Hematologic Malignancy Drugs Flashcards
(28 cards)
What does induction mean?
high dose combination chemo
What does consolidation mean?
repetition of induction therapy during remission
What does maintenance mean?
long term, lower dose therapy during remission
What is hormesis?
adaptive response of cell to moderate, intermittent stress, that can result in cell proliferation.
What does befuzizumab do?
anti-VEGF drug that prevents angiogenesis
anthracyclines, taxanes and cyclophosphamides
can stimulate T cells. Can increase antitumor immune response, and inhibit TREG cells.
What drugs are used to treat AML?
ARA-C (pyrimidine analogue antimetabolite), thioguanine (purine antimetab), and daunorubicin (free radical generator)
What is gemtuzomab?
old unsuccessful drug. antibody against CD-33 which is almost exclusively found on myeloid blast cells. It delivers a cytotoxic chemo.
What is acute promyelocytic leukemia? What drugs are useful to treat it?
fusion of PML and RARA.
Can be treated with ATRA, which disrupts the fusion. Often combined with anthracyclines and cytarabine.
What is arsenic trioxide?
similar to ATRA. cardiovascular toxicity.
What drug is used to treat acute lymphoblastic leukemia with the philadelphia t(9;22) mutation?
imatinib. It is an oral BCR-ABL tyrosine kinase inhibitor. Few toxicities. Can be used indefinitely.
methotrexate also given.
What drugs would be used to treat inductively acute lymphoblastic leukemia?
prednisone (corticosteroid), vincristine, and anthracycline
What drugs would be used in consolidation therapy for acute lymphoblastic leukemia?
methotrexate and mercaptopurine
What drugs are used to treat acute phase myeloid leukemia?
classical chemos
What drugs are used to treat chronic phase myeloid leukemia?
imatinib. It is not very useful for acute phase however.
Nilotinib
AND
Dasatinib (both are similar to imatinib but have alternate binding geometry to counteract resistances)
How is CLL treated?
Fludarabine (antimetabolite)
Cyclophosphamide (alkylating agent)
Rituximab (anti CD20 antibody, induces complement and ADCC)
Alemtuzumab (antiCD52, on lymphos, monos, and DCs)
Bendamustine (both antimetabolite and alkylate, causes DNA crosslinking, activates p53 apoptosis and mitotic catastrophe)
How is hary cell leukemia treated?
purine analogs
AND
interferon - prolong phases of cell cycle and induce differentiation. Activate host killer T cells, macros and monos.
How are hodgkin lymphomas treated?
Usually doxarubicin (anthracycline) Vincristine (mitotic spindle inhibitor) cyclophosphamide (alkylating agent) carbazene corticosteroid
How are non-hodgkin lymphomas treated?
COMP (cyclophosphamide, vincristine, methotrexate, and prednisone)
CD20 Rituximab also effective
What is the most limiting adverse effect of hodgkin lymphoma chemo?
myelosuppression is most severe and limiting
What are adverse effects of non-hodgkin lymphoma chemo?
treatment-induced secondary malignancies
List the drugs that are monoclonal CD20 antibodies?
Rituximab
Tositumomab (radiation)
Ibritumomab (radiated)
How is Burkitt Lymphoma treated?
usually intrathecally because CNS is hard to penetrate
What is the significant toxicity of Arsenic trioxide?
acute promyelocytic leukiemia differentiation syndrome, AV block, cardiac arrythmias
