Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0854467 (myelosuppression)
 5,932 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Non-Hodgkin lymphoma developing in patients with HIV infection fulfills diagnostic criteria for AIDS. Clinical manifestations of AIDS-NHL are similar to those of malignant lymphoma arising in other acquired and congenital immunodeficiency states. AIDS related NHLs therefore consist primarily of tumours with B cell phenotype, intermediate or high grade histological subtype and rapid clinical progression with a high frequency of unusual extranodal involvement. Treatment of AIDS-NHL has been much less rewarding than treatment of lymphoma in non-HIV infected individuals. Complete response rates are lower than the corresponding rates seen in the non-HIV infected population, and responses that do occur tend to be of short duration. Improvements in treatment for AIDS-NHL will require the use of new therapies, designed to cause less myelosuppression, in conjunction with aggressive efforts to prevent opportunistic infections.
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PMID:Clinical manifestations and treatment of HIV related non-Hodgkin lymphoma. 182 18

A Phase II study of a new anthracycline, (2''R)-4'-0-tetrahydropyranyladriamycin (THP), was conducted in 162 patients with various hematological malignancies in a multi-institutional cooperative study. THP was given intravenously at a dose of either 10-30 mg/body for 3-5 consecutive days or 40-60 mg/body at 3-week intervals. Of 22 patients with AML, complete remission (CR) was observed in 2 patients and partial remission (PR) in 2. Of 18 patients with ALL, CR was observed in 5 and PR in 3. Of 68 patients with NHL, CR was observed in 11 and PR in 22. Of 8 patients with HD, CR was observed in 4 and PR in 2. One CML case showed CR and one ATL case showed PR. PR was noted in one of 2 patients with mycosis fungoides. Overall remission rate was 43.1% (CR 23 cases and PR 33 cases). The predominant toxicity was myelosuppression. Leukopenia (less than 4,000/mm3) was noted in 67 (77.6%) and thrombocytopenia (less than 10 X 10(4)/mm3) in 24 (27.0%). Nausea/vomiting and anorexia were common, and were observed in 61 (43.3%) and 65 (46.1%) cases, respectively. Hair loss and cardiotoxicity were mild and recovered quickly on discontinuation of THP. Thus, THP was found to be effective for various hematological malignancies including acute leukemia and malignant lymphoma.
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PMID:[A phase II study of (2''R)-4'-0-tetrahydropyranyladriamycin (THP) in patients with hematological malignancies. THP Study Group]. 394 12

Eighteen patients with advanced refractory lymphomas were treated with 2-methyl-hydroxyellipticinium (ellipticinium); there were 14 non-Hodgkin's (NHL) and 4 Hodgkin's lymphomas (HL). Ellipticinium was administered at the dose of 100 mg/m2 daily for 3 days i.v. with courses repeated at 3 week intervals. Preliminary results indicate some antitumor activity of the drug against NHL with minimal toxicity. Of the 16 evaluable patients 1 partial remission and 7 minor responses were noted among the NHL (65%). Myelosuppression was minimal and clinical toxicity was mild. Further evaluation of this drug in untreated patients appears to be warranted.
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PMID:2-Methyl-9-hydroxyellipticinium acetate (ellipticinium) in the treatment of lymphomas. Preliminary results of a phase II study. 653 40

From August 1979 to April 1981, 33 consecutive patients with malignant hematological diseases, entered this phase II study. Sixteen patients had NHL, eight CLL, four Myeloma, three HD, one ALL, and one Polycythaemia vera. Two patients were unevaluable because of early death. The median age was 67 years. Eight patients were not pretreated with drugs. Two CR (5+, 20+ weeks) were obtained among NHL patients, whereas five PR were observed among two NHL, one CLL, one Myeloma, and one HD patients, respectively. Toxicity was almost exclusively hematologic and occurred in ten patients, in one of them causing severe myelosuppression. Moreover, severe asthenia, attributable to VM26, was encountered in three patients, in one requiring the suspension of the treatment.
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PMID:VM26 in malignant hematological diseases. A phase II study. 695 64

