losartan-potassium and Leukemia--Lymphoid

Topics: Animals; Blood Cells; Cell Differentiation; Colony-Stimulating Factors; Erythropoietin; Hematologic Diseases; Humans; Leukemia, Lymphoid; Oncogenes

This randomized study assessed if intravenous iron improves hemoglobin (Hb) response and permits decreased epoetin dose in anemic (Hb 9-11 g/dl), transfusion-independent patients with stainable iron in the bone marrow and lymphoproliferative malignancies not receiving chemotherapy. Patients (n=67) were randomized to subcutaneous epoetin beta 30 000 IU once weekly for 16 weeks with or without concomitant intravenous iron supplementation. There was a significantly (P<0.05) greater increase in mean Hb from week 8 onwards in the iron group and the percentage of patients with Hb increase >or=2 g/dl was significantly higher in the iron group (93%) than in the no-iron group (53%) (per-protocol population; P=0.001). Higher serum ferritin and transferrin saturation in the iron group indicated that iron availability accounted for the Hb response difference. The mean weekly patient epoetin dose was significantly lower after 13 weeks of therapy (P=0.029) and after 15 weeks approximately 10 000 IU (>25%) lower in the iron group, as was the total epoetin dose (P=0.051). In conclusion, the Hb increase and response rate were significantly greater with the addition of intravenous iron to epoetin treatment in iron-replete patients and a lower dose of epoetin was required.

Topics: Anemia; Dose-Response Relationship, Drug; Drug Administration Schedule; Erythropoietin; Female; Hemoglobins; Humans; Infusions, Intravenous; Iron; Leukemia, Lymphoid; Lymphoma, Non-Hodgkin; Lymphoproliferative Disorders; Male

Anemia-related fatigue in cancer patients reduces health-related quality of life (HRQOL). These analyses evaluate the effect of hemoglobin level on fatigue and examine the relationship between improved fatigue and HRQOL. Data were collected during a multicenter, randomized trial involving 344 anemic patients with lymphoproliferative malignancies receiving chemotherapy and darbepoetin alfa or placebo. At baseline, interim study visits, and end of treatment, patients completed an HRQOL questionnaire. Improved hemoglobin levels were significantly associated (P < 0.001) with improved fatigue. Mean change in the Functional Assessment of Cancer Therapy (FACT) Fatigue score was 5.9 points greater when hemoglobin improved > 2 g/dl than when it declined. Patients experiencing a clinically meaningful improvement in fatigue reported significantly (P < 0.001) greater improvements in all other scales, except the FACT Social subscale. Managing anemia-related fatigue appears to have a positive impact on HRQOL, enhancing cancer patients' activity levels, mood, and perceived overall health.

Topics: Aged; Anemia; Darbepoetin alfa; Erythropoietin; Fatigue; Female; Health Status; Hemoglobins; Humans; Leukemia, Lymphoid; Lymphoma; Male; Middle Aged; Quality of Life; Treatment Outcome

In a prospective, controlled trial 26 anaemic, neutropenic children with newly diagnosed acute lymphocytic leukaemia were randomised in pairs to receive either transfusion to a haemoglobin of 10--12 g/dl where clinically indicated (group A) or hypertransfusion to a haemoglobin of 16--18 g/dl (group B). Compared with group A (11 of 13 transfused), group B (all transfused) had a significantly more rapid rise in neutrophils at 7 and 10 days post-transfusion, a lower incidence of infection, and less interruption to chemotherapy. Hypertransfusion restored the myeloid/erythroid ratio to normal in bone-marrow of 5 of 6 children and the proportion of early myeloid precursors was greater than in controls.

Topics: Adolescent; Agranulocytosis; Blood Transfusion; Cell Count; Child; Child, Preschool; Clinical Trials as Topic; Erythropoietin; Female; Hematopoietic Stem Cells; Hemoglobins; Humans; Infant; Infection Control; Leukemia, Lymphoid; Leukocyte Count; Male; Neutropenia; Neutrophils; Prospective Studies; Random Allocation; Remission, Spontaneous

Topics: Adjuvants, Immunologic; Anemia; Antilymphocyte Serum; Erythropoiesis; Erythropoietin; Humans; Leukemia, Lymphoid; T-Lymphocytes

To determine whether the CFUE pool within human bone marrow is heterogeneous with respect to erythropoietin (Epo) requirements, we studied CFUE growth in vitro as a function of Epo exposure time. We controlled the Epo exposure time by overlaying plasma clot cultures containing 0.5 U/ml Epo with an antibody prepared against human Epo. All cultures were grown for seven days. Benzidine-positive colonies containing eight or more cells were counted as CFUE. Colonies containing eight cells required at least 24-50 h of Epo exposure, and those containing 16 cells required at least 70-90 h of Epo exposure. After 50 h, the number of CFUE progressively increased until it reached a maximum at seven days of Epo exposure. These results suggest that the CFUE pool within human bone marrow is heterogeneous with respect to Epo requirements.

