Acute Nonlymphocytic Leukemia in the Elderly: Biology and Treatment

1982 ◽  
pp. 199-235 ◽  
Author(s):  
Bruce A. Peterson
Keyword(s):  
The Elderly ◽  
Acute Nonlymphocytic Leukemia

Full dose versus attenuated dose daunorubicin, cytosine arabinoside, and 6-thioguanine in the treatment of acute nonlymphocytic leukemia in the elderly.

1984 ◽  
Vol 2 (8) ◽  
pp. 865-870 ◽  
Author(s):  
S B Kahn ◽  
C B Begg ◽  
J J Mazza ◽  
J M Bennett ◽  
H Bonner ◽  
...  
Keyword(s):  
Median Survival ◽  
Cytosine Arabinoside ◽  
Controlled Trial ◽  
Intensive Therapy ◽  
Eastern Cooperative Oncology Group ◽  
Early Death ◽  
The Elderly ◽  
Acute Nonlymphocytic Leukemia ◽  
Survival Times ◽  
Significant Difference

Between July 1, 1981 and November 1, 1982, 45 patients with acute nonlymphocytic leukemia (age, greater than or equal to 70 years) were randomly assigned to receive induction chemotherapy using either daunorubicin, cytosine arabinoside, and 6-thioguanine in full dosage (F DAT) or an attenuated schedule of the same drugs (At DAT) as part of an Eastern Cooperative Oncology Group controlled trial. Forty patients were deemed evaluable, 20 on each arm. The overall complete remission (CR) rate for all patients in both arms was 28% (11/40). There was no significant difference in CR rates between the two arms. There were 12 early deaths (less than 60 days) in the F DAT arm compared with only five early deaths on the At DAT arm (P = .05). Due primarily to this early death rate, the median survival for the F DAT group was 29 days v 159 days for the At DAT groups (P = .02). The range of survival of the patients in CR for the At DAT group given either one or two cycles of induction therapy was 121 to 414 days, while the survival range for the F DAT CR patients was 121-186 + days. The median survival for those not achieving CR was 14 days for the F DAT group v 80 days for the At DAT (P less than .02). Fifty-nine percent of the At DAT patients spent greater than 100 days out of the hospital v 12% for the F DAT group. Attenuated chemotherapy with lower doses of DAT is the preferred induction regimen for elderly patients with acute nonlymphocytic leukemia since it causes fewer early deaths, allows a better quality of life, and yields survival times as durable as intensive therapy.

Treatment of acute nonlymphocytic leukemia in the elderly with intermediate high-dose cytosine arabinoside

1989 ◽  
Vol 17 (2) ◽  
pp. 79-82 ◽  
Author(s):  
Louis Letendre ◽  
Robert D. Niedringhaus ◽  
Terry M. Therneau ◽  
Dennis A. Gastineau ◽  
Richard M. Goldberg ◽  
...  
Keyword(s):  
Cytosine Arabinoside ◽  
The Elderly ◽  
High Dose ◽  
Acute Nonlymphocytic Leukemia

Attenuated High-Dose Cytosine Arabinoside in the Treatment of the Elderly Patient with Acute Nonlymphocytic Leukemia

1989 ◽  
Vol 12 (3) ◽  
pp. 201-204 ◽  
Author(s):  
S. Benham Kahn ◽  
Kurt Ebrahim ◽  
Peter Cassileth ◽  
John M. Bennett ◽  
William H. Knospe ◽  
...  
Keyword(s):  
Elderly Patient ◽  
Cytosine Arabinoside ◽  
The Elderly ◽  
High Dose ◽  
Acute Nonlymphocytic Leukemia

Low-dose cytarabine versus intensive chemotherapy in the treatment of acute nonlymphocytic leukemia in the elderly.

1990 ◽  
Vol 8 (2) ◽  
pp. 272-279 ◽  
Author(s):  
H Tilly ◽  
S Castaigne ◽  
D Bordessoule ◽  
P Casassus ◽  
P Y Le Prisé ◽  
...  
Keyword(s):  
Overall Survival ◽  
Low Dose ◽  
De Novo ◽  
The Elderly ◽  
Multicenter Trial ◽  
Induction Treatment ◽  
Acute Nonlymphocytic Leukemia ◽  
Intensive Chemotherapy ◽  
Chemotherapy Group ◽  
Low Dose Cytarabine

We conducted a randomized multicenter trial comparing low-dose cytarabine (LD ARA-C) (20 mg/m2 for 21 days) with an intensive chemotherapy (rubidazone [a daunorubicin-derived agent], 100 mg/m2 for 4 days, ARA-C 200 mg/m2 for 7 days) in 87 patients over 65 years of age with de novo acute nonlymphocytic leukemia (ANLL). Forty-one patients received LD ARA-C and 46 received intensive chemotherapy. The number of complete remissions (CRs) but also of early deaths was higher in the intensive chemotherapy group, while partial remissions (PRs) and failures were more frequent in the LD ARA-C group (P less than .001). Infectious complications during induction treatment were more numerous and more severe in the intensive chemotherapy group (P less than .01). Patients treated with LD ARA-C required fewer RBC transfusions (P less than .02), fewer platelet transfusions (P less than .01), and had a shorter hospital stay for induction treatment (P less than .01). Overall survival and CR duration were not significantly different in either group. In the LD ARA-C group, the survival of patients with PR and those of patients in CRs was identical. We conclude that in a selected group of elderly patients with de novo ANLL a higher number of CRs may be obtained with intensive chemotherapy, but that with LD ARA-C, the number of early deaths is lower, and long-lasting PRs are obtained, resulting in a similar overall survival.

