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Query: UMLS:C0023418 (leukemia)
93,477 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty-eight patients with acute nonlymphocytic leukemia (ANLL) and myelodysplastic syndromes (MDS) were treated with low-dose Ara-C regimen (LDAC) (10 mg/m2 or 10 mg/body subcutaneously every 12 hours). Complete remission (CR) was obtained in sixteen patients (33%) and partial remission (PR) in six (16%). Seven of eight patients with hypoplastic leukemia entered CR. However, LDAC was not effective in MDS and ANLL developing from MDS. The rate of CR was 20% in relapsed or refractory ANLL. Relapse was occurred in thirteen patients until now. The median duration of remission was 7 months (range: 3-20 months). Seven of the sixteen patients who achieved CR were received LDAC at the same dose for 10 days every month as a maintenance therapy. The duration of CR of these patients was shown to be longer than that of the patients without any maintenance therapy. Myelosuppression was observed in nearly all of them and the other clinical findings including cytogenetic analysis indicated cytotoxicity rather than differentiation as the mechanism of LDAC. LDAC was effective especially in hypoplastic leukemia and the maintenance therapy was found to prolong the duration of CR.
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PMID:[Clinical effects of low-dose Ara-C in acute nonlymphocytic leukemia and myelodysplastic syndromes]. 202 36

Several new cytostatic drugs have entered clinical phase I-II studies for the treatment of leukemia: the most promising are pyrimidine analogs such as 5-aza-cytidine, 5-aza-2'-deoxycytidine, 5-aza-cytosine arabinoside, and 2',2'-difluorodeoxycytidine. Fludarabine, a fluorinated purine analog, appears to be active in CLL and multiple myeloma. Deoxycoformycin, an adenosine analog, showed good activity in the treatment of hairy cell leukemia and T-cell neoplasias. 2-chloro-deoxyadenosine has recently been introduced into the treatment of CLL and hairy-cell leukemia refractory to deoxycoformicin. Tiazofurin, an antimetabolite which interferes with nicotine-adenine-dinucleotide (NAD) metabolism, has been applied in CML blast crisis. Other agents include 13-cis retinoic acid and 1, 25-dihydroxy vitamin D3 as differentiation inducers, and homoharringtonine, an alkylating agent which is widely used for ANLL treatment in China. Among new anthracyclines, aclarubicin, idarubicin, THP-adriamycin and fluoro-adriamycin should be mentioned. Mitoxantrone, a substituted anthraquinone, has successfully been applied in the treatment of relapsed and refractory ANLL. Amsacrine (m-AMSA), finally, is a synthetic aminoacridine which intercalates into DNA and inhibits DNA topoisomerase II. m-AMSA is not cross-resistant to anthracyclines and has been particularly active in ANLL treatment. Studies using m-AMSA alone or in combination revealed comparable results to anthracycline--containing regimens. Cardiotoxicity of the anthracycline congestive type has not been observed with m-AMSA. The EORTC Leukemia Cooperative Group has successfully used m-AMSA in several trials prepositioning this drug stepwise: from relapsed and refractory ANLL, into intensive maintenance treatment during first remission in ANLL, and, still on-going, into intensive consolidation.
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PMID:New drugs in the treatment of acute and chronic leukemia with some emphasis on m-AMSA. 206 23

Interstitial deletions of the long arm of chromosome 5 (5q-) is the most common structural rearrangement in acute nonlymphocytic leukemia and myelodysplastic syndromes. Owing to the variability of both breakpoints a large number of different deletions occur. However, as banding problems have hitherto precluded the precise localization of the breakpoints, it is still uncertain whether or not different deletions are associated with clinical differences. In this paper relationships between cytogenetic and clinical data were analyzed in 96 5q- cases investigated with high resolution techniques, which allow more precise breakpoint localizations. Twenty-nine cases have not been published before; the others were extracted from the literature. The analyses show: (1) With higher age at diagnosis the proximal breakpoint approaches the centromere. (2) The female patients are older, develop additional chromosome aberrations less often, and tend to live longer than the male patients. (3) del(5)(qI3q33), which is more frequent than any other deletion, tends to be associated with female sex and older age, and shows lower frequencies of additional chromosome abnormalities, and longer survival than the other deletions. It seems to constitute a more benign subgroup than the other deletions. (4) 5q31 is missing in 91 of 93 informative cases and is the most common deleted segment. (5) These results suggest that the deletion of 5q31 may be central in the pathogenesis of 5q- related disorders and that the deletion of other bands has important consequences for prognosis.
Leukemia 1991 Jul
PMID:Clinical and prognostic implications of chromosome 5q deletions: 96 high resolution studied patients. 207 42

