scholarly journals Immunosuppressive therapy of aplastic anemia: results of a prospective, randomized trial of antithymocyte globulin (ATG), methylprednisolone, and oxymetholone to ATG, very high-dose methylprednisolone, and oxymetholone

Blood ◽  
1992 ◽  
Vol 79 (10) ◽  
pp. 2566-2571 ◽  
Author(s):  
K Doney ◽  
M Pepe ◽  
R Storb ◽  
E Bryant ◽  
C Anasetti ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Aplastic Anemia ◽  
Causes Of Death ◽  
Response To Therapy ◽  
High Dose ◽  
Actuarial Survival ◽  
High Dose Methylprednisolone ◽  
Significant Difference ◽  
Very High

Abstract Sixty-eight patients with moderate (n = 15) or severe (n = 53) aplastic anemia were entered into a prospective, randomized, two-arm treatment study comparing antihuman thymocyte globulin (ATG), lower-dose methylprednisolone (LDM) and oxymetholone to ATG, higher-dose methylprednisolone (HDM), and oxymetholone. There were no differences between the two groups when comparing age, sex, etiology of aplasia, disease duration, severity of aplasia, or pretherapy granulocyte counts. Side effects of LDM and HDM were similar. Of the 64 patients evaluable for response to therapy, 12 of 33 (36%) who received LDM had complete, partial, or minimal responses compared with 15 of 31 patients (48%) who received HDM (P = .33). Actuarial survival at 4 years is 43% for patients in the LDM group and 47% for patients in the HDM group (P = .99). Causes of death included hemorrhage, infection, evolution to acute leukemia, and complications of subsequent bone marrow transplantation. Long-term complications included paroxysmal nocturnal hemoglobinuria (n = 3), evolution to myelodysplasia or acute leukemia (n = 6), and recurrent aplasia (n = 6). We were unable to show a significant difference in toxicity, response rate, or survival for patients treated with ATG, oxymetholone, and LDM compared with patients who received ATG, oxymetholone, and HDM.

scholarly journals Immunosuppressive therapy of aplastic anemia: results of a prospective, randomized trial of antithymocyte globulin (ATG), methylprednisolone, and oxymetholone to ATG, very high-dose methylprednisolone, and oxymetholone

Blood ◽  
1992 ◽  
Vol 79 (10) ◽  
pp. 2566-2571
Author(s):  
K Doney ◽  
M Pepe ◽  
R Storb ◽  
E Bryant ◽  
C Anasetti ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Aplastic Anemia ◽  
Causes Of Death ◽  
Response To Therapy ◽  
High Dose ◽  
Actuarial Survival ◽  
High Dose Methylprednisolone ◽  
Significant Difference ◽  
Very High

Sixty-eight patients with moderate (n = 15) or severe (n = 53) aplastic anemia were entered into a prospective, randomized, two-arm treatment study comparing antihuman thymocyte globulin (ATG), lower-dose methylprednisolone (LDM) and oxymetholone to ATG, higher-dose methylprednisolone (HDM), and oxymetholone. There were no differences between the two groups when comparing age, sex, etiology of aplasia, disease duration, severity of aplasia, or pretherapy granulocyte counts. Side effects of LDM and HDM were similar. Of the 64 patients evaluable for response to therapy, 12 of 33 (36%) who received LDM had complete, partial, or minimal responses compared with 15 of 31 patients (48%) who received HDM (P = .33). Actuarial survival at 4 years is 43% for patients in the LDM group and 47% for patients in the HDM group (P = .99). Causes of death included hemorrhage, infection, evolution to acute leukemia, and complications of subsequent bone marrow transplantation. Long-term complications included paroxysmal nocturnal hemoglobinuria (n = 3), evolution to myelodysplasia or acute leukemia (n = 6), and recurrent aplasia (n = 6). We were unable to show a significant difference in toxicity, response rate, or survival for patients treated with ATG, oxymetholone, and LDM compared with patients who received ATG, oxymetholone, and HDM.

scholarly journals High-dose cyclophosphamide for severe aplastic anemia: long-term follow-up

