Acute Myeloid Leukemia in a Geriatric Patient with a History of Minimal Change Disease

Background: The increase in the incidence of malignancies globally, and the increase in the usage frequency and types of new anti-cancer drugs, have made onconephrology more important in our clinical practice. Paraneoplastic glomerulonephritis constitutes an important part of this approach as well. Purpose: The association of AML-nephrotic syndrome is relatively less defined in the literature compared to other hematological malignancies. Case presentation: In this article, we present a case of acute myelocytic leukemia in a patient who was diagnosed with minimal change disease many years ago. Discussion and Conclusion: Hematological malignancies-MCD association, is one of the best described examples of paraneoplastic glomerulonephritis. We know that cancer can be clinically diagnosed years after the detection of renal disease in paraneoplastic glomerulonephritis. In this case; rationality of follow-up, not only during the diagnosis of glomerulonephritis but also periodically in the long term, especially in clinical situations such as MCD that occur in geriatric patients, should be discussed.

Introducción: El aumento en la incidencia de neoplasias malignas a nivel mundial, y el aumento en la frecuencia de uso y tipos de nuevos medicamentos contra el cáncer, han hecho que la onconefrología sea más importante en nuestra práctica clínica. Asimismo, la glomerulonefritis paraneoplásica también constituye una parte importante de este enfoque. Propósito: La asociación de LMA-síndrome nefrótico está relativamente menos definida en la literatura a comparación de otras neoplasias malignas hematológicas. Presentación del caso: En este artículo presentamos un caso de leucemia mielocítica aguda en un paciente al que se le diagnosticó enfermedad de cambios mínimos hace años. Discusión y Conclusión: La asociación de neoplasias hematológicas malignas-MCD, es uno de los ejemplos mejor descritos de glomerulonefritis paraneoplásica. Sabemos que el cáncer puede diagnosticarse clínicamente años después de la detección de la enfermedad renal en la glomerulonefritis paraneoplásica. En este caso, debe discutirse la racionalidad del seguimiento, no solo durante el diagnóstico de glomerulonefritis, sino también periódicamente a largo plazo especialmente en situaciones clínicas como la ECM que se presenta en pacientes geriátricos.

Pharmacokinetic characteristics of 14CCHMFL-FLT3-122 in rats / 药学学报

The study was conducted to characterize the pharmacokinetics, distribution, metabolism and excretion of CHMFL-FLT3-122 after a single oral dose of 50 mg·kg-1 [14C] labeled CHMFL-FLT3-122 in rats. Isotope tracing techniques were used to analyze drug concentration and identify the distribution of drugs in tissues and metabolites in biological samples. The experiments were approved by the Animal Ethics Committee of XenoBiotic Laboratories-China, Inc. The absolute bioavailability in male and female rats were 45.83% and 50.92% respectively. The parent drug and its metabolites were extensively distributed in the stomach, intestine, liver and lung, and were eliminated completely in 48 h. The majority of radioactivity was excreted through the feces at 92.34% of the dose with a small fraction through urine at 3.99% of the dose. The parent drug was the most significant circulating component, representing 49.23% and 70.65% over the 0-48 h collection time interval in the plasma of male and female. Two major metabolites, M553 (sulfate conjugate) and M457 (N-dealkyl product), were identified in plasma. Metabolites of CHMFL-FLT3-122, including ten phase I and four phase II metabolites, were identified. The metabolic pathways of CHMFL-FLT3-122 were proposed as N-dealkylation, oxidation, amide hydrolysis, sulfate conjugation, and glucuronic conjugation.

