Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023473 (chronic myeloid leukemia)
 18,916 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A high incidence of multiple primary neoplasms has been observed in our patients with ATL in comparison to persons with other forms of hematologic malignancy who we have observed during the past 24 years (1963-1985). Five of 15 patients with ATL (33.3%) have had at least one other associated neoplasm in comparison to only 44 of 1156 patients with other forms of hematological malignancy (3.8%). The incidence figures for secondary neoplasms associated with the other hematologic malignancies were 4.3% (16/370) for acute non-lymphocytic leukemia (ANLL), 2.2% (2/90) for acute lymphocytic leukemia (ALL), 4.8% (1/21) for acute unclassifiable leukemia, 2.2% (5/225) for chronic myelogenous leukemia, 4.7% (2/43) for chronic lymphocytic leukemia, 5.9% (8/136) for malignant monoclonal gammopathy and 3.7% (10/271) for malignant lymphoma. The incidence of multiple neoplasms in patients with ATL in comparison to those with other hematological malignancies was significant (p less than 0.01 or p less than 0.001). The neoplasms associated with ATL have been adenocarcinoma of the thyroid or lung, and squamous cell carcinoma of the larynx, lip or lung. We identified ATL-derived factor (ADF) in the cytoplasm of the secondary neoplasms of the ATL patients by means of indirect immunofluoroscopy and immunohistochemical techniques utilizing anti-ADF antibody. We also identified ras p21 products in these neoplasms by means of p21 ras monoclonal antibody studies. The possibility that HTLV-I was the cause of the secondary neoplasms thus was investigated.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Studies on association between the ATL and the development of multiple malignant neoplasms--analysis of 1171 cases of hematological malignancies during the past 24 years]. 268 7

Molecular mechanisms responsible for the clinical progression of chronic myelocytic leukemia to its accelerated phase or to blast crisis have not been defined. We found alterations of the p53 gene (p53 is a 53-kDa nuclear protein) including deletions and rearrangements in 8 of 34 patients in blast crisis and 1 of 4 patients in the accelerated phase, but in only 1 of 38 patients in the chronic phase of chronic myelocytic leukemia. Only two other examples of p53 gene alterations were found among 203 patients with hematologic malignancies and solid tumors. Transcripts of the p53 gene were uniformly found in chronic-phase cells, but gene expression was variable in blast crisis, and transcripts were reduced or undetectable in 10 of 16 patients. Heterogeneous alterations in the structure and expression of the p53 gene appear to be relatively frequent in blast crisis and may be involved in the evolution of disease.
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PMID:Alterations in the p53 gene and the clonal evolution of the blast crisis of chronic myelocytic leukemia. 277 57

Assays were performed on cells from 38 consecutive malignancies for both terminal deoxynucleotidyl transferase (TdT) and common acute lymphoblastic leukemia antigen (CALLA). TdT and CALLA occurred together only on lymphoblasts from some cases of acute lymphoblastic leukemia (ALL). In other cases of ALL, chronic myelogenous leukemia (CML) in blast crisis, and acute undifferentiated leukemia (AUL), TdT was expressed, but CALLA was absent. TdT was present predominantly on cells from the lymphoid lineage as proven by special histologic stains, and CALLA marked a population with a favorable prognosis. Significant discrepancies in the expression of these two markers and the unique properties of each suggest that both markers are useful for the full characterization of specific hematologic malignancies.
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PMID:Comparison of the expression of terminal deoxynucleotidyl transferase and common acute lymphoblastic leukemia antigen in selected hematologic malignancies. 293 76

