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)

The probability of long term survival for allogeneic graft patients was 63% for ALL, 60% for ANL and 47% for CML in the 1st remission or 1st chronic phase of each leukemia. The major causes of death were interstitial pneumonia, relapse of leukemia and infections. On relationship of GVHD and the long term survival, the probability of 5 years survival was 38%, 47% and 25% in grade 0, I and II-IV of acute GVHD respectively. The difference might be due to that of relapse rate of leukemia. And the relationship between the relapse rate and GVHD, the patients with both of acute and chronic GVHD showed the lowest relapse rate 15.9%, the patients without GVHD showed the highest relapse rate 37.8% and the patients with either of GVHD showed the rate of between those of two groups. This may suggest that GVHD both acute and chronic might have an ability that can suppress the relapse of leukemia, i.e. GVL reaction. Interstitial pneumonia occurred in 32% of allograft patients and was often lethal complication (53%). Among many of prophylaxis tested, the followings were effective, a lower dose rate of total body irradiation, the selection of CMV-seronegative platelets donor, and the prophylactic administration of anti-CMV high titer globulin. Colony stimulating factor of human urine was also effective for shortening the granulopenic period after transplantation to prevent severe infections.
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PMID:[Allogeneic bone marrow transplantation]. 305 76

Data from 208 patients with leukemia who were treated with allogeneic bone marrow transplantation between 1975 and 1985 were reported to the Japanese Bone Marrow Transplant Registry and were available for this analysis. These patients were classified into 82 of acute lymphocytic leukemia, 91 of acute non-lymphocytic leukemia, and 35 of chronic myelocytic leukemia. The incidence of interstitial pneumonitis (IP) was 39% (81/208) and fatality rate was 60% (49/81). Cytomegalovirus was the most frequent causative organism (54%). Using Cox's proportional hazard regression model, age of recipient (P = 0.0068), status of disease (P = 0.0191), and number of platelet transfusion (P = 0.0425) were found to be significant risk factors associated with IP. Probabilities of developing IP at three years were 65% and 42% in single dose and fractionated total body irradiation (TBI), respectively. In single dose TBI group, dose-rate affected the incidence of IP. On the contrary, in fractionated TBI group, number of fractions as well as dose-rate had no impact on the incidence of IP.
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PMID:Interstitial pneumonitis following allogeneic bone marrow transplantation in the treatment of leukemia based on BMT survey in Japan. 306 Oct 43

This study included 44 children undergoing autologous marrow transplantation for leukemia between August 1979 and June 1987. Three of them received a second transplant. In the phase of neutropenia, 38 children presented with fever. Nineteen septicemia occurred (13 Gram positive cocci, 6 Gram negative bacteria), and 2 interstitial pneumonitis were observed. All children with documented infection or a fever of unknown origin recovered after treatment, except 3, who died from infection. The latest antimicrobial therapy used was a combination of an aminoglycoside and a third generation cephalosporin. When necessary, vancomycin or amphotericin B were added. After engraftment (granulocyte count greater than 0.5 X 10(9)/l) 14 septicemia (which recovered) and 10 herpes zoster infections were observed. Only one patient died of infection (herpes zoster with encephalitis).
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PMID:[Infections and bone marrow autograft carried out for leukemias in children. Apropos of 47 cases]. 306 29

Thirty children aged one to 15 years with acute lymphoblastic leukemia and acute nonlymphoblastic leukemia were transplanted from HLA matched donors using two different preparative regimens: 18 patients were prepared with cyclophosphamide and Total Body Irradiation while 12 patients received Busulphan and Cyclophosphamide. 15 patients survive 7 to 74 months after transplant. Although for the second group of patients a longer follow-up is needed in order to evaluate eradication of the disease and long-term toxicity, the combination chemotherapy alone results in improving survival (71% versus 28%) and decreasing relapse rate (30% versus 56%) compared with the group of patients who received the chemoradiotherapy regimen. Also the incidence of Interstitial Pneumonia has been lower in the group receiving chemotherapy alone. We conclude that this protocol is generally well tolerated in young patients, without increasing secondary toxicity.
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PMID:[Bone marrow transplant in acute leukemia in children. Experience of the Pesaro group]. 307 29

Utilization of bone marrow transplantation as a therapeutic modality continues to increase. During the 32 years between 1955 and 1986 more than 15,000 patients received allogeneic transplants; more than 50% of these were performed in the 3 years, 1984 to 1986. Transplantation is an effective therapy for acute leukemias; in some instances it is the preferred treatment. In chronic myelogenous leukemia, aplastic anemia, and some genetic and immune deficiency diseases, bone marrow transplantation provides the only possibility for cure. Bone marrow transplantation is investigational in other conditions and is associated with substantial problems such as graft-vs-host disease, interstitial pneumonitis, and the requirement for an HLA-identical donor. Recently an increasing number of transplants have been performed using HLA partially or fully matched related or unrelated donors with some success. The development of AGVHD and interstitial pneumonitis can to some extent be predicted by risk factor assessment. AGVHD can be prevented by depletion of T cells from the donor bone marrow but this is associated with an increased risk of graft rejection and leukemia relapse. Interstitial pneumonitis can be modified by prophylaxis with CMV immune globulin and by the use of CMV-negative blood donors. In this report we summarized data from the International Bone Marrow Transplant Registry concerning allogeneic bone marrow transplantation in leukemia.
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PMID:Current status of allogeneic bone marrow transplantation in leukemia: a report from the International Bone Marrow Transplant Registry. 315 78

