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)

Acute monocytic leukaemia (AMoL) was diagnosed in 99 adults, aged 18-85 years (median 56) over a period of 10 years. Sixty-five patients had extramedullary leukaemia, 13 had clinical signs of leucostasis, and 19 had disseminated intravascular coagulation. Four patients died before receiving any treatment, 12 received supportive care only and seven received low dose AraC, but only one of them responded. Seventy-six patients received intensive chemotherapy, 72 of them with an anthracycline-AraC based regimen, with or without an epipodophyllotoxin. Fifteen patients died within 7 d of diagnosis, due to leucostasis in nine cases. Predictive factors for early death were advanced age, leucostasis, fever, leucocytes above 100 x 10(9)/l, and renal failure. Fifty (66%) of the patients treated intensively reached complete remission (CR). Advanced age, fever and complex cytogenetic abnormalities were significantly associated with a lower CR rate. Median actuarial disease-free survival was 20.5 months, and was not significantly influenced by any pretreatment parameter. Five patients relapsed in the central nervous system (CNS), in spite of systematic CNS prophylaxis. No differences in CR rates were seen with the three anthracycline-AraC based regimens used in our patients. Significant differences in disease-free survival were seen between them, however, suggesting that early consolidation chemotherapy and, more hypothetically, epipodophyllotoxin agents could prolong remission duration in AMoL.
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PMID:Acute monocytic leukaemia in adults: treatment and prognosis in 99 cases. 237 23

Aclacinomycin is a member of naturally occurring anthracyclines having three sugar moieties in the molecule. It showed antitumour activity on various mouse and rat tumours. Combination therapy with AraC etc. gave remarkable clinical results on acute myeloid leukaemia. Aclacinomycin strongly inhibits RNA synthesis of the tumour cells. It has lower cardiac toxicity than adriamycin and no mutagenicity. THP-Adriamycin is a derivative of adriamycin designed from the structure of baumycins. It showed stronger effects than adriamycin in inhibiting many mouse tumours such as L1210 and P388 leukaemia, B16 melanoma and colon 38 adenocarcinoma. THP-Adriamycin is rapidly taken up by both adriamycin-sensitive and resistant leukaemic cells. Its level of cardiac toxicity is as low as that of aclacinomycin. Ditrisarubicins are new naturally occurring anthracyclines isolated from Streptomyces having six sugar moieties in the molecule. Ditrisarubicin has a potent cytostatic and antitumour activities on adriamycin resistant mouse leukaemia. Its binding constant to DNA is extremely high compared with other anthracyclines.
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PMID:Experimental studies of new anthracyclines: aclacinomycin, THP-adriamycin and ditrisarubicins. 244 79

Between April and December, 1982, a multicentre pilot study was conducted in 45 patients aged from 16 to 73 years suffering from acute lymphoblastic leukaemia to test the feasibility of an intensive and short induction phase followed by an early consolidation phase. All patients received a 5-day course of induction chemotherapy with prednisone, vincristine, AraC and rubidazone, then a "triple A regimen" for consolidation, consisting of adriamycin, AraC and asparaginase. The complete remission rate was 73 per cent. Toxicity during induction was characterized by frequent infections, but the consolidation treatment was well tolerated. Thus, the sequence intensive induction-early consolidation proved feasible and acceptable. In terms of survival, 8 out of the 33 patients in remission are still alive and well after more than 4 1/2 years.
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PMID:[Intensive induction and early consolidation of acute lymphoid leukemia in the adult. A pilot study of feasibility and long-term development]. 252 9

