Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twelve patients with refractory acute leukemia (7 patients with acute myelocytic leukemia and 5 patients with acute lymphocytic leukemia) were treated with a new anthracycline antibiotic, aclacinomycin-A (ACM). ACM was administrated by intravenous drip infusion at a dose of 20 mg/day for 7 or 14 days and this was repeated after at least 7 days. Four of 12 patients (33.3%) achieved a complete remission; 3 of 7 acute myelocytic leukemia (42.8%) and 1 of 5 acute lymphocytic leukemia (20.0%). The days required for achieving the complete remission ranged from 23 to 78 days (median: 61) and the total doses of ACM used from 180 to 500 mg (median: 310), and the durations of complete remission from 11 to 28+ weeks (median: 21+). The untoward effects on digestive organs, such as nausea, vomiting and anorexia, and hematological toxicities were frequently seen; however, they were controlled by supportive treatment. Alopecia was not observed. Arrythmia was recognized in one patient at the initiation of ACM infusion with complete remission without withdrawal of ACM. These results suggest that ACM is a potentially effective anthracycline antibiotic in the clinical management of acute leukemia.
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PMID:Treatment of refractory acute leukemia with aclacinomycin-A. 644 34

Homoharringtonine is a cephalotaxine ester derived from Cephalotaxus harringtonia, which is a Chinese evergreen tree. A limited clinical evaluation of this drug in China revealed antileukemic activity, which prompted clinical trials in the United States. We have treated 43 patients with a variety of refractory malignancies using a daily iv treatment for 5 days at 3-4-week intervals. The starting dose of homoharringtonine was 0.2 mg/m2/day and it was escalated to a maximum of 8 mg/m2/day. The dose-limiting toxic effect was hypotension, which was generally mild with daily dose levels of 3-4.5 mg/m2/day and required no specific treatment besides iv fluid supplements in some patients. Hypotension became increasingly severe at the higher dose levels and resulted in cardiovascular collapse in four of 16 patients treated with dose levels of 5-6 mg/m2/day. A moderately severe degree of myelosuppression was observed with homoharringtonine doses of greater than or equal to 3 mg/m2. Myelosuppression was clearly related to the extent of prior treatment and was minimal in patients who had not received extensive prior treatment. Gastrointestinal toxic effects of nausea, vomiting, and diarrhea were observed in approximately two-thirds of the patients but these side effects were generally mild and self-limited. Drug-related fever and alopecia were also observed in some patients. No major responses were observed, although three patients with solid tumors evidenced minor responses and three of five patients with acute leukemia showed some degree of antileukemic activity. For phase II studies of homoharringtonine in solid tumors, a daily dose of 3 mg/m2 for 5 days in patients with extensive prior treatment and 4 mg/m2/day for 5 days in patients with good bone marrow reserve will be utilized. The daily dose must not exceed 4 mg/m2 to avoid serious hypotension; further dose escalations should be accomplished by extending the number of days of treatment beyond 5 days.
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PMID:Phase I clinical investigation of homoharringtonine. 647 48

Effectiveness and side effects of VP 16-213, a semi-synthetic podophyllotoxin, on acute leukemia and histiocytic medullary reticulosis in childhood was tested. Four cases of refractory acute lymphocytic leukemia, five of acute non-lymphocytic leukemia-one induction failure and 4 in remission--and a case of histiocytic medullary reticulosis were treated with a combination of VP 16-213 (Days 1-5), cytosine arabinoside (Days 1-5) and adriamycin (Day 6). None of the acute lymphocytic leukemia patients yielded a complete response; however, one of them later attained a partial response with modified intermittent administration of VP 16-213 and cytosine arabinoside. A patient with acute non-lymphocytic leukemia who had failed to attain initial remission, achieved a complete response after the second course of the treatment with increased dosages. In the four acute non-lymphocytic leukemia patients in remission, complete remission was maintained more than 4 a months. A case of histiocytic medullary reticulosis demonstrated partial response. The major toxic effects produced by this regimen were marked pancytopenia and vomiting. VP 16-213 appears to be effective for myelocytic and monocytic malignancies in childhood.
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PMID:[VP 16-213 in the treatment of acute leukemia in childhood]. 657 30

The association between Clostridium septicum sepsis in patients with malignant disease has been frequently documented. A presentation with fever, neutropenia, vomiting, and an acute abdomen is characteristic of this anaerobic infection which has been uniformly fatal in children with acute leukemia. We report the unusual course and the successful treatment of an adolescent with an abdominal Burkitt's lymphoma with leukemic transformation and clostridium septicum sepsis and cellulitis.
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PMID:Successful therapy of Clostridium septicum sepsis in a child with Burkitt's lymphoma. 678 26

