Clinical and cytogenetic correlations in 63 patients with therapy-related myelodysplastic syndromes and acute nonlymphocytic leukemia: further evidence for characteristic abnormalities of chromosomes no. 5 and 7.

1986 ◽  
Vol 4 (3) ◽  
pp. 325-345 ◽  
Author(s):  
M M Le Beau ◽  
K S Albain ◽  
R A Larson ◽  
J W Vardiman ◽  
E M Davis ◽  
...  
Keyword(s):  
Blood Cells ◽  
Alkylating Agent ◽  
Chromosome Region ◽  
Late Complications ◽  
Cytotoxic Chemotherapy ◽  
Acute Nonlymphocytic Leukemia ◽  
Primary Disorder ◽  
High Doses ◽  
Cytotoxic Therapies ◽  
Previous Disease

Clinical, histologic, and cytogenetic features in 63 patients with a therapy-related myelodysplastic syndrome (t-MDS) or acute nonlymphocytic leukemia (t-ANLL) following cytotoxic chemotherapy or radiotherapy for a previous disease were analyzed. Eleven patients had received only radiotherapy for the primary disorder. In most cases, high doses had been administered to treatment ports that included the pelvic or spinal bone marrow. Twenty-one patients had received only chemotherapy for their primary disease, all for more than 1 year and all but one with an alkylating agent, either alone or in combination with other drugs. Thirty-one patients had received both radiotherapy and chemotherapy, either concurrently or sequentially. A clonal chromosomal abnormality was observed in marrow or blood cells from 61 of the 63 patients (97%). Fifty-five patients (87%) had a clonal abnormality of chromosomes no. 5 and/or 7 consisting of loss of all or part of the long arm of the chromosome. The critical chromosome region that was consistently deleted in all 17 patients with del(5q) comprised bands q23 to q32. In addition to nos. 5 and 7, five other chromosomes (no. 1, 4, 12, 14, and 18) were found to be nonrandomly involved. Both t-MDS and t-ANLL are late complications of cytotoxic therapies that have distinctive clinical and histologic features and are associated with characteristic aberrations of chromosomes no. 5 and 7. It seems likely that these two chromosomes contain genes involved in the pathogenesis of these hematopoietic neoplasms.

scholarly journals Acute nonlymphocytic leukemia following etoposide and cisplatin combination chemotherapy for advanced non-small-cell carcinoma of the lung

Blood ◽  
1987 ◽  
Vol 70 (5) ◽  
pp. 1412-1417 ◽  
Author(s):  
MJ Ratain ◽  
LS Kaminer ◽  
JD Bitran ◽  
RA Larson ◽  
MM Le Beau ◽  
...  
Keyword(s):  
Combination Chemotherapy ◽  
Advanced Nsclc ◽  
De Novo ◽  
Cumulative Risk ◽  
Late Complications ◽  
Small Cell ◽  
First Year ◽  
Acute Nonlymphocytic Leukemia ◽  
Acute Monoblastic Leukemia ◽  
High Doses

Combination chemotherapy is frequently used in the therapy of advanced non-small-cell lung cancer (NSCLC), but late complications are rarely recognized because of the short survival of most patients. Of 119 patients with advanced NSCLC treated with cisplatin and other drugs, four patients developed acute nonlymphocytic leukemia (ANLL). All four patients received etoposide and cisplatin with or without vindesine. Leukemia was diagnosed at 13, 19, 28, and 35 months after start of treatment. Three patients had morphologic and/or cytogenetic features of acute leukemia with significant monoblastic involvement; the fourth patient had trilineage dysplasia and cytogenetic abnormalities more commonly associated with therapy-related leukemia. Detailed analysis of the subgroup who survived longer than 1 year (24 patients) suggests that high cumulative doses of etoposide are leukemogenic; the median etoposide dose was 6,795 mg/m2 (first year only) in the four leukemic patients compared with 3,025 mg/m2 in the 20 nonleukemic patients (P less than .01). The rate of ANLL was 0.30 per person-year after the first year (95% confidence limits 0.11 to 0.90), with a cumulative risk of 15% +/- 11% at 2 years, and 44% +/- 24% at 2.5 years. We conclude that high doses of etoposide are potentially leukemogenic, and can induce a syndrome with features of acute monoblastic leukemia de novo that is distinct from other secondary leukemias.

