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

From January 1986 to April 1991, 100 consecutive patients with APL received oral ATRA at a dose of 60-100 mg/d alone or in combination with chemotherapy. In 84 cases treated with ATRA, 74 (88.1%) achieved CR; in the 16 cases treated with combined therapy, the CR Rate was 75%. Among the 50 patients followed up for a median of 36 months, 10 used ATRA (Group B) as continuation therapy, 10 chemotherapy (Group C), and 30 cases ATRA and chemotherapy alternatively (Group A). The mean survival was 8, 9, 21 months, respectively. For the 29 cases who died, the overall 3-year survival rate was higher in the group A (46.7%) than in the group B and C. ATRA did not provoke or aggravate DIC, nor did it cause bone marrow hypoplasia. The main side effects were dryness of the lip or skin, headache, nausea or vomiting and liver dysfunction. Severe scrotum exfoliative dermatitis with ulceration was seen in one case. In vitro induction of differentiation, GM-CFU, L-CFU assay and cytogenetic studies were performed. The results were discussed together with clinical observation regarding the mechanism of action of ATRA on APL. ATRA used as an inducer of differentiation is an alternative effective drug in the induction of remission in de novo APL as well as in cases in relapse.
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PMID:[Treatment of acute promyelocytic leukemia (APL) with all-trans retinoic acid (ATRA): a report of five-year experience]. 822 22

A 52-year-old female was diagnosed with relapsed APL in 2000. After obtaining informed consent, we administered 10 mg/day of arsenic trioxide intravenously. The complications were vomiting, increased transaminase and ATRA syndrome which included high fever, retention of body fluid, pleural effusion, pericardial effusion and respiratory failure from day 16. Administration of steroid and low dose chemotherapy (DNR 60 mg x day 1-2, BH-AC 250 mg x day 1-2) with arsenic was effective for APL syndrome, and complete remission (CR) was obtained at day 35 and PML-RAR mRNA became negative. After obtaining CR, consolidation chemotherapy was conducted and the patient was maintained the CR for more than 18 months. Although arsenic trioxide may be effective for relapsed APL, sufficient caution is needed because of the possibility of various complications.
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PMID:[Successful treatment after acute promyelocytic leukemia (APL) syndrome of relapsed API with arsenic trioxide]. 1266 7

A 24-year-old man was admitted to the hospital for pancytopenia. Peripheral blood test and bone marrow aspiration demonstrated an increase in hypogranular promyelocytes. Karyotype analysis and RT-PCR showed 47, XY, t(15;17)(q22;q12), +12, and PML-RARA, respectively. The patient was diagnosed as having acute promyelocytic leukemia microgranular type (M3v) and was therefore administered all-trans retinoic acid (ATRA). Idarubicin and Ara-C were later added to the treatment regimen because of an increased number of leukemic cells. Nausea, vomiting and general fatigue associated with hypercalcemia developed on day 30. There were no findings indicating infection. The administration of ATRA was thus suspected to have induced hypercalcemia. ATRA was therefore discontinued and prednisolone and elcatonin were administered instead. Five days after this change, the serum calcium level normalized. Complete remission was thereafter confirmed on day 45. Hypercalcemia associated with ATRA therapy for APL is rare, and to date, there have been no case reports describing hypercalcemia associated with M3v in the literature. Interaction of fosfluconazole was suspected of causing hypercalcemia when used concomitantly with ATRA.
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PMID:[Hypercalcemia associated with all-trans retinoic acid therapy for microgranular type acute promyelocytic leukemia]. 1864 8