Aby Buchbinder

Secondary hemochromatosis as a long-term complication of the treatment of hematologic malignancies†

The increased cure rate of hematologic malignancies including the use of bone marrow transplantation has focused attention on the chronic toxicity and quality of life of the survivors. We have observed five patients who have been diagnosed with clinically significant iron overload, presumably due to packed red blood cell transfusions, ≥12 months after transplant for a hematologic malignancy. In these patients, there is no history of veno‐occlusive disease or family history of hemochromatosis. The allotransplant patient has been free of chronic graft versus host disease. Family screening has been negative. No patient developed clinically significant endocrinopathy, arthropathy, or cardiac disease. The patients have been treated with phlebotomy to bring the transferrin saturation and ferritin levels to normal. The long‐term follow‐up of patients treated for a hematologic malignancy should include analysis of hepatitis C virus and iron status. This may prevent the development of clinically significant chronic liver disease and possibly malignancy. Am. J. Hematol. 61:262–264, 1999.

Gene Therapy in Human Cancer: Report of Human Clinical Trials

Gene therapy is a technique whereby genetic material is introduced into cells to correct a genetic defect or to alter the properties of a cell, thereby giving a therapeutic benefit to the recipient. This methodology is being developed into various treatments against cancer. Because it is only a technique, it is currently being used in multiple ways as direct or indirect means to target neoplastic cells. The success of any specific treatment that uses gene therapy thus depends both on the ability of the gene therapy method to achieve its intended goal (i.e., of achieving the desired molecular change) and the ability of the molecular alteration to achieve biologic significance. The following sections describe various methods of introducing genetic elements into cells and their potential benefits and drawbacks, and because the field of gene therapy is already diverse and has been well reviewed recently including in the present journal (1 -7), only the results of clinical trials already performed and reported in humans for the treatment of cancer are presented. A complete list of gene therapy clinical trials approved by the Office of Recombinant DNA Activities is available on the Internet (8).