1
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Diao S, Nichols ED, DiNardo C, Konopleva M, Ning J, Qiao W, Maiti A, DiPippo AJ. Incidence of tumor lysis syndrome in patients with acute myeloid leukemia undergoing low-intensity induction with venetoclax. Am J Hematol 2021; 96:E65-E68. [PMID: 33259075 PMCID: PMC10641872 DOI: 10.1002/ajh.26060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/25/2020] [Accepted: 11/29/2020] [Indexed: 11/11/2022]
MESH Headings
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Bridged Bicyclo Compounds, Heterocyclic/administration & dosage
- Bridged Bicyclo Compounds, Heterocyclic/adverse effects
- Cytarabine/therapeutic use
- Decitabine/administration & dosage
- Female
- Fluid Therapy
- Humans
- Hydroxyurea/therapeutic use
- Incidence
- Leukemia, Myeloid, Acute/complications
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myelomonocytic, Acute/complications
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/genetics
- Leukocytosis/drug therapy
- Leukocytosis/etiology
- Male
- Middle Aged
- Phosphate-Binding Proteins/therapeutic use
- Phosphorus/blood
- Proto-Oncogene Proteins c-bcl-2/antagonists & inhibitors
- Retrospective Studies
- Sulfonamides/administration & dosage
- Sulfonamides/adverse effects
- Tumor Lysis Syndrome/etiology
- Urate Oxidase/therapeutic use
- Uric Acid/blood
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Affiliation(s)
- Stacy Diao
- Division of Pharmacy – The University of Texas MD Anderson Cancer Center, Houston, Texas, 77030
| | - E Dan Nichols
- Division of Pharmacy – The University of Texas MD Anderson Cancer Center, Houston, Texas, 77030
| | - Courtney DiNardo
- Department of Leukemia – The University of Texas MD Anderson Cancer Center, Houston, Texas, 77030
| | - Marina Konopleva
- Department of Leukemia – The University of Texas MD Anderson Cancer Center, Houston, Texas, 77030
| | - Jing Ning
- Department of Biostatistics – The University of Texas MD Anderson Cancer Center, Houston, Texas, 77030
| | - Wei Qiao
- Department of Biostatistics – The University of Texas MD Anderson Cancer Center, Houston, Texas, 77030
| | - Abhishek Maiti
- Department of Leukemia – The University of Texas MD Anderson Cancer Center, Houston, Texas, 77030
| | - Adam J DiPippo
- Division of Pharmacy – The University of Texas MD Anderson Cancer Center, Houston, Texas, 77030
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2
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Lyle L, Daver N. Current and emerging therapies for patients with acute myeloid leukemia: a focus on MCL-1 and the CDK9 pathway. Am J Manag Care 2018; 24:S356-S365. [PMID: 30132679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Acute myeloid leukemia (AML) is an aggressive hematologic malignancy that largely impacts the elderly population. Not all AML patients are candidates for the mainstay induction and consolidation treatment options. In addition, despite available therapies, most patients will eventually relapse on, or be refractory to, standard induction therapy, with limited subsequent choices and poor prognosis. Recently, several new and emerging therapies, with a variety of mechanisms of action, have broadened the treatment landscape in newly diagnosed and relapsed/refractory (R/R) AML, providing patients and healthcare providers with more options and several targeted treatment approaches. Preclinical data indicate that the anti-apoptotic protein myeloid cell leukemia-1 (MCL-1) is important to AML cell survival. Cyclin-dependent kinase 9 (CDK9), a transcriptional activator necessary for the expression of MCL-1, represents a promising target for future AML therapies. A number of CDK9 inhibitors, as well as several direct MCL-1 inhibitors, are currently in clinical or preclinical development. The CDK9 inhibitors alvocidib, atuveciclib, and TG02 have completed phase 1/2 clinical trials, with results available for the alvocidib trial showing improved complete remission rates (70% vs 46%; P = .003) for alvocidib in combination with cytarabine and mitoxantrone, versus cytarabine/daunorubicin, in patients with newly diagnosed AML. In addition, several phase 1 clinical trials with CDK9 inhibitors are currently recruiting for treatment of advanced AML. A phase 1b study is also ongoing to investigate alvocidib in combination with B-cell lymphoma-2 inhibitor venetoclax for R/R AML. Although further research is needed, CDK9 inhibitors represent a promising new approach for the treatment of AML.
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Affiliation(s)
- Lindsey Lyle
- Blood Disorders Center, Department of Hematology, University of Colorado Hospital, Aurora, CO.
| | - Naval Daver
- Department of Leukemia at The University of Texas, MD Anderson Cancer Center, Houston, TX.
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3
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Safavi M, Safaei A, Hosseini M. t(9;19)(q22;p13) in Acute Myelomonocytic Leukemia. Turk J Haematol 2018; 35:89-90. [PMID: 29391333 PMCID: PMC5843787 DOI: 10.4274/tjh.2017.0368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 12/28/2017] [Indexed: 12/05/2022] Open
MESH Headings
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biopsy
- Bone Marrow/pathology
- Chromosomes, Human, Pair 19
- Chromosomes, Human, Pair 9
- Fatal Outcome
- Humans
- Immunophenotyping
- Karyotyping
- Leukemia, Myelomonocytic, Acute/diagnosis
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/genetics
- Male
- Middle Aged
- Translocation, Genetic
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Affiliation(s)
- Moeinadin Safavi
- Tehran University Faculty of Medicine, Department of Pathology, Molecular Pathology and Cytogenetic Ward, Tehran, Iran
- Shiraz University of Faculty of Medicine, Department of Pathology, Molecular Pathology and Cytogenetic Ward, Shiraz, Iran
| | - Akbar Safaei
- Shiraz University of Faculty of Medicine, Department of Pathology, Molecular Pathology and Cytogenetic Ward, Shiraz, Iran
| | - Marzieh Hosseini
- Shiraz University of Faculty of Medicine, Department of Pathology, Molecular Pathology and Cytogenetic Ward, Shiraz, Iran
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4
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Raja-Sabudin RZA, Othman A, Ahmed-Mohamed KAE, Ithnin A, Alauddin H, Alias H, Abdul-Latif Z, Das S, Abdul-Wahid FS, Hussin NH. Immature reticulocyte fraction is an early predictor of bone marrow recovery post chemotherapy in patients with acute leukemia. Saudi Med J 2014; 35:346-349. [PMID: 24749130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVE To establish the benefits of immature reticulocyte fraction (IRF) measurement using an automated hematology cells analyzer over absolute neutrophil count (ANC) in predicting bone marrow recovery post induction chemotherapy. METHODS A prospective observational study was carried out in the Departments of Pathology, Medicine, and Pediatrics, Universiti Kebangsaan Malaysia, Medical Center (UKMMC), Kuala Lumpur, Malaysia during a period of 19 months from April 2009 to December 2010 to assess the bone marrow recovery in patients with acute leukemia. A total of 22 patients in remission induction phases were enrolled in this study. The blood specimens were collected from day zero after chemotherapy, and every 3 days until patients recovered hematologically. All blood samples were measured for ANC and IRF using an automated hematology analyzer (Beckman-Coulter LH750). RESULTS The percentage of patients showing IRF recovery earlier than ANC recovery was 63.6% (14 out of 22 patients). There was a significant difference in the mean number of days for IRF recovery as compared with ANC recovery (14.05 and 17.18 days), p=0.005. CONCLUSION This study proved that IRF was more useful in predicting bone marrow recovery in a patient with acute leukemia post induction chemotherapy compared with ANC. The IRF is not affected by infection, is easily measured, and inexpensive; thus, it is a reliable parameter to evaluate bone marrow reconstitution.
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Affiliation(s)
- Raja-Zahratul A Raja-Sabudin
- Department of Pathology, University Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Bandar Tun Razak 56000, Kuala Lumpur, Malaysia. Tel. +603 (9) 1455555 Ext. 5780/5356. Fax. +603 (9) 1737340. E-mail:
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5
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Abstract
We report a breast cancer patient who developed acute myeloid leukemia (AML) one year following her adjuvant chemotherapy consisting of cyclophosphamide, adriamycin and 5-fluorouracil. Cytogenetic examination of bone marrow samples resulted in t(8;16)(p11.2;p13.3), which is a chromosome rearrangement observed in de novo and treatment related AML M4/M5 with a poor prognosis.
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MESH Headings
- Anastrozole
- Antineoplastic Agents, Hormonal/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Bone Marrow/pathology
- Breast Neoplasms/drug therapy
- Breast Neoplasms/pathology
- Breast Neoplasms/radiotherapy
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/radiotherapy
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Lobular/drug therapy
- Carcinoma, Lobular/pathology
- Carcinoma, Lobular/radiotherapy
- Carcinoma, Lobular/surgery
- Chemotherapy, Adjuvant/adverse effects
- Chromosomes, Human, Pair 16/genetics
- Chromosomes, Human, Pair 16/ultrastructure
- Chromosomes, Human, Pair 8/genetics
- Chromosomes, Human, Pair 8/ultrastructure
- Combined Modality Therapy
- Cyclophosphamide/administration & dosage
- Cyclophosphamide/adverse effects
- Cytarabine/administration & dosage
- Doxorubicin/administration & dosage
- Doxorubicin/adverse effects
- Estrogens
- Fatal Outcome
- Female
- Fluorouracil/administration & dosage
- Fluorouracil/adverse effects
- Humans
- Idarubicin/administration & dosage
- Leukemia, Myelomonocytic, Acute/chemically induced
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/genetics
- Leukemia, Myelomonocytic, Acute/pathology
- Mastectomy, Modified Radical
- Middle Aged
- Neoplasms, Hormone-Dependent/drug therapy
- Neoplasms, Hormone-Dependent/pathology
- Neoplasms, Hormone-Dependent/surgery
- Neoplasms, Multiple Primary/drug therapy
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/radiotherapy
- Neoplasms, Multiple Primary/surgery
- Neoplasms, Second Primary/drug therapy
- Neoplasms, Second Primary/genetics
- Neoplasms, Second Primary/pathology
- Nitriles/therapeutic use
- Radiotherapy, Adjuvant
- Translocation, Genetic
- Triazoles/therapeutic use
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Affiliation(s)
- Feride Iffet Sahin
- Baskent University Faculty of Medicine, Department of Medical Genetics, Ankara, Turkey.
