Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 415
Filter
2.
Journal of Experimental Hematology ; (6): 1845-1850, 2021.
Article in Chinese | WPRIM | ID: wpr-922345

ABSTRACT

OBJECTIVE@#To investigate the efficacy of high-risk myelodysplastic syndrome (MDS) patients treated by different doses of decitabine (DAC) and its safety.@*METHODS@#Thirty patients with high-risk MDS were all treated by demethylation drug DAC. According to the doses of DAC, 30 patients were divided into 10-day regimen [6 mg/(m@*RESULTS@#The patients were followed up to May 2020, in the 10-day regimen group, 10 cases achieved complete remission (CR), 3 cases achieved partial remission (PR), and 2 cases were progressive disease (PD). Four cases died, including 1 case for heart failure, 2 cases for respiratory failure and 1 case for serious infection. In the 5-day regimen group, 11 cases achieved CR, 1 case achieved PR, 3 cases were PD. Five cases died, including 2 cases for heart failure and 3 for serious infection. The CR rate and ORR of the patients in the two groups were 66.67% vs 73.33%, 86.67% vs 80.00%, respectively, which showed no significant differences, and the efficacy also showed no significant difference. After treatment, the levels of WBC, NE, Hb and PLT of the patients in 10-day regimen group were higher than those in 5-day regimen. In the 10-day regimen group, there were 11 cases of pneumonia, 2 cases of bacteremia, 1 case of skin infection and 1 case of urinary tract infection. While in the 5-day regimen group, 13 cases of pneumonia, 5 cases bacteremia, 1 case of skin infection and 3 cases of urinary tract infection. There were 2 cases with mild gastrointestinal response in the 10-day regimen group, and 7 cases with obvious nausea and anorexia in the 5-day regimen group. The symptoms were relieved after the treatment of acid suppression, stomach protection and antiemetic. The liver, kidney and heart function were monitored. One case liver function damage and 2 cases cardiac insufficiency were observed in the 10-day regimen group. Seven cases regimen cardiac insufficiency and 4 cases regimen liver function damage were observed in the 5-day regimen group.@*CONCLUSION@#10-day regimen and 5-day regimen are equally effective, but 10-day regimen is less myelosuppressive and more safer, which can be applied in clinical.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols , Azacitidine/therapeutic use , Cytarabine/therapeutic use , Decitabine/therapeutic use , Humans , Myelodysplastic Syndromes/drug therapy , Treatment Outcome
3.
Journal of Experimental Hematology ; (6): 1403-1410, 2021.
Article in Chinese | WPRIM | ID: wpr-922272

ABSTRACT

OBJECTIVE@#To establish cytarabine-resistant acute lymphoblastic leukemia (ALL) cell lines and investigate its possible resistant mechanism.@*METHODS@#Low-concentration cytarabine (Ara-C) continuously induced and cultured Jurkat and Nalm-6 cells to construct cytarabine-resistant cell lines Jurkat/Ara-C and Nalm-6/Ara-C. The cell viability was detected by CCK-8 assay, and the distribution of cell cycle was detected by flow cytometry. Real-time fluorescence quantitative PCR was used to detect the mRNA expression levels of multidrug resistant gene and Ara-C metabolic enzymes. The expression levels of cyclin were detected by Western blot.@*RESULTS@#Jurkat/Ara-C and Nalm-6/Ara-C drug-resistant cell lines were successfully established, the resistance index of which was 1 973.908±161.163 and 7 231.643± 1 190.624, respectively. Drug-resistant cell lines had no cross-resistance to commonly used chemotherapeutic drugs, such as doxorubicin. Flow cytometry showed that the ratio of G@*CONCLUSION@#Cytarabine-resistant ALL cell lines are successfully established by using low concentration continuous induction method, and its drug-resistant mechanism may be related to the deficiencies of DCK and cyclinB1.


Subject(s)
ATP Binding Cassette Transporter, Subfamily G, Member 2 , Cell Line , Cytarabine/pharmacology , Drug Resistance, Neoplasm , Humans , Neoplasm Proteins , Precursor Cell Lymphoblastic Leukemia-Lymphoma
4.
Journal of Experimental Hematology ; (6): 1071-1079, 2021.
Article in Chinese | WPRIM | ID: wpr-888520

ABSTRACT

OBJECTIVE@#To compare the efficacy and safety of different doses of daunorubicin combined with a standard dose of cytarabine as induction chemotherapy in newly diagnosed primary acute myeloid leukemia (AML) patients.@*METHODS@#The clinical data and outcome were retrospectively analyzed in 86 newly diagnosed primary AML patients who were under 65 years old and treated with daunorubicin combined with cytarabine (DA regimen) at West China Hospital of Sichuan University from January 2017 to June 2019. Patients were divided into 2 groups based on the dose of daunorubicin they received, 35 cases in the escalated-dose group [75 mg/(m@*RESULTS@#Median follow-up time of all the patients was 15 months. The CR rate and MRD@*CONCLUSION@#The escalated dose of daunorubicin can induce higher complete remission rate, deeper remission and longer duration of remission without increasing adverse events in newly diagnosed primary AML patients.


