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	<title>APL, Information and Support</title>
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	<description>Inspired by Anita's Journey through Acute Promyelocytic Leukemia</description>
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		<title>Improved APL survival in developing countries</title>
		<link>http://www.aplblog.org/?p=110</link>
		<comments>http://www.aplblog.org/?p=110#comments</comments>
		<pubDate>Mon, 07 Dec 2009 21:45:54 +0000</pubDate>
		<dc:creator>chris</dc:creator>
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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
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Here is an interesting article on [...]]]></description>
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<p>Here is an interesting article on improved APL survival stats in developing=<br />
 countries,</p>
<p>http://www.hemonctoday.com/article.aspx?rid=3D51173</p>
<p>Its good to see treatments such as Arsenic and Retinoic Acid having a world=<br />
wide impact on APL.</p>
<p>Chris</p>
<p>[cid:bayside.jpg]<br />
Bayside Networks<br />
Information Technology Service and Support</p>
<p>http://baysidenetworks.com</p>
<p>3655 Nobel Drive Suite 640<br />
San Diego CA 92122-1052</p>
<p>858-654-4080 Phone<br />
877-654-4080 Toll-free</p>
<p>&#8211;_000_D7CE2E25B2A8664C8B704ECE815F926F1FC9C340F3fallbrookbsnl_<br />
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<p>Here is an interesting article on improved APL surviva=<br />
l<br />
stats in developing countries,</p>
<p>&nbsp;</p>
<p><a>http://www.hemonctoday.com/article.aspx?rid=3D51173</a></p>
<p>&nbsp;</p>
<p>Its good to see treatments such as Arsenic and Retinoi=<br />
c Acid<br />
having a worldwide impact on APL.</p>
<p>&nbsp;</p>
<p>Chris</p>
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		<slash:comments>4</slash:comments>
		</item>
		<item>
		<title>Prominent College Offensive Coordinator Coach diagnosed with APL</title>
		<link>http://www.aplblog.org/?p=106</link>
		<comments>http://www.aplblog.org/?p=106#comments</comments>
		<pubDate>Wed, 25 Nov 2009 16:49:28 +0000</pubDate>
		<dc:creator>chris</dc:creator>
				<category><![CDATA[Uncategorized]]></category>

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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
&#8211;_000_D7CE2E25B2A8664C8B704ECE815F926F1FC9C33CBFfallbrookbsnl_
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I wish Dana Bible the best for his treatment.&#160;&#38;nb=
sp; 
&#160;
According to [...]]]></description>
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<p>I wish Dana Bible the best for his treatment.</p>
<p>According to this article he is going in for 30 days of initial treatment f=<br />
or APL:</p>
<p>http://www.sportingnews.com/college-football/article/2009-11-24/north-carol=</p>
<p>ina-nc-state-preview</p>
<p>[cid:bayside.jpg]<br />
Bayside Networks<br />
Information Technology Service and Support</p>
<p>http://baysidenetworks.com</p>
<p>3655 Nobel Drive Suite 640<br />
San Diego CA 92122-1052</p>
<p>858-654-4080 Phone<br />
877-654-4080 Toll-free</p>
<p>&#8211;_000_D7CE2E25B2A8664C8B704ECE815F926F1FC9C33CBFfallbrookbsnl_<br />
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<p>I wish Dana Bible the best for his treatment.&nbsp;&amp;nb=<br />
sp; </p>
<p>&nbsp;</p>
<p>According to this article he is going in for 30 days o=<br />
f initial<br />
treatment for APL:</p>
<p>&nbsp;</p>
<p><a>http://www.sportingnews.com/college-football/=<br />
article/2009-11-24/north-carolina-nc-state-preview</a></p>
<p>&nbsp;</p>
<p>&nbsp;</p>
<p>&nbsp;</p>
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			<wfw:commentRss>http://www.aplblog.org/?feed=rss2&amp;p=106</wfw:commentRss>
		<slash:comments>1</slash:comments>
		</item>
		<item>
		<title>Brief mention of a young APL survivor</title>
		<link>http://www.aplblog.org/?p=104</link>
		<comments>http://www.aplblog.org/?p=104#comments</comments>
		<pubDate>Wed, 11 Nov 2009 17:09:05 +0000</pubDate>
		<dc:creator>chris</dc:creator>
				<category><![CDATA[Uncategorized]]></category>