Effect of the PI3K/AKT signaling pathway regulated by HMGCS1 on drug sensitivity of HL-60 cells / 上海交通大学学报（医学版）

Objective: To explore the mechanism of 3-hydroxymethyl-3-methylglutaryl-CoA synthase 1 (HMGCS1) on drug sensitivity of acute myelocytic leukemia (AML) HL-60 cells. Methods: HL-60 cells were cultured. The negative control group and the HMGCS1 overexpressed group were constructed by infecting the negative control lentivirus and HMGCS1 lentivirus,and the untreated HL-60 cells were set as the blank control group. Real-time quantitative PCR (qPCR) was used to detect the expression of HMGCS1 mRNA in the 3 groups,and to verify whether the cell lines of the HMGCS1 overexpressed group were successfully constructed. The effect of HMGCS1 on the expression of AKT and phosphorylated AKT (p-AKT) in phosphatidylinositol 3 kinase (PI3K) / protein kinase B (PKB / AKT) signaling pathway was detected by Western blotting. CCK8 method was used to detect the effects of HMGCS1 and PI3K/AKT signaling pathway inhibitor LY29400 on the activity of HL-60 cells. The effect of LY29400 on HMGCS1 expression was detected by qPCR and Western blotting. Results: Compared with the negative control group,the HMGCS1 mRNA expression was increased significantly in the HMGCS1 overexpressed group (P=0.000). Compared with the blank control group and the negative control group,the p-AKT protein level in the HMGCS1 overexpression group was significantly increased,while the AKT expression of the 3 groups was not significantly different. CCK8 method showed that compared with the blank control group and the negative control group,HMGCS1 could reduce the effect of adriamycin on cell viability in the HMGCS1 overexpressed group (P=0.003,P=0.006),while LY294002 could inhibit the effect produced by HMGCS1 (P=0.000). The intervention of LY294002 could reduce the expression levels of HMGCS1 and p-AKT protein and HMGCS1 mRNA (both P=0.000) in the negative control group and the blank control group. Conclusion: HMGCS1 can reduce the sensitivity of HL-60 cells to chemotherapy drug adriamycin,while PI3K/AKT signaling pathway inhibitor LY294002 can restore its sensitivity.

Predictors of the Posttraumatic Growth in Parents of Children with Leukemia

PURPOSE: Parents caring for children with leukemia experience a tremendous challenge to get positive results in overcoming traumatic events with their children. The purpose of this study was to identify predictors of posttraumatic growth in parents of children with leukemia. METHODS: One hundred thirty seven parents (117 mothers and 20 fathers) of children with leukemia participated this study from May to August in 2016. Participants completed self-report measures of posttraumatic growth, core belief, deliberate rumination, resilience and social support. RESULTS: All the variables were positively correlated with posttraumatic growth. Core belief, resilience and social support were significant predictors related to posttraumatic growth in parents of children with leukemia and explained for 54% of the variance in posttraumatic growth. CONCLUSION: The results show that there are several factors affecting posttraumatic growth in parents of children with leukemia. Therefore, nursing intervention programs including strengthening resilience, revising core belief as well as utilizing social support systems should be provided for this population in order to enhance positive psychological change beyond parental traumatic events related to children with leukemia.

Midostaurin as a Novel Drug for the Therapy of FLT3 Mutation-positive Acute Myeloid Leukaemia / 中国药师

Midostaurin is an orally administered inhibitor of multiple tyrosine kinase receptors developed by Novartis Pharmaceuti-cals. In May 2017,it was approved in the USA for the treatment of adult patients with newly diagnosed FMS-like tyrosine kinase 3 (FLT3) mutation-positive acute myeloid leukaemia (AML). Its pharmacokinetics,pharmacodynamics,clinical trials,adverse effects and drug interactions were introduced in the paper.