Subject(s)
Aged , Antineoplastic Combined Chemotherapy Protocols , Cytarabine/therapeutic use , Daunorubicin , Humans , Induction Chemotherapy , Leukemia, Myeloid, Acute/drug therapy , Remission Induction , Retrospective Studies
5.
Article in Chinese | WPRIM | ID: wpr-880132

ABSTRACT

OBJECTIVE@#To analysis the relationship between different BMI (body mass index) and the clinical characteristics, laboratory examination indexes of newly diagnosed adult patients with acute myeloid leukemia (AML), so as to investigate the effects of BMI to the efficacy of first induction chemotherapy.@*METHODS@#The clinical data of 145 newly diagnosed adult AML patients treated in the First Hospital of Lanzhou University from August 2015 to August 2019 were retrospective analyzed. According to the guidelines for prevention and control of overweight and obesity in Chinese adults, the BMI (kg/m@*RESULTS@#Among the 145 newly diagnosed adult AML patients, there were 71 males and 74 females. The median age was 50 years old(range 18 to 82 years old). There were 21 patients in underweight group (14.5%), 79 patients in normal weight group (54.5%), and 45 patients in overweight and obese group (31.0%). The patients with higher BMI level showed the older in age(P=0.018). There were significant differences in sex between the patients in each group(P=0.035). In overweight and obese patients, the number of male was significantly higher than female. There were no statistical differences in AML classification, comorbidities(Diabetes, hypertension, coronary heart disease), hospital days, whether secondary AML and FLT3 gene mutation among the patients in different BMI groups. There were significant differences in TG of the patients in the different groups, the overweight and obese patients were higher (P=0.007). There were no significant differences in WBC and Hb counts, ALB, TC, HDL, LDL, or LDH between the patients in each BMI group at newly diagnosed. The complete remission rate of the patients in the low body mass group or overweight and obese group were lower than that in the normal body weight group (P=0.035). The rate of documented infection during the first induction chemotherapy were significantly higher for the patients in low body mass group than those in normal weight group or overweight and obese group (P=0.038). There was no statistical difference in chemotherapy regimens, the number of chemotherapy until CR, febrile neutropenia, bleeding, and the time of neutropenia, liver and kidney toxicity among each BMI group. Multivariate analysis showed that overweight and obese (P=0.012) , FLT3 mutation (P=0.015) were the risk factors affecting the CR rate of the patients. And the patients with secondary AML, high-risk type, and newly diagnosed WBC ≥50×10@*CONCLUSION@#In newly diagnosed adult patients with AML, low body mass, overweight and obesity, and FLT3 mutations were the factors reducing the early efficacy of AML patients. There were more adverse reactions induced by chemotherapy in the low body mass group. Therefore, inappropriate BMI level can be a risk factor for assessing the prognosis of adults with newly diagnosed AML.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Body Mass Index , Cytarabine/therapeutic use , Female , Humans , Induction Chemotherapy , Leukemia, Myeloid, Acute/drug therapy , Male , Middle Aged , Prognosis , Retrospective Studies , Young Adult
6.
Article in Chinese | WPRIM | ID: wpr-880078

ABSTRACT

OBJECTIVE@#To study the efficacy and safety of continuous intravenous infusion of 2-Chlorodeoxyadenosine (2-CdA) combined with high-dose cytarabine (Ara-C) and granulocyte colony-stimulating factor (G-CSF) (CLAG regiem) in the treatment of relapsed/refractory acute myeloid leukemia (AML).@*METHODS@#Fifteen patients with refractory/relapsed AML hospitalized in 5 medical units such as Department of Hematology, the Affiliated Tumor Hospital of Zhengzhou University and received one course of CLAG regimen from June 2014 to August 2019 were analyzed retrospectively (specifically: cladribine 5 mg/M@*RESULTS@#Among the 15 patients with refractory/relapsed AML, 9 males and 6 females, the median age was 35 (13-63) years old. FAB classification: 1 case of M@*CONCLUSION@#The CLAG regimen consisting of continuous intravenous infusion of cladribine shows high CR in the treatment of AML patients, but the duration of CR is short, myelosuppression is sever, so that infection control is the key. Allogeneic hematopoietic stem cells transplantation should be performed as soon as possible after CR.