Blood ◽  
2010 ◽  
Vol 115 (11) ◽  
pp. 2136-2141 ◽  
Author(s):  
Robert A. Brodsky ◽  
Allen R. Chen ◽  
Donna Dorr ◽  
Ephraim J. Fuchs ◽  
Carol Ann Huff ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Aplastic Anemia ◽  
Severe Aplastic Anemia ◽  
High Dose ◽  
Actuarial Survival ◽  
Free Survival ◽  
Long Term Follow Up ◽  
Treatment Naïve

Abstract Severe aplastic anemia (SAA) is a life-threatening bone marrow failure disorder that can be treated with bone marrow transplantation, immunosuppressive therapy, and high-dose cyclophosphamide. Here, we report long-term follow-up on 67 SAA patients (44 treatment-naive and 23 refractory) treated with high-dose cyclophosphamide. At 10 years, the overall actuarial survival was 88%, the response rate was 71% with the majority being complete, and the actuarial event-free survival was 58% in 44 treatment-naive SAA patients. Patients with refractory SAA fared less well after high-dose cyclophosphamide therapy; at 10 years, overall actuarial survival, response, and actuarial event-free survival rates were 62%, 48%, and 27%, respectively. High-dose cyclophosphamide is highly effective therapy for severe aplastic anemia. Large randomized controlled trials will be necessary to establish how results of high-dose cyclophosphamide compare with either bone marrow transplantation or standard immunosuppressive regimens, such as antithymocyte globulin and cyclosporine.

scholarly journals Evaluation of Soil S Pools under 23 Years of Maize Monoculture

Agronomy ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2376
Author(s):  
Pavel Suran ◽  
Martin Kulhánek ◽  
Jiří Balík ◽  
Jindřich Černý ◽  
Ondřej Sedlář
Keyword(s):  
High Dose ◽  
The Czech Republic ◽  
S Uptake ◽  
Biomass Yields ◽  
Entire Experiment ◽  
Initial Content ◽  
Phosphorus And Potassium ◽  
Very High ◽  
Sulfur Nutrition

Sulfur nutrition is a critical part of proper crop growth and development. In our study, biomass yields (BY) and S uptake were investigated on long-term maize monoculture on haplic luvisol soil during the 23 years of this trial, as well as changes in water extractable (Sw), adsorbed (Sads), mineral (Sav), and pseudo-total S (St) fractions. Treatments used in this study are: (1) Control (Cont); (2) ammonium sulfate (AS); (3) urea and ammonium nitrate (UAN); (4) UAN + phosphorus and potassium (UAN + PK); (5) UAN + phosphorus, magnesium, sulfur (UAN + PMgS); and (6) Fallow. Recently, the Mehlich 3 method started to be used in the Czech Republic to determine content of plant available S. Using this method, it was found that the content of S extracted by Mehlich 3 (SM3) closely correlates to Sav in both topsoil and subsoil (r = 0.958 in 1997 and 0.990 in 2019, both at p < 0.001). We also found that, on average, during the entire experiment, all treatments had increased yields over Cont (135–147%) and increased S uptake (291, 192, 180, and 246% of Cont for AS, UAN, UAN + PK, and UAN + PMgS, respectively). Examining the changes from 1997 to 2019 in topsoil (0–30 cm depth), we discovered a decrease of S content in Sw, Sads, Sav, and St fractions on all treatments to an average of 34.6%, 65.8%, 42.2%, and 78.6% of their initial values. The exception was AS treatment, which doubled its initial content in mineral fractions and maintained the same levels of St, and which we attribute to the very high dose of S on this treatment (142 kg ha−1 year−1). Using the simple balance method, AS and UAN + PMgS treatments lost 142.2 and 95.3 kg S ha−1 year−1 to other sinks, except plant uptake, from the entire soil profile (0–60 cm) during 23 years of experiment. Other treatments also show significant losses with the exception of Fallow. Given these results, it is clear that content of sulfur in soil is generally decreasing and attention should be paid mainly towards minimizing of its losses.

scholarly journals BST-236, a novel cytarabine prodrug for patients with acute leukemia unfit for standard induction: a phase 1/2a study

2019 ◽  
Vol 3 (22) ◽  
pp. 3740-3749 ◽  
Author(s):  
Tsila Zuckerman ◽  
Ron Ram ◽  
Luiza Akria ◽  
Maya Koren-Michowitz ◽  
Ron Hoffman ◽  
...  
Keyword(s):  
Older Adults ◽  
Acute Leukemia ◽  
Phase 1 ◽  
Intensive Therapy ◽  
High Dose ◽  
Term Survival ◽  
Long Term Survival ◽  
Key Points ◽  
High Dose Cytarabine

Key Points The majority of older adults or unfit acute leukemia patients are not offered intensive therapy, resulting in dismal long-term survival. A novel cytarabine prodrug BST-236 enables delivery of high-dose cytarabine and appears to be safe and efficacious in these patients.

