allopurinol and Leukemia--Myeloid

Topics: Allopurinol; Animals; Antimetabolites; Azathioprine; Binding Sites; Drug Therapy; Enzyme Inhibitors; Enzyme Precursors; Folic Acid; Folic Acid Antagonists; Humans; Lactobacillus; Leukemia, Myeloid; Liver; Mercaptopurine; Methotrexate; Mice; Molecular Weight; Neoplasms; Nucleic Acids; Proteus; Purines; Research; Species Specificity; Thymine; Transferases; Uric Acid; Xanthine Oxidase

Topics: Allopurinol; Busulfan; Drug Evaluation; Drug Therapy, Combination; Humans; Leukemia, Myeloid; Leukocyte Count; Mercaptopurine

Topics: Administration, Oral; Adolescent; Adult; Alkaline Phosphatase; Allopurinol; Blood Urea Nitrogen; Child; Child, Preschool; Clinical Trials as Topic; Female; Gout; Humans; Injections, Intravenous; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Male; Middle Aged; Uric Acid

Topics: Allopurinol; Antimetabolites; Desensitization, Immunologic; Drug Hypersensitivity; Humans; Leukemia, Myeloid; Male; Young Adult

We report a case of Stevens-Johnson syndrome (SJS) caused by imatinib combined with allopurinol. An 82-year-old female patient who had a diagnosis of chronic myeloid leukemia was initially treated with imatinib 200 mg/day and allopurinol 100 mg for 42 days, and had a satisfactory hematological response. The dose of imatinib was adjusted to 400 mg/day for 14 days. After two weeks, she developed SJS and was transferred to the intensive care unit for further treatment because her general condition had deteriorated. The aggravated cutaneous adverse reaction improved approximately 7 days after withdrawal of imatinib. Oral steroids with antihistamines were prescribed for the treatment of severe cutaneous reaction. The symptoms of SJS completely improved 1 month after discontinuation of imatinib and allopurinol. We concluded that imatinib alone may cause serious cutaneous reaction, but the combination of 2 high-risk drugs may increase the likelihood of exposed patients developing SJS. Physicians should be aware of the possibility of SJS caused by imatinib and allopurinol prescribed simultaneously.

Topics: Aged, 80 and over; Allopurinol; Antineoplastic Combined Chemotherapy Protocols; Benzamides; Chronic Disease; Female; Humans; Imatinib Mesylate; Kidney Failure, Chronic; Leukemia, Myeloid; Piperazines; Pyrimidines; Stevens-Johnson Syndrome

Topics: Acute Disease; Adult; Allopurinol; Antimetabolites; Antineoplastic Agents; Epistaxis; Fever; Fluid Therapy; Humans; Hydroxyurea; Leukapheresis; Leukemia, Myeloid; Leukocytosis; Male; Vision Disorders

We retrospectively analyzed 126 acute myelogenous leukemia (AML) patients aged > or =60 years who had all been referred to the same hematological department between 1989 and 1999. In 76 de novo AML cases, 53 patients (median age, 72 years) were treated with combination chemotherapy (CT) for remission induction. Complete remission (CR) rate was 57.1%. The median overall survival (OS) was 16 months, and the rate of 3-year OS was 28%. The favorable prognostic factors were performance status < or =2, cholinesterase > or =100 IU, and intermediate or favorable karyotype (P < .01). Seventeen patients (median age, 78 years) with hypocellular bone marrow or poor general condition were treated with low-dose cytosine arabinoside (LDAraC). In these patients, the CR rate was 50% and the median OS was 11 months, with an OS estimate at 3 years of 14%. All patients with hypocellular bone marrow who received LDAraC for 21 days achieved CR. In 50 patients who developed AML following a myelodysplastic syndrome (MDS/AML), 22 patients (median age, 74 years) were treated with CT, and 14 (median age, 74 years) patients were treated with LDAraC. The CR rates were 22.7% and 21.4%, respectively, and the median OS durations were 8 months and 11 months, respectively. There were no significant factors that would indicate a good prognosis in MDS/AML patients.

