Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023418 (leukemia)
 93,477 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

22 HL-A antigen and mixed leukocyte culture-matched sibling bone marrow transplants were attempted in patients with acute leukaemia (at the National Cancer Institute) to define the toxicities of four different immunosuppressive regimens, the complications associated with warrow engraftment and antileukaemic effect. 73% (16/22) were engrafted as indicated by a change to donor red blood cells (RBC) type, leukocyte, immunoglobulin allotype or by the speed of morrow repopulation and the occurrence of the Graft Versus Host Disease (GVHD). 12 of 16 (75%) successful engrafted patients developed GVHD. The current published results of clinical bone marrow transplantation from major centers has been reviewed and will be discussed in relationship to current clinical complications associated with bone marrow transplantation.
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PMID:Allogeneic marrow transplantation for the treatment of leukaemia. A review. 0 Jul 89

A three-step treatment plan incorporating adoptive immunotherapy and chemoradiotherapy was used to treat AKR (H-2k) mice bearing spontaneous leukemia-lymphoma (SLL). 1) Leukemic mice were treated with chemoradiotherapy for immunosuppression and leukemia cytoreduction. 2) To introduce a graft-versus-leukemia reaction against residual malignant cells, the immunosuppressed AKR mice were given immunocompetent cells from H-2 mismatched DBA/2 (H-2d) donors. 3) To "rescue" the AKR hosts from incipient graft-versus-host disease, the mismatched DBA/2 cells were killed with combination chemotherapy, and cells from allogeneic H-2 matched RF (H-2k) donors were administered to restore hematopoiesis. Leukemic AKR mice thus treated had significant prolongation of their median survival time and a higher 60-day survival rate post treatment than did untreated controls, chemoradiotherapy controls, or control mice that received chemoradiotherapy plus cells from syngeneic donors. Therefore, adoptive immunotherapy may be useful as an adjunct to conventional therapy for treatment of SLL in AKR mice.
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PMID:Graft versus leukemia. VI. Adoptive immunotherapy in combination with chemoradiotherapy for spontaneous leukemia-lymphoma in AKR mice. 0 46

Seventy-six patients, aged 2 to 17 years, were treated with bone marrow transplantation for severe aplastic anaemia or acute leukaemia refractory to conventional therapy. 16 of the 22 patients (73%) who received marrow transplantations for aplastic anaemia are surviving, 12 of these for over one year. In acute leukaemia, using preparation with cyclophosphamide and total body irradiation, 8 of 33 patients (24%) receiving allogeneic and 5 of 8 (63%) receiving syngeneic transplantations are continuing in remission from 3 months to beyond 2 years. The longest continuing remission off therapy is now over 4 1/2 years after preparation with total body irradiation. The major causes of failure remain graft-versus-host disease, infection, graft rejection (aplastic anaemia), and leukaemic relapse.
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PMID:Marrow transplantation in treatment of children with aplastic anaemia or acute leukaemia. 0 16

Marrow transplantation in aplastic anemia and leukemia has generally been limited to siblings who have been histocompatible at both the serological (A and B) and lymphocyte determined (D or MLC) loci of the HLA system. We studied three male patients, two with aplastic anemia and one with acute myelogenous leukemia, who received transplants from their histoincompatible mothers. MLC studies between donors and recipients showed varying degrees of stimulation. Definite engraftment occurred in one patient and transient engraftment in another. Engraftment in the third patient could not be evaluated. In the patient with sustained engraftment, there was clinical evidence of severe graft versus host disease (GVHD) however, this was not substantiated by histologic findings. This preliminary study suggests that MLC incompatibility may be more of an indicator of the risk of GVHD than of bone marrow rejection. If more effective control of GVHD can be accomplished, marrow transplantation between MLC-reactive individuals may become feasible.
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PMID:Experience with incompatible maternal donors for bone marrow transplantation. 1 47

Fifteen patients with acute leukemia resistant to standard chemotherapy were treated by bone marrow transplantation from HLA-matched siblings after conditioning with a new combination chemotherapy/radiation therapy regimen--SCARI. SCARI consists of 5 days of high-dose cytosine arabinoside and 6-thioguanine followed by 3 days of daunorubicin. After a rest period, cyclophosphamide and total-body irradiation are given sequentially. This regimen had acceptable morbidity. Median survival was 169 days. Overall survival and disease-free survival was 27% at over 11 months. Relapse rate was 13% of the entire group and 30% by actuarial projection. Relapses were late and initially extramedullary. Deaths from causes other than leukemia occurred early secondary to fungal infection and late secondary to interstitial pneumonia (frequently cytomegalovirus). Graft-versus-host disease and graft rejection were not causes of mortality. In these patients conditioned with SCARI, leukemic recurrences were infrequent but infectious complications were a major hazard.
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PMID:Bone marrow transplantation with intensive combination chemotherapy/radiation therapy (SCARI) in acute leukemia. 1 96

