scholarly journals Arabinosyl Cytosine: A Useful Agent in the Treatment of Acute Leukemia in Adults

Blood ◽  
1968 ◽  
Vol 32 (4) ◽  
pp. 507-523 ◽  
Author(s):  
ROSE RUTH ELLISON ◽  
JAMES F. HOLLAND ◽  
MARISE WEIL ◽  
CLAUDE JACQUILLAT ◽  
MICHEL BOIRON ◽  
...  
Keyword(s):  
Remission Rate ◽  
Hemoglobin Level ◽  
Lymphocytic Leukemia ◽  
Acute Myelocytic Leukemia ◽  
Pyrimidine Nucleoside ◽  
Myelocytic Leukemia ◽  
Daily Dose ◽  
Significant Superiority ◽  
Infusion Duration ◽  
Arabinosyl Cytosine

Abstract Arabinosyl cytosine (ara-C), a synthetic pyrimidine nucleoside related to the normal metabolites cytidine and deoxycytidine, has been found capable of producing marrow remission at tolerable doses in acute myelocytic and acute lymphocytic leukemia in adults. There were 16 per cent remissions complete in all aspects, 3 per cent complete except for hemoglobin level, and 6 per cent partial remissions among 180 adults with acute myelocytic leukemia treated with any one of 8 variants of infusion duration or daily dose of ara-C. Twenty-four per cent of 37 adults with acute lymphocytic or unclassified leukemia had complete or partial remissions. The comparison of 1, 4, 12 and 24 hours infusion of ara-C (to total dose tolerated) does not show significant superiority for any one group. The complete remission rate with 1 or 12 hour infusions, however, is 25 per cent (superior to that obtained with 6-mercaptopurine) and the recommended schedule of treatment for ara-C based on these data is, therefore, daily infusions of 100 or 50 mg./m.2 in one hour for approximately 3 to 6 weeks followed by maintenance therapy of once weekly subcutaneous injection of 30 mg./m.2 of ara-C. Platelet transfusions should be available when ara-C is used.

scholarly journals A Comparative Study of Two Regimens of Combination Chemotherapy in Acute Leukemia

Blood ◽  
1958 ◽  
Vol 13 (12) ◽  
pp. 1126-1148 ◽  
Author(s):  
EMIL FREI ◽  
JAMES F. HOLLAND ◽  
MARVIN A. SCHNEIDERMAN ◽  
DONALD PINKEL ◽  
GEORGE SELKIRK ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Survival Time ◽  
Median Survival ◽  
Combination Chemotherapy ◽  
Drug Toxicity ◽  
Acute Lymphocytic Leukemia ◽  
Lymphocytic Leukemia ◽  
Acute Myelocytic Leukemia ◽  
Myelocytic Leukemia ◽  
Remission Status

Abstract A comparative clinical trial of two regimens of combination chemotherapy has been accomplished in acute leukemia by four separate medical and pediatric services. Sixty-five patients were allocated at random to one of two treatment programs. Daily administration of methotrexate with daily 6-mercaptopurine has been compared to methotrexate every third day in the same total dose with daily 6-mercaptopurine. No difference in frequency of remission, extent of remission or toxicity was observed between the two groups. Among those patients who attained remission status, however, duration of remission (P = .05-.10) and of survival (P = <.05) was longer for the continuous group. All remissions in children occurred in acute lymphocytic leukemia, whereas all remission in adults were observed in acute myelocytic leukemia. The duration of remissions was somewhat shorter for children with acute lymphocytic leukemia than for adults with acute myelocytic leukemia. The frequency of remission, either partial or complete, was higher in children, however (36 per cent), than in adults (19 per cent), although the confidence limits for each figure overlap. The duration of acute leukemia in previously untreated patients did not influence response to therapy from the two antimetabolite regimens in this study. In patients who had had prior antimetabolite therapy, however, complete remissions were attained less often than in previously untreated patients. The toxic manifestations encountered during the administration of these antimetabolites are described. Seventeen deaths occurred during this study, of which 8 occurred in the first 10 days, presumably from leukemia and not drug toxicity. Five patients died with hypoplastic marrows ascribed to drug toxicity. The toxic manifestations were qualitatively and proportionately the same in patients who attained remission status, and in those patients who failed to remit, but who lived long enough to recognize the onset of remission if it were going to occur. No indication was obtained, therefore, that patients who attained remission were subjected to a greater toxic hazard, in order to achieve the therapeutic benefits observed, than those who did not remit. The median survival of patients who achieved remission was longer (p <.05) than for patients who did not remit. Since the survival time of remitters from relapse to death was almost identical with the survival time of nonremitters from onset of treatment to death, this difference can be accounted for by the time spent in remission and getting to remission. The median survival time from symptomatic onset for all children in this study was 12 months, and for adults, 7 months. The median in children is similar to that reported from other clinics. This is evidence that a comparative therapeutic trial in acute leukemia can be accomplished without recognizable compromise of patient welfare.

