Improved APL survival in developing countries

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Here is an interesting article on improved APL survival stats in developing=
countries,

http://www.hemonctoday.com/article.aspx?rid=3D51173

Its good to see treatments such as Arsenic and Retinoic Acid having a world=
wide impact on APL.

Chris

[cid:bayside.jpg]
Bayside Networks
Information Technology Service and Support

http://baysidenetworks.com

3655 Nobel Drive Suite 640
San Diego CA 92122-1052

858-654-4080 Phone
877-654-4080 Toll-free

–_000_D7CE2E25B2A8664C8B704ECE815F926F1FC9C340F3fallbrookbsnl_
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Here is an interesting article on improved APL surviva=
l
stats in developing countries,

 

http://www.hemonctoday.com/article.aspx?rid=3D51173

 

Its good to see treatments such as Arsenic and Retinoi=
c Acid
having a worldwide impact on APL.

 

Chris












Bayside Networks

Information Technology Ser=
vice and Support
http://baysidenetworks.com

3655 Nobel Drive =
Suite 640
San Diego CA 92122-1052

858-654-4080 Phone
877-654-4=
080 Toll-free


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Prominent College Offensive Coordinator Coach diagnosed with APL

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I wish Dana Bible the best for his treatment.

According to this article he is going in for 30 days of initial treatment f=
or APL:

http://www.sportingnews.com/college-football/article/2009-11-24/north-carol=

ina-nc-state-preview

[cid:bayside.jpg]
Bayside Networks
Information Technology Service and Support

http://baysidenetworks.com

3655 Nobel Drive Suite 640
San Diego CA 92122-1052

858-654-4080 Phone
877-654-4080 Toll-free

–_000_D7CE2E25B2A8664C8B704ECE815F926F1FC9C33CBFfallbrookbsnl_
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I wish Dana Bible the best for his treatment. &nb=
sp;

 

According to this article he is going in for 30 days o=
f initial
treatment for APL:

 

http://www.sportingnews.com/college-football/=
article/2009-11-24/north-carolina-nc-state-preview

 

 

 












Bayside Networks

Information Technology Ser=
vice and Support
http://baysidenetworks.com

3655 Nobel Drive =
Suite 640
San Diego CA 92122-1052

858-654-4080 Phone
877-654-4=
080 Toll-free


–_000_D7CE2E25B2A8664C8B704ECE815F926F1FC9C33CBFfallbrookbsnl_–

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Brief mention of a young APL survivor

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APL isn’t mentioned in the news very often – it’s a rare disease so that’s =
understandable. Here’s an article that briefly mentions a girl named Ashe=
ly Jones that was diagnosed and treated at 9 year’s old and is doing fine n=
ow at 14,

http://www.explorernews.com/articles/2009/11/11/news/doc4af9f3fbe35e8187370=

243.txt

[cid:bayside.jpg]
Bayside Networks
Information Technology Service and Support

http://baysidenetworks.com

3655 Nobel Drive Suite 640
San Diego CA 92122-1052

858-654-4080 Phone
877-654-4080 Toll-free

–_000_D7CE2E25B2A8664C8B704ECE815F926F1FC9C33682fallbrookbsnl_
Content-Type: text/html; charset=”us-ascii”
Content-Transfer-Encoding: quoted-printable

APL isn’t mentioned in the news very often &#821=
1; it’s
a rare disease so that’s understandable.   Here’s an =
article that
briefly mentions a girl named Ashely Jones that was diagnosed and treated a=
t 9
year’s old and is doing fine now at 14,

 

http://www.explorernews.com/articles/2009/11/11/news/doc4a=
f9f3fbe35e8187370243.txt

 

 












Bayside Networks

Information Technology Ser=
vice and Support
http://baysidenetworks.com

3655 Nobel Drive =
Suite 640
San Diego CA 92122-1052

858-654-4080 Phone
877-654-4=
080 Toll-free


–_000_D7CE2E25B2A8664C8B704ECE815F926F1FC9C33682fallbrookbsnl_–

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children with APL?

Hello everyone. My 21-month-old nephew (adjusted age 19 months) was diagnosed with APL on Saturday. I know that you will all understand our shock and grief. Here’s my question: he is at the Boston Children’s Hospital. They say they very rarely see such a young child with APL. Are there other people here with experience in this? Since I live in China, where ATRA was discovered, I am trying to contact Dr Wang Zhenyi at the Ruijin Hospital in Shanghai, to ask for a consultation on behalf of my brother’s family, since APL apparently is commoner here in China than in the West, and the hope is that he will have experience with treating such young children. Does anyone know him or have a contact for him? So far I have not been able to get through to the hospital. They have a terrible phone manner and no-one in hematology is even picking up. Thanks everyone. Didi/Beijing.

Patty’s APL Survivor Story

I’m so happy to have found this site! My name is Patty Chambers and I was diagnosed with APL November 2005, when I was 19 years old. I’m now a 21 year old college student and am currently in the “maintenance” phase of treatment (taking oral chemotherapy such as Atra, Methotrexate, and Mercatopurine). I was apart of a research study where I also got treated with Arsenic 5 times a week for 6 weeks. I am so happy that this website is dedicated to all of the people that have or have had APL, we all have gone through alot and continue to live through it everyday, atleast we have somewhere to share our own experiences.

