Speciality
Spotlight

 




 


Oncology


 

 





Leukemia

   

  • Dighiero G, for the French Co-operative Group on Chronic Lymphocytic Leukemia [Institut Pasteur, Paris; Hopital Pitie- Salpetriere, Paris; Centre Hospitalier Regional-Hopital Sud, Ameins, France; et al]

    Chlorambucil in Indolent Chronic Lymphocytic Leukemia

    N Engl J Med 338: 1506-1514, 1998

          

    Two randomized trials were conducted to determine whether the alkylating agent chlorambucil, can relieve symptoms and improve survival In patients with stage A indolent form CLL. 

        

    Neither trial indicated a survival benefit. The advantage of deferring treatment to stage B or stage C includes the postponement of the side effects of cytotoxic therapy. 

        

    The editor comments a higher rate of secondary malignancy due to prolonged use of alkylating agent,
    which was not observed by the Italian Cooperative Trial published earlier but in this French study acute myelogenous leukemia in 6 cases was reported compared to none in the patients who did not receive the drug.

          

  • Cheson BD, Sorensen JM, Vena DA, et al [ NIH, Bethesda, Md; EMMES Corp, Potomac, Md]

    Treatment of Hairy Cell Leukemia with 2-Chlorodeoxyadenosine via the Group C Protocol Mechanism of the National Cancer Institute: A Report of 979 Patients

    J Clin Oncol 16: 3007-3015, 1998

          

    Complete remission with cladribine [CdA] has been well reported. The response rate, duration, survival and toxicity were assessed in group C treatment protocol of the NCI.

         

    The CdA administered as 0.1 mg/kg/day as 7-day continuous intravenous infusion in HCL patients led to CR & PR in 50% & 37% respectively. At a median follow-up of 52 months, 12% of patients had disease progression and 7% died of disease. The possible increased risk of second malignancy need additional information. These response rates were lower than those in earlier studies. Previous therapy with interferon did not affect survival rates while earlier therapy with deoxycorfomycin led to lower 4-year survival rates.

      

  • Niu C, Yan H, Yu T, et al [Shanghai Second Med Univ, China; Harbin Med Univ, China]

    Studies on Treatment of Acute Promyelocytic Leukemia With Arsenic Trioxide: Remission Induction, Follow-up, and Molecular Monitoring in 11 Newly Diagnosed and 47 Relapsed Acute Promyelocytic Leukemia Patients

    Blood 94: 3315-3324, 1999

       


    This study is of patients with Acute Promyelocytic Leukemia, 11 in untreated and 47 patients with relapse received Arsenic Trioxide 10mg daily for 6 weeks those not in CR after two courses received chemotherapy. CR was achieved in 85.1% of patients with relapse. The toxicity was mild and is, a new treatment option in patients with
    APML.

       

  • Estey EH, Thall PF, Pierce S, et al (Univ of Texas MD Anderson Cancer Ctr, Houston)

    Randomized Phase II study of Fludarabine + Cytosine Arabinoside + Idarubicin ± All-trans Retinoic Acid ± Granulocyte Colony-Stimulating Factor in Poor Prognosis Newly Diagnosed Acute Myeloid Leukemia and Myelodysplastic
    Syndrome
    .

    Blood 93: 2478-2484, 1999.

        


    All-trans retinoic acid (ARTA) lowers the concentrations of antipoptotic proteins including bcl-2, thus possibly improving the outcome of chemotherapy and G-CSF may be synergistic with ATRA. This randomized study of 153 patients with newly diagnosed AML and 62 patients with high-risk myelodysplastic syndrome received Fludarabine, cytosine, idarubicin, ATRA and G-CSF in various combinations.

       


    The addition of ATRA with or without G-CSF to idarubicin did not alter CR rate, survival, event free survival in newly diagnosed AML or high risk myelodysplastic syndrome.