Topics: Acute Disease; Age Factors; Aged; Allopurinol; Antimetabolites, Antineoplastic; Antineoplastic Combined Chemotherapy Protocols; Bone Marrow; Cholinesterases; Cytarabine; Daunorubicin; Disease Progression; Female; Humans; Japan; Karyotyping; Leukemia, Myeloid; Life Tables; Male; Mercaptopurine; Middle Aged; Myelodysplastic Syndromes; Neoplasm Proteins; Prognosis; Remission Induction; Risk Factors; Survival Analysis; Survival Rate

Reactive oxygen species (ROS) and caspases have been implicated as potential mediators of cell death. However, their mechanistic relationship remains to be elucidated. Here we investigated the roles of caspases in apoptosis and necrosis induced by ROS, generated by the mixture of xanthine and xanthine oxidase (X/XO). A low concentration of XO (0.025 U/ml) induced DNA fragmentation with little cellular membrane damage 3 h after treatment, suggesting the induction of apoptosis. The same treatment induced membrane blebbing, a morphological change typical of apoptosis, 15 min after treatment. A high concentration of XO (0.1 U/ml) damaged cell membranes with little concomitance of DNA fragmention, suggesting the induction of necrosis. ROS also activated caspase 3-like proteases and caspase 3 itself together with the release of cytochrome c which might be the cause of caspase activation. Apoptosis induced by low concentrations of XO and necrosis induced by high concentrations of XO was inhibited by z-DEVD-CH2F, an irreversible inhibitor of caspase 3. However, rapid induction of membrane blebbing was not inhibited by z-DEVD-CH2F. These results suggest that both apoptosis and necrosis could be induced by ROS through the activation of caspase 3-like protease; however, caspase 3 activation is not needed for ROS-induced membrane blebbing.

Topics: Apoptosis; Caspase 3; Caspases; Cell Membrane; Cytochrome c Group; DNA Fragmentation; Endopeptidases; Enzyme Activation; Enzyme Inhibitors; Humans; Leukemia, Myeloid; Necrosis; Neoplasm Proteins; Oxidative Stress; Protease Inhibitors; Reactive Oxygen Species; Tumor Cells, Cultured; Xanthine; Xanthine Oxidase

Topics: Allopurinol; Animals; Chemistry; Coronary Disease; Gout; History, 20th Century; Humans; Hypertension; Leukemia, Myeloid; National Institutes of Health (U.S.); Nephritis, Interstitial; Purines; United States; Uric Acid; Urinary Calculi; Xanthine Oxidase

Two patients with chronic myeloid leukemia (CML) showed previously undescribed variants of a "masked" Ph1 abnormality. The first patient had the karyotype 46,XY, + 21, -9, -22, +mar9,mar18 at presentation in the chronic phase. The dicentric marker 9 was interpreted as representing the usual translocation of 22q11 to 9q34, followed by translocation of the Ph1 chromosome (the deleted 22) to 9p and probable translocation of 9p to the distal long arm of the marker. The patient developed clones containing 2 and 3 copies of the "Ph1-containing" marker 9 concomitant with the metamorphosis of his disease to a more aggressive phase. The second case presented with the karyotype 46,XY,-9,-22,+two D-group markers. A complex rearrangement of chromosomes 9 and 22 is postulated, with interstitial insertion of either 9p or distal 9q into chromosome 22q11. This patient is still in the chronic phase of his disease 9 mo after presentation. The common denominator in these unusual "masked" cases is the 22q11 breakpoint. The paucity of published reports of duplication of 9q + without concurrent duplication of the Ph1 chromosome, supported by the findings in our first case, leads us to conclude that the amplification of genes on the Ph1 chromosome are more important for the evolution of the abnormal stem cell in CML than the chromosome 9 derivative.

