levoleucovorin and Leukemia--Myeloid--Acute

Topics: Adolescent; Adult; Antineoplastic Agents; Cyclophosphamide; Drug Therapy, Combination; Hodgkin Disease; Humans; Leucovorin; Leukemia, Myeloid, Acute; Lymphoma; Methotrexate; Middle Aged; Neoplasm Staging; Nitrogen Mustard Compounds; Prednisone; Procarbazine; Remission, Spontaneous; Vincristine

Topics: Child; Drug Resistance; Folic Acid Antagonists; Humans; Leucovorin; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Methotrexate

Topics: Adult; Animals; Carboxypeptidases; Carcinoma 256, Walker; Carcinoma, Squamous Cell; Deoxyuridine; Diet; Drug Combinations; Drug Synergism; Folic Acid Antagonists; Humans; Leucovorin; Leukemia L1210; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Methotrexate; Mice; Rats; Tritium

Topics: Adult; Animals; Antibiotics, Antineoplastic; Antimetabolites; Antineoplastic Agents; Asparaginase; Child; Drug Combinations; Drug Interactions; Drug Synergism; Folic Acid Antagonists; Humans; Injections, Subcutaneous; Leucovorin; Leukemia L1210; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Male; Methotrexate; Mice; Mice, Inbred Strains; Nitrogen Mustard Compounds; Prednisone; Time Factors

Topics: Adult; Aged; Clinical Trials as Topic; Female; Humans; Kidney Neoplasms; Leucovorin; Leukemia, Myeloid, Acute; Lymphoma; Male; Methotrexate; Middle Aged

Topics: Bone Marrow; Bone Marrow Cells; Cytarabine; Daunorubicin; DNA, Neoplasm; Drug Therapy, Combination; Humans; Kinetics; Leucovorin; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Methotrexate; Mitotic Index; Thioguanine

Topics: Adult; Antimetabolites, Antineoplastic; Bone Marrow Transplantation; Female; Humans; Injections, Spinal; Leucovorin; Leukemia, Myeloid, Acute; Magnetic Resonance Imaging; Methotrexate; Peripheral Blood Stem Cell Transplantation; Prednisone; Spinal Cord; Spinal Cord Diseases; Vitamin B 12

Topics: Adenocarcinoma; Adult; Antineoplastic Combined Chemotherapy Protocols; Camptothecin; Fluorouracil; Humans; Intestinal Neoplasms; Intestine, Small; Irinotecan; Leucovorin; Leukemia, Myeloid, Acute; Male; Prognosis; Recurrence; Remission Induction

A 56-year-old woman diagnosed with a poorly differentiated cecal adenocarcinoma with metastases to ovaries, omentum, and sigmoid colon went into remission after 12 cycles of infusional 5-fluorouracil, luecovorin, and oxaliplatin (FOLFOX-4 regimen). Thirteen months later, a pelvic recurrence was diagnosed, and the patient received nine cycles of FOLFOX-6 plus bevacizumab, resulting in a clinical complete response but the development of pancytopenia. Bone marrow biopsy was consistent with therapy-related acute myelogenous leukemia. Chromosome analysis showed structural rearrangements with partial deletions of the long arms of chromosomes 5, 7, 20, and 21, as well as trisomy of chromosome 8 and losses of chromosomes 3 and 11. Induction chemotherapy led to remission, but the patient died two months later from complications of colon cancer progression. It is likely that the leukemia was related to the oxaliplatin administration.

Topics: Adenocarcinoma; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Antineoplastic Combined Chemotherapy Protocols; Bevacizumab; Cecal Neoplasms; Chromosome Deletion; Female; Fluorouracil; Humans; Leucovorin; Leukemia, Myeloid, Acute; Middle Aged; Omentum; Organoplatinum Compounds; Ovarian Neoplasms; Peritoneal Neoplasms; Sigmoid Neoplasms; Trisomy

We describe a case of an acute myelogenous leukemia (AML) associated with t(1;11) (q23;p15), which is a novel simple variant translocation of t(7;11)(p15;p15). The patient was a Japanese man who had a history of non-Hodgkin lymphoma (NHL) and received MACOP-B combination chemotherapy. Fifteen months after the completion of the treatment, the patient developed AML (M2), which was regarded as a therapy-related leukemia. Cytogenetic study of bone marrow cells showed t(1;11). Although he achieved complete remission by combination chemotherapy, a relapse of NHL and gastric cancer were revealed in the course of the consolidation chemotherapy for AML. The NHL was considered a histological conversion from follicular lymphoma because lymphoma cells carried t(14;18) (q32;q21) and were strongly positive for BCL2 protein. Translocation (1;11), together with AML having t(7;11) or inv(11) involving 11p15, shows that 11p15 is a common acceptor site of these chromosome aberrations and suggests the significance of the NUP98 gene located in 11p15 in therapy-related leukemia.

