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1.
Naturwissenschaften ; 103(3-4): 31, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26956233

ABSTRACT

Shifts to new ecological settings can drive evolutionary changes in animal sensory systems and in the brain structures that process sensory information. We took advantage of the diverse habitat ecology of Neotropical army ants to test whether evolutionary transitions from below- to above-ground activity were associated with changes in brain structure. Our estimates of genus-typical frequencies of above-ground activity suggested a high degree of evolutionary plasticity in habitat use among Neotropical army ants. Brain structure consistently corresponded to degree of above-ground activity among genera and among species within genera. The most above-ground genera (and species) invested relatively more in visual processing brain tissues; the most subterranean species invested relatively less in central processing higher-brain centers (mushroom body calyces). These patterns suggest a strong role of sensory ecology (e.g., light levels) in selecting for army ant brain investment evolution and further suggest that the subterranean environment poses reduced cognitive challenges to workers. The highly above-ground active genus Eciton was exceptional in having relatively large brains and particularly large and structurally complex optic lobes. These patterns suggest that the transition to above-ground activity from ancestors that were largely subterranean for approximately 60 million years was followed by re-emergence of enhanced visual function in workers.


Subject(s)
Ants/anatomy & histology , Ecosystem , Animals , Biological Evolution , Brain/anatomy & histology
2.
Bone Marrow Transplant ; 17(4): 549-54, 1996 Apr.
Article in English | MEDLINE | ID: mdl-8722353

ABSTRACT

Twenty-five patients with hematologic malignancies were treated with busulfan (16 mg/kg) and cyclophosphamide (50 mg/kg x 3 days) as conditioning for bone marrow transplantation using marrow from serologically matched, DR locus genotypically identical unrelated donors. Previous studies of BuCy2 as conditioning for UD-BMT have reported a graft failure rate of up to 21% suggesting it may be insufficiently immunosuppressive in this setting. We elected not to use BuCy4 as it may have a higher incidence of extramedullary toxicity. In addition the patients received GM-CSF (500 mg/m2) from day 0, cyclosporine and short-course methotrexate (15 mg/m2 x 1, then 10 mg/m2 x 3) as GVHD prophylaxis and prophylactic ganciclovir at engraftment if either they or their donor were CMV antibody positive. The median age of the 25 patients was 41 years and the most common diagnosis was CML (76%). Seven patients were considered poor risk and eight males were recipients of marrow from female donors. Sixteen patients survive at a median of 435 days from transplant. The actuarial overall and disease-free survivals at 1 year in this group of older patients were 62 +/- 20% and 57 +/- 20% and 100-day survival was 70%. The engraftment rate was 100%; there have been no instances of secondary graft failure. Fifteen patients (60%) developed grade II-IV GVHD and 12 of 16 (75%) developed some chronic GVHD but only half of these were extensive. The performance status of survivors is good (median of 90); seven of 12 eligible patients are back at work. This study demonstrates that UD-BMT can be successfully performed in very closely HLA-matched older patients using a chemotherapy-only protocol and that low rates of severe acute GVHD can be achieved without T cell depletion.


Subject(s)
Bone Marrow Transplantation , Busulfan , Cyclophosphamide , Hematologic Neoplasms/therapy , Tissue Donors , Transplantation Conditioning/methods , Actuarial Analysis , Acute Disease , Adult , Anti-Infective Agents/therapeutic use , Bone Marrow Transplantation/adverse effects , Cause of Death , Critical Care , Cyclosporine/therapeutic use , Disease-Free Survival , Female , Graft Survival , Graft vs Host Disease/epidemiology , Graft vs Host Disease/etiology , Graft vs Host Disease/prevention & control , Granulocyte-Macrophage Colony-Stimulating Factor/therapeutic use , HLA-DR Antigens/genetics , Hematologic Neoplasms/mortality , Hepatic Veno-Occlusive Disease/etiology , Histocompatibility , Humans , Immunosuppressive Agents/therapeutic use , Infections/epidemiology , Lymphocyte Depletion , Male , Methotrexate/therapeutic use , Middle Aged , Risk , Survival Analysis , T-Lymphocytes , Transplantation, Homologous , Treatment Outcome
3.
Bone Marrow Transplant ; 15(3): 361-5, 1995 Mar.
Article in English | MEDLINE | ID: mdl-7599559

