scholarly journals EFFICACY OF GRANULOCYTE TRANSFUSION FOR SEVERE METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS INFECTION AFTER HIGH-DOSE CYTARABINE FOR ACUTE MYELOGENOUS LEUKEMIA

2009 ◽  
Vol 55 (1) ◽  
pp. 37-42
Author(s):  
Souichi Shiratori ◽  
Takeshi Kondo ◽  
Kentaro Wakasa ◽  
Makoto Ibata ◽  
Yusuke Shono ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Acute Myelogenous Leukemia ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Myelogenous Leukemia ◽  
High Dose ◽  
Granulocyte Transfusion ◽  
Methicillin Resistant ◽  
Aureus Infection ◽  
High Dose Cytarabine ◽  
Acute Myelogenous

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.

1988 ◽  
Vol 6 (3) ◽  
pp. 499-508 ◽  
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.

Severe palmar-plantar erythrodysesthesia and aplasia in an adult undergoing re-induction treatment with high-dose cytarabine for acute myelogenous leukemia: a possible drug interaction between posaconazole and cytarabine

2016 ◽  
Vol 23 (6) ◽  
pp. 476-480 ◽  
Author(s):  
Saeed K Alzghari ◽  
Susan E Seago ◽  
Christian T Cable ◽  
Jon D Herrington
Keyword(s):  
Acute Myelogenous Leukemia ◽  
Myelogenous Leukemia ◽  
Induction Treatment ◽  
High Dose ◽  
Pharmacokinetic Studies ◽  
P Glycoprotein ◽  
High Dose Cytarabine ◽  
Acute Myelogenous ◽  
Hands And Feet ◽  
Glycoprotein Inhibition

High-dose cytarabine is recommended for re-induction chemotherapy in patients less than 60 years of age with acute myelogenous leukemia. This case describes a patient receiving high-dose cytarabine for re-induction and subsequently developed tingling and numbness in her hands and feet followed by severe pain, swelling, and erythema consistent with a diagnosis of palmar-plantar erythrodysesthesia. Furthermore, the patient’s hemoglobin, platelets, and neutrophils did not recover after over 30 days post high-dose cytarabine. The patient was concurrently receiving posaconazole for fungal prophylaxis which was initiated after the induction therapy. We speculate that posaconazole may inhibit the cytarabine efflux through P-glycoprotein inhibition leading to the patient’s palmar-plantar erythrodysesthesia and subsequent aplasia. Future pharmacokinetic studies need to be conducted to ascertain if posaconazole does influence the pharmacokinetics of cytarabine.

scholarly journals High-dose cytarabine and daunorubicin induction and postremission chemotherapy for the treatment of acute myelogenous leukemia in adults

Blood ◽  
1991 ◽  
Vol 77 (7) ◽  
pp. 1429-1435 ◽  
Author(s):  
GL Phillips ◽  
DE Reece ◽  
JD Shepherd ◽  
MJ Barnett ◽  
RA Brown ◽  
...  
Keyword(s):  
Acute Myelogenous Leukemia ◽  
Previous History ◽  
Myelogenous Leukemia ◽  
Remission Induction ◽  
High Dose ◽  
Free Survival ◽  
High Dose Cytarabine ◽  
Acute Myelogenous ◽  
History Of ◽  
Leukocyte Counts

Seventy consecutive adult patients with acute myelogenous leukemia (AML), median age 44 years, received high-dose cytarabine (3 g/m2 every 12 hours for 12 doses) followed by daunorubicin (45 mg/m2 daily for three doses) for remission induction. A single, identical course was planned for postremission therapy. Complete remission (CR) was achieved in 63 patients (90%, 95% confidence interval [CI] 83% to 97%), 60 after a single course. Eight patients were selected to undergo elective bone marrow transplantation (BMT) during first CR. Of the remaining 55 patients, 40 (73%) underwent planned post-CR therapy; 15 patients did not, owing to early relapse, excessive toxicity from the induction chemotherapy, or refusal. Nineteen patients, including 13 who received planned post-CR therapy, remain in continuous CR at a median follow-up of 5.2 years (range 3.0 to 7.1 years). The 5-year actuarial leukemia- free survival was 30% (95% Cl, 19% to 42%) for all patients achieving CR and 32% (95% Cl, 19% to 47%) for the 40 patients who received the planned post-CR chemotherapy. Analysis of various putative prognostic factors for CR and overall and leukemia-free survival showed significance for a previous history of myelodysplasia, higher initial leukocyte counts, certain French-American-British (FAB) types, and certain abnormal karyotypes. None of these factors was consistently significant regarding the above parameters, although small patient numbers in certain analyses may have obscured significant associations. Myelosuppression was occasionally prolonged after remission induction and especially post-CR therapy. Severe cerebellar toxicity was observed in 13 patients; in 11 cases, this toxicity was fully reversible. Other serious complications were infrequent. Intensive chemotherapy with high- dose cytarabine and daunorubicin has substantial antileukemic activity in adult AML, and may represent an improvement over conventional therapy. Relapses were common, however, even in patients who received planned therapy, and substantial toxicity was observed. The optimum use of this regimen in AML remains to be determined.

High-Dose Cytarabine (HIDAC) plus Daunorubicin for Remission Induction of Acute Myelogenous Leukemia

2003 ◽  
Vol 38 (1) ◽  
pp. 20-24
Author(s):  
J. Aubrey Waddell ◽  
Paula Doulaveris ◽  
Dominic A. Solimando
Keyword(s):  
Cancer Chemotherapy ◽  
Acute Myelogenous Leukemia ◽  
Myelogenous Leukemia ◽  
Remission Induction ◽  
High Dose ◽  
Malignant Diseases ◽  
Toxic Agents ◽  
High Dose Cytarabine ◽  
Acute Myelogenous ◽  
Investigational Agents

The increasing complexity of cancer chemotherapy makes it mandatory that pharmacists be familiar with these highly toxic agents. This column focuses on the commercially available and investigational agents used to treat malignant diseases, reviewing issues related to the preparation, dispensing, and administration of cancer chemotherapy.

Benefit of High-Dose Cytarabine-Based Consolidation Chemotherapy for Adults with Acute Myelogenous Leukemia

1994 ◽  
Vol 15 (1-2) ◽  
pp. 85-90 ◽  
Author(s):  
Gary Schiller ◽  
James Gajewski ◽  
Myung Lee ◽  
Winston Ho ◽  
Mary Territo ◽  
...  
Keyword(s):  
Acute Myelogenous Leukemia ◽  
Myelogenous Leukemia ◽  
High Dose ◽  
Consolidation Chemotherapy ◽  
High Dose Cytarabine ◽  
Acute Myelogenous
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