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6
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Kato A, Ono Y, Nagahata Y, Yamauchi N, Tabata S, Yonetani N, Matsushita A, Ishikawa T. The need for continuing chemotherapy for leukemic cell lysis pneumopathy in patients with acute myelomonocytic/monocytic leukemia. Intern Med 2013; 52:1217-21. [PMID: 23728559 DOI: 10.2169/internalmedicine.52.9117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Although fatal pulmonary complications frequently occur during the course of acute leukemia, a minor proportion of the complications are due to leukemia itself. Infections, drug reactions and concomitant medical conditions are the major causes of respiratory distress in leukemic patients. We treated four patients with acute myeloid leukemia complicated by leukemic cell lysis pneumopathy (LCLP). All of the patients had leukemia of monocytoid origin and their respiratory function deteriorated soon after chemotherapy initiation. Although two of the patients required mechanical ventilation, all four improved after continued chemotherapy. Our experience indicates that, in cases of LCLP, chemotherapy should be continued with maximal respiratory support.
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MESH Headings
- Adolescent
- Aged
- Cell Death/physiology
- Female
- Humans
- Leukemia, Monocytic, Acute/blood
- Leukemia, Monocytic, Acute/diagnosis
- Leukemia, Monocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/blood
- Leukemia, Myelomonocytic, Acute/diagnosis
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemic Infiltration/blood
- Leukemic Infiltration/diagnosis
- Leukemic Infiltration/drug therapy
- Male
- Middle Aged
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Affiliation(s)
- Aiko Kato
- Departments of Hematology and Clinical Immunology, Kobe City Medical Center General Hospital, Japan.
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7
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Cheng X, Quintás-Cardama A, Golemovic M, Zingaro R, Gao MZ, Freireich EJ, Andreeff M, Kantarjian HM, Verstovsek S. The organic arsenic derivative GMZ27 induces PML-RARα-independent apoptosis in myeloid leukemia cells. Anticancer Res 2012; 32:2871-2880. [PMID: 22753750 PMCID: PMC5166574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Arsenic trioxide (ATO) is an inorganic arsenic derivative that is very effective against acute promyelocytic leukemia. However, organic arsenic derivatives (OAD) have a more favorable toxicity profile than ATO. We herein characterized dipropil-S-glycerol arsenic (GMZ27), a novel OAD. GMZ27 had potent antiproliferative activity against human acute myeloid leukemia (AML) cell lines that was higher than that of ATO. In contrast to ATO, GMZ27 only marginally induced maturation of leukemia cells and had no effect on the cell cycle. The anti-leukemia activity of GMZ27 against AML cells was independent of the presence of the PML-RARα fusion protein. GMZ27 dissipates mitochondrial transmembrane potential, and induces cleavage of caspase 9 and activation of caspase 3 without altering the expression levels of (BCL-2), BAX and BCL-xl. GMZ27 induces the formation of intracellular superoxide, a reactive oxygen species (ROS) which plays a major role in the antileukemia activity of this OAD. In addition to ROS generation, GMZ27 concomitantly reduces intracellular glutathione which markedly weakens the cellular antioxidant capacity, thus enhancing the detrimental intracellular effects of ROS production. These results indicate that GMZ27 induces apoptosis in AML cells in a PML-RARα-independent fashion, through the induction of ROS production. This activity provides the rationale for the testing of GMZ27 in patients with AML.
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MESH Headings
- Animals
- Antineoplastic Agents/pharmacology
- Apoptosis/drug effects
- Apoptosis/physiology
- Arsenic Trioxide
- Arsenicals/pharmacology
- Caspase 9/metabolism
- Cell Cycle/drug effects
- Cell Growth Processes/drug effects
- Cell Line, Tumor
- Dose-Response Relationship, Drug
- Enzyme Activation/drug effects
- Female
- HL-60 Cells
- Humans
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/metabolism
- Leukemia, Myelomonocytic, Acute/pathology
- Leukemia, Promyelocytic, Acute/drug therapy
- Leukemia, Promyelocytic, Acute/metabolism
- Leukemia, Promyelocytic, Acute/pathology
- Mice
- Oncogene Proteins, Fusion/biosynthesis
- Oxides/pharmacology
- Oxygen/metabolism
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Affiliation(s)
- Xiaodong Cheng
- Anderson Cancer Center, Department of Leukemia, Unit 428, 1515 Holcombe Blvd., Houston, TX 77030, USA
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8
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Fredly H, Reikvam H, Gjertsen BT, Bruserud O. Disease-stabilizing treatment with all-trans retinoic acid and valproic acid in acute myeloid leukemia: serum hsp70 and hsp90 levels and serum cytokine profiles are determined by the disease, patient age, and anti-leukemic treatment. Am J Hematol 2012; 87:368-76. [PMID: 22374841 DOI: 10.1002/ajh.23116] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Revised: 11/30/2011] [Accepted: 12/29/2011] [Indexed: 02/05/2023]
Abstract
Heat shock protein (HSP) 70 and HSP90 are released by primary human acute myeloid leukemia (AML) cells during stress-induced spontaneous in vitro apoptosis. The AML cells also show constitutive release of several cytokines and the systemic serum levels of several soluble mediators are altered in patients with untreated AML. In the present study, we have investigated serum levels of HSP70/HSP90 and the serum cytokine profiles of patients with untreated AML and patients receiving AML-stabilizing palliative treatment based on all-trans retinoic acid (ATRA) plus valproic acid. Patients with untreated AML showed increased HSP90 levels and a distinct serum cytokine profile when compared with healthy controls, and low pre-therapy HSP90 levels were associated with a prolonged survival during treatment with ATRA + valproic acid + theophyllin. Hierarchical cluster analysis showed a close association between HSP70, HSP90, IL-1 receptor antagonist (IL-1ra), and hepatocyte growth factor (HGF) levels. Furthermore, disease-stabilizing therapy altered the serum-cytokine profile, but the correlations between HSP70/HSP90/IL-1ra/HGF were maintained only when ATRA + valproic acid were combined with theophyllin but not when combined with cytarabine. We conclude that both HSP levels and serum cytokine profiles are altered and may represent possible therapeutic targets or prognostic markers in human AML.
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MESH Headings
- Adult
- Age Factors
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Cytarabine/administration & dosage
- Cytokines/blood
- Female
- HSP70 Heat-Shock Proteins/blood
- HSP90 Heat-Shock Proteins/blood
- Humans
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/immunology
- Leukemia, Myelomonocytic, Acute/blood
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/immunology
- Male
- Middle Aged
- Neoplasm Proteins/blood
- Palliative Care
- Prognosis
- Theophylline/administration & dosage
- Tretinoin/administration & dosage
- Tretinoin/pharmacology
- Tumor Cells, Cultured/drug effects
- Tumor Cells, Cultured/metabolism
- Valproic Acid/administration & dosage
- Valproic Acid/pharmacology
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Affiliation(s)
- Hanne Fredly
- Section for Hematology, Institute of Medicine, University of Bergen, Bergen, Norway.
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9
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Eghtedar A, Borthakur G, Ravandi F, Jabbour E, Cortes J, Pierce S, Kantarjian H, Garcia-Manero G. Characteristics of translocation (16;16)(p13;q22) acute myeloid leukemia. Am J Hematol 2012; 87:317-8. [PMID: 22228403 DOI: 10.1002/ajh.22258] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Accepted: 11/17/2011] [Indexed: 11/10/2022]
Abstract
A subgroup of patients with core binding factor acute myeloid leukemias (AML) is characterized by the presence of the fusion gene CBFb-Myh11. At the cytogenetic level, most of these patients are identified by the presence of an inversion of chromosome 16 [inv(16)(p13q22)] and rarely by a translocation t(16;16)(p13;q22). The aim of this study is to describe the natural history of patients with t(16;16) [N = 6] treated at MD Anderson Cancer Center and compared them with a cohort of patients with inv(16)(p13q22) [n = 61]. In patients with t(16;16) the complete remission rate (CR) was 100% when treated with a combination of fludarabine and high-dose cytarabine. Median overall survival (OS) had not been achieved. There was no difference in response or OS or progression free survival between both groups. Presence of additional chromosomal abnormalities and molecular aberrations had no effect on prognosis. In conclusion, and consistent with previous reports, the natural history of patients with t(16:16)(p13;q22) is similar to that of classic patients with inv16 AML and therefore should be treated similarly.
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MESH Headings
- Adult
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Chromosome Inversion
- Chromosomes, Human, Pair 16/genetics
- Chromosomes, Human, Pair 16/ultrastructure
- Cytarabine/administration & dosage
- Disease-Free Survival
- Female
- Humans
- Kaplan-Meier Estimate
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/genetics
- Male
- Middle Aged
- Oncogene Proteins, Fusion/genetics
- Remission Induction
- Retrospective Studies
- Translocation, Genetic
- Vidarabine/administration & dosage
- Vidarabine/analogs & derivatives
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Affiliation(s)
- Alireza Eghtedar
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
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10
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Sonoi N, Soga Y, Maeda H, Ichimura K, Yoshino T, Aoyama K, Fujii N, Maeda Y, Tanimoto M, Logan R, Raber-Durlacher J, Takashiba S. Histological and immunohistochemical features of gingival enlargement in a patient with AML. Odontology 2011; 100:254-7. [PMID: 22075755 DOI: 10.1007/s10266-011-0051-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2011] [Accepted: 10/30/2011] [Indexed: 11/26/2022]
Abstract
Here, we discuss the pathophysiology of leukemia-associated gingival enlargement based on a case of acute myelomonocytic leukemia (AML-M4) with typical gingival enlargement. Uniquely, this patient was well enough to allow full periodontal examination and incisional gingival biopsy to be performed both before and after chemotherapy. The patient was a 39-year-old Japanese woman with AML-M4 showing gingival enlargement. Histological and immunohistochemical features of gingiva and bacterial counts in the periodontal pockets were examined before and after chemotherapy. The results were as follows: (1) infiltration of myelomonocytic blasts in enlarged gingiva; (2) resolution of gingival enlargement with complete remission of AML by anticancer chemotherapy; and (3) the numbers of bacteria in the periodontal pockets were not high and were not altered before or after chemotherapy. In patients with AML-M4, remarkable mucosal enlargement is not generally observed in the body except in the gingiva. We hypothesized that antigens derived from periodontal bacteria, even if they are not present in large numbers, could act as chemoattractants for myelomonocytic leukemic cells.