One hundred patients, 54 with acute myelogenous leukemia (AML) and 46 with acute lymphoblastic leukemia (ALL), considered to be in the end stages of their disease, after combination chemotherapy were treated by marrow transplantation. All patients were given a marrow graft from an HLA-identical sibling after receiving 1000-rad total body irradiation (TBI). One group of 43 patients was given cyclophosphamide (CY), 60 mg/kg on each of 2 days, 5 and 4 days before TBI. In a second group of 31 patients, additional chemotherapy was given before CY and TBI. In a third group of 19 patients, BCNU was given before CY and TBI. A fourth group of 7 patients received other chemotherapy regimens before TBI. Six patients died 3-17 days after marrow infusion without evidence of engraftment. Ninety-four patients were engrafted and only one patient rejected the graft. Thirteen patients are alive with a marrow graft, on no maintenance antileukemic therapy, and without recurrent leukemia 1-4 1/2 yr after transplantation. Three have chronic graft-versus-host disease (GVHD). Four patients are alive 1 1/2 - 3 1/2 yr after grafting but have had a relapse of their leukemia. Of 93 evaluable patients, 19 did not develop GVHD and 24 developed very mild GVHD. Fifty patients developed moderate to severe GVHD, and 40 of these were treated with antithymocyte globulin. Interstitial pneumonia occurred in 54 patients and was the primary cause of death in 34. Interstitial pneumonia often occurred in association with GVHD and the most common etiologic agent was cytomegalovirus. A total of 31 patients have had a relapse of leukemia. There was no definite correlation between relapse of leukemia and the presence or absence of GVHD. The relapse rate appeared to be relatively constant over the first 2 yr and was extremely low after that time. Neither survival nor leukemic relapse appeared to be influenced by the type of leukemia nor by the preparative chemotherapy regimen given before TBI. Patients in fair clinical condition at the time of transplantation showed significantly longer survival times than patients in poor condition (p = 0.001). This observation, coupled with the observation that some patients may be cured of their disease, indicates that marrow transplantation should now be undertaken earlier in the management of patients with acute leukemia who have an HLA-matched sibling marrow donor.
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PMID:One hundred patients with acute leukemia treated by chemotherapy, total body irradiation, and allogeneic marrow transplantation. 1 51

The neutrophil function of seven patients receiving allogeneic bone marrow transplantion was studied. Five of the patients had been transplanted for aplastic anaemia and two for acute leukaemia. Determinations were made of neutrophil phagocytosis, chemotaxis, random migration, and microbicidal activity for Candida albicans and Staphylococcus aureus. One patient showed a decreased ability to kill C. albicans at a time when she had active pneumonia due to Pneumocystis carinii. The remainder of the studies showed normal neutrophil functions. No differences were observed in the patients who had graft versus host disease [GvH] from those without GvH. These studies suggest that defects in phagocytic neutrophil function do not contribute significantly to the impaired host defenses in recipients of bone marrow transplantation.
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PMID:Neutrophil function in bone marrow transplant recipients. 1 82

Improvements in the results of bone marrow transplantation for the treatment of SCID may be expected by employing purified stem-cell concentrates for patients who do not have a compatible sibling available. Refinements in the purification technique and its monitoring are required, however. For the same category of patients it seems worthwhile to continue attempts at restoration with liver cells from fetuses less than 12 weeks of age. In addition, full protection against infections should be provided for patients expected to develop GVHD, and, therefore, such patients should only be treated in centers where reverse isolation and bacteriologic decontamination can be performed. In view of the rarity of the disease, transplanters should agree on a limited number of graft protocols. For the treatment of bone marrow aplasia, attempts to identify the factors that can serve to predict the occurrence of GVHD in compatible host-donor sibling pairs should be continued. Only when the patients who will develop GVHD can be recognized in advance will it be feasible to fully exploit available GVHD reductive measures. In particular the role of the intestinal microflora should be investigated in this respect. Experimental evidence is presented, suggesting an aggravating influence of microflora on GVHD lesions, which are primarily induced by histocompatibility reactions. For such studies with incompatible siblings, the dog is the best available animal model. For the selective isolation of hemopoietic stem cells for transplantation purposes (as one means of reducing GVHD), methods for rapid identification of stem cells and immune competent cells, respectively, have to be developed. In leukemia, more research is necessary on the factors that play a role in the late complications of bone marrow transplantation. The toxicity of aggressive regimens employed in the eradication of the leukemia should be further analyzed. The collection of autologous normal hemopoietic stem cells from leukemic patients as introduced by Dicke et al. warrants further exploration to see whether these cells may replace the allogeneic transplantation procedure, thus avoiding all the complications generally encountered in GVHD. For all three diseases, it is extremely important to develop a method for the selection of compatible donors among unrelated individuals, because this will at least double the number of candidates for therapeutic bone marrow transplantation. Current progress in histocompatibility typing in the rhesus monkey and the dog makes these species excellent models for such investigations.
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PMID:Bone marrow transplantation. 1 88

Jaundice after bone marrow transplantation is usually a consequence of graft versus host disease. Reported is a patient who presented with obstructive jaundice several months after a successful marrow allograft. Despite a benign bone marrow examination, abdominal ultrasound, upper gastrointestinal series, and endoscopic biopsy were utilized to diagnose recurrent leukemia at the pancreatic head and descending duodenum. The entities of graft versus host disease as related to jaundice, and gastrointestinal leukemia, in the presence of a "remission" bone marrow, are reviewed.
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PMID:Obstructive jaundice after bone marrow transplantation. 1 36

We previously reported a successful model for treatment of BW 5147 leukemia in AKR mice by adoptive immunotherapy using allogeneic spleen cells from C57BL/6 mice. The leukemia cells were given 3 days before initiation of therapy. Graft-versus-host reaction was prevented by treatment with spleen cells from a second allogeneic strain (CBA), followed by cyclophosphamide and syngeneic spleen cells. We now show that it is not necessary to use syngeneic spleen cells in the final transplant since H-2-compatible, allogeneic CBA cells are as effective. In addition, it is possible to initiate successful therapy 5 days after leukemia implantation providing that the initial cyclophosphamide, given in two doses of 100 mg/kg each and spaced 7 days apart, is administered prior to establishment of graft-versus-host reaction. Higher single doses of drugs were followed by fatal graft-versus-host disease.
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PMID:Further development of a successful protocol of graft versus leukemia without fatal graft-versus-host disease in AKR mice. 2 Feb 23


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