The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

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The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

(410) 955-5222

10753 Falls Road, Pavilion II, Suite 415
Lutherville, MD 21093

Acute Lymphocytic Leukemia

About this Cancer
Most commonly associated with childhood leukemia, ALL occurs in a smaller proportion of adults. This cancer of the blood progresses rapidly and affects lymphocyte cells – immune cells that include B- and T- cells.

New Treatment Approaches
Since most young adults with ALL typically do not fare as well as children with the disease, a more intensive approach to therapy is being studied through Johns Hopkins and multi-institutional clinical trials using multiple drugs and pilot studies investigating new therapies.

Combinations of experimental drugs including SNDX-275 and clofarabine are being studied at Johns Hopkins.

Johns Hopkins patients also have access to innovative clinical trials for acute leukemias and, as one of the nation’s leaders in bone marrow transplant, our clinicians have designed unique inpatient/outpatient (IPOP) programs to shorten hospital stays for select patients while maintaining the same level of expert care.

Acute Myelogenous Leukemia

About this Cancer
AML is the common type of leukemia (cancer of the blood) in adults. It occurs in myeloid cells and progresses more rapidly than chronic leukemias. Myeloid cells are a class of blood cells that develop into red and white blood cells and platelets. Though cure rates for AML remain low, Johns Hopkins hematologic oncologists are experts in treating refractory acute leukemias. Fewer than 20 percent of AML patients older than 60 survive beyond one year. Because of this, there is no standard treatment regimen and many patients opt to enroll in clinical trials.

New Treatment Approaches
Our experimental therapeutics program focuses on patients with poor-risk leukemia with the goal of increasing the number, quality and duration of remissions, cures and improvements in quality of life. Patients with poor-risk leukemia include those with complex disease, specific gene factors (mutations and deletions in certain genes), age greater than 60, development of leukemia as a secondary effect of myelodysplastic syndrome, or systemic disease. Our investigators are studying the effectiveness of blending new targeted therapies with existing treatments and methods for diagnosing and treating minimal residual disease.

--Farnesyltransferase inhibitors
Johns Hopkins Kimmel Cancer Center investigators are among the world’s experts in studying a new therapeutic class of compound called farnesyltransferase inhibitors, which block certain enzymes involved in cell-to-cell communication. Investigators at Johns Hopkins led the first study of one of these compounds in elderly patients to find that it may have an advantage for this population segment. Studies underway include determining the drug’s dosing and schedule and combinations with existing chemotherapy agents and other new targeted therapies.

--FLT3 inhibtors

Chronic Lymphocytic Leukemia

About this Cancer
CLL is a type of leukemia that leads to overproduction of certain white blood cells. It typically progresses more slowly than acute leukemias, but in certain people, the disease can become aggressive.

Current Treatments
Our doctors pioneered the technique of bone marrow transplantation and remain leaders in improving the effectiveness and safety of the procedure. They developed and studied a now widely used drug called 4H-C, which purges the bone marrow of cancer cells in autologous transplantations (when bone marrow is removed from a patient and reinfused after high-dose drug treatment). Cancer center physicians also have been successful in extending the option of allogeneic transplants (transplants using donor marrow) for patients up to the age of 65. For patients who are not candidates for allogeneic transplants, another similar treatment option offered at the Kimmel Cancer Center is stem cell transplantation, which can be performed on patients up to age 70. Stem cell transplantation involves collecting stem cells (the bone marrow cells from which blood cells arise) from the blood rather than from the bone marrow.

The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins is one of the few centers in the country that has developed an intensive inpatient/outpatient (IPOP) unit to provide extended care for transplant patients. Thus, the experienced teams of transplant physicians and nurses have reduced the length of hospitalization for many patients.

Chronic Myelogeneous Leukemia

About this Cancer
A slow growing leukemia, CML is characterized by an overgrowth of white blood cells. It occurs mainly in adults. Scientists have long known that in CML patients, chromosomes 9 and 12 fuse together to form the “Philadelphia” chromosome. The Philadelphia chromosome overproduces an enzyme called tyrosine kinase causing the bone marrow to make too many white blood cells. A drug called Gleevec was developed to block this enzyme and has become a standard therapy for the disease.

Diagnostic Tests
CML is usually diagnosed with bone marrow aspiration, which involves taking a sample of cells or tissues from the bone marrow to examine under the microscope for abnormalities. The diagnosis is usually confirmed by finding the Philadelphia chromosome in the cells. In some cases, special molecular tests are required to detect an abnormal gene known as bcr/abl, when the Philadelphia chromosome is not detected by usual methods.

Current Treatment
In May 2001, the Food and Drug Administration (FDA) approved the new drug Gleevec (also know as Glivec or STI-571) for use in patients with chronic myelogenous leukemia. This drug is considered to represent a new direction in the treatment of cancer by its ability to target only the myeloid cells and leave healthy cells unharmed. A number of centers, including the Johns Hopkins Kimmel Cancer Center, were involved in the initial studies of this drug and researchers are continuing to investigate its benefit through clinical trials.

New Treatment Approaches
For patients whose cancer returns after Gleevec therapy, Johns Hopkins investigators are studying ways to use the body’s immune system to attack the cancer using a vaccine to prime immune cells to recognize and destroy cancerous ones. Other agents that target the biologic nature of CML also are being studied.

New generations of experimental tyrosine kinase inhibitors, including the drugs nilotinib and dasatinib, also are being studied.

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