Chap. 38

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av8girl
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10880
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Chap. 38
Updated:
2010-03-18 13:34:09
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Biologic Response Modifiers
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Week 9 Biologic responses Modifiers
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  1. Biologic Response Modifiers BRMs
    • used to enhance the body's immune system
    • Enhance host immunologic function (immunomodulation)
    • Destroy or interfere with tumor activites (cytotoxic/cytostatic effects)
    • Promote differentation of stem cells (other biologic effects)
  2. Interferons (IFNs)
    • regulate the immune system to improve resistance to invading micro-organisms
    • reduce cell proliferation
    • Type 1: Alpha and Beta - bind selectively to either alpha or beta cell surface receptors on effector cells
    • Type 2: gamma - binds to different cell surface receptor
  3. Interferon alpha
    • -Produced by B, T cells, macrophages.
    • has antiviral antiproliferative, and immunomodulatory effects
    • inhibits intracellular replication of viral DNA, interferes with tumor cell groth and enhances natural killer cell activity
    • treats: hairy cell leukemia, chronic phase piladelphia chromosome positive chronic myelogenous leukemia, follicular non-Hodgkins lymphoma, AIDS related kaposi sarcoma, non-malignant condition-chronic hepatitis
    • SA: flulike syndrom - may progress to rigors.
    • Dose limiting: fatigue, anorexia
  4. Interferon Beta
    • enhances the activity of suppressor T cells
    • reduces the production of proinflammatory cytokines
    • reduces antigen presentation
    • inhibits the movement of lymphocytes in the CNS
    • treats: multiple sclerosis
  5. Interferon Gamma
    • delays time to disease progession of severe malignant osteopetrosis
    • reducing the frequency and severity of serious infections related to chronic granulomatous disease
    • Enhances oxidative metabolism of pacrophages
    • enhances antibody-dependent cell cytotoxicity
    • activates natural killer cells
    • enhanses the Fc receptors on the antibody and major histocompatibility antigens
  6. Erythropoietin Stimulating Agents
    • stimulates red blood cell production
    • Monitor hemoglobin closely - should never excede 12g/dl
    • SA: hypertension, headache, arthalgias, N&V&D, edema, fatigue, chest pain, injection site skin reaction, asthenia, dizziness, seizures, thrombosis, allergic reactions.
    • Contra: uncontrolled hypertension, known hypersensitivity to mammalian cell-derived products, known hypersensitivity to human albumin or polysorbate.

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