Subject(s)
Adolescent , Adult , Antineoplastic Combined Chemotherapy Protocols , Cladribine/therapeutic use , Cytarabine/therapeutic use , Female , Granulocyte Colony-Stimulating Factor/therapeutic use , Humans , Infusions, Intravenous , Leukemia, Myeloid, Acute/drug therapy , Male , Middle Aged , Retrospective Studies , Treatment Outcome , Young Adult
7.
Hematol., Transfus. Cell Ther. (Impr.) ; 42(3): 252-254, July-Sept. 2020.
Article in English | LILACS | ID: biblio-1134035

ABSTRACT

ABSTRACT Introduction:: Most adults with acute myeloid leukemia (AML) will eventually relapse from their disease. The combination of 7-day cytarabine and an anthracycline on days 1-3 (the so called "7 + 3" regimen) can be considered standard of care of younger patients with AML. However, the treatment of the elderly ineligible for intensive chemotherapy remains a challenge. Low-dose of subcutaneous cytarabine or hypomethylating agents (HMA) have been studied this group. There are no studies investigating physician practice variation in treating AML in Brazil. Methods:: We developed a survey with ten questions in order to explore the approach to AML in Brazil. Results:: The sample size comprised 100 hematologists. Most reported regular (63%) or occasional (29%) treatment of AML patients. Karyotype analysis and polymerase chain reaction were available in 88% and 71% of institutions, respectively. Next generation sequencing analysis was used in 7% of instituitions. Younger patients receive the "7 + 3" protocol with continuous infusion of cytarabine and anthracycline in 98% of cases. The preferred anthracycline is daunorubicin (64%), followed by idarubicin (34%). The most prescribed daunorubicin dose was 60 mg/m2 (56%). Consolidation after CR with high cytarabine doses (HIDAC) was indicated by 84% of hematologists and 70% use 3 g/m2 twice a day for 3 days. Elderly and unfit patients received HMA (47%) as the preferred treatment. Conclusion:: We showed that the most prevalent AML treatments were according to current guidelines. There is room to improve on the availability of diagnostic tools and the capacity to perform bone marrow transplantation.


Subject(s)
Humans , Brazil , Leukemia, Myeloid, Acute/therapy , Surveys and Questionnaires , Bone Marrow Transplantation , Idarubicin/therapeutic use , Daunorubicin/therapeutic use , Anthracyclines/therapeutic use , Cytarabine/therapeutic use
8.
Journal of Experimental Hematology ; (6): 1991-1997, 2020.
Article in Chinese | WPRIM | ID: wpr-880004

ABSTRACT

OBJECTIVE@#To evaluate the efficacy of decitabine combined with low-dose CEG regimen (DCEG) and decitabine combined with low-dose CAG regimen (DCAG) in the treatment of elderly patients with MDS and MDS-transformed acute myeloid leukemia (AML).@*METHODS@#A prospective study was conducted in 7 medical centers, 45 patients with MDS (≥ 60 years old) and MDS-transformed AML from October 2016 to January 2019 were enrolled, with the median age of 68.5 years old. The risk stratification of patients was poor or very poor, according to IPSS-R score. The treament results of decitabine combined with CEG and decitabine combined with CAG were compared.@*RESULTS@#The comparison of the two regiem showed that the DCEG regimen had advantages on total effective rate (ORR, 86.4% vs 47.8%, respectively), overall survival time (OS) (10.0 months vs 6.0 months, respectively) and progression-free survival time (PFS) (9.0 months vs 3.0 months, respectively). About 50% of MDS patients treated by DCEG regimen achieved PR or CR, with a median OS of 31 months. Multivariate analysis showed that patients with PR or CR after induction therapy and DCEG regimen had longer survival time (31months). The incidence of bone marrow suppression, infection and treatment-related mortality rate were similar between the two groups.@*CONCLUSION@#Decitabine combined with CEG regimen could improve the survival of patients with high-risk MDS and MDS-transformed AML. The conclusion of the reaserch needs to be validated by a larger prospective randomized clinical trial.


Subject(s)
Aclarubicin , Aged , Antineoplastic Combined Chemotherapy Protocols , Azacitidine/therapeutic use , Cytarabine/therapeutic use , Decitabine/therapeutic use , Granulocyte Colony-Stimulating Factor , Humans , Leukemia, Myeloid, Acute/drug therapy , Myelodysplastic Syndromes/drug therapy , Patients , Prospective Studies , Treatment Outcome
9.
Article in Chinese | WPRIM | ID: wpr-827193

ABSTRACT

OBJECTIVE@#To investigate the effect of modified LMB 89± rituximab regimen on long-term clinical benefit for patients with Burkitt lymphoma.@*METHODS@#Clinical data of 43 patients with Burkitt lymphoma were collected and retrospectively analyzed in the period from July 2006 to October 2017. Forty-three patients were divided into 2 groups, including Hyper-CVAD regimen, R-EPOCD regimen or VDCLP regimen treated group as control (20 patients) and modified regimen group with modified LMB 89±rituximab regimen (23 patients); the event-free survival (EFS) rate, overall survival (OS) rate, cumulative incidence of relapse (CIR), non-relapse mortality rate (NRM) and adverse reaction incidence of 2 groups were compared. At the same time, the efficacy analysis for patients of modified regimen group was performed according to age and using rituximab or no.@*RESULTS@#The EFS rate and OS rate of modified regimen group were significantly higher than those of control group (P<0.05). The CRR rate and NRM rate of modified regimen group were significantly lower than those of control group (P<0.05). The EFS rate and OS rate of patients for <40 years old were significantly higher than those of patients for ≥40 years old in modified regimen group (P<0.05). The EFS rate and OS rate of patients with rituximab were significantly higher than those of patients without rituximab in modified regimen group (P<0.05). There was no significant difference in the adverse reaction incidence between 2 groups (P>0.05).@*CONCLUSION@#Modified LMB 89± rituximab regimen in the treatment of patients with Burkitt lymphoma can efficiently prolong survival time and shows the better safety; and the remigen combined with rituximab is more helpful to improve the clinical prognosis and show the better clinical effects for the patients≤40 years old.


