High-dose cytosine arabinoside in the treatment of acute myeloid leukaemia

Cole, Nolan; Gibson, Brenda

doi:10.1016/s0268-960x(97)90005-9

Cited by 31 publications

(28 citation statements)

References 15 publications

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“…Age-adapted high-dose cytarabine was given as 3 or 1g/m 2 intravenously(i.v. )ina3-hinfusionevery12hondays1,3,and5 forpatients<60yearsoldandpatients≥60yearsold,respectively [7,16]. The first day a patient received a consolidation therapy was defined as day1ofthatcycle,withthecycleendinguponleukocyteandthrombocyterecoveryat≥1/nland≥50/nl,respectively.Supportivecareconsisted ofconjunctivitisprophylaxis,theuseof5-HT 3 antagonistsfornauseaand vomiting, and recommendations for good oral hygiene.…”

Section: Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Outpatient Management of Acute Myeloid Leukemia after Intensive Consolidation Chemotherapy Is Feasible and Reduces Hospital Treatment Costs

Eisele

Günther²,

Ebeling³

et al. 2010

Onkologie

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Background: This study assessed the feasibility and safety of outofhospital management of acute myeloid leukemia (AML) patients during consolidation therapy. Methods: 103 consolidation cycles were analyzed retrospectively. All patients received treatment as inpatients; they were discharged provided they were in a good clinical condition and then either electively readmitted or managed as outpatients during the aplastic phase. Results: In 95/103 cycles (92%), discharge was feasible after a median of 7 (6–16) days. In 45 cycles, patients were electively readmitted at the onset of chemotherapyinduced cytopenia after a median time of 12 (9–16) days. In 50 cycles, patients were managed as outpatients. In 23/50 outpatient cycles (46%), patients required rehospitalization, the main cause being neutropenic fever. There was 1 treatmentrelated death due to sepsis in a patient in the outpatient group, accounting for an overall mortality of 2%. Transfusion requirements, occurrence of grade 3–4 toxicity, and diseasefree and overall survival after a median followup of 20 months did not differ between the treatment strategies. Comparison of diagnosisrelated group (DRG) proceeds revealed a 40% reduction with the outpatient strategy. Conclusion: Outpatient management of consolidation therapy in selected AML patients appears to be feasible and safe and may reduce hospital treatment costs.

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Section: Treatmentmentioning

confidence: 99%

“…Results: In 95/103 cycles (92%), discharge was feasible after a median of 7 (6-16) days. In 45 cycles, patients were electively readmitted at the onset of chemother apyinduced cytopenia after a median time of 12 (9)(10)(11)(12)(13)(14)(15)(16) days. In 50 cycles, patients were managed as outpa tients.…”

Section: Introductionmentioning

confidence: 99%

Outpatient Management of Acute Myeloid Leukemia after Intensive Consolidation Chemotherapy Is Feasible and Reduces Hospital Treatment Costs

Eisele

Günther²,

Ebeling³

et al. 2010

Onkologie

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“…[6][7][8][9][10] Treatment with ara-C is also associated with several adverse side effects, including myelosuppression, infections, mucositis, neurotoxicity, and acute pulmonary syndrome. [11][12][13][14] Greater sensitivity to the cytotoxic effect of ara-C may translate into an increased risk of adverse side effects in host normal tissue.…”

Section: Introductionmentioning

confidence: 99%

Population-specific genetic variants important in susceptibility to cytarabine arabinoside cytotoxicity