Relationship of the MTHFRC677T , MTHFRA1298C , and MTRRA66G Gene Polymorphisms with Acute Myelocytic Leukemia / 中国医科大学学报

Objective To investigate the relationship of the MTHFRC677T,MTHFRA1298C,and MTRRA66G gene polymorphisms with acute myelocytic leukemia (AML).Methods Mononuclear cells were collected from 63 patients diagnosed with AML,and 60 healthy,non-AML control-group patients.DNA extracted from each sample was screened for the MTHFRC677T,MTHFRA1298C,and MTRRA66G polymorphisms.Results No significant difference was observed in the distribution of the MTHFRC677T,MTHFRA1298C,and/or MTRRA66G polymorphisms between the two patient groups.In contrast,the MTRR G allele was observed to occur 1.935 times more frequently than the MTRR an allele (x2 =4.708,P ＜ 0.05,95％ CI:1.061-3.530).No significant difference was observed in the distribution of a combination of the three gene polymorphisms (MTHFRC677T,MTHFRA1298C,and MTRRA66G)between the AML and the control group.Conclusion The results of the present study suggest that the MTHFRC677T,MTHFRA1298C,and MTRRA66G polymorphisms are not associated with AML.

Anti-apoptosis of hepatocyte growth factor on CML K562 cells / 中国药学杂志

OBJECTIVE: To investigate the protection of hepatocyte growth factor (HGF) on CML cell line K562 from apoptosis induced by etoposide (VP-16) and its molecular mechanism. METHODS: Quantitative and qualitative analyses on cell morphological change of apoptosis were performed through acridine orange (AO) staining and HE staining, and fluorescent flow cytometry.The test analyzes membrane on the surface of the PS evagination and integrity of cell membrane surface and mitochondrial membrane potential changes were performed through Annexin V-FITC/PI double dyeing and JC-1 cell dyeing tests, and apoptotic factors such as Bcl-2, Bax, Caspase-3 and Caspase-9 were measured by SYBR Green (Takara) qRT-PCR. RESULTS: The HE and AO staining revealed that apoptotic rates in HGF+VP-16 groups were significantly lower than those in VP-16 groups (P<0.05, P<0.05), HGF can inhibit the apoptosis of cells induced by VP-16; FCM (Annexin V-FITC/ PI and JC-1) tests showed that cells apoptotic rates in HGF+VP-16 groups were significantly lower than those in VP-16 groups (P<0.05, P<0.001), indicating that HGF has the anti-apoptosis function. Apoptosis related gene mRNA expression tests found that the Bcl-2 mRNA expression in HGF+VP group was obviously higher than that in the VP-16 group (P<0.001), while Bax mRNA, Caspase-3 mRNA, and Caspase-9 mRNA expressions were significantly lower than those in the VP-16 group (P<0.05, P<0.001, P<0.001), suggesting that HGF possesses antiapoptotic effect through inhibiting apoptosis gene expression and promoting the antiapoptotic gene expression simultaneously. CONCLUSION: HGF can significantly protect K562 cells from apoptosis induced by VP-16 through the HGF/c-Met way to regulate PI3K/AKT pathway.

Effects of hydroxyl morpholine resistance on K562 cells of chronic myelocytic leukemia / 中国药学杂志

OBJECTIVE: To investigate the inhibitory activity, induced differentiation-inducing activity and apoptosis-inducingactivity of hydroxyl morpholine (QDML-01) on chronic myelocytic leukemia cells line K562. METHODS: The cell growth curve was drawn based on cell counting method. The IC50 value of QDML-01 and positive control medicine to K562 cells were evaluated by methyl thiazolyl tetrazolium (MTT) assay method. Double soft agar assay method was carried out to study the ability of cell proliferation to determine efficacy of phamacognosy. The pathomorphism was analyed by the Wright-Giemsa staining method. The mechanism of cell apoptosis from morphology and gene level were investigated, by AO-EB double-staining method and DNA breakage test. The effect of QDML-01 on K562 cells from the protein level was determined by Western-blot. RESULTS: The growth curves showed the K562 cells had strong cell vitality. They came into logarithmic phase on the third generation. The MTT assay results showed that the IC50 values of QDML-01 and imatinib to K562 cells were 5. 81 and 596.88 nmol ·L-1. Double soft agar colony formation test showed that clone formed at 21 d and the inhibitory rate of QDML-01 was 81.7%. It indicated that K562 cells were sensitive to QDML-01. Morphology test result showed that QDML-01 induced K562 cells to normal cells. The results of AO-EB double-staining method showed that QDML-01 induced the apoptosis of K562 cells. The study of DNA breakage test indicated that QDML-01 can induce the apoptosis of K562 cells to produce DNA banding with step-like. Western-blot analysis result suggested that QDML-01 can downregulated the expression of P210bcr/abl protein. CONCLUSION: QDML-01 has the inhibitory activity on chronic myelocytic leukemia cells line K562 by promoting the apoptosis of K562 cells and inducing differentiation to normal cells.

