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NCI CANCERLIT® Search: Therapy of Acute Myeloid Leukemia - August 2002
National Cancer Institute®
Last Modified: August 1, 2002
- [Management of childhood acute leukemia with standard protocol for increasing the long-time disease free survival rate]
- [Pure red cell aplasia after allogeneic peripheral blood stem cell transplantation: a case report and literature review]
- [Therapeutic strategy for adult acute myeloid leukemia]
- Therapeutic potential of a reduced-intensity preparative regimen for allogeneic transplantation with cladribine, busulfan, and antithymocyte
- Treatment of acute promyelocytic leukemia with arsenic trioxide: clinical and basic studies.
- Risk group definition in children with acute myeloid leukemia by calculating individual risk factors on the basis of a multivariate
- G-CSF related capillary leak syndrome in a child with leukemia.
- Reduced total number of cobblestone area forming cells and in vitro stromal-cell growth in autografts from acute myeloid leukemia patients.
- Treatment of refractory and relapsed acute myelogenous leukemia.
- Biological treatment in acute myelogenous leukaemia: how should T-cell targeting immunotherapy be combined with intensive chemotherapy?
- Neutropenic colitis after treatment of acute myelogenous leukemia with idarubicin and cytosine arabinoside.
Table of Contents
1
UI - 11721427
AU - Guo L
TI -
[Management of childhood acute leukemia with standard protocol for
increasing the long-time disease free survival rate]
SO - Zhonghua Xue Ye Xue Za Zhi 1999 Jul;20(7):341-2
2
UI - 11721433
AU - Li C; Han M; Feng S
TI -
[Pure red cell aplasia after allogeneic peripheral blood stem cell
transplantation: a case report and literature review]
SO - Zhonghua Xue Ye Xue Za Zhi 1999 Jul;20(7):359-61
AD - Institute of Hematology and Blood Diseases Hospital, CAMS, PUMC, Tianjin
300020.
OBJECTIVE: To report a case of post-allogeneic peripheral blood stem
cell transplantation (allo-PBSCT) pure red cell aplasia(PRCA) and the
treatment outcome. METHODS: A patient with acute non-lymphoblastic
leukemia(M2a) was treated with allo-PBSCT. His post-PBSCT PRCA was
treated with plasmapheresis(2-3 times weekly) and Epo(3,000 U/day,
subcutaneously). RESULTS: Reticulocyte count (Ret) recovered to 0.01 at
day +131 and hemoglobin reached 110 g/L at day +154. Erythroid cells in
the bone marrow recovered to 0.25, and BFU-E and CFU-E within normal
range. This normalized hematopoiesis remained for over 5 months after
the cessation of Epo. CONCLUSION: Post allo-PBSCT PRCA can be
successfully treated with plasma exchange and Epo.
3
UI - 12134693
AU - Tomonaga M
TI -
[Therapeutic strategy for adult acute myeloid leukemia]
SO - Rinsho Ketsueki 2002 Jun;43(6):424-6
4
UI - 11948108
AU - Saito T; Kanda Y; Kami M; Kato K; Shoji N; Kanai S; Ohnishi T; Kawano Y;
TI -
Nakai K; Ogasawara T; Matsubara H; Makimoto A; Tanosaki R; Tobinai K;
Wakasugi H; Takaue Y; Mineishi S
Therapeutic potential of a reduced-intensity preparative regimen for
allogeneic transplantation with cladribine, busulfan, and antithymocyte
globulin against advanced/refractory acute leukemia/lymphoma.
SO - Clin Cancer Res 2002 Apr;8(4):1014-20
AD - Hematopoietic Stem Cell Transplantation and Hematology Division,
National Cancer Center Hospital, Tokyo 104-0045, Japan.