Retrospective analysis has included 323 patients with acute nonlymphocytic leukaemia. The comparable patient groups were treated since 1981, according to protocols used by the Polish Acute Leukaemia Group. The prognostic value for achieving complete remission and survival of 67 pre-treatment factors (42 quantitative and 25 qualitative) was evaluated. The most important 9 parameters were scored according to their prognostic value as follows: age, percent of blasts in bone marrow, peripheral blood blast count, morphological subtype, percent of granulocytes in bone marrow, percent of blasts with CD-15 antigen, thrombocyte count, spleen/liver enlargement, CSF protein levels. Proposed scoring system enables classification of ANLL patients to a standard and high risk groups.
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PMID:[Prognostic usefulness of certain defined indicators for achieving complete remission and survival of ANLL in adults: proposal of a prognostic scale]. 209 41

An infant with Down syndrome (DS) and RH isoimmunization developed transient myeloproliferative disorder (TMD) during the neonatal period. At 16 months she presented with acute nonlymphocytic leukemia (ANLL). Cytogenetic studies during TMD showed trisomy 21 only but new abnormalities emerged during ANLL. She is now in complete remission 5 years after diagnosis. Patients with TMD have either trisomy 21 or mosaic 21 in blood and bone marrow but in phenotypically normal children this cell line disappears with resolution of the TMD. A review of the literature indicates that there are no clinical, hematological, or cytogenetic differences between DS children with TMD who subsequently develop acute leukemia and those who do not. However, the leukemia in the former group may differ in presentation, type, and possibly survival time from other DS children who develop leukemia de novo.
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PMID:Acute nonlymphocytic leukemia after transient myeloproliferative disorder in a patient with Down syndrome. 214 49

This report describes three cases with Down's syndrome. These cases initially had transient abnormal myelopoiesis (TAM), from which they recovered spontaneously. They finally developed into overt acute leukemia characterized by an increase of blasts, hepatosplenomegaly, and elevated lactic dehydrogenase. Of these three cases, one was thought to have ANLL, which broke out 5 months after spontaneous remission. The other two had ALL, each occurring 8 and 9 years later. Chromosomal abnormality, in addition to trisomy 21, was detected in blast cells from one of the patients with acute leukemia. All three patients with acute leukemia experienced complete remission. However, two of the three patients relapsed and died. It is noted in the literature that remission is permanent in most cases of TAM, and is rarely terminated by leukemic relapse. In view of our observations, the importance of following up on such patients who evidence apparent remission of their leukemia-like disorder is emphasized.
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PMID:[Transient abnormal myelopoiesis followed by acute leukemia in children with Down syndrome]. 215 Apr 19

A case of acute nonlymphocytic leukemia (ANLL) following chemotherapy with cisplatin (CDDP) and etoposide (VP16) for non-small-cell lung cancer (NSCLC) diagnosed 24 months before is reported. Although the fortuitous occurrence of two unrelated malignancies cannot be excluded, the hypothesis of secondary leukemia must be taken into account. The clinical and experimental data implying these agents, generally considered to be noncarcinogenic in man, in the occurrence of secondary malignancies are briefly discussed.
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PMID:Acute nonlymphocytic leukemia following chemotherapy with cisplatin and etoposide for non-small-cell carcinoma of the lung: case report. 216 44