Bone marrow transplantation is widely used to treat hematologic, immune, and genetic diseases. More than 9,500 transplants have been performed by 199 transplant teams worldwide; 162 are currently active. The annual rate of allogeneic bone marrow transplants now exceeds 2,500 plus more than 1,000 autotransplants annually. Transplantation is an effective therapy for acute leukemias; in some instances, it is the preferred treatment. In chronic myelogenous leukemia, aplastic anemia, and some genetic and immune diseases, bone marrow transplantation provides the only possibility for cure. Bone marrow transplantation remains investigational in many conditions and is associated with substantial problems such as GvHD, interstitial pneumonitis, and the requirement for an HLA-identical donor. Recently an increasing number of transplants have been performed using HLA partially or fully matched, related or unrelated donors with some success. The development of GvHD and interstitial pneumonitis can, to some extent, be predicted by risk-factor assessment. Although GvHD can be prevented by depleting T cells from the donor bone marrow, this is associated with an increased risk of graft rejection and leukemia relapse. Interstitial pneumonitis can be modified by prophylaxis with CMV-immune globulin and by the use of CMV-negative blood donors. In this report, we summarized data from the International Bone Marrow Transplant Registry concerning allogeneic bone marrow transplantation in man.
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PMID:Current status of allogeneic bone marrow transplantation: a report from the International Bone Marrow Transplant Registry. 315 98

A report is given of three new cases of acute monocytic leukemia, FAB M5a, with a t(8;16)(p11;p13). Two cases showed a marked erythrophagocytosis, including one with phagocytosis of normoblasts and granulocytes. Phagocytosis was absent in the third case. The t(8;16) was the only abnormality in two cases, whereas one case showed clonal evolution with partial trisomy 1q and a deletion of part of the short arms of chromosomes 1 and 3. Treatment results and survival were poor in all cases. A complete remission was achieved in two patients, which lasted only for 3 and 6 months, respectively. In one of these cases a central nervous system relapse occurred. Survival was short, lasting between 1 and 9 months. One patient succumbed to interstitial pneumonitis, a complication of allogeneic bone marrow transplantation without evidence for relapsing leukemia.
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PMID:Translocation t(8;16) in acute monocytic leukemia. 316

One hundred seventy-nine patients with acute nonlymphoblastic leukemia in first remission (n = 75), chronic myelocytic leukemia in chronic or accelerated phase (n = 48) or leukemia in advanced stage (n = 56) were given HLA-identical marrow grafts and randomized to receive methotrexate or cyclosporine for prevention of graft-v-host disease (GVHD). The current report updates the three prospective trials with follow-ups ranging from 3.2 to 6.2 years after marrow grafting. Results were analyzed separately for each individual study and for all three studies combined. Overall, 40% of patients given cyclosporine and 55% of those given methotrexate developed acute GVHD (P = .13); the incidence of chronic GVHD was 42% and 48%, respectively (P = .67). Twenty-two percent of cyclosporine-treated patients and 30% of methotrexate-treated patients developed interstitial pneumonia of any etiology (P = .25), and the figures for cytomegalovirus pneumonia were 18% and 20%, respectively (P = .41). The overall incidence of leukemic relapse was 31% in cyclosporine-treated patients and 36% in methotrexate-treated patients (P = .75). The probabilities of survival for cyclosporine-v methotrexate-treated patients were comparable for all three study groups: 52% v 48% in patients with acute nonlymphoblastic leukemia (P = .42), 55% v 60% for those with chronic myelocytic leukemia (P = .61), 12% and 12% for those with advanced leukemia (P = .93), and 39% v 38% overall (P = .72). We conclude that cyclosporine and methotrexate are comparable regarding the likelihood of acute/chronic GVHD, interstitial pneumonia, leukemic relapse, and long-term survival.
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PMID:Cyclosporine v methotrexate for graft-v-host disease prevention in patients given marrow grafts for leukemia: long-term follow-up of three controlled trials. 327 60

Twenty children with acute lymphoblastic leukemia in second (18 patients) or third (two patients) complete remission after bone marrow relapse received allogeneic bone marrow transplants from histocompatible sibling donors. The preparative regimen for marrow transplantation consisted of 12 doses of 3,000 mg/m2 cytosine arabinoside twice daily for six days followed by 1,200 cGy total-body irradiation (six doses of 200 cGy twice daily for three days). The preparative regimen was well tolerated, and all patients showed marrow engraftment promptly. Twelve patients are alive in complete remission 12+ to 79+ months posttransplant; eight patients are over 48 months posttransplant. Six patients died 1 to 9 months posttransplant of nonleukemic causes: (two each of graft-v-host disease, interstitial pneumonitis, and infection). Two patients developed recurrent leukemia at 15 and 30 months posttransplant. Both have died at 19 and 36 months posttransplant. Life table analysis reveals an actuarial survival and event-free survival rate of 58% and a marrow relapse rate of 17%. These results suggest that high-dose cytosine arabinoside and fractionated total-body irradiation is a relatively nontoxic and highly effective preparative regimen for allogeneic bone marrow transplantation for acute lymphoblastic leukemia that deserves further evaluation.
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PMID:High-dose cytosine arabinoside and fractionated total-body irradiation: an improved preparative regimen for bone marrow transplantation of children with acute lymphoblastic leukemia in remission. 328 25

Data from 224 patients with leukemia who received TBI followed with allogeneic BMT between 1975 and 1985 were retrospectively analyzed to determine the effects of dose-fractionation factors on the incidences of interstitial pneumonitis (IP). Among several factors examined, the fraction size most predominantly correlated with the IP rate. The selection of the optimal dose rate adjusted to the fraction size also contributed to decreasing the rate of the IP. The total lung dose significantly correlated with the IP rate on a single dose, and the fractionated TBI with a high fraction dose. The dose-response curves of idiopathic IP, derived by a multivariate analyses using the three factors mentioned above, have been presented.
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PMID:[Effects of regimens of total body irradiation on interstitial pneumonitis after bone marrow transplantation]. 328 90


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