Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023467 (acute myeloid leukemia)
 35,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One hundred-sixty-three children with acute nonlymphocytic leukemia (ANLL) were treated with a multiple-drug induction program (PATCO) consisting of prednisone (PDN), cytosine arabinoside ((Ara-C), 6-thioguanine (6-TG), cyclophosphamide (CPM), and Oncovin (VCR). Ninety-six, 59%, obtained a remission. Remission was maintained with daily 6-TG and four-day pulses of Ara-C and CPM with a single dose of VCR every 28 days. The median duration of remission was 11.5 months. Certain prognostic factors affected induction rate and remission duration. Initial white blood count (WBC) was a significant factor in achieving a remission, whereas age, sex, and type of ANLL had no effect. Initial WBC, age, and sex had a significant effect on remission duration, but type of ANLL had no effect. Relapsing patients were treated with daunomycin and 5-azacytidine. The reinduction rate was 53% with a median second remission duration of 190 days. Overall survival for the 163 patients is 55.4% at 12 months, 31.5% at 24 months, 21.4% at 36 months, and 19% at 48 months.
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PMID:Increased survival in childhood acute nonlymphocytic leukemia after treatment with prednisone, cytosine arabinoside, 6-thioguanine, cyclophosphamide, and oncovin (PATCO) combination chemotherapy. 35 21

Twenty-eight patients with advanced acute nonlymphocytic leukemia, 16 with acute lymphoblastic leukemia, and two with acute undifferentiated leukemia were treated with ICRF-159. No patient achieved a complete remission and only three patients (6%) achieved a partial bone marrow remission. The only significant toxic effect was myelosuppression which probably contributed to the death of six patients. Five patients with acute nonlymphocytic leukemia and one with acute lymphoblastic leukemia received a combination of ICRF-159 and low-dose cytosine arabinoside. There were no remissions in this group and the toxic effects were more marked than with ICRF-159 alone. This study confirms the limited activity of ICRF-159 as a single agent in acute leukemia demonstrated in smaller series, and shows that, when used in combination with low-dose cytosine arabinoside, it was ineffective and resulted in increased toxicity. ICRF-159 alone or in combination with cytosine arabinoside has very limited activity in advanced adult acute leukemia.
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PMID:Limited activity of ICRF-159 in advanced acute leukemia. 36 84

To estimate the leukemogenic potential of alkylating agents, we surveyed 70 institutions using these drugs for the frequency of second cancers in patients with advanced ovarian cancer. Thirteen cases of acute nonlymphocytic leukemia occurred among 5455 patients, as compared to 0.62 cases expected (relative risk = 21.0). All 13 had received alkylating agents. Nine also received radiotherapy. The relative risk for patients given chemotherapy was 36.1 and rose to 171.4 for those surviving for two years (rate = 13.75 per 1000 patients per year). To evaluate the role of therapy versus underlying disease, a historical control of 13,309 patients with ovarian cancer in the National Cancer Institute's End Results Program was analyzed. No excess of leukemia was noted in this group, even among 6596 women receiving radiation. The excess of acute nonlymphocytic leukemia, therefore, appears attribute to alkylating agents, although the effect may be enhanced by exposure to radiation, as previously suggested for Hodgkin's disease.
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PMID:Acute leukemia after alkylating-agent therapy of ovarian cancer. 40 60

Consistent cytogenetic abnormalities have been detected in the bone marrow cells of 19 out of 33 patients (57.57%) with a recent diagnosis of acute leukaemia. Chromosome imbalances were apparently non-random, chromosomes 8, 17, 20 and 21 being more frequently involved. The median survival in the patients' group with abnormal metaphases was 55 vs. 210 days in patients with only normal metaphases. In the former group complete remission was obtained in 2 of 3 ALL patients and in 4 of 16 ANLL patients. Major karytypic abnormalities were consistently found in 5 subjects with EL. Peripheral blood culture lymphocytes showed a 9qh polymorphism in 2 of 35 patients and sporadic or consistent chromosome abnormalities in 6.
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PMID:Cytogenetic studies in acute leukaemias. Prognostic implications of chromosome imbalances. 41 Feb 25

Granulocytic-monocytic colony-forming activity of marrow cells was evaluated at presentation in 20 patients with acute nonlymphocytic leukemia (ANLL). A double-layer agar culture was employed to determine colony- and cluster-forming activity. All patients underwent induction chemotherapy with cytosine arabinoside and daunorubicin. Five patients died during induction. Eight of the 11 patients entering complete remission had absent or decreased colony and cluster growth of marrow cells. Four patients who failed to obtain a complete remission produced increased or only cluster growth in culture. Our data support the conclusions of others that decreased colony and cluster formation in vitro is associated with a more favorable response to induction chemotherapy for ANLL.
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PMID:Predictive value of in vitro colony and cluster formation in acute nonlymphocytic leukemia. 42 1