Chromosome’s Influence and Curative Effect on First and Second Generation Tyrosine Kinase Inhibitor Therapy to CML / 现代检验医学杂志

Objective Research of chromosome’s influence and curative effect on first and second generation tyrosine kinase inhibitor therapy to CML patients.Methods Giving conventional genetic analysis to 80 Ph+ CML patients,and contrast CML patients’chromosome changing situation with first and second generation tyrosine kinase inhibitor therapy.Results There were 1 1 cases with other abnormalities of chromosome number and structure in 80 cases of Ph+ CML patients,and 10 cases were resistant or intolerant to imatinib.35 patients (87.5%)achieve sustained complete cytogenetic remission (CCyR)who treated with imatinib (TKI-Ⅰ)in the total 40 cases,in these 35 patients,7 cases (17.5%)got CCyR in 3 months;10 cases (25%)got CCyR in 6 months,13 cases (32.5%)got CCyR in 12 months,and 5 cases (12.5%)got CCyR in 18 months.33 patients (82.5%)achieve sustained completecytogenetic remission (CCyR)who treated with dasatinib/nilotinib (TKI-Ⅱ)in the total 40 cases,in these 33 cases,16 cases (40%)got CCyR in 3 months;9 cases (22.5%)got CCyR in 6 months,5 cases (1 2.5%)got CCyR in 1 2 months,and 3 cases (7.5%)got CCyR in 1 8 months.Conclusion Ph+ CML patients combined with other chromosome abnormity were more easily to be resistant or intolerant to imatinib,espe-cially in acceleratd phase and blastic phase.First and second generation tyrosine kinase inhibitor have little difference to treat with CML patients in long time efficacy,but the second generation effect is better than first generation in short time effica-cy.

The significance of Treg and T lymphocyte subsets in acute myelocytic leukemia / 安徽医科大学学报

Objective To explore the alterations, relationship and clinical significance of CD4 +CD25 +CD127 low/ - regulatory T cells ( Treg ) and lymphocyte subsets in peripheral blood of patients with acute myelocytic leukemia ( AML) . Methods The level of peripheral blood lymphocyte subsets and Treg of untreated AML patients and com-plete remission( CR) patients were tested by flow cytometry,and were compared with that of 30 normal controls. Re-sults The proportions of Treg were much higher in untreated AML patients and CR patients than in normal con-trols, while the mean proportion of Treg in untreated AML patients was higher than that in CR patients(P<0. 05). The proportions of NK( CD3 -CD16 +CD56 +) cells in untreated AML patients and CR patients were both decreased compared with normal controls,and the mean proportion of NK cells in untreated AML patients was lower than that in CR patients(P<0. 05). Compared with the normal controls,the proportions of CD3 +T cell, CD4 +T cell,and the ratio of CD4 +/CD8 + decreased in untreated AML patients ( P <0. 05 ) , but the proportions of CD8 +T cell was higher than in normal controls;the proportions of CD3 +T cell, CD4 + T cell, CD8 +T cell and the ratio of CD4 +/CD8 + in CR patients were close to the proportions in normal controls, but there was significant difference between CR patients and untreated AML patients(P<0. 05). Conclusion The increase of Treg, CD8 +T cell and decrease of NK cells, CD3 +T cell, CD4 +T cell, and the ratio of CD4 +/CD8 + in peripheral blood of patients with AML in-dicate that the immune function of patients with AML is depressed. Treg control the immune response of CD8 +T cells,at the same time inhibit the natural immune response of NK cells, playing a major role in the disorders of CD4 +T cells and CD8 +T cell balance,and closely relate with the development of AML. The immune treatment of patients with AML will be optimised by reducing the amount of Treg or removing the suppression function.

