Activity of 2-chlorodeoxyadenosine (Cladribine) in 2-hour intravenous infusion in 94 previously treated patients with low grade non-Hodgkin's lymphoma.

The purpose of our study was to determine the efficacy of 2-chlorodeoxyadenosine (2-CdA) administered in 2-hour intravenous infusions in previously treated patients with low grade non-Hodgkin's lymphoma (LGNHL). We treated 94 LGNHL patients with 2-CdA at a dosage of 0.12 mg/kg/24h in 2-hour intravenous infusion for 5 consecutive days. The treatment consisted of from 1 to 7 courses (median 3), repeated usually at monthly intervals. All patients were refractory to or relapsed after standard chemotherapy. Of these 94 patients 78 (83%) had clinical stage IV of the disease. Complete response (CR) was obtained in 12 (12.8%) and partial response (PR) in 36 (38.3%) giving an overall response rate of 51.1%. In 12 (12.8%) grade 4 thrombocytopenia with haemorrhagic diathesis was noted, grade 4 neutropenia was observed in 12 (12.8%) and infections complicated the course of treatment in 38 (40.4%) patients. 2-CdA treatment was the cause of death of 3 patients. The results of our study show that 2-CdA given in 2-hour infusions is an effective agent in advanced, heavily pretreated patients with LGNHL.

[Clinical and immunologic characteristics of CD 34 positive acute myeloid leukemia]. / Charakterystyka kliniczna i immunologiczna ostrej bialaczki szpikowej CD 34 dodatniej.

Expression of antigen CD 34+ on acute myeloid leukemia is admittedly regarded as a negative prognostic factor, however some authors deny it. The aim of our studies was clinical, morphological and immunological analysis of AML CD 34+. In the group of 39 patients with de novo AML there was 46% of AML CD 34+ (18 cases--14 women and 4 men aged 18 to 80 years--mean 52.5). The diagnosis was made according to FAB criteria and immunophenotype estimation by immunocytochemical method APAAP. The following types of AML were found: MO-4 cases, M1-1, M2-4, M4-8, M5-1. Analysis of clinical features of AML CD 34+ did not show any characteristic features either in peripheral blood smear, or bone marrow smear. Most patients were treated according to the EPR+Ara-C scheme, with addition of VP-16 in M4 types, one patient--IDA+VP-16 + Ara-C, three elderly patients were treated with low doses of Ara-c, one patient refused cytostatic treatment. Three patients achieved complete remission (17.6%), three achieved partial remission (17.6%), four died during the phase of aplasia and seven others (41.2%) were completely resistant for chemotherapy. These results confirm association between CD34 expression and drug resistance.

[Spontaneous and induced production of tumor necrosis factor (TNF alpha) by peripheral blood leukocytes in patients with acute leukemia type M 4 and M5 according to FAB]. / Spontaniczne i indukowane wytwarzanie czynnika martwicy nowotworów (TNF alpha) przez leukocyty krwi obwodowej chorych na ostra bialaczke typu M4 i M5 wg FAB.

Tumor necrosis factor (TNF) is a cytokine with pleiotropic biological activity. We have undertaken the present study to evaluate a possible ability of peripheral blood cells of healthy subjects and patients with acute monocytic leukemia to produce TNF alpha. We studied 17 leukemia patients and 8 control subjects. Spontaneous production of TNF alpha induced by LPS and Newcastle disease virus (NDV) were determined in blood cell cultures. Leukemic cells released markedly higher level of TNF alpha than control cells cultured in vitro in contrast to control cells producing TNF spontaneously. It seems that leukemic cells can produce TNF in response to very small amount of LPS; however, we cannot exclude that spontaneous TNF may be involved in autocrine regulation of proliferation and differentiation of bone marrow monocyte precursors.