This article summarizes recent studies characterizing nucleoside transport in mammalian cells and discusses evidence for a role of membrane transport in the pharmacologic action of nucleoside analogues. Some of these studies have also addressed the controversy concerning the multiplicity in transport routes. It seems clear that erythrocytes and, perhaps, some other mammalian cells possess a single, broadly specific system for transporting nucleosides. However, substantial evidence from valid studies discriminating between transport and intracellular metabolism suggests that at least some mammalian cells, including some tumor cells, possess more than a single system. Evidence now exists for a determining role of membrane transport of nucleoside analogues in their cytotoxicity and, in the case of one pyrimidine nucleoside (AraC), in therapeutic responsiveness in leukemic patients. There are also numerous examples of transport-related resistance to nucleoside analogues. Included in this article are the results of studies from the authors' laboratory pertaining to the therapeutic activity of the purine nucleoside, FAraA, in murine tumor models. These studies provide evidence for a determining role of both membrane transport and intracellular phosphorylation in the selective antitumor action of this agent against murine leukemia. Substantially increased transport inward of FAraA occurs at pharmacologically achievable concentrations of this agent in tumor cells as compared to drug-limiting, normal proliferative epithelium of the small intestine. The basis for this differential appears to be the kinetic duality of FAraA and adenosine transport inward found in tumor cells, but not in proliferative intestinal epithelial cells. Tumor cells have highly saturable (low influx Km) and poorly saturable (high influx Km) systems for adenosine transport, both of which are shared by FAraA. In contrast, proliferative epithelial cells have only a poorly saturable system for these substrates. If a similar kinetic duality of nucleoside transport is found in other tumor cells certain implications arise concerning the significance of the duality to neoplastic transformation.
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PMID:Membrane transport and the antineoplastic action of nucleoside analogues. 332 28

Eight pediatric patients with acute lymphoblastic leukemia (ALL) were treated with intermediate-dose cytosine arabinoside (ID-AraC, 1 g/m2) in combination with adriamycin except one patient. Of the eight patients, four refractory to the initial induction therapy and one in bone marrow relapse gained complete remission with two to three cycles of this therapy. Four of the five patients have been in continuous remission for 4 to 24 months with the maintenance therapy of monthly administration of ID-AraC. One patient in central nervous system (CNS) relapse has continued in remission from CNS leukemia after two cycles of the therapy. Side effects of ID-AraC and adriamycin were generally mild to moderate and tolerable in all children. These results suggest that the use of ID-AraC and adriamycin might prove effective in the treatment of ALL refractory to other regimens.
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PMID:Treatment of childhood acute lymphoblastic leukemia with intermediate-dose cytosine arabinoside and adriamycin. 345 99

Pharmacokinetic studies of intermediate and high dose 1-beta-D-arabinofuranosylcytosine (araC) therapy were performed in 14 children with acute leukemia and four with non-Hodgkin's lymphoma (NHL). AraC administration differed by method, dosage, and time of infusion to obtain the optimal tumorcidal concentration. The toxicity of these regimens was limited to transient severe nausea and vomiting, which were tolerable. Infusion time and dose are important factors to obtain optimal and clinically effective cerebrospinal fluid (CSF) araC concentrations. A concentration of araC above 1 micrograms/mL in CSF, which was lethal to cells in culture, was obtained by intravenous infusion of more than 2,000 mg/m2 of araC for four hours. We propose that araC 2,000 mg/m2 by constant intravenous infusion is preferable in the treatment of leukemia and is associated with the fewest side effects.
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PMID:Pharmacokinetic studies of intermediate-to high-dose 1-beta-D-arabinofuranosylcytosine in children with acute leukemia and lymphoma. 368 May 93

27 patients (aged 15-55 years) with relapsed acute myelogenous (AML) and lymphoblastic leukaemia (ALL), and with lymphoblastic non Hodgkin's lymphoma (NHL) have been treated with intermediate dose cytosine arabinoside (AraC, 1 g/m2 q 12 h X 12) and 3 d of m-AMSA (20 patients), 90-115 mg/m2 daily, or daunorubicin (7 patients). 18 of them attained a complete remission (AML 10/14, ALL 3/5, NHL 5/8). 7 patients received consolidation treatment with 1-2 courses comprising 4 d of AraC (3 g/m2 q 12 h X 8) and m-AMSA (90-115 mg/m2) on d 5 of each course. 2 patients underwent allogeneic bone marrow transplantation and 9 received no further treatment after remission induction. In addition to vomiting, fever and conjunctivitis, toxicity in 6 patients included a combination of severe diarrhoea, fever and signs of paralytic ileus. 3 of them died during the pancytopenic phase. The pancytopenic period ranged from 16-25 d (median 21 d) after the remission induction and 14-21 d (median 19 d) after the consolidation course. Median remission duration was 5 months for those patients who received no treatment after remission induction and greater than 9 months (4+ - 16+ months) for the patients who received consolidation courses. Increased dosages of AraC are active in relapsed leukaemia and lymphoma, although optimal dose and schedule are still undetermined.
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PMID:Intermediate and high-dose ARA-C and m-AMSA (or daunorubicin) as remission and consolidation treatment for patients with relapsed acute leukaemia and lymphoblastic non-Hodgkin lymphoma. 385 71