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Affiliation(s)
- Norihiro Sonoi
- Department of Patho-physiology-Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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11
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Fukushima T, Kawabata H, Nakamura T, Iwao H, Nakajima A, Miki M, Sakai T, Sawaki T, Fujita Y, Tanaka M, Masaki Y, Hirose Y, Umehara H. Iron chelation therapy with deferasirox induced complete remission in a patient with chemotherapy-resistant acute monocytic leukemia. Anticancer Res 2011; 31:1741-1744. [PMID: 21617233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND A patient with chemotherapy-resistant acute monocytic leukemia who achieved complete remission (CR) after iron chelation therapy (ICT) with deferasirox is reported for the first time. A 73-year-old Japanese man with acute monocytic leukemia who was refractory to conventional remission induction chemotherapies achieved a partial response, with some improvement of his hemoglobin level and white blood cell count after gemtuzumab ozogamicin (GO) treatment. Seven months after GO treatment, the disease relapsed and the patient developed pancytopenia. He declined further chemotherapy, and started receiving 1,200-1,800 ml of packed red blood cell transfusion per month together with ICT with deferasirox (baseline serum ferritin level was 1,412 ng/ml). Twelve months after the initiation of deferasirox, the patient's serum ferritin level decreased to below 1,000 ng/ml and deferasirox was discontinued. Four months after discontinuation of deferasirox, the blood cell count normalized and the patient became transfusion-independent. Bone marrow aspiration and biopsy revealed hematological and cytogenetic CR. CONCLUSION CR was achieved after ICT with deferasirox in a patient with acute myelogenous leukemia, suggesting that deferasirox may have an antileukemic effect in the clinical setting.
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Affiliation(s)
- Toshihiro Fukushima
- Department of Hematology and Immunology, Kanazawa Medical University, Ishikawa, Japan.
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12
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Grigoleit GU, Kapp M, Tan SM, Unzicker C, Einsele H, Mielke S, Topp MS, Stuhler G. Clofarabine-based salvage chemotherapy for relapsed or refractory acute leukemia before allogeneic stem cell transplantation: results from a case series. Leuk Lymphoma 2010; 50:2071-4. [PMID: 19886845 DOI: 10.3109/10428190903350413] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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13
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Romani C, Di Tucci AA, Dessalvi P, Pettinau M, Emanuele A. Intrathecal chemotherapy and meningeal relapses in myelomonocytic AML. A single institution experience. Am J Hematol 2010; 85:219. [PMID: 20063278 DOI: 10.1002/ajh.21606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
MESH Headings
- Adult
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Bone Marrow Transplantation
- Combined Modality Therapy
- Cytarabine/administration & dosage
- Daunorubicin/administration & dosage
- Etoposide/administration & dosage
- Female
- Humans
- Idarubicin/administration & dosage
- Injections, Spinal
- Leukemia, Monocytic, Acute/drug therapy
- Leukemia, Monocytic, Acute/pathology
- Leukemia, Monocytic, Acute/surgery
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/pathology
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/pathology
- Leukemic Infiltration/drug therapy
- Leukemic Infiltration/prevention & control
- Male
- Meninges/pathology
- Middle Aged
- Mitoxantrone/administration & dosage
- Testis/pathology
- Young Adult
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15
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16
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Fernandez HF, Sun Z, Yao X, Litzow MR, Luger SM, Paietta EM, Racevskis J, Dewald GW, Ketterling RP, Bennett JM, Rowe JM, Lazarus HM, Tallman MS. Anthracycline dose intensification in acute myeloid leukemia. N Engl J Med 2009; 361:1249-59. [PMID: 19776406 PMCID: PMC4480917 DOI: 10.1056/nejmoa0904544] [Citation(s) in RCA: 683] [Impact Index Per Article: 45.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND In young adults with acute myeloid leukemia (AML), intensification of the anthracycline dose during induction therapy has improved the rate of complete remission but not of overall survival. We evaluated the use of cytarabine plus either standard-dose or high-dose daunorubicin as induction therapy, followed by intensive consolidation therapy, in inducing complete remission to improve overall survival. METHODS In this phase 3 randomized trial, we assigned 657 patients between the ages of 17 and 60 years who had untreated AML to receive three once-daily doses of daunorubicin at either the standard dose (45 mg per square meter of body-surface area) or a high dose (90 mg per square meter), combined with seven daily doses of cytarabine (100 mg per square meter) by continuous intravenous infusion. Patients who had a complete remission were offered either allogeneic hematopoietic stem-cell transplantation or high-dose cytarabine, with or without a single dose of the monoclonal antibody gemtuzumab ozogamicin, followed by autologous stem-cell transplantation. The primary end point was overall survival. RESULTS In the intention-to-treat analysis, high-dose daunorubicin, as compared with a standard dose of the drug, resulted in a higher rate of complete remission (70.6% vs. 57.3%, P<0.001) and improved overall survival (median, 23.7 vs. 15.7 months; P=0.003). The rates of serious adverse events were similar in the two groups. Median follow-up was 25.2 months. CONCLUSIONS In young adults with AML, intensifying induction therapy with a high daily dose of daunorubicin improved the rate of complete remission and the duration of overall survival, as compared with the standard dose. (ClinicalTrials.gov number, NCT00049517.)
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MESH Headings
- Adolescent
- Adult
- Age Factors
- Antibiotics, Antineoplastic/administration & dosage
- Antibiotics, Antineoplastic/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Combined Modality Therapy
- Cytarabine/administration & dosage
- Daunorubicin/administration & dosage
- Daunorubicin/adverse effects
- Female
- Histone-Lysine N-Methyltransferase
- Humans
- Infusions, Intravenous
- Kaplan-Meier Estimate
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/genetics
- Leukemia, Myelomonocytic, Acute/mortality
- Leukemia, Myelomonocytic, Acute/therapy
- Male
- Middle Aged
- Mutation
- Myeloid-Lymphoid Leukemia Protein/genetics
- Proportional Hazards Models
- Remission Induction/methods
- Risk Factors
- Stem Cell Transplantation
- Young Adult
- fms-Like Tyrosine Kinase 3/genetics
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Affiliation(s)
- Hugo F Fernandez
- Department of Blood and Marrow Transplantation, Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL 33612, USA.
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17
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Löwenberg B, Ossenkoppele GJ, van Putten W, Schouten HC, Graux C, Ferrant A, Sonneveld P, Maertens J, Jongen-Lavrencic M, von Lilienfeld-Toal M, Biemond BJ, Vellenga E, van Marwijk Kooy M, Verdonck LF, Beck J, Döhner H, Gratwohl A, Pabst T, Verhoef G. High-dose daunorubicin in older patients with acute myeloid leukemia. N Engl J Med 2009; 361:1235-48. [PMID: 19776405 DOI: 10.1056/nejmoa0901409] [Citation(s) in RCA: 624] [Impact Index Per Article: 41.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND A complete remission is essential for prolonging survival in patients with acute myeloid leukemia (AML). Daunorubicin is a cornerstone of the induction regimen, but the optimal dose is unknown. In older patients, it is usual to give daunorubicin at a dose of 45 to 50 mg per square meter of body-surface area. METHODS Patients in whom AML or high-risk refractory anemia had been newly diagnosed and who were 60 to 83 years of age (median, 67) were randomly assigned to receive cytarabine, at a dose of 200 mg per square meter by continuous infusion for 7 days, plus daunorubicin for 3 days, either at the conventional dose of 45 mg per square meter (411 patients) or at an escalated dose of 90 mg per square meter (402 patients); this treatment was followed by a second cycle of cytarabine at a dose of 1000 mg per square meter every 12 hours [DOSAGE ERROR CORRECTED] for 6 days. The primary end point was event-free survival. RESULTS The complete remission rates were 64% in the group that received the escalated dose of daunorubicin and 54% in the group that received the conventional dose (P=0.002); the rates of remission after the first cycle of induction treatment were 52% and 35%, respectively (P<0.001). There was no significant difference between the two groups in the incidence of hematologic toxic effects, 30-day mortality (11% and 12% in the two groups, respectively), or the incidence of moderate, severe, or life-threatening adverse events (P=0.08). Survival end points in the two groups did not differ significantly overall, but patients in the escalated-treatment group who were 60 to 65 years of age, as compared with the patients in the same age group who received the conventional dose, had higher rates of complete remission (73% vs. 51%), event-free survival (29% vs. 14%), and overall survival (38% vs. 23%). CONCLUSIONS In patients with AML who are older than 60 years of age, escalation of the dose of daunorubicin to twice the conventional dose, with the entire dose administered in the first induction cycle, effects a more rapid response and a higher response rate than does the conventional dose, without additional toxic effects. (Current Controlled Trials number, ISRCTN77039377; and Netherlands National Trial Register number, NTR212.)
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MESH Headings
- Age Factors
- Aged
- Aged, 80 and over
- Aminoglycosides/administration & dosage
- Antibiotics, Antineoplastic/administration & dosage
- Antibiotics, Antineoplastic/adverse effects
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal, Humanized
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Combined Modality Therapy
- Cytarabine/administration & dosage
- Daunorubicin/administration & dosage
- Daunorubicin/adverse effects
- Female
- Gemtuzumab
- Humans
- Infusions, Intravenous
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/mortality
- Leukemia, Myelomonocytic, Acute/therapy
- Male
- Middle Aged
- Proportional Hazards Models
- Remission Induction/methods
- Stem Cell Transplantation
- Survival Analysis
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Affiliation(s)
- Bob Löwenberg
- Erasmus University Medical Center, Department of Hematology (L413), P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
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18
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Tsavaris N, Kopterides P, Kosmas C, Siakantaris M, Patsouris E, Pangalis G. Spontaneous remission of acute myeloid leukemia associated with GnRH agonist treatment. Leuk Lymphoma 2009; 47:557-60. [PMID: 16396781 DOI: 10.1080/10428190500343126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Spontaneous remission of acute myeloid leukemia (AML) in adults is a rare but well documented phenomenon. This study reports on a 64-year-old male patient with acute myelogenous leukemia (AML-M4, according to the French-American-British classification) that was developed on a background of chronic myelomonocytic leukemia (CMML) and then underwent remission after treatment with the gonadotropin-releasing hormone agonist (GnRH agonist) triptorelin for presumed prostate cancer. Remission persisted for at least 4 years before the patient was lost to follow-up. To the author' knowledge, this is the first report of remission in an AML-M4 case associated with hormone manipulation. Possible mechanisms of this phenomenon are discussed.
