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Query: UMLS:C0023418 (
leukemia
)
93,477
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
An adult with acute nonlymphoblastic
leukemia
involving the central nervous system is presented. Unusual features included: (1) Focal signs and radiographic evidence of sagittal sinus occlusion early in the course of disease; (2) progressive meningeal, cranial nerve, and spinal nerve involvement despite a 4-year bone marrow remission; (3) intracerebral tumor formation, and (4) retrobulbar optic neuritis associated with microscopic findings of herpeslike viral particles. The incidence of clinically overt neurologic disease in adults with acute nonlymphoblastic
leukemia
seems to have increased in tandem with improved chemotherapy. The prophylactic treatment of the central nervous system during prolonged remission of
adult acute nonlymphoblastic leukemia
may prove of benefit to these patients.
...
PMID:Neurologic complications of acute myelomonoblastic leukemia of four years' duration. 27 73
The need for prophylactic therapy of the central nervous system in
adult acute nonlymphoblastic leukemia
has been suggested but no proven. Over a 4-year period from January 1973, to December 1976, we have maintained 40 patients achieving complete remission on a regimen consisting of monthly courses of Cytosine Arabinoside and 6-thioguanine. Twenty patients remain in remission with a predicted median remission duration for the entire group of 14.5 months. Thirty nine of the patients did not have central nervous system
leukemia
at diagnosis, and only one of these patients (2.6%) has had remission tenance regimen there is little need for central nervous system prophylaxis in
adult acute nonlymphoblastic leukemia
.
...
PMID:Maintenance therapy of adult acute nonlymphoblastic leukemia: an argument against the need for central nervous system prophlyaxis. 27 47
Although progress in the treatment of adult acute
leukaemia
has been much less dramatic than that which has occurred in the management of children with ALL, it should be clear from this progress report that significant strides have recently been made in the treatment of both
adult ANLL
and ALL that are of real benefit to the individual patient. This improvement is equally the result of improved supportive care and antileukaemia treatment. The progress has been of sufficient magnitude to clearly justify the optimism expressed in several recent reviews of
leukaemia
treatment (Freireich et al, 1976; Holland et al, 1976; Wiernik, 1976).
...
PMID:Treatment of acute leukaemia in adults. 35 32
The presenting features and clinical course of 89 adults and 15 children with acute myeloblastic
leukaemia
(AML) presenting to a Regional
Leukaemia
Centre has been analysed. Remission rate was related to age, being 40% for the total adult group and 60% for all children. Young adults and children had a particularly high remission rate, whilst elderly patients faired badly. Survival diminished with increasing age and patients who entered complete remission survived for a significantly longer time (P less than 0.001) than those who did not.
Adult AML
differs from childhood AML, the adults having a lower remission rate, a significantly shorter survival (P less than 0.005) and almost complete absence of second remissions. Adults showed no correlation between complete remission and initial WBC or initial blast cell count, but in children there was a significant correlation (P less than 0.05) between initial total WBC and complete remission. A significant correlation between initial platelet count and complete remission could not be demonstrated in either group. Although the numbers of children are small, preadolescent children may represent a favourable sub-group, particularly those between 7 and 8 years of age.
...
PMID:A comparative study of acute myeloblastic leukaemia in children and adults. 105 77
In order to investigate the role of T-cell receptor (TcR)-delta and TcR-gamma gene rearrangements and/or deletions in acute myeloid leukemia (AML) coexpressing T-cell-associated antigens (i.e. CD2 and/or CD4 and/or CD7), we examined blasts from a selected group of 56 AML cases (25 children, 31 adults) coexpressing either of these antigens without cytoplasmic CD3 expression. Forty-four typical AML cases (7 children, 37 adults) without T-cell associated antigens were further studied as controls. Germline configuration of the TcR-delta gene was observed in 91 out of the total of 100 AML cases investigated. Eight of nine cases with rearranged or deleted TcR-delta genes coexpressed T-cell-associated antigens. Blast cells of 7/9 cases were classified as FAB M1, two as FAB M2. In six of these cases TcR-gamma gene rearrangements were also detected. TcR-delta alterations were predominantly found in children whose blasts coexpressed T-lymphoid associated antigens (6/25, 24%), but were rarely detected in
adult AML
with or without coexpression of T-cell antigens (2/31 and 0/37, respectively).
Leukemia
1992 Dec
PMID:Rearrangements of T-cell receptor delta, gamma and beta genes in acute myeloid leukemia coexpressing T-lymphoid features. 133 55
We asked 2 questions in this study. First was the additional effect of VCR in induction therapy, and the second was the duration of maintenance therapy.
