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3 results on '"Leigh A. Gray"'

1. A phase 2 trial of combination low-dose thalidomide and prednisone for the treatment of myelofibrosis with myeloid metaplasia

Author

Scott H. Kaufmann, Ayalew Tefferi, Terra L. Reeder, Animesh Pardanani, Leigh A. Gray, Michelle A. Elliott, Ruben A. Mesa, Georgene Schroeder, Chin Yang Li, Jerome B. Zeldis, Gregory A. Wiseman, and David P. Steensma

Subjects
Male, medicine.medical_specialty, Antineoplastic Agents, Hormonal, Pancytopenia, Anemia, medicine.drug_class, medicine.medical_treatment, Immunology, Angiogenesis Inhibitors, Biochemistry, Gastroenterology, Adrenal Cortex Hormones, Prednisone, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Myelofibrosis, Adverse effect, Aged, Chemotherapy, business.industry, Cell Biology, Hematology, Middle Aged, medicine.disease, Thalidomide, Surgery, Treatment Outcome, Tolerability, Primary Myelofibrosis, Hematopoiesis, Extramedullary, Splenomegaly, Technetium Tc 99m Sulfur Colloid, Corticosteroid, Female, business, medicine.drug
Abstract

Single-agent thalidomide (THAL) at “conventional” doses (> 100 mg/d) has been evaluated in myelofibrosis with myeloid metaplasia (MMM) based on its antiangiogenic properties and the prominent neoangiogenesis that occurs in MMM. THAL monotherapy at such doses produces approximately a 20% response rate in anemia but is poorly tolerated (an adverse dropout rate of > 50% in 3 months). To improve efficacy and tolerability, we prospectively treated 21 symptomatic patients (hemoglobin level

Published
2003

2. Phase 2 trial of imatinib mesylate in myelofibrosis with myeloid metaplasia

Author

Gordon W. Dewald, Michelle A. Elliott, Leigh A. Gray, Ayalew Tefferi, Scott H. Kaufmann, Animesh Pardanani, Ruben A. Mesa, Timothy G. Call, Georgene Schroeder, John K. Camoriano, David P. Steensma, Stephen M. Ansell, Curtis A. Hanson, and Gerardo Colon-Otero

Subjects
Adult, Male, medicine.medical_specialty, Myeloid, Anemia, medicine.medical_treatment, Immunology, Neutropenia, Biochemistry, Gastroenterology, Piperazines, Colony-Forming Units Assay, hemic and lymphatic diseases, Metaplasia, Internal medicine, medicine, Humans, Enzyme Inhibitors, Myelofibrosis, Myeloid Progenitor Cells, Aged, Chemotherapy, Thrombocytosis, Dose-Response Relationship, Drug, business.industry, Cell Biology, Hematology, Middle Aged, Protein-Tyrosine Kinases, medicine.disease, Surgery, medicine.anatomical_structure, Imatinib mesylate, Pyrimidines, Primary Myelofibrosis, Benzamides, Imatinib Mesylate, Female, medicine.symptom, business
Abstract

In a phase 2 study, 23 patients with myelofibrosis with myeloid metaplasia were treated with imatinib mesylate at a constant dose of 400 mg/d. Treatment was held in 16 patients (70%), after 1 to 12 weeks, because of side effects (neutropenia, 6 patients; musculoskeletal pain, 5 patients; thrombocytosis, 4 patients; edema, 3 patients; diarrhea and hyperbilirubinemia, 1 patient). Including patients in whom retreatment at a reduced dose was possible, 11 patients (48%) were able to continue treatment beyond 3 months. None of the patients experienced a response in anemia, and only 2 had partial responses in splenomegaly. A greater than 50% increase in platelet count was documented in 11 (48%) patients, but not in those with baseline platelet counts of less than 100 × 109/L. In vitro, imatinib mesylate caused variable degrees of growth suppression of myeloid and erythroid progenitors that unfortunately did not translate into clinical benefit.

Published
2002

3. Etanercept, a soluble tumor necrosis factor receptor, palliates constitutional symptoms in patients with myelofibrosis with myeloid metaplasia: results of a pilot study

Author

Ayalew Tefferi, David P. Steensma, Ruben A. Mesa, Leigh A. Gray, and Chin Yang Li

Subjects
Male, medicine.medical_specialty, Pathology, Myeloid, Palliative care, Constitutional symptoms, medicine.medical_treatment, Immunology, Pilot Projects, Biochemistry, Gastroenterology, Receptors, Tumor Necrosis Factor, Etanercept, Metaplasia, Internal medicine, medicine, Humans, Myelofibrosis, Aged, Aged, 80 and over, Chemotherapy, business.industry, Platelet Count, Anti-Inflammatory Agents, Non-Steroidal, Cell Biology, Hematology, Middle Aged, medicine.disease, Pancytopenia, medicine.anatomical_structure, Treatment Outcome, Primary Myelofibrosis, Immunoglobulin G, Splenomegaly, medicine.symptom, business, Immunosuppressive Agents, medicine.drug
Abstract

Patients with myelofibrosis with myeloid metaplasia (MMM) often experience debilitating constitutional symptoms such as drenching night sweats, profound fatigue, unexplained fevers, and unintentional weight loss. Tumor necrosis factor (TNF) contributes to organ fibrosis and hypercatabolic symptoms in a variety of disease states. We conducted an open-label pilot study of etanercept, a soluble TNF receptor, administered at a dose of 25 mg subcutaneously twice weekly for up to 24 weeks in 22 patients with MMM. Of 20 evaluable patients, 12 (60%) experienced an improvement in constitutional symptoms, and 4 (20%) had an objective response (improvement in peripheral cytopenias or spleen size). The degree of marrow fibrosis was unchanged, and only minor changes in overall marrow cellularity were observed. Toxicity was mild, with injection site reactions (20%) and minor infections (10%) as the most common side effects. One patient developed reversible pancytopenia. Etanercept may be useful for palliation of constitutional symptoms in MMM.

Published
2002

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