scholarly journals Remission induction chemotherapy induces in vivo caspase-dependent apoptosis in bone marrow acute myeloid leukemia blast cells and spares lymphocytes

2006 ◽  
Vol 70B (3) ◽  
pp. 115-123 ◽  
Author(s):  
J.-P. Vial ◽  
R. Tabrizi ◽  
A. Pigneux ◽  
F. Lacombe ◽  
V. Praloran ◽  
...  
1988 ◽  
Vol 6 (5) ◽  
pp. 802-812 ◽  
Author(s):  
E Kokenberg ◽  
P Sonneveld ◽  
W Sizoo ◽  
A Hagenbeek ◽  
B Löwenberg

In an attempt to identify pharmacokinetic factors that determine the response of acute myeloid leukemia (AML) patients to induction chemotherapy, we determined the concentrations of daunorubicin (DNR) and the main metabolite daunorubicinol (DOL) in vivo and particularly evaluated the concentrations in blood and bone marrow nucleated cells. Cell measurements were obtained in 37 evaluable patients during their first remission induction treatment with DNR and cytarabine (ara-C) and directly compared with the plasma distribution kinetics of DNR. We show that (1) plasma DNR concentrations do not correlate with DNR concentrations in bone marrow nucleated cells; but (2) plasma area under the curve (AUC) values of DNR correlate inversely (P less than .01) with AUC values of DNR in WBCs; (3) concentrations of DNR in WBCs correlate positively (P less than .01) with DNR concentrations in bone marrow nucleated cells; and (4) the concentrations of DNR in WBCs show a negative correlation (P less than .01) with the numbers of peripheral blast cells at diagnosis. We then tested whether the pharmacokinetic parameters had predictive value for the clinical outcome of therapy, but none of the plasma levels or WBC and bone marrow concentrations of DNR predicted treatment outcome. The inverse correlation between the concentrations of DNR in WBC and the numbers of peripheral blast cells suggests that the effective DNR concentrations achieved intracellularly are mainly a function of the tumor load so that lesser amounts of DNR accumulate intracellularly when the AML cell numbers in blood are higher.


1995 ◽  
Vol 1 (1) ◽  
pp. 54-59 ◽  
Author(s):  
Béla Schmidt ◽  
Márta Válay ◽  
Sarolta Nahajevszky ◽  
Ervin Pitlik ◽  
György Füst

Blood ◽  
2000 ◽  
Vol 95 (8) ◽  
pp. 2637-2644 ◽  
Author(s):  
Teresa Padró ◽  
Sandra Ruiz ◽  
Ralf Bieker ◽  
Horst Bürger ◽  
Martin Steins ◽  
...  

The importance of angiogenesis for the progressive growth and viability of solid tumors is well established. In contrast, only few data are available for hematologic neoplasms. To investigate the role of angiogenesis in acute myeloid leukemia (AML), bone marrow biopsies from 62 adults with newly diagnosed, untreated AML (day 0) were evaluated. Further studies were done after the completion of remission induction chemotherapy (day 16 of induction chemotherapy, n = 21; complete remission, n = 20). Microvessels were scored in at least 3 areas (×500 field, 0.126 mm2) of the highest microvessel density in representative sections of each bone marrow specimen using immunohistochemistry for von Willebrand factor and thrombomodulin. Microvessel counts were significantly higher in patients with AML (n = 62) compared with control patients (n = 22): median (interquartile range) 24.0 (21.0-27.8)/×500 field vs 11.2 (10.0-12.0)/×500 field, respectively (P < .001). On day 16 of induction chemotherapy, microvessel density was reduced by 60% (44-66) (P < .001) in hypoplastic marrows without residual blasts, in contrast to only 17% (0-37) reduction in hypoplastic marrows with ≥ 5% residual blasts (P < .001 for the difference between both groups). Bone marrow biopsies taken at the time of complete remission displayed a microvessel density in the same range as the controls. In conclusion, there is evidence of increased microvessel density in the bone marrow of patients with AML, which supports the hypothesis of an important role of angiogenesis in AML. Furthermore, these findings suggest that antiangiogenic therapy might constitute a novel strategy for the treatment of AML.


Blood ◽  
2000 ◽  
Vol 95 (8) ◽  
pp. 2637-2644 ◽  
Author(s):  
Teresa Padró ◽  
Sandra Ruiz ◽  
Ralf Bieker ◽  
Horst Bürger ◽  
Martin Steins ◽  
...  

