Malignancies, hematologic Cancer Leukemia Lymphomas

Corticosteroids have been useful in the treatment of acute leukemia, lymphoma, multiple myeloma, and other hematologic malignancies as well as in advanced breast cancer. In addition, they are effective as supportive therapy in the management of cancer-related hypercalcemia. The steroid hormones and related agents most useful in cancer therapy are listed in Table 55-5. 

In June 1999, phase I clinical trials of OTI-010 were initiated in cancer patients receivingchemotherapy and HSC transplantation for the treatment of high-risk hematological malignancies (including acute myeloid leukemia, acute lymphoblastic leukemia, chronic myeloid leukemia and non-Hodgkin s lymphoma). The multicenter studies, conducted in seven US and European cancer centers, showed OTI-010 to be safe and efficacious, with 52% of patients ( 40 patients) responding positively to the therapy [327297], [495015]. 

Compared with untreated patients and patients treated with busulfan or hydroxyurea, interferon alfa produced a significantly higher frequency of clonal aberrant cytogenetic abnormalities and chronic clonal evolution in patients with chronic myeloid leukemia (386). However, the possible role of interferon alfa in the secondary occurrence of hematological malignancies is purely speculative. Only isolated cases of myeloproliferative syndrome, leukemia, or lymphoma have been attributed to interferon alfa (SED-13, 1098) (SEDA-20, 331) (SEDA-21, 373). There was no increased incidence of second cancers in patients treated for hairy cell leukemia (SEDA-20, 331). 

Cancer is a major health issue worldwide. The most common solid tumors are breast, colorectal, ovarian, prostate and lung cancer, which account for more than 3.2 million new cases annually, and 1.7 million deaths each year [1]. In addition, large numbers of individuals are diagnosed with and die each year from hematological malignancies such as lymphomas (>166000 new cases and 93 000 deaths, respectively) or leukemias (144000 new cases and 109000 deaths, respectively). Early detection combined with advances in surgery and external radiotherapy have improved the prognosis for many patients with solid tumors in which the disease is confined to the primary anatomical site, but the outlook for patients with advanced disseminated cancer remains poor. Lymphomas and leukemias are more... 

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