Annals of Oncology Advance Access originally published online on June 21, 2006
Annals of Oncology 2007 18(1):7-12; doi:10.1093/annonc/mdl129
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
© 2006 European Society for Medical Oncology
reviews |
Extramedullary disease and targeted therapies for hematological malignancies—is the association real?
1 Institute of Hematology, Rabin Medical Center, Beilinson Campus, Petah-Tikva
2 Institute of Hematology, The Chaim Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
* Correspondence to: Dr P. Raanani, Institute of Hematology, Rabin Medical Center, Beilinson Campus, Petah-Tikva 49100, Israel. Tel: +972-3-9376506; Fax: +972-3-9240145; E-mail: praanani{at}012.net.il
During the past years targeted therapies have gained a major role in the treatment of cancer patients, including those with hematological malignancies. Extramedullary involvement is a rare manifestation of acute and chronic leukemias and of multiple myeloma. Nevertheless, with the expanding use of targeted treatments there is an impression that the incidence of extramedullary relapses is increasing. We reviewed the reports on this phenomenon in patients treated with all-trans-retinoic acid and arsenic trioxide for acute promyelocytic leukemia, thalidomide and bortezomib for multiple myeloma and imatinib for chronic myeloid leukemia. The pathogenetic mechanisms suggested are: life prolongation by these treatments allowing for disease progression arising from dormant cells; poor penetration of the drugs to sanctuary sites like the central nervous system; the requirement of some of these drugs, especially thalidomide, for the marrow microenvironment to exert their action; and finally, a possible active role for some of the drugs, like all-trans-retinoic acid. Since the use of these targeted therapies is expanding we should be aware of this association.
Key words: extramedullary, targeted therapy, ATRA, thalidomide, imatinib
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. Varettoni, A. Corso, G. Pica, S. Mangiacavalli, C. Pascutto, and M. Lazzarino Incidence, presenting features and outcome of extramedullary disease in multiple myeloma: a longitudinal study on 1003 consecutive patients Ann. Onc., February 1, 2010; 21(2): 325 - 330. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Herbst, S. W. Renner, Q. S. Ringenberg, R. Fass, and R. S. Krouse Multiple Myeloma Presenting With a Colonic Obstruction and Bony Lesions: A Clinical Dilemma J. Clin. Oncol., December 1, 2008; 26(34): 5645 - 5647. [Full Text] [PDF]
|
|
|
|
 |
|
 A. Bergeron, D. Rea, V. Levy, C. Picard, V. Meignin, J. Tamburini, H. Bruzzoni-Giovanelli, F. Calvo, A. Tazi, and P. Rousselot Lung Abnormalities after Dasatinib Treatment for Chronic Myeloid Leukemia: A Case Series Am. J. Respir. Crit. Care Med., October 15, 2007; 176(8): 814 - 818. [Abstract] [Full Text] [PDF]
|
|