Acute nonlymphocytic leukemia following etoposide and cisplatin combination chemotherapy for advanced non-small-cell carcinoma of the lung

Blood ◽  
1987 ◽  
Vol 70 (5) ◽  
pp. 1412-1417 ◽  
Author(s):  
MJ Ratain ◽  
LS Kaminer ◽  
JD Bitran ◽  
RA Larson ◽  
MM Le Beau ◽  
...  
Keyword(s):  
Combination Chemotherapy ◽  
Advanced Nsclc ◽  
De Novo ◽  
Cumulative Risk ◽  
Late Complications ◽  
Small Cell ◽  
First Year ◽  
Acute Nonlymphocytic Leukemia ◽  
Acute Monoblastic Leukemia ◽  
High Doses

Abstract Combination chemotherapy is frequently used in the therapy of advanced non-small-cell lung cancer (NSCLC), but late complications are rarely recognized because of the short survival of most patients. Of 119 patients with advanced NSCLC treated with cisplatin and other drugs, four patients developed acute nonlymphocytic leukemia (ANLL). All four patients received etoposide and cisplatin with or without vindesine. Leukemia was diagnosed at 13, 19, 28, and 35 months after start of treatment. Three patients had morphologic and/or cytogenetic features of acute leukemia with significant monoblastic involvement; the fourth patient had trilineage dysplasia and cytogenetic abnormalities more commonly associated with therapy-related leukemia. Detailed analysis of the subgroup who survived longer than 1 year (24 patients) suggests that high cumulative doses of etoposide are leukemogenic; the median etoposide dose was 6,795 mg/m2 (first year only) in the four leukemic patients compared with 3,025 mg/m2 in the 20 nonleukemic patients (P less than .01). The rate of ANLL was 0.30 per person-year after the first year (95% confidence limits 0.11 to 0.90), with a cumulative risk of 15% +/- 11% at 2 years, and 44% +/- 24% at 2.5 years. We conclude that high doses of etoposide are potentially leukemogenic, and can induce a syndrome with features of acute monoblastic leukemia de novo that is distinct from other secondary leukemias.

scholarly journals Secondary hemophagocytic syndrome after renal transplantation: two case-reports

2020 ◽  
Vol 42 (1) ◽  
pp. 118-123 ◽  
Author(s):  
José Narciso Júnior ◽  
Beatriz de Oliveira Neri ◽  
Gilberto Loiola de Alencar Dantas ◽  
Lara de Holanda Jucá Silveira ◽  
Maria Luiza de Mattos Brito Oliveira Sales ◽  
...  
Keyword(s):  
Blood Cells ◽  
Hemophagocytic Syndrome ◽  
Case Reports ◽  
Ivig Therapy ◽  
Clinical Results ◽  
Ivig Treatment ◽  
High Morbidity ◽  
Neoplastic Processes ◽  
Precise Diagnosis ◽  
High Doses

ABSTRACT Hemophagocytic syndrome or hemophagocytic lymphohistiocytosis (HLH) is an infrequent and underdiagnosed condition caused by an overactive immune response, resulting in blood cells phagocytosis. After kidney transplantation (KTx), HLH is usually secondary (or reactive) to infectious and neoplastic processes and has a high mortality rate. No effective treatment is available for this condition. Usual procedures include detecting and treating the pathology triggering the immune system dysregulation, other than administration of intravenous human immunoglobulin (IVIG) and high doses of steroids, and plasmapheresis. The best protocol for maintenance immunosuppressive therapy is also unknown. This article presents two cases of post-KTx reactive HLH that underwent adjuvant IVIG treatment and obtained good clinical results. Despite the high morbidity and mortality associated with reactive HLH after KTx, the early and precise diagnosis and the administration of IVIG therapy along with the treatment of the triggering disease, was an effective strategy to control HLH.