Subject(s)
Adult , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Burkitt Lymphoma , Drug Therapy , Cyclophosphamide , Cytarabine , Disease-Free Survival , Doxorubicin , Humans , Methotrexate , Neoplasm Recurrence, Local , Retrospective Studies , Rituximab , Treatment Outcome
10.
Article in Chinese | WPRIM | ID: wpr-827189

ABSTRACT

OBJECTIVE@#To investigate the influence of conventional CAG regimen and decitabine + decreased dose CAG (D+dCAG) regimen on the clinical efficacy and safety of patients with MDS-RAEB/AML-MRC.@*METHODS@#The clinical data of 67 patients with MDS-RAEB/AML-MRC hospitalized in our hospital from March 2012 to July 2017 were analyzed retrospectively. According to chemotherapecctic regimens, 76 patients were divided into 2 groups: 37 patients treated with conventional CAG regimen were enrolled in control group, 30 patients treated with decitabine + decreased dose CAG regimen were enrolled in D+dCAG group. The complete remission (CR) rate, overall remission rate (ORR), OS and PFS time and incidence of adverse reactions in 2 groups were compared.@*RESULTS@#The CR in D+dCAG group was significantly higher than that in control group (P<0.05). ORR was not significanly different between 2 groups (P>0.05). There was no significant difference in the cumulative OS rate between 2 groups (P>0.05). There was no significant difference in the cumulative OS rate and PFS rate in nonimplantation between 2 groups (P>0.05). The incidence of adverse reactions of hematological system, pulmonary infection, skin and soft tissue infection, agranulocytosic fever and mycotic infection was not significanly different between 2 groups (P>0.05). The duration of granulocyte deficiency and platelet count less than 20×10/L were not significanly different between 2 groups (P>0.05).@*CONCLUSION@#Compared with conventional CAG regimen, decitabine + decreased dose CAG regimen in the treatment of patients with MDS-RAEB/AML-MRC can efficiently improve the remission effects and showed the well overall safety, but can not increase the survival rate.


Subject(s)
Anemia, Refractory, with Excess of Blasts , Antineoplastic Combined Chemotherapy Protocols , Cytarabine , Decitabine , Granulocyte Colony-Stimulating Factor , Humans , Leukemia, Myeloid, Acute , Myelodysplastic Syndromes , Retrospective Studies , Treatment Outcome
11.
Article in Chinese | WPRIM | ID: wpr-829036

ABSTRACT

OBJECTIVE@#To study the efficacy of small dose HAG combined with decitabine regimen in the treatment of elderly patients with acute myeloid leukemia (AML).@*METHODS@#134 elderly AML patients treated in our hospital from March 2015 to December 2018 were selected, and the patients were divided into CAG group and combined treatment group. The AML patients in CAG group was treated with CAG regimen, while the AML patients in combined treatment group was treated with small dose HAG regimen combined with decitabine. Efficacy was evaluated after treatment.@*RESULTS@#After treatment, the OR rate of the patients in combined treatment group was significantly higher than that in CAG group (χ=5.311, P=0.021). The nausea and vomiting rate, infection rate, myelosuppression rate, bleeding rate and intestinal discomfort rate showed no significant difference between the two groups (P>0.05). The CD3, CD4 and CD8 levels of patients in combined treatment group were significantly lower than those in CAG group (P<0.05). The result of followed-up for 2 years, showed that the overall survival rate of patients in combined treatment group was significantly higher than that in CAG group [(76.2±6.3)% vs (45.7±7.6)%] (χ=4.214, P<0.05), while the disease free survival rate of patients in combined treatment group were (57.4±7.7)%, which was significantly higher than that in CAG group (30.3±7.9)% (χ=5.250, P<0.05).@*CONCLUSION@#Small dose HAG regimen combined with decitabine for elderly patients with acute myeloid leukemia has a certain curative efficacy.


