Acute Lymphocytic Leukemia: The Future

Acute Lymphocytic Leukemia: The Future

Clinical Trials
New approaches to therapy are under study in clinical trials, which permit physicians to determine the beneficial effects of new treatments and what, if any, adverse effects they have. New drugs, new types of immunotherapy and new approaches to stem cell transplantation are continually being explored to bring new and better treatments to the patient. The Society's Information Resource Center offers guidance on how patients can work with their physicians to find out if a specific clinical trial is an appropriate treatment option. Information Specialists will conduct clinical trial searches for patients, family members and healthcare professionals. Information Specialists can be called at (800) 955-4572. The service is also available on the Society's Web site at www.LLS.org.

Leukemia-Specific Therapy
Increasingly, clinical studies are identifying leukemia by more specific criteria than the appearance of the leukemia cells. These additional factors include the type of chromosome abnormality, the presence of multidrug resistance characteristics, the immunophenotype, and others. New and different drug regimens are being tested in situations that are likely to be refractory to the usual chemotherapy.
These and other new approaches, many of which are being supported by the research programs of The Leukemia & Lymphoma Society, hold the promise of increasing the rate of remission and finding cures for all blood-related cancers.

New Drug Treatments
Extensive testing is being conducted to synthesize new drugs or find them from natural (botanical) sources. These drugs are first tested for their usefulness in the laboratory and then, through the method of clinical trials, on patients. Researchers are also investigating new combinations of existing drugs for their usefulness in the treatment of leukemia, Hodgkin and non-Hodgkin lymphoma, and myeloma.

Drug Resistance
The leukemia cells of some patients are not as easily killed by drugs as those of other patients. This may lead to a failure of current treatment. Research has uncovered mechanisms in some leukemia cells that protect them from the effects of chemotherapy. As these mechanisms become better understood, ways of getting around them are being developed.

Immunotherapy
Research is being conducted on several approaches that may enhance the body's natural defenses. The goal is to kill or prevent the growth of leukemia cells. Radioimmunotherapy is an example of immunotherapy. This approach combines antibodies with attached isotopes that emit irradiation. These antibodies can be made in the laboratory. They are injected into the patient to destroy leukemia cells. Another approach uses normal lymphocytes which can attack leukemia cells because they have been immunized to recognize the leukemia cells as foreign or abnormal.

Transplantation
The use of stem cells from blood and from cord blood may make transplantation easier. These stem cells can be frozen and stored in a manner similar to a blood bank, making them available to potential recipients who do not have related (sibling) donors with similar tissue types.

Cytokines
These naturally occurring chemicals can be made commercially using the techniques of biotechnology. These chemicals can be used to help restore normal blood cells during treatment or enhance the immune system to attack the leukemia.

Oncogenes
Defining the precise changes (mutations) in DNA that cause a normal cell to be transformed into a leukemia cell is leading to the development of new therapies. These therapies could block the effects of cancer-causing genes (oncogenes) and the cancer-causing proteins that the genes direct the cells to make.

Gene Expression Profiling
Current research suggests that the use of molecular techniques, including gene expression profiling, may supplement or replace epidemiologic risk factors. These studies may also help identify molecular targets for leukemia-specific therapy. The development of laboratory methods that assess the overexpression or underexpression of genes in leukemic cells compared to normal cells can give reliable patterns of gene expression that may correlate with the outcome of treatment. The changes in gene expression may also provide targets for new therapies.

The Leukemia & Lymphoma Society