		<guid isPermaLink="false">http://www.aplblog.org/?p=104</guid>
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APL isn&#8217;t mentioned in the news very often &#8211; it&#8217;s a rare disease so that&#8217;s =
understandable.   Here&#8217;s an article that briefly mentions a girl named Ashe=
ly Jones that was diagnosed and treated at 9 year&#8217;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 [...]]]></description>
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<p>APL isn&#8217;t mentioned in the news very often &#8211; it&#8217;s a rare disease so that&#8217;s =<br />
understandable.   Here&#8217;s an article that briefly mentions a girl named Ashe=<br />
ly Jones that was diagnosed and treated at 9 year&#8217;s old and is doing fine n=<br />
ow at 14,</p>
<p>http://www.explorernews.com/articles/2009/11/11/news/doc4af9f3fbe35e8187370=</p>
<p>243.txt</p>
<p>[cid:bayside.jpg]<br />
Bayside Networks<br />
Information Technology Service and Support</p>
<p>http://baysidenetworks.com</p>
<p>3655 Nobel Drive Suite 640<br />
San Diego CA 92122-1052</p>
<p>858-654-4080 Phone<br />
877-654-4080 Toll-free</p>
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<div>
<p>APL isn&#8217;t mentioned in the news very often &amp;#821=<br />
1; it&#8217;s<br />
a rare disease so that&#8217;s understandable.&nbsp;&nbsp; Here&#8217;s an =<br />
article that<br />
briefly mentions a girl named Ashely Jones that was diagnosed and treated a=<br />
t 9<br />
year&#8217;s old and is doing fine now at 14,</p>
<p>&nbsp;</p>
<p><a>http://www.explorernews.com/articles/2009/11/11/news/doc4a=<br />
f9f3fbe35e8187370243.txt</a></p>
<p>&nbsp;</p>
<p>&nbsp;</p>
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<DIV>Information Technology Ser=<br />
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<TD></TD><br />
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<DIV>3655 Nobel Drive =<br />
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080 Toll-free</DIV></TD></TR></TBODY></TABLE><br />
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2Y5JMxJ/7bSV8vxErZjUS8v/AElHo4FJYeKR19eIdYUAFAH/2Q==</p>
<p>&#8211;_004_D7CE2E25B2A8664C8B704ECE815F926F1FC9C33682fallbrookbsnl_&#8211;</p>
]]></content:encoded>
			<wfw:commentRss>http://www.aplblog.org/?feed=rss2&amp;p=104</wfw:commentRss>
		<slash:comments>1</slash:comments>
		</item>
		<item>
		<title>children with APL?</title>
		<link>http://www.aplblog.org/?p=90</link>
		<comments>http://www.aplblog.org/?p=90#comments</comments>
		<pubDate>Wed, 11 Nov 2009 05:07:17 +0000</pubDate>
		<dc:creator>chris</dc:creator>
				<category><![CDATA[Anita updates]]></category>

		<guid isPermaLink="false">http://www.aplblog.org/?p=90</guid>
		<description><![CDATA[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&#8217;s my question: he is at the Boston Children&#8217;s Hospital. They say they very rarely see such a young child with APL. Are there other people here with experience [...]]]></description>
			<content:encoded><![CDATA[<p>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&#8217;s my question: he is at the Boston Children&#8217;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&#8217;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.</p>
]]></content:encoded>
			<wfw:commentRss>http://www.aplblog.org/?feed=rss2&amp;p=90</wfw:commentRss>
		<slash:comments>1</slash:comments>
		</item>
		<item>
		<title>Patty&#8217;s APL Survivor Story</title>
		<link>http://www.aplblog.org/?p=91</link>
		<comments>http://www.aplblog.org/?p=91#comments</comments>
		<pubDate>Wed, 11 Nov 2009 05:06:56 +0000</pubDate>
		<dc:creator>chris</dc:creator>
				<category><![CDATA[Survivor Roll Call]]></category>

		<guid isPermaLink="false">http://www.aplblog.org/?p=91</guid>
		<description><![CDATA[I&#8217;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&#8217;m now a 21 year old college student and am currently in the &#8220;maintenance&#8221; phase of treatment (taking oral chemotherapy such as Atra, Methotrexate, and Mercatopurine). I was [...]]]></description>
			<content:encoded><![CDATA[<p>I&#8217;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&#8217;m now a 21 year old college student and am currently in the &#8220;maintenance&#8221; 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.</p>
<p>Patty</p>
]]></content:encoded>
			<wfw:commentRss>http://www.aplblog.org/?feed=rss2&amp;p=91</wfw:commentRss>
		<slash:comments>0</slash:comments>
		</item>
		<item>
		<title>News article about an APL survivor, Vesanoid is mentioned, Side Effects?</title>
		<link>http://www.aplblog.org/?p=103</link>
		<comments>http://www.aplblog.org/?p=103#comments</comments>
		<pubDate>Mon, 12 Oct 2009 17:38:35 +0000</pubDate>
		<dc:creator>chris</dc:creator>
				<category><![CDATA[Uncategorized]]></category>