Patty

News article about an APL survivor, Vesanoid is mentioned, Side Effects?

I’m always watching for first hand =
information from
people that have been treated for APL.     Such =
stories don’t
appear very often.  

 

This article describes a 41 yr old male named Rick =
that
experienced a lot of complications apparently from Vesanoid.   =
Seems
like any drug that is active against APL blasts can cause tremendous =
potential
problems like this.     Rick may have suffered from =
“retinoic
acid syndrome” as the blasts were being cleared.   =
Arsenic can
also cause similar side effects.

 

I’m not sure its always fair to report =
problems like
this as “Vesanoid specific” (the article doesn’t use =
is term
but the cause and effect is implied).

 

My concern is that people might read an article =
like this
and assume Vesanoid is a “bad drug.”   Well, a lot =
of
drugs including Vesanoid have potentially terrible side =
effects.  
The problem is that untreated, or poorly treated leukemia is usually =
worse than
any drug!  

 

Anita experienced some troubles while she was =
taking
Vesanoid but nothing severe like this article mentions.

 

Its nice to see that Rick is doing =
well.   I
wonder if he will also receive any Arsenic treatment?    =
Some
treatment centers are offering both Vesanoid and Arsenic for their front =
line APL
treatment regimen now.

 

h=
ttp://www.knoxnews.com/news/2009/oct/12/returning-the-favors/

 

 

Chris

 

Amazing story, leukemia and heart transplant survivor, Ironman participant

 

The next time I feel lazy or unmotivated – I =
will try
to think of this interesting guy,

 

Com=
petitor
takes on Ironman after heart transplant

 

Chris

 

The use of the word “cure” in connection with leukemia

CML is one of the few leukemias that you sometime =
hear the
word “cure” in connection with.   You also hear =
the “c”
word occasionally in connection with some of the treatment regimens for =
APL.

 

Anita has a friend that has been treated =
successfully (so
far) with Glivec so I was interested to hear this story,

 

http://www.upi.com/Top_News/2009/10/0=
7/Leukemia-drug-Australia-trials-promising/UPI-80311254947768/

 

Chris

 

An improved ability to detect residual leukemia, magnetic nanoparticles

I thought this article was interesting.  It =
discusses a
new leukemia diagnostic / detection technique that should help improve =
the
ability to detect extremely small residual amounts of leukemic =
cells.

 

I would imagine that this method might be used to =
gather a marrow
or blood sample that would then be used with a  sensitive PCR test =
for
residual leukemia.

 

http://www.modernmedicine.com/modernmedici=
ne/Pathology/Technique-May-Aid-Detection-of-Residual-Leukemia/ArticleNews=
Feed/Article/detail/632256?contextCategoryId=3D40165

 

PCR tests are sensitive to begin with and this =
technique
might be able to help make them even more sensitive.  My question =
is what should
be done with an even more sensitive detection method for leukemia =
cells?  

 

Anita’s Dr’s always seemed a bit unsure =
what to
do if a positive PCR test was to come through for her.   The =
best
answer I could ever get was that “all the Dr’s oncologists =
in our
group would talk” if a positive result came through and they would =
decide
“what do to next” together.    =

 

I actually liked the “all the Dr’s will =
talk
about what to do next” – that sounded =
reasonable.   
I think that answer is code for “We don’t know what to do if =
that
happens” but we’ll do our best to make a good =
decision.

 

My thought is that a further improvement of PCR =
sensitivity
could offer an even earlier warning of possible relapse and the need for =
more
frequent testing upon which a decision for further treatment could be =
based if
relapse became more apparent.

 

I’ll leave it up to you to find, but there is =
an
earlier article on this blog that discusses the fact that a few stray =
(apparent)
leukemia cells don’t always mean a relapse is certain.  =

 

In fact, cells that exhibit genetic markers (such =
as CD33) that
are consistent with leukemia cells are sometimes found in healthy people =
that
will never develop leukemia!   Points like this help me =
understand
why Anita’s Dr’s were loathe to explain how or what =
treatment
decision would result if a positive PCR test was to come =
in.

 

Anita is still doing fine, in her second here of =
nursing
school now.

 

Chris

 

 

How are treaments for tough diseases improved?

