Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027947 (neutropenia)
 17,527 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report the safety and efficacy of autologous bone marrow transplantation (ABMT) in 30 patients with high-grade non-Hodgkin's lymphoma (NHL) in first complete remission (CR1) following remission induction chemotherapy. Two patients relapsed prior to ABMT. All patients were conditioned with high-dose melphalan. In Addition, ten received fractionated total body irradiation, one hemi-body irradiation and four high-dose etoposide. Unmanipulated non-cryopreserved autologous marrow was reinfused within 56 h of harvesting. Engraftment occurred in all patients with a median of 11 days of neutropenia (< 0.5 x 10(9) l-1), a median requirement for platelet transfusion of 3 days and packed red cell transfusion of 2 units, with a median hospital stay of 18 days post transplant. There was no procedure-related mortality and only minor morbidity was observed. Two patients relapsed at 1 and 2 months post transplantation, and one patient died of carcinoma of the lung 33 months after transplantation. The remaining 25 patients remain alive, well and in CR1 with a median follow-up of 44 months. The event-free survival at 3 years for all patients considered for ABMT was 83%. We conclude that ABMT for high-grade NHL in CR1 with non-cryopreserved marrow results in rapid haematological recovery without growth factor support. It is safe and is associated with high survival when used as consolidation of CR in high-risk patients.
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PMID:Autologous bone marrow transplantation in poor-risk high-grade non-Hodgkin's lymphoma in first complete remission. Newcastle and Northern Lymphoma Group. 752 62

A phase-I clinical study with coadministration of a new vinca alkaloid derivative KW-2307 with cisplatin (CDDP) at 80 mg/m2 to patients with non-small cell lung cancer was conducted by a collaborative study among 6 institutions. CDDP was given on day 1 and KW-2307 on days 1, 8 and 15, both intravenously. One 28-day course was specified to be repeated twice. The initial dose of KW-2307 was 15 mg/m2 and increased to 20 mg/m2 and then to 25 mg/m2. The numbers of enrolled subjects for each dose were 5, 8 and 12 cases, respectively, in the total 25 cases. This regimen as well as KW-2307 monotherapy induced leukocytopenia (neutropenia) as the main adverse reaction. The coadministration with CDDP tended to increase the occurrence of anorexia and nausea/vomiting. Tumor response was obtained in 5 among 24 evaluable cases (CR1, PR 4). The response rate in the cases untreated with KW-2307 and given at 20 mg/m2 or higher doses was 29.4% (5/17, 95% confidence interval of the response rate: 10.3 to 54.7%). Considering drug compliance, etc., the maximum tolerated dose in this regimen was supposed to be 25 mg/m2, and the recommended dose in phase-II study to be 20 mg/m2.
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PMID:[Phase-I clinical study of KW-2307 combined with cisplatin in non-small cell lung cancer patients]. 800 39

Pretransplant conditioning therapy with i.v. BuCy followed by allogeneic hematopoietic stem cell transplantation (BMT) was investigated in a phase II trial in patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS). We gave i.v. Bu at a dose of 0.8 mg/kg every 6h x 16 doses, followed by Cy 60 mg/kg daily for 2 days. Twenty-six AML patients (18 males/eight females) were treated, only eight of whom were in CR1. The rest were either refractory to induction chemotherapy (four patients) or in a more advanced stage of their disease (14 patients). In addition, nine patients with MDS (1M/8F) were treated. Their median age was 41 years (range 21-64). Engraftment to > or =500 neutrophils/microl was reached at 14 days (range 10-29 days) post BMT, and the median time of neutropenia was only 11 days (range 4-28 days). The most common regimen-related toxicity was grade 2-3 nausea. In the post-BMT period (including BMT day +30), two patients died, one each from pulmonary hemorrhage secondary to CMV pneumonia and hepatic veno-occlusive disease (VOD), for an early treatment-related mortality (TRM) of 5.7%. Three patients developed VOD and two of them died. There was no direct regimen-related pulmonary or neurologic toxicity. Overall, the clinical side-effect spectrum was analogous to what would be expected from a high-dose oral Bu-based regimen; there was no unique toxicity experienced with the used solvent system. The disease-free survival in the high-risk subgroup (all patients not in CR1) at 1 and 2 years post transplant was 44% and 31%, respectively. The 13 patients still alive in CR have been followed for a median of 24 months (range 18-32). Pharmacokinetic analysis showed very good interdose reproducibility, and limited interpatient variability in area under the plasma concentration vs time curve, peak concentration, and clearance of Bu after this i.v. formulation. We conclude, that this new i.v. Bu formulation is well tolerated; it has an impressive safety profile, and we suggest that it should be considered as appropriate replacement for oral busulfan in pretransplant conditioning therapy prior to allogeneic BMT for patients with AML or MDS.
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PMID:Allogeneic stem cell transplantation (BMT) for AML and MDS following i.v. busulfan and cyclophosphamide (i.v. BuCy). 1093 85

Natural As4S4 and As2S3 are major components in realgar and orpiment, which also contain small amount of As2O3 and other toxic materials. Liu YF showed with us that NB4 cell line and its mice model were more sensitive to As4S4 than to As2O3 and As2S3. That was in agreement with the clinical data available from China. Wang FR and we proved in mice and in clinical pharmaceutical study that ground Seman platycladi as an excipient can appreciably increase the blood level of arsenic when taken P.O. together with As4S4. Our clinical study with 130 patients with t(15;17) APL showed both As4S4 and As2S3 alone were very effective in CR induction, including cytogenetic remission and PML-RAR reversion, yet the relapse rate was higher in the group treated by As4S4 alone than in the group treated together with other autileukemic agents, either together or in sequence. In the later group, LFS for 1 and 6 years was 96.7% and 87.4%, and the over-all survival for 1 and 6 years was 98.9% and 93.9%. High dose chemotherapy was proven to be not only unsafe but also unnecessary. In newly diagnosed APL patients with neutropenia, CR could be safely achieved by As4S4 P.O. and/with ATRA. Chemotherapy was then followed. In patients with leukocytosis, chemotherapeutic agents such as hydroxyurea or harringtonine was added at the beginning and then followed by anthracycline and asparaginase. The reasons of APL relapse after patients receiving As4S4 P.O. were: 1: emergence of a resistant cell clone showing additional chromosomal abnormalities other than t(15;17); 2: decrease of blood As level. The resistant APL case could respond favorably to combination of As4S4 P.O. together with ATRA. The blood level of As could be raised by modification of the preparation under investigation. Allogeneic stem cell transplantation (allo-SCT) is the last option in relapsed patients, became autologous stem cell transplantation (ASCT) has a significantly better outcome. In a few hospitals ASCT was performed early in the CR1. In rare cares, patients were referred with intra-cranial hemorrhage. CT or EMR scan was done urgently at this instance. Cranial surgery carried out without a minute of delay resulted in the rescue and long survival of patient, while delay of surgery had resulted in irreversible damage of Pons/Medulla oblongata and ended in death. As2O3 IV had been used with success in mentally unclear patients not suffering from intra-cranial hemorrhage. Although no parallel clinical trial has been done to compare the efficacy of As2O3 and As4S4, yet the fact was it was easier for doctors and patients to carry out and receive maintenance treatment with oral As4S4 rather than with As2O3. According to the data and principles above, most of the t(15;17) APL patients can be cured.
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PMID:Current study of APL treatment in China. 1243 Aug 72