scholarly journals Human B-lymphocyte antigens expressed by lymphocytic and myelocytic leukemia cells. I. Detection by rabbit antisera.

1976 ◽  
Vol 144 (1) ◽  
pp. 167-178 ◽  
Author(s):  
R Billing ◽  
B Rafizadeh ◽  
I Drew ◽  
G Hartman ◽  
R Gale ◽  
...  
Keyword(s):  
B Cell ◽  
B Lymphocytes ◽  
Cell Lines ◽  
B Lymphocyte ◽  
Lymphocytic Leukemia ◽  
Immunofluorescent Staining ◽  
Leukemia Cells ◽  
Acute Myelocytic Leukemia ◽  
Normal Peripheral Blood ◽  
Myelocytic Leukemia

A previously uncharacterized human B-lymphocyte antigen has been detected by rabbit antisera raised to papain digests of spleen cell membranes. The unabsorbed sera reacted in both cytotoxicity and immunofluorescent tests with normal B lymphocytes and cultured B-cell lines but not with normal T lymphocytes or cultured T-cell lines. The cytotoxicity titers against B cells were as high as 1:32,000, whereas the same sera undiluted were negative against T cells. By immunofluorescent staining 6-14% of unfractionated normal lymphocytes and 48-85% of B-rich lymphocyte preparations were positive. Normal peripheral blood granulocytes, platelets, erythrocytes, and phytohemagglutinin blasts were negative. The antisera reacted with the same high titers against leukemia cells from approximately 70% of the patients with acute lymphocytic leukemia, acute myelocytic leukemia, chronic myelocytic leukemia, and seven of eight cases of chronic lymphocytic leukemia. From absorption studies it appeared that the same antigen was being expressed by leukemia cells and normal B lymphocytes. Using immunofluorescent staining the anti-B-cell antisera were able to detect positive leukemia cells in the bone marrow of patients with advanced leukemia and to monitor the elimination of these cells after chemotherapy. Soluble B-cell antigen was found in the serum of some leukemia and lymphoma patients do but not in normal serum.

scholarly journals Association between thrombocyte and neutrophyl count with cutaneous manifestations in children with acute lymphocytic leukemia and acute myelocytic leukemia

2019 ◽  
Vol 7 (2) ◽  
pp. 551
Author(s):  
Eva Hariani ◽  
Sri Wahyuni Purnama ◽  
Remenda Siregar
Keyword(s):  
Acute Leukemia ◽  
Acute Lymphocytic Leukemia ◽  
Lymphocytic Leukemia ◽  
P Value ◽  
Acute Myelocytic Leukemia ◽  
Cross Sectional ◽  
Hematopoietic Stem ◽  
Cutaneous Manifestations ◽  
Peripheral Tissues ◽  
Myelocytic Leukemia