		<guid isPermaLink="false">http://www.aplblog.org/?p=103</guid>
		<description><![CDATA[
I&#8217;m always watching for first hand =
information from
people that have been treated for APL.&#160;&#160;&#160;&#160; Such =
stories don&#8217;t
appear very often.&#160;&#160; 
&#160;
This article describes a 41 yr old male named Rick =
that
experienced a lot of complications apparently from Vesanoid.&#160;&#160; =
Seems
like any drug that is active against APL blasts can cause tremendous =
potential
problems like this.&#160;&#160;&#160; &#160;Rick may have [...]]]></description>
			<content:encoded><![CDATA[<div>
<p>I&#8217;m always watching for first hand =<br />
information from<br />
people that have been treated for APL.&nbsp;&nbsp;&nbsp;&nbsp; Such =<br />
stories don&#8217;t<br />
appear very often.&nbsp;&nbsp; </p>
<p>&nbsp;</p>
<p>This article describes a 41 yr old male named Rick =<br />
that<br />
experienced a lot of complications apparently from Vesanoid.&nbsp;&nbsp; =<br />
Seems<br />
like any drug that is active against APL blasts can cause tremendous =<br />
potential<br />
problems like this.&nbsp;&nbsp;&nbsp; &nbsp;Rick may have suffered from =<br />
&#8220;retinoic<br />
acid syndrome&#8221; as the blasts were being cleared.&nbsp;&nbsp; =<br />
Arsenic can<br />
also cause similar side effects.</p>
<p>&nbsp;</p>
<p>I&#8217;m not sure its always fair to report =<br />
problems like<br />
this as &#8220;Vesanoid specific&#8221; (the article doesn&#8217;t use =<br />
is term<br />
but the cause and effect is implied).</p>
<p>&nbsp;</p>
<p>My concern is that people might read an article =<br />
like this<br />
and assume Vesanoid is a &#8220;bad drug.&#8221;&nbsp;&nbsp; Well, a lot =<br />
of<br />
drugs including Vesanoid have potentially terrible side =<br />
effects.&nbsp;&nbsp;<br />
The problem is that untreated, or poorly treated leukemia is usually =<br />
worse than<br />
any drug!&nbsp;&nbsp; </p>
<p>&nbsp;</p>
<p>Anita experienced some troubles while she was =<br />
taking<br />
Vesanoid but nothing severe like this article mentions.</p>
<p>&nbsp;</p>
<p>Its nice to see that Rick is doing =<br />
well.&nbsp;&nbsp; I<br />
wonder if he will also receive any Arsenic treatment?&nbsp;&nbsp;&nbsp; =<br />
Some<br />
treatment centers are offering both Vesanoid and Arsenic for their front =<br />
line APL<br />
treatment regimen now.</p>
<p>&nbsp;</p>
<p>h=<br />
ttp://www.knoxnews.com/news/2009/oct/12/returning-the-favors/</p>
<p>&nbsp;</p>
<p>&nbsp;</p>
<p>Chris</p>
<p>&nbsp;</p>
</div>
]]></content:encoded>
			<wfw:commentRss>http://www.aplblog.org/?feed=rss2&amp;p=103</wfw:commentRss>
		<slash:comments>0</slash:comments>
		</item>
		<item>
		<title>Amazing story, leukemia and heart transplant survivor, Ironman participant</title>
		<link>http://www.aplblog.org/?p=102</link>
		<comments>http://www.aplblog.org/?p=102#comments</comments>
		<pubDate>Fri, 09 Oct 2009 16:38:35 +0000</pubDate>
		<dc:creator>chris</dc:creator>
				<category><![CDATA[Uncategorized]]></category>

		<guid isPermaLink="false">http://www.aplblog.org/?p=102</guid>
		<description><![CDATA[
&#160;
The next time I feel lazy or unmotivated &#8211; I =
will try
to think of this interesting guy,
&#160;
Com=
petitor
takes on Ironman after heart transplant
&#160;
Chris
&#160;