28 consecutive patients (age 15-58 years) with refractory acute leukaemia (24 AML, 4 ALL) have been treated with high or intermediate dose cytosine arabinoside (AraC). Twenty patients received AraC at a dose of 3000 mg/m2, twice daily for 6 days (13 patients AraC alone, 7 patients AraC and doxorubicin) and 8 patients received AraC at a dose of 1000 mg/m2, twice daily for 6 days and daunorubicin. 10 of the 20 patients treated with high dose AraC achieved a complete remission (50%) and 2 a partial remission. No patients in the intermediate dose AraC group achieved a remission (p = 0.05). Toxicity of these protocols was acceptable. Vomiting, headache, somnolence, fever, conjunctivitis, and minor cardiac arrhythmias were found most frequently. The pancytopenic period ranged from 16-30 days for the high dose protocol and 14-23 days for the intermediate dose protocol. Sophisticated isolation and blood banking facilities are required in this period. Median duration of remission was 6 months. Results obtained are in favour of the high dose protocol in refractory leukaemia. Only a large dosage increment of AraC can overcome refractoriness of leukaemic blast cells.
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PMID:Experience with intermediate and high dose cytosine arabinoside in refractory acute leukaemia. 635 50

The kinetics of cytosine arabinoside (AraC) were studied in vitro using P388 murine leukemia lines sensitive (P388-S) and resistant (P388-R) to the drug. Using P388-S cells, the 3H-thymidine index (L.I.) was paralleled by the 3H-AraC index, i.e. any cell in the S-phase of the cycle also incorporated the 3H-AraC into DNA. With the resistant line, the 3H-AraC index was zero in spite of high L.I. This discrepancy between the L.I. and 3H-AraC index could be used to predict the percentage of resistant cells when known mixtures of sensitive and resistant populations were used. The reason for lack of incorporation into DNA by the resistant cells was shown to be the presence of very low levels of the enzyme deoxycytidine kinase in P388-R cells resulting in an inability to phosphorylate AraC to its active form AraCTP. Immediate inhibition of DNA synthesis caused by AraC was directly proportional to the number of sensitive cells present in the population, but was not as accurate a predictor of sensitivity as the 3H-AraC index. Cloning in methylcellulose was found to be the least sensitive predictor of the percentage of sensitive and resistant cells, most likely related to the difference in cloning efficiency of the sensitive and resistant lines.
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PMID:Comparison of in vitro assays for detecting subpopulations of P388 leukemic cells resistant to AraC. 654 97

17 patients (age 15-58 years) with refractory acute leukaemia (14 AML, 3 ALL) were treated with high dose cytosine arabinoside (AraC) at a dose of 3000 mg/m2, twice daily for 6 d (13 patients with AraC alone, 4 patients with AraC and doxorubicin). 9 patients achieved complete remission (53%) and 2 a partial remission. Although sophisticated isolation and blood banking facilities are required during the pancytopenic period, the toxicity of this treatment was acceptable. Vomiting, headache, somnolence, fever, conjunctivitis and cardiac arrhythmias were found most frequently. The unexpected pulmonary failure in 3 patients was worrisome. The duration of remissions was from 1 to 12 months. Results obtained with high dose AraC are satisfactory and hold promise for the treatment of patients with previously untreated AML.
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PMID:High dose cytosine arabinoside in the management of refractory acute leukaemia. 695 4


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