ABSTRACT

Relapse is still a common problem after bone marrow transplant (BMT) and teh value of adding etoposide to standard conditioning agents is being tested. The aim of the study was to assess the extramedullary toxicity which resulted from adding etoposide to busulphan 16 mg/kg and cyclophoshamide 120 mg/kg (BuCY2). Eighty four patients received etoposide 40 mg/kg in addition to BuCY2 as conditioning for autologous and allogeneic BMT for leukemia and lymphoma. The Bearman system of grading extramedullary toxicity was used along with a system of grading skin toxicity that we devised. There were seven acute toxic deaths (8%) and in total 15 patients experienced life-threatening or fatal toxicity. The major finding was a striking increase in pulmonary toxicity with six deaths (five alveolar hemorrhage and one pulmonary embolus). Five of seven of the patients with severe pulmonary toxicity had been given irradiation to the lung fields (P < 0.001). Thirty nine per cent of patients had veno-occlusive disease of the liver but the case fatality rate was low (1 of 33). Dermatologic toxicity was experienced by 82% of patients and was symptomatically troublesome but rapidly reversible. The addition of etoposide to BuCY2 increases non-hematological toxicity. This regimen is associated with severe pulmonary toxicity in patients with a history of prior chest irradiation. A high incidence of skin toxicity was seen; a system for describing this toxicity is proposed.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/adverse effects , Bone Marrow Transplantation , Leukemia/therapy , Lymphoma/therapy , Adolescent , Adult , Biopsy , Busulfan/adverse effects , Combined Modality Therapy , Cyclophosphamide/adverse effects , Etoposide/adverse effects , Female , Graft vs Host Disease/etiology , Humans , Leukemia/mortality , Lung/drug effects , Lymphoma/mortality , Male , Middle Aged , Recurrence , Skin/drug effects , Skin/pathology , Skin/radiation effects , Survival Rate , Transplantation, Autologous , Transplantation, Homologous
4.
Semin Oncol ; 20(4 Suppl 4): 50-4; quiz 55, 1993 Aug.
Article in English | MEDLINE | ID: mdl-8342076

ABSTRACT

Most bone marrow transplantation preparative regimens use total body irradiation as one component. Recently, however, two non-total body irradiation containing autologous bone marrow transplantation preparative regimens have been evaluated in patients with lymphoid malignancies. The first regimen consisted of carmustine, etoposide, and cisplatin; some patients also received involved-field radiotherapy to sites of prior disease. Of the 79 patients with relapsed or refractory lymphoma who participated in this study, 57 (72%) achieved a complete remission and 40 (51%) remain in complete remission. Treatment-related deaths occurred in five patients (6%). The second preparative regimen evaluated consisted of busulfan, etoposide, and cyclophosphamide and included 21 patients with Hodgkin's lymphoma, non-Hodgkin's lymphoma, or acute lymphocytic leukemia. Sixteen patients (76%) achieved complete remission and 12 (57%) remain disease free. The regimen-related mortality rate in this study was 14%. The three treatment-related deaths were all due to pulmonary toxicity. The results of these clinical trials indicate that both the carmustine/etoposide/cisplatin regimen and the busulfan/etoposide/cyclophosphamide regimen are effective in treating lymphoid malignancies. Treatment-related toxicities and deaths are significant, but not prohibitive. Accordingly, these new preparative regimens deserve further evaluation in the treatment of patients with lymphoma or leukemia.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bone Marrow Transplantation/methods , Lymphoma/therapy , Adolescent , Adult , Busulfan/administration & dosage , Carmustine/administration & dosage , Cisplatin/administration & dosage , Combined Modality Therapy , Cyclophosphamide/administration & dosage , Etoposide/administration & dosage , Humans , Lymphoma/drug therapy , Lymphoma/radiotherapy , Middle Aged , Survival Analysis , Treatment Outcome
6.
Bone Marrow Transplant ; 10(5): 435-8, 1992 Nov.
Article in English | MEDLINE | ID: mdl-1464006