]]></description>
			<content:encoded><![CDATA[<div>
<p>&nbsp;</p>
<p>The next time I feel lazy or unmotivated &#8211; I =<br />
will try<br />
to think of this interesting guy,</p>
<p>&nbsp;</p>
<p>Com=<br />
petitor<br />
takes on Ironman after heart transplant</p>
<p>&nbsp;</p>
<p>Chris</p>
<p>&nbsp;</p>
</div>
]]></content:encoded>
			<wfw:commentRss>http://www.aplblog.org/?feed=rss2&amp;p=102</wfw:commentRss>
		<slash:comments>1</slash:comments>
		</item>
		<item>
		<title>The use of the word &#8220;cure&#8221; in connection with leukemia</title>
		<link>http://www.aplblog.org/?p=101</link>
		<comments>http://www.aplblog.org/?p=101#comments</comments>
		<pubDate>Thu, 08 Oct 2009 04:12:42 +0000</pubDate>
		<dc:creator>chris</dc:creator>
				<category><![CDATA[Uncategorized]]></category>

		<guid isPermaLink="false">http://www.aplblog.org/?p=101</guid>
		<description><![CDATA[
CML is one of the few leukemias that you sometime =
hear the
word &#8220;cure&#8221; in connection with.&#160;&#160; You also hear =
the &#8220;c&#8221;
word occasionally in connection with some of the treatment regimens for =
APL.
&#160;
Anita has a friend that has been treated =
successfully (so
far) with Glivec so I was interested to hear this story,
&#160;
http://www.upi.com/Top_News/2009/10/0=
7/Leukemia-drug-Australia-trials-promising/UPI-80311254947768/
&#160;
Chris
&#160;

]]></description>
			<content:encoded><![CDATA[<div>
<p>CML is one of the few leukemias that you sometime =<br />
hear the<br />
word &#8220;cure&#8221; in connection with.&nbsp;&nbsp; You also hear =<br />
the &#8220;c&#8221;<br />
word occasionally in connection with some of the treatment regimens for =<br />
APL.</p>
<p>&nbsp;</p>
<p>Anita has a friend that has been treated =<br />
successfully (so<br />
far) with Glivec so I was interested to hear this story,</p>
<p>&nbsp;</p>
<p>http://www.upi.com/Top_News/2009/10/0=<br />
7/Leukemia-drug-Australia-trials-promising/UPI-80311254947768/</p>
<p>&nbsp;</p>
<p>Chris</p>
<p>&nbsp;</p>
</div>
]]></content:encoded>
			<wfw:commentRss>http://www.aplblog.org/?feed=rss2&amp;p=101</wfw:commentRss>
		<slash:comments>1</slash:comments>
		</item>
		<item>
		<title>An improved ability to detect residual leukemia, magnetic nanoparticles</title>
		<link>http://www.aplblog.org/?p=100</link>
		<comments>http://www.aplblog.org/?p=100#comments</comments>
		<pubDate>Thu, 08 Oct 2009 04:03:58 +0000</pubDate>
		<dc:creator>chris</dc:creator>
				<category><![CDATA[Uncategorized]]></category>