One hundred and forty-one consecutive patients above and 231 below the age of 60 years with previously untreated intermediate or high grade non-Hodgkin's lymphoma were included in this study. Patients above the age of 60 years were treated with the COPP chemotherapy regimen. The younger patients, at or below the age of 60, received a doxorubicin-containing regimen (119 had CHOP, 65 had BACOP and 47 had m-BACOD). For stage I patients, the clinical results were similar but for stage II, III or IV disease, those receiving COPP had significantly worse CR rate and survival than those who had a doxorubicin-containing regimen. Multivariate analysis on patients receiving the COPP chemotherapy revealed that the independent prognostic variables significantly determining CR rate and survival included clinical stage (p = 0.04) and serum lactate dehydrogenase level (p = 0.001). Myelosuppression was the major toxicity following COPP chemotherapy in this group of patients. There were 10 (7 per cent) treatment-related deaths. Compared to the reported results using doxorubicin-containing regimens to treat elderly patients with aggressive NHL in the literature, the more aggressive treatment does not appear to improve significantly the clinical outcome of this group of patients and seems to produce treatment results very much similar to COPP. However, accurate comparison is difficult because of the variation in the patient characteristics. Further prospective controlled randomized trials will be necessary to determine the optimal therapy for these patients.
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PMID:COPP chemotherapy for elderly patients with intermediate and high grade non-Hodgkin's lymphoma. 768 80

Methylglyoxalbisguanylhydrazone or MGBG is an agent with a unique mechanism of action (polyamine biosynthesis inhibition). MGBG was discarded in the 1960s because of severe mucositis and other toxicities. New clinical trials in the late 1970s and early 1980s utilized weekly administration and indicated MGBG had significant activity in patients with chemotherapy-refractory Hodgkin's and non-Hodgkin's lymphoma. In addition, some activity was noted in patients with head and neck, prostate, esophageal, and endometrial cancer. The toxicities on the weekly schedule were minimal and no myelosuppression was noted. Based on MGBG's spectrum of antitumor activity and its activity in severely debilitated patients, we hypothesize that MGBG may have greater antitumor activity in patients who are malnourished (possibly based on polyamine depletion). MGBG is a good candidate for treatment of AIDS-associated NHL because it has proven activity in patients with NHL which is not associated with AIDS, crosses the blood brain barrier, is non-myelosuppressive, and appears to work in patients with inanition (no polyamines available to reverse MGBG's antitumor effects). Clinical trials are ongoing to determine the activity of MGBG in AIDS-associated NHL and other diseases. Based on encouraging initial results, it appears MGBG may become part of our therapeutic armamentarium.
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PMID:MGBG: teaching an old drug new tricks. 791 20

Between April 1988 and April 1992 we conducted a study of DICE (dexamethasone 10 mg q6h, ifosfamide 1 g/m2, cisplatin 25 mg/m2, etoposide 100 mg/m2, and mesna uroprotection daily x 4 given every 28 days) in thirty six patients with intermediate or high-grade non-Hodgkin's lymphomas (NHL's). All patients had disease refractory to anthracycline-based chemotherapy and were ineligible for our dose intensive salvage chemotherapy program including autologous bone marrow transplant (ABMT). Twenty six men and 10 women aged 21-79 years (median 61) were given 100 courses of treatment in hospital. Twenty three patients had stage IV, 7 stage III and 6 stage II disease. Fourteen patients had bone marrow involvement and 11 had B symptoms. Thirty two patients had received only 1 previous chemotherapy regimen. After a follow-up of 1-70 months (median 7), 8 of the 34 (23%) patients evaluable for response had complete remission (CR) of their disease for 8-70+ months (med 24) and 15/34 (44%) partial remission (PR) for 2-55+ months (med 13), giving an overall response rate of 67% (23/34). Eight of the 36 patients are alive 34-70 months (median 48) after being enrolled on study, 6 of whom relapsed and responded to subsequent treatment. The estimated survival rates for all patients at 1 and 2 years are 50% and 36% respectively (Kaplan Meier). Response to prior chemotherapy was the only baseline characteristic statistically predictive (p = 0.04) of response to DICE by logistic regression analysis. Myelosuppression was the dose limiting toxicity.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:DICE (dexamethasone, ifosfamide, cisplatin, etoposide) as salvage therapy in non-Hodgkin's lymphomas. 858 Aug 14

