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

Doxorubicin is an essential component of the treatment of aggressive lymphoma, childhood solid tumors, bone and soft tissue sarcomas, and breast cancer and additional indications are emerging. On the other hand, daunorubicin has occupied the central position of interest in the treatment of acute leukemia. Epirubicin has a spectrum very similar to doxorubicin but lesser toxicity. The ability to protect against cardiotoxicity with ICRF-187 further enhances clinical interest in exploiting modifications in doze intensity to therapeutic advantage. Idarubicin has at least equivalent activity to daunorubicin and doxorubicin in leukemia. New areas of research in relation to anthracycline antibiotics include introduction of new the analogs, insight into mechanisms of resistance, the reversal of multidrug resistance in vitro, the protection of cardiac toxicity, and the study of other important biochemical reactions relevant to cytotoxicity. Orally active anthracyclines such as idarubicin and compounds which lack cross-resistance with the parent drugs or have other mechanisms for cytotoxicity are being developed. It is likely that these modifications will lead to an expanding therapeutic spectrum for these already widely useful drugs.
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PMID:New anthracycline antitumor antibiotics. 183 87

Cytogenetic studies were conducted on fresh and cultured cells from 11 patients with human T-cell leukemia virus-associated adult T-cell leukemia-lymphoma. Clones with abnormal karyotypes were detected in 9 of the 11 patients. Chromosome numbers were near-diploid in cells from all but 1 patient who also had a tetraploid clone. The chromosome abnormalities in these cells were extensive; numerous complex structural changes were seen in every chromosome pair. Structural abnormalities occurred most frequently in chromosome 6. The 6 patients with chromosome 6 deletions had breakpoints at bands q11, q13, q16q23, q21q23, q22q24, and q23q24. The characteristic clinical features of these 6 patients were aggressive course, short survival, poor response to chemotherapy, high white blood cell counts, hypercalcemia, and bone lesions, whereas cytogenetically abnormal patients without chromosome 6q deletions tended to have a more indolent course. The precise role of the 6q deletion cannot be established with certainty from these data. However, this abnormality appears to occur with a greater than expected frequency in this large cell aggressive lymphoma, in association with hypercalcemia and lytic bone lesions.
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PMID:Cytogenetic studies in human T-cell lymphoma virus (HTLV)-positive leukemia-lymphoma in the United States. 298 35

Two pediatric cases of acute lymphoblastic leukemia with L1 morphology who also demonstrated immunoglobulin on the leukemic cell surface are presented. The first patient's disease progressed on standard induction therapy, despite the presence of good prognostic features at presentation. The second patient has achieved a sustained remission with an aggressive lymphoma regimen. These two cases represent the first report on the outcome of patients with this rare phenotype. They indicate the importance of assessing cell surface immunoglobulin in children with acute leukemia, even in the absence of the L3 phenotype, in addition to the currently utilized batteries of monoclonal antibodies. Failure to recognize this phenotype may have significant therapeutic implications.
Leukemia 1988 Jan
PMID:Acute B-lymphocytic leukemia with L1 morphology: a report of two pediatric cases. 312 10

Recent progress in the chemotherapy of malignant lymphoma is described from the viewpoint of survival advantage. Malignant lymphoma is classified into the following five major categories: aggressive lymphoma, indolent B-lymphoma, Hodgkin's disease, T-lymphoblastic lymphoma and adult T-cell leukemia-lymphoma (ATL). In aggressive lymphoma of advanced stages, recent multicenter phase III studies revealed that first-generation CHOP therapy remains the best available treatment. By multivariate analysis on prognostic factors of non-ATL lymphoma patients who were treated by the second generation LSG 4 protocol, CRP and total number of involved lesions were found to be significantly unfavorable factors. In non-ATL lymphoma, mainly B-lymphoma, three risk groups (low, intermediate and high) were identified. Similarly, the International Non-Hodgkin's Lymphoma Prognostic Factors Project proposed a new predictive model for survival of aggressive lymphoma patients. Such predictive models would be very useful in the design of future chemotherapy trials for aggressive lymphoma. In advanced-stage Hodgkin's disease, about two-thirds of patients are expected to be long-term survivors, thanks to state-of-the-art chemotherapy. A recent phase III study conducted by CALGB disclosed that MOPP/ABVD and ABVD are superior to MOPP. In ATL and indolent B-lymphoma, no state-of-the-art chemotherapy has been established. In order to improve the prognosis of both diseases, innovative treatment strategies should be pursued.
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PMID:[Recent progress in the chemotherapy of malignant lymphoma]. 788 35