Cell surface changes during aging of human bladder epithelium examined by lectin probes and SEM

1990 ◽  
Vol 48 (3) ◽  
pp. 966-967
Author(s):  
J. Jacob ◽  
M.F.M. Ismail
Keyword(s):  
The Elderly ◽  
Ultrastructural Changes ◽  
Pokeweed Mitogen ◽  
Asymmetric Structure ◽  
Luminal Surface ◽  
Bladder Epithelium ◽  
Aldehyde Groups ◽  
Cell Surface Changes ◽  
Phosphate Buffered Saline ◽  
Surface Changes

Ultrastructural changes have been shown to occur in the urinary bladder epithelium (urothelium) during the life span of humans. With increasing age, the luminal surface becomes more flexible and develops simple microvilli-like processes. Furthermore, the specialised asymmetric structure of the luminal plasma membrane is relatively more prominent in the young than in the elderly. The nature of the changes at the luminal surface is now explored by lectin-mediated adsorption visualised by scanning electron microscopy (SEM).Samples of young adult (21-31 y old) and elderly (58-82 y old) urothelia were fixed in buffered 2% glutaraldehyde for 10 m and washed with phosphate buffered saline (PBS) containing Ca++ and Mg++ at room temperature. They were incubated overnight at 4°C in 0.1 M ammonium chloride in PBS to block any remaining aldehyde groups. The samples were then allowed to stand in PBS at 37°C for 2 h before incubation at 37°C for 30 m with lectins. The lectins used were concanavalin A (Con A), wheat germ agglutinin (WGA), phytohaemagglutinin (PHA) and pokeweed mitogen (PWM) at a concentration of 500 mg/ml in PBS at pH 7.A.

The effect of dental geriatric curricula on attitudes toward the elderly

1988 ◽  
Vol 52 (9) ◽  
pp. 516-518 ◽  
Author(s):  
J Mann ◽  
TJ Bomberg ◽  
JM Holtzman ◽  
DB Berkey
Keyword(s):  
The Elderly

Pharmacology Issues Related to Dementia Syndrome of Depression in Elderly Residents of Long-Term Care Settings

2015 ◽  
Vol 25 (2) ◽  
pp. 61-69
Author(s):  
Angel L. Ball ◽  
Adina S. Gray
Keyword(s):  
Depressive Symptoms ◽  
The Elderly ◽  
Environmental Communication ◽  
Pharmacological Intervention ◽  
Team Approach ◽  
Discussion Paper ◽  
Term Care ◽  
Anticholinergic Medications ◽  
Inappropriate Treatment ◽  
Dementia Syndrome

Pharmacological intervention for depressive symptoms in institutionalized elderly is higher than the population average. Among the patients on such medications are those with a puzzling mix of symptoms, diagnosed as “dementia syndrome of depression,” formerly termed “pseudodementia”. Cognitive-communicative changes, potentially due to medications, complicate the diagnosis even further. This discussion paper reviews the history of the terminology of “pseudodementia,” and examines the pharmacology given as treatment for depressive symptoms in the elderly population that can affect cognition and communication. Clinicians can reduce the risk of misdiagnosis or inappropriate treatment by having an awareness of potential side effects, including decreased attention, memory, and reasoning capacities, particularly due to some anticholinergic medications. A team approach to care should include a cohesive effort directed at caution against over-medication, informed management of polypharmacology, enhancement of environmental/communication supports and quality of life, and recognizing the typical nature of some depressive signs in elderly institutionalized individuals.

Acquired haemophilia in the elderly is a severe disease: report of five new cases

Haemophilia ◽  
2001 ◽  
Vol 7 (4) ◽  
pp. 428-432 ◽  
Author(s):  
S. Godreuil ◽  
R. Navarro ◽  
P. Quittet ◽  
L. Landreau ◽  
J-F. Schved ◽  
...  
Keyword(s):  
Severe Disease ◽  
The Elderly ◽  
Acquired Haemophilia

Chewing activity and activities of daily living in the elderly

1997 ◽  
Vol 24 (6) ◽  
pp. 457-460 ◽  
Author(s):  
H. MIURA ◽  
Y. ARAKI ◽  
T. UMENAI
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
The Elderly ◽  
Chewing Activity
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