Topics: Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Chromosomes, Human, Pair 1; Chromosomes, Human, Pair 11; Chromosomes, Human, Pair 7; Cyclophosphamide; Doxorubicin; Humans; Immunohistochemistry; Karyotyping; Leucovorin; Leukemia, Myeloid, Acute; Lymphoma, Non-Hodgkin; Male; Methotrexate; Middle Aged; Neoplasms, Second Primary; Prednisone; Stomach Neoplasms; Translocation, Genetic; Vincristine

We describe nine asymptomatic chronic carriers of hepatitis B virus, four males and five females, with a mean age of forty-six years and all were Chinese, who developed exacerbation of hepatitis following chemotherapy for haematological malignancies. Seven patients had non-Hodgkin's lymphoma of whom three were treated with MACOP-B, two with BCEPP, one with PROMACE-CYTABOM and one with CHOP. Two patients had acute myeloid leukaemia and were treated with daunorubicin and cytosine arabinoside. Exacerbation of hepatitis occurred between one to four weeks following the last course of chemotherapy in eight patients. Two patients developed exacerbation of hepatitis when the dosage of prednisolone was reduced after they had ten weeks of high dose prednisolone. The outcome was fatal in six patients; all of whom developed hepatic encephalopathy. In four of these patients, alanine transaminase levels exceeded 1000 iu/l. Cytotoxic and immunosuppressive therapy permit enhanced viral replication. Withdrawal of the drugs results in partial restoration of immunocompetence and leads to rapid destruction of hepatocytes with consequent hepatic necrosis. Hence, patients who are hepatitis B virus carriers undergoing chemotherapy should be closely monitored. The fatal outcome of reactivation of chronic hepatitis B virus warrants prospective trials addressing preventive measures.

Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carrier State; Chronic Disease; Cyclophosphamide; Cytarabine; Daunorubicin; Disease Progression; Doxorubicin; Etoposide; Female; Hepatic Encephalopathy; Hepatitis B; Humans; Leucovorin; Leukemia, Myeloid, Acute; Lymphoma, Non-Hodgkin; Male; Methotrexate; Middle Aged; Prednisone; Vincristine

Topics: Adult; Arthritis, Rheumatoid; Bone Marrow Transplantation; Cyclosporine; Female; Graft vs Host Disease; Granulocyte Colony-Stimulating Factor; Granulocyte-Macrophage Colony-Stimulating Factor; Humans; Leucovorin; Leukemia, Myeloid, Acute; Methotrexate; Neutropenia; Prednisolone

Treatment of elderly patients with hematological malignancies is difficult and a matter of controversy. Low responsiveness to therapy and high risk of mortality have been reported. The risk of chemotherapeutic death increases after age 60, and an age-adjusted chemotherapy schedule is needed. In stage III and IV Hodgkin's disease, for example, an age-adjusted COPP regimen may be adopted. Many non-Hodgkin lymphomas (NHL) of elderly patients have a slow course. However, for intermediate to high grade aggressive NHL, dose-reduced CHOP regimen, or non- or low-dose methotrexate-containing programs like BECALM, CNOP, and low dose-ACOP-B are acceptable. MACOP-B regimen with G-CSF may be used for patients under age 65. For the treatment of elderly patients with AML, it is reported that a reduced-dose DAT regimen is better than the standard dose for inducing CR in patients older than 60. In elderly AML patients over 60, the dose-adjustment reported by Mori, or low-dose cytarabine with G-CSF, is recommended. Information about elderly patients with acute lymphoblastic leukemia is scarce. Aggressive treatments like L-17 M regimen are not tolerable by elderly patients, and a combination chemotherapy consisting of vincristine and prednisolone is recommended.