High-dose cytosine arabinoside: Clinical response to therapy in acute leukemia

1982 ◽  
Vol 10 (S1) ◽  
pp. 239-250 ◽  
Author(s):  
A. P. Early ◽  
H. D. Preisler ◽  
D. J. Higby ◽  
M. Brecher ◽  
G. Browman ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Clinical Response ◽  
Cytosine Arabinoside ◽  
Response To Therapy ◽  
High Dose

Combination Chemotherapy (CVP or Chop)-Radiotherapy Approach in Early Stage Non-Hodgkin's Lymphomas

1982 ◽  
Vol 68 (2) ◽  
pp. 137-142 ◽  
Author(s):  
Pasquale Comella ◽  
Gianfranco Scoppa ◽  
Giuseppe Abate ◽  
Giuseppe Comella ◽  
Gaetano Apice ◽  
...  
Keyword(s):  
Combination Chemotherapy ◽  
Early Stage ◽  
Response To Therapy ◽  
Stage I ◽  
Stage Ii ◽  
Actuarial Survival ◽  
Favorable Histology ◽  
Significant Difference ◽  
Extended Field ◽  
Hodgkin's Lymphomas

From January 1978 to December 1980, 42 patients with early stage non-Hodgkin's lymphoma other than of the gastrointestinal tract were treated with radiotherapy and combination chemotherapy. Eighteen patients in stage I were submitted to locally extended-field radiotherapy up to a mean dose of 48 Gy with a Co60 source and, after a 3-week rest period, to 6 cycles of combination chemotherapy. Twenty-four patients in stage II received 3 cycles of combination chemotherapy before and after irradiation, the same as for stage I. Combination chemotherapy consisted of cyclophosphamide, vincristine and prednisone (CVP) for 15 cases with favorable histology (3 NWDL, 1 NPDI, 11 DWDL), whereas it included cyclophosphamide, adriamycin, vincristine and prednisone (CHOP) for 27 cases with unfavorable histology (20 DPDL, 3 DM, 4 DH). Complete remission (CR) was achieved in 35/42 (83%) patients, with a highly significant difference between stage I (100%) and stage II (71%). After 42 months of follow-up, the probability of survival for all patients was 72%. Survival was better for stage I (88%) than for stage II (68%) and for favorable histology (87%) as compared to unfavorable histology (70%). Furthermore, survival was highly influenced by response to therapy. Indeed, actuarial survival rate for CR was 91% as compared to a median survival time of 10.2 months for the remaining patients. Four patients, all with poor histology, relapsed after 5–24 (mean 11) months of CR. Only one of them had an extension in extranodal sites and eventually died, despite the salvage treatment utilized. In our experience, locally extended-field irradiation combined with chemotherapy gave a high proportion of CR and seemed to prevent relapses, particularly in extranodal sites.

scholarly journals Multicenter randomized study comparing cyclosporine-A alone and antithymocyte globulin with prednisone for treatment of severe aplastic anemia

Blood ◽  
1992 ◽  
Vol 79 (10) ◽  
pp. 2540-2546 ◽  
Author(s):  
E Gluckman ◽  
H Esperou-Bourdeau ◽  
A Baruchel ◽  
M Boogaerts ◽  
J Briere ◽  
...  
Keyword(s):  
Partial Response ◽  
Aplastic Anemia ◽  
Antithymocyte Globulin ◽  
Bone Marrow Failure ◽  
Randomized Study ◽  
Alternative Therapy ◽  
Survival Rates ◽  
Severe Aplastic Anemia ◽  
Actuarial Survival ◽  
Significant Difference