Mixed lymphocyte reactions (MLR) and mixed epidermal cell-lymphocyte reactions (MECLR) were performed concurrently before grafting in patients scheduled to receive a bone marrow graft from an HLA-identical sibling for an hematological malignancy. For each donor-recipient pair, the ratio of the counts per minute (cpm) for MECLR to the cpm for MLR was calculated. This ratio was significantly higher in the group of patients who subsequently developed grade II to IV graft-vs-host (GVH) disease as compared to the group who had grade O-I GVH. Statistical analysis showed that this parameter was the most significant risk factor for acute GVH, as it was the leading factor selected by stepwise discriminant analysis. The other significant risk factors for acute GVH were previous pregnancies in female donors and chronic myeloid leukemia in recipients. Thus, these parameters allow more accurate evaluation of the risk for GVH in individual recipients before grafting and therefore of the indications for T-cell depletion.
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PMID:[The mixed lympho-epidermal culture: a predictive test of the graft-versus-host reaction in receivers of bone marrow grafts]. 296 58

Risk factors for acute graft-versus-host disease (GvHD) remain controversial. We performed uni- and multivariate statistical analyses on a series of 37 patients receiving a non-depleted allogeneic bone marrow transplant from an HLA-identical sibling donor for a haematological malignancy, in order to identify risk factors for GvHD. Three factors were associated with development of moderate to severe GvHD: a positive mixed epidermal cell-lymphocyte reaction (MECLR) between donor and recipient, previous pregnancies in female donors and chronic myeloid leukaemia diagnosis. The MECLR was the most important predictive factor, selected in first rank by the stepwise linear discriminant analysis. Combining these three prognostic factors in the jackknifed procedure, we could correctly classify 33/37 patients in two groups: grade O-I versus grade II-IV acute GvHD. These results should apply to donor selection and to predict donor/recipient pairs at high risk of GvHD who might benefit of bone marrow T-cell depletion and those at low risk for whom depletion could be avoided.
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PMID:The mixed epidermal cell lymphocyte-reaction is the most predictive factor of acute graft-versus-host disease in bone marrow graft recipients. 297

Chronic leukemias account for fewer than 5 per cent of childhood hematologic malignancies. The various subtypes are chronic mylocytic leukemia (adult, juvenile, and familial), chronic myelomonocytic leukemia chronic monocytic leukemia, and chronic lymphocytic leukemia. The most common of these, adult-type chronic myelocytic leukemia, is characterized by specific cytogenetic alterations; recent advances in molecular biology are linking these genetic events to the pathophysiology and course of this fascinating neoplasm.
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PMID:Chronic leukemias of childhood. 304 53

The ability to transplant bone marrow makes it possible to treat patients with hematologic malignancies with doses of systemic radiotherapy or chemotherapy that would ordinarily result in fatal myelosuppression. With this approach, some otherwise incurable patients can be treated successfully. For most hematologic malignancies (acute nonlymphocytic leukemia, acute lymphocytic leukemia, chronic myelogenous leukemia, and malignant lymphoma), if transplantation is delayed until patients have end-stage disease (drug-resistant relapse) or blast crisis, approximately 10 to 20% of patients can be saved. If transplantation is carried out earlier in the course of disease, the outcome improves considerably. Some of the major limitations of marrow transplantation are the need for an appropriate source of marrow, the severe myelosuppression seen in the immediate posttransplant period, the complications of graft-v-host disease (GVHD), and disease recurrence. The use of autologous marrow and the formation of a national donor registry may make transplantation more widely applicable. The availability of growth factors can hasten hematopoietic recovery, making the immediate posttransplant period safer. New immunosuppressive regimens and T-cell depletion of donor marrow can diminish the impact of GVHD. The need for better preparative regimens persists and has emerged as the major requirement for continued progress in marrow transplantation.
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PMID:Marrow transplantation for hematologic malignancies: a brief review of current status and future prospects. 305 5