		<guid isPermaLink="false">http://www.aplblog.org/?p=100</guid>
		<description><![CDATA[
I thought this article was interesting.&#160; It =
discusses a
new leukemia diagnostic / detection technique that should help improve =
the
ability to detect extremely small residual amounts of leukemic =
cells.
&#160;
I would imagine that this method might be used to =
gather a marrow
or blood sample that would then be used with a &#160;sensitive PCR test =
for
residual leukemia.
&#160;
http://www.modernmedicine.com/modernmedici=
ne/Pathology/Technique-May-Aid-Detection-of-Residual-Leukemia/ArticleNews=
Feed/Article/detail/632256?contextCategoryId=3D40165
&#160;
PCR tests [...]]]></description>
			<content:encoded><![CDATA[<div>
<p>I thought this article was interesting.&nbsp; It =<br />
discusses a<br />
new leukemia diagnostic / detection technique that should help improve =<br />
the<br />
ability to detect extremely small residual amounts of leukemic =<br />
cells.</p>
<p>&nbsp;</p>
<p>I would imagine that this method might be used to =<br />
gather a marrow<br />
or blood sample that would then be used with a &nbsp;sensitive PCR test =<br />
for<br />
residual leukemia.</p>
<p>&nbsp;</p>
<p>http://www.modernmedicine.com/modernmedici=<br />
ne/Pathology/Technique-May-Aid-Detection-of-Residual-Leukemia/ArticleNews=<br />
Feed/Article/detail/632256?contextCategoryId=3D40165</p>
<p>&nbsp;</p>
<p>PCR tests are sensitive to begin with and this =<br />
technique<br />
might be able to help make them even more sensitive.&nbsp; My question =<br />
is what should<br />
be done with an even more sensitive detection method for leukemia =<br />
cells?&nbsp;&nbsp;
</p>
<p>&nbsp;</p>
<p>Anita&#8217;s Dr&#8217;s always seemed a bit unsure =<br />
what to<br />
do if a positive PCR test was to come through for her.&nbsp;&nbsp; The =<br />
best<br />
answer I could ever get was that &#8220;all the Dr&#8217;s oncologists =<br />
in our<br />
group would talk&#8221; if a positive result came through and they would =<br />
decide<br />
&#8220;what do to next&#8221; together.&nbsp;&nbsp;&nbsp; =
</p>
<p>&nbsp;</p>
<p>I actually liked the &#8220;all the Dr&#8217;s will =<br />
talk<br />
about what to do next&#8221; &#8211; that sounded =<br />
reasonable.&nbsp;&nbsp;&nbsp;<br />
I think that answer is code for &#8220;We don&#8217;t know what to do if =<br />
that<br />
happens&#8221; but we&#8217;ll do our best to make a good =<br />
decision.</p>
<p>&nbsp;</p>
<p>My thought is that a further improvement of PCR =<br />
sensitivity<br />
could offer an even earlier warning of possible relapse and the need for =<br />
more<br />
frequent testing upon which a decision for further treatment could be =<br />
based if<br />
relapse became more apparent.</p>
<p>&nbsp;</p>
<p>I&#8217;ll leave it up to you to find, but there is =<br />
an<br />
earlier article on this blog that discusses the fact that a few stray =<br />
(apparent)<br />
leukemia cells don&#8217;t always mean a relapse is certain.&nbsp; =
</p>
<p>&nbsp;</p>
<p>In fact, cells that exhibit genetic markers (such =<br />
as CD33) that<br />
are consistent with leukemia cells are sometimes found in healthy people =<br />
that<br />
will never develop leukemia!&nbsp;&nbsp; Points like this help me =<br />
understand<br />
why Anita&#8217;s Dr&#8217;s were loathe to explain how or what =<br />
treatment<br />
decision would result if a positive PCR test was to come =<br />
in.</p>
<p>&nbsp;</p>
<p>Anita is still doing fine, in her second here of =<br />
nursing<br />
school now.</p>
<p>&nbsp;</p>
<p>Chris</p>
<p>&nbsp;</p>
<p>&nbsp;</p>
</div>
]]></content:encoded>
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		</item>
		<item>
		<title>How are treaments for tough diseases improved?</title>
		<link>http://www.aplblog.org/?p=96</link>
		<comments>http://www.aplblog.org/?p=96#comments</comments>
		<pubDate>Wed, 11 Jun 2008 04:16:00 +0000</pubDate>
		<dc:creator>chris</dc:creator>
				<category><![CDATA[APL Emerging Therapies]]></category>