Abstract We report the results of a randomized multicenter study comparing the efficacy of antithymocyte globulin (ATG) with that of cyclosporin A (CsA) as first-line therapy for severe aplastic anemia (SAA). Patients were randomized to receive ATG and prednisone (PDN) or CsA; hematologic response and toxicity were compared. At 3-month evaluation, patients who had no or minimal response received the alternative therapy to assess the value of a sequential immunosuppressive therapy for treatment of severe aplastic anemia. One hundred nineteen patients were randomized; 25 were excluded, of whom 3 were misdiagnosed and 22 did not follow the cross-over protocol. Ninety-four patients were analyzed; 46 received CsA, and 48 received ATG-PDN. The actuarial survival was 66.7%, with a median follow-up time of 19 months. There was no significant difference in survival between the groups with, at 3 months, an actuarial survival of 88% in the CsA group and 75% in the ATG group (NS); at 12 months, it was 70% in the CsA group and 64% in the ATG group (NS). The percentage of complete and partial response was 11.6% and 16%, respectively, at 3 months, and 31.6% and 30%, respectively, at 12 months (NS). The main prognostic factor was the absolute neutrophil count (ANC) at entry: Patients with ANC less than 0.2 x 10(9)/L had a significantly lower survival as compared with patients with more than 0.2 x 10(9)/L ANC (P = .0001). At 12 months, 62 evaluable patients were alive, with a complete or partial response in 36 patients. Patients who had responded to the first treatment had a better recovery of bone marrow failure than those who had sequential immunosuppression. The main complication was infection, which was more often observed and more often lethal during ATG and PDN therapy. In this study, initial treatment of SAA with either CsA or ATG-PDN followed by cross-over therapy for nonresponders produced comparable response and survival rates.

scholarly journals Can very high-dose anti-tumor necrosis factor blockade at onset of rheumatoid arthritis produce long-term remission?

2002 ◽  
Vol 46 (7) ◽  
pp. 1971-1972 ◽  
Author(s):  
Philip G. Conaghan ◽  
Mark A. Quinn ◽  
Philip O'Connor ◽  
Richard J. Wakefield ◽  
Zunaid Karim ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Tumor Necrosis Factor ◽  
Tumor Necrosis ◽  
High Dose ◽  
Very High ◽  
Necrosis Factor

Medulloblastoma: freedom from relapse longer than 8 years — a therapeutic cure?

1991 ◽  
Vol 75 (4) ◽  
pp. 575-582 ◽  
Author(s):  
Mark G. Belza ◽  
Sarah S. Donaldson ◽  
Gary K. Steinberg ◽  
Richard S. Cox ◽  
Philip H. Cogen
Keyword(s):  
Medical Center ◽  
Survival Rates ◽  
Adjunctive Treatment ◽  
High Dose ◽  
Content Type ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Fine Print

✓ Seventy-seven patients presenting with medulloblastoma between 1958 and 1986 were treated at Stanford University Medical Center and studied retrospectively. Multimodality therapy utilized surgical extirpation followed by megavoltage irradiation. In 15 cases chemotherapy was used as adjunctive treatment. The 10- and 15-year actuarial survival rates were both 41% with an 18-year maximum follow-up period (median 4.75 years). There were no treatment failures after 8 years of tumor-free survival. Gross total removal of tumor was achieved in 22 patients (32%); the surgical mortality rate was 3.9%. No significant difference was noted in the incidence of metastatic disease between shunted and nonshunted patients. The classical form of medulloblastoma was present in 67% of cases while the desmoplastic subtype was found in 16%. Survival rates were best for patients presenting after 1970, for those with desmoplastic tumors, and for patients receiving high-dose irradiation (≥ 5000 cGy) to the posterior fossa. Although early data on freedom from relapse suggested a possible beneficial effect from chemotherapy, long-term follow-up results showed no advantage from this modality of treatment. The patterns of relapse and survival were examined; 64% of relapses occurred within the central nervous system, and Collins' rule was applicable in 83% of cases beyond the period of risk. Although patients treated for recurrent disease could be palliated, none were long-term survivors. The study data indicate that freedom from relapse beyond 8 years from diagnosis can be considered as a cure in this disease. Long-term follow-up monitoring is essential to determine efficacy of treatment and to assess survival patterns accurately.

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