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

The phase II trial of natural interferon-alpha (HLBI) in treatment of adult T-cell leukemia was carried out as a cooperative study. Of the 24 cases which could be evaluated, 3 cases in crisis type and 5 cases in chronic type with lymphadenopathy and/or skin infiltration achieved PR, giving a response rate of 33.3%. The anti-tumor effect of HLBI for skin lesion could be assessed in 16 cases with skin infiltration, giving a response rate of 50.0% (5 CR and 3 PR) and demonstrating a high efficacy. Of the 31 eligible patients, side effects were recognised in 27 (87.1%). Major subjective and objective symptoms were fever (38.7%), fatigue (25.8%), anorexia (12.9%) and nausea (12.9%), and leukopenia (22.6%), granulocytopenia (38.7%), thrombocytopenia (38.7), elevation of GPT (12.9%) and GOT (12.9%) were observed.
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PMID:[Clinical study on the effect of natural alpha-interferon (HLBI) in the treatment of adult T-cell leukemia]. 305 2

Six patients with hairy-cell leukemia were treated with gamma-(IFN-gamma) and alpha-(IFN-alpha-2b) interferon; 3-35 months following splenectomy, treatment was started with 4 X 10(6) U/m2 IFN-gamma sc (iv) every second day for 9-35 weeks. Although the white blood cell counts decreased during therapy from 4.1-49 X 10(9)/l to 1.5-43 X 10(9)/l, no hematological or clinical improvement was obtained. Subsequently (interval 0-13 weeks), IFN-alpha-2b was given at an initial dose of 4 X 10(6) U/m2 sc every second day to all patients. After a treatment period corresponding to that of IFN-gamma administration, a significant hematological improvement was observed in five patients (one early death due to pulmonary embolism). At the last follow-up (9-14 months after start of treatment; maintenance therapy, 1 X 10(6) U every second day), these patients exhibited normal peripheral blood cell counts, and in bone marrow biopsy specimens a marked decrease of hairy cells was seen (1 CR, 3 PR, 1 MR). Adverse reactions including fever, headache, nausea, dryness of the mouth, myalgia, and fatigue did not significantly differ between the two interferon preparations. Whereas IFN-gamma is unlikely to have any significant impact on the course of hairy cell leukemia, IFN-alpha-2b does result in improvement of hematological values and well-being in almost all patients.
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PMID:[Effectiveness of gamma interferon and alpha interferon in hairy cell leukemia]. 311 51

A young woman presented with a short history of fatigue and confusion. Investigation showed that she was hypoglycaemic with a metabolic acidosis due to acute monocytic leukaemia. She died before specific treatment could be given for her leukaemia, but illustrates some of the problems in treating the metabolic complications of neoplastic disease.
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PMID:Hypoglycaemia and metabolic acidosis in a patient with an acute leukaemia. 318 1

Acute lymphoblastic leukemia accounts for 80% of leukemia in children. The exact cause is unknown, but some genetic, immunologic, viral, and environmental factors have been implicated. Symptoms at the time of diagnosis frequently include fever, bleeding, fatigue, and irritability. Initial white blood cell count and patient age at diagnosis are the most reliable indicators of prognosis. Acute lymphoblastic leukemia is a heterogenous disease. Lymphoblast morphology, immunologic markers, enzyme abnormalities, cytogenetic findings, and staining characteristics in conjunction with clinical characteristics allow classification into risk groups. Appropriate therapy for each risk group is based on these parameters. Combination chemotherapy administered alone or with additional chemotherapy or radiotherapy to sanctuary sites is the principal modality for treatment of ALL. Optimal therapy for relapse has not yet been determined, but for patients with appropriate donors, allogeneic bone marrow transplant is promising. Common complications of chemotherapy include tumor lysis syndrome, myelosuppression, and other problems such as gastrointestinal toxicity, neurotoxicity and cardiac toxicity. Significant late effects of chemotherapy include neurological impairment ranging from learning problems to leukoencephalopathy and a possible increased risk of second malignancy. Complete remission is achieved in 95% of children with acute lymphoblastic leukemia, and more than 55% will continue to be in complete remission at five years. Optimal CNS prophylaxis, effective treatment of relapse, and adjustment of therapy to minimize acute and late adverse effects are a continuing challenge. With improved understanding of biologic factors, and development of more specific therapy for each subgroup, children with acute lymphoblastic leukemia should enjoy a better long term outcome.
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PMID:Childhood acute lymphoblastic leukemia. 328 Nov 3

Thirty-one children with leukemia or lymphoma treated with multi-drug chemotherapy for more than 2 years were reviewed to identify and characterize the occurrence of febrile episodes related to vincristine (VCR) injection. In nine of the 31 children, more than two febrile episodes apparently attributable to VCR during maintenance therapy were identified. No such episodes were found to have occurred during induction therapy. The median age at diagnosis of these nine children was 3.2 +/- 1.6 years, significantly lower than the 6.8 +/- 4 years of the other 22 children (P less than 0.01). No significant difference was observed between these two groups in laboratory data obtained before the VCR injections, and the drugs used in combination with VCR were apparently unrelated to the incidence of febrile episodes. All of these febrile episodes began within 24 hours after VCR injection. Peak levels of 38 degrees C to 39 degrees C occurred 6 to 24 hours after onset. The episodes also were accompanied by mild, general fatigue and a loss of appetite. They ranged in duration from half of a day to 4 days, but those persisting more than 3 days occurred in three of the five children whose regimens did not include corticosteroid. The results thus suggest that fever is an immediate reaction to the toxicity of VCR in young children, and that the duration of fever can be shortened by combining VCR with corticosteroid.
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PMID:Vincristine-induced fever in children with leukemia and lymphoma. 342 76

