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)

Sixteen patients with poor-prognosis acute myelogenous leukemia (AML), acute lymphoblastic leukemia (ALL), and non-Hodgkin's lymphoma (NHL) underwent conditioning with busulfan (16 mg/kg) and cyclophosphamide (120 mg/kg) (BUCY-2) plus melphalan (90 or 135 mg/m2) and autologous bone marrow transplantation (AuBMT) in a phase I study. At the melphalan dose of 90 mg/m2, grade greater than or equal to 3 regimen-related toxicity (RRT) was observed in five patients (31%; 95% confidence interval [CI], 11% to 59%), with hepatic (venoocclusive disease [VOD]) and urinary (hemorrhagic cystitis) RRT being the most frequent complications. Further escalation of the melphalan dose to 135 mg/m2 was deemed excessively toxic, as three of five patients had grade greater than or equal to 3 RRT. Following this experience, 21 patients with multiple myeloma (MM) and chronic myelogenous leukemia (CML) were treated with BUCY-2 plus melphalan 90 mg/m2 and AuBMT in separate studies. Three of these patients--all with extensively pretreated MM--had grade greater than or equal to 3 RRT (14%; 95% CI, 3% to 36%); no others had grade greater than or equal to 3 RRT. Therefore, a total of eight of the 37 patients (22%; 95% CI, 10% to 38%) who received BUCY-2 plus melphalan 90 mg/m2 conditioning developed grade greater than or equal to 3 RRT; three of these patients (8%; 95% CI, 3% to 25%) died of RRT. Although limited by the relatively small number of patients, our analysis of the patients receiving this regimen showed that the presence of parameters denoting the lymphoid diagnostic group (ie, ALL, NHL, and MM), more extensive pretreatment, and/or more advanced disease status were associated with a higher incidence of grade greater than or equal to 3 RRT. Response data on the AML, ALL, and NHL patients who received BUCY-2 plus melphalan 90 mg/m2 were analyzed: three patients (all with AML in first or second remission) are leukemia-free at 3.0, 2.8, and 1.4 years after AuBMT. The actuarial 2-year event-free survival in this group is 17% (95% CI, 5% to 54%). Response data on the MM and CML patients will be reported subsequently. BUCY-2 plus melphalan at a dose of 90 mg/m2 before AuBMT produces acceptable toxicity in patients who are not heavily pretreated. A full evaluation of the antineoplastic effects of this regimen requires further study.
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PMID:Busulfan, cyclophosphamide, and melphalan conditioning for autologous bone marrow transplantation in hematologic malignancy. 191 38

Nine cases of pleural fluid infection caused by Listeria monocytogenes (one case described here and eight cases previously reported in the literature) were reviewed. Eight patients (88.9%) had an underlying malignancy (three had Hodgkin's disease, three had non-Hodgkin's lymphoma, and two had leukemia), and six (66.7%) were receiving immunosuppressive therapy at the time of presentation. Seven patients (77.8%) presented with fever and five (55.6%) with respiratory tract symptoms. Those with symptoms of greater than 3 weeks' duration had a relatively poor prognosis. Bacteremia was documented in five patients (55.6%). Examination of pleural fluid typically revealed normal levels of glucose, slightly elevated concentrations of protein, and a negative gram stain. Four patients died, for an overall mortality of 44.4%. Mortality appeared to be lower for patients who received a combination of penicillin or ampicillin plus an aminoglycoside and for those who underwent drainage of pleural fluid than for those not given such treatment. Rapid diagnosis, prompt institution of appropriate antimicrobial therapy, and drainage of the pleural fluid are likely to improve the chances for survival in listerial infection of pleural fluid.
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PMID:Pleural fluid infection caused by Listeria monocytogenes: case report and review. 156 73

Recent evidence suggests that tumour necrosis factor alpha (TNF) is an autocrine growth factor for the chronic B-cell malignancies hairy cell leukaemia (HCL) and some cases of B-chronic lymphocytic leukaemia (B-CLL). Incubation with TNF in vitro has been shown to increase viability, DNA synthesis and the expression of the protooncogenes myc, fos and jun in the tumour cells from these patients. TNF in vitro also increases expression of TNF-mRNA, suggesting the existence of an autocrine growth loop for TNF in these cells. Current experiments are compatible with the hypothesis that interferon alpha (IFN) interferes with this autocrine growth loop in HCL and B-CLL by stimulating degradation of messenger RNAs (mRNAs) for a number of cytokines including that of TNF. This RNA degradation may be mediated through induction of the enzyme 2,5 oligo-A synthetase with consequent increased synthesis of 2,5 oligo-A which is known to stimulate the activity of a latent ribonuclease capable of degrading cytokine mRNAs. Circulating tumour-derived TNF may also contribute to the pancytopenia in HCL and B-CLL. Whether cytokine autocrine growth loops are important in other B-cell malignancies, e.g. myeloma and non-Hodgkin's lymphoma, and subject to IFN-stimulated breakdown needs further study.
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PMID:Possible mechanism of action of interferon alpha in chronic B-cell malignancies. 193 2

