KC CHEMOTHERAPY NATURAL PRODUCT:

1/ ATB :

1. ***DACTINOMYCIN [ACTINOMYCIN D]

2. ***ANTHRACYCLINES

3. ***BLEOMYCIN

4. ***MYTOMYCIN [MITOMYCIN C]

2/ VINCA ALKALOIDS

3/BIOLOGIC RESPONSE MODIFIERS: ***INTERLEUKINE-2 [IL-2]

***INTERFERONS [ a, b, g]

4/ ENZYMES : ***L - ASPARAGINASE

5/ EPIPODOPHYLLOTOXINS [ ETOPOSIDE AND TENIPOSIDE]

KC CHEMOTHERAPY HORMONES AND ANTAGONISTS:

***TAMOXIFEN

***ANDROGENS AND ANTIANDROGENS

| |

FLUOXYMESTERONE FLUTAMIDE

DROMOSTANOLONE

TESTOSTERONE

***ADRENAL CORTICOSTEROIDS :+++PREDNISONE +++PROGESTINS

MISCELLANEOUS AGENTS : ***HYDROXYUREA

***PROCARBAZINE

***MITOTANE [OP'-DDD]

***CISPLATIN

***INTERLEUKIN 2 [IL-2]

ANTIMETABOLITES:

1. ***METHOTREXATE

2. ***PURINE ANALOGS: +++6-MERCAPTOPURINE +++6- THIOGUANINE +++PENTOSTATINE

3. ***PYRIMIDINE ANALOG: +++5 FLUOROURACIL +++CYTARABINE

ALKYLATING AGENTS:

1. ***NITROGEN MUSTARDS

2. ***NITROSOUREAS

3. ***ALKYL SULFONATES

4. ***TRIAZENES

1/ nitrogens mustards: ***MECHLORETHAMINE

***CYCLOPHOSPHAMIDE

***MELPHALAN

***CHLORAMBUCIL

2/ NITROSOUREAS ***CARMUSTINE

***LOMUSTINE

3/ALKYL SULFONATES ***BISULFAN

4/TRIAZENES ***DACARBAZINE

S PHASE=DNA SYNTHESIS

THE FOLLOWING DRUGS ARE COMPONENTS OF THE MOPP CANCER CHEMOTHERAPY REGIMEN:

***MECHLORETHAMINE

***VINCRISTINE

***PREDNISONE

***PROCARBAZINE

CYCLOPHOSPHAMIDE CAN BE USED TO TREAT ALL OF THE FOLLOWING NEOPLASTIC DISORDERS:

***HODGKIN'S DISEASE

***BURKITT'S LYMPHOMA

***OVARIAN CARCINOMA

***BREAST CARCINOMA

PROLIFERATION INDEPENDENT AGENTS INCLUDE ALL THE FOLLOWING:

***CARMUSTINE

***CYCLOPHOSPHAMIDE

***MECHLORETHAMINE

***MELPHALAN

ALL THE FOLLOWING ADVERSE EFFECTS ARE COMMONLY ASSOCIATED WITH KC CHEMOTHERAPY:

***ALOPECIA

***TERATOGENESIS

***MYELOSUPPRESSION

***NAUSEA

ALL THE FOLLOWING AGENTS HAVE BEEN USED FOR KC CHEMOTHERAPY:

***ALKYLATING AGENTS

***ANTIMETABOLITES

***PLANT ALKALOID

***HORMONAL AGENT

CHARACTERISTICS OF METHOTREXATE INCLUDE ALL OF THE FOLLOWING:

***IT CAN BE USED IN THE TRT OF PSORIASIS

***IT IS ELIMINATED BY THE KIDNEY

***IT IS A SELF LIMITING S-PHASE SPECIFIC DRUG

***IT COMPETITIVELY INHIBITS DIHYDROFOLATE REDUCTASE.

· METHOTREXATE : ***ANTIMETABOLITES CANCER CHEMOTHERAPY

· THERE IS 3 MAJOR CLASSES OF ANTIMETABOLITES : +++FOLIC ACID ANALOGS

+++PYRIMIDINE

+++PURINE RELATED AND RELATEd INHIBITOR

TRUE STATEMENT REGARDING ALKYLATING AGENTS INCLUDE ALL OF THE FOLLOWING:

***THEY ARE PHASE NON SPECIFIC

***THEY KILL RAPIDLY PROLIFERATING CELLS

***ACQUIRED RESISTANCE CAN OCCUR

***THEY KILL NON PROLIFERATING CELLS

ALKYLATING AGENTS: - PHASE NON SPECIFIC

-KILLING RAPIDLY PROLIFERATING CELLS

-KILL NON PROLIFERATING CELLS==> ALKYLATION OF RNA

DNA

ESSENTIAL PROTEINS

-SOME NITROGEN MUSTARD ARE PROLIFERATION -INDEPENDENT

-ALKYLATION OF DNA IS RESPONSIBLE FOR THE CYTOTOXIC ANTITUMOR ACTIVITY.