Sixty-four patients with hairy-cell leukemia (HCL) (61 had undergone prior splenectomy) were treated with alpha-2 interferon (Intron A, Schering Corp, Kenilworth, NJ) subcutaneously three times per week at a dosage of 2 X 10(6) U/m2. Three patients (5%) demonstrated a complete response (CR) with apparent eradication of hairy cells from the bone marrow, 45 patients (70%) showed a partial response (PR) defined as normalization of all three blood counts associated with decreased involvement in the bone marrow, and nine patients (14%) showed a minor response that included improvement in at least one blood count. Three patients had no response, three patients died before completing 1 month of therapy, and one patient refused further therapy after 1 month of therapy. The median platelet count returned to normal by the second month of treatment. The median hemoglobin returned to greater than 12 mg/dL by the fourth month of treatment, and the median granulocyte count to greater than 1,500/mu by the fifth month of treatment. Bone marrow biopsy analysis during interferon therapy demonstrated a decrease in median hairy-cell index by more than half. Transfusion of both RBCs and platelets were decreased within 4 months of initiating treatment. Serious infections, which averaged four per month in 16 of the 64 patients before interferon therapy, were rarely observed after the first month of treatment. Treatment-induced toxicity was mild, consisting primarily of influenza-like symptoms, fatigue, and minor skin disorders. Alpha-2 interferon therapy is highly effective in reversing the course of progressive HCL and should be considered the treatment of choice for a minimum of 12 months in patients who have progressive disease post-splenectomy.
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PMID:Alpha-2 interferon therapy of hairy-cell leukemia: a multicenter study of 64 patients. 351 80

Thirty-six patients with progressive hairy cell leukemia were treated with recombinant alpha 2b-interferon injected subcutaneously 2 X 10(6) IU/m2, three times a week. Twenty-seven patients completed 12 months of therapy and were randomized either to receive 6 months of continued interferon or to go off treatment. At the time of randomization, two patients had achieved a complete response, 22 a partial response, and three a minimal response. Three patients have relapsed, one while receiving interferon during the randomization period and two who were off therapy for 6 months. The outpatient regimen of interferon administration was well tolerated, with the principal acute toxicities being fever and an influenza-like syndrome and the major long-term toxicity being mild-moderate fatigue.
Leukemia 1987 Apr
PMID:The treatment of hairy cell leukemia with alpha 2b-interferon: experience with 27 patients treated more than one year. 366 56

The preleukemic syndrome occurs mainly after middle age. We report 11 patients, aged 62 to 92 years, who presented with weakness, fatigue, malaise and pallor. Eight patients died; survival from the time of diagnosis was between 2 and 21 months. Two of them developed acute myelomonocytic leukemia. A third patient developed Philadelphia chromosome-negative chronic myeloid leukemia within 9 months. Serum unsaturated B12 binding capacity and transcobalamin I were elevated in this patient, preceding the transformation to chronic myeloid leukemia. Five other patients died from sepsis or pneumonia. All patients were anemic, and 10 were leukopenic. Bone marrow was hypocellular in 1 and hypercellular in 10 cases. Chromosomal studies were performed in five patients, with three showing abnormal findings: 47xx, trisomy 8 and a tetraploid karyotype 92xxyy5q-. No cytotoxic treatment should be given during the preleukemic phase until transformation to acute leukemia occurs. Since preleukemic patients are very susceptible to infections, early diagnosis of the condition is important, as is supportive care in the case of surgery.
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PMID:Preleukemic syndrome in elderly patients--report of 11 cases. 385 73

Four new cases of acute myelofibrosis are reported, and 63 cases reported in the literature are reviewed. The typical features of this disease include a rapidly progressive clinical course; nonspecific symptoms such as weight loss, anorexia, fatigue and weakness; the absence of organomegaly; pancytopenia; circulating blast cells; and mild abnormalities in the red blood cell morphology. The bone marrow aspirates are usually "dry." The bone marrow biopsies are essential for the diagnosis and show four consistent features: hypercellularity, reticulin fibrosis, proliferation of blast cells and bizarre, atypical megakaryocytes. In 16 cases, the blast cells in peripheral blood and bone marrow, which are unclassifiable by conventional morphology, could be identified as megakaryoblasts by ultrastructural and immunocytochemical techniques. It is concluded that acute myelofibrosis is a definite clinicopathologic entity, which may be related to acute megakaryoblastic leukemia.
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PMID:Acute myelofibrosis. A report of four cases and review of the literature. 637 42

Four patients with adult T-cell leukemia (ATL) and 4 patients with non-Hodgkin's lymphoma were treated with alpha-type interferon (Human Lymphoblastoid Interferon: HLBI). Treatment regimen consisted of 3 to 12 million units (MU) of HLBI given intramuscularly once daily. The total dose varied from 36 to 520 MU. Complete remissions were obtained in one of 4 patients with ATL and one of 3 patients with B-cell lymphoma. A partial remission was yielded in one patient with B-cell lymphoma. An overall response rate (CR + PR) was 37.5%. Toxicity included flu-like symptoms, myelosuppression, G-I tract symptoms, fatigue, high fever and hepatic disturbance. On the basis of this study, we have concluded that HLBI is effective for the treatment of ATL and B-cell lymphoma.
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PMID:[Effect of human lymphoblast interferon in adult T-cell leukemia and non-Hodgkin's lymphoma]. 660 14


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