Adult AML
were treated by an individualized response-oriented induction therapy with behenoyl Ara-C 200 mg/m2 daily + 6MP 70 mg/m2 daily + prednisolone 40 mg/m2 on days 1-4 + DNA 40 mg/m2 on days 1-3 and additionally on days 7, 8, 11, 12 (for M3, DNR 50 mg/m2 daily) (BHAC-DMP) until bone marrow became severely hypoplastic with less than 5% of blasts. Patients were randomized to BHAC-DMP or BHAC-DMP + VCR 0.35 mg/m2 on days 1-4. After obtaining CR, 3 courses of intensive consolidation therapy were given together with I.T. MTX+Ara-C+PSL. Maintenance intensification therapy was randomized to either 4 or 12 courses given every 2 months. Patients of age greater than or equal to 60 received about 2/3 reduced doses. From June 1987 to Sept. 1989, 265 consecutive
adult AML
were registered from 19 institutions and 258 were evaluable. Age ranged from 15 to 79 (med., 48). Out of 258, 200 (77.5%) achieved CR (80% in 209 of age less than 60 and 65% in 49 of age greater than or equal to 60). Unexpectedly, addition of VCR reduced the high CR rate of BHAC-DMP significantly (84% to 70%, p = 0.007). At the median follow-up of 37 mo., overall survival is 37%, and event-free survival (EVS) 27%. Survival, continuing CR and disease-free survival (DFS) rates of 200 CR cases are 45%, 40% and 35%, respectively. Patients received 12 courses of maintenance therapy showed better DFS (P = 0.0555). The VCR group had significantly worse EFS. By multivariate analysis, significant prognostic factors for the achievement of CR were age less than 60, PS 0-2 and no addition of VCR. Significant factors for longer DFS were induction of CR by one course, FAB M3 or M5 and age less than 50. The present multi-institutional study confirmed the high CR rates of the response-oriented individualized therapy reported from several centers in Japan, but failed to support an additional effect of VCR reported from one center.
Leukemia
1992
PMID:Randomized study of individualized induction therapy with or without VCR, and of maintenance of 4 or 12 courses in adult AML: JALSG-AML87. Japan Adult Leukemia Study Group (JALSG). 157 54
The Philadelphia chromosome, originally thought to be associated solely with chronic myelogenous leukemia (CML), has since been identified in acute leukemias and in some cases of lymphoma. The Philadelphia chromosome results from reciprocal translocation of genetic material between chromosome 9 and 22 involving the c-abl and BCR genes respectively. Southern blot analysis of the BCR genes was carried out on biopsy specimens from 49 patients presenting with malignant lymphoma without a previously documented CML phase. In two patients, BCR gene rearrangements were detected in the malignant lymph nodes but not in the bone marrow samples. A third patient showed BCR gene rearrangements in the bone marrow but not in the lymph node. From this limited study, it seems that the overall incidence of BCR gene rearrangement in malignant lymphoma is similar to that observed in
adult AML
.
Leukemia
1992 Jun
PMID:Rearrangement of BCR genes in malignant lymphoma. 160 94
Acute leukemia has become a curable disease. In 3 studies for
adult AML
(BHAC-DMP, BHAC-DMP (II) and M-85) at Nagoya University Hospitals from 1979 to 1987, intensive induction resulted in higher cure rate, and the reduction of the blasts in bone marrow at 2 weeks after the initiation of therapy to less than 20% was the most important prognostic factor to predict the long CR. However, it seemed impractical to give very intensive chemotherapy during the induction because of high frequency of complications due to prolonged myelosuppression. Thus, consolidation should be as intensive as possible. In M-85 protocol, the predicted 5-years survival and disease-free survival (DFS) of CR cases are 70 and 53% respectively. The result of JALSG-AML 87 study seems to confirm the above result. As for the indication of bone marrow transplantation (BMT) at the first CR for
adult AML
, only a prospective randomized study will answer this important question. In case that DFS of chemotherapy will exceed 40 to 45%, it seems be wise to give chemotherapy first, and then BMT when the
leukemia
relapse. Differentiation induction therapy seems to be indicated in acute promyelocytic leukemia, although a confirmative study is awaited.
...
PMID:[Recent progress in the treatment of acute leukemia]. 171 2
From October 1983 to December 1988, 84 consecutive adult patients with acute non-lymphoblastic
leukaemia
(ANLL; median age = 51 yr) were uniformly treated to induce remission (CR) with intravenous vincristine and cytarabine sequentially followed by daunomycin and infusion cytarabine. From October 1983 to December 1985 consolidation was non-intensive (2 courses with the same drugs used for induction) (protocol ANLL83: 27 patients, median age = 45). From January 1986 to December 1988 consolidation was intensive (4 courses of vincristine and cytarabine sequentially followed by etoposide plus thioguanine or amsacrine) (protocol ANLL86: 57 patients, median age = 57). Excluding early deaths, the CR rate was 71.6%. Median CR, responsive patient survival and overall survival were 11.1, 15.3 and 8.5 mo, respectively. For protocol ANLL83 and ANLL86, median CR was 8.7 and 13.2 mo (P less than 0.05) and median survival was 13.1 and 16.9 mo (P less than 0.05) for responders and 8.0 and 9.2 mo (P not significant) for all patients. Intensive consolidation including drugs not previously used for induction seems to prolong CR duration and responder survival in
adult ANLL
.
...
PMID:Postremission chemotherapy in adult acute non-lymphoblastic leukaemia including intensive or non-intensive consolidation therapy. 182 17
Twenty-seven
adult AML
patients (13 with active disease and 14 in complete remission) were investigated for their cellular cytotoxic potential and function. All AML patients, whether with active disease or in complete remission, showed increased percentage of CD3+ lymphocytes expressing the cytotoxicity-linked cytoplasmic serine esterase, suggesting a higher than normal cytotoxic potential. However, when the cytotoxic function in these patients were analysed in terms of the natural killer and lectin-dependent cellular cytotoxicity, all AML patients, whether with active disease or in complete remission, had impaired target cell lytic activity. This paradox of cytotoxicity is most likely due to the immunosuppressive effect of the serum factor elaborated by
leukaemia
myeloblasts.
...
PMID:Cellular cytotoxic function and potential in acute myelogenous leukaemia. 186 45
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