Reversible Neutropenia Associated with Ampicillin Therapy in Pediatric Patients

1981 ◽  
Vol 15 (10) ◽  
pp. 802-806 ◽  
Author(s):  
Kusum Kumar ◽  
Ashir Kumar
Keyword(s):  
Bone Marrow ◽  
Blood Cell ◽  
Red Blood Cells ◽  
White Blood Cell ◽  
Blood Cells ◽  
Pediatric Patients ◽  
Bone Marrow Examination ◽  
High Dose ◽  
Maturation Arrest ◽  
High Doses

Hematologic abnormalities associated with penicillin compounds are uncommon, and neutropenia associated with ampicillin is reported even less frequently. Neutropenia developed in three pediatric patients after high-dose (150–400 mg/kg) ampicillin therapy over a period of 3 to 12 days. In all cases, the white blood cell and neutrophil counts returned towards normal within 4 to 11 days after discontinuation of the antibiotic. Bone marrow examination revealed a maturation arrest in one and slight shift to the left in the maturation of granulocytic cells in another. Other marrow components were normal. Red blood cells, reticulocytes, platelets, and hemoglobin did not show any abnormal alteration in any of the patients. Physicians administering ampicillin, particularly in high doses, should be alert to the possible development of neutropenia; however, all reported neutropenias have been reversible.

scholarly journals Congress of Neurological Surgeons Systematic Review and Evidence-based Guidelines Update on the Role of Targeted Therapies and Immunotherapies in the Management of Progressive Glioblastomaoncolo

2021 ◽  
Author(s):  
Evan Winograd ◽  
Isabelle Germano ◽  
Patrick Wen ◽  
Jeffrey J. Olson ◽  
David Ryan Ormond
Keyword(s):  
Overall Survival ◽  
Combination Therapy ◽  
Progression Free Survival ◽  
Cytotoxic Chemotherapy ◽  
Cytotoxic Agents ◽  
Defined Benefit ◽  
Targeted Agents ◽  
Insufficient Evidence ◽  
Free Survival ◽  
Cytotoxic Therapies

Abstract The following questions and recommendations are pertinent to the following:Target PopulationThese recommendations apply to adults with progressive GBM who have undergone standard primary treatment with surgery and/or chemoradiation.Question 1In adults with progressive glioblastoma is the use of bevacizumab as monotherapy superior to standard salvage cytotoxic chemotherapy as measured by progression free survival and overall survival?RecommendationLevel III: Treatment with bevacizumab is suggested in the treatment of progressive GBM, as it provides improved disease control compared to historical controls as measured by best imaging response and progression free survival at 6 months, while not providing evidence for improvement in overall survival. Question 2In adults with progressive glioblastoma is the use of bevacizumab as combination therapy with cytotoxic agents superior to standard salvage cytotoxic chemotherapy as measured by progression free survival and overall survival?RecommendationLevel III: There is insufficient evidence to show benefit or harm of bevacizumab in combination with cytotoxic therapies in progressive glioblastoma due to a lack of evidence supporting a clearly defined benefit without significant toxicity.Question 3In adults with progressive glioblastoma is the use of bevacizumab as a combination therapy with targeted agents superior to standard salvage cytotoxic chemotherapy as measured by progression free survival and overall survival?Recommendation There is insufficient evidence to support a recommendation regarding this question.Question 4In adults with progressive glioblastoma is the use of targeted agents as monotherapy superior to standard salvage cytotoxic chemotherapy as measured by progression free survival and overall survival?RecommendationThere is insufficient evidence to support a recommendation regarding this question.Question 5In adults with progressive glioblastoma is the use of targeted agents in combination with cytotoxic therapies superior to standard salvage cytotoxic chemotherapy as measured by progression free survival and overall survival?Recommendation There is insufficient evidence to support a recommendation regarding this question.Question 6In adults with progressive glioblastoma is the use of immunotherapy monotherapy superior to standard salvage cytotoxic chemotherapy as measured by progression free survival and overall survival?RecommendationThere is insufficient evidence to support a recommendation regarding this question.Question 7In adults with progressive glioblastoma is the use of immunotherapy in combination with targeted agents superior to standard salvage cytotoxic chemotherapy as measured by progression free survival and overall survival?Recommendation There is insufficient evidence to support a recommendation regarding this question.Question 8In adults with progressive glioblastoma is the use of immunotherapy in combination with bevacizumab superior to standard salvage cytotoxic chemotherapy as measured by progression free survival and overall survival?RecommendationThere is insufficient evidence to support a recommendation regarding this question.

