Seminars in hematology
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Seminars in hematology · Apr 2008
ReviewNovel and engineered anti-B-cell monoclonal antibodies for non-Hodgkin's lymphoma.
Over the past decade, the safety and efficacy of the anti-CD20 antibody rituximab has resulted in its use in virtually all patients with B-cell non-Hodgkin's lymphoma (NHL). Unfortunately, many patients who initially benefit from rituximab develop resistance while others may never respond. ⋯ Each of these strategies has shown varying degrees of preclinical and clinical success. In this review we discuss the rationale for various strategies and report results from clinical trials employing these agents.
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Seminars in hematology · Apr 2008
ReviewAntibody and immunomodulatory agents in the treatment of indolent non-Hodgkin's lymphoma.
Immunomodulatory agents, including cytokines, CpG oligonucleotides, and anti-idiotype vaccines have properties that suggest they have the ability to augment rituximab in the treatment of non-Hodgkin's lymphoma (NHL). Although several clinical trials have shown promising results, no randomized trials of reasonable size have been reported to date, limiting the ability to discern whether combinations of immunomodulatory agents with rituximab impact clinical outcome. Until such trials are mature, we do not recommend using these agents in combination outside of the research setting.
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Seminars in hematology · Apr 2008
ReviewSafety update on recombinant factor VIIa in the treatment of congenital and acquired hemophilia.
Recombinant activated factor VII (rFVIIa) appears to be safe when used for its licensed indication of congenital and acquired hemophilia A or B with inhibitors. One should carefully consider the clinical indication for which the agent is used when patient risk factors are present that might predispose the subject to a thromboembolic (TE) event, or when concomitant hemostatic agents are being used. ⋯ However, the incidence of serious TE events in hemophilia patients with inhibitors treated with rFVIIa appears to be much less than 1%. The role of rFVIIa in off-label indications should be assessed through rigorously controlled clinical trials or by analyzing carefully collected data from national and international registries.