Successful treatment of Aspergillus spondylodiscitis with high-dose itraconazole in a patient with acute myelogenous leukemia

The response to and survival following first salvage therapy regimens for 243 patients with acute myelogenous leukemia (AML) treated between 1974 and 1985 were evaluated. Eighty (33%) patients obtained a complete remission (CR), 24% died prior to achieving a response, and 43% were resistant on their first salvage regimen. The median survival was 18 weeks. Five percent overall and 16% of the CR patients are predicted to survive for more than 5 years. The factor most strongly associated with response and survival was the duration of the initial remission with 49 of 82 (60%) patients whose initial CR duration was at least 1 year in duration obtaining a second CR v 31 of 161 (19%) for patients with a shorter remission (P less than .01). Age, liver function, serum lactic dehydrogenase (LDH), karyotype, and the proportion of blasts plus promyelocytes present at the time of starting salvage therapy were strongly associated with probability of response and survival. Multivariate analysis was used to develop logistic regression and proportional hazard models to predict probability of response and survival, respectively. The major regimens used were conventional-dose cytarabine (ara-C) (combined with anthracyclines or amsacrine), high-dose ara-C, rubidazone, amsacrine (AMSA), other anthracyclines, and autologous or allogeneic transplant programs. After allowing for the prognostic factors in the models, specific treatment regimens were not strongly associated with prognosis.

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Successful treatment of invasive aspergillosis complicating prolonged treatment-related neutropenia in acute myelogenous leukemia with amphotericin B lipid complex

Medical and Pediatric Oncology ◽

10.1002/mpo.2950250214 ◽

1995 ◽

Vol 25 (2) ◽

pp. 119-122 ◽

Cited By ~ 16

Author(s):

Duane R. Hospenthal ◽

John C. Byrd ◽

Raymond B. Weiss

Keyword(s):

Invasive Aspergillosis ◽

Amphotericin B ◽

Successful Treatment ◽

Acute Myelogenous Leukemia ◽

Myelogenous Leukemia ◽

Prolonged Treatment ◽

Lipid Complex ◽

Acute Myelogenous ◽

Amphotericin B Lipid Complex

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High-Dose Cytosine-Arabinoside Plus AMSA for Reinduction or Consolidation-Maintenance in Acute Myelogenous Leukemia

Minimal Residual Disease in Acute Leukemia 1986 ◽

10.1007/978-94-009-4273-8_15 ◽

1986 ◽

pp. 159-166

Author(s):

R. Zittoun

Keyword(s):

Cytosine Arabinoside ◽

Acute Myelogenous Leukemia ◽

Myelogenous Leukemia ◽

High Dose ◽

Acute Myelogenous

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Does cranial irradiation reduce the risk for bone marrow relapse in acute myelogenous leukemia? Unexpected results of the Childhood Acute Myelogenous Leukemia Study BFM-87.

Journal of Clinical Oncology ◽

10.1200/jco.1993.11.2.279 ◽

1993 ◽

Vol 11 (2) ◽

pp. 279-286 ◽

Cited By ~ 90

Author(s):

U Creutzig ◽

J Ritter ◽

M Zimmermann ◽

G Schellong

Keyword(s):

Bone Marrow ◽

Acute Myelogenous Leukemia ◽

Cranial Irradiation ◽

Low Risk ◽

Myelogenous Leukemia ◽

High Dose ◽

Number Of Patients ◽

Acute Myelogenous ◽

Wbc Count ◽

Group B

PURPOSE One of the goals of study AMA-BFM-87 was to test prospectively in acute myelogenous leukemia (AML) patients if cranial irradiation could be replaced by late intensification therapy with high-dose cytarabine (Ara-C) and etoposide (VP-16). PATIENTS AND METHODS Patients with a low risk of CNS relapses (ie, no initial CNS disease, WBC count at diagnosis < or = 70.000/microL) were randomized for irradiation (group A, 31 patients). In 25 patients (group B), randomization was refused. As interim results showed no increase of CNS relapses in nonirradiated patients, prophylactic irradiation was discontinued after 2 1/2 years to prevent unnecessary CNS toxicity. Forty-four patients (group C) entered the study after randomization had been stopped. RESULTS In all patients with a low risk of CNS recurrences (n = 100), a significantly higher probability of relapse-free interval (pRFI) of 5 years was found in irradiated patients (pRFI = .78) compared with nonirradiated patients (pRFI = .41) (P = .007). Moreover, a slightly higher incidence of CNS relapses was observed in nonirradiated patients. Due to the small number of patients, this was not observed when randomized patients only were analyzed. In accordance with these findings, the favorable outcome of low-risk patients in the preceding study, AML-BFM-83 (pRFI > .80), could only be reproduced in study AML-BFM-87 in patients who had received cranial irradiation. CONCLUSION These results indicate that cranial irradiation should be an integral part of the treatment of all AML patients not undergoing bone marrow transplantation. Residual blasts in the CNS may escape systemic chemotherapy and lead to recurrence of the initial disease not only in the CNS, but also in the bone marrow.

