mercaptopurine and Leukemia--Myeloid

We report two additional patients with acute myeloid leukemia (AML) and a translocation between chromosomes 7 and 11: t(7;11)(p15;p15). One patient was diagnosed as having AML-M2 and the other as AML with myelofibrosis. Both patients had low-level neutrophil alkaline phosphatase (NAP) scores. In the literature, only 15 AML patients with t(7;11)(p15;p15) have been reported; nine of them had an AML-M2 morphology, and all had a decreased NAP score. Moreover, mean survival of the reported AML patients with t(7;11)(p15;p15) was 15 months, although 85% of them obtained complete remission, indicating that this type of leukemia frequently tends to relapse. These findings indicate a strong association between the chromosome abnormality and hematologic manifestations of this disease.

Topics: Acute Disease; Adult; Alkaline Phosphatase; Antineoplastic Combined Chemotherapy Protocols; Bone Marrow Transplantation; Chromosomes, Human, Pair 11; Chromosomes, Human, Pair 7; Cytarabine; Daunorubicin; Female; Humans; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Middle Aged; Neutrophils; Prednisolone; Primary Myelofibrosis; Remission Induction; Translocation, Genetic

Topics: Acute Disease; Adolescent; Adult; Aged; Antineoplastic Agents; Child; Child, Preschool; Female; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Prednisone; Prognosis; Remission, Spontaneous; Vincristine

Topics: Adrenal Cortex Hormones; Alkylating Agents; Antibiotics, Antineoplastic; Antineoplastic Agents; Cytarabine; Drug Synergism; Drug Therapy, Combination; Fluorouracil; Hodgkin Disease; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Mitosis; Neoplasm Metastasis; Thymine Nucleotides

Topics: Adult; Burkitt Lymphoma; Child; Cyclophosphamide; Cytarabine; Daunorubicin; Drug Combinations; Hodgkin Disease; Humans; Immunotherapy; Infections; Leukemia, Lymphoid; Leukemia, Myeloid; Lymphoma; Mercaptopurine; Methotrexate; Middle Aged; Nitrogen Mustard Compounds; Prednisone; Procarbazine; Prognosis; Remission, Spontaneous; Vincristine

Topics: Antineoplastic Agents; Blood Platelet Disorders; Bromine; Busulfan; Dose-Response Relationship, Drug; Galactitol; Humans; Hydroxyurea; Immunotherapy; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Mannitol; Mercaptopurine; Splenectomy; Uracil Mustard

Topics: Busulfan; Cytarabine; Dexamethasone; DNA; DNA, Neoplasm; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Leukocytes; Mercaptopurine; Nucleic Acids; Prednisolone; Pyrimidines; RNA; RNA, Neoplasm

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: Adrenal Cortex Hormones; Antineoplastic Agents; Betamethasone; Folic Acid Antagonists; Humans; Leukemia, Myeloid; Mercaptopurine; Nitrogen Mustard Compounds; Vinblastine

Topics: Acid Phosphatase; Alkaline Phosphatase; Biochemical Phenomena; Biochemistry; Carbohydrate Metabolism; DNA; Folic Acid Antagonists; Glutathione; Heparin; Histamine; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Leukocytes; Lipid Metabolism; Lymphocytes; Mercaptopurine; Metabolism; Pathology; Peroxidases; Phagocytosis; Plasminogen; Pyrimidines; RNA; Thymidine; Trace Elements

Topics: Adrenal Cortex Hormones; Anti-Bacterial Agents; Antineoplastic Agents; Busulfan; Cyclophosphamide; Folic Acid Antagonists; Humans; Leukemia; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Mercaptopurine

To determine whether, after very intensive induction and consolidation therapy in childhood AML, further maintenance therapy (MT) confers any advantage.. Three hundred-nine children with previously untreated AML were registered in the LAME 89/91 protocol. This three-cycle intensive regimen included an induction phase (mitoxantrone plus cytarabine) and, for non-allografted patients, two consolidation courses, one containing timed-sequential high-dose cytarabine, asparaginase and amsacrine. In the LAME 89 study, patients were given an additional MT consisting of mercaptopurine and cytarabine for 18 months. In the LAME 91 trial, patients were randomized to be given or not MT after consolidation therapy.. Out of 309 patients, 276 (90%) achieved a complete remission. The overall survival (OS) and event-free survival at 6 years for all patients were 60% +/- 6% and 48% +/- 6%, respectively. For the complete responders after consolidation therapy, the 5-year OS was significantly better in patients randomized for no further treatment than in patients randomized for MT (81% +/- 13% vs 58% +/- 15%; p = 0.04) whilst the 5-year disease-free survival was not significantly different (60% +/- 19% vs 50% +/- 15%; p = 0.25). The improvement of OS in MT-patients appeared to be related to a higher salvage rate after relapse.. Over 50% of patients can be cured of AML in childhood. In the context of a very short and drug-intensive regimen, low-dose MT, owing to the lack of improvement in disease control and the worsening of survival, should not be recommended. Over the past 20 years, the outcome of acute myeloid leukemia (AML) in children has improved substantially. In the eighties, complete remission (CR) was achieved in nearly 90% of patients but event-free survival (EFS) was poor. Myeloablative therapy followed by allogenic bone-marrow transplantation (allo BMT) from an HLA-identical sibling was demonstrated, in our experience, to be the treatment of choice for improving DFS in children with AML in first remission. The major issue was how best to maintain complete remission for patients without an HLA sibling donor. Whereas several groups continued to include low-dose MT and others decided to omit it, in 1991, our group undertook a prospective randomized trial (LAME 91 protocol), the main aim of which was to assess the efficacy of MT in addition to an intensive induction and consolidation chemotherapy. The main results have been published previously and are now updated and described in a higher number of patients.