PURPOSE: Cladribine (2-CdA) is a purine analogue that exhibits activity
against a variety of hematological malignancies and has a potent
immunosuppressive effect. We therefore performed a pilot study to
evaluate the feasibility of a novel 2-CdA-based reduced-intensity stem
cell transplantation (RIST) regimen. EXPERIMENTAL DESIGN: A total of 16
scheduled patients with hematological malignancies were enrolled for
comparison of their data with conventional stem cell transplantation (n
= 19). The regimen for RIST consisted of 2-CdA (0.11 mg/kg/day for 6
days), busulfan (4 mg/kg/day for 2 days), and rabbit antithymocyte
globulin (2.5 mg/kg/day for 4, 2, or 0 days). The underlying diseases
included acute myelogenous leukemia (n = 6), chronic myelogenous
leukemia (n = 2), myelodysplastic syndrome (n = 6), and non-Hodgkin's
lymphoma (n = 2). RESULTS: After RIST, four patients died before day 100
as a result of acute graft-versus-host disease (n = 1), bacteremia (n =
1), disseminated candidasis (n = 1) and congestive heart failure (n =
1). Another patient died of cerebral infarction on day 140. Thus,
acute-phase regimen-related toxicities >grade III were observed in only
one patient. Engraftment and complete donor chimerism were achieved by
day 28 in 14 evaluable patients, and 6 of them (43%) experienced grade
II-IV acute graft-versus-host disease. With a median follow-up of 328
days (range, 231-633 days), the actuarial 1-year overall and
disease-free survival rates were 69% and 50%, respectively. Notably,
among seven high-risk patients (five patients had been in complete
remission two or more times and two not in complete remission with
refractory disease at transplant), only two patients developed leukemia
relapse after RIST. Although the recovery of CD4+ cells was
significantly slower (P = 0.02) in RIST than in conventional stem cell
transplantation, the incidence of clinically documented infections was
not significantly different between the two groups. CONCLUSION: The
results suggest that this novel regimen containing 2-CdA is well
tolerated and induces early complete donor chimerism. The unexpected
durable remission achieved in patients with advanced disease at
transplant suggests the presence of an acceptable antileukemia/lymphoma
effect, which would warrant a further clinical trial.
5
UI - 11911407
AU - Zhao WL; Chen SJ; Shen Y; Xu L; Cai X; Chen GQ; Shen ZX; Chen Z; Wang ZY
TI -
Treatment of acute promyelocytic leukemia with arsenic trioxide:
clinical and basic studies.
SO - Leuk Lymphoma 2001 Nov-Dec;42(6):1265-73
AD - Shanghai Institute of Hematology, Rui Jin Hospital affiliated to
Shanghai Second Medical University, People's Republic of China.
Arsenic trioxide (As2O3) has recently been identified as an effective
drug in the treatment of newly diagnosed and relapsed acute
promyelocytic leukemia (APL) without cross-resistance to all-trans
retinoic acid and achieved complete remission rates of 80-90% according
to most reports. With intravenous infusion at a dose of 0.08-0.16 mg/kg
daily, a course of 28-42 days is required to induce remission. As2O3 in
combination with chemotherapy as postremission therapy results in longer
survival than arsenic alone. In vitro, As2O3 exerts dose-dependent dual
effect; triggering apoptosis at relatively high concentration (0.5-2.0
micromol/l), which is associated with the disruption of mitochondrial
transmembrane potentials, while inducing partial differentiation at low
concentration (0.1-0.5 micromol/l), which might be related to retinoic
acid signaling pathway. Importantly, at both concentrations, As2O3 can
degrade PML (promyelocytic leukemia) -RAR alpha (retinoic acid
receptor), an oncoprotein that has a central role in leukemogenesis.
6
UI - 11911410
AU - Steinbach D; Hermann J; Littlewood T; Zintl F
TI -
Risk group definition in children with acute myeloid leukemia by
calculating individual risk factors on the basis of a multivariate
stepwise Cox regression analysis.