Hartford¹,

Duan²,

Delaney³

et al. 2009

Blood

113

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Cytarabine arabinoside (ara-C) is an antimetabolite used to treat hematologic malignancies. Resistance is a common reason for treatment failure with adverse side effects contributing to morbidity and mortality. Identification of genetic factors important in susceptibility to ara-C cytotoxicity may allow for individualization of treatment. We used an unbiased wholegenome approach using lymphoblastoid cell lines derived from persons of European (CEU) or African (YRI) ancestry to identify these genetic factors. We interrogated more than 2 million single nucleotide polymorphisms (SNPs) for association with susceptibility to ara-C and narrowed our focus by concentrating on SNPs that affected gene expression. We identified a unique pharmacogenetic signature consisting of 4 SNPs explaining 51% of the variability in sensitivity to ara-C among the CEU and 5 SNPs explaining 58% of the variation among the YRI. Population-specific signatures were secondary to either (1) polymorphic SNPs in one population but monomorphic in the other, or (2) significant associations of SNPs with cytotoxicity or gene expression in one population but not the other. We validated the gene expressioncytotoxicity relationship for a subset of genes in a separate group of lymphoblastoid cell lines. These unique genetic signatures comprise novel genes that can now be studied further in functional studies.

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“…Although several studies in adults with AML have demonstrated that high-dose Ara-C (3 g/m 2 ) can induce remission in patients who have not responded to conventional-dose Ara-C (100 mg/m 2 ), a randomized comparison of different dosing levels of high-dose Ara-C has not been performed. 26 In patients who underwent autologous BMT, we have shown that conditioning with melphalan alone is safe, with no BMTrelated deaths and with survival rates equal to those achieved with BU/CY. Furthermore, if relapse occurred following melphalan autografting, significantly more patients benefited from further chemotherapy or allogeneic BMT than from autograft conditioned with BU/CY.…”

Section: Discussionmentioning

confidence: 86%

Results of consecutive trials for children newly diagnosed with acute myeloid leukemia from the Australian and New Zealand Children's Cancer Study Group

O’Brien

Russell

Vowels

et al. 2002

Blood

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Despite improvements in the treatment of acute myeloid leukemia (AML), approximately 50% of children die of the disease. Clinical trials in adult patients with AML indicate that idarubicin may have superior efficacy when compared to daunorubicin in the remission-induction phases of chemotherapy. We conducted consecutive clinical trials in children with newly diagnosed AML in which daunorubicin (group 1, n ‫؍‬ 102) or idarubicin (group 2, n ‫؍‬ 160) was used during the remissioninduction (RI) and the early consolidation phases of chemotherapy. Idarubicin was given at a dose of either 10 mg/m 2 (group 2A, n ‫؍‬ 106) or 12 mg/m 2 (group 2B, n ‫؍‬ 53). A high rate of RI was achieved for all groups (95% group 1, 90% group 2A, 94% group 2B). There were no significant differences in 5-year event-free survival (EFS) or in overall survival (OS) when the 3 groups were compared (group 1: EFS 50%, OS 56%; group 2A: EFS 50%, OS 60%; group 2B: EFS 34%, OS 50%). RI deaths resulting from treatment toxicity were low-2% for group 1 and 5% for group 2. More gastrointestinal, pulmonary, and renal toxicity but fewer infections were observed in patients receiving idarubicin (P < .001, P ‫؍‬ .04, P ‫؍‬ .03, respectively). Following RI chemotherapy, all patients received 3 to 4 more courses of identical chemotherapy and then underwent either autologous (n ‫؍‬ 156) or an allogeneic bone marrow transplantation (BMT) (n ‫؍‬ 35). OS was higher in allogeneic BMT patients than in autologous BMT patients (79% vs 63%; P ‫؍‬ .23). We conclude that daunorubicin is as effective as idarubicin for remission-induction therapy for childhood AML and has reduced toxicity. (Blood. 2002;100: 2708-2716)

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High-dose cytosine arabinoside in the treatment of acute myeloid leukaemia

Cited by 31 publications

References 15 publications

Outpatient Management of Acute Myeloid Leukemia after Intensive Consolidation Chemotherapy Is Feasible and Reduces Hospital Treatment Costs

Outpatient Management of Acute Myeloid Leukemia after Intensive Consolidation Chemotherapy Is Feasible and Reduces Hospital Treatment Costs

Population-specific genetic variants important in susceptibility to cytarabine arabinoside cytotoxicity

Results of consecutive trials for children newly diagnosed with acute myeloid leukemia from the Australian and New Zealand Children's Cancer Study Group

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