ABSTRACT

We performed a retrospective analysis of 42 consecutive patients undergoing autologous BMT to determine the incidence of second and third degree heart block following the infusion of cryopreserved autologous bone marrow and to identify any predisposing characteristics. A decrease in heart rate > or = 10 beats/min was observed in 80.5% of patients, with a mean decrement of 27 +/- 7 beats/min. 48.8% of patients developed absolute bradycardia (< or = 60 beats/min). Four of 41 patients (9.7%) experienced high-grade heart block: 9.7% second degree and 4.8% third degree. Heart block patients did not differ from the non-heart block group with respect to age, interval from diagnosis or bone marrow harvest to transplant, cardiac risk factors, pretransplant electrocardiograms or radionuclide angiograms, transplant chemotherapy regimens or serum chemistry values. There was an increased incidence of heart block in patients with prior exposure to cyclophosphamide (p < 0.05) and vinca alkaloids (p < 0.05). There appears to be a high incidence of transient second and third degree heart block following autologous marrow infusion. This may be related to prior chemotherapy, but more likely is an effect of the infusate itself. Predisposing factors were not identified.


Subject(s)
Bone Marrow Transplantation/adverse effects , Heart Block/etiology , Hodgkin Disease/surgery , Leukemia, Myeloid, Acute/surgery , Adolescent , Adult , Cyclophosphamide/therapeutic use , Female , Hodgkin Disease/drug therapy , Humans , Leukemia, Myeloid, Acute/drug therapy , Male , Middle Aged , Retrospective Studies , Vinca Alkaloids/therapeutic use
7.
J Clin Oncol ; 10(11): 1682-9, 1992 Nov.
Article in English | MEDLINE | ID: mdl-1403051

ABSTRACT

PURPOSE: We determined the toxicity and efficacy of a new preparative autologous bone marrow transplantation (ABMT) regimen in patients with relapsed or refractory non-Hodgkin's lymphoma or Hodgkin's disease. PATIENTS AND METHODS: Forty-four non-Hodgkin's lymphoma and 35 Hodgkin's disease patients 16 to 63 years of age were given intravenous carmustine (BCNU) 600 to 1,050 mg/m2, etoposide 2,400 to 3,000 mg/m2, and cisplatin 200 mg/m2 (BEP) and ABMT. Fifty-nine patients also received 15 to 20 Gy local radiation (involved-field radiotherapy [RI]) to active or previously bulky (> 5 cm) disease sites. RESULTS: Nonhematologic toxicities included nausea, vomiting, high-tone hearing loss, stomatitis, esophagitis, diarrhea, and hepatic and pulmonary toxicity. Two patients died within 40 days of marrow infusion as a result of sepsis and one patient died 7 months after transplant as a result of pulmonary fibrosis. Complete remissions (CRs) were noted in 72% (n = 57) of patients (n = 33 non-Hodgkin's lymphoma; n = 24 Hodgkin's disease). Forty patients (51%) remained alive and disease-free (n = 24 non-Hodgkin's lymphoma; n = 16 Hodgkin's disease) at a median of 17 (range, 8 to 57) months after marrow reinfusion. CONCLUSIONS: This regimen seems to be effective for relapsed lymphoma patients whose disease continues to exhibit chemotherapy sensitivity (16 of 24 [67%] disease-free). Furthermore, this regimen seems to be effective in patients who have never attained a CR (seven of 19 [37%] disease-free).


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bone Marrow Transplantation , Lymphoma/therapy , Adolescent , Adult , Bone Marrow Purging , Carmustine/administration & dosage , Cisplatin/administration & dosage , Combined Modality Therapy , Etoposide/administration & dosage , Humans , Middle Aged , Recurrence , Survival Analysis , Transplantation, Autologous , Treatment Outcome
8.
Leuk Res ; 16(4): 415-6, 1992.
Article in English | MEDLINE | ID: mdl-1564944

ABSTRACT

Two cases of IgA multiple myeloma treated with syngeneic bone marrow transplant and a non-total body irradiation (TBI) conditioning regimen are reported. Both patients presented with stage III disease which responded to standard chemotherapeutic management. The myelo-ablative program for transplant consisted of busulfan and cyclophosphamide (Bu/Cy). Evaluation at 40 days post-transplant revealed no evidence of residual myeloma in either patient. One patient died of disseminated Aspergillus fumigatus at day 73 post-transplant. The other patient relapsed at 18 months post-transplant. This conditioning regimen shows efficacy in aggressive myeloma and could be considered earlier in the disease.


