Miscellaneous agents

The presence of increased angiogenesis in CMML41 stimulated interest in the potential use of angiogenesis inhibitors for managing this disease. A limited number of patients with CMML have been treated with thalidomide. Of seven patients with CMML treated with 100-400 mg thalidomide orally, daily in two stud-ies,42,43 only one experienced a minor and transient improvement in platelet counts. Because of its poorly predictable adverse effects and the seeming lack of activity, future use of thalidomide in treating patients with CMML is unlikely. Other antiangiogenic and immunomodulating agents, including derivatives of thalidomide that have both antiangiogenic and immunomodulatory properties, are in early stages of clinical development. Phase I/II studies are including patients with CMML.

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