High-dose cytosine arabinoside: Clinical response to therapy in acute leukemia

1982 ◽  
Vol 10 (S1) ◽  
pp. 239-250 ◽  
Author(s):  
A. P. Early ◽  
H. D. Preisler ◽  
D. J. Higby ◽  
M. Brecher ◽  
G. Browman ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Clinical Response ◽  
Cytosine Arabinoside ◽  
Response To Therapy ◽  
High Dose

scholarly journals High dose cytosine arabinoside (HDARAC) in refractory acute leukemia

Cancer ◽  
1979 ◽  
Vol 44 (4) ◽  
pp. 1189-1193 ◽  
Author(s):  
Seth A. Rudnick ◽  
Edwin C. Cadman ◽  
Robert L. Capizzi ◽  
Roland T. Skeel ◽  
Joseph R. Bertino ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Cytosine Arabinoside ◽  
High Dose

scholarly journals Immunosuppressive therapy of aplastic anemia: results of a prospective, randomized trial of antithymocyte globulin (ATG), methylprednisolone, and oxymetholone to ATG, very high-dose methylprednisolone, and oxymetholone

Blood ◽  
1992 ◽  
Vol 79 (10) ◽  
pp. 2566-2571 ◽  
Author(s):  
K Doney ◽  
M Pepe ◽  
R Storb ◽  
E Bryant ◽  
C Anasetti ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Aplastic Anemia ◽  
Causes Of Death ◽  
Response To Therapy ◽  
High Dose ◽  
Actuarial Survival ◽  
High Dose Methylprednisolone ◽  
Significant Difference ◽  
Very High

Abstract Sixty-eight patients with moderate (n = 15) or severe (n = 53) aplastic anemia were entered into a prospective, randomized, two-arm treatment study comparing antihuman thymocyte globulin (ATG), lower-dose methylprednisolone (LDM) and oxymetholone to ATG, higher-dose methylprednisolone (HDM), and oxymetholone. There were no differences between the two groups when comparing age, sex, etiology of aplasia, disease duration, severity of aplasia, or pretherapy granulocyte counts. Side effects of LDM and HDM were similar. Of the 64 patients evaluable for response to therapy, 12 of 33 (36%) who received LDM had complete, partial, or minimal responses compared with 15 of 31 patients (48%) who received HDM (P = .33). Actuarial survival at 4 years is 43% for patients in the LDM group and 47% for patients in the HDM group (P = .99). Causes of death included hemorrhage, infection, evolution to acute leukemia, and complications of subsequent bone marrow transplantation. Long-term complications included paroxysmal nocturnal hemoglobinuria (n = 3), evolution to myelodysplasia or acute leukemia (n = 6), and recurrent aplasia (n = 6). We were unable to show a significant difference in toxicity, response rate, or survival for patients treated with ATG, oxymetholone, and LDM compared with patients who received ATG, oxymetholone, and HDM.

High-dose cytosine arabinoside and mitoxantrone in previously-treated acute leukemia patients

2009 ◽  
Vol 44 (4) ◽  
pp. 240-243 ◽  
Author(s):  
C. Lejeune ◽  
N. Tubiana ◽  
J. A. Gastaut ◽  
D. Maraninchi ◽  
B. Richard ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Cytosine Arabinoside ◽  
High Dose ◽  
Previously Treated

Combined Factor VIII And Plasma Exchange Therapy In The Management Of Patients With Factor VIII Inhibitors

1981 ◽  
Author(s):  
R T Wensley ◽  
R F Stevens ◽  
A M Burn
Keyword(s):  
Factor Viii ◽  
Clinical Response ◽  
Plasma Exchange ◽  
Anticoagulant Activity ◽  
Response To Therapy ◽  
Response To Treatment ◽  
High Dose ◽  
Haemophilia A ◽  
Human Factor Viii ◽  
Plasma Factor