Subject(s)
Aged , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Cytarabine , Decitabine , Disease-Free Survival , Granulocyte Colony-Stimulating Factor , Humans , Leukemia, Myeloid, Acute , Drug Therapy , Survival Rate , Treatment Outcome
12.
Rev. colomb. cardiol ; 26(5): 272-278, sep.-oct. 2019. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1092937

ABSTRACT

Resumen Introducción: cada día se reportan efectos tóxicos de la quimioterapia en el corazón, entre ellos las arritmias; sin embargo, las publicaciones sobre bradicardia ocasionada por antineoplásicos son escasas. Objetivo: describir y analizar la presencia de bradicardia posquimioterapia en el paciente oncológico. Materiales y métodos: estudio no experimental, descriptivo, retrospectivo, en el que se incluyeron pacientes atendidos durante el año 2017 en un Servicio de Cardiología, a causa de bradicardia posquimioterapia. Resultados: se evaluaron 59 pacientes, 31 varones (52,5%) y 28 mujeres (47,5%), con una mediana de edad de 42 años. La mediana de la frecuencia cardiaca fue 46 latidos por minuto. La bradicardia fue más frecuente en leucemia mielocítica aguda (25,42%), seguida por leucemia linfoblástica aguda (20,34%). Fue asintomática en el 88,13% de los casos. Los fármacos quimioterápicos relacionados con bradicardia en leucemia mielocítica aguda fueron la citarabina en combinación con la daunorubicina, mientras que en leucemia linfoblástica aguda fueron la vincristina en combinación con la daunorubicina. Se presentó intervalo QTc largo en 12 casos (20,34%). El tiempo entre quimioterapia y el inicio de la bradicardia fue 24 a 48 horas en 35,6% y la recuperación de la frecuencia cardiaca fue entre 24 a 48 horas en el 61,02%. Conclusiones: la bradicardia sinusal como efecto adverso de la quimioterapia, es más frecuente en la leucemia mielocítica aguda, mientras que los medicamentos antineoplásicos relacionados con la bradicardia más comunes fueron la citarabina y la daunorubicina.


Abstract Introduction: There are daily reports of the toxic effects of chemotherapy on the heart, among them are the arrhythmias. However, there are very few publications on bradycardia caused by anti-neoplastic treatment. Objective: To describe and analyse the presence of post-chemotherapy bradycardia in the oncology patient. Materials and methods: A non-experimental, descriptive and retrospective study was conducted on patients seen during the year 2017 in a Cardiology Department due to post-chemotherapy bradycardia. Results: A total of 59 patients were evaluated, of whom 31 (52.5%) were males and 28 (47.5%) women, and with a median age of 42 years. The median heart rate was 46 beats per minute. The bradycardia was more common in acute myelocytic leukaemia (25.42%), followed by acute lymphoblastic leukaemia (20.34%). It was asymptomatic in 88.31% of cases. The chemotherapy drugs associated with bradycardia in acute myelocytic leukaemia were cytarabine in combination with daunorubicin, whilst in acute lymphoblastic leukaemia they were vincristine in combination with daunorubicin. A prolonged QTc interval was present in 12 (20.34%) of cases. The time between the chemotherapy and the onset of bradycardia was 24 to 48 hours in 35.6%, and the recovery of the heart rate was between 24 and 48 hours in 61.02%. Conclusions: Sinus bradycardia as an adverse effect of chemotherapy is more frequent in acute myelocytic leukaemia, whilst the most common anti-neoplastic drugs associated with bradycardia were cytarabine and daunorubicin.


Subject(s)
Humans , Male , Female , Adult , Arrhythmias, Cardiac , Bradycardia , Pharmaceutical Preparations , Cardiology , Leukemia, Myeloid , Cytarabine/adverse effects , Drug Therapy
13.
Article in English | WPRIM | ID: wpr-758904

ABSTRACT

The development of long-term surviving fetal cell cultures from primary cell tissue from the developing brain is important for facilitating studies investigating neural development and for modelling neural disorders and brain congenital defects. The field faces current challenges in co-culturing both progenitors and neurons long-term. Here, we culture for the first time, porcine fetal cells from the dorsal telencephalon at embryonic day (E) 50 and E60 in conditions that promoted both the survival of progenitor cells and young neurons. We applied a novel protocol designed to collect, isolate and promote survival of both progenitors and young neurons. Herein, we used a combination of low amount of fetal bovine serum, together with pro-survival factors, including basic fibroblast growth factor and retinoic acid, together with arabinofuranosylcytosine and could maintain progenitors and facilitate in vitro differentiation into calbindin 1+ neurons and reelin+ interneurons for a period of 7 days. Further improvements to the protocol that might extend the survival of the fetal primary neural cells would be beneficial. The development of new porcine fetal culture methods is of value for the field, given the pig's neuroanatomical and developmental similarities to the human brain.


