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)

Twenty children with acute myeloblastic leukemia were given induction and maintenance regimens combining cytosine arabinoside (ARA-C) and 6-thioguanine (TG). Two died before completing induction therapy and were considered unevaluable. Of the 18 remaining patients, 3 died shortly after induction, 2 had no response, 1 had a partial response and 12 (66%) had a complete remission (CR) lasting 4 to 68 months. Six still survive: two in their initial CR and four who relapsed but were reinduced to CR. Although no prophylactic central nervous system (CNS) therapy was given, only one patient has developed CNS involvement after diagnosis. Two girls became pregnant while on maintenance therapy. One delivered a normal, full-term infant; both she and the child are well 24 months later.
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PMID:Cytosine arabinoside and 6-thioguanine in the treatment of childhood acute myeloblastic leukemia. 26 1

Results of the treatment of 102 acute leukemia patients are presented. The diagnosis in 61 patients was acute myeloid leukemia (AML) and in 41 patients acute lymphoid leukemia (ALL). In the treatment of AML were used Daunorubicyne (DNR), Cytosine arabinoside (ARA-C) or combination of both drugs, some elder patients being treated with 6-mercapropurine. Number of patients were made aplastic and died during the initial phase of therapy. Nine of 24 patients treated with DNR, ARA-C or combined developed complete remission, 6 patients lived for one year and 4 patients two years. ALL patients were treated with Prednisone-Vincristine, Prednisone-Vincristine-DNR and some of them with Prednisone-Vincristine-DNR-Cyclophosphamide-L-Asparaginase combinations of drugs. Complete remission was obtained in 22 out of 32 patients (69%) and 6 patients lived for 2 years.
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PMID:[Results in the treatment of acute leukemias at the Internal Clinic B in the period 1970-1975]. 106 23

The results of treatment of 84 acute leukaemia patients during a 15-year period are reported. Sixty-three of the patients suffered from acute myeloid leukaemia, 14 had blastic crisis of chronic leukaemia and 7 had acute myelomonocytic leukaemia. Administration of prednisolone + purinethol, prednisolone + vincristine, and prednisolone + vincristine + purinethol combinations resulted in partial remission. The best results were achieved with the combination ARA-C + thioguanine + prednisolone, which produced complete remission in 2 out of 8 cases. One patient was refractory to this treatment.
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PMID:Comparative observations in the treatment of acute leukaemia. 107 Apr 70

Autologous bone marrow transplantation is widely used as late intensification therapy for patients with AML in remission without an HLA identical donor or who are older than 40-45 years. We report our experience in 21 AML patients in 1st or 2nd CR transplanted with a regimen including HD-ARA-C in addition to Cyclophosphamide (CY) and TBI. The median age was 32 years (3-50). Fourteen patients were transplanted in 1st CR and 7 in 2nd CR. In all but one patient BM harvesting and ABMT were done in the same remission status and after at least 3 courses of consolidation therapy. Two patients (9.5%) died from treatment related toxicity on Day +15 and Day +31. The median time to reach 1000 WBC and 50,000 platelets per cmm was 23 (13-55) and 55 (22-790) days respectively. Only 4 (21%) of the 19 evaluable patients (median observation time of 32 months) relapsed, at 3, 8, 18 and 26 months from ABMT. The projected event free survival curve shows survival of 67% at 96 months with a relapse rate of 26%.
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PMID:Use of high-dose cytarabine in autologous bone marrow transplantation in acute myeloid leukemia. 149 59