Subject(s)
Bone Marrow Transplantation , Multiple Myeloma/surgery , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Busulfan/administration & dosage , Combined Modality Therapy , Cyclophosphamide/administration & dosage , Female , Humans , Middle Aged , Multiple Myeloma/drug therapy , Multiple Myeloma/radiotherapy , Transplantation, Isogeneic , Whole-Body Irradiation
9.
Am J Clin Oncol ; 14(1): 52-4, 1991 Feb.
Article in English | MEDLINE | ID: mdl-1987740

ABSTRACT

Thirteen patients with leukemia were treated with a combination of cytosine arabinoside (ara-C) (3 g/m2 by 1-h infusion every 12 h for 12 doses) and etoposide (100 mg/m2 daily over 1 h for 3 doses). Toxicity of the regimen consisted of severe hematologic suppression, moderate abdominal colic with vomiting and diarrhea, and occasionally severe central nervous system (CNS) toxicity. Two patients received the regimen as consolidation for acute myelogenous leukemia in remission. Of the remaining 11 patients with chronic myeloid leukemia (CML)-blast crises or relapsed/refractory acute myeloid leukemia (AML), nine patients (82%) obtained CR (or chronic phase) and two patients obtained partial remission (PR). High-dose ara-C and etoposide is an effective but toxic regiment for the treatment of relapsed or refractory myeloid leukemias.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy , Leukemia, Myeloid, Acute/drug therapy , Adult , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Cytarabine/administration & dosage , Etoposide/administration & dosage , Female , Humans , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/mortality , Leukemia, Myeloid, Acute/mortality , Male , Middle Aged , Recurrence , Remission Induction , Survival Rate
10.
Bone Marrow Transplant ; 7(2): 133-7, 1991 Feb.
Article in English | MEDLINE | ID: mdl-2049557

ABSTRACT

Patients with advanced stage cutaneous T cell lymphoma (CTCL) have a median survival of 2-5 years with no currently available curative therapy. This limited pilot study was performed to determine if CTCL patients could undergo autologous bone marrow transplantation (ABMT) as a curative treatment without developing life-threatening infections. Since selection of a chemotherapeutic regimen is essentially empirical at this time, several drug combinations were screened. Total skin electron beam radiotherapy was used prior to transplantation to control the skin disease of four patients. Six patients have been transplanted and all have engrafted normally. Infections that developed after transplantation responded to conventional therapy and were typical of those observed in other patients undergoing ABMT. Five of the six patients had a complete clinical response to ABMT but three of these responses lasted less than 100 days. Two recent patients who were treated with carmustine, etoposide, and cisplatin are alive more than 1 year after transplantation without evidence of active disease. Thus, although this study does not prove the efficacy of ABMT, it does demonstrate that patients with CTCL can undergo ABMT without developing life-threatening infections and that carmustine-etoposide-cisplatin plus ABMT should be evaluated in subsequent studies to treat patients with poor prognosis CTCL.


Subject(s)
Bone Marrow Transplantation , Mycosis Fungoides/surgery , Skin Neoplasms/surgery , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carmustine/administration & dosage , Cisplatin/administration & dosage , Combined Modality Therapy , Etoposide/administration & dosage , Female , Hospitalization , Humans , Incidence , Male , Middle Aged , Mycosis Fungoides/complications , Mycosis Fungoides/drug therapy , Prognosis , Sepsis/epidemiology , Sepsis/etiology , Skin Neoplasms/complications , Skin Neoplasms/drug therapy , Transplantation, Autologous
11.
Am J Clin Oncol ; 13(3): 221-5, 1990 Jun.
Article in English | MEDLINE | ID: mdl-2346127