Subject(s)
Brain , Calbindins , Cell Culture Techniques , Congenital Abnormalities , Cytarabine , Fibroblast Growth Factor 2 , Humans , In Vitro Techniques , Interneurons , Neurons , Stem Cells , Telencephalon , Tretinoin
14.
Blood Research ; : 108-113, 2019.
Article in English | WPRIM | ID: wpr-763063

ABSTRACT

BACKGROUND: Bendamustine is an attractive option for the management of both de novo and relapsed lymphomas. It is being increasingly used in the conditioning regimen for autologous stem cell transplantation (SCT) and can be an alternative to the traditionally-used carmustine. In this study, we aimed to determine the safety and efficacy of bendamustine in the conditioning regimen for autologous SCT in refractory/relapsed lymphomas. METHODS: We designed a descriptive study to evaluate bendamustine in combination with etoposide, cytarabine, and melphalan (BeEAM) in the conditioning regimen for autologous SCT. RESULTS: Fourteen patients (median age, 28 yr) with Hodgkin's lymphoma (HL) (N=8), non-Hodgkin's lymphomas (NHL) (N=5), or peripheral T-cell lymphoma, not otherwise specified (PTCL NOS) (N=1) were included in the study. A median number of 5.95×10⁶ CD34+ cells/kg were transfused. Median times to absolute neutrophil count and platelet engraftment were 17 days and 24 days, respectively. The 100-day transplantation mortality rate was 28% (4 patients). Eight patients (57.14%) had GII-III acute kidney injury, four patients (28.5%) had GIII-IV hyperbilirubinemia, and twelve patients (85%) had GII-III diarrhea. After 3 months, 37% (5 patients) and 21.4% (3 patients) demonstrated complete response and partial response, respectively. The median follow-up was 5.5 months (15 days–19 mo). At the final follow-up, 7 patients (50%) were alive and in CR. CONCLUSION: Our study showed that bendamustine is a potentially toxic agent in the conditioning regimen for autologous SCT, resulting in significant liver, kidney, and gastrointestinal toxicity. Further studies are required to assess its safety and efficacy at reduced doses.


Subject(s)
Acute Kidney Injury , Bendamustine Hydrochloride , Blood Platelets , Carmustine , Cytarabine , Diarrhea , Etoposide , Follow-Up Studies , Hodgkin Disease , Humans , Hyperbilirubinemia , Kidney , Liver , Lymphoma , Lymphoma, Non-Hodgkin , Lymphoma, T-Cell, Peripheral , Melphalan , Mortality , Neutrophils , Stem Cell Transplantation , Stem Cells
15.
Article in Chinese | WPRIM | ID: wpr-776659

ABSTRACT

OBJECTIVE@#To investigate the complications and clinical outcome of children with acute myeloid leukemia (AML) undergoing mitoxantrone-cytarabine-etoposide (MAE) induction therapy.@*METHODS@#A total of 170 children with AML were given MAE induction therapy, and the complications and remission rate were analyzed after treatment.@*RESULTS@#The male/female ratio was 1.33:1 and the mean age was 7.4 years (range 1-15 years). Leukocyte count at diagnosis was 29.52×10/L [range (0.77-351)×10/L]. Of all children, 2 had M0-AML, 24 had M2-AML, 2 had M4-AML, 48 had M5-AML, 3 had M6-AML, 7 had M7-AML, 69 had AML with t(8;21)(q22;q22), and 15 had AML with inv(16)(p13.1q22) or t(16;16)(p13.1;q22). The most common complication was infection (158/170, 92.9%). Among these 158 patients, 22 (13.9%) had agranulocytosis with pyrexia (with no definite focus of infection), and 136 (86.1%) had definite focus of infection (including bloodstream infection). Other complications included non-infectious diarrhea, bleeding, and drug-induced hepatitis. Treatment-related mortality was observed in 10 children, among whom 8 had severe infection, 1 had multiple organ failure, and 1 had respiratory failure. Remission rate was evaluated for 156 children and the results showed a complete remission rate of 85.3%, a partial remission rate of 4.5%, and a non-remission rate of 10.3%.@*CONCLUSIONS@#Induction therapy with the MAE regimen helps to achieve a good remission rate in children with AML after one course of treatment. Infection is the main complication and a major cause of treatment-related mortality.


Subject(s)
Adolescent , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Child , Child, Preschool , Cytarabine , Drug Administration Schedule , Etoposide , Female , Humans , Infant , Leukemia, Myeloid, Acute , Drug Therapy , Male , Mitoxantrone , Remission Induction
16.
Journal of Experimental Hematology ; (6): 1339-1343, 2019.
Article in Chinese | WPRIM | ID: wpr-775717

ABSTRACT

Abstract   Demethylating agents (HMAs) hold an important status in therapy for elderly acute myeloid leukemia, who are not eligible for intensive chemotherapy (ICT). Beyond the edge of monotherapy, domestic and foreign scholars have carried out a lot of studies on combination strategies, such as HMAs with low-intensity therapy (G-CSF, low-dose cytarabine and aclarubicin, CAG), with targeted therapy (BCL-2 inhibitor), with immunotherapy (immune checkpoint inhibitors, ICI), and with other epigenetic therapys (isocitrate dehydrogenase or histonedeacetylase inhibitor). Some of these researches have obtained positive results and discussed the mechanisms of combination strategies besides. In this review, the combination of HMAs with other drugs are summraized briefly.