++THE 7 NITROGEN AND GO2 OF GUANINE ARE THE MOST FAVORED SITES OF

DNA FOR ALKYLATION : RESULT : = CROSS LINKING

BIFUNCTIONAL ALKYLATING AGENTS } ==> INHIBITS DNA REPLICATION =MISPAIRING OF BASES: ALKYLATED GUANINE FORMS BASE PAIRS WITH THYMINE===> DEFECTIVE PROTEIN. =DEPURINATION OF DNA: CLEAVAGE OF IMIDAZOLE RING

MAJOR CLASS: ***NITROGENS MUSTARD

***NITROUREAS

***ALKYL SULFONATES

***TRIAZENES

-ALKYLATING NITROGEN MUSTARDS OFTEN PRODUCES:

***APLASIA OF THE BONE MARROW

***ALOPECIA

***MENSTRUAL IRREGULARITIES

***NAUSEA AND VOMITING

-NITROGEN MUSTARD :

+++1/ MECHLORETHAMINE

+++ 2/ CYCLOPHOSPHAMIDE

+++ 3/ MELPHALAN [L-SARCOLYSIN]

+++4/CHLORAMBUCIL

1- THERAPEUTIC USES: ***HODGKIN'S AND NON HODGKIN'S

COMBINED WITH:

MOPP { -VINCRISTINE

{-PROCARBAZINE

{-PREDNIZONE

*** TRT MYCOSIS FUNGOID

ADVERSE EFFECT: -MYELOSUPPRESSION

-NAUSEA AND VOMITING

-ALOPECIA

-MENSTRUAL IRREGULARITIES

2- CYTOTOXIC SPECIFIE= PHOSPHARAMIDE MUSTARD + ACROLEIN

ACTIVATED: BY THE LIVER
ELIMINATION: KIDNEY
THERAPEUTIC USES: -ALONE AND IN COMBINATION AND IN ORGAN TRANSPLANT IMMUNOSUPPRESSING

1. ***HODGKIN'S DISEASE

2. ***BURKITT'S LYMPHOMA

3. ***OVARIAN AND BREAST CARCINOMAS

4. ***OAT CELLS LUNG ***NEUROBLASTOMA

ADVERSE EFFECTS: -RARELY THROMBOCUTOPENIA

-ALOPECIA

-10% STERILE HEMORRHAGIC CYSTITIS

-PROLONGED TRT: -INTERSTITIAL PULMONARY FIBROSIS -FATAL CARDIOMYOPATHY

3-MELPHALAN [L-SARCOLYSIN]: GI ABSORPTION

USED : -MULTIPLE MYELOMA+++

-BREAST KC

-OVARIAN KC

ADVERSE EFFECTS: -MYELOSUPPRESSION

-VOMITING -NAUSEA

-ALOPECIA RARE

4-CHLORAMBUCIL: -GI ABSOPTION

-COMPLETELY METABOLIZED

-IT IS THE SLOWEST ACTING NITROGEN MUSTARD USED:

· -CHRONIC LYMPHOCYTIC LEUKEMIA

· -WALDENSTROM'S MACROGLOBULINEMIA

· -HODGKIN'S DISEASE AND NON HODGKIN'S LYMPHOMAS

ADVERSE EFFECTS -MYELOSUPPRESSION

-NAUSEA-VOMITING

TRT CHEMOTHERAPY GN:

CELL CYCLE AND ANTI KC THERAPY

A/ GROWTH OF A TUMOR:

***FRACTION OF THE TOTAL ALL POPULATION THAT IS PROLIFERATING ***TIME REQUIRED FOR AN INDIVIDUAL CELL TO DIVIDE [CELL CYCLE TIME] ***RATE OF CELL LOSS

