Early results of intensified remission induction chemotherapy for childhood acute lymphocytic leukemia

1986 ◽  
Vol 14 (3) ◽  
pp. 177-181 ◽  
Author(s):  
Gaston K. Rivera ◽  
Stephen L. George ◽  
Dorothy Williams ◽  
A. Thomas Look ◽  
Minnie Abromowitch ◽  
...  
Keyword(s):  
Induction Chemotherapy ◽  
Acute Lymphocytic Leukemia ◽  
Lymphocytic Leukemia ◽  
Remission Induction ◽  
Early Results

Vincristine and prednisone vs vincristine, l-asparaginase, and prednisone for second remission induction of acute lymphocytic leukemia in children

1979 ◽  
Vol 6 (4) ◽  
pp. 317-323 ◽  
Author(s):  
Jay Herson ◽  
Kenneth A. Starling ◽  
Paul G. Dyment ◽  
G. Bennett Humphrey ◽  
Jeanette Pullen ◽  
...  
Keyword(s):  
Acute Lymphocytic Leukemia ◽  
Lymphocytic Leukemia ◽  
Remission Induction ◽  
Leukemia In Children

scholarly journals Intensive chemotherapy with mitoxantrone and high-dose cytosine arabinoside followed by granulocyte-macrophage colony-stimulating factor in the treatment of patients with acute lymphocytic leukemia

Blood ◽  
1992 ◽  
Vol 79 (4) ◽  
pp. 876-881 ◽  
Author(s):  
HM Kantarjian ◽  
EH Estey ◽  
S O'Brien ◽  
E Anaissie ◽  
M Beran ◽  
...  
Keyword(s):  
Acute Lymphocytic Leukemia ◽  
Complete Response ◽  
Lymphocytic Leukemia ◽  
Remission Induction ◽  
Intensive Chemotherapy ◽  
Colony Stimulating Factor ◽  
Gm Csf ◽  
Macrophage Colony Stimulating Factor ◽  
Macrophage Colony ◽  
Stimulating Factor

Abstract Thirty-four adults with refractory acute lymphocytic leukemia received salvage therapy with mitoxantrone 5 mg/m2 intravenously over 1 hour daily for 5 days and cytosine arabinoside (ara-C) 3 g/m2 intravenously over 2 hours every 12 hours for six doses, followed by granulocyte- macrophage colony-stimulating factor (GM-CSF) 125 microgram/m2 intravenously over 4 hours daily until recovery of granulocytes above 2.0 x 10(3)/microL. Their outcome was compared with 29 prognostically similar historical control patients treated with the identical chemotherapy without GM-CSF. Overall, the complete response rates were similar in the treatment and control groups (13 of 34 [38%] v 11 of 29 [38%]). There was a trend for less remission induction mortality in the GM-CSF-treated patients (2 of 34 [6%] v 6 of 29 [21%]; P = .08), but, conversely, a higher rate of resistant disease (19 of 34 [56%] v 10 of 29 [34%]; P = .09). Recovery of granulocyte counts above 500/microL was significantly faster in the GM-CSF-treated group (25 days v 33 days; P less than .01), but there was no reduction in the incidence of febrile episodes (91% v 93%) or of documented infections (59% v 59%). Survival was prolonged in the GM-CSF-treated patients but was not of clinical relevance (31 v 20 weeks; P = .05). In summary, the addition of GM-CSF to intensive chemotherapy in refractory adult ALL was associated with a reduction in the remission induction mortality, probably secondary to a shorter duration of granulocytopenia, but not with an improvement in complete response rates.

Cutaneous Mucormycosis during Induction Chemotherapy for Acute Lymphocytic Leukemia

2004 ◽  
Vol 45 (1) ◽  
pp. 199-200 ◽  
Author(s):  
MAKI TAKABAYASHI ◽  
RIKA SAKAI ◽  
HIROSHI SAKAMOTO ◽  
MIWA KAKINUMA ◽  
YOICHI IEMOTO ◽  
...  
Keyword(s):  
Induction Chemotherapy ◽  
Acute Lymphocytic Leukemia ◽  
Lymphocytic Leukemia ◽  
Cutaneous Mucormycosis

Longitudinal Assessment of Nutritional Status in Adults with Acute Leukemia.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4360-4360
Author(s):  
Aurora Serralde ◽  
Erick Crespo-Solis ◽  
Xavier Lopez-Karpovitch ◽  
Ericka Damasco ◽  
Adriana Rosas-Lopez ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Acute Leukemia ◽  
Induction Chemotherapy ◽  
Nutritional Assessment ◽  
Demographic Data ◽  
Laboratory Data ◽  
Length Of Hospital Stay ◽  
Lymphocytic Leukemia ◽  
Remission Induction ◽  
Longitudinal Assessment