Occasionally someone askes me “When will they find a cure for leukemia?”
Of course this is a tremendously naive question that ignores the  tremendous improvements in treatments that have developed in the last  20 years.   I usually answer the question by trying to explain that  cancer has to be fought on hundreds of different fronts and that while  many battles have been won, the war is certainly a long way from being  over.
My answer on this type of question always felt a little bit hollow.   What exactly was a battle in this context?   Why are the survival  statistics for certain types of cancer so much better now than they  were 20 years ago?
Today, I read a short article in the health section of Slate.com  that provided a great explanation on how the treatment of juvenile  leukemia was improved from a 20% to 80% survival rate between the early  70’s and late 90’s.   From my reading across a wide variety of cancer  related subjects, I think this short article provides a good paradigm  for how health treatments are improved for just about every tough  chronic disease.
Here’s the article- http://www.slate.com/id/2193294/  (also pasted below)

Old Drugs, New Tricks Why big health advances rarely involve new medicines.
By Darshak Sanghavi
Posted Tuesday, June 10, 2008, at 1:36 PM ET

Leukaemic cells

Leukaemic cellsBetween the early 1970s and the late 1990s, the  long-term survival rate of children with leukemia skyrocketed from less  than 20 percent to around 80 percent. Over this relatively short  period, many children presumed to be dying instead ended up living. As  remarkable as the surge is the reason for it. Dr. Steve Sallan, the  chief of staff at the Dana-Farber Cancer Institute in Boston, recently  told me that not a single newly discovered drug was involved. Nobody  invented some magical genetic therapy either. So what changed?
Too often, medical advances get advertised as the work of  swashbuckling doctors and patients who take big risks against big odds  and seize miraculous results with new treatments taken straight from  the lab. That narrative is misleading. As with pediatric leukemia, the  reality often is far less dramatic but no less impressive, and therein  lie critical lessons for patients with many chronic, tough-to-treat  diseases like asthma, attention-deficit disorder, and obesity.
The leukemia doctors saved lives simply by refining the use of  old-school drugs like doxorubicin and asparaginase. Over the course of  almost a dozen clinical trials, they painstakingly varied the doses of these older drugs, evaluated the benefit of continuing  chemotherapy in some kids who appeared to be in remission, and tested  the benefit of injecting drugs directly into the spinal column. The  doctors gradually learned what drug combinations, doses, and sites of  injection worked best. And they kept at it. With each small innovation,  survival rates crept forward a bit—a few percent here and there every  couple of years—and over decades those persistent baby steps added up  to a giant leap.

Today, we’re far more likely to hear exaggerated tales of  breakthrough new drugs, aggressively marketed and hyped. But it’s the  leukemia story that’s the historical norm. Back in the early 20th century, for example—decades before the discovery of antibiotics—tuberculosis mortality fell almost 70 percent (subscription required) due largely to careful studies of nutrition and hygiene. From 1980 to 2000, death from heart disease plummeted an astonishing 50 percent,  almost entirely from the use of existing medicines and surgical  treatments. These were gradually tweaked, like leukemia therapy, in  response to scores of incremental studies. During the past 30 years,  mortality from diabetes in men also has decreased by half, largely due to improved use of flu vaccines, smoking reduction, and possibly aspirin use—but not a new blockbuster drug.
Of course, new drugs can sometimes change everything. Example: Genentech’s novel angiogenesis inhibitor Lucentis, which restored vision in patients (subscription required) with macular degeneration. But such successes  are incredibly rare and even in cases like Lucentis, often unforeseen.  (James Watson, the co-discoverer of DNA, imprudently predicted in 1998 that angiogenesis inhibitors might “cure cancer in two years”  and said nothing about their use for treating eye disease.) And in  truth, we don’t have that many new drugs to call on anyway. Last year,  for example, the U.S. Food and Drug Administration approved only 19 entirely new drugs, many of which treat pretty rare diseases or offer little benefit over older medications.
If the greatest medical advances depend mostly on small but  consistent improvements in the use of old drugs, why do certain  specialties (such as psychiatry) fall behind others (such as  cardiology) in producing major results, like a 50 percent  population-wide improvement? The difference isn’t related to a lack of  drug choices. A psychiatrist now has a bewildering array of medications  to treat, say, attention-deficit disorder or depression, just as a  cardiologist can choose from dozens of anti-hypertensive pills. And the  influence of pharma companies is roughly equivalent in both specialties.
The real problem for lagging specialties is that they possess  numerous poorly studied, often recently approved drugs instead of a  small core arsenal of older drugs that are well-understood and so can  be dosed systematically. As the experience with leukemia shows, that’s  exactly the wrong way to cure disease. Successful specialties are  anchored by centralized, rigorous professional organizations that  served, over decades, as clearinghouses for study after study aimed at  calibrating therapy. Thus, cardiologists depended on the Framingham  Heart Study and the scientific committees of the American Heart  Association, pediatric oncologists have the Children’s Oncology Group,  and children’s lung specialists have the Cystic Fibrosis Foundation.  These specialties don’t pin all their hopes on new miracle cures;  instead, they do the grunt work of incremental clinical trials with the  pills they have. And as a result, they save many lives.
That doesn’t mean duplicating these successes is easy. Just as no automaker has successfully copied Toyota’s ingrained kaizen culture (which The New Yorker’s James Surowiecki likens to a hard-to-follow “regular, sustained diet”), the incremental doggedness of certain medical subspecialties resists imitation. But the lagging subfields should try.
Doctors in these fields first should take a long, hard look at their  priorities. Lagging fields are often the scene of paralyzing turf  battles between various institutions over clinical trials. By contrast,  the more successful specialties have overcome such pettiness and forged  nationwide partnerships to churn out study after study. The successful  specialties also encourage studies that choose incremental goals over  the big score.
Old Drugs, New Tricks Why big health advances rarely involve new medicines.

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