Analysis of Treatment Failure in Acute Nonlymphocytic Leukemia Patients over Fifty Years of Age
| Autor: | Harry E. Hynes, Conrad H. Gumbart, Robert W. Veith, Donna H. Ryan, Richard H. Vial, David R. Head, Kenneth J. Kopecky, David A. Lipschitz, Michael R. Grever, Stephen M. Shiaer |
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| Rok vydání: | 1992 |
| Předmět: |
Male
Oncology Cancer Research medicine.medical_specialty medicine.medical_treatment Disease Bolus (medicine) Acute lymphocytic leukemia Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Etoposide Aged Chemotherapy business.industry Daunorubicin Remission Induction Cytarabine Hematopoietic stem cell Bone Marrow Examination Middle Aged medicine.disease Leukemia Myeloid Acute Leukemia Treatment Outcome medicine.anatomical_structure Female business medicine.drug |
| Zdroj: | American Journal of Clinical Oncology. 15:69-75 |
| ISSN: | 0277-3732 |
| Popis: | Fourteen participating centers registered 33 patients on a Southwest Oncology Group Study of adults with acute non-lymphocytic leukemia (ANLL). Induction consisted of cytosine arabinoside 70 mg/m2 days 1-7 by continuous intravenous (i.v.) infusion, VP-16 50 mg/m2 i.v. over 1 hour days 1-3, and daunomycin 30 mg/m2 i.v. bolus days 1-3. Twenty-five patients (median age 69 years) were evaluable for response. Eleven (44%) achieved a remission marrow but only 8 fulfilled both blood and marrow criteria for complete remission. Of the 11 patients with a remission marrow, there were no patients over 70 years of age. Major coexisting disease data were evaluated. Only 5 patients had no major coexisting disease and 4 of those 5 achieved a remission marrow. The study illustrates and underscores the following problems of remission induction in the elderly: (a) increased susceptibility to the stress of the induction period, with 6 patients (24%) dying before treatment day sixteen; (b) disease resistance to antileukemic therapy with persistent ANLL in 6 patients (24%), despite two induction courses; and (c) hematopoietic stem cell sensitivity in the elderly with marrow regeneration failure documented in 2 patients (8%) following induction. Acute nonlymphocytic leukemia in the elderly has a poor prognosis, and novel therapeutic approaches are warranted. |
| Databáze: | OpenAIRE |
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