scholarly journals Effects of radiotherapy on oral cavity tissues

2017 ◽  
Vol 64 (4) ◽  
pp. 179-183
Author(s):  
Marko Dožić ◽  
Suzana Stojanović-Rundić ◽  
Vesna Plešinac-Karapandžić ◽  
Srđan Milanović ◽  
Nikola Milošević
Keyword(s):  
Oral Cavity ◽  
Oral Mucosa ◽  
Multidisciplinary Approach ◽  
Late Complications ◽  
Radiation Toxicity ◽  
Neck Tumors ◽  
Secondary Infections ◽  
Radical Therapy ◽  
High Doses ◽  
Acute Radiation Toxicity

Abstract Radiotherapy in the treatment of head and neck tumors is most often used as an independent method or in combination with surgery and / or chemotherapy. These therapeutic methods in a multidisciplinary approach generally lead to favourable therapeutic response. During radiotherapy of this region, oral mucosa is inevitably covered within irradiated volume. Radical therapy is achieved with high doses of radiation, which usually results in development of undesired toxic effects, which, depending on the time of manifestation can be acute and late. Acute radiation toxicity occurs during or immediately after completion of performed therapy, and the late one several months or years after the completed treatment. The most common acute complications in the oral cavity are inflammation of oral mucosa, loss of taste, dry mouth and secondary infections. Late complications include radiation caries, trismus, and osteoradionecrosis. The aim of this paper was to present the effects and specificities of toxicity observed on oral cavity tissues after radiotherapy.

scholarly journals Hemiballismus and Normal Pressure Hydrocephalus as Long-Term Sequelae following a Hemispherectomy for Intractable Epilepsy in a Man with a Learning Disability

1997 ◽  
Vol 10 (1) ◽  
pp. 43-46
Author(s):  
Joseph Joyce ◽  
Shoumitro Deb
Keyword(s):  
Learning Disability ◽  
Normal Pressure Hydrocephalus ◽  
Intractable Epilepsy ◽  
Normal Pressure ◽  
Late Complications ◽  
Shunt Operation ◽  
Confusional State ◽  
Complex Partial Seizures ◽  
High Doses

We report here a case of a 48-year-old gentleman with mild/moderate learning disability who developed late complications of hemispherectomy 28 years following the operation. The original operation was performed to treat intractable epilepsy (both generalized tonic/clonic and complex partial seizures) in an 8-year-old boy. After a 28 year seizure-free period, the patient developed cognitive decline, seizures, hemiballismus and a subacute confusional state, possibly related to normal pressure hydrocephalus. A ventriculo-peritoneal shunt operation, along with treatment with high doses of sulpiride, brought improvement in both mental state and hemiballismus.

scholarly journals A Comparison of Flow Cytometry, Bone Marrow Biopsy and Bone Marrow Aspirates in the Detection of Lymphoid Infiltration in T Cell Disorders

2021 ◽  
pp. 674-714
Author(s):  
Elena Locci ◽  
Silvia Raymond
Keyword(s):  
Bone Marrow ◽  
Cancer Cells ◽  
Blood Cells ◽  
Prolonged Exposure ◽  
Genetic Diseases ◽  
White Blood Cells ◽  
Severe Bleeding ◽  
Proliferating Cells ◽  
High Doses ◽  
Lymphoid Infiltration

Leukemia occurs when a person's entire bone marrow tissue space is occupied by cancer cells or blasts that are young, dysfunctional, undifferentiated, and proliferating cells. In this situation, there is no space left for the bone marrow to be able to produce normal blood cells such as platelets, red and white blood cells. These patients suffer from severe bleeding due to decreased platelets or due to a decrease in white blood cells, which are often diagnosed with dangerous infections that cause death in these patients. The exact cause of leukemias is not yet known, but a number of factors have been identified that play a role in the development of these cancers, including high doses of radiation or atomic radiation, prolonged exposure to certain chemicals, and some Mentioned viruses and some genetic diseases such as Down syndrome or underlying diseases. Keywords: Cancer; Cells; Tissues, Tumors; Prevention, Prognosis; Diagnosis; Imaging; Screening; Treatment; Management

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