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MESH Headings
- Follow-Up Studies
- Gonadotropin-Releasing Hormone/agonists
- Humans
- Leukemia, Myelomonocytic, Acute/diagnosis
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/pathology
- Leukemia, Myelomonocytic, Chronic/diagnosis
- Leukemia, Myelomonocytic, Chronic/drug therapy
- Leukemia, Myelomonocytic, Chronic/pathology
- Male
- Middle Aged
- Remission, Spontaneous
- Treatment Outcome
- Triptorelin Pamoate/therapeutic use
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Affiliation(s)
- Nicolas Tsavaris
- Department of Pathophysiology, Medical Oncology Unit, 'Laikon' General Hospital, Athens University School of Medicine, Athens, Greece
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19
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Suzuki HI, Asai T, Tamaki Z, Hangaishi A, Chiba S, Kurokawa M. Drug-induced hypersensitivity syndrome with rapid hematopoietic reconstitution during treatment for acute myeloid leukemia. Haematologica 2008; 93:469-70. [PMID: 18310542 DOI: 10.3324/haematol.12029] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Drug-induced hypersensitivity syndrome (DIHS) is a rare but severe life-threatening, drug-induced, systemic hypersensitivity reaction. We report two patients who developed DIHS during treatment for acute myeloid leukemia. Awareness of DIHS is necessary when systemic eruptions and high fever occur in leukemic patients, especially with rapid hematopoietic recovery after chemotherapies.
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MESH Headings
- Aged
- Allopurinol/administration & dosage
- Allopurinol/adverse effects
- Allopurinol/therapeutic use
- Anti-Infective Agents/administration & dosage
- Anti-Infective Agents/adverse effects
- Antibodies, Viral/blood
- Antibodies, Viral/immunology
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Bone Marrow/physiopathology
- Cytarabine/administration & dosage
- Cytarabine/adverse effects
- Drug Eruptions/etiology
- Exanthema Subitum/diagnosis
- Exanthema Subitum/etiology
- Exanthema Subitum/virology
- Female
- Fever/chemically induced
- Hematopoiesis
- Herpesvirus 6, Human/immunology
- Herpesvirus 6, Human/physiology
- Histiocytosis/etiology
- Histiocytosis/pathology
- Humans
- Idarubicin/administration & dosage
- Idarubicin/adverse effects
- Immunocompromised Host
- Leukemia, Myeloid, Acute/complications
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/pathology
- Leukemia, Myelomonocytic, Acute/complications
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/pathology
- Leukemic Infiltration/pathology
- Middle Aged
- Skin/pathology
- Virus Activation/drug effects
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20
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21
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Chevallier P, Al Nawakil C, Vigouroux S, Talmant P, Harousseau JL, Garand R. Two cases of acute lymphoblastic leukaemia following acute myeloid leukaemia. Leuk Res 2007; 32:1001-3. [PMID: 18093650 DOI: 10.1016/j.leukres.2007.11.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2007] [Revised: 11/09/2007] [Accepted: 11/11/2007] [Indexed: 12/01/2022]
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22
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Riccioni R, Senese M, Diverio D, Riti V, Buffolino S, Mariani G, Boe A, Cedrone M, Lo-Coco F, Foà R, Peschle C, Testa U. M4 and M5 acute myeloid leukaemias display a high sensitivity to Bortezomib-mediated apoptosis. Br J Haematol 2007; 139:194-205. [PMID: 17897295 DOI: 10.1111/j.1365-2141.2007.06757.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The present study explored the sensitivity of leukaemic blasts derived from 30 acute myeloid leukaemia (AML) patients to Bortezomib. Bortezomib induced apoptosis of primary AML blasts: 18/30 AMLs were clearly sensitive to the proapoptotic effects of Bortezomib, while the remaining cases were moderately sensitive to this molecule. The addition of tumour necrosis factor-related-apoptosis-inducing ligand, when used alone, did not induce apoptosis of AML blasts and further potentiated the cytotoxic effects of Bortezomib. The majority of AMLs sensitive to Bortezomib showed immunophenotypic features of the M4 and M5 French-American-British classification subtypes and displayed myelomonocytic features. All AMLs with mutated FLT3 were in the Bortezomib-sensitive group. Biochemical studies showed that: (i) Bortezomib activated caspase-8 and caspase-3 and decreased cellular FLICE [Fas-associated death domain (FADD)-like interleukin-1beta-converting enzyme]-inhibitory protein (c-FLIP) levels in AML blasts; (ii) high c-FLIP levels in AML blasts were associated with low Bortezomib sensitivity. Finally, analysis of the effects of Bortezomib on leukaemic cells displaying high aldehyde dehydrogenase activity suggested that this drug induced in vitro killing of leukaemic stem cells. The findings of the present study, further support the development of Bortezomib as an anti-leukaemic drug and provide simple tools to predict the sensitivity of AML cells to this drug.
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MESH Headings
- Aldehyde Dehydrogenase/metabolism
- Apoptosis
- Boronic Acids/therapeutic use
- Bortezomib
- CASP8 and FADD-Like Apoptosis Regulating Protein/analysis
- CASP8 and FADD-Like Apoptosis Regulating Protein/metabolism
- Caspase 3/metabolism
- Caspase 8/metabolism
- Cells, Cultured
- Fas-Associated Death Domain Protein/analysis
- Fas-Associated Death Domain Protein/metabolism
- Flow Cytometry
- Humans
- Immunophenotyping
- Leukemia, Monocytic, Acute/drug therapy
- Leukemia, Monocytic, Acute/pathology
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/pathology
- Protease Inhibitors/therapeutic use
- Pyrazines/therapeutic use
- Receptors, TNF-Related Apoptosis-Inducing Ligand/analysis
- Stem Cells/drug effects
- TNF-Related Apoptosis-Inducing Ligand/analysis
- X-Linked Inhibitor of Apoptosis Protein/analysis
- X-Linked Inhibitor of Apoptosis Protein/metabolism
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Affiliation(s)
- Roberta Riccioni
- Department of Haematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
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23
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Fianchi L, Pagano L, Leoni F, Storti S, Voso MT, Valentini CG, Rutella S, Scardocci A, Caira M, Gianfaldoni G, Leone G. Gemtuzumab ozogamicin, cytosine arabinoside, G-CSF combination (G-AraMy) in the treatment of elderly patients with poor-prognosis acute myeloid leukemia. Ann Oncol 2007; 19:128-34. [PMID: 17906298 DOI: 10.1093/annonc/mdm451] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Gemtuzumab ozogamicin (GO) is effective as single agent in the treatment of acute myeloid leukemia (AML). We evaluated efficacy and safety of a chemotherapy including growth factors, cytarabine, and GO (G-AraMy) in the treatment of poor-prognosis AML in elderly patients. PATIENTS AND METHODS In three Italian hematology departments from September 2003 to September 2006, 53 elderly patients [median age 69 years (range 65-77)] with untreated or primary refractory/relapsed AML were enrolled on the combination G-AraMy administered according to two consecutive schedules (G-AraMy1 and G-AraMy2), with intensified consolidation in the second. Twenty-three of 53 patients had a secondary acute myeloid leukemia (sAML). RESULTS The overall response rate was 57%. The most common adverse event was myelosuppression. Seven patients died in induction (13%). No differences for response rate and toxicity profile were observed between untreated and primary resistant/relapsed patients, de novo AML and sAML, and in the two treatment trials. Median disease-free survival and overall survival were 8 months (range 2-23+) and 9 months (range 2-24+). CONCLUSIONS G-AraMy therapy may be considered an useful treatment approach for poor-risk elderly AML patients, with a complete remission rate comparable to literature data with reduced side-effects, also in a poor-prognosis population.
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Affiliation(s)
- L Fianchi
- Istituto di Ematologia, Università Cattolica del Sacro Cuore, Roma, Italy.
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24
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MESH Headings
- Adrenal Gland Neoplasms/complications
- Adrenal Gland Neoplasms/diagnostic imaging
- Adrenal Gland Neoplasms/drug therapy
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Cytarabine/therapeutic use
- Daunorubicin/therapeutic use
- Fatal Outcome
- Female
- Gingiva/pathology
- Humans
- Hypertrophy
- Leukemia, Myelomonocytic, Acute/complications
- Leukemia, Myelomonocytic, Acute/diagnostic imaging
- Leukemia, Myelomonocytic, Acute/drug therapy
- Middle Aged
- Sarcoma, Myeloid/complications
- Sarcoma, Myeloid/diagnostic imaging
- Sarcoma, Myeloid/drug therapy
- Tomography, X-Ray Computed
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Affiliation(s)
- Pierre Sujobert
- Service d'hématologie de l'Hôpital Cochin (AP-HP), Paris, France.
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25
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Abstract
The RAS proteins function as fundamental signaling switches that control normal cell growth and differentiation. Deregulated activation of RAS-dependent signaling pathways constitutes a potent mechanism of malignant cell transformation. Juvenile myelomonocytic leukemia (JMML) is a rapidly fatal myeloproliferative disorder of early childhood for which no effective treatment other than hematopoietic stem cell transplantation is currently available. Many aspects of JMML pathobiology are linked to deregulated RAS signaling. Hence, targeting RAS or its interactors on a molecular level is a promising strategy in the development of novel rational therapies for this menacing disease. Here we give an overview of current concepts on the pathogenesis of JMML, present important aspects of cellular RAS biology that can be exploited for pharmacologic manipulation, and discuss mouse models that have greatly advanced our understanding of the role RAS plays in JMML. In addition, we review recent approaches to develop agents that interfere with the RAS network at the level of the granulocyte-macrophage colony-stimulating factor receptor, posttranslational RAS processing (prenylation and endoprotease cleavage), RAF serine/threonine kinase, MEK mitogen-activated protein kinase, and target of rapamycin activity. Preclinical and clinical data of these pharmaceuticals in JMML and other myeloid malignancies is discussed.