ANTITUMOR AGENT: 2 GN CLASSES:

1. ***PHASE SPECIFIC AGENTS

ACT AT SPECIFIC PHASES OF THE CELL CYCLE: +++HYDROXYUREA}

KILL ON THE S PHASE +++CYTARABINE }

2. ***PHASE NON SPECIFIC AGENTS

+++5-FLUOROURACIL

+++CYCLOPHOSPHAMIDE

***METHOTREXATE KILLS CELLS IN THE S PHASE BUT ALSO INHIBITS RNA SYNTHESIS IN G1 AND G2 PHASES===> LIMITING ITS OWN CYTOTOXICITY -COMMON SIDE EFFECTS:

***MYELOSUPPRESSION

***GI BLEEDING AND ULCERS-NAUSEA-VOMITING

***ALOPECIA

***NEPHROTOXICITY

***TERATOGENESIS,ABORTION

***IMMUNOSUPPRESSION

CLASSIFICATION:

1. ***ALKYLATING AGENTS

2. ***ANTIMETABOLITES

3. ***NATURAL PRODUCTS

4. ***HORMONES AND ANTAGONISTS

5. ***MISCELLANEOUS AGENTS

===========================================================================================================================================================

THE FOLLOWING STATEMENTS REGARDING THE CHEMOTHERAPY OF CANCER ARE TRUE:

***50% OF ALL NEW DIAG KC PATIENTS WILL BE CURED OF THEIR DISEASE ***CHEMOTHERAPY IS

THE ONLY TRT THAT CAN EFFECTIVELY TREAT SYSTEMIC DISEASE

***CHEMOTHERAPY POSSESSES NUMEROUS SIDE EFFECTS, SUCH NAUSEA VOMITING AND SUPPRESSION OF BONE MARROW. ***NEW AGENT ARE CELL CYCLE SPECIFIC

THE FOLLOWING ARE CHEMOTHERAPEUTIC DRUG THAT POSSESSES A MECHANISM OF ACTION INVOLVING ALKYLATION:

***CYCLOPHOSPHAMIDE

THE FOLLOWING STATEMENTS IS CORRECT ABOUT ANTIMETABOLITES:

***THEY ARE STRUCTURALANALOGUES OF NATURALLY OCCURING SUBSTANCES .

THE FOLLOWING DRUGS ARE USED IN THE MOPP PROTOCOL FOR THE TRT OF HODGKIN'S DISEASE:

***PREDNISONE

***VINCRISTINE

***PROCARBAZINE

***MECHLORETHAMINE

THE FOLLOWING STATEMENT CONCERNING ALKYLATING AGENTS:

***THEY ARE ABLE TO FORM COVALENT COVALENT BONDS WITH NUCLEOPHILIC SITES ON NUCLEIC ACIDS

***THEY ARE CYTOTOXIC OWING TO THEIR ACTIVITY AGAINST DNA

***THEY ARE ABLE TO FORM A POSITIVE CARBONIUM ION

***THEY CAN AFFECT ANY PART OF THE CELL CYCLE

CARDIOTOXICITY LIMITS THE CLINICAL USEFULNESS OF THE FOLLOWING ANTIBIOTIC:

***DOXORUBICIN [ADRIAMYCIN]

ALSO: STOMATITIS-ALOPECIA-BONE MARROW DEPRESSION-

=ANTHRACYCLINE : ***DOXORUBICIN

***DAUNORUBICIN

***MITOXANTRONE

ACTION : ***INTERCALATION WITH DNA AND RNA ==> DNA AND RNA ARE DISTORTED

***PHASE NON SPECIFIC

***TISSUE CYTOTOXICITY

***CARDIOTOXICITY =CHRONIC CARDIOMYOPATHY AND ACUTE

DOXORUBICIN: ***SOLID TUMOR

***ACUTE LEUKEMIAS

***MALIGNANT LYMPHOMAS

DAUNORUBICIN: ***ACUTE LYMPHOCYTIC AND GRANULOCYTIC LEUKEMIA

MITOXANTRONE: LESS TOXIC THAN DAUNORUBICIN WHEN COMBINED WITH CYTARABINE FOR INITIAL TRT OF ACUTE NONLYMPHOCYTIC LEUKEMIA.