Endogenous plasma levels of granulocyte colony stimulating factor (G- CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF),IL-6 and IL-10 were measured in a total of 70 patients undergoing cytoreductive chemotherapy for treatment of acute leukaemia or non-Hodgkin's lymphomas. the diagnoses were acute myeloid leukaemia (AML; n = 30), acute lymphoblastic leukaemia (ALL;n=6), non-Hodgkin's lymphomas (NHL; n=11) and other malignant haematological disorders including myelodysplastic syndromes (n=23). After chemotherapy, plasma G-CSF was elevated (mean 5.6 ng/ml; range 1.2-10 ng/ml), and was inversely correlated with white blood cell counts (WBC) (r=-0.7, p<0.001). Occurrence of fever (T>38.0 degrees C) during severe myelosuppression (WBC<1x10(9)/1) was associated with an additional increase of G-CSF levels (P<0. (P<0.001). Plasma IL-6 correlated significantly with fever (range <1 to 1100 pg/ml, mean 130 pg/ml; r=0.5, P<0.001) but revealed only a weak association with WBC or platelet counts. In patients treated with recombinant G-CSF (n = 9), an association between IL-6 and fever was still observed after chemotherapy. During the nonfebrile status (total n = 242; AML n = 124), IL-6 levels remained <9 pg/ml in 90% of cases, whereas G-CSF increased with leucopenia (r = -0.72;P<0.001). In contrast, endogenous GM-CSF remained normal and IL-10 showed only a slight increase (21% of samples; maximum 22 pg/ml) in severe leucopenia. In particular, IL-10 levels did not correlate with G-CSF or IL-6 levels. We conclude that systemic release of G-CSF and IL-6 is obviously nit abrogated by cytoreductive chemotherapy in acute leukaemia and NHL may add to the therapeutic efficacy of recombinant cytokines. Also, plasma levels of G-, GM-CSF or IL-6 appear to be regulated by separate mechanisms.
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PMID:Regulated plasma levels of colony-stimulating factors, interleukin-6 and interleukin-10 in patients with acute leukaemia and non-hodgkin's lymphoma undergoing cytoreductive chemotherapy. 861 84

This paper is a preliminary report of a clinical trial for the treatment of patients with refractory chronic lymphocytic leukaemia, using autologous In-114m-labelled lymphocytes. Fourteen patients have been treated so far with doses ranging from 69 to 211 MBq. All patients had progressive low grade NHL, resistant to chemotherapy and conventional radiotherapy. Following the intravenous administration of radiolabelled autologous lymphocytes 53% (range 33-92%) of the activity accumulated in the spleen, 35% (21-64%) in the liver and 5% in the bone marrow. The initial response in all patients was a rapid decrease in lymphocyte count in peripheral blood. 10 of the 14 (72%) patients showed a response to the treatment. In 2 patients, there was a complete response which lasted 24 and 36 months respectively, 8 patients showed a partial response of 2 to 17 months duration. None of the patients experienced any subjective toxicity although myelosuppression was seen in all patients. This is a novel concept for the administration of therapeutic radiation in a selective way for the treatment of lymphoid cell malignancy and has produced significant antitumour effect in patients with highly resistant disease. The trial is ongoing and a full report will be published on its completion.
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PMID:Treatment of lymphoid cell malignancy with In-114m labelled autologous lymphocytes. 917 39

From August 1984 to August 1994 ninety-one caese of malignant lymphoma (NHL 84 casese, HD 7 cases) were treated with Etoposide (VP-16) combinationn chemotherapy. In 70 evaluable patients, 18 achieved CR, 35 PR, total response rate was 75.7%, response time (RT) 1-79 months, medium response time (MRT) 9 months, survival time (ST) 2-79 months, medium survival time (MST) 12 months. The therapeutic efficacy was better than VP-16 alone. The major side effects were myelosuppression and gastrointestinal toxicity. In COPEP, CHEP, PEP and IEP regimens, best result was seen in COPEP (CTX + VCR + PYM + VP-16 + PDN), with a response rate of 93%. Authors suggest that COPEP protocol could be the first line treatment for patients with malignant lymphoma who did not tolerate anthracycline drugs and the second line treatment for anthracycline-resistant patients.
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PMID:[Etoposide combination chemotherapy for malignant lymphoma: a report of 91 cases]. 938 62


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