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Affiliation(s)
- Christian Flotho
- Division of Pediatric Hematology/Oncology, Department of Pediatrics and Adolescent Medicine, University of Freiburg, Germany
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26
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Wang D, Ke XY, Wang J, Xu F, Hu YF. [Correlation between MDR1 genetic polymorphism and prognosis in acute myeloid leukemia]. Zhonghua Yi Xue Za Zhi 2007; 87:1384-8. [PMID: 17785057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE To assess the correlation of the multidrug resistance-1 (MDR1) gene single nucleotide polymorphisms (SNP) C1236T, G2677T/A and C3435T with the outcome of induction chemotherapy in patients with de novo acute myeloid leukemia (AML). METHODS A total of 44 AML patients were enrolled in this study. Genotype of MDR1 C1236T, G2677T/A and C3435T were analyzed with PCR/PFLP assay. Bone marrow smear was made at the end of the first induction chemotherapy to estimate whether complete remission (CR) has been achieved with the clinical characteristics. The Hardy-Weinberg equilibrium for the MDR1 C1236T, G2677T/A and C3435T were tested using a chi(2) analysis. Frequencies of genotype and allele in MDR1 C1236T, G2677T/A and C3435T were compared using a chi(2) test or Fisher's test in terms of the clinical characteristics or achievement of CR. RESULTS There were significant differences among ethnicities in exon 12, 21, 26, but which were not between healthy chinese volunteers and AML patients. The CR rate of the group with the number of white blood cells (WBC) < 10 x 10(9)/L were significantly higher than that of the group with WBC > 10 x 10(9)/L (chi(2) = 7.207, P = 0.007). There was no correlation between the MDR1 C1236T and C3435T and CR rate (P = 0.349, P = 0.074), but MDR1 G2677T/A genetic polymorphisms were strong associated with the probability of CR (chi(2) = 6.214, P = 0.045). In addition, the CR was lower in G/G genotype at -2677 than non G/G genotype (chi(2) = 6.142, P = 0.013), and was lower in C/T genotype at -3435 than non C/T genotype (chi(2) = 3.991, P = 0.046), even lower than T/T genotype (chi(2) = 5.134, P = 0.023). CONCLUSION With important prognostic significance, MDR1 genetic polymorphisms, such as G2677T/A can predict whether complete remission can be achieved after the first course of induction chemotherapy.
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MESH Headings
- ATP Binding Cassette Transporter, Subfamily B
- ATP Binding Cassette Transporter, Subfamily B, Member 1/genetics
- Acute Disease
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Base Sequence
- DNA Mutational Analysis
- Female
- Gene Frequency
- Genotype
- Humans
- Leukemia, Erythroblastic, Acute/drug therapy
- Leukemia, Erythroblastic, Acute/genetics
- Leukemia, Erythroblastic, Acute/pathology
- Leukemia, Megakaryoblastic, Acute/drug therapy
- Leukemia, Megakaryoblastic, Acute/genetics
- Leukemia, Megakaryoblastic, Acute/pathology
- Leukemia, Monocytic, Acute/drug therapy
- Leukemia, Monocytic, Acute/genetics
- Leukemia, Monocytic, Acute/pathology
- Leukemia, Myeloid/drug therapy
- Leukemia, Myeloid/genetics
- Leukemia, Myeloid/pathology
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/pathology
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/genetics
- Leukemia, Myelomonocytic, Acute/pathology
- Leukemia, Promyelocytic, Acute/drug therapy
- Leukemia, Promyelocytic, Acute/genetics
- Leukemia, Promyelocytic, Acute/pathology
- Male
- Middle Aged
- Polymorphism, Single Nucleotide
- Prognosis
- Remission Induction
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Affiliation(s)
- Dan Wang
- Department of Pharmacy, Peking University Third Hospital. Therapeutic Drug Monitoring and Clinical Toxicology Center of Peking University, Beijing 100083, China
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27
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Roche-Gamón E, Febrer-Bosch I, Verdeguer A, Alegre de Miquel V. [Cutaneous chloromas as the presenting feature of acute myeloid leukemia in a child]. Actas Dermosifiliogr 2007; 98:293-4. [PMID: 17506966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
MESH Headings
- Antigens, CD/analysis
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Combined Modality Therapy
- Hematopoietic Stem Cell Transplantation
- Humans
- Infant
- Leukemia, Myelomonocytic, Acute/diagnosis
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/pathology
- Leukemia, Myelomonocytic, Acute/surgery
- Leukemic Infiltration/diagnosis
- Male
- Sarcoma, Myeloid/etiology
- Skin/pathology
- Transplantation, Homologous
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28
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Farhat M, Venugopal P. Long-term remission of extramedullary relapse from acute promyelocytic leukemia after treatment with arsenic trioxide, intrathecal chemotherapy, and brain irradiation. Clin Adv Hematol Oncol 2007; 5:320-3; discussion 323-4. [PMID: 17607291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
MESH Headings
- Adult
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Arsenic Trioxide
- Arsenicals/administration & dosage
- Cranial Irradiation
- Daunorubicin/administration & dosage
- Ear Neoplasms/cerebrospinal fluid
- Ear Neoplasms/diagnostic imaging
- Ear Neoplasms/genetics
- Ear Neoplasms/secondary
- Ear Neoplasms/therapy
- Humans
- Injections, Spinal
- Leukemia, Myelomonocytic, Acute/complications
- Leukemia, Myelomonocytic, Acute/diagnosis
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/genetics
- Leukemia, Myelomonocytic, Acute/pathology
- Male
- Oxides/administration & dosage
- Radiography
- Remission Induction
- Sarcoma, Myeloid/cerebrospinal fluid
- Sarcoma, Myeloid/diagnostic imaging
- Sarcoma, Myeloid/etiology
- Sarcoma, Myeloid/genetics
- Sarcoma, Myeloid/therapy
- Tretinoin/administration & dosage
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29
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Lu HF, Liu JY, Hsueh SC, Yang YY, Yang JS, Tan TW, Kok LF, Lu CC, Lan SH, Wu SY, Liao SS, Ip SW, Chung JG. (-)-Menthol inhibits WEHI-3 leukemia cells in vitro and in vivo. In Vivo 2007; 21:285-9. [PMID: 17436578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
(-)-Menthol ([1-alpha]-5-methyl-2-[1-methylethyl]-cyclohexanol), is a widely used flavoring ingredient in mouthwash, foods, toothpaste and cigarettes. The studies reported here revealed that (-)-menthol induced cytotoxicity against murine leukemia WEHI-3 cells in vitro in a dose-dependent manner. The effects of (-)-menthol on WEHI-3 cells in vivo (BALBIc mice) were also examined, and it was observed that the Mac-3 and CD11b markers were decreased, indicating inhibition of differentiation of the precursor of macrophage and granulocyte. The weights of liver and spleen samples from mice treated with (-)-menthol were found to be decreased compared to untreated animals.
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MESH Headings
- Animals
- Body Weight/drug effects
- Cell Line, Tumor
- Cell Survival/drug effects
- Leukemia, Experimental/drug therapy
- Leukemia, Experimental/pathology
- Leukemia, Myelomonocytic, Acute/blood
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/pathology
- Liver/drug effects
- Liver/pathology
- Menthol/blood
- Menthol/pharmacokinetics
- Menthol/pharmacology
- Menthol/therapeutic use
- Mice
- Mice, Inbred BALB C
- Spleen/drug effects
- Spleen/pathology
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Affiliation(s)
- Hsu-Fung Lu
- Department of Clinical Pathology, Cheng Hsin Rehabilitation Medical Center, Taipei
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30
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Yoshimi A, Mohamed M, Bierings M, Urban C, Korthof E, Zecca M, Sykora KW, Duffner U, Trebo M, Matthes-Martin S, Sedlacek P, Klingebiel T, Lang P, Führer M, Claviez A, Wössmann W, Pession A, Arvidson J, O'Marcaigh AS, van den Heuvel-Eibrink MM, Starý J, Hasle H, Nöllke P, Locatelli F, Niemeyer CM. Second allogeneic hematopoietic stem cell transplantation (HSCT) results in outcome similar to that of first HSCT for patients with juvenile myelomonocytic leukemia. Leukemia 2007; 21:556-60. [PMID: 17268527 DOI: 10.1038/sj.leu.2404537] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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31
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Affiliation(s)
- Nermin Halkic
- University of Lausanne Medical School, CH-1101 Lausanne, Switzerland.
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32
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Lamkin TJ, Chin V, Yen A. All-trans retinoic acid induces p62DOK1 and p56DOK2 expression which enhances induced differentiation and G0 arrest of HL-60 leukemia cells. Am J Hematol 2006; 81:603-15. [PMID: 16823827 DOI: 10.1002/ajh.20667] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
p62(DOK1) (DOK1) and p56(DOK2) (DOK2) are sequence homologs that act as docking proteins downstream of receptor or nonreceptor tyrosine kinases. Originally identified in chronic myelogenous leukemia cells as a highly phosphorylated substrate for the chimeric p210(bcr-abl) protein, DOK1 was suspected to play a role in leukemogenesis. However, p62(DOK1-/-) fibroblast knockout cells were found to have enhanced MAPK signaling and proliferation due to growth factors, suggesting negative regulatory capabilities for DOK1. The role of DOK1 and DOK2 in leukemogeneis thus is enigmatic. The data in this report show that both the DOK1 and the DOK2 adaptor proteins are constitutively expressed in the myelomonoblastic leukemia cell line, HL-60, and that expression of both proteins is induced by the chemotherapeutic differentiation causing agents, all-trans retinoic acid (atRA) and 1,25-dihydroxyvitamin D3 (VD3). Ectopic expression of either protein enhances atRA- or VD3-induced growth arrest, differentiation, and G(0)/G(1) cell cycle arrest and results in increased ERK1/2 phosphorylation. DOK1 and DOK2 are similarly effective in these capabilities. The data provide evidence that DOK1 and DOK2 proteins have a similar role in regulating cell proliferation and differentiation and are positive regulators of the MAPK signaling pathway in this context.
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MESH Headings
- Adaptor Proteins, Signal Transducing/drug effects
- Adaptor Proteins, Signal Transducing/genetics
- Adaptor Proteins, Signal Transducing/metabolism
- Calcitriol/pharmacology
- Cell Cycle/drug effects
- Cell Differentiation/drug effects
- Cell Line, Tumor
- Cell Proliferation/drug effects
- DNA-Binding Proteins/drug effects
- DNA-Binding Proteins/genetics
- DNA-Binding Proteins/metabolism
- Drug Screening Assays, Antitumor
- Flow Cytometry/methods
- Gene Expression Profiling
- Gene Expression Regulation, Leukemic/drug effects
- Gene Expression Regulation, Leukemic/genetics
- HL-60 Cells
- Humans
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/metabolism
- MAP Kinase Signaling System/drug effects
- Mitogen-Activated Protein Kinase Kinases/drug effects
- Mitogen-Activated Protein Kinase Kinases/metabolism
- Molecular Sequence Data
- Phenotype
- Phosphoproteins/drug effects
- Phosphoproteins/genetics
- Phosphoproteins/metabolism
- RNA-Binding Proteins/drug effects
- RNA-Binding Proteins/genetics
- RNA-Binding Proteins/metabolism
- Resting Phase, Cell Cycle/drug effects
- Reverse Transcriptase Polymerase Chain Reaction/methods
- Signal Transduction/drug effects
- Structure-Activity Relationship
- Time Factors
- Tretinoin/pharmacology
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Affiliation(s)
- Thomas J Lamkin
- Department of Biomedical Sciences, Cornell University, Ithaca, New York 14853, USA
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33
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Kiratli H, Bilgiç S, Emeç S. Conjunctival infiltration as the first sign of acute myelomonocytic (M4) leukemia in a 2-year-old child. J AAPOS 2006; 10:375-6. [PMID: 16935242 DOI: 10.1016/j.jaapos.2006.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2005] [Accepted: 02/10/2006] [Indexed: 11/30/2022]
Affiliation(s)
- Hayyam Kiratli
- Ocular Oncology Service, Department of Ophthalmology, Hacettepe University School of Medicine, Sihhiye 06100, Ankara, Turkey.
