New cancer therapies. Are haematopoietic cell transplants a dead duck?

Questions concerning tyrosine kinase-inhibitor therapy and transplants in chronic phase chronic myeloid leukaemia

In this provocative commentary, we consider several questions posed by the late chronic myeloid leukaemia (CML) expert Prof. Michele Baccarani, which he challenged us to address after his death. He noted only a small proportion of people with chronic phase CML receiving tyrosine kinase-inhibitor (TKI)-therapy are likely to achieve sustained therapy-free remission (TFR) and even fewer are likely to be cured. Persons most likely to fail TKItherapy can be identified at diagnosis or soon after starting TKI-therapy. These persons are likely to need lifetime TKI-therapy with attendant risks of adverse events, cost and psychological consequences. Allogeneic transplants achieve much higher rates of leukaemia-free survival compared with TKI-therapy but are associated with transplant-related adverse events including an almost 20 percent risk of transplant-related deaths within 1 year post-transplant and a compromised quality-of-life because of complications such as chronic graft-versus-host disease. Subject-, disease- and transplant-related co-variates associated with transplant outcomes are known with reasonable accuracy. Not everyone likely to fail TKI-therapy is a transplant candidate. However, in those who candidates are physicians and patients need to weigh benefits and risks of TKI-therapy versus a transplant. We suggest transplants should be more often considered in the metric when counseling people with chronic phase CML unlikely to achieve TFR with TKI-therapy. We question whether we are discounting a possible important therapy intervention; we think so.

Doxorubicin Anticancer Drug Monitoring by ds-DNA-Based Electrochemical Biosensor in Clinical Samples

In this research, glassy carbon electrode (GCE) amplified with single-wall carbon nanotubes (SWCNTs) and ds-DNA was fabricated and utilized for voltammetric sensing of doxorubicin with a low detection limit. In this technique, the reduction in guanine signal of ds-DNA in the presence of doxorubicin (DOX) was chosen as an analytical factor. The molecular docking study revealed that the doxorubicin drug interacted with DNA through intercalation mode, which was in agreement with obtained experimental results. The DOX detection performance of ds-DNA/SWCNTs/GCE was assessed at a concentration range of 1.0 nM-20.0 µM. The detection limit was found to be 0.6 nM that was comparable and even better (in many cases) than that of previous electrochemical reported sensors. In the final step, the ds-DNA/SWCNTs/GCE showed powerful ability for determination of the DOX in injection samples with acceptable recovery data.