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BL22 and Hairy Cell Leukemia: A Magic Bullet? Hairy cell leukemia occurs in roughly two percent of all diagnosed cases of leukemia. It has proven resistant to many of the contemporary therapies that have brought about remission in other forms of this carcinoma. In an effort to find an effective course of treatment, clinicians have turned to cutting edge genetic research that can approach the problem on the molecular level and help patients build an effective line of defense. While pharmacological compounds in the purine analogue family (a preferred chemotherapeutic protocol) have proved ineffective against hairy cell leukemia, new studies offer encouragement in the use of immunotoxins at the genetic level. Studies have established that certain cells in leukemia patients, known as B-cells, contain a particular molecule know as CD22. Researchers believed that if this molecule could be attacked, the leukemia cells could be eliminated. To test this theory, a recent study headed by Dr. Robert J. Kreitman followed a group of 31 patients previously diagnosed with B-cell carcinoma. The group was further divided by identifying sixteen individuals who had the hairy-cell variety of the disease. The test group had received traditional chemotherapy, which had been ineffective. BL22 is an immunotoxin previously identified as having significant anti-CD22 properties. The researchers began intravenous administration for various periods of one to nine cycles. A treatment cycle was defined as three treatments with the compound, once per day, every other day. Patients were monitored to see what effect, if any, the therapy had and after how many cycles. BL22 seems to be accepted by the body more easily than other formulas and is far less toxic. This made multiple applications of the therapy possible. Kreitman's group found that, of the sixteen individuals who had this form of leukemia, eleven had complete remissions after the BL22 treatment. Significantly, seven of the eleven had never shown remission in response to any other form of chemotherapy. Moreover, the incidence of any residual disease was far less (one out of eleven) than traditional chemotherapeutic protocols, which have reported residuals as high as fifty percent. Attacking carcinoma on the molecular level holds tremendous potential for patients and practitioners alike. Isolating various components of cancer cells and then pinpointing a chemotherapy regimen that can target essential elements of those cells promises new and effective treatments with far fewer side effects. The need for additional studies to explore these avenues is obvious and the potential results are unlimited. Resource Kreitman, R., Wilson, W., Bergeron, K., Raggio, M., Stetler-Stevenson, M., FitzGerald, D., & Pastan, I. (2001, July 26). Efficacy of the anti-CD22 recombinant immunotoxin BL22 in chemotherapy-resistant hairy-cell leukemia [electronic version]. The New England Journal of Medicine, 345(4), 241-247.

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