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884    Part VII  Hematologic Malignancies


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        life-threatening  condition  when  relapsed  would  be  better  treated   mustine,  bortezomib,  and  rituximab  for  patients  with  relapsed/
        with curative intent. Strategies for aggressive, resistant, or relapsed   refractory  indolent  and  mantle  cell  non-Hodgkin  lymphoma.  Blood
        disease  will  likely  require  inclusion  of  multiple  agents  of  different   17(10):2807–2812, 2011.
        generations  and  mechanisms  of  action.  Current  clinical  trials  are   12.  Roberts AW, Seymour JF, Brown JR, et al: Substantial susceptibility of
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        may achieve sufficient disease control to achieve disease eradication   13.  Tong WG, Chen R, Plunkett W, et al: Phase I and pharmacologic study
        and cure in a larger number of patients. Researchers and clinicians   of SNS-032, a potent and selective Cdk2, 7, and 9 inhibitor, in patients
        will need to also take into account the cost of these therapies and their   with  advanced  chronic  lymphocytic  leukemia  and  multiple  myeloma.
        impact on quality of life, particularly as several target-based agents   J  Clin  Oncol  28:3015,  2010.  [Epub  2010  May  17].  PubMed  PMID:
        have been demonstrated to have activity as maintenance therapies.   20479412.
        The  long-term  effects  of  many  of  these  agents  are  still  unknown.   14.  Chen R, Wierda WG, Chubb S, et al: Mechanism of action of SNS-
        Future clinical trial design and planning should include answers to   032, a novel cyclin-dependent kinase inhibitor, in chronic lymphocytic
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        therapeutic approaches for each disease.              14a.  Wijermans PW, Krulder JW, Huijgens PC, et al: Continuous infusion
           Certainly  future  considerations  include  the  incorporation  of   of  low-dose  5-Aza-2′-deoxycytidine  in  elderly  patients  with  high-risk
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        capacity to tolerate and metabolize drugs. Extensive validation studies   14c.  de Lima M, Giralt S, Thall PF, et al: Maintenance therapy with low-
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