[Fludarabine in the treatment of chronic lymphocytic leukemia and other lymphoproliferative disorders]. / Fludarabina w leczeniu przewleklej bialaczki limfatycznej i innych zespolów limfoproliferacyjnych.

Fludarabine, an analogue of arabinosyl adenine, used since 1986 proved to be a new agent effective particularly in chronic lymphocytic leukaemia. About 35% of patients refractory to previous cytostatic treatment and about 75% of untreated patients obtained complete remissions. Nearly 90% of them revealed no minimal residual disease and no relapse during 2 years of observation. Worse response was found in patients with other low grade non-Hodgkin's lymphomas.

[Hairy cell leukemia and its treatment with 2-chlorodeoxyadenosine (2-CdA)]. / Bialaczka wlochatokomórkowa i jej leczenie 2-chlorodeoksyadenozyna (2-CdA).

In the last years a great progress was observed in the treatment of hairy cell leukaemia due to the introduction of interferon-alfa, pentostatin and above all -2-CdA. Through the programmed death - apoptosis of the hairy lymphocytes 2-CdA causes after 1-2 courses of treatment complete remissions in about 85% of previously treated as well as untreated patients. In the majority of them there are no symptoms of minimal residual disease and probability of their cure is significant.

[Effectiveness of interferon alfa in different stages of thrombocythemia (preliminary report)]. / Skutecznosc interferonu-alfa w róznych stanach nadplytkowosci (Doniesienie wstepne).

In 6 women aged 38 to 68 years with thrombocythaemia during chronic myeloid leukaemia (4 cases), myelofibrosis (1 case), and idiopathic thrombocythaemia (1 case) the effects of recombinant human alpha-interferon (Intron A, rh IFN alpha -2b, Schering) were studied. The drug was given to all patients subcutaneously in one daily dose of 3 x 10(6) u, every day for 3 weeks, and then in the same doses twice weekly for 2 weeks (5 cases) and for 14 weeks (1 case). Intron A caused in all cases a fall of peripheral blood platelet count by 37% to 65.5% (mean 50%) in relation to the initial count (532 - 1,453 x 10(9)/l). The fall of the platelet count occurred usually after 7-10 days of this treatment, and the lowest count was noted usually after 24 days (10 to 42 days). During the treatment in 4 cases the peripheral leucocyte count dropped as well by 20-70%. In no cases exacerbation of chronic myeloid leukaemia was noted, and in the patient with myelofibrosis the enlarged spleen shrunk somewhat. These results of treatment and follow-up of patients with thrombocythaemia treated with Intron A indicate a significant although short-lasting effect of platelet count fall limited, however, to the time of the treatment. Side effects of the drug included mainly febrile conditions, myalgia and arthralgia.

ALG/ATG treatment--a useful alternative for BMT in selected aplastic anaemia patients.

8 patients with severe and 4 with non-severe aplastic anaemia, aged 7 to 46 years, whose suppressor lymphocyte activity was in most cases elevated and who had no histocompatible sibling donor, underwent 1-2 courses of ALG/ATG treatment. 6 patients got CR and 1 PR and during 1-4 years they live with sustaining haemopoiesis, independent of blood transfusion (except one in PR). Among these seven responders increased suppressor lymphocyte activity normalized in 6. The adverse effects of the treatment were granulocyto- and thrombocytopenia, subfebrile states, hepatotoxicity, serum sickness and skin allergy. Five patients died because of early or late complications of the treatment or it's failure. Our results, similar to other authors', are like after BMT and supports the immunological mechanism of A.A. Immunosuppressive treatment with ALG/ATG has many advantages: no need to have identical bone marrow donor, no GVHD, possibility of treatment of patients over 30, even pretreated with blood transfusions, and finally much lower costs and efforts.

The results of treatment of selected patients with ANLL with low-dose Ara-C.

Low dose Ara-C (10-15 mg/m2) was administered subcutaneously in 1-5 courses of 14 to 21 days to 16 patients with acute nonlymphoblastic leukaemia, mostly in elderly persons and/or with pancytopenia in whom conventional chemotherapy was contraindicated or ineffective. 18 of the 26 patients were females and 8 males. The mean age was 54.9 years ranging from 31 to 81 years. Mean duration of treatment was 15.2 days. Five complete remissions and three partial remissions were obtained. The mean duration of complete remission was 4.7 months and the mean duration of partial remission was 6.7 months. Aggravation of cytopenia during the treatment and hypocellularity of bone marrow aspirates at the end of therapy suggest that low dose Ara-C exerts its main activity by suppression of leukaemic proliferation rather than by induction of differentiation in malignant cells. Our results show that low dose of Ara-C could be valuable alternative treatment in patients with contraindications or ineffectiveness of conventional intensive chemotherapy.

[Results of the treatment of patients with advanced Hodgkin's disease by the ABDiC and/or BVCPP protocols]. / Wyniki leczenia programami ABDiC i/lub BVCPP chorych w zaawansowanym okresie ziarnicy zlosliwej.

In 22 patients with phase IV of Hodgkin's disease refractory to treatment by the programmes MOPP and/or CVPP, and ABCD and/or BACOP, and in patients with recurrences after this treatment the ABDIC and/or BVCPP programmes were applied. In 5 cases this treatment was associated with radiotherapy. Complete remission lasting 30 months was achieved in one case. In 9 cases only clinical improvement was noted. Twelve patients failed to respond to this treatment. Ten patients died. The mean survival time of all patients from the beginning of treatment by ABDIC and BVCPP programmes to the end of the observation was 14 months, and the time from the diagnosis to the end of the observation was 69 months. The results of this treatment are not satisfactory.