		<guid isPermaLink="false">http://www.aplblog.org/?p=96</guid>
		<description><![CDATA[Occasionally someone askes me &#8220;When will they find a cure for leukemia?&#8221;
Of course this is a tremendously naive question that ignores theÂ  tremendous improvements in treatments that have developed in the lastÂ  20 years.Â Â  I usually answer the question by trying to explain thatÂ  cancer has to be fought on hundreds of different fronts and [...]]]></description>
			<content:encoded><![CDATA[<p>Occasionally someone askes me &#8220;When will they find a cure for leukemia?&#8221;<br />
Of course this is a tremendously naive question that ignores theÂ  tremendous improvements in treatments that have developed in the lastÂ  20 years.Â Â  I usually answer the question by trying to explain thatÂ  cancer has to be fought on hundreds of different fronts and that whileÂ  many battles have been won, the war is certainlyÂ a long way from beingÂ  over.<br />
My answer on this type of question always felt a little bit hollow.Â Â  What exactly was a battle in this context?Â Â Â Why are the survivalÂ  statistics for certain types of cancer so much better now than theyÂ  were 20 years ago?<br />
Today, I read a short article in the health section of Slate.comÂ  that providedÂ a great explanation on how the treatment of juvenileÂ  leukemia was improved from a 20% to 80% survival rate between the earlyÂ  70&#8217;s and late 90&#8217;s.Â Â  From my reading across a wide variety of cancerÂ  related subjects, I think this short article provides a good paradigmÂ  for how health treatments are improved for just about every toughÂ  chronic disease.<br />
Here&#8217;s theÂ article- <a href="http://www.slate.com/id/2193294/">http://www.slate.com/id/2193294/</a>Â  (also pasted below)</p>
<dl>
<dt><strong>Old Drugs, New Tricks Why big health advances rarely involve new medicines.</strong></dt>
<dd>By Darshak Sanghavi</dd>
<dd>Posted Tuesday, June 10, 2008, at 1:36 PM ET </dd>
<blockquote>
<h3>Leukaemic cells</h3>
<p><a href="http://www.slate.com/id/2193312/"><img alt="Leukaemic cells" title="Leukaemic cells" src="http://img.slate.com/media/1/123125/123104/2180680/2192953/080610_MX_LeukemiaTN.jpg" /></a>Between the early 1970s and the late 1990s, theÂ  long-term survival rate of children with leukemia skyrocketed from lessÂ  than 20 percent to around 80 percent. Over this relatively shortÂ  period, many children presumed to be dying instead ended up living. AsÂ  remarkable as the surge is the reason for it. Dr. Steve Sallan, theÂ  chief of staff at the Dana-Farber Cancer Institute in Boston, recentlyÂ  told me that not a single newly discovered drug was involved. NobodyÂ  invented some magical genetic therapy either. So what changed?<br />
Too often, medical advances get advertised as the work ofÂ  swashbuckling doctors and patients who take big risks against big oddsÂ  and seize miraculous results with new treatments taken straight fromÂ  the lab. That narrative is misleading. As with pediatric leukemia, theÂ  reality often is far less dramatic but no less impressive, and thereinÂ  lie critical lessons for patients with many chronic, tough-to-treatÂ  diseases like asthma, attention-deficit disorder, and obesity.<br />
The leukemia doctors saved lives simply by refining the use ofÂ  old-school drugs like doxorubicin and asparaginase. Over the course ofÂ  almost a dozen clinical trials, they <a target="_blank" href="http://clincancerres.aacrjournals.org/cgi/content/full/12/11/3553s">painstakingly varied</a> the doses of these older drugs, evaluated the benefit of continuingÂ  chemotherapy in some kids who appeared to be in remission, and testedÂ  the benefit of injecting drugs directly into the spinal column. TheÂ  doctors gradually learned what drug combinations, doses, and sites ofÂ  injection worked best. And they kept at it. With each small innovation,Â  survival rates crept forward a bitâ€”a few percent here and there everyÂ  couple of yearsâ€”and over decades those persistent baby steps added upÂ  to a giant leap.</p>
<p>Today, we&#8217;re far more likely to hear exaggerated tales ofÂ  breakthrough new drugs, aggressively marketed and hyped. But it&#8217;s theÂ  leukemia story that&#8217;s the historical norm. Back in the early 20th century, for exampleâ€”decades before the discovery of antibioticsâ€”tuberculosis mortality <a target="_blank" href="http://www.ajph.org/cgi/content/full/98/1/44">fell almost 70 percent</a> (subscription required) due largely to careful studies of nutrition and hygiene. From 1980 to 2000, death from heart disease <a target="_blank" href="http://content.nejm.org/cgi/content/full/356/23/2388">plummeted an astonishing 50 percent</a>,Â  almost entirely from the use of existing medicines and surgicalÂ  treatments. These were gradually tweaked, like leukemia therapy, inÂ  response to scores of incremental studies. During the past 30 years,Â  mortality from diabetes in men also has <a target="_blank" href="http://www.annals.org/cgi/content/full/0000605-200708070-00167v1">decreased by half</a>, largely due to improved use of flu vaccines, smoking reduction, and possibly aspirin useâ€”but not a new blockbuster drug.<br />
Of course, new drugs can sometimes change everything. Example: Genentech&#8217;s novel angiogenesis inhibitor Lucentis, which <a target="_blank" href="http://content.nejm.org/cgi/content/full/355/14/1493">restored vision in patients</a> (subscription required) with macular degeneration. But such successesÂ  are incredibly rare and even in cases lik