Abstract RATIONALE: The nutritional status of patients with acute leukemia (AL) is frequently impaired during intensive induction chemotherapy. Previous studies have suggested that malnutrition may have an adverse effect on prognosis. The aim of the study was to determine the prevalence of malnutrition during induction chemotherapy treatment and its impact on the outcome. METHODS: The study was performed over a period of 18 consecutive months. Acute leukemia patients were prospectively studied during first remission induction chemotherapy. The Subjective Global Assessment (SGA), anthropometric and laboratory data were determined at diagnosis and on day 30 of the treatment in order to evaluate nutritional status. Patients were prospectively followed until 60 days after diagnosis. An analysis was made including demographic data, nutritional assessment, albumin, complications, rate of complete remission (CR), rate of early mortality (EM) and length of hospital stay (LOS). RESULTS: 32 patients (18 men, 14 women) were included; median age 31 years (range 15–62); 16 with myeloid leukemia, 13 with lymphocytic leukemia and 3 with hybrid leukemia. The median of body mass index (BMI) was 25 kg/m2 (18.3–41.7); triceps skinfold (TSF) 16.5 mm (7–42); albumin 3.24 g/dL (1.98–4.18). At diagnosis, the prevalence of malnutrition was 59% according to the SGA (moderately and severely malnourished) and increased to 90% on day 30, (p<0.05). We obtained initial CR in 22 patients (69%), the mortality rate due to post-chemotherapy aplasia (EM) in the prospective cohort was 9%. Patients with deterioration of the nutritional status had longer LOS in comparison with those patients well nourished (15.61 vs. 9.68 p<0.05). They also needed antibiotics for a longer time (16 vs. 10 days, p< 0.05). Nutritional status was not associated with CR rate or EM rate. CONCLUSIONS: The high incidence of malnutrition at the time of diagnosis and during chemotherapy indicate the importance of nutritional status evaluation. Malnutrition in AL is caused by chemotherapy side effects and/or the disease itself, during this period intensive supportive care, including nutritional therapy is required.

Management of adult acute lymphocytic leukemia: present issues and key challenges.

1994 ◽  
Vol 12 (6) ◽  
pp. 1312-1322 ◽  
Author(s):  
A Preti ◽  
H M Kantarjian
Keyword(s):  
T Cell ◽  
High Risk ◽  
Maintenance Therapy ◽  
Acute Lymphocytic Leukemia ◽  
Lymphocytic Leukemia ◽  
Remission Induction ◽  
High Risk Patients ◽  
Risk Patients ◽  
First Remission ◽  
Adult Acute Lymphocytic Leukemia

PURPOSE To discuss the controversies in current adult acute lymphocytic leukemia (ALL) management in relation to its different phases of therapy. DESIGN A review of treatments in adult ALL from the English literature. RESULTS Features signaling high risk for systemic relapse (older age, high WBC count at diagnosis, non-T-cell immunophenotype, Philadelphia chromosome (Ph)-positive karyotype, and longer time to achieve remission) are found in 60% to 70% of patients with adult ALL. These patients have a potential cure rate of 20% to 25%, compared with 60% to 70% for low-risk patients. Induction regimens with vincristine, anthracyclines, and corticosteroids appear to be optimal. Intensification-consolidation therapy increased cure rates modestly in adult ALL; higher-dose schedules of mercaptopurine (6-MP), methotrexate, and asparaginase may be beneficial. Maintenance therapy with 6-MP and methotrexate is suggested based on the worse outcome of patients in whom such maintenance was omitted. Allogeneic bone marrow transplantation (BMT) is indicated for patients in first remission with high-risk for relapse; autologous BMT for patients in first remission remains investigational. Patients with mature B-cell ALL require short-term, dose-intensive therapy that alternates hyperfractionated doses of cyclophosphamide with high-dose cytarabine (ara-C) and methotrexate. Patients with T-cell ALL may benefit from ara-C/cyclophosphamide combinations during maintenance therapy. CNS prophylaxis with intrathecal chemotherapy should be administered in patients at risk for CNS relapse. CONCLUSION Potential strategies to improve the prognosis of high-risk patients with ALL include increasing the dose-intensity of remission induction and consolidation-intensification therapies with growth factor support; discovering and using new anti-ALL drugs; improving autologous BMT results; translating biologic studies of leukemia cell characteristics, karyotype-related molecular aberrations, abnormal oncogenic expression, and minimal residual disease into clinically relevant therapies; and using investigational treatment strategies in high-risk patients.

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