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34
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Tavil B, Sipahi T, Kara A. The use of pamidronate in a leukemic child with immobilization hypercalcemia. Leuk Res 2006; 30:907-8. [PMID: 16289681 DOI: 10.1016/j.leukres.2005.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2005] [Revised: 10/07/2005] [Accepted: 10/09/2005] [Indexed: 10/25/2022]
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35
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Sharabani H, Izumchenko E, Wang Q, Kreinin R, Steiner M, Barvish Z, Kafka M, Sharoni Y, Levy J, Uskokovic M, Studzinski GP, Danilenko M. Cooperative antitumor effects of vitamin D3 derivatives and rosemary preparations in a mouse model of myeloid leukemia. Int J Cancer 2006; 118:3012-21. [PMID: 16395705 PMCID: PMC2824511 DOI: 10.1002/ijc.21736] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
1alpha,25-dihydroxyvitamin D(3) (1,25D(3)) is a powerful differentiation agent, which has potential for treatment of myeloid leukemias and other types of cancer, but the calcemia produced by pharmacologically active doses precludes the use of this agent in the clinic. We have shown that carnosic acid, the major rosemary polyphenol, enhances the differentiating and antiproliferative effects of low concentrations of 1,25D(3) in human myeloid leukemia cell lines (HL60, U937). Here we translated these findings to in vivo conditions using a syngeneic mouse leukemia tumor model. To this end, we first demonstrated that as in HL60 cells, differentiation of WEHI-3B D(-) murine myelomonocytic leukemia cells induced by 1 nM 1,25D(3) or its low-calcemic analog, 1,25-dihydroxy-16-ene-5,6-trans-cholecalciferol (Ro25-4020), can be synergistically potentiated by carnosic acid (10 microM) or the carnosic acid-rich ethanolic extract of rosemary leaves. This effect was accompanied by cell cycle arrest in G0 + G1 phase and a marked inhibition of cell growth. In the in vivo studies, i.p. injections of 2 microg Ro25-4020 in Balb/c mice bearing WEHI-3B D(-) tumors produced a significant delay in tumor appearance and reduction in tumor size, without significant toxicity. Another analog, 1,25-dihydroxy-16,23Z-diene-20-epi-26,27-hexafluoro-19-nor-cholecalciferol (Ro26-3884) administered at the same dose was less effective than Ro25-4020 and profoundly toxic. Importantly, combined treatment with 1% dry rosemary extract (mixed with food) and 1 microg Ro25-4020 resulted in a strong cooperative antitumor effect, without inducing hypercalcemia. These results indicate for the first time that a plant polyphenolic preparation and a vitamin D derivative can cooperate not only in inducing leukemia cell differentiation in vitro, but also in the antileukemic activity in vivo. These data may suggest novel protocols for chemoprevention or differentiation therapy of myeloid leukemia.
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MESH Headings
- Abietanes/adverse effects
- Abietanes/pharmacology
- Animals
- Anticarcinogenic Agents/adverse effects
- Anticarcinogenic Agents/pharmacology
- Antineoplastic Agents/adverse effects
- Antineoplastic Agents/pharmacology
- Apoptosis/drug effects
- Calcium/blood
- Cholecalciferol/adverse effects
- Cholecalciferol/analogs & derivatives
- Cholecalciferol/pharmacology
- Dose-Response Relationship, Drug
- Drug Synergism
- Flavonoids
- Leukemia, Experimental/blood
- Leukemia, Experimental/drug therapy
- Leukemia, Myeloid/drug therapy
- Leukemia, Myelomonocytic, Acute/blood
- Leukemia, Myelomonocytic, Acute/drug therapy
- Mice
- Mice, Inbred BALB C
- Phenols
- Plant Extracts/adverse effects
- Plant Extracts/pharmacology
- Plant Preparations/pharmacology
- Polyphenols
- Rosmarinus
- Tumor Cells, Cultured
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Affiliation(s)
- Hagar Sharabani
- Department of Clinical Biochemistry, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eugene Izumchenko
- Department of Clinical Biochemistry, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Qing Wang
- Department of Pathology and Laboratory Medicine, UMDNJ-New Jersey Medical School, Newark, NJ, USA
| | - Rita Kreinin
- Department of Clinical Biochemistry, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Michael Steiner
- Department of Clinical Biochemistry, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Zeev Barvish
- Department of Virology and Molecular Genetics, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Michael Kafka
- Laboratory of Hematology, Soroka Medical Center, Beer-Sheva, Israel
| | - Yoav Sharoni
- Department of Clinical Biochemistry, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Joseph Levy
- Department of Clinical Biochemistry, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | | | - George P. Studzinski
- Department of Pathology and Laboratory Medicine, UMDNJ-New Jersey Medical School, Newark, NJ, USA
| | - Michael Danilenko
- Department of Clinical Biochemistry, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Correspondence to: Endocrine laboratory, Department of Clinical Biochemistry, Faculty of Health Science, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva, Israel. Fax: +972-8-640-3177 or +972-8-628-1361.
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36
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Anghel R, Matache G, Vasile M, Matache RI, Oprea L, Popa R, Sucitu A, Costandache N, Bărbulescu I, Colita D, Varady Z, Tanase A, Moicean A, Arion C, Colita A, Dumitrache L. Total body irradiation prior to bone marrow transplantation--the experience of the Institute of Oncology Prof. Dr. Al. Trestioreanu Bucharest. J BUON 2006; 11:167-74. [PMID: 17318966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
PURPOSE To present the technique of total body irradiation (TBI), applied for the first time in Romania, at the Institute of Oncology Bucharest, as part of stem cell transplantation for hematological malignancies. PATIENTS AND METHODS The total dose administered was 12 Gy at the reference point, 2 Gy/fraction, one fraction per day, 6 consecutive days, with a total dose of 8 - 11.4 Gy delivered to the lung, using Mevatron Primus linear accelerator (6 MV & 15 MV, 200-300 cGy/min in isocenter), in vivo dosimetry detectors and equipment for the reference dosimetry, personalized blocks for lung shielding sustained by polymethylmethaacrylate (PPMA) plate, Simulix HP simulator, and computer tomographic (CT) scans. Techniques used were: a) two parallel opposed anteroposterior / posteroanterior (AP/PA) fields with the patient in prone and supine position; b) two parallel opposed lateral fields with the patient placed on a lateral table, at 320 cm from the source. The percentage depth dose, tissue maximum ratio (TMR), off axis ratio (OAR) and the reference dose rate were measured for every patient's geometrical characteristics, with an uncertainty of +/- 2.2% and were used to calculate monitor units and to evaluate the dose in organs at risk (lungs, gonads, eyes etc). RESULTS 5 patients (3 with the AP/PA technique and 2 with the lateral technique) were irradiated. All patients completed their irradiation in good clinical condition. The acute side effects were minimal (WHO grade 1: nausea/ vomiting--all patients; diarrhea--1 patient; headache--2 patients; photophobia and diplopia--1 patient; head and neck skin erythema--all patients). Because of the short follow-up period no safe evaluation of late side effects can be done. However, during this period one patient developed a non-aggressive form of chronic liver graft vs. host disease (GVHD) and one patient died due to acute GVHD. CONCLUSION TBI as part of stem cell transplantation for hematological malignancies was successfully realized at our Institute, with favorable clinical results. This technique is easy to carry out and reproducible.
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Affiliation(s)
- R Anghel
- University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.
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37
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Lee JH, Choi SJ, Lee JH, Park JH, Kim H, Joo YD, Lee WS, Zang DY, Kim HJ, Lee KH. Standard induction chemotherapy followed by attenuated consolidation in elderly patients with acute myeloid leukemia. Ann Hematol 2006; 85:357-65. [PMID: 16575580 DOI: 10.1007/s00277-006-0110-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2006] [Accepted: 03/13/2006] [Indexed: 10/24/2022]
Abstract
The benefits of intensive post-remission chemotherapy have not been verified in elderly patients with acute myeloid leukemia (AML). To reduce fatal complications caused by intensive post-remission therapy, we performed a prospective phase II multicenter trial of standard induction chemotherapy ('7+3' of cytarabine plus daunorubicin), followed by two cycles of attenuated consolidation therapy ('5+1' of cytarabine plus daunorubicin) for elderly patients with AML, excluding those with M3. Of the 41 patients enrolled in the study, 24 (58.5%) attained CR. Of these 24, 17 (70.8%) completed both planned cycles of consolidation therapy. After a median follow-up of 566 days (range, 63-1190 days) among surviving patients, 15 relapsed, with an actuarial 3-year disease-free survival rate of 22.5%. There were no fatal complications during consolidation therapy. Actuarial 3-year overall survival was 17.0%. These findings suggest that, when compared with previous findings using more intensive consolidation therapy, attenuated consolidation therapy does not compromise outcomes in elderly AML patients.
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MESH Headings
- Acute Disease
- Aged
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Disease-Free Survival
- Female
- Flow Cytometry
- Humans
- Immunophenotyping/methods
- Leukemia, Erythroblastic, Acute/drug therapy
- Leukemia, Erythroblastic, Acute/immunology
- Leukemia, Erythroblastic, Acute/pathology
- Leukemia, Megakaryoblastic, Acute/drug therapy
- Leukemia, Megakaryoblastic, Acute/immunology
- Leukemia, Megakaryoblastic, Acute/pathology
- Leukemia, Monocytic, Acute/drug therapy
- Leukemia, Monocytic, Acute/immunology
- Leukemia, Monocytic, Acute/pathology
- Leukemia, Myeloid/drug therapy
- Leukemia, Myeloid/immunology
- Leukemia, Myeloid/pathology
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/immunology
- Leukemia, Myeloid, Acute/pathology
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/immunology
- Leukemia, Myelomonocytic, Acute/pathology
- Male
- Middle Aged
- Prognosis
- Prospective Studies
- Treatment Outcome
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Affiliation(s)
- Je-Hwan Lee
- Department of Internal Medicine, Asan Medical Center, 388-1 Pungnap-2dong, Songpa-gu, Seoul 138-736, South Korea.