ABSTRACT

Veno-occlusive disease (VOD) of the liver is a major complication of bone marrow transplantation (BMT). The overall frequency of VOD has ranged from 20 to 30%, with a mortality rate greater than 40%, as reported by centers utilizing cyclophosphamide (Cy) and total body irradiation (CyTBI) or various chemotherapeutic regimens, including the busulfan (Bu) (4 mg/kg for 4 days) and Cy (50 mg/kg for 4 days) (BuCy4) combination. Since 1986, Hahnemann University (HU) has primarily used the BuCy2 regimen, i.e., Bu (4 mg/kg for 4 days) followed by Cy (60 mg/kg for 2 days). We reviewed 74 consecutive patients who received either an autologous or allogeneic BMT for various malignancies from January 1986 through October 1988 to determine the frequency of VOD. Seven of 74 consecutive patients met clinical criteria for VOD, for a total frequency of 9.5%. Fifty-five patients were conditioned with various other regimens. Only 5 of the patients conditioned with BuCy2 developed VOD (9.1%). This is less than the 25% reported frequency of VOD in patients who received CyTBI (1,000 rads) and less than the 24% reported frequency of VOD in patients who received BuCy4. Only one of seven patients who developed VOD died from the disease. One patient died of sepsis after the VOD had almost completely resolved. The remaining five completely recovered. We conclude that the total Cy dose, and not Bu, is the major factor in the occurrence of VOD in Bu/Cy BMT preparative regimens, and the BuCy2 regimen reduces the frequency of VOD in autologous and allogeneic graft recipients when compared to CyTBI or the BuCy4 regimens.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bone Marrow Transplantation/adverse effects , Hepatic Veno-Occlusive Disease/etiology , Adolescent , Adult , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Busulfan/administration & dosage , Combined Modality Therapy , Cyclophosphamide/administration & dosage , Evaluation Studies as Topic , Hepatic Veno-Occlusive Disease/epidemiology , Humans , Middle Aged , Premedication , Retrospective Studies
12.
Am J Clin Oncol ; 13(3): 238-43, 1990 Jun.
Article in English | MEDLINE | ID: mdl-2346129

ABSTRACT

Recurrent leukemia following allogeneic bone marrow transplantation (BMT) for acute nonlymphocytic leukemia (ANLL) continues to be a cause of morbidity and mortality. Most relapses occur within the first 6-12 months, although disease-free survival curves do not begin to plateau until 24 months posttransplant. The majority of relapses occur in the bone marrow. Extramedullary relapses usually occur in "sequestered sites," i.e., the testis and central nervous system. Although the true incidence of extramedullary relapse in "nonsequestered" sites after allogeneic BMT for ANLL is unknown, it appears that this type of relapse is distinctly unusual. The authors present a case of an unusual extramedullary relapse of ANLL in the breast at day +613 after allogeneic BMT for ANLL. In addition, we briefly review the English BMT literature and discuss the differential diagnosis of breast masses in women who survive allogeneic BMT for ANLL.


Subject(s)
Bone Marrow Transplantation/adverse effects , Breast Neoplasms/etiology , Breast/pathology , Leukemia, Myeloid, Acute/surgery , Adult , Biopsy , Breast Neoplasms/diagnostic imaging , Breast Neoplasms/pathology , Female , Humans , Leukemia, Myeloid, Acute/pathology , Radiography
13.
Am J Clin Oncol ; 13(2): 144-7, 1990 Apr.
Article in English | MEDLINE | ID: mdl-2316481

ABSTRACT

Thirteen patients with metastatic liver carcinoma were treated with hepatic irradiation, leukopheresis and monoclonal antibodies to test the tumoricidal effects of murine 17-1A immunoglobulin G (IgG) Mab. A significant increase in survival for this group of patients was identified.


Subject(s)
Antibodies, Monoclonal/therapeutic use , Leukapheresis , Liver Neoplasms/therapy , Adult , Aged , Combined Modality Therapy , Female , Follow-Up Studies , Humans , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/secondary , Male , Middle Aged , Pilot Projects , Tomography, X-Ray Computed
14.
Bone Marrow Transplant ; 5(3): 187-91, 1990 Mar.
Article in English | MEDLINE | ID: mdl-2331539