Recent progress in the chemotherapy for malignant lymphoma is reviewed. From the viewpoint of treatment, malignant lymphoma is classified into five major categories; aggressive lymphoma, indolent B-lymphoma, Hodgkin's disease, T-lymphoblastic lymphoma and adult T-cell leukemia-lymphoma (ATL). Based on the results of the clinical chemotherapy trials conducted by the cooperative oncology groups in Western countries and the Lymphoma Study Group (LSG) in Japan, the state of the art of chemotherapy for malignant lymphoma is described. In aggressive lymphoma of advanced stages, after establishment of CHOP therapy (first generation), better results were reported in the United States for single institute single-arm studies of non-cross resistant alternating multiagent chemotherapy (second generation) and high relative dose intensity chemotherapy (third generation). However, recent multicenter phase III studies, comparing CHOP with third generation regimens, revealed that CHOP remains the best available treatment, because of similar failure-free and overall survival with lower cost and lower severe toxicity. More recently, the results of the International Non-Hodgkin's Lymphoma Prognostic Factors Project were reported. Based on the number of the five unfavorable factors present, such as age, stage, LDH, performance status and the number of extranodal disease sites, a new predictive model "international index" for aggressive lymphoma was developed. Such predictive models based on prognostic factor analyses would be very useful in the design of future clinical trials in patients with aggressive lymphoma and in the selection of appropriate therapeutic approaches for individual patients.
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PMID:[Recent progress in the treatment of malignant lymphoma]. 803 Nov 55

Nationwide epidemiological studies have disclosed that lymphoid malignancies in Japan are markedly different from those in Western countries; they are less frequent in indolent B-lymphoma and Hodgkin's disease and more frequent in T-cell lymphoma, particularly adult T-cell leukemia-lymphoma (ATL). In 1978, the Lymphoma Study Group (LSG) of Japan started multicenter clinical trials for malignant lymphoma. Since then various kinds of phase II and III studies for aggressive lymphoma, Hodgkin's disease, ATL, T-lymphoblastic lymphoma, acute lymphoblastic leukemia and multiple myeloma have been conducted by the LSG. Based on the results of clinical trials conducted in Western countries and the LSG, the state of the art of chemotherapy for malignant lymphoma is described. In aggressive lymphoma of advanced stages, after establishment of CHOP therapy (1st generation), better results were reported in Western countries for single institute phase II studies of non-cross resistant alternating multiagent chemotherapy (2nd generation) and high relative dose intensity chemotherapy (3rd generation). However, recent multicenter phase III studies, comparing CHOP with 3rd generation regimens, revealed that CHOP remains the best available treatment, because of similar failure-free and overall survival with lower cost and lower severe toxicity.
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PMID:[Chemotherapy for malignant lymphoma in Western countries and Japan]. 827 44