Observation and nursing of adverse reactions in chronic myelocytic leukemia patients receiving imatinib therapy / 中国实用护理杂志

Objective To discuss the observation and nursing of adverse reactions in chronic myelocytic leukemia patients receiving imatinib therapy.Methods Adverse reactions were observed and recorded in 193 chronic phase myelocytic leukemia patients who received imatinib therapy,and corresponding treatment and nursing were given to them.Results Among 193 patients,more than 60％ of patients had adverse reactions,of which,54％ of patients showed gastrointestinal adverse reactions including nausea,vomiting,anepithymia and diarrhea; 22％ of them had muscle and bone pain; 7％ had rash; 65％ got edema.After proper treatment and nursing,all adverse effects obtained satisfactory remission.Condusions During the treatment course of chronic myelocytic leukemia patients using imatinib,careful observation of any possible adverse reactions,and giving corresponding treatment and nursing can facilitate good compliance and longterm remission of patients.

Generalized granuloma annulare in a patient with myelocytic leukemia and chronic hepatitis B virus infection.

Granuloma annulare is a granulomatous disorder of the dermis and subcutaneous tissue, with different clinical types. Generalized granuloma annulare is a rarely encountered clinical entity. We describe a 60-year-old woman with a 4-month history of generalized annular lesions. She had a history of myelocytic leukemia and chronic hepatitis B virus infection. To date, both acute myelocytic leukemia and hepatitis B virus infection have been described independently in association with generalized granuloma annulare but have never been described together in association with generalized granuloma annulare. Probable etiological causes of granuloma annulare are discussed in our patient.

Study of Acute Myelocytic Leukemia Patient Treatment That Used Total Skin Electron Beam / 의학물리

Total Skin Electron Beam Therapy (TSEBT) of linear accelerator has become use so as to be useful, 2~9 MeV of energy territories came to be used with mycosis fungoides and cutaneous lymphomas in the superficial lesion treatment which covers the major portion of the body. I treat a patient to Stanford technique in this study, and it is 60 degrees around the patients whom Stanford technique irradiated electronic beam to a linear accelerator in horizontal directions and there is a way a standard of TSEBT treat it to six located field (anterior, posterior, and four obliques) becoming. An each field does horizontally it and consist to beam of the two component which fitted the center to a suitable angle. a patient treats it to three dual field a day in order to make short treatment time. when a first day, we treat one dual field at anterior position and two dual field at posterior position. when the second day, treat one dual field at posterior position and two dual field at anterior position. Therefore, six dual field is finished in perfect periodic two days. we made cylindrical acrylic phantom, and I inserted a dosimeter film between phantom. in order to measure a dose distribution calculation before treat a patient, and a patient checked it in six field directions that got from a treatment. It is after that thermoluminescent dosimetry (TLD) as it uses Rando phantom and then measurement dose distribution in six field directions after attaching at chest, the right and left flank, a back after irradiation.

Study of Acute Myelocytic Leukemia Patient Treatment That Used Total Skin Electron Beam / 의학물리

Total Skin Electron Beam Therapy (TSEBT) of linear accelerator has become use so as to be useful, 2~9 MeV of energy territories came to be used with mycosis fungoides and cutaneous lymphomas in the superficial lesion treatment which covers the major portion of the body. I treat a patient to Stanford technique in this study, and it is 60 degrees around the patients whom Stanford technique irradiated electronic beam to a linear accelerator in horizontal directions and there is a way a standard of TSEBT treat it to six located field (anterior, posterior, and four obliques) becoming. An each field does horizontally it and consist to beam of the two component which fitted the center to a suitable angle. a patient treats it to three dual field a day in order to make short treatment time. when a first day, we treat one dual field at anterior position and two dual field at posterior position. when the second day, treat one dual field at posterior position and two dual field at anterior position. Therefore, six dual field is finished in perfect periodic two days. we made cylindrical acrylic phantom, and I inserted a dosimeter film between phantom. in order to measure a dose distribution calculation before treat a patient, and a patient checked it in six field directions that got from a treatment. It is after that thermoluminescent dosimetry (TLD) as it uses Rando phantom and then measurement dose distribution in six field directions after attaching at chest, the right and left flank, a back after irradiation.

