One hundred ninety-five adult patients with refractory or first relapse acute myelogenous leukemia (AML) were randomly assigned to receive high-dose cytarabine (HiDAC), 3 g/m2 as a three-hour intravenous (IV) infusion every 12 hours for four doses, followed by 6,000 IU/m2 asparaginase (ASNase) administered at hour 42, or HiDAC without ASNase. Treatment was repeated on day 8. The median patient age was 52 years. There was an overall superior complete remission (CR) rate for HiDAC/ASNase (40%) v HiDAC (24%), P = .02. Subset analysis according to prior response and age showed the following CR rates: 54% from HiDAC/ASNase treatment of refractory AML in patients less than 60 years, and 31% in patients greater than 60 years; CR from HiDAC in the same refractory groups were 18% (less than 60) and 0% (greater than 60); 37% from HiDAC/ASNase treatment of relapsed AML in patients less than 60 years, and 43% in patients greater than 60 years; CRs from HiDAC in the same relapsed groups were 33% (less than 60) and 21% (greater than 60). Toxicity in the two treatment arms was comparable and consisted primarily of leukopenia, thrombocytopenia, mild hepatic dysfunction, diarrhea, conjunctivitis and serositis, and hyperglycemia. There was only one case of transient cerebellar toxicity and no cutaneous toxicity. Median time to full hematologic recovery was 5 weeks. There was an overall survival benefit for patients treated with HiDAC/ASNase (19.6 weeks) compared with HiDAC (15.9 weeks), P = .046, primarily attributable to effects in refractory patients. Median time to failure for refractory patients who achieved CR was 38.5 weeks with HiDAC/ASNase, and 13.3 weeks for those treated with HiDAC. For relapsed patients in CR from HiDAC/ASNase the median time to failure was 17.7 weeks and 18.3 weeks for HiDAC. The overall 42% CR rate from HiDAC/ASNase v 12% from HiDAC in patients with refractory AML indicates that HiDAC/ASNase is not cross-resistant with standard-dose cytarabine (SDAC) and anthracyclines. We conclude that HiDAC/ASNase has substantial activity in poor-prognosis AML and that this combination warrants further trials in earlier stage disease.
Inflatable aeroshells offer several advantages over traditional rigid aeroshells for atmospheric entry. Inflatables offer increased payload volume fraction of the launch vehicle shroud and the possibility to deliver more payload mass to the surface for equivalent trajectory constraints. An inflatable's diameter is not constrained by the launch vehicle shroud. The resultant larger drag area can provide deceleration equivalent to a rigid system at higher atmospheric altitudes, thus offering access to higher landing sites. When stowed for launch and cruise, inflatable aeroshells allow access to the payload after the vehicle is integrated for launch and offer direct access to vehicle structure for structural attachment with the launch vehicle. They also offer an opportunity to eliminate system duplication between the cruise stage and entry vehicle. There are however several potential technical challenges for inflatable aeroshells. First and foremost is the fact that they are flexible structures. That flexibility could lead to unpredictable drag performance or an aerostructural dynamic instability. In addition, durability of large inflatable structures may limit their application. They are susceptible to puncture, a potentially catastrophic insult, from many possible sources. Finally, aerothermal heating during planetary entry poses a significant challenge to a thin membrane. NASA Langley Research Center and NASA's Wallop's Flight Facility are jointly developing inflatable aeroshell technology for use on future NASA missions. The technology will be demonstrated in the Inflatable Re-entry Vehicle Experiment (IRVE). This paper will detail the development of the initial IRVE inflatable system to be launched on a Terrier/Orion sounding rocket in the fourth quarter of CY2005. The experiment will demonstrate achievable packaging efficiency of the inflatable aeroshell for launch, inflation, leak performance of the inflatable system throughout the flight regime, structural integrity when exposed to a relevant dynamic pressure and aerodynamic stability of the inflatable system. Structural integrity and structural response of the inflatable will be verified with photogrammetric measurements of the back side of the aeroshell in flight. Aerodynamic stability as well as drag performance will be verified with on board inertial measurements and radar tracking from multiple ground radar stations. The experiment will yield valuable information about zero-g vacuum deployment dynamics of the flexible inflatable structure with both inertial and photographic measurements. In addition to demonstrating inflatable technology, IRVE will validate structural, aerothermal, and trajectory modeling techniques for the inflatable. Structural response determined from photogrammetrics will validate structural models, skin temperature measurements and additional in-depth temperature measurements will validate material thermal performance models, and on board inertial measurements along with radar tracking from multiple ground radar stations will valid...
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