p53 mutations are found in a variety of neoplasia. B-immunoblastic lymphoma (BIBL) is a rapidly progressive, aggressive lymphoma. As patients with acquired immunodeficiency syndrome (AIDS) live longer, BIBL is becoming an increasing problem. We asked three questions in our study. What is the frequency of p53 mutations in BIBL? Is it more frequent in patients with AIDS? Can immunohistochemical staining of lymph nodes for expression of p53 substitute for mutational analysis of p53 to detect lymphomas with mutated p53? Exons 5, 6, 7, 8 of the p53 gene (hot-spots for mutations) were amplified and examined for mutations by single-strand conformation polymorphism (SSCP) analysis. Altered migration was observed in 7 of 52 BIBL samples. Of these, 4 of 25 were from individuals infected with human immunodeficiency virus (HIV) and 3 of 27 were not infected with HIV. Direct sequencing of amplified material confirmed the presence of mutations in exons 5, 7, 8 of p53. A total of 26 BIBL as well as other lymphoma/leukemia samples, stained strongly by immunohistochemistry with three antibodies directed against human p53. Five of 6 BIBL samples with p53 mutations stained strongly for p53, but 20 lymphoma samples with no detectable p53 mutations also stained strongly for p53. Of note, however, 10 hyperplastic, nonmalignant lymph nodes from individuals either infected or not infected with HIV had negligible staining for p53 protein. In conclusion, p53 mutations occur in about 14% BIBL samples; the frequency of p53 mutations in BIBL in individuals with and without AIDS was similar. Positive p53 immunohistochemistry did not correlate with detectable p53 mutations in the same tissue, but positive immunohistochemical staining for p53 was only found in neoplastic lymph nodes. This latter finding provides a strong warning that p53 immunochemistry with available reagents cannot be used to determine which tumors have mutations of p53.
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PMID:Mutation and protein expression of p53 in acquired immunodeficiency syndrome-related lymphomas. 833 55

Patients with B cell chronic lymphocytic leukemia (CLL) occasionally develop high-grade B cell lymphomas that are associated with constitutional symptoms, rapidly progressive lymphadenopathy, and swift clinical deterioration. Now known as Richter syndrome, this symptom complex develops in approximately 5% of all patients with CLL. Structural and molecular analysis of the immunoglobulin (Ig) genes have allowed investigators to define the clonal relationship between the leukemia and lymphoma cells of a given patient. In most cases the aggressive lymphoma evolves from the original leukemia cell clone. However, in some cases the lymphoma apparently represents a second malignancy. Differentiation between these two types of lymphoma may have clinical significance. Further investigation is required to allow for identification of CLL patients who are at risk for developing Richter syndrome and to understand factors involved in its etiopathogenesis.
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PMID:Origin of high-grade lymphomas in Richter syndrome. 852 42

In order to analyze systemic immune surveillance in patients with B cell non-Hodgkin's lymphomas (B-NHL), we investigated circulating lymphocytes using two-color flow cytometry. The proportions of CD3-CD56+ natural killer (NK) cells and CD8++(bright) S6F1++ killer-effector T cells corresponding to activated cytotoxic T lymphocytes (aCTL) were studied in the peripheral blood of 26 patients with indolent lymphoma (IL) and 24 with aggressive lymphoma (AL). The AL patients with both limited disease and advanced disease had an increased proportion of NK cells. However, this feature was not evident in IL patients with either limited or advanced disease. In contrast, an increased proportion of aCTL was observed only in IL patients with advanced disease. These findings indicate that IL may differ from AL in terms of immune surveillance against neoplastic B cells.
Leukemia 1995 Dec
PMID:Cytotoxic lymphocytes in the peripheral blood of patients with B cell lymphomas. 860 27

The incidence of non-Hodgkin's lymphoma continues to rise. Molecular events in lymphocytes from individuals without lymphoma are found with increasing age and may represent early changes toward malignant transformation. Molecular, immunophenotypic, and histologic data have been used to propose a new classification system and several new entities have been identified. Localized, low-grade non-Hodgkin's lymphoma can be cured by radiotherapy, whereas patients with extensive disease experience a continuous remitting course. The effect of high-dose regimens is yet to be determined. Current therapy cures less than 50% of patients with advanced aggressive lymphoma and randomized multi-institutional trials using several regimens have shown similar outcomes. The addition of high-dose therapy to patients in remission may offer a survival advantage to a high-risk subset. Late complications of myeloablative therapy, including myelodysplasia and leukemia, are being increasingly recognized. A significant advance in the treatment of posttransplantation lymphoproliferative disorders using donor T cells was made and future applications of this approach are anticipated.
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PMID:Non-Hodgkin's lymphoma. 937 5


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