            


 

 



 

 

Speciality Spotlight

 

 

Leukemia
   

  • Dighiero G, for the French Co-operative Group on Chronic Lymphocytic Leukemia [Institut Pasteur, Paris; Hopital Pitie- Salpetriere, Paris; Centre Hospitalier Regional-Hopital Sud, Ameins, France; et al]
    Chlorambucil in Indolent Chronic Lymphocytic Leukemia
    N Engl J Med 338: 1506-1514, 1998
          
    Two randomized trials were conducted to determine whether the alkylating agent chlorambucil, can relieve symptoms and improve survival In patients with stage A indolent form CLL. 
        
    Neither trial indicated a survival benefit. The advantage of deferring treatment to stage B or stage C includes the postponement of the side effects of cytotoxic therapy. 
        
    The editor comments a higher rate of secondary malignancy due to prolonged use of alkylating agent, which was not observed by the Italian Cooperative Trial published earlier but in this French study acute myelogenous leukemia in 6 cases was reported compared to none in the patients who did not receive the drug.
          

  • Cheson BD, Sorensen JM, Vena DA, et al [ NIH, Bethesda, Md; EMMES Corp, Potomac, Md]
    Treatment of Hairy Cell Leukemia with 2-Chlorodeoxyadenosine via the Group C Protocol Mechanism of the National Cancer Institute: A Report of 979 Patients
    J Clin Oncol 16: 3007-3015, 1998
          
    Complete remission with cladribine [CdA] has been well reported. The response rate, duration, survival and toxicity were assessed in group C treatment protocol of the NCI.
         
    The CdA administered as 0.1 mg/kg/day as 7-day continuous intravenous infusion in HCL patients led to CR & PR in 50% & 37% respectively. At a median follow-up of 52 months, 12% of patients had disease progression and 7% died of disease. The possible increased risk of second malignancy need additional information. These response rates were lower than those in earlier studies. Previous therapy with interferon did not affect survival rates while earlier therapy with deoxycorfomycin led to lower 4-year survival rates.
      

  • Niu C, Yan H, Yu T, et al [Shanghai Second Med Univ, China; Harbin Med Univ, China]
    Studies on Treatment of Acute Promyelocytic Leukemia With Arsenic Trioxide: Remission Induction, Follow-up, and Molecular Monitoring in 11 Newly Diagnosed and 47 Relapsed Acute Promyelocytic Leukemia Patients
    Blood 94: 3315-3324, 1999
       
    This study is of patients with Acute Promyelocytic Leukemia, 11 in untreated and 47 patients with relapse received Arsenic Trioxide 10mg daily for 6 weeks those not in CR after two courses received chemotherapy. CR was achieved in 85.1% of patients with relapse. The toxicity was mild and is, a new treatment option in patients with APML.
       

  • Estey EH, Thall PF, Pierce S, et al (Univ of Texas MD Anderson Cancer Ctr, Houston)
    Randomized Phase II study of Fludarabine + Cytosine Arabinoside + Idarubicin ± All-trans Retinoic Acid ± Granulocyte Colony-Stimulating Factor in Poor Prognosis Newly Diagnosed Acute Myeloid Leukemia and Myelodysplastic Syndrome.
    Blood 93: 2478-2484, 1999.
        
    All-trans retinoic acid (ARTA) lowers the concentrations of antipoptotic proteins including bcl-2, thus possibly improving the outcome of chemotherapy and G-CSF may be synergistic with ATRA. This randomized study of 153 patients with newly diagnosed AML and 62 patients with high-risk myelodysplastic syndrome received Fludarabine, cytosine, idarubicin, ATRA and G-CSF in various combinations.
       
    The addition of ATRA with or without G-CSF to idarubicin did not alter CR rate, survival, event free survival in newly diagnosed AML or high risk myelodysplastic syndrome.
            

 

 

 

By |2022-07-20T16:42:22+00:00July 20, 2022|Uncategorized|Comments Off on Leukemia

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