Study AML-BFM-87 compared prospectively if cranial irradiation could be abandoned by adding two blocks of intensification with high dose ARA-C and VP-16 after consolidation and furthermore, improve prognosis compared to study -83. 210 children were enrolled in study AML-BFM-87 until March 31, 1991. 164 (78%) achieved complete remission. Probabilities for event-free survival (EFS) and event-free interval (EFI) of 5 years were: .45 (SD .04) and .57 (SD .05). In the first 2.5 years of the study irradiation was randomized (n = 31), selected or refused (n = 24). However, during this period irradiation was mandatory in patients with leukocyte count greater than 70,000/mm3, and also in children with initial CNS involvement. Since July 1989 prophylactic cranial irradiation was abandoned. Patients of the group with mandatory irradiation (n = 39) presented with more unfavourable risk parameters than the group of non-irradiated children, who were enrolled in the study after randomisation had been stopped. Nevertheless, results showed in randomized and selected patient groups as well as in the total cohort a longer relapse-free interval (RFI) in irradiated (n = 66) compared to non-irradiated (n = 94) patients (RFI of 5 years: .70, SD .04 vs. .51, SD .07, p less than .05). Relapses in non-irradiated children occurred mainly in the bone marrow and less often in the CNS. The increase in relapse rate was seen especially in non-irradiated patients of the low risk group as defined in study AML-BFM-83 (RFI: .40, SD .14 vs. .79, SD .09 with irradiation, p less than .01). In the high risk group, however, the differences were not significant. Our results suggest that cranial irradiation is an important part of therapy in childhood AML, and that the good prognosis of the low risk group in study AML-BFM-83 was probably based on the combination of intensive chemotherapy and cranial irradiation.
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PMID:[Effect of cranial irradiation on rate of recurrence in children with acute myeloid leukemia. Initial results of the AML-BFM-87 study. The AML-BFM Study Group]. 151 59

Complete remission (CR) rates of 80% are achieved with the AML-BFM protocols but one third of patients relapse within the first three years. There are few reports of treatment of relapsed childhood AML, and these deal with the evaluation of new drugs for frontline therapy. We performed a retrospective analysis to investigate how patients previously treated with the AML-BFM-83 protocol were treated after relapse and how many long term remissions were achieved. 48 of 139 patients relapsed after having achieved complete remission with the AML-BFM-83 protocol which consists of continous infusion of ARA-C 100 mg/m2 day 1-2, ARA-C 200 mg/m2 day 3-8, Daunorubicin 60 mg/m2 day 3, 4, and 5, and VP-16 150 mg/m2 day 6, 7, and 8, and an 8 week consolidation therapy consisting of Prednisolone, Thioguanine, Vincristine, ADR, ARA-C, Cyclophosphamide, intrathecal ARA-C and cranial irradiation followed by maintenance therapy. Duration of first remission ranged from 1.5 months to 66.3 months. Excluding 5 children with either isolated or combined extramedullary relapses and another 4 patients for missing data, 39 children were evaluable. 20 children received no therapy or palliative therapy while 16 patients received chemotherapy and another 3 children were transplanted in relapse. Although 9 different intensive chemotherapy regimens were used for reinduction, a high number (12 of 16 = 75%) of second complete remissions was achieved. Several therapeutic options were used to maintain a second remission: regular maintenance therapy (7 patients), allogeneous bone marrow transplantation (BMT) (2 patients), autologous BMT (3 patients).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Treatment of recurrence of acute myeloid leukemia in childhood. A retrospective analysis of recurrence in the AML-BFM-83 study]. 151 61

From 1987 to 1990, intensive postremission chemotherapy was compared to autologous bone marrow transplant in previously untreated children with AML who received identical induction therapy with two courses of Daunorubicin (DNR) and conventional dose ARA-C (protocol AIEOP LAM 87). Overall, 121 of the 155 eligible patients achieved complete remission (CR) (78%). Patients in CR who lacked HLA-MLC compatible donor were randomized to receive either autologous BMT (Auto-BMT) or further sequential postremission therapy. Patients with HLA-MLC compatible donor were assigned to allogeneic BMT (Allo-BMT). Projected 3-years disease free survival (DFS) are 58% for Allo-BMT group, 24% for Auto-BMT group, 26% for chemotherapy group and 30% for a group of not randomized patients (intention to treat analysis). On March 1990 a pilot study LAM 87M was initiated. Patients in CR after induction therapy (identical to the previous protocol) receive a single intensification course consisting of high dose ARA-C plus DNR. The study continues to accrue patients.
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PMID:Therapeutic strategies for postremission treatment in childhood acute myeloid leukemia (AML). The AIEOP experience 1987-1991. 157 40

