ABSTRACT
The most important studies about outcome of acute leukemia come from developed countries, whereas most of the patients with this disease are in developing countries. We report predictive and prognostic factors in patients with acute lymphoblastic leukemia [ALL] in a tertiary care center in a developing country. We retrospectively reviewed the records of adult patients with acute leukemia who were referred to the American University of Beirut Medical Center between 1996 and early 2006. Of 105 patients, 36 [34%] patients were diagnosed with ALL, and included 19 [53%] males and 17 [47%] females with a median age of 34 years [range, 14-79 years]. Induction chemotherapy with curative intent was administered to 34 [94%] patients. Twenty-seven patients received intrathecal chemotherapy as prophylaxis [n=24] or as treatment for CNS disease [n=3]. Twenty-eight patients [82%] achieved complete remission [CR] after induction chemotherapy. The median overall survival [OS] time was 22 months and the five-year OS for ALL patients was 38%. The median disease-free survival [DFS] time was 12 months, while the five-year DFS was 38%. Multivariate analysis showed that age <40 years, WBC <30x10[9]/L, achievement of CR after first induction, and CNS prophylaxis were predictive factors for OS and DFS. Despite limitations and the relatively low socioeconomic status of the Lebanese population, OS [38%] and DFS [38%] are quite similar to international data. Trends toward a higher CR and DFS in adults are due to intensified consolidation chemotherapy, the use of stem cell transplantation, and improvements in supportive care
Subject(s)
Humans , Male , Female , Long-Term Care , Universities , Retrospective StudiesABSTRACT
The aim of this study is to evaluate the activity and toxicity of the combination docetaxel and irinotecan as first-line therapy for advanced non-small-cell lung cancer [NSCLC]. Twenty-two chemotherapy-naive patients with stage IIIB with pleural effusion or stage IV NSCLC received irinotecan 50 mg/m[2] on days 1, 8, and 15, and docetaxel 50 mg/m[2] on day 2, every 28 days until disease progression. Median follow-up was 10 months [range: 2-28 months]. The overall response rate was 36.4% [8/22 patients; 95% confidence interval: 16.8-56.0], with no complete responses. Median time to disease progression was 5 months [range: 1-24 months] and median overall survival was 10 months [range: 2-28]. Grade 3-4 diarrhea was observed in 2 patients [9.1%]. Grade 3-4 neutropenia occurred in 2 patients [9.1%]: 1 episode of febrile neutropenia in one patient, and 1 death due to neutropenic sepsis in another patient. One patient received transfusion for grade 4 anemia. Irinotecan showed a moderate response rate and overall survival of clinical interest. Diarrhea was the main toxicity. This regimen may be suitable for patients unable to tolerate cisplatin-based therapy, for elderly and/or for patients with poor performance status, and should be investigated in a larger trial