There have been times when it felt like I went back to being the same person. I didn't turn to God and become born again. I didn't retreat from big city life or remain vegetarian or macrobiotic. Other times I think I have been completely shaped by those experiences. I think my life has become about trying hard to move beyond the cancer.
Updated statistics with estimated new cases and deaths for 2014 (cited American Cancer Society as reference 1).
Added text to state that a characteristic genetic finding in almost 50% of the patients with T-cell large granular lymphocyte leukemia involves mutations in the signal transducer and activator of the transcription 3 gene (STAT 3) (cited Koskela et al. as reference 41).
Stage I, II, III, and IV CLL
Revised text to state that lenalidomide is an oral immunomodulatory agent with response rates over 50%, with or without rituximab, for patients with previously treated and untreated disease (cited Wendtner et al. and Badoux et al. as references 38 and 39, respectively).
Added Pettitt et al. as reference 59.
Added Gritti et al. as reference 63.
Revised text to state that in a combination regimen, subcutaneous alemtuzumab plus fludarabine (with or without cyclophosphamide) or intravenous alemtuzumab plus alkylating agents have resulted in excess infectious toxicities and death, with no compensatory improvement in efficacy in phase II trials (cited Lepretre et al. as reference 66).
Added text to state that ibrutinib is a selective irreversible inhibitor of Bruton tyrosine kinase, a signaling molecule located upstream in the B-cell receptor signaling cascade; other trials of relapsed and refractory CLL have shown durable responses to the oral agent in phase I and II studies (cited Advani et al. as reference 86 and level of evidence 3iiiDiii). A phase Ib-II trial (NCT01105247) of 85 patients with relapsed or refractory CLL showed a 26-month progression-free survival rate of 76%, including patients with 17p- or unmutated IgVH fluorescence in situ hybridization testing (cited Byrd et al. as reference 87 and level of evidence 3iiiDiii).
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May 28, 2015
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