***ADVANCED BREAST KC

THE FOLLOWING DRUGS ARE CONSIDERED TO BE CELL CYCLE-SPECIFIC :

***5-FLUOROURACIL

***METHOTREXATE

***6-MERCAPTOPURINE

***VINCRISTINE

THE FOLLOWING STATEMEMRNT REGARDING ALLOPURINOL:

***IT INHIBITS THE METABOLISM OF 6-MERCAPTOPURINE

***IT INCREASES THE ANTINEOPLASTIC ACTION OF 6-MERCAPTOPURINE ***IT INHIBITS XANTHINE OXIDASE

***IT DECREASES SERUM URIC ACID LEVEL.

THE FOLLOWING STATEMENTS CONCERNING CYCLOSPORINE :

***THEY CROSS CELL MEMBRANES EASILY

***THEY BIND TO A FAMILY OF INTERCELLULAR PROTEIN =CYCLOPHILLINS ***THEY INHIBIT THE PRODUCTION OF IL 2 BY HELPER T CELLS.

***ACTIVE BIOTRANSFORMATION OF CYCLOSPORINE IS BY CYTOCHROME P-450.

AZATHIOPRINE IS CORRECTLY CHARACTERIZED BY ALL THE FOLLOWING STATEMENTS :

***IT HAS LITTLE ACTION ON AN ETABLISHED GRAFT REJECTION

***IT HAS NON SELECTIVE ACTION IN THE SUPPRESSION OF LYMPHOID CELLS

***IT GREATLY INCREASES THE SUSCEPTIBILITY OF THE PATIENT TO INTERCURRENT INFECTIONS. AZATHIOPRINE IS CONVERTED BY THE BODY TO MERCAPTOPURINE.

WELL ABSORBED BY GI

LATE TOXICITY = RISK OF MALIGNANCY [SKIN KC-LYMPHOID TUMORS]

METHOTREXATE :

***BINDS TO SITES ON THE ENZYME DIHYDROFOLATE REDUCTASE.

***INDICATED IN:

ACUTE LYMPHATIC LEUKOMIA
CHORIOCARCINOMA
NON HODGKIN'S LYMPHOMA
MYCOSIS FUNGOIDES
SARCOMA OF THE BONE
CANCER NECK AND HEAD

***ANTIMETABOLITE

GLUCOCORTICOIDS PERFORM ALL THE FOLLOWING IMMUNOSUPPRESSIVE ACTIONS:

***INHIBIT THE SYNTHESIS OF PROSTAGLANDINS AND LEUKOTRIENES

***LYSE T CELLS

***INCREASE CATABOLISM OF GAMMA G GLOBULIN [IG G] ON CONTINUOUS ADMINISTRATION

***DIMINISH THE ABILITY TO WITHSTAND INFECTIONS AND HEAL WOUNDS.

THE FOLLOWING IS CONSIDERED TO BE THE EFFECTIVE MECHANISM OF ACTION OF THE VINCA ALKALOIDS:

***INHIBITION OF THE FUNCTION OF MICROTUBULE

VINCA ALKALOIDS: ***VINCRISTINE

***VINBLASTINE

BOTH BIND TO TUBULINE===> INTERFERING WITH ASSEMBLING OF SPINDLE PROTEINS DURING MITOSIS M-PHASE SPECIFIC==> BLOCKING PROLIFERATING CELLS AS THEY ENTER METAPHASE CAUSING CELL DEATH. METABOLIZED IN THE LIVER EXCRETED IN THE BILE.

CROSS RESISTANCE DOES NOT APPEAR TO OCCUR IN HUMAN TUMORS.

VINBLASTINE IS COMBINED WITH BLEOMYCIN AND CISPLATIN===> -TESTICULAR CARCINOMA.

-LYMPHOMAS -----NEUROBLASTOMAS

-LETTERER-SIWE DISEASE

VINCRISTINE:

· ACUTE LYMPHOBLASTIC LEUKEMIA

· HODGKIN'S DISEASE AND NON HODGKIN'S

· SOLID TUMOR IN CHILDREN

· TUMOR OF THE BREAST

· LUNG

· CERVIX

THE COMBINATION OF VINCRISTINE WITH PREDNISONE IS CONSIDERED THE TRT OF CHOICE FOR INDUCING REMISSION IN CHILDHOOD LEUKEMIA.

VINBLASTINE CAUSES LEUKOPENIA WITHIN 4-10 DAYS

PARESTHESIA

JAW PAIN

VINCRISTINE IS NEUROTOXIC WITH PARESTHESIA AND MOTOR WEAKNESS.

