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Drug makes leukemia more vulnerable to chemo
Date:3/20/2012

are addicted to in this case, the relatively normal environment of the bone marrow."

DiPersio calls the results of this study encouraging and worthy of additional exploration.

"If these results are repeated in a larger study, it would be transformative," he says. "It would change the standard way we treat these patients we would use this approach with everybody. In addition, the approach of targeting the tumor microenvironment could also be exploited for the treatment of other hematologic and solid tumor malignancies."

Bone marrow protects leukemia cells by inhibiting the cell-suicide response that might otherwise lead AML cells to self-destruct. Although leukemia cells in the bone marrow do not rapidly divide, their stability makes them very resistant to treatment. And while chemotherapy can clear the bloodstream of leukemia for a period of time, these "protected" cells in the bone marrow may cause the cancer to return.

The drug used in this study, called plerixafor, blocks the leukemia cells from attaching to the bone marrow. Released from their protective environment into the bloodstream, the cells lose the bone marrow's survival signals and begin to divide. Rapidly dividing cells are more sensitive to chemotherapy.

Plerixafor received approval from the U.S. Food and Drug Administration in 2008 for use prior to a stem cell transplant to treat patients with two other types of blood cancers: multiple myeloma and non-Hodgkin's lymphoma. In these diseases, plerixafor is used to dislodge normal stem cells from the bone marrow. Once in the bloodstream, those stem cells can then be collected for a transplant. Returning the patient's own stem cells after aggressive chemotherapy is a standard treatment for these two cancers.

"We helped in plerixafor's development for stem cell mobilization," DiPersio says. "So we thought if it makes normal stem cells leave the bone marrow to circulate, maybe it would do the same wit
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Contact: Julia Evangelou Strait
straitj@wustl.edu
314-286-0141
Washington University School of Medicine
Source:Eurekalert

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