This phase III, randomized trial in previously untreated adults with ANLL compared mitoxantrone plus cytosine arabinoside with the CALGB "7 + 3" daunorubicin-based regimen. Two hundred evaluable patients (98 treated with the mitoxantrone-based regimen and 102 with the daunorubicin-based regimen) were included in the analysis of efficacy. The median age of the patients was 60 years. The induction regimen comprised cytosine arabinoside 100 mg/m2 by infusion daily for 7 days and mitoxantrone 12 mg/m2 or daunorubicin 45 mg/m2 daily for days 1-3. If needed, a second induction course was administered: cytosine arabinoside for 5 days and mitoxantrone or daunorubicin for 2 days. Postremission therapy consisted of two consolidation courses, identical to the second induction course. Sixty-three percent (62 of 98) of patients treated with mitoxantrone achieved complete remission (CR), compared to 53% (54 of 102) treated with daunorubicin. The median time to CR was 35 days in patients treated with mitoxantrone and 43 days for those treated with daunorubicin. Eighty-nine percent (55 of 62) of patients treated with mitoxantrone who entered complete remission achieved CR following one induction course, compared to 68% (37 of 54) of patients treated with daunorubicin who entered CR. The median duration of CR was 240 days in patients treated with mitoxantrone and 198 days in those treated with daunorubicin; the median length of survival was 328 days in patients who received mitoxantrone and 247 days in those who received daunorubicin. The toxicity profiles in patients treated with either of the two regimens were comparable in incidence and in severity. Patients treated with mitoxantrone required fewer median platelet units and were treated with fewer median days of intravenous antibiotics, compared to those who received daunorubicin. Mitoxantrone in combination with cytosine arabinoside is effective in previously untreated ANLL. complete remissions occur more frequently after a single induction course of the mitoxantrone-based regimen, compared to the standard Cancer and Acute Leukemia Group B regimen. This should be explored in further trials.
Leukemia 1990 Mar
PMID:Randomized multicenter trial of cytosine arabinoside with mitoxantrone or daunorubicin in previously untreated adult patients with acute nonlymphocytic leukemia (ANLL). Lederle Cooperative Group. 217 38

DNA aneuploidy (DA) was examined in adult leukemia using flow cytometry, and the method and the clinical implication of DA as a tumor marker were evaluated. The method was simple, rapid, objective, quantitative and further did not need any mitotic cells, so was proved to be very useful for screening of DA. While, DA was detected in 50 (27%) out of 185 adult cases with various types of leukemia. The frequencies of DA in the subtypes of leukemia were 55% in ATL, 26% in ALL, 17% in ANLL, 26% in CML-BC and 6% in CLL, respectively. When compared with other subtypes, the frequency in ATL was significantly higher (p less than 0.01), which suggested a special entity of this disease. In general, however, the frequency of DA in leukemia was rather low, which indicated the difficulty in application of DA by itself in diagnosis of leukemia. While, in cases with DA, DA was very useful as a tumor marker in monitoring the clinical course, for example, in the detection of early relapse or recruitment of leukemic cells. Furthermore, DA was found to be a good prognostic factor which indicates a poor prognosis in cases with ANLL and CML-BC.
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PMID:[Analysis of DNA aneuploidy as a tumor marker]. 221 64

The majority of childhood acute leukemias can be classified as acute lymphoblastic leukemia and acute nonlymphocytic leukemia with light microscopy and cytochemical stains alone. However, myeloperoxidase-negative myeloblastic leukemias and megakaryoblastic leukemias, as well as some metastatic tumors, can mimic lymphoblastic leukemia when these cytologic examinations are used. Conversely, occasional cases of Sudan black B-positive ALL can be confused with myeloblastic leukemia. Thus, additional immunologic and sometimes further ultrastructural studies should complement the morphologic diagnosis of ALL. The significance of L1 and L2 subtypes of ALL is still controversial. Modern chemotherapy may have obscured any significance of this division. Future studies of lymphoblast morphology should center on biologic correlates of the L2 cytology. Little prognostic significance has been found for the morphologic variants of ALL, such as the granular and hand-mirror cell types. It is important not to confuse granular ALL with acute myeloblastic leukemia. Functional immunologic studies may help in delineating the cause of uropod formation in hand-mirror variant ALL.
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PMID:Morphologic and cytochemical characteristics of childhood lymphoblastic leukemia. 222 93


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