Subject(s)
Aclarubicin , Aged , Antineoplastic Combined Chemotherapy Protocols , Cytarabine , Granulocyte Colony-Stimulating Factor , Humans , Isocitrate Dehydrogenase , Leukemia, Myeloid, Acute
17.
Journal of Experimental Hematology ; (6): 1568-1573, 2019.
Article in Chinese | WPRIM | ID: wpr-775684

ABSTRACT

OBJECTIVE@#To investigate the clinical efficacy and safety of low-dose decitabine (DAC) alone for treatment of myelodysplastic syndrome (MDS) Methods: Fifty-one patients with meddle- and high-risk MDS were selected, and were randomly divided into A, B and C groups according to the drug regimens: the therapeutic regimen in A group consisted of low dose DAC 10 mg/(m·d)×7 d; the therapeutic regimen in B group: normal dose DAC 20 mg/(m·d) ×5 d; the therapeutic regimen in C group: low dose DAC+CAG DAC 10 mg/(m·d) d 1-5,cytarabine 10 mg/(m·d) q12h d 1-7, aclaromycin 10 mg/d d 1-4,G-CSF 200 μg/(m·d), d 1-7. All patients in 3 groups were treated for 4 circles. The efficacy and response were compared among 3 groups.@*RESULTS@#The complete remission rates (CR%) in A, B and C groups were 18.75%, 22.22% and 23.53% respectively, and the overall response rate (ORR%) in A, B and C groups were 56.25%, 61.11% and 58.82% respectively, without statistical difference among 3 groups (P>0.05).After 1 year of follow-up, the survival rate was not significantly different among 3 groups, the blood cell accounts were higher than the basic value. After 1 course of treatment, the inhibition rate of III-IV grade myelosuppression was statistically significantly different among the 3 groups (P<0.05), and the infection rate among 3 groups also was statistically different, The incidence of myelosuppression and infection in A group was significantly lower than that in B and C groups. The per capita blood transfusion during the four-month treatment was not statistically different among 3 groups. however, that in the A group was lesser than B and C groups.@*CONCLUSION@#The therapeutic efficacy of low dose decitabine alone for treatment of MDS is equal to routine dose decitabine and decitabine plus CAG, but the low dose group shows less myelosuppressive and more safe effects.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols , Cytarabine , Decitabine , Therapeutic Uses , Humans , Myelodysplastic Syndromes , Drug Therapy , Treatment Outcome
18.
Article in English | WPRIM | ID: wpr-763514

ABSTRACT

Sinus histiocytosis with massive lymphadenopathy, also known as Rosai-Dorfman disease (RDD), is a rare histiocytic disorder of unknown etiology. Most patients with RDD have spontaneous remission, but in some patients, the disease recurs after complete remission and may not respond to general treatment. Some patients with RDD involving the extranodal system can have serious symptoms such as vital organ dysfunction due to mass effects, neurological symptoms caused by intracranial involvement, and respiratory distress with airway involvement. We report the case of a 7-year-old girl with severe dyspnea due to refractory extranodal RDD that caused progressive upper airway obstruction. She was admitted because of nasal congestion and persistent cervical lymphadenopathy, and diagnosed as having RDD by cervical lymph node incisional biopsy. The initial prednisone treatment did not improve her symptoms. The following contrast-enhanced neck computed tomography revealed a newly developed airway mass protruding in the upper trachea. After 8 weeks of chemotherapy with vinblastine, methotrexate, and prednisone, complete remission was attained. Seven months after chemotherapy cessation, the disease recurred, and chemotherapy with vincristine, cytarabine, and prednisone was resumed. Despite the chemotherapy and emergency radiotherapy, no improvement was observed in the cervical lymph node enlargement and airway obstructive symptom due to the upper tracheal mass. 2-Chlorodeoxyadenosine (cladribine) therapy was initiated, and the patient got complete remission after 6 cycles of the cladribine treatment and maintained no evidence of disease for 2 years. We suggest that cladribine is an effective treatment option for recurrent/refractory RDD.


Subject(s)
Airway Obstruction , Biopsy , Child , Cladribine , Cytarabine , Drug Therapy , Dyspnea , Emergencies , Estrogens, Conjugated (USP) , Female , Histiocytosis, Sinus , Humans , Lymph Nodes , Lymphatic Diseases , Methotrexate , Neck , Prednisone , Radiotherapy , Remission, Spontaneous , Trachea , Vinblastine , Vincristine
19.
Article in Chinese | WPRIM | ID: wpr-771930

