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Forodesine treatment and post-transplant graft-versus-host disease in two patients with acute leukemia: facilitation of graft-versus-leukemia effect?

Abstract
This article presents two case studies of patients diagnosed with T-cell acute lymphoblastic leukemia who relapsed following allogeneic hematopoietic stem cell transplantation and were subsequently enrolled in a clinical trial in which they received forodesine hydrochloride, a rationally designed, potent, transition-state inhibitor of purine nucleoside phosphorylase. Forodesine induced complete remission in both patients. Graft-versus-host disease developed subsequently but was treated successfully with conventional immunosuppressive therapy. Both patients remain in complete remission at the most recent follow-up. We hypothesize that forodesine contributed to a primary anti-leukemic cytotoxic effect as well as a secondary immunologic effect by allowing the development of an ongoing graft-versus-leukemia effect in these patients.
AuthorsLia Gore, Matthias Stelljes, Mattias Stelljes, Ralph Quinones
JournalSeminars in oncology (Semin Oncol) Vol. 34 Issue 6 Suppl 5 Pg. S35-9 (Dec 2007) ISSN: 0093-7754 [Print] United States
PMID18086346 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Antineoplastic Agents
  • Purine Nucleosides
  • Pyrimidinones
  • forodesine
  • Purine-Nucleoside Phosphorylase
Topics
  • Adult
  • Antineoplastic Agents (therapeutic use)
  • Child, Preschool
  • Disease-Free Survival
  • Female
  • Graft vs Leukemia Effect (drug effects)
  • Hematopoietic Stem Cell Transplantation (adverse effects)
  • Humans
  • Male
  • Neoplasm Recurrence, Local (drug therapy)
  • Precursor T-Cell Lymphoblastic Leukemia-Lymphoma (drug therapy, therapy)
  • Purine Nucleosides (therapeutic use)
  • Purine-Nucleoside Phosphorylase (antagonists & inhibitors)
  • Pyrimidinones (therapeutic use)

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