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Query: UMLS:C0023467 (acute myeloid leukemia)
 35,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The initial features, response to therapy, complications, cause of death, and prognostic factors of 171 consecutive children with ANLL are described and compated to historical data for adults with ANLL and for children with ALL. Major differences between children and adults with ANLL include a higher frequency of CNS leukemia and a lower frequency of early deaths in the children. The most important differences between children with ANLL and ALL are the absence of a peak age of incidence in ANLL and the far better response to therapy in ALL. Among features present at 100,000/mm3 or above, and no palpable hepatomegaly had significantly longer survivals, while patients with platelet counts below 10,000/mm3 had significantly shorter survivals. The frequency and duration of remission were significantly better with three protocols used since 1968 than previously. However, even with these protocols, the results were far from satisfactory, with a complete remission frequency of 66%, a median duration of hematological remission of 6 months, and a median duration of survival of 10 months. The striking contrast of these results in childhood ANLL with current results in childhood ALL underscores the need for novel, imaginative therapeutic approaches for ANLL.
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PMID:Acute nonlymphocytic leukemia in 171 children. 78 98

Two hundred and seventy-two adults diagnosed between 1949 and 1971 as having acute leukemia were evaluated. Two hundred and fifty-seven patients had died and autopsies were obtained in 202 cases. Central nervous system (CNS) leukemia was demonstrated in 22 of 93 autopsies with acute nonlymphocytic leukemia (ANLL) during the period 1949 through 1966 and 8 of 47 during the period 1967 through 1971. Nine of 45 autopsies on acute lymphoblastic leukemia (ALL) patients diagnosed during 1949 through 1966 had CNS involvement, compared to 7 of 17 during 1967 through 1971. The median time from diagnosis of acute leukemia to CNS manifestations was two months for ANLL and six months for ALL. Headache, papilledema, and cranial nerve palsy were the common findings with meningeal leukemia. Early CNS involvement was observed in patients with high initial leukocyte/blast counts, low platelet counts, and early lymphadenopathy and hepatosplenomegaly. Ten of 13 patients treated between 1967 and 1971 with cranial irradiation and intrathecal chemotherapy responded; however, the duration of remission in ALL was short-lived with subsequent relapses at various intervals. In contrast, CNS recurrence in ANLL was rare. The value of CNS prophylactic and maintenance therapy is discussed.
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PMID:Adult central nervous system leukemia: incidence and clinicopathologic features. 82 17

Twenty-seven patients over 60 years of age with acute nonlymphocytic leukemia (ANLL) were prospectively treated with one of three intensive chemotherapeutic regimens. Complete remissions were achieved in eight patients (30%). Remissions were obtained in seven of 14 patients (50%) age 61 to 70 years, but in only one of 13 patients (8%) 71 years and older. The most effective regimen in patients 61 to 70 years consisted of a combination of daunorubicin and cytosine arabinoside. The median duration of remission for all eight responders is 9+ months and their median survival is 14+ months. Intensive therapy is indicated in the elderly patient 61 to 70 years of age with ANLL.
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PMID:Treatment of acute nonlymphocytic leukemia in elderly patients: a prospective study of intensive chemotherapy. 89 Jun 52

Fourteen of 21 adult patients (67%) with acute nonlymphocytic leukemia achieved a complete remission (CR) after receiving combination chemotherapy with daunorubicin and cytosine arabinoside (ara-C). Eight of the 14 CRs developed after a single course and four of 14 after two courses of induction therapy making initial hospitalization relatively brief (median, 38 days). Four of five patients greater than 60 years old achieved CR. The induction therapy was repeated monthly up to the dosage limits imposed by daunorubicin cardiotoxicity in an attempt to lengthen subsequent remission duration. The media duration of CR was 12 months which compares favorably with previously reported series. In this series, treatment with 3 days of daunorubicin and 7 days of ara-C proved to be a highly effective induction regimen for patients with acute nonlymphocytic leukemia regardless of age. The improved duration of CR may be a manifestation of the extent of initial leukemic cell-kill in successful induction and consolidation therapy rather than an effect of maintenance therapy cycles.
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PMID:Chemotherapy for adult acute nonlymphocytic leukemia with daunorubicin and cytosine arabinoside. 92 49

The white blood cell count response was documented in various patients following transfusions of 500 ml of autologous or unrelated donor blood that had been subjected to 10 minutes of dialysis with 15 minutes of stagnation. Patients studied included 1 patient with acute nonlymphocytic (ANLL) and 2 patients with chronic lymphocytic leukemia (CLL). The control group consisted of 4 patients with renal failure. The ANLL patient showed a normal two-phase reaction after administration of donor's blood. It is possible that even under conditions of severe disturbance of hemopoiesis the general dependence on normal humoral regulation remains. The CLL patients showed a marked drop in circulating WBC in the first descending phase of the hemodialysis-induced reaction (HDIR). All blood cell types including lymphocytes and blast cells took part in this decrease of blood count; this suggests a cell-nonspecific effect. It is presumed that leukocytes that leave the circulation do not return into the blood and the procedure may be considered as a form of leukophoresis in vivo, with possible therapeutic value.
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PMID:The hemodialysis-induced reaction in patients with leukemia. 92 31