High-dose cytarabine (HDARA-C) at doses ranging from 1000 to 3000 mg/m2 administered as 30-min iv infusions was used in 12 patients with acute leukemia. HDARA-C toxicity was marked by nausea, vomiting, and somnolence; fever occurred in one patient. Myelosuppression was brief and reversible; the wbc count nadir occurred between Days 10 and 15 after treatment. In this study of a limited number of patients, no reliable conclusions could be drawn about antileukemic activity. However, (a) HDARA-C appeared to be a well-tolerated regimen in acute myeloblastic leukemia in complete remission; (b) a clear improvement was obtained in a patient with central nervous system leukemia; and (c) a sharp but transient decrease in peripheral blast cell counts was seen in two patients with acute myeloblastic leukemia. Cytarabine distribution was bi- or tri-compartmental; plasma final half-life was greater than 4 hrs in six patients. Pharmacokinetic parameters were not correlated with serum deoxycytidine deaminase activity. HDARA-C crosses the blood-brain barrier and may be useful in the prophylaxis against and treatment of central nervous system leukemia.
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PMID:High-dose cytarabine in acute leukemia: toxicity and pharmacokinetics. 685 Jun 54

m-AMSA is a synthetic aminoacridine DNA intercalator found to have experimental murine antitumor activity. A phase I investigation was undertaken in 71 patients with solid tumors and acute leukemia. Using an intermittent every 3-week schedule in solid tumors, toxicity encountered was primarily hematologic, predominantly leukopenia with relative platelet sparing. The recommended dose for phase II evaluation in patients with solid tumors is 90 mg/m2 every 3 weeks; patients with minimal prior therapy could be treated at 120 mg/m2 and patients with hepatic dysfunction or marginal bone marrow reserve should have an initial dose reduction to 70 mg/m2. Therapeutic activity was seen in Hodgkin's disease, hepatoma, and epidermoid carcinoma of the esophagus. Various dose schedules were studied in leukemia. The recommended dose for phase II evaluation is 120 mg/m2 daily for 5 days as a daily 30-minute infusion. At this dose, nausea, vomiting, mucositis, alopecia, and hepatic toxicity were noted. Therapeutic activity was seen in AML, blastic CML, and CLL. Further clinical trials with this agent are warranted.
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PMID:Phase I study of m-AMSA in patients with solid tumors and leukemias. 689 83

AMSA, an acridine derivative with significant antitumor activity in experimental tumors, was administered to 17 patients with advanced tumors refractory to standard chemotherapies. A phase I study was undertaken in 10 patients with solid tumors and lymphomas. Dose-limiting toxicity was myelosuppression. With a median dose of 90 mg/m2 (75-148 mg/m2), median lowest WBC count was 1,000/mm3 (100-3,200) on day 11 and its recovery up to 4,000/mm3 was seen on day 21, while lowest platelet count was 42 X 10(3)/mm3 (7-300 X 10(3) on day 12 and its recovery up to 100 X 10(3)/mm3 was on day 20. Non-hematological toxicities were nausea (39%), vomiting (11%) and phlebitis (17%) in 18 courses of therapy. The result indicated that the recommended dose schedule for a phase II evaluation was 90 mg/m2, every three weeks. Therapeutic activity was observed in patients with non-Hodgkin's lymphoma (one partial response and two minor responses out of four). Two out of five breast, one ovarian, and one melanoma patients showed stable diseases. Five leukemic patients (three AMLs, one MoL, and one blastic CML) were treated with AMSA, and in these cases cytoreduction of peripheral and bone marrow blasts was seen, but it was not adequate to induce remission. Further clinical trials with this agent are warranted, especially in patients with acute leukemia, lymphoma and breast cancer.
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PMID:[Phase I-II studies of a new antineoplastic agent, 4'-(9-acridinylamino)-methanesulfon-m-anisidide (AMSA)]. 689 58

29 patients with advanced malignant lymphoma were included in a phase-II trial conducted by Cancer and Acute Leukemia Group B. The patients received cis-diamminedichloroplatinum (DDP) in a dose of 70 mg/m2 every three weeks. In this still ongoing study, 23 patients are already evaluable. Out of 23 cases partial remission was observed in 6. The main toxicity was profuse vomiting. Myelosuppression and nephrotoxicity were both manageable. Based on these preliminary data, the incorporation of DDP in combination chemotherapy for malignant lymphoma appears to be warranted.
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PMID:[Phase-II-study with cis-diamminedichloroplatinum (II) in the treatment of advanced malignant lymphomas]. 719 77

In a cooperative study of the Cancer and Acute Leukemia Group B, 27 evaluable patients with advanced malignant lymphomas were treated with 70 mg/m2 of cisdichlorodiammineplatinum(II) (cis-platinum) once every three weeks. All patients had received extensive prior therapy. Partial remission was obtained in two of eight patients (25%) with Hodgkin's disease, for six and 40 weeks, and in five of 19 (26%) patients with non-Hodgkin's lymphoma, for a median duration of six weeks. The major toxic effects were profuse vomiting and, to a lesser degree, myelosuppression. Nephrotoxicity was easily controlled. Cis-platinum is an active agent in lymphoma and should merit incorporation into combination therapy for recently diagnosed disease.
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PMID:Phase II trial of cis-dichlorodiammineplatinum (II) in advanced malignant lymphoma: a study of the cancer and acute leukemia group B. 719 82

3-Deazauridine, a uridine analog, was administered to 36 patients with acute leukemia by both intermittent and continuous iv infusion at doses ranging from 400 to 6000 mg/m2/day x 5, repeated at 1--3-week intervals. There were no complete or partial responses but three patients showed hematologic improvement. Major toxic effects were myelosuppression, stomatitis, vomiting, diarrhea, and skin erythema. Daily doses greater than 3000 mg/m2 were associated with significantly increased toxicity, including three drug-related deaths. The recommended dose for future studies is 2500 mg/m2/day as a continuous 5-day infusion.
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PMID:Phase I--II study of 3-deazauridine in adults with acute leukemia. 723 73


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