To determine the risk and pertinent features of non-Hodgkin's lymphoma (NHL) as a second malignancy, medical records were searched of 5484 consecutive children treated for various malignancies at a single institution during a 27 year period. Of these, three have developed secondary NHL. The probability of secondary NHL in this cohort at 5 and 10 years after the diagnosis of the first malignancy was 0.05% (95% confidence interval, 0.01%, 0.2%) and at 15 years 0.16% (0.04%, 0.63%). With 30710 person-years observed, the risk in this cohort was 9.8 per 100,000 person-years. A literature search disclosed variously detailed descriptions of 21 cases of secondary NHL in patients whose primary malignancy had been diagnosed when they were less than 20 years old. Of 18 cases with documented secondary NHL histology, the most common subtypes were large cell (n = 7) and small non-cleaved cell (n = 6); mixed histology was found in three and lymphoblastic in two cases. Twenty-three of 24 children with secondary NHL had initial lymphohematopoietic neoplasms: Hodgkin's disease (n = 18), acute lymphoblastic leukemia (n = 4) and acute myelogenous leukemia (n = 1); the remaining child had astrocytoma. Of 18 patients (including three cases from this institution) with known outcome, only four were reported to be alive at 5+, 6+, 12+ and 96+ months, respectively. Secondary NHL occurs most often after therapy for Hodgkin's disease and confers a dismal prognosis.
Leukemia 1991 Oct
PMID:Secondary non-Hodgkin's lymphoma after treatment for childhood cancer. 196 Oct 25

2-Chlorodeoxyadenosine is a simple purine nucleoside that has previously been shown to be effective in the treatment of low-grade malignant disorders of lymphoid tissue, including chronic lymphocytic leukemia and non-Hodgkin's lymphoma. Because of these encouraging results, we treated 12 patients with another low-grade B-cell neoplasm, hairy-cell leukemia. The patients received 2-chlorodeoxyadenosine (0.1 mg per kilogram of body weight per day) by continuous infusion for seven days. All the patients responded to treatment. Eleven had complete remissions characterized by the normalization of peripheral blood and bone marrow and disappearance of tumor masses. The longest remission has been 3.8 years. None of the patients have relapsed, and the median duration of remission has been 15.5 months. No serious toxic reactions occurred as a result of 2-chlorodeoxyadenosine therapy. These results suggest that 2-chlorodeoxyadenosine may be the most effective therapy available for hairy-cell leukemia. The administration of 2-chlorodeoxyadenosine resulted in a higher rate of complete remission than is observed with interferon alfa, and it required no maintenance therapy. Its toxicity may be lower than that of deoxycoformycin, and the responses were achieved with single courses of treatment.
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PMID:Lasting remissions in hairy-cell leukemia induced by a single infusion of 2-chlorodeoxyadenosine. 196 13

A 34-year-old man was found to have granulocytopenia with a white blood count of 2.3 x 10(9) l-1, consisting of 10% segmented neutrophils, 50% monocytes and 40% lymphocytes. A bone marrow aspirate showed 20% promyelocytes and 10% blasts with monoblastic features, and a smouldering myelomonocytic leukaemia was considered to be a possible diagnosis. In cold weather the patient experienced cold intolerance with acrocyanosis and small ulcerations on the ears. The test for heparin-precipitable protein ('cryofibrinogen') was strongly positive. During the following year, these signs and symptoms persisted, and the patient also developed constant moderate pain in the epigastric region. Gastroscopy revealed a large lymphoma of the stomach, which was a high-grade malignant centroblastic type of non-Hodgkin's lymphoma. After successful removal of the tumour, and six courses of potent cytostatic combinations, the patient recovered completely, and the granulocytopenia and cold intolerance disappeared.
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PMID:Gastric lymphoma causing granulocytopenia and cold intolerance, with recovery after treatment. 199 44

The risk of second primary cancer (SPC) was evaluated in 947 patients treated for Hodgkin's disease (HD) during the period January 1969 to December 1979. The median follow-up of this series was 10.5 years (range, 9 to 19). Treatment categories included radiotherapy (RT) alone (115 patients, 12%), chemotherapy (CHT) alone (161 patients, 17%), combined RT plus CHT (381 patients, 40%), and salvage treatment for resistant or relapsing HD (290 patients, 30.6%). Fifty-six SPCs were observed, occurring between 1 and 17 years from initial treatment. Among these, secondary acute nonlymphoid leukemia (s-ANLL) was the most frequent SPC (23 cases). Secondary non-Hodgkin's lymphoma (s-NHL) occurred in 5 patients, whereas a secondary solid tumor (s-ST) was observed in 28 patients. The calculated actuarial risk (+/- SE) of developing SPC was 5.0% (+/- 0.9%) and 23.1% (+/- 5.8%) at 10 and 19 years, respectively. Concerning treatment modalities and s-ANLL risk, no cases were observed in the radiotherapy group, whereas CHT plus RT and salvage groups showed the highest actuarial risk. This was, in fact, at 10 and 19 years, 3.1% (+/- 0.9%) and 8.1% (+/- 4.0%) in the former group, and 1.8% (+/- 1.0%) and 16% (+/- 9.0%) in the latter. A statistically significant difference was observed when the CHT plus RT group was compared with CHT and RT groups (P = .04). Concerning the relationships with chemotherapeutic regimens, 12 s-ANLL cases occurred in the mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) plus RT group, and only one case in the group receiving doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) plus RT. A statistically significant difference of s-ANLL actuarial risk was found comparing patients receiving MOPP plus RT to all other treatment groups (P = .04). With respect to s-ST, the actuarial risk at 10 and 19 years was 2.0% (+/- 0.6%) and 13.0% (+/- 3.8%), respectively. No significant differences were found among groups treated with different modalities. These data were confirmed by a multivariate analysis, which indicated treatment modality and age as independent variables for s-ANLL and s-ST development, respectively. Based on the prolonged follow-up analysis, the actuarial SPC risk at 10 years hereby reported should reflect the real SPC incidence in our series.
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PMID:Second primary cancer following Hodgkin's disease: updated results of an Italian multicentric study. 199 12