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Successful Treatment with Imatinib Mesylate in a Case of Minor BCR-ABL-Positive Acute Myelogenous Leukemia

International Journal of Hematology ◽

10.1532/ijh97.04098 ◽

2005 ◽

Vol 81 (3) ◽

pp. 242-245 ◽

Cited By ~ 21

Author(s):

Katsuro Ito ◽

Kazunori Tominaga ◽

Toshiya Suzuki ◽

Itsuro Jinnai ◽

Masami Bessho

Keyword(s):

Imatinib Mesylate ◽

Successful Treatment ◽

Acute Myelogenous Leukemia ◽

Myelogenous Leukemia ◽

Acute Myelogenous

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Successful treatment of acute myelogenous leukemia with favorable cytogenetics by reduced-intensity stem cell transplantation

International Journal of Hematology ◽

10.1007/s12185-009-0487-y ◽

2010 ◽

Vol 91 (2) ◽

pp. 310-321

Author(s):

Takeshi Kondo ◽

Atsushi Yasumoto ◽

Kotaro Arita ◽

Jun-ichi Sugita ◽

Akio Shigematsu ◽

...

Keyword(s):

Stem Cell ◽

Stem Cell Transplantation ◽

Cell Transplantation ◽

Successful Treatment ◽

Acute Myelogenous Leukemia ◽

Myelogenous Leukemia ◽

Acute Myelogenous ◽

Reduced Intensity

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Synergy between high-dose cytarabine and asparaginase in the treatment of adults with refractory and relapsed acute myelogenous leukemia--a Cancer and Leukemia Group B Study.

Journal of Clinical Oncology ◽

10.1200/jco.1988.6.3.499 ◽

1988 ◽

Vol 6 (3) ◽

pp. 499-508 ◽

Cited By ~ 58

Author(s):

R L Capizzi ◽

R Davis ◽

B Powell ◽

J Cuttner ◽

R R Ellison ◽

...

Keyword(s):

Median Time ◽

Acute Myelogenous Leukemia ◽

Standard Dose ◽

Myelogenous Leukemia ◽

High Dose ◽

Time To Failure ◽

Cutaneous Toxicity ◽

High Dose Cytarabine ◽

Acute Myelogenous ◽

Refractory Aml

One hundred ninety-five adult patients with refractory or first relapse acute myelogenous leukemia (AML) were randomly assigned to receive high-dose cytarabine (HiDAC), 3 g/m2 as a three-hour intravenous (IV) infusion every 12 hours for four doses, followed by 6,000 IU/m2 asparaginase (ASNase) administered at hour 42, or HiDAC without ASNase. Treatment was repeated on day 8. The median patient age was 52 years. There was an overall superior complete remission (CR) rate for HiDAC/ASNase (40%) v HiDAC (24%), P = .02. Subset analysis according to prior response and age showed the following CR rates: 54% from HiDAC/ASNase treatment of refractory AML in patients less than 60 years, and 31% in patients greater than 60 years; CR from HiDAC in the same refractory groups were 18% (less than 60) and 0% (greater than 60); 37% from HiDAC/ASNase treatment of relapsed AML in patients less than 60 years, and 43% in patients greater than 60 years; CRs from HiDAC in the same relapsed groups were 33% (less than 60) and 21% (greater than 60). Toxicity in the two treatment arms was comparable and consisted primarily of leukopenia, thrombocytopenia, mild hepatic dysfunction, diarrhea, conjunctivitis and serositis, and hyperglycemia. There was only one case of transient cerebellar toxicity and no cutaneous toxicity. Median time to full hematologic recovery was 5 weeks. There was an overall survival benefit for patients treated with HiDAC/ASNase (19.6 weeks) compared with HiDAC (15.9 weeks), P = .046, primarily attributable to effects in refractory patients. Median time to failure for refractory patients who achieved CR was 38.5 weeks with HiDAC/ASNase, and 13.3 weeks for those treated with HiDAC. For relapsed patients in CR from HiDAC/ASNase the median time to failure was 17.7 weeks and 18.3 weeks for HiDAC. The overall 42% CR rate from HiDAC/ASNase v 12% from HiDAC in patients with refractory AML indicates that HiDAC/ASNase is not cross-resistant with standard-dose cytarabine (SDAC) and anthracyclines. We conclude that HiDAC/ASNase has substantial activity in poor-prognosis AML and that this combination warrants further trials in earlier stage disease.

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