The clinical and laboratory features of the stages in the evolution of acute nonlymphocytic leukemia are reviewed. Based on a retrospective analysis of 34 patients who died with an acute myelomonoblastic leukemia, the "preleukemic syndrome" has been shown to display a clinical picture sufficiently specific to permit its recognition prospectively (i.e., before the development of overt leukemia). The results to date of a variety of prospective studies are reviewed, and the approach(es) to the management of these cases is considered.
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PMID:The preleukemic syndrome: clinical and laboratory features, natural course, and management. 100 97

Reverse isolation and prophylactic oral nonabsorbable antibiotics were evaluated among 64 consecutive noninfected adults with acute nonlymphocytic leukemia admitted for remission induction. Patients were randomly allocated to laminar air flow room reverse isolation with oral nonabsorbable antibiotics (LAF plus A), routine hospital ward care with antibiotics (W plus A), or ward care alone (W). The LAF plus A patients had a significantly decreased incidence of total infection, bacteremias, pneumonias, rectal abscesses, urinary tract infection, and pharyngitis. Infectious deaths were reduced in the LAF plus A group and the time to the first infection or to fatal infection was delayed. The W plus A patients who regularly ingested the antibiotics had a reduction in infections similar to that of the LAF plus A patients but those who could not tolerate the antibiotics had an incidence of infection comparable to the ward patients. The LAF plus A and the W plus A patients also had higher complete remission rates and longer median survival than the unprotected ward patients.
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PMID:Infection prevention in acute nonlymphocytic leukemia. Laminar air flow room reverse isolation with oral, nonabsorbable antibiotic prophylaxis. 105 22

Between 1970 and 1973, seven cases of acute nonlymphocytic leukemia were diagnosed in the village of Elmwood, Wis, and the surrounding area. The patients ranged in age from 14 to 97 years. Interpersonal relationships were noted among all patients in the group. This cluster of cases represents a greater than 20-fold increase in the expected incidence of this disease for this population. Morphologic similarities in the blast cells were seen in all cases. This cluster of cases may bear a relationship to bovine leukemia since the town was located in dairy farming country and because a number of the patients had either worked at or lived near the town creamery.
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PMID:Acute nonlymphocytic leukemia. An adult cluster. 105 26

The relationship of a variety of initial features and the outcome of therapy was analyzed for 363 children with acute lymphocytic leukemia (ALL). All had entered "total therapy" studies between 1962 and 1971. The standard for comparing outcome of therapy was whether patients with a given feature attained or exceeded the median duration of complete remission, hematologic remission or survival for the group. The results showed that, in general, the more massive or extensive the disease at diagnosis, the poorer the outcome. Factors associated with a significantly poorer prognosis included: initial leukocyte count above 100,000/mm; spleen enlargement greater than 5 cm; mediastinal involvement and early CNS involvement. Children over 10 years old at diagnosis and Negro children also had a poor prognosis. From another viewpoint features were examined for patients who attained at least 3 years of continuous complete remission. This confirmed some earlier findings and, in addition, showed that children under 2 years of age at diagnosis or with hepatomegaly over 5 cm were less likely to attain this goal. With the exception of early CNS involvement, however, patients with excellent responses to therapy were found with each factor of poor prognosis. Two major factors were not analyzed because their relationship to prognosis is generally accepted: therapeutic differences and acute nonlymphocytic leukemia.
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PMID:Initial features and prognosis in 363 children with acute lymphocytic leukemia. 106 May 5

A remission-induction regimen for childhood leukemia using cyclophosphamide, asparaginase, vincristine, and prednisone (CAVP) was compared to standard vincristine-prednisone (VP) induction. The more intensive regimen was associated with a lower complete remission rate (81% vs 93%) and a higher early death rate from infection (15% vs 5%) for acute lymphocytic leukemia. In contrast, complete remission was achieved in 58% of children with acute nonlymphocytic leukemia treated with CAVP compared to 18% for VP. Early death rates were similar (27% vs 25%). These observations corroborate previous studies in childhood nonlymphocytic leukemia showing activity for asparaginase. Preliminary analysis of remission duration and survival for responders shows no advantage for those who survived the more intensive induction.
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PMID:Cyclophosphamide-asparaginase- vincristine-prednisone induction therapy in childhood acute lymphocytic and nonlymphocytic leukemia. 106 49


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