The risks of developing leukemia and non-Hodgkin's lymphoma from living near industrial facilities were evaluated among men from Iowa and Minnesota in a population-based, case-control study. We found a statistically significant increase in the risk of developing non-Hodgkin's lymphoma (RR = 1.4) and a slight, nonsignificant excess for leukemia (RR = 1.2) among individuals who lived .8-3.2 km (1/2-2 miles) from a factory. Risks were greater for certain histologic types: follicular lymphoma (RR = 1.5), acute lymphocytic leukemia (RR = 5.4), and acute myelocytic leukemia (RR = 2.2). For non-Hodgkin's lymphoma (but not for leukemia), the relative risks for those living within .8 km (1/2 mile) of a factory were similar or slightly larger than for those living .8-3.2 km (1/2-2 miles) from a factory. Risks did not increase with duration of residence near a factory. The elevated risks of non-Hodgkin's lymphoma were particularly associated with residing near stone, clay, or glass industry facilities. The risk of developing leukemia was greater among persons who resided near chemical and petroleum plants. These preliminary findings raise the possibility that general environmental exposure associated with certain industrial activities may elevate the risk of developing leukemia and non-Hodgkin's lymphoma. Evaluation of data on proximity to industrial plants from studies in other geographic locations is needed to determine whether our results represent a meaningful association.
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PMID:Leukemia and non-Hodgkin's lymphoma and residential proximity to industrial plants. 200 96

The incidence of cancer, or the mortality attributed to it, has been compared in urban and rural residents in 13 populations. In each case, the incidence (or mortality) has been higher in the urban areas in each sex, the ratios varying from a minimum of 1.03 to 1 in men in Japan to 1.63 to 1 in men in Denmark. Examination of 26 separate types of cancer showed that 23 tended to be more common in towns, 1 (myeloma) to be evenly distributed, and 2 (cancers of the lip and eye) to be more common in the countryside. The urban excess was greatest for cancers of the bladder, larynx, liver, lung, mouth and pharynx, and oesophagus, and least for leukaemia and non-Hodgkin's lymphoma. It is concluded that differences in personal behaviour (cigarette smoking, alcohol consumption, sexual promiscuity, exposure to ultraviolet light, type of diet, and family size) are the principal factors responsible for the urban excess. Other factors include general atmospheric pollution, occupational hazards, genetic differences in susceptibility, and artefacts of diagnosis and recording. The rural excess was marked for cancer of the lip in both sexes, but less marked and clearly evident only in men for cancer of the eye. Three-quarters of eye cancers are melanomas and the excess incidence in rural areas provides some weak support for the idea that exposure to sunlight contributes to the production of the disease.
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PMID:Urban and rural factors in the aetiology of cancer. 201 Feb 24

A retrospective study was done of the incidence of non-Hodgkin's lymphoma (NHL) in children in the Netherlands in the period 1973-85 in relation to that of acute lymphoblastic leukemia (ALL). Complete ascertainment of cases was most likely achieved through the network of cooperating pediatricians of the Dutch Childhood Leukemia Study Group (DCLSG). The incidence of NHL remained constant at 0.75 per 10(5) children per year; the boy/girl ratio was 2.5. In +/- 25% of cases the disease was localized at diagnosis. Of children with NHL who were not listed in the DCLSG leukemia register, 19% had greater than or equal to 25% lymphoblasts in the bone marrow at diagnosis, representing an overlap with ALL of +/- 5%. In 1% of the children with NHL an immuno-deficiency disorder preceded the diagnosis. The incidence of Hodgkin's disease (HD) was 0.3 per 10(5) children per year, with some fluctuation over time, the peak being 0.7 in 1983. The boy/girl ratio was 2.7. Age-specific incidence rates, clinical features of NHL and HD, as well as the ALL to NHL ratio corresponded with those in other European countries and for white children in the USA.
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PMID:Malignant lymphomas in children in The Netherlands in the period 1973-1985: incidence in relation to leukemia: a report from the Dutch Childhood Leukemia Study Group. 202 65


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