Topics: Adult; Allopurinol; Busulfan; Chromosome Aberrations; Chromosomes, Human, 21-22 and Y; Chromosomes, Human, 6-12 and X; Humans; Karyotyping; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged

A 20-year-old male with chronic myelogenous leukemia (CML) and severe bone marrow fibrosis underwent splenectomy, then ablative chemotherapy, followed by bone marrow transplantation from a histocompatible sister. The myelofibrosis completely resolved. Prompt marrow engraftment and disappearance of Philadelphia chromosome positive cells were documented. Therefore, the presence of marrow fibrosis which frequently accompanies CML is rapidly reversible following high dose chemotherapy and is not indicative of a hostile microenvironment which could preclude marrow transplantation for patients with CML and myelofibrosis.

Topics: Adult; Allopurinol; Aspirin; Bone Marrow; Bone Marrow Transplantation; Busulfan; Drug Therapy, Combination; Fibroblasts; Hematopoiesis; Humans; Leukemia, Myeloid; Male; Primary Myelofibrosis; Splenectomy

Chronic granulocytic leukemia (CGL) developed in a 31-year-old man after he underwent a third renal transplant. The leukemia was initially controlled with azathioprine sodium and prednisone therapy, but eventually it entered blast cell crisis. This was controlled with an adult acute lymphocytic leukemia protocol with an excellent response. Despite discontinuing treatment with azathioprine and with the use of busulfan to control the peripheral WBC count, the patient maintained stable renal function for one year following treatment of the blast cell crisis and subsequently died of sepsis. We suggest that CGL after renal transplantation is similar to that observed in the general population and can be treated with the usual chemotherapeutic agents for the disorder without sacrificing renal function.

Topics: Adult; Allopurinol; Azathioprine; Humans; Hydroxyurea; Kidney Transplantation; Leukemia, Myeloid; Male; Melphalan; Postoperative Complications; Prednisone

Topics: Allopurinol; Antineoplastic Agents; Busulfan; Drug Therapy, Combination; Humans; Leukemia, Myeloid; Mercaptopurine

Topics: Adult; Allopurinol; Anemia, Aplastic; Azathioprine; Blood Transfusion; Drug Interactions; Humans; Kidney Failure, Chronic; Kidney Transplantation; Leukemia, Myeloid; Leukocytes; Male; Transplantation, Homologous

Topics: Aged; Allopurinol; Colchicine; Female; Gout; Humans; Leukemia, Myeloid; Male; Middle Aged; Myeloproliferative Disorders; Polycythemia; Polycythemia Vera; Primary Myelofibrosis

24 patients with Philadelphia chromosome positive chronic myeloid leukaemia (CML) in blast crisis were treated with intensive chemotherapy. 16 patients showed either partial or complete response to this treatment, but median survival remained short (13 weeks), and much of this time was spent in hospital. These results were not significantly better than those obtained by others using vincristine and prednisolone alone, and this combination of drugs can often be given on an outpatient basis. It is concluded that until more effective intensive therapy becomes available patients in CML blast crisis should be managed in such a way that the quality of life is not impaired; and that at present vincristine and prednisolone appears to be the most impaired; and that at present vincristine and prednisolone appears to be the most appropriate initial treatment, though even this is far from satisfactory.

Topics: Adolescent; Adult; Aged; Allopurinol; Antineoplastic Agents; Asparaginase; Chromosome Aberrations; Chromosomes, Human, 21-22 and Y; Cytarabine; Drug Administration Schedule; Drug Therapy, Combination; Female; Humans; Leukemia, Myeloid; Male; Middle Aged; Prednisolone; Thioguanine; Vincristine

In an attempt to convert the bone-marrow population from Philadelphia-chromosome (Ph-1) positivt to partially or wholly Ph-1 negative, thioguanine was used as primary therapy in seven patients with chronic granulocytic leukaemia (C.G.L.). Although eight episodes of neutropenia were induced, prolonged remission or conversion to Ph-1-negativity was not achieved in any patient. However, thioguanine was at least as effective as busulphan for initial therapy in C.G.L., and had the advantage of rapid reversibility of haemopoietic depression when discontinued. Thioguanine merits further evaluation as an agent for the management of C.G.L. in its chronic phase.