Topics: Bone Marrow Cells; Child; Dose-Response Relationship, Drug; Erythroblasts; Erythropoietin; Humans; Leukemia, Lymphoid; Stem Cells; Time Factors

2 patients with coexistent polycythaemia vera and chronic lymphocytic leukaemia are described. A 61-year-old man presented with an increased packed cell volume (PCV) and a leucoerythroblastic blood picture, which was reversible upon treatment, neutrophil leucoytosis, bone marrow lymphocyte infiltration and splenomegaly, and subsequently developed lymphomas, blood lymphocytosis and thrombocytosis. The second case was a 58-year-old female presenting with increased PCV and leucocyte alkaline phosphatase score. She later had neutrophil leucocytosis, thrombocytosis, lymphocytosis, lymphomas and splenomegaly. These cases, together with 6 cases published by others, suggest that an association exists between the two diseases.

Topics: Erythropoietin; Female; Hematocrit; Hematopoiesis; Hematopoietic Stem Cells; Humans; Leukemia, Lymphoid; Leukocyte Count; Male; Middle Aged; Neutrophils; Polycythemia Vera

Erythropoietin level in the serum and urine of adult patients with acute leukaemia (AML, ALL, MML) was estimated by polycythaemic mouse bioassay in order to obtain more information about the associated anaemia. In AML and ALL patients the serum erythropoietin level as found to be increased and in a negative correlation with the blood haemoglobin concentration. In ALL patients erythropoietin in urine was increased regularly while in AML patients it was not. No correlation between the serum level and the urinary excretion of ESF, or between the blood Hb and the serum ESF, was found in MML patients. The results show that anaemia in leukaemia is not due to the low ESF level.

Topics: Acute Disease; Adult; Anemia; Animals; Erythropoiesis; Erythropoietin; Humans; Iron; Leukemia; Leukemia, Lymphoid; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Mice; Mice, Inbred CBA

Topics: Animals; Bone Marrow; Bone Marrow Cells; Cells, Cultured; Erythropoietin; Heme; Leukemia, Lymphoid; Leukemia, Myeloid, Acute

Topics: Animals; Erythropoietin; Female; Half-Life; Hematocrit; Iron Radioisotopes; Leukemia, Experimental; Leukemia, Lymphoid; Rats; Rauscher Virus; Regression Analysis

Topics: Binding Sites, Antibody; Bone Marrow; Bone Marrow Cells; Cells, Cultured; Culture Techniques; Erythropoietin; Hematopoiesis; Hematopoietic Stem Cells; Humans; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukocytes; Macrophages; Methods; Microscopy, Electron; Mitosis; Multiple Myeloma; Neoplasms; Phagocytosis; Thymidine; Tritium; Waldenstrom Macroglobulinemia

Topics: Alpharetrovirus; Animals; Biological Assay; Cell Transformation, Neoplastic; Erythropoietin; Friend murine leukemia virus; Helper Viruses; Humans; Leukemia; Leukemia Virus, Murine; Leukemia, Experimental; Leukemia, Lymphoid; Mice; Polycythemia; Splenic Neoplasms

Topics: Animals; Erythropoietin; Hemoglobinometry; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Mice

Topics: Erythropoietin; Humans; Leukemia, Lymphoid; Leukemia, Myeloid, Acute

Topics: Anemia; Anemia, Aplastic; Blood Transfusion; Epoetin Alfa; Erythropoiesis; Erythropoietin; Humans; Leukemia; Leukemia, Lymphoid; Metabolism

Topics: Alpha-Globulins; Anemia; Antibodies; Biological Assay; Blood; Cerebellar Neoplasms; Electrophoresis; Epoetin Alfa; Erythropoiesis; Erythropoietin; Exudates and Transudates; Hemangiosarcoma; Humans; Hypoxia; Immune Sera; Kidney; Kidney Diseases, Cystic; Leukemia; Leukemia, Lymphoid; Neuraminidase; Trypsin