Five patients with Haemophilia A and Factor VIII inhibitors and three patients with spontaneous Factor VIII inhibitors presented with severe or life-threatening haemorrhage. All, except one, received intermittent high dose human Factor VIII therapy combined with one or more plasma exchanges. The exception was a patient with spontaneous Factor VIII inhibitors who was plasma-exchanged without receiving Factor VIII. The five Haemophilia A patients showed a uniformly good clinical response to treatment with complete resolution of their bleeding episodes. Their inhibitors were reduced to a level approaching zero and adequate plasma Factor VIII levels were achieved. In contrast, the three patients with spontaneous Factor VIII inhibitors failed to show any clinical response to therapy. They had measurable plasma Factor VIII levels before the Factor VIII therapy, but the administered Factor VIII produced no additional increment. Their inhibitor levels were only minimally altered by therapy. Studies of the inhibitors from the haemophiliacs showed complete Factor VIII neutralisation in incubation mixtures, but inhibitor plasmas from the spontaneous cases failed to completely neutralise the admixed Factor VIII. It is postulated that in haemophiliacs with antibodies, replacement therapy is associated with the formation of stable imnune complexes which remain in the intravascular space and are removed at subsequent plasma exchange. These complexes do not show coagulant or anticoagulant activity. However, in non-haemophiliacs with acquired Factor VIII inhibitors, weaker association of Factor VIII and antibody in the immune complexes may account for the measurable plasma Factor VIII activity, and also enable the dissociated antibody to diffuse out of the intravascular space and hence be unavailable for removal by plasma exchange.

Alteration of the pharmacokinetics of high-dose ara-C by its metabolite, high ara-U in patients with acute leukemia.

1983 ◽  
Vol 1 (12) ◽  
pp. 763-771 ◽  
Author(s):  
R L Capizzi ◽  
J L Yang ◽  
E Cheng ◽  
T Bjornsson ◽  
D Sahasrabudhe ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Cytosine Arabinoside ◽  
Half Life ◽  
Disease Status ◽  
Inhibitory Effect ◽  
High Dose ◽  
Elimination Half ◽  
Kinetics Of ◽  
Time Of Administration

The pharmacokinetics of high-dose cytosine arabinoside (HiDAC) given as a three-hour intravenous infusion at 3 g/m2 were studied in five patients with acute leukemia during relapse and/or remission of their disease. Apparent steady state plasma levels of ara-C during 13 infusions averaged 115 +/- 32 microM. Upon cessation of the infusion, cytosine arabinoside (ara-C) was rapidly cleared from the plasma. The apparent postinfusion kinetics of ara-C were triexponential with a distribution half-life of 16 minutes and elimination half-lives of 1.8 hours and six hours. Total clearance averaged 86 L per hour and mean residence time averaged 0.47 hours. Disease status (relapse or remission) had no apparent effect on the pharmacokinetic characteristics of ara-C. Peak levels of ara-U averaged 310 microM and the metabolite had an average apparent elimination half-life of 3.75 hours. Despite the persistence of ara-U at about 100 microM at the time of administration of subsequent infusions of ara-C, there was no further accumulation of ara-U in the plasma with repetitive infusions of HiDAC. In vitro studies indicate that ara-U can exert an inhibitory effect on deoxycytidine (dCyd) deaminase activity. The ratio of the Ki of ara-U to the Km of ara-C for cytidine (Cyd)-dCyd deaminase is 40:1; however, during the gamma phase of ara-C elimination, the ratio of ara-U:ara-C in plasma is at least 100:1. Thus, a retardation of systemic catabolism of ara-C by ara-U is possible. Two to three hours after the termination of the HiDAC infusion, the ara-C cerebrospinal fluid: plasma ratio is 1-3:1, a feature of potential therapeutic significance. The slower elimination of ara-C from the CSF may also contribute to the plasma gamma half-life.

scholarly journals Fatal pulmonary failure complicating high-dose cytosine arabinoside therapy in acute leukemia

Cancer ◽  
1990 ◽  
Vol 65 (5) ◽  
pp. 1079-1084 ◽  
Author(s):  
Borje S. Andersson ◽  
Cassian Yee ◽  
Michael J. Keating ◽  
Kenneth B. McCredie ◽  
Mario A. Luna ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Cytosine Arabinoside ◽  
High Dose ◽  
Pulmonary Failure
Sign in / Sign up

Export Citation Format

Share Document