Topics: Adult; Alkaline Phosphatase; Allopurinol; Chromosomes, Human, 21-22 and Y; Drug Evaluation; Drug Therapy, Combination; Female; Hematopoietic Stem Cells; Hemoglobins; Humans; Leukemia, Myeloid; Leukocyte Count; Male; Middle Aged; Neutropenia; Neutrophils; Thioguanine

Topics: Allopurinol; Amenorrhea; Busulfan; Chlorambucil; Chronic Disease; Drug Eruptions; Female; Hemolysis; Humans; Leukemia, Lymphoid; Leukemia, Myeloid; Leukocytosis; Lymphocytosis; Prednisolone; Pulmonary Fibrosis; Splenectomy; Vincristine

Topics: Allantoin; Allopurinol; Antineoplastic Agents; Female; Humans; Leukemia, Myeloid; Middle Aged; Uric Acid

Topics: Aged; Allopurinol; Bone Marrow Examination; Busulfan; Chromosome Aberrations; Female; Humans; Kidney; Leukemia, Myeloid; Liver; Male; Muramidase; Prednisone; Spleen

Topics: Aged; Allopurinol; Chemical and Drug Induced Liver Injury; Humans; Hydroxyurea; Iatrogenic Disease; Leukemia, Myeloid; Liver; Liver Diseases; Male; Prednisone; Splenomegaly; Vincristine

Topics: Adult; Aged; Allopurinol; Cells; Female; Humans; Leukemia, Myeloid; Male; Methods; Middle Aged; Muramidase; Neoplasm Recurrence, Local; Neutrophils; Prognosis; Spleen; Urea

Topics: Allopurinol; Bone Marrow Diseases; Gout; Hodgkin Disease; Humans; Leukemia; Leukemia, Myeloid; Plasmacytoma; Polycythemia Vera; Uric Acid

Topics: Adolescent; Adult; Aged; Agranulocytosis; Allopurinol; Anti-Bacterial Agents; Antibiotics, Antineoplastic; Blood Transfusion; Cytarabine; Humans; Leukemia; Leukemia, Erythroblastic, Acute; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Mercaptopurine; Methotrexate; Middle Aged; Muramidase; Nausea; Prednisolone; Thrombocytopenia; Vincristine

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenal Insufficiency; Adrenocorticotropic Hormone; Adult; Allopurinol; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; Leukemia, Myeloid; Male; Mercaptopurine; Metyrapone

Topics: Adrenal Insufficiency; Adrenocorticotropic Hormone; Allopurinol; Aminopterin; Busulfan; Humans; Leukemia, Myeloid; Mercaptopurine; Myeloproliferative Disorders; Pituitary-Adrenal System

Topics: Adenine Nucleotides; Allopurinol; Aminohydrolases; Blood Cell Count; Blood Coagulation Disorders; Blood Platelets; Carbon Isotopes; Chronic Disease; Hemoglobins; Humans; Leukemia, Myeloid; Nucleosides; Uric Acid

Topics: Adult; Allopurinol; Animals; Bone Marrow Examination; Calcium; Child, Preschool; Female; Haplorhini; Humans; Infusions, Parenteral; Kidney; Kidney Function Tests; Leukemia, Lymphoid; Leukemia, Myeloid; Liver Function Tests; Male; Thyroid Function Tests; Uric Acid

Topics: Adolescent; Antineoplastic Agents; Blood; Blood Urea Nitrogen; Drug Therapy; Geriatrics; Humans; Hyperuricemia; Leukemia; Leukemia, Myeloid; Lymphoma; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Metabolism; Neoplasms; Nitrogen; Pyrimidines; Sarcoma; Urea; Uric Acid; Uricosuric Agents; Urine; Xanthine Oxidase