This report provides long-term results of the treatment of patients with newly-diagnosed AML with a single high dose of mitoxantrone combined with once daily cytarabine. One-hundred and sixty-five patients treated on four studies of high-dose mitoxantrone-based induction therapy are included. Patients with a prior antecedent hematologic disorder were eligible. The median follow-up time is 65.9 months (95% CI: 55.7-86.2 months). The overall complete remission rate was 64%, with responses in 78% of patients less than 60 years of age and 51% of patients 60 years of age or older. The median duration of response is 21.2 months and 8.0 months and overall survival is 15.4 months and 7.6 months, respectively. For a sub-set of patients who would be eligible for most US trials, the complete remission rate was 84% in younger patients and 60% in older patients. The median duration of response was 39.0 and 8.2 months and the median overall survival was 19.4 and 7.6 months, respectively. The efficacy of these regimens compared favorably to results reported with standard '3 + 7' regimens. Use of a once-daily cytarabine regimen resulted in almost no neurotoxicity and allowed for administration of consolidation in the outpatient setting.
Background: Do colorectal cancer patients with hyperbilirubinemia and liver metastases benefi t from chemotherapy? Methods/Results: This study entailed a review of 3,019 consecutive patients with colorectal cancer. Within this cohort, 20 met the study's a priori selection criteria, which included a new diagnosis of colorectal cancer, no prior therapy, and a total bilirubin of Ն3.0 mg/dL. All 20 patients had liver metastases, and as a whole the group had a median serum bilirubin of 6.4 mg/dL (range 3.1, 28 mg/dL). Six patients received chemotherapy with an oxaliplatincontaining regimen, and four subsequently sustained a drop in their bilirubin. In one instance, a drop from 27.2 to 2.5 mg/dL occurred. These six patients lived a median of 71 days (range 23+, 283 days), but one treatment-related death occurred. In contrast, patients who received only supportive care lived a median of 28 days. Conclusion: Chemotherapy appears to provide modest benefi t to newly diagnosed colorectal cancer patients with severe hyperbilirubinemia.
We investigated in 335 patients (mean age-63 year) with suspected myocardial ischemia the prevalence of moderate or severe left ventricular diastolic dysfunction (LVDD) in patients with an abnormal adenosine or exercise sestamibi stress test (SST) or prior coronary revascularization and in patients with a normal SST and no prior coronary revascularization. Moderate or severe LVDD was present in 117 of 142 patients (82%) with an abnormal SST or prior coronary revascularization and in 111 of 193 patients (58%) with a normal SST and no prior coronary revascularization (p < 0.001). Moderate or severe LVDD was present in 34 of 38 patients (89%) with an abnormal SST or prior coronary revascularization and an abnormal left ventricular ejection fraction (LVEF) and in 4 of 8 patients (50%) with a normal SST and no prior coronary revascularization and an abnormal LVEF (p < 0.01).
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