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1 Shinichiro Okamoto MD, PhD Keio University School of Medicine Tokyo Japan
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6 vincristine) Berberidaceae etoposide VP-16)
7 MRD PCR ( CR) ( CR)
8 AML Study n Ind Consol % 3 5yr CALGB 474 DA/HiDACx3 or HiDACx1, E, CTX or diaziquone, M GAMLCG 535 TAD, HAM/TAD HOVON 253 DA, AMSA A/ME ALFA 345 DA MA AMSA A; MEC ALLG 298 ICE ICE or IcEx JALSG 1,057 IA or DA MA, DA, ACR-A, A-triple-V or HiDACx
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10 / P P PI3K/Akt
11 Mylotarg (gemtuzumab ozogamicin) gemtuzumab ozogamicin internalization CD33 calicheamicin DNA
12 ATP BCR-ABL 9 9 BCR-ABL (q+) Ph (22q-) Effector X Y abl bcr Effector bcr-abl
13 CML Imatinib IRIS Study % CML ASH 2009
14 Affinity of Three TKIs to Abl Imatinib Nilotinib Dasatinib
15 III AP24534 II Dasatinib Nilotinib AP SRC ABL1 ABL1 SRC ABL1 VEGF T315I T315I E255V E255K V V299L F317L E255K V Y253F H Q252H F359V T315I E255V
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17 AML Farnesyl tranferase FLT3 P CD33 Tipifarnib PKC412 CEP-701 Bortezomib Decitabine Azacytidine Clofarabine Cloretazine Bcl-2 Oblimeresen sodium Zosuquidar GO
18 P15 P21 P15 P21 MAP P15 P210 AKT0 P15 P21 MAP MAP MAP C-KIT RAS ERK ERK PKC ERK IL ERK STAT BCR-ABL
19 ( Ph + ALL N= (3 100 (3 + (N=25 Probability (%) % % % % Including one CR after Salvage Tx + Imatinib P < P < Blood 2005; 105:
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22 JMDP) 600 Nations
23 / Probability % % 37.2% % 57.5% 46.7% 17.5% % % BBMT 14: , 2008, BMT 39; , 2007
24 AML LFS OS % 100 % 100 Leukemia-free survival Transplant group No transplant group Overall survival Transplant group No transplant group P= P= Leukemia 23: , 2009
25 Painting its brighter future
26 GVHD
27 UVAR XTS TM or CELLEX TM Photopheresis Systems
28 Extracorporeal Photopheresis (ECP)
29 A Multicenter Prospective Phase 2 Randomized Study of Extracorporeal Photopheresis for Treatment of Chronic Graft-Versus-Host Disease Median % Change in Steroid Dose By 12W 50% reduction of PSL is achieved in 20.8% ECP group vs 6.4% Control p <0.04 ECP Control Probability of a Response / p < ECP Control W2 W4 W6 W8 W10 W12 Study Week Study Week Blood 2008; 112:
30 ECP Complete and Partial Response Rate % % 65% 12 50% 43% 36% 27% 12% 7% Complete and Partial Response Rate % % 70% 24 50% 50% 47% 42% 29% 26% Original Randomized Non-ECP Cross-over Open-Label ECP Study Original Randomized ECP Crossover Open-Label ECP Study
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32 Nitch
33 G-CSF CXCR4 CD44 HA SDF- VLA-4 VCAM-1 c-kit KL MMP9 NE+ CG Plerixafor (AMD3100)
34 AMD3100 Washington University School of Medicine MD Anderson Cancer Center Dana Farber Cancer Institute Washington University School of Medicine Multicenter Multicenter Phase II. HLA plerixafor Phase I/II. plerixafor Phase I/II. AML MEC plerixafor Phase I/II. CLL plerixafor Phase I. plerixafor
35 Shh AMD3100 AMD3465 SDF-1 VEGF C CXCR4 FLT4 Notch Cell cycling p27 Kip1 PI3K/Akt & MAPK signaling mtor S6 kinase Bcl-2 expression Sorafeni b Sorafenib FLT3 KIT KL CD44 CD62L VLA-4 Natalizuma b BIO5192 VCAM-1 Osteopontin Fibronectin Collagen Hyaluronin PSGL GMI-1070 Blood 2009; 113:
36 Thank you for your attention!!
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10 1113 14 1516 1719 20 21 22 2324 25 2627 i 2829 30 31 32 33 3437 38 3941 42 4344 4547 48 4950 5152 53 5455 ii 56 5758 59 6061 iii 1 2 3 4 5 6 7 8 9 10 PFI 30 20 10 PFI 11 12 13 14 15 10 11 16 (1) 17
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2303 16 2 9 1 14 5 31 (423) 1 (4), (6) C55H84ClN17O21S3 HCl (BLM-A2) 1487.47 11 2 1 4 104 2 14 5 31 [ ] ( ) ( ) 1. 15mg 30mg( ) 5 20mL 1 5mg( ) 2. 3 15mg 30mg( ) 5mL 1mg( ) 1mL 3. 5mg 15mg( ) 4. 1 2 1
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