic leukemias and relapsed or refractory relapsed or refractory FL.
Duvelisib was well tolerated in people with relapsed or refractory CLL who received prior systemic therapy. The most commonly reported adverse events were fatigue (40%), nausea (37%), headache (21%) and diarrhea (16%); all were mild or moderate in severity. Longer follow-up data are now awaited.
AML is a very serious disease. It has a relatively high rate of mortality (21% overall), especially if it progresses quickly (> 7 days) and involves the CNS (central nervous system). After remission, the long-term prognosis remains poor. Lymphoblastic lymphoma is a less aggressive disease that may respond well to chemotherapy. However, it has a relatively good long-term prognosis after remission. Patients with myeloid leukemias should be treated according to their disease-specific characteristics rather than the WHO classification system.
Duvelisib (RDEB573) is an inhibitor of CDK4/6 and CDK7, which are important kinases involved in the cell cycle transition.[founding drug development] It inhibits these kinases by binding between their ATP binding pockets of both CDK4/6 and CDK7. This leads to p16 and p21 expression and inhibition of G1 phase progression. Duvelisib also acts as a dual p53 specific inhibitor.
The risk factors were similar to those reported in previous studies. There was no significant difference between patients with ALL and age-matched controls in terms of development of CLL. Patients with CLL had a higher risk for developing ALL as compared to age-matched controls.