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38
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Cai D, Wang Y, Ottmann OG, Barth PJ, Neubauer A, Burchert A. FLT3-ITD–, but not BCR/ABL-transformed cells require concurrent Akt/mTor blockage to undergo apoptosis after histone deacetylase inhibitor treatment. Blood 2006; 107:2094-7. [PMID: 16304046 DOI: 10.1182/blood-2005-08-3317] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Leukemias are differentially sensitive to histone deacytelase inhibitor (HDI)–induced apoptosis, but molecular reasons for this remain unclear. We here show that BCR/ABL-, but not FMS-like tyrosine kinase 3 (FLT3)–internal tandem duplication (ITD)–transformed 32D cells or primary acute myeloid leukemia (AML) blasts undergo apoptosis after treatment with the HDI valproic acid (VPA) plus all-trans retinoic acid (VPA/ATRA). A particular VPA/ATRA responsiveness of Philadelphia chromosome–positive (Ph+) acute lymphatic leukemia (ALL) was confirmed in a therapy-refractory patient in vivo. HDI-stimulated apoptosis in Ph+ cells was caspase dependent, but independent from Akt pathway inhibition. Conversely, separate blockage of the Akt/mTor-signaling pathway was a prerequisite for overcoming apoptosis resistance to VPA/ATRA in FLT3-ITD cells, and primary AML blasts (n = 9). In conclusion, constitutive Akt activation causes apoptosis resistance to VPA/ATRA in AML, but not in Ph+ leukemia. This warrants the application of HDI-based therapies in poor-risk Ph+ ALL, and the use of Akt/mTor inhibitors to overcome HDI resistance in AML.
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MESH Headings
- Antineoplastic Agents/pharmacology
- Antineoplastic Agents/therapeutic use
- Apoptosis/drug effects
- Apoptosis/genetics
- Caspases/metabolism
- Cell Transformation, Neoplastic/genetics
- Cell Transformation, Neoplastic/metabolism
- Drug Resistance, Neoplasm/drug effects
- Drug Resistance, Neoplasm/genetics
- Enzyme Inhibitors/pharmacology
- Enzyme Inhibitors/therapeutic use
- Fusion Proteins, bcr-abl/metabolism
- Histone Deacetylase Inhibitors
- Humans
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/genetics
- Leukemia, Myelomonocytic, Acute/metabolism
- Mutation
- Oncogene Protein v-akt/antagonists & inhibitors
- Oncogene Protein v-akt/metabolism
- Philadelphia Chromosome
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/metabolism
- Protein Kinases/metabolism
- Signal Transduction/drug effects
- Signal Transduction/genetics
- TOR Serine-Threonine Kinases
- Tretinoin/pharmacology
- Tretinoin/therapeutic use
- Tumor Cells, Cultured
- Valproic Acid/pharmacology
- Valproic Acid/therapeutic use
- fms-Like Tyrosine Kinase 3/genetics
- fms-Like Tyrosine Kinase 3/metabolism
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Affiliation(s)
- Dali Cai
- Universitätsklinikum Marburg und Giessen, Standort Marburg, Klinik für Hämatologie, Onkologie, und Immunologie, Marburg, Germany
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39
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Turhan N, Yürür-Kutlay N, Topcuoglu P, Sayki M, Yüksel M, Gürman G, Tükün A. Translocation (13;17)(q14;q25) as a novel chromosomal abnormality in acute myeloid leukemia-M4. Leuk Res 2006; 30:903-5. [PMID: 16469377 DOI: 10.1016/j.leukres.2005.12.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2005] [Revised: 12/09/2005] [Accepted: 12/14/2005] [Indexed: 11/30/2022]
Abstract
We report a case of AML-M4 in which G-band karyotyping revealed a previously unreported t(13;17)(q14;q25) in metaphase preparations. The breakpoints at 13q14 and 17q25 are associated with poor prognosis. The MSF and FKHR genes are located on 17q25 and 13q14, respectively. This report of AML-M4 harboring t(13;17)(q14;q25) as a unique cytogenetic abnormality provides more data on the leukomogenesis with rearrangements related with 13q14 and 17q25.
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MESH Headings
- Adult
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Chromosome Aberrations
- Chromosomes, Human, Pair 13/genetics
- Chromosomes, Human, Pair 17/genetics
- Cytogenetic Analysis/methods
- Fatal Outcome
- Female
- Humans
- In Situ Hybridization, Fluorescence/methods
- Karyotyping
- Leukemia, Myelomonocytic, Acute/diagnosis
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/genetics
- Sensitivity and Specificity
- Translocation, Genetic/genetics
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Affiliation(s)
- Nihan Turhan
- Ankara University, Faculty of Medicine, Medical Genetics Department, Ankara, Turkey.
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40
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Ali R, Ozkalemkas F, Ozkocaman V, Ozcelik T, Akalin H, Ozkan A, Altundal Y, Tunali A. Hydatid disease in acute leukemia: effect of anticancer treatment on echinococcosis. Microbes Infect 2006; 7:1073-6. [PMID: 15996888 DOI: 10.1016/j.micinf.2005.02.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2004] [Revised: 01/31/2005] [Accepted: 02/02/2005] [Indexed: 11/20/2022]
Abstract
Echinococcosis, also known as hydatid disease or hydatidosis, is a zoonotic illness caused by the larval form of Echinococcus spp. It is highly prevalent in areas where the parasite is endemic such as the Mediterranean region. However, occurrence of echinococcosis and cancer together is rare. We treated and followed approximately 1200 patients with different hematologic neoplastic diseases between 1985 and 2003, and only one of these individuals had concomitant acute leukemia and liver hydatidosis. This report describes the case of a 19-year-old man who had both primary refractoriness of acute leukemia (AML-M4) and liver hydatidosis. Management is discussed. The patient had cystic echinococcosis (CE) of the liver that was classified as CE1 according to the system established by the World Health Organization's Informal Working Group on Echinococcosis. The patient underwent 3 months of treatment with agents that targeted the leukemia (daunorubicin, idarubicin, cytarabine, fludarabine) and its complications (amphotericin B, amphotericin B lipid complex, liposomal amphotericin B). Throughout this period, the size and the contents of the cyst did not change, Echinococcus titers remained unchanged, and the cyst classification remained CE1.
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Affiliation(s)
- Ridvan Ali
- Division of Hematology, Department of Internal Medicine, Uludag University School of Medicine, Uludag University Hospital, Bursa, Turkey.
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41
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Takahashi W, Arai Y, Tadokoro J, Takeuchi K, Yamagata T, Mitani K. [Disappearance of a Philadelphia chromosome-positive clone and appearance of a -negative clone following treatment with imatinib mesylate in acute myelomonocytic leukemia]. Rinsho Ketsueki 2006; 47:111-4. [PMID: 16529013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
A 63-year-old female was diagnosed as having Philadelphia chromosome-positive acute myelomonocytic leukemia in June 2002. The patient received monotherapy with imatinib mesylate or combination therapy with DCM and idarubicin/cytarabine, both of which failed in attaining disease remission. However, the second imatinib administration plus CAG therapy resulted in disappearance of the Philadelphia chromosome-positive clone and increase of Philadelphia chromosome-negative cells. During a therapy-withholding period due to fungal infection, the Philadelphia chromosome-positive clone expanded and the patient died of cerebral hemorrhage in February 2003. The transient suppression of the Philadelphia chromosome-positive clone may have brought about amplification of the Philadelphia chromosome-negative cells after the secondary imatinib treatment.
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42
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Matsuda K, Matsuzaki S, Miki J, Hidaka E, Yanagisawa R, Nakazawa Y, Sakashita K, Kamijo T, Asami K, Sano K, Koike K. Chromosomal change during 6-mercaptopurine (6-MP) therapy in juvenile myelomonocytic leukemia: the growth of a 6-MP-refractory clone that already exists at onset. Leukemia 2006; 20:485-90. [PMID: 16424864 DOI: 10.1038/sj.leu.2404106] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Among 11 JMML children, two had an abnormal karyotype, and nine had a normal karyotype at onset. In one patient with trisomy 8 and four patients with a normal karyotype, a new clone with an aberrant karyotype emerged 1-14 months after 6-mercaptopurine (6-MP) therapy as shown by G-banding analyses. Fluorescence in situ hybridization disclosed that an abnormal clone existed in approximately 3-6% of bone marrow cells at onset or before 6-MP therapy in all the four cases examined, and increased to approximately 12-90% during the treatment. In culture with granulocyte-macrophage colony-stimulating factor, cytogenetically abnormal clones that proliferated during 6-MP therapy possessed significantly less sensitivity to the antimetabolite, compared with cells that decreased in numbers after the therapy. A PTPN11 mutation was detected in all of granulocyte-macrophage colonies irrespective of karyotypic aberration in one patient, whereas approximately 80% of erythroid colonies and 20% of mixed colonies possessed neither a PTPN11 mutation nor chromosomal abnormalities. The appearance of chromosomal aberrations shown by G-banding during 6-MP therapy in some JMML cases may result, in part, from the growth of a 6-MP-refractory clone that already exists at onset. It is possible that treatment with 6-MP promotes progression of the disease.
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Affiliation(s)
- K Matsuda
- Department of Laboratory Medicine, Shinshu University Hospital, Matsumoto, Japan
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43
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Stachel DK, Leipold A, Kuhlen M, Gravou-Apostolatou C, Hirv K, Bader P, Niemeyer CM, Beck JD, Holter W. Simultaneous control of third-degree graft-versus-host disease and prevention of recurrence of juvenile myelomonocytic leukemia (JMML) with 6-mercaptopurine following fulminant JMML relapse early after KIR-mismatched bone marrow transplantation. J Pediatr Hematol Oncol 2005; 27:672-4. [PMID: 16344675 DOI: 10.1097/01.mph.0000193471.91690.f4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The authors describe a young boy with juvenile myelomonocytic leukemia (JMML) who relapsed 45 days after HLA and killer immunoglobulin-like receptor (KIR) mismatched unrelated donor bone marrow transplant (MMUD-BMT) and subsequently developed life-threatening graft-versus-host disease (GvHD). Treatment with 6-mercaptopurine (6-MP) appeared to control severe GvHD and possibly prevented recurrence of leukemic relapse.