Experimental Study on Eqi Compound Prescription Induced Apoptosis of Acute Myelocytic Leukemia HL-60 / 中国中医药信息杂志

Objective To explore the apoptotic effect of Eqi compound prescription (contained-herb serum) on cute myelocytic leukemia HL-60 cell, which is relative to intracellular Ca2+, Caspase-3 and Bcl-2. Methods According to serum pharmacology, HL-60 cells were exposed to 10% concentrations of contained-herb serum for 24, 48, 72 and 96 hours respectively. Cells were observed under a fluore-scence microscope. SubG1 DNA was examined by flow cytometer. Intracellular Ca2+ concentration was measured by fura-2 fluorescence load method. Caspase-3 enzymatic activity were measured by colorimetry. Bcl-2 gene expression were measured by LSAB. Results The contained-herb serum could induce apoptosis of HL-60 cells. Intracellular Ca2+ concentration of treatment with Eqi was higher evidently than that of control (P

Detection of bcr-abl Fusion Gene in Chronic Myelocytic Leukemia Patients by Reverse Transcriptase Polymerse Chain Reation / 医学研究杂志

Objective To increase the sensitivity of residual leukemic cells detectin in chronic myelocytic leukemia(CML) patients with RT-PCR,the optional annealing temperature and PCR cycles were studied to confirm bcr-abl fused gene types,and bcr-abl mRNA transcripts were monitored by RQ-PCR to study the relation with CML at different phases. Methods Through changing the PCR conditions, the annealing temperature was measured from 55℃ to 60℃, and the number of reaction cycles was increased from 30 to 45.All 22 samples were examined, and bcr-abl mRNA transcripts were quantified by RQ-PCR kit. Results Bcr-abl fused gene types were found in 22 samples,of all 9 cases were b_2a_2 type, 13 cases were b_3a_2.When the annealing temperature was set for 58℃ and the number of reation cycles was set for 45,10~3 copies/ul standard samples was detected.18 samples were positive tested by RQ-PCR kit,and the value was between 10~2 to 10~6 copies/g.There were significant differce between the results of chronic phase samples and those of accelerated phase. Conclusions The RT-PCR is a reliable,sensitive and reproducible method of monitoring CML patients.The real-time RT-PCR is useful in evaluating leukemic burden,assessing response to treatment and predicating the prognosis of the disease.

Relationship of chronic myelocytic leukemia and angiogenesis factors / 中国癌症杂志

Purpose:To study the secretion and gene expression of Angiogenesis factors in the patients with CML and study the effect of Angiogenesis in the occurrence and development of CML. Methods:Concentration of VEGF in peripheral blood was determined by using ELISA. Myeloid tissue was extracted from all CML cases and ITP patients to detect MVD by using CD34 labelling. At the same time the level of VEGF,b-FGF were detected by using RT-PCR in both peripheral blood and myeloid cells.Results:Our results showed that the concentration of VEGF was obviously higher in the peripheral blood of CML patients(177.53?153.45 pg/ml) than in those of control group(73.12?19.82 pg/ml). The gene expression of VEGF and b-FGF were both higher than those of control group. The difference has statistical significance(P

A Case of Acute Myelocytic Leukemia developed the Cutaneous Granulocytic Sarcoma (Chloroma) and Leukemia Cutis / 대한피부과학회지