STREPTOZOTOCIN: RETAINED SPECIALLY IN BETA CELLS OF THE ISLETS OF LANGHERANS.

DACARBAZINE: USED AS SINGLE AGENT AGAINST MALIGNANT MELANOMA

MITOCIN: CLASSIFIED AS AN ANTITUMOR ANTIBIOTIC AND RESULTS IN A HIGH INCIDENCE OF BONE MARROW SUPPRESSION.

MECHLORETHAMINE: USED IN TRT OF HODGKIN'S LYMPHOMA

LOMUSTINE: CLASSIFIED AS AN ALKYLATING AGENT AND ORALLY ADMINISTERED.
ADVERSE EFFECTS OF THESE DRUGS

1. FLUOROURACIL: ORAL AND GI ULCERATION ASPARAGINASE:PANCREATITIS

2. CYCLOPHOSPHAMIDE

· [CYTOXAN]: ***ASEPTIC

· ***HEMORRHAGIC

***CYSTITIS

· CIS-DIAMMINEDICHLOROPLATINIUM [PLATINOL]: ***NEPHROTOXICITY

· PROCARBAZINE [MATULANE]: ***PERIPHERAL NEUROPATHY

· CHLORAMBUCIL: MACROGLOBULINEMIA

1. FLUOURACIL: CARCINOMA OF THE COLON

2. DACARBAZINE: MELANOMA

3. TAMOXIFEN: BREAST KC

4. RADIOACTIVE IODINE: CARCINOMA OF THE THYROID

CYCLOPHOSPHAMIDE CAN BE USED TO TREAT ALL OF THE FOLLOWING NEOPLASTIC DISORDERS:

***HODGKIN'S DISEASE

***BURKITT'S LYMPHOMA

***OVARIAN CARCINOMA

***BREAST CARCINOMA

CHARACTERISTICS OF METHOTREXATE INCLUDE ALL OF THE FOLLOWING:

***IT CAN BE USED IN THE TRT OF PSORIASIS

***IT IS ELIMINATED BY THE KIDNEY

***IT IS A SELF LIMITING S-PHASE SPECIFIC DRUG

***IT COMPETITIVELY INHIBITS DIHYDROFOLATE REDUCTASE

METHOTREXATE : ANTIMETABOLITES CANCER CHEMOTHERAPY

THERE IS 3 MAJOR CLASSES OF ANTIMETASBOLITES:

***FOLIC ACID ANALOGS

***PURIMIDINE

***PURINE AND RELATED INHIBITOR

===========================================================================================================================================================

TUMORS AND IMMUNOLOGY:

· SPONTANEOUS REGRESSION OF SOME TUMOR :

***MALIGNANT MELANOMA

***NEUROBLASTOMA

· LONG TERM INDOLANCE OF SOME TUMOR THEN SUDDENLY METASTASIZE

· PRESENCE OF MONOCLONAL CELL INFILTRATE IN SITU IN INFLAMMATORY CARCINOMAS CORRELATES WITH IMPROVED SURVIVAL RATES.

· IMMEDIATE AND DELAYED HYPERSENSITIVITY.TO AUTOLOGUS TUMOR CELL EXTRACTS IN SKIN REACTION TEST.

· THE INCIDENCE OF MALIGNANCY IS HIGHEST IN THE NEONATALE PERIOD AND IN OLD AGE, WHEN THE IMMUNE SYSTEM FUNCTIONS LESS EFFECTIVELY .

1. CHILDREN WITH CERTAIN CONGENITAL IMMUNODEFICIENCIES ARE AT INCREASED RISK FOR KC:

i) LYMPHOMAS AND ACUTE MYELOGENOUS LEUKEMIA OCCUR IN 10-30% OF CHILDREN WITH WISKOTT-ALDRICH SYNDROME.

ii) NON HODGKIN’S LYMPHOMA AND STOMAC KC ARE MORE COMMON IN CHILDREN WITH ATAXIA TELANGIECTASIA AND COMMON IMMUNODEFICIENCY THAN THEY ARE IN AGE MATCHED HEALTHY CHILDREN.

2. ANOGENITAL CARCINOMAS [CERVIX KC+++] ARE INCREASED

· NEUROBLASTOMA:

***THE LYMPHOCYTES OF CHILDREN WITH NEUROBLASTOMA ARE CYTOTOXIC TO THE CELLS OF THIS TUMOR BUT EXPRESS NO TOXICITY AGAINST NORMAL CELLS OR CELLS OF OTHER TUMORS.