Abstract The importance of angiogenesis for the progressive growth and viability of solid tumors is well established. In contrast, only few data are available for hematologic neoplasms. To investigate the role of angiogenesis in acute myeloid leukemia (AML), bone marrow biopsies from 62 adults with newly diagnosed, untreated AML (day 0) were evaluated. Further studies were done after the completion of remission induction chemotherapy (day 16 of induction chemotherapy, n = 21; complete remission, n = 20). Microvessels were scored in at least 3 areas (×500 field, 0.126 mm2) of the highest microvessel density in representative sections of each bone marrow specimen using immunohistochemistry for von Willebrand factor and thrombomodulin. Microvessel counts were significantly higher in patients with AML (n = 62) compared with control patients (n = 22): median (interquartile range) 24.0 (21.0-27.8)/×500 field vs 11.2 (10.0-12.0)/×500 field, respectively (P &lt; .001). On day 16 of induction chemotherapy, microvessel density was reduced by 60% (44-66) (P &lt; .001) in hypoplastic marrows without residual blasts, in contrast to only 17% (0-37) reduction in hypoplastic marrows with ≥ 5% residual blasts (P &lt; .001 for the difference between both groups). Bone marrow biopsies taken at the time of complete remission displayed a microvessel density in the same range as the controls. In conclusion, there is evidence of increased microvessel density in the bone marrow of patients with AML, which supports the hypothesis of an important role of angiogenesis in AML. Furthermore, these findings suggest that antiangiogenic therapy might constitute a novel strategy for the treatment of AML.


2015 ◽  
Vol 8 (1) ◽  
Author(s):  
Valentina Folgiero ◽  
Loredana Cifaldi ◽  
Giuseppina Li Pira ◽  
Bianca Maria Goffredo ◽  
Luciana Vinti ◽  
...  

2010 ◽  
Vol 71 (3) ◽  
pp. 1177-1186 ◽  
Author(s):  
Andrew J. Lilly ◽  
Farhat L. Khanim ◽  
Rachel E. Hayden ◽  
Quang T. Luong ◽  
Mark T. Drayson ◽  
...  

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 3678-3678 ◽  
Author(s):  
Shin-ichiro Fujiwara ◽  
Kazuo Muroi ◽  
Raine Tatara ◽  
Kiyoshi Okazuka ◽  
Sato Kazuya ◽  
...  

Abstract Background: Elderly patients with acute myeloid leukemia (AML) show unfavorable biologic characteristics and inferior clinical outcomes compared to younger patients. Because some elderly patients can benefit from intensive chemotherapy, the identification of prognostic markers is important for therapeutic decision-making. CD25 (interleukin 2 receptor alpha) has been reported to be highly expressed in leukemia stem cells and correlate with adverse outcomes in younger (less than 60 years) patients with AML. However, the significance of CD25 expression in elderly patients with AML has not yet been investigated. Methods: We retrospectively reviewed 154 newly diagnosed AML (de novo, secondary) patients aged 60 years or over (median: 69, range: 60-85 years), admitted between 2005 and 2013 to Jichi Medical University Hospital. Blast cells from bone marrow at diagnosis were identified by flow cytometry (FCM) using CD45/side scatter properties. CD25 expression in the blast region was analyzed by FCM combined with single- and two-color staining. Results: The two-color FCM analysis showed that CD25 was expressed in CD34, CD117, and CD13-positive blast cells. The median CD25 expression of the blast cells was 0.7% (range: 0-75.3%). On the basis of CD25 expression in bone marrow blasts from healthy volunteers (n=5; median, 3.2%; range, 1.5-5.6%), we defined CD25 expression >10% as positivity. In this setting, we identified CD25-positive blasts in 21 patients (14%). CD25+AML was characterized by the MDS/MPN history (30%) and, a low or zero frequency of favorable cytogenetics (0%), FAB M2 subtype (5%), and FAB M3 subtype (0%) compared with CD25-AML (n=133). Among the 118 patients who underwent induction chemotherapy, including 75 patients who received a combination of anthracyclin and cytarabine (Ara-C), 69 (58%) achieved complete remission (CR). CD25+AML was associated with an inferior CR rate (20 vs. 64%, respectively, P=0.003), inferior event-free survival (EFS) (1-year EFS, 0 vs. 33%, respectively, P< 0.001), and inferior overall survival (OS) (2-year OS, 13 vs. 38%, respectively, P=0.003) compared with CD25-AML. On multivariate analysis using the following factors: cytogenetics, age (over 75 years), MDS/MPN history, and intensity of induction chemotherapy, CD25-positivity was a significant risk factor for the CR rate (HR: 8.0, 95% CI: 1.7-36.6; P=0.008) and EFS (HR: 2.3, 95% CI: 1.1-4.7; P=0.021). For CD25+AML, the CR rate was higher with induction chemotherapy using a regimen of low-dose Ara-C combined with granulocyte colony-stimulating factor (50%) than that using a regimen of daunorubicine and Ara-C (0%). However, there was no significant difference in OS between patients with CD25+AML treated with induction chemotherapy and those who treated with best supportive care (2-year OS, 13 vs. 11%, respectively, P=0.29). There were no patients with CD25+AML received stem cell transplantation due to disease progression. Conclusion: This study demonstrated that CD25 is an independent prognostic factor for elderly AML patients. The prognosis of CD25+AML patients is extremely poor; therefore, it is necessary to develop alternative approaches, such as a regime including anti-CD25 antibody, therapy targeting leukemia stem cells, and nonmyeloablative stem cell transplantation. Disclosures No relevant conflicts of interest to declare.


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