Topics: Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Combined Modality Therapy; Cyclophosphamide; Doxorubicin; Drug Administration Schedule; Etoposide; Hodgkin Disease; Humans; Leucovorin; Leukemia, Myeloid, Acute; Lymphoma, Non-Hodgkin; Methotrexate; Mitoxantrone; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Prednisolone; Prednisone; Vincristine

Acute nonlymphocytic leukemia (ANLL) developed in 2 of 142 pediatric patients with osteosarcoma treated with a cis-diamminedichloroplatinum-II (CDP)-based regimen: acute monomyelogenous leukemia (M4) with a normal female karyotype in one and acute myelogenous leukemia (M2) with t (8,21) in the other. The ANLLs occurred, respectively, in each patient 3 and 4 years after the initial diagnosis of osteosarcoma. In contrast to most of the adult experience and consistent with the majority of reported ANLL in children, the disease was characterized by an absence of the smoldering phase and cytogenetic findings similar to those seen in de novo ANLL.

Topics: Adolescent; Child; Cisplatin; Female; Humans; Leucovorin; Leukemia, Myeloid, Acute; Leukemia, Myelomonocytic, Acute; Male; Methotrexate; Neoplasms, Second Primary; Osteosarcoma; Vincristine

We report three cases of a distinctive palmar-plantar erythema associated with the treatment of non-Hodgkin's lymphoma and acute myeloid leukaemia. The rash is characterized by a painful, sharply demarcated, intense erythema of the palms and/or soles followed by bulla formation, desquamation and healing. The eruption is self limiting in nature and did not adversely affect prognosis. Treatment need be neither altered nor stopped; only symptomatic measures are required.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cyclophosphamide; Doxorubicin; Erythema; Female; Foot Dermatoses; Hand Dermatoses; Humans; Leucovorin; Leukemia, Myeloid, Acute; Lymphoma, Non-Hodgkin; Male; Methotrexate; Middle Aged; Prednisone; Vincristine

We have tested folinic acid (FA) for ability to increase peripheral blood stem cells (PBSC) after chemotherapeutic aplasia in acute leukaemia. Five adult patients (four AML, one ALL) entered the study, each patient underwent two series of three leukapheresis, the first following induction chemotherapy and the second following the first course of consolidation. The first leukapheresis of each series was done when the white blood cell count reached 10(9)/l with subsequent leukapheresis every other day. Folinic acid (Lederle Laboratories, France) was administered at a dose of 50 mg (i.v.) per day, 15 days from initiation of chemotherapy and continuing through the third leukapheresis of the series (days 25-30). PBSC were collected on a Haemonetics V50 cell separator. In these five cases we observed an increased yield of both colony-forming units, granulocyte macrophage (CFU-GM) and burst forming units-erythroid (BFU-E) expressed per ml of cytapheresis product: CFU-GM x 18, BFU-E x 3 and if expressed per 10(4)/kg of body weight: CFU-GM x 30, BFU-E x 3 (CFU-GM P less than 0.05, BFU-E less than 0.01). Long-term blood culture (LTSC) from FA stimulated leukapheresis, in an attempt to quantitate the most primitive stem cells, demonstrated that this expansion of the PBSC was sustained in time. We found by means of LTSC that FA did not stimulate CFU-L from patients with AML (two cases tested). Finally two AML patients were grafted with FA-PBSC after Cytotoxan and total body irradiation (TBI). Haematopoietic reconstitution was rapid complete and sustained in time in both patients. This indication for folinic acid should be further studied with or as an alternative to haematopoietic growth factors.

Topics: Adult; Colony-Forming Units Assay; Combined Modality Therapy; Female; Hematopoietic Stem Cell Transplantation; Hematopoietic Stem Cells; Humans; Leucovorin; Leukapheresis; Leukemia, Myeloid, Acute; Male; Middle Aged; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Transplantation, Autologous

Phosphoribosylpyrophosphate (PRPP) levels increase several-fold in HL-60 cells adapted to folate deficiency either by continuous passage in folate-deficient medium or by short-term incubation with 10(-8) M methotrexate (MTX). The addition of folic acid (PteGlu) or 5-formyltetrahydrofolic acid (5-CHO-H4PteGlu) in the form of Leucovorin normalizes this effect. The reactions for measuring PRPP levels are time and temperature dependent and are influenced by PRPP-reacting substances in undialyzed serum. Inorganic phosphate (PO4), when added to the assay, markedly stimulates PRPP levels in HL-60 cells and can be used to stress folate-dependent PRPP utilization for purine synthesis. The integrity of the folate-dependent pathways of purine-synthesizing cells can be sensitively assessed by measurement of PRPP levels during a 2-hr assay in the presence of PO4 in medium free of folate but containing dialyzed serum. In HL-60 cells that are folate deficient or in the presence of MTX (as low as 2 X 10(-9) M), PO4-stimulated PRPP levels remain elevated due to ineffective utilization unless folate is added to the incubation mixture. The sensitivity of this PRPP assay to metabolically assess the integrity of folate-dependent reactions in purine synthesis is comparable to that of the deoxyuridine suppression assay. Inorganic phosphate can also be used to stimulate the incorporation of purine analogs, such as 6-mercaptopurine, into intact red blood cells which may have therapeutic implications for targeting drug delivery.