SO - Leuk Lymphoma 2001 Nov-Dec;42(6):1289-95
AD - University Children 's Hospital, Jena, Germany.
danielsteinbach@hotmail.com
To define risk groups in children with acute myeloid leukaemia (AML), we
conducted a multivariate stepwise Cox regression analysis of three
consecutive multicentre studies in East Germany. The total number of
patients was 240, but cytogenetics and remission status on day 15 were
routinely investigated only in the most recent study, AML-III/93 (78
patients). We derived an equation to calculate individual risk factors,
determined those risk factors for all patients of study AML-III/93 and
divided them into three groups with 26 patients in each. The variables
in the equation were: WBC, FAB-type, auer rods, cytogenetics and
response status on day 15. The event-free survival was 80% in the low
risk, 55% in the intermediate risk and 15% in the high risk group. Our
results strongly suggest that calculating individual risk factors on the
basis of a multivariate stepwise Cox regression analysis is a useful
tool in defining risk groups.
7
UI - 11911434
AU - Dagdemir A; Albayrak D; Dilber C; Totan M
TI -
G-CSF related capillary leak syndrome in a child with leukemia.
SO - Leuk Lymphoma 2001 Nov-Dec;42(6):1445-7
8
UI - 12042043
AU - Olesen G; Tonder H; Hokland P
TI -
Reduced total number of cobblestone area forming cells and in vitro
stromal-cell growth in autografts from acute myeloid leukemia patients.
SO - Cytotherapy 2000;2(3):201-9
AD - Department of Hematology, Aarhus University Hospital, Opgang 4A, DK 8000
Aarhus C, Denmark.
BACKGROUND: It is well known that ABMT in acute myeloid leukemia (AML)
often results in delayed hematopoietic engraftment, but the reason
behind this has not been resolved. Previous studies have largely dealt
with measurements of committed myeloid progenitors as surrogate markers
for hematopoiesis. METHODS: Measurements of Week 5 cobblestone area
forming cells (CAFC) and stromal-cell growth in BM autografts from 14
AML patients were compared with those from 10 NHL patients. RESULTS:
Grafts achieved from the AML patients contained a significantly lower
total number of CAFC than those from the NHL patients. The reason for
this was a lower total amount of mononuclear cells (MNC) obtained during
harvest procedure (mean 0.4 x 10(8)/kg for AML, versus 0.8 x 10(8)/kg
for NHL). In contrast, the frequency of CAFC was comparable both between
patient groups (mean 1.47, range 0.15-6.33 per 10(4) MNC for AML versus
mean 1.47, range 0.53-3.57 per 10(4) MNC for NHL) and compared with that
of eight normal donors (mean 1.12, range 0.73-1.73 per 10(4) MNC). An
inverse relationship was observed between the total CAFC number in the
grafts and the hematopoietic reconstitution of both granulocytes > or =
2.0 x 10(9)/L and thrombocytes > or = 50 x 10(9)/L, in which the level
of 9.0 x 10(3) CAFC/kg implied a prompt engraftment for both patient
groups. Whereas the stromal cell outgrowth in vitro from 8/10 NHL
patients was similar to that of six normal donors, only a few stromal
cells appeared in the majority of nine evaluable AML patients.
DISCUSSION: A decreased total CAFC content, as well as an inferior
stromal-cell function, may be critical elements for prolonged
hematopoietic reconstitution in AML.
9
UI - 12113052
AU - Stanisic S; Kalaycio M
TI -
Treatment of refractory and relapsed acute myelogenous leukemia.
SO - Expert Rev Anticancer Ther 2002 Jun;2(3):287-95
AD - Cleveland Clinic Foundation, Department of Hemotology and Medical
Oncology, 9500 Euclid Ave. R-35, Cleveland, OH 44195, USA.
Staniss@ccf.org
Refractory and relapsed disease occurs in most acute myelogenous
leukemia patients. Salvage chemotherapy offers a 30-70% chance of a
second complete remission. Unfortunately, this second remission is
usually short lived and salvage chemotherapy is rarely curative.
Allogeneic bone marrow transplant, either human leukocyte antigen
(HLA)-sibling matched or matched unrelated donor, is the only treatment
to offer long-term disease-free survival and possible cure. Many
patients will be ineligible for allogeneic bone marrow transplant. A
conjugated antiCD33 monoclonal antibody, gemtuzumab ozogamicin, has
recently been approved for use in relapsed and refractory acute
myelogenous leukemia patients. New and novel agents are also undergoing
trials in an attempt to improve on the overall poor outcomes.