Autologous bone marrow reinfusion rapidly repopulates severely damaged bone marrow thus shortening the period of myelosuppression following high-dose chemotherapy programs. This strategy has been successfully employed in several hematologic malignancies such as acute leukemia, Hodgkin's disease, non-Hodgkin's lymphoma, and chronic myelogenous leukemia. More recently a number of clinical trials have investigated the role of high-dose chemotherapy with autologous bone marrow transplant in solid tumors. This strategy, when used in patients with advanced refractory metastatic breast cancer, results in a high objective response rate (30-70%) but most of these remissions are of short duration (3-4 months). When using high-dose single agents complete remissions are rare; with combination chemotherapy they are more frequent (20-50%). The utilization of high-dose chemotherapy with autologous marrow transplant as a consolidation after achieving a partial or complete remission with standard chemotherapy has shown more promising results with complete remissions approaching 70% in some series. The impact of any of these strategies on overall survival of patients with metastatic breast cancer remains to be demonstrated. The optimal patient selection criteria and strategies for additional development of this field are discussed.
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PMID:The role of high-dose chemotherapy with autologous bone marrow transplantation in the treatment of breast cancer. 306 20

Interferon-alpha 2b (IFN-alpha) was administered by continuous subcutaneous (s.c.) infusion to 23 patients with hematologic malignancies or metastatic solid tumors: 5 patients with multiple myeloma, 3 with malignant melanoma, 2 with chronic myelogenous leukemia (CML), 10 patients with renal cell cancer, and 3 patients with other solid tumors. Drug was delivered by continuous s.c. infusion for 28 days (1 cycle) at daily dose levels of 0.7, 1.4, 2.5, 3.6, or 5.0 X 10(6) IU/m2 to 3, 3, 3, 8, and 6 patients, respectively. At the highest dose level, a severe flu-like syndrome was seen in 3 patients and severe gastrointestinal toxicity in 2 patients. The maximally tolerated dose (MTD) was 3.6 X 10(6) IU/m2.day and the principal toxicity was a mild to moderate flu-like syndrome. Local skin reactions were occasionally noted at all dose levels if the s.c. needle site was not rotated every 3-4 days. At dose levels of 2.5-3.6 X 10(6) IU/m2.day, IFN-alpha serum levels at steady state ranged from 19 to 61 IU/ml. The time to achieve steady-state conditions ranged from 40 to 72 h and at steady state, 24 h area under the concentration time curve (AUC24 h) ranged from 480 to 1,464 IU/ml.h. Objective responses were seen 3 of 17 evaluable patients: 1/7 in renal cell cancer (14%); 1/2 in CML and in one patient with ependymoma. Remissions lasted 4, 8, and 15 months in renal cell, CML, and ependymoma, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Phase I-II trial of interferon-alpha 2b by continuous subcutaneous infusion over 28 days. 323 Mar 30

High dose cytarabine (HDARAC) therapy is used increasingly to treat hematologic malignancies. Recent data indicate that HDARAC at doses of 2-3 g/M2 every 12 hr x 10-12 doses is of comparable or greater efficacy in remission induction as standard doses of cytarabine in acute myelogenous leukemia. HDARAC can also produce remissions in individuals resistant to conventional doses. HDARAC-containing regimens are reported to result in substantially higher long-term, disease-free survival than previous approaches to post-remission therapy, but this has not yet been confirmed in controlled trials. HDARAC is also active in acute lymphocytic leukemia. Because intravenous HDARAC achieves high levels in the spinal fluid, it is useful to treat central nervous system leukemia and may provide adequate CNS prophylaxis in acute lymphocytic leukemia. HDARAC is reported to be active in advanced non-Hodgkin lymphomas and chronic myelogenous leukemia in acute phase; optimal use in these settings is under study. HDARAC has also been combined with other drugs. Randomized trials are needed to determine whether these combinations are more effective than HDARAC alone. Apart from potent myelosuppression, the dose-limiting toxicity of HDARAC is cerebellar damage. This occurs with increased frequency in patients greater than 50 years old. HDARAC is active in hematologic malignancies and may further improve therapeutic results if combined with other drugs.
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PMID:High dose cytarabine: a review. 328 15


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