Cutaneous granulocytic sarcoma are rare extramedullary tumor composed of immature leukemic cells of the myeloid series. It has a characteristic greenish color caused by myeloperoxidase in the granulocytic cells. 58-year-old female patient who had been diagnosed as acute myelocytic leukemia presented multiple, variable sized, tender brown-pigmented nodules, papules and plaques on the abdomen and both upper extremities for about 4 weeks. An incision biopsy of the large subcutaneous nodule on her abdomen showed a dense dermal infiltrate of immature myeloblastic cells with pleomorphic hyperchromatic vesicular nuclei and conspicuous nucleoli. A punch biopsy of the other small papule on her abdomen showed an infiltrate of granulocytic cells with round hyperchromic nuclei and granular acidophilic cytoplasm, between the dermal collagen bundles. We present a case of the cutaneous granulocytic sarcoma (chloroma) with coexistent leukemia cutis in acute myelocytic leukemia developed from myelodysplastic syndrome.

A Case of Acute Myelocytic Leukemia developed the Cutaneous Granulocytic Sarcoma (Chloroma) and Leukemia Cutis / 대한피부과학회지

Cutaneous granulocytic sarcoma are rare extramedullary tumor composed of immature leukemic cells of the myeloid series. It has a characteristic greenish color caused by myeloperoxidase in the granulocytic cells. 58-year-old female patient who had been diagnosed as acute myelocytic leukemia presented multiple, variable sized, tender brown-pigmented nodules, papules and plaques on the abdomen and both upper extremities for about 4 weeks. An incision biopsy of the large subcutaneous nodule on her abdomen showed a dense dermal infiltrate of immature myeloblastic cells with pleomorphic hyperchromatic vesicular nuclei and conspicuous nucleoli. A punch biopsy of the other small papule on her abdomen showed an infiltrate of granulocytic cells with round hyperchromic nuclei and granular acidophilic cytoplasm, between the dermal collagen bundles. We present a case of the cutaneous granulocytic sarcoma (chloroma) with coexistent leukemia cutis in acute myelocytic leukemia developed from myelodysplastic syndrome.

Leukapheresis for Collection of Peripheral Blood Stem Cells in Children with Acute Myelocytic Leukemia / 대한혈액학회지

BACKGROUND: Post remission therapy is one of the most important issues in the treatment of acute myelocytic leukemia (AML). Recently, autologous peripheral blood stem cell transplantation (PBSCT) has become an accepted procedure to support high dose chemotherapy in children with AML. But collection of PBSC from small pediatric patients provides many challenges not faced when collecting from adult patients. Therefore, the efficient procedures and optimal timing to perform the leukapheresis should be decided. The goal of the present study was to evaluate the practice of PBSC mobilization and collection and establish predictors of the leukapheresis in children with AML. METHODS: From November 1995 to February 1998, PBSC mobilizations were performed in 15 patients with AML. PBSCs were mobilized by high dose of cytosine arabinoside and etoposide plus G-CSF. CBC and peripheral blood smear were performed daily after WBC nadir. Leukapheresis was started when the WBC count recovered to 1,000/microliter from myelosuppression and monocytes appeared on the peripheral blood smear. Leukapheretic products were assayed for mononuclear cells, CD34+ cells and CFU-GM colonies. Correlations between the yields of leukapheresis and patients characteristics were evaluated by Wilcoxon rank sums test and Pearson correlation analysis. RESULTS: Eighteen mobilizations were done in 15 patients. The duration of absolute neutrophil count or = 3,000/microliter/day) during recovery was independent variable correlated to the peak MNCs, average MNCs, peak CD34+ cells and average CD34+ cells (P<0.01). CONCLUSIONS: Mobilization procedures using high dose cytosine arabinoside and etoposide plus G-CSF are tolerable and the leukapheresis can be initiated when WBC count recovers to 1,000/microliter from myelosuppression and monocytes appear on the peripheral blood smear. Sufficient numbers of PBSC can be obtained by three leukapheresis procedures without serious adverse effects in children with AML.