Gamma Heavy Chain Disease Medication

Updated: Feb 12, 2020
  • Author: Guy B Faguet, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Medication Summary

Chemotherapy is typically ineffective in γ-heavy chain disease (HCD). Agents that are effective in lymphoma and multiple myeloma have generally been used, but results have been disappointing. Treatment with fludarabine and/or rituximab has resulted in partial, short-lived responses.


Antineoplastic Agents

Class Summary

Antineoplastic agents inhibit cell growth and proliferation.

Fludarabine (Fludara, Oforta)

Fludarabine is a purine analogue that interferes with DNA synthesis by inhibiting ribonucleotide reductase. It is also incorporated into RNA, causing inhibition of RNA and protein synthesis; however, its primary effect may result from activation of apoptosis.

Rituximab (Rituxan)

Rituximab is a genetically engineered chimeric murine/human monoclonal antibody directed against the CD20 antigen found on the surface of normal and malignant B lymphocytes. The antibody is an immunoglobulin G1 (IgG1) kappa immunoglobulin containing murine light- and heavy-chain variable region sequences and human constant region sequences.

Vincristine (Oncovin, Vincasar PFS)

Vincristine is a vesicant agent that blocks mitosis by arresting cells in metaphase.

Doxorubicin (Adriamycin)

Doxorubicin is an anthracycline and antimicrobial compound produced by Streptomyces in culture, which causes topoisomerase-II–dependent DNA cleavage and intercalation with the DNA double helix.

Cyclophosphamide (Cytoxan)

Cyclophosphamide is a nitrogen-mustard alkylating compound that produces highly reactive carbonium ions, which react with electron-rich areas of susceptible molecules. It is used to treat a large number of malignancies.

Chlorambucil (Leukeran)

Chlorambucil is a nitrogen-mustard alkylating agent, generally used for the treatment of chronic lymphocytic leukemia, Waldenstrom macroglobulinemia, and as a second- or third-line therapy for patients with lymphomas. It alkylates cross-link the strands of DNA, inhibiting DNA replication and RNA transcription. It may be given as a single agent or as part of a multidrug treatment regimen; depending on protocol of choice, the dose and schedule of administration are decided.



Class Summary

Corticosteroids have anti-inflammatory properties and cause profound and varied metabolic effects. These agents modify the body's immune response to diverse stimuli.

Prednisone (Deltasone, Sterapred, Orasone)

Prednisone suppresses mRNA synthesis and causes lysis of lymphoid tumors. Cell death results from cell fragmentation.