Subject(s)
Cord Blood Stem Cell Transplantation/adverse effects , Lymphoma, Follicular/therapy , Primary Graft Dysfunction/etiology , Cord Blood Stem Cell Transplantation/methods , Female , Hematopoiesis/physiology , Humans , Lymphoma, Follicular/drug therapy , Lymphoma, Follicular/surgery , Middle Aged , Treatment OutcomeSubject(s)
Eosinophilia/diagnosis , Leukemia, Myeloid, Acute/diagnosis , Mutation/genetics , Oncogene Proteins, Fusion/genetics , Receptor, Platelet-Derived Growth Factor alpha/genetics , mRNA Cleavage and Polyadenylation Factors/genetics , Adult , Eosinophilia/genetics , Genetic Testing , Humans , Leukemia, Myeloid, Acute/genetics , MaleABSTRACT
Elderly patients (age >60 years) with AML who are selected for curative treatment frequently receive anthracycline/cytarabine containing regimens. The anthracendione mitoxantrone (MTN) in combination with cytarabine (Ara-C) produces comparable complete remission rates to other regimens and may be less toxic. Over a 12 year period, 75 patients (median age 67 years, range 60-83 years) referred with newly diagnosed AML were treated with MTN and ara-C. MTN was administered at 12 mg/m(2)/day intravenously for three days in the first 26 patients, and 10 mg/m(2)/day intravenously for five days in a subsequent 49 patients. Ara-C was administered at a dose of 100 mg/m(2) twice daily intravenously for seven days. Complete remission (CR) was achieved in 34 out of 75 patients (45%). The median disease-free survival overall was 7.5 months (one month to nine and a half years). The median survival was one year for patients in whom CR was achieved, compared to four months in patients whom treatment failed (P=0.001). Age alone was predictive of achievement of CR, whilst presentation karyotype, serum LDH and patient age correlated with overall survival. These results confirm that although elderly patients have a poor outcome, prognostic factors can be identified that influence treatment outcome in this important group of patients.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cytarabine/administration & dosage , Leukemia, Myeloid, Acute/drug therapy , Mitoxantrone/administration & dosage , Aged , Aged, 80 and over , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/toxicity , Biomarkers/blood , Chromosome Aberrations , Female , Humans , Leukemia, Myeloid, Acute/diagnosis , Leukemia, Myeloid, Acute/mortality , Male , Middle Aged , Ploidies , Prognosis , Remission Induction/methods , Survival Analysis , Treatment OutcomeABSTRACT
Comparative genomic hybridization (CGH) and multiplex-fluorescence in situ hybridization (M-FISH) were used to evaluate the presentation karyotype in 15 and 18 patients respectively, aged >/=60 years, with acute myeloid leukemia (AML). Conventional G-banded analysis was performed in all patients prior to evaluation. Comparative genomic hybridization confirmed the G-banded karyotype fully in 12 patients and partially in two patients. Normal CGH profiles were observed in patients with a normal karyotype and in one patient with a balanced chromosomal translocation as the sole cytogenetic aberration. Multiplex-fluorescence in situ hybridization provided additional information in two patients with a complex karyotype, but failed to detect a telomeric translocation in one patient. Eight patients with normal G-banded karyotypes appeared normal by M-FISH. These results demonstrate that both CGH and M-FISH analysis correlate well with the G-banded karyotype in AML. Furthermore, although additive cytogenetic data was not provided by either technique in cases with normal karyotype, DNA copy number change and cryptic translocations below the resolution of CGH and M-FISH may still be the initiating event for leukemogenesis for these patients.