Acute myelogenous leukemia (AML) represents a heterogenous group of leukemias in adults as well as in children. The BFM group initiated 3 consecutive studies on the treatment of this disease. Between December 1978 and April 1991, 543 children under the age of 17 years entered the 3 consecutive multicenter studies, AML-BFM-78 (n = 151), AML-BFM-83 (n = 182), and the still ongoing study AML-BFM-87 (n = 210). The treatment strategy of BFM-78 consisted of an eight week induction/-consolidation regimen employing 7 different drugs together with cranial irradiation, followed by continuous maintenance for two years. The main alteration in the second study BFM-83 was the addition of an intensive 8-day ADE induction course (cytosine arabinoside, daunorubicin, etoposide). In the ongoing trial BFM-87 two courses of HD-ARA-C and etoposide are given after consolidation. CR rates were 80% in trials I and II, and 78% in trial III. The probability of a 4.5-year event-free survival was 35%, SD 4% in study I; 49%, SD 4% in study II, and 45%, SD 4% in study III. The probability of a 4.5-year event-free interval (EFI) was increased from 45%, SD 5% in study I to 61%, SD 4% in study II, it is in the same range in study III (58%, SD 5%). Seven of 10 children which underwent bone marrow transplantation (BMT) in 1. CR are still in first CR after a maximum follow-up time of 3.5 yrs. In summary, the addition of HD-ARA-C together with etoposide given after induction/consolidation treatment did not further reduce the incidence of relapses in childhood AML. So far, the results of study BFM-87 are in the same range than those of study BFM-83.
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PMID:Treatment results of three consecutive German childhood AML trials: BFM-78, -83, and -87. AML-BFM-Group. 157 43

The results of four consecutive trials designed by the GIMEMA group for the treatment of ANLL in elderly patients are reviewed. Complete remission (CR) has been achieved in 20.8% of patients older than 60 years treated with 5-day courses of ARA-C plus thioguanine, in 22.7% of patients treated with high dose ARA-C (HDARAC) plus Asparaginase, in 39.5% of patients aged 55 to 80 receiving either Idarubicin or Daunorubicin in combination with Cytarabine in a standard 3+7 protocol and in 51% of patients older than 60 years treated with intermediate dose ARA-A (IDARAC) plus Mitoxantrone. From 1988, patients ineligible for aggressive chemotherapy entered a study of palliative treatment with Thioguanine and ARA-C. This 18 year GIMEMA experience showed that: CR can be obtained only with regimens producing marrow aplasia, the inclusion of anthracyclines or Mitoxantrone improves the CR rate, without prohibitive toxicity, haematological toxicity is very high in elderly patients and account for the most frequent cause of treatment failure namely death in aplasia, palliative treatment does not improve the quality of life and prolongs median survival only slightly. When comparing the results of these trials, it appears that in the GIMEMA group the capability of offering effective treatment to elderly patients with ANLL has continuously improved and that IDARAC plus Mitoxantrone is so far the most active and best tolerated regimen. Death in aplasia remains a major problem and future trials will be aimed at exploiting the possibility of reducing the haematological toxicity by using recombinant colony stimulating factors.
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PMID:Treatment of acute non lymphoid leukemia (ANLL) in elderly patients. The GIMEMA experience. 157 48

Changes in treatment of ANLL in children over 23 years (1968-90) and advances made in the last ten years in a pediatric hematological unit are reported herein. Of 124 patients under 15 years of age, 18 of whom were infants, 118 were evaluable. Of these, 58 were treated before 1980 and, although complete remission (CR) was attained in 75%, the median duration was lower than 12 months and no patient survived in CR more than 6 years. From 1981 to 1987, 40 patients received one or two induction treatments followed by three consolidations and then blocks of sequential intensive chemotherapy for 12-15 months. CR was attained in 87.5% and event-free survival (EFS) was 22.5% at 8 years: 14% for those treated from 1981 to 1983 and 33% for those included in the ANLL-84 protocol. In 1988, a post-remission protocol with intensification therapy (two high-dose ARA-C treatments combined with mitoxantrone in the first and amsacrine in the second) followed by allogeneic or autologous bone marrow transplant (BMT) was initiated. Of 20 patients included, 17 reached CR (85%) and 16 underwent BMT. EFS of the 20 patients was 65% at 2 years and post-BMT relapse-free survival was 75%. These results are compared with those obtained separately with present intensive chemotherapy protocols and with BMT and it is concluded that intensification treatment followed by BMT (allogeneic or autologous) might constitute an advance in the treatment of children with ANLL.
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PMID:[Evolution of the treatment of acute nonlymphoblastic leukemias in children (1968-1990)]. 174 70


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