Topics: Cell Line; Deoxyuridine; Erythrocytes; Folic Acid; Humans; Leucovorin; Leukemia, Myeloid, Acute; Male; Methotrexate; Pentosephosphates; Phosphates; Phosphoribosyl Pyrophosphate; Purines; Stimulation, Chemical

The effects of extracellular folate concentration on intracellular folate and phosphoribosylpyrophosphate (PRPP) levels and the cytotoxicity of methotrexate and 5-fluorouracil were studied in human KB cells grown in fetal bovine serum-supplemented Eagle's minimum essential medium, which contained standard high folic acid levels (2.3 microM) (standard or S medium), or folic acid-free serum-supplemented medium containing approximately 4 nM 5-methyltetrahydrofolate (physiological or P medium), a folate level and form more comparable to that in normal human serum. Macrocytosis and prolongation of the doubling time by 150% were observed after 5-10 serial passes in P medium, but after 10-15 serial passes, KB cells became "adapted" to P medium with return of size and doubling time to values indistinguishable from cells maintained in S medium. Cellular folate levels fell, and marked elevations in PRPP levels from 68 +/- 43 to 642 +/- 287 pmol/mg cell protein (mean +/- SD) were observed as KB cells were serially passed through P medium. Human leukemia HL-60 and K562 cells and MJY-alpha mouse mammary tumor cells serially passed in P medium also exhibited 10- to 20-fold elevations in PRPP levels. Glucose consumption, glucose decarboxylation, thymidine and adenosine specific uptake, thymidine incorporation into DNA, and 5-fluorouracil uptake were studied in KB cells with elevated and control PRPP levels. As determined by clonal assay, despite elevated PRPP levels, KB cells cultured in P medium were less sensitive to 5-fluorouracil than cells cultured in S medium unless exogenous folate was added. These data support the concept that endogenous folate levels may be inadequate for optimal 5-FU pharmacological action in KB cells with a modulated increase in PRPP levels.

Topics: Adenosine; Carcinoma, Squamous Cell; Cell Survival; Fluorouracil; Folic Acid; Glucose; Humans; KB Cells; Leucovorin; Leukemia, Myeloid, Acute; Methotrexate; Nasopharyngeal Neoplasms; Pentosephosphates; Phosphoribosyl Pyrophosphate; Thymidine

A five-year-old girl developed acute myelomonocytic leukemia after fifteen months of intensive chemotherapy and irradiation for glioblastoma multiforme. The leukemia became manifest while the patient was in a remarkable remission brought about by treatment with high-dose methotrexate with citrovorum rescue. This is the first reported association of these disorders in the same patient. It is possible that the leukemia was induced by the treatment, since both radiation and the chemotherapeutic drugs used have been shown to be leukemogenic in some circumstances. The patient developed leukemia in a setting of relatively normal peripheral blood counts, having had very little myelosuppression from her treatment.

Topics: Antineoplastic Agents; Brain Neoplasms; Carmustine; Child, Preschool; Dexamethasone; Drug Therapy, Combination; Female; Glioblastoma; Humans; Leucovorin; Leukemia, Myeloid, Acute; Leukemia, Radiation-Induced; Methotrexate; Neoplasms, Multiple Primary

Topics: Adult; Bone Marrow; Bone Marrow Cells; Child; Cytarabine; Deoxyuridine; DNA; Drug Administration Schedule; Female; Humans; In Vitro Techniques; Leucovorin; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Male; Methotrexate; Middle Aged; Mitosis; Thymidine; Thymine

Methodichlorophen was given to 26 patients with terminal malignant disease. Eight patients received adequate doses, and five of them showed objective evidence of tumour regression while three failed to respond. Those who responded included four out of five patients with lung cancer (three with squamous-cell carcinoma and one with oat-cell carcinoma) and a patient with hypernephroma. Two patients with testicular teratomas and one with acute myeloid leukemia failed to respond. The drug may be given safely by mouth to outpatients if certain precautions are taken.