ABSTRACT

OBJECTIVE@#To systematically evaluate the efficacy and safety of DCAG regimen for treating the intermediate or high risk MDS and AML.@*METHODS@#PubMed, EMbase, The Cochrane Library, WanFang Data and CNKI databases were searched to collect randomized controlled trials (RCTs) of decitabine combined with CAG regimen for intermediate or high risk MDS and AML from inception to March, 2018. The quality of each RCT was evaluated by the Cochrane collaboration´s tool for assessing the risk of bias.Then, the data were analyzed by using RevMan 5.3.@*RESULTS@#Twenty-four RCTs were included in the meta-analysis, containing 1 557 patients with intermediate or high-risk MDS and AML, of whom 594 were AML patients and 590 were MDS patients. The patients treated with the DCAG regimen were enrolled in DCAG group, and the patients treated with single-agent decitabine or CAG regimen were enrolled in control group.@*RESULTS@#The results of meta-analysis showed that compared with other therapies, the complete remission rate of DCAG regimen in patients with intermediate or high-risk MDS and AML was high (RR=1.63,95% CI=1.43-1.85,P<0.000 01), and the overall response rate was also high (RR=1. 35,95% CI=1.24-1.46,P<0.000 01); Subgroup analysis results showed that DCAG regimen was better than CAG regimen in the complete remission rate (RR=1.71,95% CI=1.49-1.97,P<0.000 01), and slightly better than single-agent decitabine group (RR=1.43,95% CI=1.08-1.91,P=0.01). In terms of adverse reactions, there was no statistically significant difference in the rates of myelosuppression, pulmonary infection, gastrointestinal reactions, and bleeding events between the 2 groups (P>0.05).@*CONCLUSION@#DCAG regimen has significant efficacy in the treatment of intermediate or high-risk MDS and AML, and is superior to CAG regimen and single-agent dicitabine regimen. As compared with control group, there was no significant difference in adverse events. Due to limited quantity and quality of the included studies, more high quality studies are needed to verify above mentioned conclusion.


Subject(s)
Aclarubicin , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Cytarabine , Decitabine , Granulocyte Colony-Stimulating Factor , Humans , Leukemia, Myeloid, Acute , Drug Therapy , Myelodysplastic Syndromes , Drug Therapy
20.
Article in Chinese | WPRIM | ID: wpr-774304

ABSTRACT

OBJECTIVE@#To investigate the efficacy, prognosis and safety of decitabine combined with low-dose CAG regimen in the treatment of elderly patients with acute myeloid leukemia (AML).@*METHODS@#The clinical data of 40 elderly patients with relapsed/refractory AML (69-85 years old) admitted to our hospital from January 2014 to August 2016 were analyzed retrospectively. 40 patients were divided into combination therapy group and CAG group according to different treatment methods. 20 patients of the combination therepy group were treated with decitabine combined with low-dose CAG (decitabine, 15 mg/m, d 1; aclarithromycin, 10 mg/m, d 3-6; Cytidine, 10 mg/m, d 1-14; recombinant human granulocyte macrophage colony-stimulating factor (G-CSF) for injection, 200 μg/(m·d), d 1-14). 20 patients of CAG group were treated by the standard CAG protocol (acralmycin 20 mg/m, d 1-4; cytarabine for injection, 15 mg/m, d 1-14; G-CSF 400 μg/(m·d), d 1-14). One course of treatment lasted for 2 weeks, after 2 courses of continuous medication, the complete remission rate (CR), overall remission rate (ORR), overall survival (OS), 1-year survival rate, hemoglobin, white blood cells, platelets improvement, and incidence of adverse reactions were compared.@*RESULTS@#In combination therapy group the CR was 55.00% (11/20), OR was 85.00% (17/20), but in the CAG group CR was 30.00% (6/20), and OR was 50.00% (10/20). Till to February 2018, out of 40 patients 17 survived, 20 died, and 3 failed to be followed-up. The median follow-up time was 12 (2 to 35) months; the median survival time in the comtination therapy group was 13 (2-35) months, and the 1-year OS rate was 70.00%, and the median survival time of the CAG group was 10 (2-31) months, and the 1-year OS rate was 50.00%, without staistical significance between the 2 groups (P>0.05). After treatment, the WBC and Plt counts in the combination therapy group were higher than those in the CAG group, but the Hb level was lower than that in the CAG group with statistically significant difference (P<0.05). In the combination therapy group, the incidence of lung infection, nausea and vomiting was higher than that of the CAG group (65.00% vs 25.00%, 50.00% vs 20.00%), with statistically significant difference (P<0.05).@*CONCLUSION@#Decitabine combined with low-dose CAG regimen is effective for the treatment of relapsed/refractory AML in the elderly. Compared with the standard CAG regimen, the long-term efficacy of this regimen is not different significantly, but its adverse reactions are increase, thus the preventive treatment should be given in time.


Subject(s)
Aged , Aged, 80 and over , Antineoplastic Combined Chemotherapy Protocols , Cytarabine , Decitabine , Granulocyte Colony-Stimulating Factor , Humans , Leukemia, Myeloid, Acute , Drug Therapy , Prognosis , Retrospective Studies , Treatment Outcome
SELECTION OF CITATIONS
SEARCH DETAIL