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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 authors report an analysis of 47 leukemia patients (including 9 from our own medical center) whose courses were complicated by 48 episodes of clostridial septicemia. There were 36 adults and 11 children; acute myelogenous leukemia and acute lymphoblastic leukemia accounted for 61.7% and 14.9% of cases, respectively. All patients for whom remission status was known were in leukemic relapse. Fever was a presenting complaint in at least 36 patients whereas neutropenia, thrombocytopenia, and gastrointestinal lesions were noted in 100%, 90.9%, and 87.9%, respectively, of the patients for whom information on these parameters was available. Overall mortality from clostridial septicemia was 78%; none of the children and none of the patients with intravascular hemolysis survived. Overall, antibiotic therapy resulted in a 40% survival rate. However, among patients receiving beta lactam and/or chloramphenicol therapy, 57% survived their episode of clostridial septicemia. Prompt initiation of appropriate antimicrobial therapy offers the best chance of survival in leukemia patients with clostridial septicemia.
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PMID:Clostridial septicemia complicating the course of leukemia. 345 20

Five children treated for acute myeloid leukemia according to the BFM protocol AML 83 experienced first bone marrow relapse after 7, 10, 14, 18, and 30 months and were retreated for second remission induction. The chemotherapy consisted of mAMSA (100 mg/m2 per day i.v., days 1-3), ARA-C (100 mg/m2, twice daily, days 1-6), and VP 16 (150 mg/m2 per day, days 4-6). Four of the children achieved a complete second remission after one course of chemotherapy, and the fifth child died of pneumonia during bone marrow aplasia. All surviving children received an identical second course within 4-5 weeks, followed by maintenance chemotherapy. Remission duration was 0, 3, 4, 5, and 5 months. Toxicity was confined to heavy bone marrow depression with thrombocytopenia (nadir 2-7000, days 7-13) and leukocytopenia (nadir 0-400, days 8-14). Bleeding episodes could be prevented by substitution with platelets. Four patients experienced infections (pneumonia, septicemia). We conclude that combination chemotherapy using mAMSA, ARA-C, and VP 16 is effective in inducing a second remission in patients with early bone marrow relapse. The main side effect was considerable bone marrow toxicity.
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PMID:Effective remission induction in children with recurrent acute myeloid leukemia by mAMSA, Ara-C, and VP 16. 347 74

Aclarubicin is a new anthracycline antibiotic that produces substantially less cardiotoxicity in animals that does doxorubicin. Based upon prior Phase I and II trials in leukemia, a Phase II study in acute myeloblastic leukemia was developed to assess the response rate and toxicity in previously treated patients. Forty patients received aclarubicin 100 mg/m2 per day X 3 with repeated course on days 14-16 if marrow hypoplasia was not produced. Complete responses were achieved in 27.5% (11/40) with durations of 1.5, 2, 2, 2, 3, 3+, 4, 5+, 32+, 33+, and 34+ months. Toxic effects of this therapy included severe neutropenia and thrombocytopenia, nausea/vomiting, mucositis, and diarrhea. No patient developed significant changes in the left ventricular ejection fraction, as measured by radionuclide angiography, or any clinical cardiac symptoms. Alopecia was minimal. Aclarubicin can produce a significant response rate in previously treated patients with acute myeloblastic leukemia and should be considered for study in initial therapy.
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PMID:Phase II study of aclarubicin in acute myeloblastic leukemia. 347 91

The treatment of acute leukemia in childhood has been increasingly successful. Infectious complications are the major cause of morbidity and mortality among these patients receiving aggressive chemotherapy. In particular, neutropenic enterocolitis or typhlitis has had a reported mortality of 50% to 100%. The authors reviewed a series of 77 previously untreated patients with acute myelogenous leukemia begun on treatment from March 1976 to June 1984 to better define the characteristics of typhlitis and its optimum management. Twenty-five patients had episodes of typhlitis, characterized by fever, abdominal pain, and tenderness, occurring during periods of neutropenia. Ten of these patients had watery diarrhea as a major additional symptom, and nine patients had a significant episode of gastrointestinal bleeding. In seven instances, blood culture results were positive, all for intestinal flora. The episodes of typhlitis occurred most frequently during the induction therapy (19 patients). Five patients experienced typhlitis during maintenance therapy, and one patient had acute appendicitis. Two patients had typhlitis during their reinduction therapy, and of note, one had had abdominal symptoms during her initial induction. All patients were treated initially with broad-spectrum antibiotics and bowel rest. Four criteria have been used for surgical intervention: (1) persistent gastrointestinal bleeding after resolution of neutropenia and thrombocytopenia and correction of clotting abnormalities; (2) evidence of free intraperitoneal perforation; (3) clinical deterioration requiring support with vasopressors, or large volumes of fluid, suggesting uncontrolled sepsis; and (4) development of symptoms of an intra-abdominal process, in the absence of neutropenia, which would normally require surgery. Using these criteria, five patients required surgical intervention for typhlitis or its sequelae and one for acute appendicitis. There was one perioperative death resulting from miliary tuberculosis. Among the 21 patients managed medically, there was 1 death resulting from typhlitis in a patient in whom surgery was deferred because of her multiple failures to enter remission.
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PMID:The medical and surgical management of typhlitis in children with acute nonlymphocytic (myelogenous) leukemia. 348 59