Background: Acute leukemia is a hematopoietic stem cell malignant disease, with abnormal proliferation of leukemic and immature cells that suppress the production of normal blood cell and extensively invade peripheral tissues organs including skin. Homeostatic abnormalities that occur in leukemia e.g. thrombocytopenia and neutropenia. Various cutaneous manifestations can be observed in leukemia but the etiology is usually unknown, because many factors are responsible for this cutaneous manifestation. The aim of the present study was to determine association between thrombocyte and neutrophyl count with cutaneous manifestations in children with Acute Lymphocytic Leukemia (ALL) and Acute Myelocytic Leukemia (AML).Methods: This is an observational analytical cross-sectional study involving 51 children with acute leukemia (ALL and AML) were hospitalized in H. Adam Malik General Hospital Medan during April – September 2018. Interview, dermatology examination and recording thrombocyte and neutrophil count were performed to the subjects. Differences between thrombocyte and neutrophyl count with cutaneous manifestations were analyzed using Mann Whitney test. Association between thrombocyte and neutrophyl count with cutaneous manifestations were analyzed using Kolmogorov Smirnov test.Results: Children with Acute Leukemia in this study most of them were girls (51.0%), age between 0 - 5years old (39.2%). There were no significant differences between thrombocyte and neutrophyl count with cutaneous manifestations in children with acute leukemia (p value 0.692 and 0.814). There was no significant association between thrombocyte and neutrophyl count with cutaneous manifestations in children with acute leukemia (p value 0.490 and 0.803).Conclusions: There is no significant association between thrombocyte and neutrophyl count with cutaneous manifestations in children with acute leukemia.

scholarly journals COPING STRESS PADA ORANG TUA ANAK DENGAN LEUKEMIA LIMFOSITIK AKUT(ALL)

Psibernetika ◽  
2017 ◽  
Vol 9 (2) ◽  
Author(s):  
Shanty Sudarji ◽  
Desy Lustiyani Wahono
Keyword(s):  
Lymphoblastic Leukemia ◽  
Lymphocytic Leukemia ◽  
Self Control ◽  
Acute Myelocytic Leukemia ◽  
Coping With Stress ◽  
Myelocytic Leukemia ◽  
Role Of Parents ◽  
Sick Children ◽  
And Coping

<p>Cancer is not a contagious disease but can cause death, especially in children. Cancer that primarily affects children is leukemia with the number of about 25 to 30% of all types of cancer that affects all children in Indonesia. Common type of leukemia in children is acute lymphocytic or lymphoblastic leukemia (ALL) with a percentage of 82% and acute myelocytic leukemia (AML) by 18%. The role of parents in caring for sick children ALL is not easy, a lot of problems that will occur during the care of children who ALL, either of themselves, their families and the environment. Coping with stress is necessary to handle problems that occur during the care for ALL children. Researchers conducted<br />qualitative research with interviews of five parents who have children with acute lymphocytic leukemia. The data obtained showed that the main source of stress experienced came from a family that is the condition of a sick child, then the source of the stress from the environment and self. Symptoms of stress<br />experienced by the whole subject is prolonged fear and sadness. The whole subject S, RS, ME, DM, and NP using problem focused coping that are planful problem solving, seeking social support and coping confrontative. All subjects also use emotion focused coping. The whole subject of S, RS, ME, DM, and NP<br />using self control, accepting responsibility, and positive reappraisal. Only the subject of RS, ME, NP which uses distancing.</p>

scholarly journals A two-step timed sequential treatment for acute myelocytic leukemia

Blood ◽  
1989 ◽  
Vol 74 (5) ◽  
pp. 1499-1506 ◽  
Author(s):  
RB Geller ◽  
PJ Burke ◽  
JE Karp ◽  
RL Humphrey ◽  
HG Braine ◽  
...  
Keyword(s):  
Overall Survival ◽  
Complete Remission ◽  
De Novo ◽  
Remission Rate ◽  
Disease Free Survival ◽  
Acute Myelocytic Leukemia ◽  
Significant Prognostic Factor ◽  
Myelocytic Leukemia ◽  
De Novo Aml ◽  
To Receive