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Affiliation(s)
- Daniel K Stachel
- Department of Pediatrics, University of Erlangen-Nurnberg, Erlangen, Germany.
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44
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Stam RW, Hubeek I, den Boer ML, Buijs-Gladdines JGCAM, Creutzig U, Kaspers GJL, Pieters R. MLL gene rearrangements have no direct impact on Ara-C sensitivity in infant acute lymphoblastic leukemia and childhood M4/M5 acute myeloid leukemia. Leukemia 2005; 20:179-82. [PMID: 16307022 DOI: 10.1038/sj.leu.2404031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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45
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Shimada H, Shima H, Shimasaki N, Yoshihara H, Mori T, Takahashi T. Little response to zoledronic acid in a child of juvenile myelomonocytic leukemia (JMML) harboring the PTPN11 mutation. Ann Oncol 2005; 16:1400. [PMID: 15857842 DOI: 10.1093/annonc/mdi233] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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46
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Li GW, Wang DN, Lin DJ, Li XD, Lin GZ, He Y, Lin Q, Huang RW. [Expression of MUC1 gene and MDR1 gene in non-M3 subtype acute leukemia and their correlations to clinical treatment efficacy]. Ai Zheng 2005; 24:1011-4. [PMID: 16086884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND & OBJECTIVE Mucin 1 (MUC1) gene is expressed in various tumors, and overexpressed in acute leukemia. This study was to evaluate the expression of MUC1 gene and multidrug-resistance protein-1 (MDR1) gene in non-M3 subtype acute leukemia and their correlations to clinical treatment efficacy. METHODS The expression of MUC1 and MDR1 genes were measured in 34 patients with non-M3 subtype acute leukemia by reverse transcription-polymerase chain reaction (RT-PCR); their correlations to clinical treatment efficacy were observed. RESULTS The positive rate of MUC1 gene in the 34 patients was 50.0%, and the positive rate of MDR1 gene was 29.4%. The positive rate of MDR1 was significantly higher in MUC1-positive patients than in MUC1-negative patients (52.9% vs. 5.9%, P=0.003). Complete remission (CR) rate was significantly higher in MUC1-negative patients than in MUC1-positive patients (94.1% vs. 52.9%, P<0.01). CR rate was significantly higher in MDR1-negative patients than in MDR1-positive patients (91.7% vs. 50.0%, P<0.05). In 9 patients with positive expression of both MUC1 and MDR1, the CR rate was 55.6%; while in 16 patients with negative expression of both MUC1 and MDR1, the CR rate was 100%. CONCLUSIONS The non-M3 subtype acute leukemia patients with positive expression of MUC1 have high positive rate of MDR1. The patients with negative expression of both MUC1 and MDR1 have high CR. Co-detection of MUC1 gene and MDR1 gene can predict treatment efficacy on non-M3 subtype acute leukemia.
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MESH Headings
- ATP Binding Cassette Transporter, Subfamily B, Member 1/genetics
- ATP Binding Cassette Transporter, Subfamily B, Member 1/metabolism
- Adolescent
- Adult
- Antigens, Neoplasm/genetics
- Antigens, Neoplasm/metabolism
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Child
- Female
- Gene Expression Regulation, Neoplastic
- Humans
- Leukemia, Monocytic, Acute/drug therapy
- Leukemia, Monocytic, Acute/metabolism
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/metabolism
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/metabolism
- Male
- Middle Aged
- Mucin-1
- Mucins/genetics
- Mucins/metabolism
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/metabolism
- Remission Induction
- Treatment Outcome
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Affiliation(s)
- Guo-Wei Li
- Department of Hematology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, P. R. China
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47
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Wu XX, Da WM, Li HH, Zhao Y, Wang QS, Wang SH, Zhu HY. [Effects of FLAG regimen in treatment of refractory or relapsed acute myeloid leukemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2005; 13:394-6. [PMID: 15972128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
In order to evaluate the effects of FLAG regimen in treatment of refractory and relapsed acute myeloid leukemia (AML), 27 patients with refractory or relapsed acute myeloid leukemia (10 refractory AML patients, 17 relapsed AML patients) were treated with FLAG regimen. The results show that the rate of complete remission was 48.2% (13/27), the rate of partial remission was 14.8% (4/27), and the overall response rate was 63.0%. Main toxicities were gastrointestinal side effectes, myelosupression and neutropenia. It is concluded that FLAG regimen can be employed in treatment of the refractory or relapsed patients who were not respond to other regimen, and the regiment was safe.
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MESH Headings
- Adolescent
- Adult
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Cytarabine/administration & dosage
- Cytarabine/adverse effects
- Diarrhea/chemically induced
- Drug Resistance, Neoplasm
- Female
- Granulocyte Colony-Stimulating Factor/administration & dosage
- Granulocyte Colony-Stimulating Factor/adverse effects
- Humans
- Leukemia, Monocytic, Acute/drug therapy
- Leukemia, Monocytic, Acute/pathology
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/pathology
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/pathology
- Male
- Middle Aged
- Nausea/chemically induced
- Neoplasm Recurrence, Local
- Respiratory Tract Infections/chemically induced
- Treatment Outcome
- Vidarabine/administration & dosage
- Vidarabine/adverse effects
- Vidarabine/analogs & derivatives
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Affiliation(s)
- Xiao-Xiong Wu
- Department of Hematology, General Hospital of Chinese PLA, Beijing 100853, China.
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48
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Contractor R, Samudio IJ, Estrov Z, Harris D, McCubrey JA, Safe SH, Andreeff M, Konopleva M. A novel ring-substituted diindolylmethane,1,1-bis[3'-(5-methoxyindolyl)]-1-(p-t-butylphenyl) methane, inhibits extracellular signal-regulated kinase activation and induces apoptosis in acute myelogenous leukemia. Cancer Res 2005; 65:2890-8. [PMID: 15805291 DOI: 10.1158/0008-5472.can-04-3781] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We investigated the antileukemic activity and molecular mechanisms of action of a newly synthesized ring-substituted diindolylmethane derivative, 1,1-bis[3'-(5-methoxyindolyl)]-1-(p-t-butylphenyl) methane (DIM #34), in acute myelogenous leukemia (AML) cells. DIM #34 inhibited AML cell growth via the induction of apoptosis and abrogated clonogenic growth of primary AML samples. Exposure to DIM #34 induced loss of mitochondrial inner transmembrane potential, release of cytochrome c into the cytosol, and caspase activation. Bcl-2-overexpressing, Bax knockout, and caspase-9-deficient cells were partially resistant to cell death, suggesting the involvement of the intrinsic apoptotic pathway. Furthermore, DIM #34 transiently inhibited the phosphorylation and activity of the extracellular signal-regulated kinase and abrogated Bcl-2 phosphorylation. Because other methylene-substituted diindolylmethane analogues have been shown to transactivate the nuclear receptor peroxisome proliferator-activated receptor gamma (PPARgamma), we studied the role of PPARgamma in apoptosis induction. Cotreatment of cells with a selective PPARgamma antagonist or with retinoid X receptor and retinoic acid receptor ligands partially modulated apoptosis when combined with DIM #34, suggesting PPARgamma receptor-dependent and receptor-independent cell death. Together, these findings suggest that diindolylmethanes are a new class of compounds that selectively induce apoptosis in AML cells through the modulation of the extracellular signal-regulated kinase and PPARgamma signaling pathways.
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MESH Headings
- Acute Disease
- Apoptosis/drug effects
- Apoptosis/physiology
- Caspases/metabolism
- Enzyme Activation/drug effects
- Extracellular Signal-Regulated MAP Kinases/antagonists & inhibitors
- HL-60 Cells
- Humans
- Indoles/pharmacology
- Jurkat Cells
- Leukemia, Monocytic, Acute/drug therapy
- Leukemia, Monocytic, Acute/enzymology
- Leukemia, Monocytic, Acute/pathology
- Leukemia, Myeloid/drug therapy
- Leukemia, Myeloid/enzymology
- Leukemia, Myeloid/pathology
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/enzymology
- Leukemia, Myeloid, Acute/pathology
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/enzymology
- Leukemia, Myelomonocytic, Acute/pathology
- MAP Kinase Signaling System/drug effects
- PPAR gamma/metabolism
- Protein Kinase Inhibitors/pharmacology
- Proto-Oncogene Proteins c-bcl-2/physiology
- U937 Cells
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Affiliation(s)
- Rooha Contractor
- Department of Blood and Marrow Transplantation, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA
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Ito K, Tominaga K, Suzuki T, Jinnai I, Bessho M. Successful Treatment with Imatinib Mesylate in a Case of Minor BCR-ABL-Positive Acute Myelogenous Leukemia. Int J Hematol 2005; 81:242-5. [PMID: 15814335 DOI: 10.1532/ijh97.04098] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Philadelphia (Ph) chromosome-positive acute myelogenous leukemia (AML) is a rare disease that is resistant to conventional antitumor chemotherapy and has a poor prognosis. We describe a case of Ph chromosome-positive AML in which imatinib mesylate was used and a favorable outcome was obtained.A 64-year-old man was found to have Ph chromosome-positive, minor BCR-ABL-positive AML. Remission could not be induced by remission induction therapy with antitumor agents. Because the patient had a serious concomitant infectious disease, administration of 600 mg/day of imatinib mesylate, a specific inhibitor of BCR-ABL tyrosine kinase, was started after written informed consent was obtained. Complete cytogenetic response (CCR) was achieved without serious adverse events and persisted for more than 1 year. Our results suggested that imatinib mesylate was very useful for treating Ph chromosome-positive AML.
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MESH Headings
- Antineoplastic Agents/administration & dosage
- Benzamides
- Humans
- Imatinib Mesylate
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/physiopathology
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/physiopathology
- Male
- Middle Aged
- Piperazines/administration & dosage
- Pyrimidines/administration & dosage
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50
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Liu WM, Baird R, Sarker D, Powles T. Antiapoptotic effect of growth factors in leukemia. J Clin Oncol 2005; 23:649; author reply 649-50. [PMID: 15659515 DOI: 10.1200/jco.2005.05.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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