Fifteen patients developed acute nonlymphocytic leukemia (ANLL) 31 to 182 months following chemotherapy and/or radiotherapy for various malignancies and one non-neoplastic disorder. The ANLL was commonly heralded by a brief preleukemic phase consisting of cytopenias and a variety of morphologic abnormalities. At diagnosis of ANLL, all of the patients had a panmyelosis with variation in the predominant abnormal cell line. Neutrophilic and erythroid abnormalities were most striking in 12 of the patients, megakaryocytic abnormalities predominated in 2 and monocytic abnormalities in 1. Pancytopenia, marked anisopoikilocytosis, normoblastemia, large hypogranular platelets, hypogranular neutrophils, pseudo-Pelger-Huet nuclei, low myeloblast counts and basophilia were the most common abnormalities in the blood. Bone marrows were hypercellular with increased myeloblasts and basophils, abnormal neutrophil precursors, occasional monocytoid blasts, dyserythropoiesis with PAS positive erythroblasts, ring sideroblasts and micromegakaryocytes. All of the 7 patients who had bone marrow chromosome studies exhibited major chromosomal abnormalities. Response to anti-leukemic therapy was poor. The morphologic and clinical findings of these 15 patients appear to define a clinical-pathologic entity.
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PMID:Therapy-related leukemia: a panmyelosis. 44 30

Axillary skin lesions can cause significant morbidity in patients with acute nonlymphocytic leukemia. The incidence in relation to the level of circulating granulocytes and the microbiology of 15 such lesions among 150 patients over a three year period were determined. Lesions occurred predominantly during periods of profound granulocytopenia (0-499 cells/microliter). Gram-negative bacilli were the most common pathogens isolated from these lesions. The initiation of a supervised preventive program for 84 patients over 19 months which includes the regular swabbing of each axilla with povidone-iodine cotton sticks in addition to measures to avoid skin trauma has virtually eliminated inflammatory axillary lesions in this high risk patient population.
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PMID:Axillary lesions in patients with acute leukemia: evaluation of a preventive program. 44 45

Thirty adult patients suffering from acute nonlymphocytic leukemia (ANLL) were treated according to a modified COAP regimen. Vincristine, cyclophosphamide, and prednisone were given by push injection, while cytosine arabinoside was infused over periods of 8 h. Nineteen patients (63%) achieved complete remission. Remission maintenance therapy consisted of 6-mercaptopurine daily and methotrexate twice weekly. Later in the study, COAP consolidation and reinduction was added, which improved the median duration of complete remission from 7 to 24 months. Comparison of the results with the literature shows that the modified COAP regimen is one of the most effective treatment schedules for adult ANLL.
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PMID:Remission induction and remission maintenance in adult acute nonlymphocytic leukemia employing a modified cytostatic (COAP) regimen. 46 42

The clinical usefulness of bone marrow scintigraphy in evaluating adult acute nonlymphocytic leukemia (ANLL) was assessed through 39 studies of 23 adult patients. Nineteen patients were in various stages of relapse and remission of ANLL and four patients were preleukemic. Results of scintigraphic studies were correlated with information concerning bone marrow status, therapy, and subsequent clinical response. When 99mTc-sulfur colloid was utilized, eight of 34 studies were normal, but in the majority of patients there was an abnormal distribution of bone marrow reticuloendothial activity. Three of the patients with normal studies were in complete remission at the time of the normal scan. The duration of these remissions tended to be long. In four patients, 67Ga-citrate scintigraphy showed a wide variation of bone marrow uptake despite a marked increase in bone marrow myeloblasts. There was no significant correlation between scintigraphic distribution and bone marrow morphological status nor with subsequent ability to induce a complete remission with chemotherapy. Nevertheless, these studies raise the possibility that bone marrow scintigraphy may be useful in predicting the stability of an induced complete remission in ANLL. Confirmation of this possibility must await further studies.
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PMID:Bone marrow scintigraphy in the evaluation of acute nonlymphocytic leukemia. 46 6

Nineteen noninfected adults receiving initial induction chemotherapy for acute nonlymphocytic leukemia (ANLL) were randomized to receive either prophylactic granulocyte transfusion or platelet transfusion alone on an alternate-day schedule. An average of 11 granulocyte transfusions (range 3--19) were administered/patient with a mean dose of 11.5 X 10(9) granulocytes/transfusion. The groups were identical with respect to age, sex, number of days on study, granulocytopenic days, percent of days receiving systemic antibiotics, febrile days, complete remission rate, and incidence of minor infection. Significant transfusion reactions were much increased in the granulocyte transfusion group (7/10 versus 1/9 in controls) and were associated with the development of lymphocytotoxic antibodies (7/10 versus 4/9 controls), refractoriness to platelet transfusion, repeated fevers, and a pulmonary infiltrate in one patient. Alloimmunization to granulocytes occurred as early as the second week in some patients complicating platelet support during induction and maintenance. No severe infections occurred in the granulocyte transfusion group while three fungal infections occurred in the controls. The high rate of alloimmunization suggests that histocompatibility considerations indicate that prophylactic granulocyte transfusion should not be routine therapy and should be studied only in investigational settings.
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PMID:Alloimmunization following prophylactic granulocyte transfusion. 47


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