ABSTRACT

Twenty-five consecutive patients with acute myelogenous leukemia (AML) underwent 26 allogeneic bone marrow transplants at Hahnemann University Hospital. Marrow ablation for all patients consisted of busulfan 16 mg/kg and cyclophosphamide 120 mg/kg (BUCY2). Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and methylprednisolone. Seventeen transplants were performed during first remission and the rest during subsequent remission or relapse. All patients engrafted and all but one achieved a complete remission (CR) following a short period of aplasia. Twenty-two of 25 patients are alive. All 17 patients with AML transplanted in first CR are alive and 15 of these patients are in sustained hematologic remission with an estimated 2-year disease free survival of 85%. The estimated 2-year disease free survival is 70% for all patients followed for a median of 622 days (range 134-1533). Acute GVHD of grades 2-4 occurred in 23% of these patients. Toxicities of the regimen including interstitial pneumonitis, veno-occlusive disease (VOD) and hemorrhagic cystitis were minimal. There were no treatment related deaths. These results demonstrate that BUCY2 should be considered as a preparative regimen for allogeneic bone marrow transplantation for patients with AML in first remission.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bone Marrow Transplantation/methods , Busulfan/administration & dosage , Cyclophosphamide/administration & dosage , Leukemia, Myeloid, Acute/surgery , Adolescent , Adult , Female , Graft vs Host Disease/prevention & control , Humans , Leukemia, Myeloid, Acute/drug therapy , Male , Middle Aged , Remission Induction , Survival Rate
17.
Physiol Behav ; 42(2): 173-82, 1988.
Article in English | MEDLINE | ID: mdl-3368537

ABSTRACT

Nesting and burrowing activity were measured in hamsters acclimated to either long or short day photoperiod in thermoneutrality and at 10 degrees C. Hamsters build larger nests under short day photoperiod or at 10 degrees C as compared to long day photoperiod or thermoneutrality. Both environmental cues contributed about 50% to a total increase in nest size from 1.8 g cotton/day to 7.7 g cotton/day (long day thermoneutral versus short day at 10 degrees C). Burrowing activity was suppressed by both cold or short day exposure. Daily melatonin injections, effective in inducing physiological short day adjustment under a long day photoperiod, also increased nesting scores. Hamsters which did not respond to short day conditions or to melatonin treatment physiologically lacked behavioral adjustments as well. Collectively, these results demonstrate analogies in the environmental control of physiological thermoregulatory adjustment and nesting behavior. Burrowing activity seems to be more related to reproductive needs than to thermoregulatory requirements in this hamster.


Subject(s)
Body Temperature Regulation/drug effects , Melatonin/pharmacology , Acclimatization , Animals , Behavior, Animal/drug effects , Behavior, Animal/physiology , Cricetinae , Female , Light , Male , Periodicity , Seasons , Temperature
18.
Am J Clin Oncol ; 6(4): 493-502, 1983 Aug.
Article in English | MEDLINE | ID: mdl-6191561

ABSTRACT

Between March 1980 and December 1981, 22 patients were treated with 4'(9-acridinylamino)methanesulfon-m-anisidide (m-AMSA) and 5-azacytidine (AZA), each given by I.V. push in a dosage of 150 mg/m2 for 5 days. Seven of 12 prior-remitting, acute nonlymphoblastic leukemia (ANLL) patients achieved complete remission (58%). Six ANLL patients who failed to remit on standard daunorubicin-cytosine arabinoside programs also failed to remit on the m-AMSA-AZA combination. Two patients with relapsed acute lymphatic leukemia (ALL) also failed while two patients with chronic myelocytic leukemia (CML) in evolution were cytoreduced. The seven patients who achieved remission had additional relapse-free survival for a median of six months (range 1-23+ months). One patient obtained a second remission with m-AMSA-AZA after relapse which followed a 9-month period of nonmaintained remission. Most patients demonstrated mild to moderate nausea and vomiting. Hepatic toxicity was mild to infrequent. Only four patients showed cardiac toxicity which was not life-threatening. The most troublesome toxicity was mucositis and was seen in 11 patients; four whom required I.V. hyperalimentation. We conclude that this combination is an effective salvage program for relapsed prior-remitting ANLL. Future studies should be conducted in three areas. The first study might be a comparison of relapsed prior-remitting ANLL with single-agent m-AMSA. The second, in untreated ANLL, following induction with DAT, might use m-AMSA-AZA in consolidation and maintenance arms of future protocols. The final study should explore m-AMSA-AZA activity in evolved CML in a greater number of patients.


Subject(s)
Aminoacridines/administration & dosage , Antineoplastic Agents/administration & dosage , Azacitidine/administration & dosage , Leukemia/drug therapy , Acute Disease , Adult , Aged , Aminoacridines/adverse effects , Amsacrine , Antineoplastic Agents/adverse effects , Azacitidine/adverse effects , Drug Therapy, Combination , Female , Humans , Male , Middle Aged , Prognosis , Recurrence
20.
Nursing ; 8(2): 82, 1978 Feb.
Article in English | MEDLINE | ID: mdl-244811
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