Combination Chemotherapy using L-Asparaginase, Daunorubicin, and Cytosine Arabinoside in Adults with Acute Myelogenous Leukaemia

Crowther, Derek; Bateman, Chris; Vartan, C. P.; Whitehouse, J. M. A.; Malpas, J. S.; Fairley, G. Hamilton; Scott, Ronald Bodley

doi:10.1136/bmj.4.5734.513

Cited by 122 publications

(36 citation statements)

References 7 publications

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“…The idea of using BCG as maintenance immunotherapy in acute leukemia dates back to the late 1960s, 61 before the combination of cytarabine and daunorubicin was recognized as a potent induction regimen in AML. 62 Of the four RCTs conducted in the 1970s and 1980s to assess the value of BCG vaccination as maintenance therapy over observation after consolidation, 22,49,56,63 only 1 was a group 1 study. 22 In that small study, 41 patients were randomly assigned to observation vs BCG vaccination together with irradiated allogeneic AML cells, and remission duration (median, 35 vs 20 weeks) and OS (median, 90 vs 45 weeks) were significantly longer in the maintenance arm.…”

Section: Case 1: Maintenance Therapy After Consolidationmentioning

confidence: 99%

Maintenance therapy in acute myeloid leukemia: an evidence-based review of randomized trials

Rashidi

Walter

Tallman

et al. 2016

Blood

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Section: Case 1: Maintenance Therapy After Consolidationmentioning

confidence: 99%

Maintenance therapy in acute myeloid leukemia: an evidence-based review of randomized trials

Rashidi

Walter

Tallman

et al. 2016

Blood

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“…Subsequent to initial clinical and experimental experiences, 1,[115][116][117][118] it became evident that a definitive experimental model for AML was essential for the development of new therapeutic advances. Preliminary described mouse models, [119][120][121][122][123] were inadequate subsequent to poor transplantability, difficulties in separating extramedullary haematopoiesis and leukemoid reactions from true leukaemia, 124 with an inability to perform extracorporeal blood experimentation.…”

Section: Transplantable Modelsmentioning

confidence: 99%

Animal models of acute myelogenous leukaemia – development, application and future perspectives

2005

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From the early inception of the transplant models through to contemporary genetic and xenograft models, evolution of murine leukaemic model systems have been critical to our general comprehension and treatment of cancer, and, more specifically, disease states such as acute myelogenous leukaemia (AML). However, even with modern advances in therapeutics and molecular diagnostics, the majority of AML patients die from their disease. Thus, in the absence of definitive in vitro models which precisely recapitulate the in vivo setting of human AMLs and failure of significant numbers of new drugs late in clinical trials, it is essential that murine AML models are developed to exploit more specific, targeted therapeutics. While various model systems are described and discussed in the literature from initial transplant models such as BNML and spontaneous murine leukaemia virus models, to the more definitive genetic and clinically significant NOD/SCID xenograft models, there exists no single compendium which directly assesses, reviews or compares the relevance of these models. Thus, the function of this article is to provide clinicians and experimentalists a chronological, comprehensive appraisal of all AML model systems, critical discussion on the elucidation of their roles in our understanding of AML and consideration to their efficacy in the development of AML chemotherapeutics.

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“…The most successful therapy for the induction of remission in acute myelogenous leukaemia is with regimens that employ cytosine arabinoside, either in combination with daunorubicin (Crowther et al, 1970(Crowther et al, , 1973 or 6-mercaptopurine (6MP) (Bailey et al, 1971), or 6-thioguanine (Clarkson, 1972). Only a small proportion of patients with acute lymphoblastic leukaemia fail to respond to prednisone and vincristine therapy, at least in children (Simone et al, 1972).…”

mentioning

confidence: 99%

Adult Acute Leukaemia

Atkinson¹,

Wells²,

Clink³

et al. 1974

Br J Cancer

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Seventy-eight adult patients with acute leukaemia were classified cytologically into 3 categories: acute lymphoblastic leukaemia (ALL), acute myelogenous leukaemia (AML) or acute undifferentiated leukaemia (AUL). The periodic acid-Schiff stain was of little value in differentiating the 3 groups. The treatment response in each group was different: 94% of patients with ALL (16/17) achieved complete remission with prednisone, vincristine and other drugs in standard use in childhood ALL; 59% of patients with AML (27/46) achieved complete remission with cytosine arabinoside and daunorubicin (22 patients), or 6-thioguanine and cyclophosphamide (2 patients), 6-thioguanine, cyclophosphamide and Adriamycin (1 patient), and cytosine and Adriamycin (1 patient); only 2 out of 14 patients (14%) with acute undifferentiated leukaemia achieved complete remission using cytosine and daunorubicin after an initial trial of prednisone and vincristine had failed. Prednisone and vincristine would seem to be of no value in acute undifferentiated leukaemia. It would seem also that no benefit is obtained by classifying all patients with acute leukaemia over 20 years of age as “adult acute leukaemia” and treating them with the same polypharmaceutical regimen. The problems posed by each disease are different and such a policy serves only to obscure them. Images Fig. 1 Fig. 2 Fig. 3

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Combination Chemotherapy using L-Asparaginase, Daunorubicin, and Cytosine Arabinoside in Adults with Acute Myelogenous Leukaemia

Cited by 122 publications

References 7 publications

Maintenance therapy in acute myeloid leukemia: an evidence-based review of randomized trials

Maintenance therapy in acute myeloid leukemia: an evidence-based review of randomized trials

Animal models of acute myelogenous leukaemia – development, application and future perspectives

Adult Acute Leukaemia

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