Abstract Since 1980, adults with acute myelocytic leukemia (AML) have been treated on two clinical studies using intensive timed sequential therapy. All patients ages 16 to 80, including those with secondary AML (SAML) and those with AML preceded by a hematologic disorder (AHD), were treated, regardless of medical complications at the time of diagnosis. The first study combined high doses of cytarabine (ara-C, AC) and daunorubicin (DRN, D) in sequence (Ac2-D-Ac) and resulted in a complete remission rate of 55%. A group of these patients selected by functional status was able to receive a second course of therapy in remission, which resulted in a disease-free survival (DFS) of greater than 40% at 7 years. Because of toxicity in that study, 114 patients were entered on a second trial initiated 4 years ago, using a less aggressive first course, with amsacrine, to achieve a stable remission (Ac2-D-Amsa). This first treatment was followed by a more intensive second course (Ac6-D-Ac). With this two-step approach, a higher complete remission (CR) rate (76% for de novo AML and 54% for SAML-AHD) was achieved, and more patients were able to receive the second course of therapy. At the current median follow-up of 26 months, the median duration of DFS and overall survival are 11 and 14 months for patients with de novo AML. Age less than or equal to 55 is the most significant prognostic factor for both prolonged DFS and overall survival, with median durations of 17 and 18 months, respectively, for these younger patients. Patients with SAML-AHD remain relatively refractory to treatment despite aggressive chemotherapy, with median durations of DFS and overall survival of 9 months and 5 months, respectively.

scholarly journals Clinical characteristics and drug tolerance for Pseudomonas aeruginosa infection in patients with agranulocytosis and fever in Shanghai

2019 ◽  
Vol 17 ◽  
pp. 205873921882494
Author(s):  
Xiu-Hua Han ◽  
Hui-Li Xu ◽  
Jun Zhu ◽  
Yuan-Fei Mao ◽  
Jiong Hu ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antibiotic Resistance ◽  
Drug Sensitivity ◽  
High Sensitivity ◽  
Lymphocytic Leukemia ◽  
Acute Myelocytic Leukemia ◽  
Myelocytic Leukemia ◽  
Neutropenic Sepsis ◽  
Drug Sensitivity Test ◽  
Resistance Rates

The characteristics of distribution of Pseudomonas aeruginosa in patients with agranulocytosis and fever in 12 hospitals in Shanghai from 2012 to 2014 were retrospectively analyzed. WHONET 5.6 software was used to analyze the results of drug sensitivity test. Data from different diseases, different sample sources, and drug sensitivity tests were statistically analyzed to investigate the clinical distribution characteristics and drug resistance of Pseudomonas aeruginosa in patients with agranulocytosis and fever in Shanghai, China. This study revealed that, among these 109 strains of P. aeruginosa, they were mainly found in patients with acute myelocytic leukemia (AML; 48 strains, 44.04%) and patients with acute lymphocytic leukemia (ALL; 36 strains, 33.03%). The specimen sources were mainly respiratory tract secretions (58 strains, 53.21%) and blood (21 strains, 19.26%). The P. aeruginosa isolates from neutropenic sepsis patients showed high sensitivity to the following antibiotics: piperacillin/tazobactam, cefepime, ciprofloxacin, ceftazidime, and amikacin with 91.1%, 89%, 89%, 87.9%, and 85.7% of isolates being sensitive, respectively. Furthermore, for P. aeruginosa isolates from the AML group of patients, the lowest antibiotic resistance rates were seen for ciprofloxacin (0%), cefoperazone/sulbactam (2.1%), and cefepime (7.1%), while for the ALL group the lowest antibiotic resistance rates were seen for piperacillin (2.8%), ceftazidime (2.8%), and cefepime (2.8%). Isolates from AML patients (21.3%) were significantly more likely to be piperacillin resistant than those from the ALL patients (2.8%). Therefore, P. aeruginosa infection is relatively common in patients with agranulocytosis and fever. The strains had a certain degree of resistance to commonly used antibiotics.

scholarly journals Factors That Influence the Appearance of Central Nervous System Leukemia

Blood ◽  
1973 ◽  
Vol 42 (6) ◽  
pp. 935-938 ◽  
Author(s):  
Santiago Pavlovsky ◽  
Mariana Eppinger-Helft ◽  
Federico Sackmann Muriel
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Acute Lymphocytic Leukemia ◽  
Treatment Protocol ◽  
Lymphocytic Leukemia ◽  
Acute Myelocytic Leukemia ◽  
Cns Involvement ◽  
Lymphoid Leukemia ◽  
Myelocytic Leukemia ◽  
Wbc Count