52 patients entered a study for remission induction and intensified consolidation in AML. Group I (age less than or equal to 50 years) received a combination of DNR, ara-C and VP16-213 for induction and early consolidation and HDara-C/DNR for late consolidation. Of 34 evaluable patients (25 first diagnosis, 9 first relapse), 27 achieved CR. 13 patients received 1-2 courses of HDara-C/DNR. Toxic symptoms of HDara-C/DNR were severe myelosuppression, infections, skin reactions, diarrhea and hepatotoxicity. CNS toxicity was not observed. 2 patients died from infection. The duration of granulocytopenia (less than 500/microliter) was 7-43 days (range) and of thrombocytopenia (less than 25,000/microliter) 5-34 days (range). Patients of group II (age greater than 50 years) received a modified regimen with reduced toxicity. Their number is too small for evaluation as yet.
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PMID:Age adapted induction and intensified consolidation therapy in acute myelogenous leukemia. 352 59

Diaziquone (AZQ) is a synthetic quinone with considerable activity against L1210 leukemia and potent myelosuppressive activity in man. To test the efficacy and toxicity of AZQ administered by continuous infusion, a phase II multi-institutional trial was undertaken by the Southeastern Cancer Study Group. Eligible adults with acute myeloid leukemia (AML) received AZQ at a dose of 28 mg/m2 daily by continuous infusion for 5 days. Patients failing to achieve complete remission received a second course utilizing the same dose and schedule. Of 25 evaluable patients with relapsed or refractory AML, three achieved complete response (12%) and two achieved partial response (8%). All patients experienced marked myelosuppression. Severe or life-threatening infection was observed in 15 (56%) patients. Clinical or postmortem evidence of central nervous system hemorrhage was encountered in three (12%) patients with severe refractory thrombocytopenia. Minimal nonhematologic toxicity was observed, suggesting that further studies of this agent in combination regimens and possibly for marrow transplantation preparation in patients with acute leukemia are warranted.
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PMID:Continuous-infusion diaziquone in acute myeloid leukemia: a Southeastern Cancer Study Group trial. 354 62

Fourteen patients with acute nonlymphocytic leukemia were treated with low-dose arabinosylcytosine (LDAC). Thirteen patients received subcutaneous injections at a dose of 10 mg/M2 every 12 h. One patient received 25 mg intramuscularly daily. All cases received one to three courses with each course lasting 10-60 days (median 19). Complete remission was achieved in 6 (or 43%) of the patients. Three patients had only cytoreduction and 5 patients did not respond. During the therapy severe thrombocytopenia occurred in all patients while prominent other cytopenias occurred in 10. Two-thirds of the patients achieving a remission had significant myelosuppression. There was one treatment-related death. During therapy 11 patients demonstrated a decrease in leukemia cells with an associated increase in differentiated granulocytes. This included 3 of the 4 complete remitters, and 3 of the 5 nonresponders. These results seem to suggest that the therapeutic effect of low-dose Ara-C may result from a combination of differentiation induction, cytotoxicity and unusual sensitivity of the leukemic cells to this agent.
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PMID:Low-dose Ara-C can cause complete remission of acute non-lymphocytic leukemia: differentiation induction? 377 65

At least 22 members of a large kindred have a bleeding tendency resulting from an autosomal dominant disorder of platelet production and function. Phenotypic manifestations include mild to moderate thrombocytopenia, bleeding time prolongation, and abnormal platelet aggregation. Platelet survival time is normal. The platelet disorder in this family appears to differ from known hereditary thrombocytopenic or thrombocytopathic syndromes and may represent a new genetic disease. Six family members reportedly developed hematologic neoplasms: acute monocytic leukemia nine years after treatment for congenital neuroblastoma; lymphosarcoma at age 10 years; myeloid leukemia at age 23 years; acute myelocytic leukemia at age 62 years; leukemia of unknown type at age 48 years; and lymphocytic lymphoma at age 52 years.
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PMID:Studies of a familial platelet disorder. 385 65

Nineteen cases of canine acute leukemia were diagnosed during a 4-year period. Two main categories were identified on the basis of cytologic, hematologic, and clinical features: acute lymphoid leukemia and acute myelogenous leukemia. Clinical features included history of weight loss, anorexia, shifting limb lameness, and incoordination. Physical findings were characterized by hepatomegaly, splenomegaly, mild generalized lymphadenopathy, and pallor. Ocular lesions were found in 29% of dogs with acute myelogenous leukemia. Hematologic abnormalities included anemia, thrombocytopenia, pancytopenia, leukemia, and leukoerythroblastic reactions. Results of therapy were discouraging.
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PMID:Clinicopathologic aspects of acute leukemias in the dog. 385 21

Twenty-two patients with either a myelodysplastic syndrome or acute nonlymphocytic leukemia were treated with 10-21 days of subcutaneous cytosine arabinoside (Ara-C) (5-10 mg/m2 every 12 hours). There were two complete remissions and ten partial responses. Clinically significant improvements in peripheral blood counts persisted for periods of 8 weeks to greater than 21 weeks. Responses were seen even in patients who had previously proven refractory to conventional induction regimens or high-dose Ara-C. The toxicity, however, was considerable. Nearly all patients developed significant thrombocytopenia. Platelet and red cell transfusion support was required in many cases. The response to low-dose Ara-C therapy seen in patients with the leukemic and myelodysplastic disorders may be mediated by the induction of cell differentiation or a direct cytotoxic effect on a sensitive population of cells. Low-dose Ara-C may provide an alternative therapy in the selected patient with acute nonlymphocytic leukemia or a myelodysplastic syndrome.
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PMID:Low-dose cytosine arabinoside (Ara-C) therapy in the myelodysplastic syndromes and acute leukemia. 385 62


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