Topics: Adenocarcinoma; Aged; Antineoplastic Agents; Bone Marrow Diseases; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Chlorobenzenes; Drug Therapy, Combination; Erythema; Headache; Humans; Kidney Neoplasms; Leucovorin; Leukemia, Myeloid, Acute; Lung Neoplasms; Male; Middle Aged; Neoplasms; Pyrimethamine; Pyrimidines; Teratoma; Testicular Neoplasms

Short treatment with four cytostatics in acute granulocytic leukemia induced aplasia and reduction of total leukemic cells in 50 over 59 patients. Complete remission occured in 30 and 20 died with infectious complications during induction. Short induction treatment allowed a reduction of induction period and so a reduction of high risk period of induction before completion of complete remission.

Topics: Adolescent; Adult; Aged; Antineoplastic Agents; Cytarabine; Daunorubicin; Drug Administration Schedule; Female; Fever; Hemorrhage; Humans; Leucovorin; Leukemia, Myeloid, Acute; Male; Methotrexate; Middle Aged; Pyruvaldehyde; Remission, Spontaneous; Sepsis

Topics: Adult; Aged; Bone Marrow; Bone Marrow Cells; Cell Division; Cytarabine; DNA, Neoplasm; Drug Therapy, Combination; Female; Humans; Leucovorin; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Male; Methotrexate; Middle Aged; Mitosis; Thymidine; Time Factors; Tritium

Topics: Adolescent; Adult; Bone Marrow; Bone Marrow Cells; Cell Biology; Cell Survival; Child; DNA, Neoplasm; Humans; In Vitro Techniques; Leucovorin; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Leukocytes; Methotrexate; Purines; Remission, Spontaneous; Thymidine; Tritium

Topics: Autopsy; Bone Marrow; Bone Marrow Cells; Cytarabine; Daunorubicin; Humans; Leucovorin; Leukemia, Myeloid, Acute; Pyrimethamine; Toxoplasmosis

Topics: Adolescent; Adult; Aged; Antineoplastic Agents; Cyclophosphamide; Cytarabine; Evaluation Studies as Topic; Female; Humans; Leucovorin; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Male; Methotrexate; Middle Aged; Remission, Spontaneous; Time Factors

Topics: Cytosine; Daunorubicin; Drug Synergism; Drug Therapy, Combination; Glyoxal; Humans; Leucovorin; Leukemia, Myeloid, Acute; Methotrexate; Remission, Spontaneous

Topics: Adenine; Allopurinol; Bone Marrow; Bone Marrow Cells; Carbon Radioisotopes; Cell-Free System; Chromatography, Paper; Formates; Guanine Nucleotides; Humans; Hypoxanthines; Kinetics; Leucovorin; Leukemia; Leukemia, Myeloid, Acute; Leukocytes; Ligases; Mercaptopurine; Pentosephosphates; Pentosyltransferases; Spectrophotometry, Ultraviolet; Tetrahydrofolates

Topics: Antidotes; Female; Hodgkin Disease; Humans; Leucovorin; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Male; Methotrexate; Middle Aged; Neoplasms

Topics: Breast Neoplasms; Choriocarcinoma; Female; Head; Head and Neck Neoplasms; Humans; Leucovorin; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Methotrexate; Neoplasm Metastasis; Neoplasms; Ovarian Neoplasms; Pregnancy; Remission, Spontaneous; Uterine Cervical Neoplasms

Topics: Adolescent; Adult; Aged; Carcinoma, Squamous Cell; Child, Preschool; Choriocarcinoma; Chorionic Gonadotropin; Female; Humans; Infusions, Parenteral; Injections, Intravenous; Leucovorin; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Lung Neoplasms; Male; Methotrexate; Middle Aged; Pregnancy; Teratoma; Testicular Neoplasms

Topics: Agranulocytosis; Antineoplastic Agents; Breast Neoplasms; Female; Hemangiosarcoma; Hodgkin Disease; Humans; Kidney Neoplasms; Leucovorin; Leukemia, Lymphoid; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Lung Neoplasms; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Male; Melanoma; Methotrexate; Osteosarcoma; Pancreatic Neoplasms; Radiography; Rectal Neoplasms; Rhabdomyosarcoma; Testicular Neoplasms; Thrombocytopenia

Topics: Folic Acid; Humans; Leucovorin; Leukemia, Erythroblastic, Acute; Leukemia, Myeloid, Acute