Abstract At present, central nervous system (CNS) leukemia is one of the principal causes for termination of complete remission in acute lymphocytic leukemia (ALL). The factors which influence the increase of CNS infiltration have been studied comparing different parameters (age, initial peripheral WBC count, type of leukemia, and presence or absence of initial organomegaly) to determine the leukemia population with highest risk of developing this syndrome. A total of 127 cases of acute lymphoid leukemia (ALL) (98 children and 29 adults) and 101 acute myelocytic leukemia (AML) (41 children and 60 adults), on the same treatment protocol from 1967 to 1970, were included in this study. The median survival and the rate of incidence of symptomatic CNS leukemia was 18 mo and 32% in ALL and 4 mo and 7% in AML. The incidence of CNS leukemia per month of survival was similar in both groups: 4 mo, 3% in AML and 4% in ALL, at 8 mo, 13% in both ALL and AML. The incidence of CNS leukemia was higher in children with ALL than in adults: 41% in children and 19% in adults at 20-mo survival. Organomegaly (spleen, liver and/or lymph nodes) as an early manifestation increased the risk of CNS involvement. The CNS infiltration was significantly greater in patients with high initial peripheral WBC count. The incidence of meningeal leukemia did not differ in ALL and AML. In conclusion, CNS leukemia infiltration was more frequent in children with initial organomegaly and high WBC count at the time of diagnosis.

Effective chemotherapy of acute myelocytic leukemia occurring after alkylating agent or radiation therapy for prior malignancy.

1983 ◽  
Vol 1 (3) ◽  
pp. 204-207 ◽  
Author(s):  
W P Vaughan ◽  
J E Karp ◽  
P J Burke
Keyword(s):  
Radiation Therapy ◽  
Complete Remission ◽  
Alkylating Agent ◽  
Remission Rate ◽  
High Dose ◽  
Acute Myelocytic Leukemia ◽  
Secondary Leukemia ◽  
Sequential Chemotherapy ◽  
Myelocytic Leukemia ◽  
Prior Malignancy

Eleven consecutive patients with acute myelocytic leukemia occurring as a second malignancy were treated with high-dose, timed, sequential chemotherapy. Eight of the patients were felt to have "secondary" acute leukemia because they had received an alkylating agent or radiation therapy. The other three patients were considered controls. Despite a median age of 65, four of the eight secondary leukemia patients achieved complete remission with this regimen. One of the three control patients also achieved complete remission. This remission rate and duration are comparable to what was achieved with this treatment of "primary" acute myelocytic leukemia during the same period of time. These results suggest that patients with leukemia occurring after an alkylating agent or radiation therapy are not at especially high risk if treated aggressively.

scholarly journals Insulin receptors on leukemia and lymphoma cells

Blood ◽  
1983 ◽  
Vol 62 (2) ◽  
pp. 251-255
Author(s):  
PM Chen ◽  
SH Kwan ◽  
TS Hwang ◽  
BN Chiang ◽  
CK Chou
Keyword(s):  
Binding Sites ◽  
Insulin Receptors ◽  
Insulin Binding ◽  
Lymphocytic Leukemia ◽  
Acute Monocytic Leukemia ◽  
Acute Myelocytic Leukemia ◽  
Chronic Myelocytic Leukemia ◽  
Monocytic Leukemia ◽  
Myelocytic Leukemia ◽  
Specific Insulin

Tumor cells obtained from leukemia and lymphoma patients were investigated for specific insulin receptors. Using radioactive 125I- labeled insulin, specific insulin binding sites were demonstrated on most acute lymphocytic leukemia (ALL) and acute myelocytic leukemia (AML) cells, including acute promyelocytic leukemia (APL), chronic myelocytic leukemia (CML), and acute monocytic leukemia (AMoL) cells. Insulin receptors were not found on chronic lymphocytic leukemia (CLL) and malignant lymphoma (ML) cells. Specific insulin binding sites were also found on monocytes and thymocytes after treatment with phytohemagglutinin (PHA-P), but not on inactivated tonsil cells, peripheral blood lymphocytes, or thymocytes. There was no inverse correlation between the content of insulin receptors and the basal level of circulating insulin. These data suggest that the insulin receptor may be a new marker of acute leukemia and chronic myelocytic leukemia.

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