***LYMPHOCYTES FROM MOTHERS OF CHILDREN WITH NEUROBLASTOMA DEMONSTRATE IN VITRO TUMOR SPECIFIC CYTOTOXICITY TOWARD NEUROBLASTOMA TUMOR CELLS BUT TOWARD OTHER TUMOR CELL TYPE.

***IN SOME CASE CHILDREN AND MOTHER HAVE ANTIBODIES THAT ARE CYTOTOXIC FOR THE NEUROBLASTOMA CELLS .

IN OTHER CASES , THE SERUM DOES NOT KILL THE TUMOR CELLS BUT INSTEAD PROTECTS THEM THROUGH BLOCKING FACTORS SUCH AN ANTIGEN - ANTIBODY COMPLEX.

· TUMOR ASSOCIATED ANTIGENS [TAA] INCREASES PROPORTIONALLY WITH TUMOR GROWTH AND DECREASES WITH TUMOR RESPONSE TO TRT.

1. NEOANTIGENS MAY EXIST IN THE NUCLEUS , THE CYTOPLASM, OR THE CELL MEMBRANE

2. NEOANTIGENS MAY BE EXCRETED FROM THE CELL.[HORMONES: HCG (TESTIS KC) - ACTH ( LUNG KC).

ANTIGENS ASSOCIATED WITH HUMAN MALIGNANCY [NON SPECIFIC]

ANTIGEN

TUMOR

VIRAL

1. HEPATITIS B

2. HUMAN PAPILLOMA VIRUSES 16 AND 18

3. EPSTEIN BARR

4. HUMAN T CELL LEUKEMIA VIRUS I [HTLV-1]

· PRIMARY LIVER KC

· CERVICAL CARCINOMA

· BURKITT’S LYMPHOMA

· NASOPHARYNGEAL KC

· ADULT T CELL LEUKEMIA

ONCOFETAL

1. CARCINOEMBRYONIC

2. ALPHA PROTEIN

· COLORECTAL CARCINOMA

· PANCREATIC CARCINOMA

· PRIMARY LIVER KC

· TESTICULAR AND OVARIAN KC

· GASTRIC AND PANCREATIC KC

OTHER

1. MYELONEMA PROTEINS

2. PROSTATE SPECIFIC ANTIGENS

3. PROSTATIC ACID PHOSPHATASE

4. S-100 CALCIUM BINDING PROTEIN

5. CA-125 GLYCOPROTEIN

6. CA 19-9 GLYCOPROTEIN

7. 15-3 GLYCOPROTEIN

· MULTIPLE MYELOMA

· PROSTATIC KC

· MELANOMA

· OVARIAN KC

· PANCREATIC KC

· BREAST - LUNG KC

· TAAs MAY BE ANTIGENS THAT ARE COMPLETELY UNIQUE TO A PARTICULAR TUMOR IN A SPECIFIC PERSON. THEY ACCOMPANIES CARCINOGENE INDUCED CANCERS.

1. THE CARCINOGEN ACTS AS A MUTAGEN

2. TAAs MORE COMMONLY ARE SIMILAR IN ALL PEOPLE CARRYING A PARTICULAR TUMOR:

· ANTIGENS = TUMOR SPECIFIC ANTIGENS [TSAs] CAN BE FOUND IN MORE THAN ONE TYPE TUMORS OR EVEN IN NONMALIGNANT DISEASES.

3. SOME TUMORS EXPRESS NORMAL ANTIGENS IN EXCESSIVE AMOUNTS:

· MYELOMA PROTEINS [B CELLS OUT OF CONTROL AND BECAME MALIGNANT]

· COMMON ACUTE LYMPHOBLASTIC LEUKEMIA ANTIGEN [ CALLA] = CHILDHOOD LEUKEMIA

- NORMALLY , CALLA IS EXPRESSED ONLY ON B-CELL PROGENITORS , WHICH COMPRISE LESS THAN 1% OF NORMAL BONE MARROW CELLS.

KC CHEMOTHERAPY AND IMMUNOLOGY

MOPP { -VINCRISTINE

CELL CYCLE AND ANTI KC THERAPY

· HODGKIN'S DISEASE AND NON HODGKIN'S