10
UI - 11728232
AU - Bruserud O; Wendelboe O
TI -
Biological treatment in acute myelogenous leukaemia: how should T-cell
targeting immunotherapy be combined with intensive chemotherapy?
SO - Expert Opin Biol Ther 2001 Nov;1(6):1005-16
AD - Division of Hematology, Department of Medicine, Haukeland University
Hospital and the University of Bergen, Norway.
oystein.bruserud@haukeland.no
T-cell targeting immunotherapy is now considered as a possible strategy
in the treatment of acute myelogenous leukaemia (AML). Clinical
importance of antileukaemic T-cell reactivity after allogeneic stem cell
transplantation (SCT) is well established and the early experience from
IL-2 therapy suggests that even autologous T-cells can mediate
antileukaemic reactivity. The clinical experience also indicates that
immunotherapy should begin when the leukaemia cell burden is minimal,
and the detection of an operative cellular immune system, even in
patients with chemotherapy-induced cytopenia, further suggests that it
is possible to begin T-cell targeting therapy early after chemotherapy
while patients are still cytopenic. However, adult patients in
particular have a T-cell defect after chemotherapy that may last for
several months. For this reason immunotherapy should probably be
continued or repeated until a maximal effect is achieved when the
patients no longer have a T-cell defect. This treatment approach may
also be considered in combination with autologous SCT. T-cell targeting
regimens should include, if possible, several therapeutic components.
Firstly, native AML blasts can function as accessory cells during T-cell
activation and in vivo therapy with T-cell growth factors (e.g., IL-2,
IL-15) may then enhance antileukaemic reactivity or non-specific
cytotoxicity against the AML cells; and secondly, a further enhancement
of AML-specific reactivity may be achieved by vaccination with
AML-specific peptides, immunisation with AML-blasts expressing a
dendritic cell phenotype, or exposure to normal antigen-presenting cells
(APC) pulsed with or expressing AML-specific peptide sequences.
11
UI - 12173711
AU - Hogan WJ; Letendre L; Litzow MR; Tefferi A; Hoagland HC; Pruthi RK;
TI -
Kaufmann SH
Neutropenic colitis after treatment of acute myelogenous leukemia with
idarubicin and cytosine arabinoside.
SO - Mayo Clin Proc 2002 Aug;77(8):760-2
AD - Division of Hematology and Internal Medicine, Mayo Clinic, Rochester,
Minn 55905, USA.
OBJECTIVE: To determine the gastrointestinal toxic effects of idarubicin
and cytosine arabinoside combination therapy in patients with newly
diagnosed acute myelogenous leukemia (AML). PATIENTS AND METHODS: We
performed a single-institution retrospective analysis of the incidence
of neutropenic colitis in patients with newly diagnosed AML receiving
idarubicin and cytosine arabinoside combination therapy. Using pharmacy
records, we identified 78 patients who received idarubicin during the
review of their medical records. Patients with preexisting bowel
conditions were excluded from this analysis. We used a strict definition
of neutropenic colitis that included clinical findings (severe abdominal
pain, diarrhea, hematochezia, and/or peritoneal signs) plus radiographic
evidence of bowel inflammation in the absence of an identified bacterial
pathogen. RESULTS: Of the 78 patients receiving idarubicin and cytosine
arabinoside for treatment of AML, 65 were included in this study. We
observed neutropenic colitis in 10 of these 65 AML patients. This
complication was followed by sepsis in 3 patients and was the major
cause of death in 4 of the 8 patients who died. CONCLUSION: This
analysis suggests that neutropenic colitis is a frequent and serious
complication of idarubicin and cytosine arabinoside treatment.
The above citations and abstracts reflect those newly added to CANCERLIT for the month and topic listed in the title. The citations have been retrieved from CANCERLIT using a predefined search strategy of indexed subject terms. Although the search strategy has been refined as best as possible, citations may appear that are not directly related to the topic, and occasionally relevant references may be omitted.
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