Topics: Acute Disease; Amsacrine; Antineoplastic Combined Chemotherapy Protocols; Asparaginase; Bone Marrow Transplantation; Child; Chromosome Aberrations; Cytarabine; Disease-Free Survival; Humans; Leukemia, Myeloid; Mercaptopurine; Mitoxantrone; Prognosis; Survival Analysis; Time Factors

We investigated the prognostic significance of genetic polymorphism in glutathione-S transferase mu 1 (GSTM1), glutathione-S transferase theta 1 (GSTT1), NAD(P)H:quinone oxidoreductase (NQO1) and myeloperoxidase (MPO), the products of which are associated with drug metabolism as well as with detoxication, in 193 patients with de novo acute myeloid leukemia (AML) other than M3. Of the patients, 64.2% were either homozygous or heterozygous for GSTT1 (GSTT1(+)), while 35.8% showed homozygous deletions of GSTT1 (GSTT1(-)). The GSTT1(-) group had a worse prognosis than the GSTT1(+) group (P = 0.04), whereas other genotypes did not affect the outcome. Multivariate analysis revealed that GSTT1(-) was an independent prognostic factor for overall survival (relative risk: 1.53; P = 0.026) but not for disease-free survival of 140 patients who achieved complete remission (CR). The rate of early death after the initiation of chemotherapy was higher in the GSTT1(-) group than the GSTT1(+) group (within 45 days after initial chemotherapy, P = 0.073; within 120 days, P = 0.028), whereas CR rates and relapse frequencies were similar. The null genotype of GSTT1 might be associated with increased toxicity after chemotherapy.

Topics: Antineoplastic Combined Chemotherapy Protocols; Cytarabine; Daunorubicin; Disease-Free Survival; Etoposide; Follow-Up Studies; Gene Deletion; Genotype; Glutathione Transferase; Humans; Isoenzymes; Leukemia, Myeloid; Mercaptopurine; Multivariate Analysis; NAD(P)H Dehydrogenase (Quinone); Neoplasm Proteins; Peroxidase; Polymorphism, Genetic; Prednisolone; Prognosis; Remission Induction; Survival Analysis; Treatment Outcome

In acute myeloid leukemia (AML), p53 mutations are reportedly infrequent but associated with a poor prognosis. The majority of mutations are missense mutations, which generally lead to accumulation of nuclear p53 protein. However, the prognostic significance of the accumulation remains unknown in AML. In this study, we compared the prognostic value of p53 mutations versus accumulation of the product. p53 mutations were found in 9 (4.5%) of 200 patients with de novo AML. The p53 mutation detectable (mutation+) group had a worse prognosis (p = 0.0009) than the mutation not detectable (mutation-) group. Multivariate analysis showed that the p53 mutation was an independent factor (p = 0.005) for short overall survival as well as 60 yr or older (p = 0.001) and unfavorable karyotypes (p = 0.001). In 79 of the 200 patients, the expression of p53 was studied by immunocytochemistry (ICC) using anti-p53 monoclonal antibody (DO-7). All samples carrying missense mutations (N = 6) were positive for ICC in over 15% of nuclei of each sample, chosen as the optimized cutoff value of p53 accumulation. Accumulation was thus found in 14 of the 79 patients. However, there was no prognostic difference according to the accumulation, because the mutation-/accumulation+ group (N = 8) tended to have a good prognosis. These findings indicate that molecular detection of p53 mutations yields better prognostic information than ICC. In a subset of AML, p53 protein might be accumulated without mutation presumably due to upstream signals of p53.

Topics: Acute Disease; Adult; Aged; Amino Acid Substitution; Antineoplastic Combined Chemotherapy Protocols; Cytarabine; Daunorubicin; DNA Mutational Analysis; Etoposide; Female; Gene Deletion; Genes, p53; Humans; Japan; Leukemia, Myeloid; Life Tables; Male; Mercaptopurine; Middle Aged; Mutation; Mutation, Missense; Neoplasm Proteins; Prednisolone; Prognosis; Regulatory Sequences, Nucleic Acid; Single-Blind Method; Survival Analysis; Tumor Suppressor Protein p53; Vincristine

To assess the efficacy of etoposide added to the standard remission induction therapy for acute myeloid leukemia (AML), newly diagnosed adult AML patients were randomized to receive either daunorubicin (40 mg/m2/day x 4 or more), behenoyl cytarabine (200 mg/m2/day x 10 or more), and 6-mercaptopurine (70 mg/m2/day x 10 or more) (BHAC-DM), or the same three drugs plus etoposide (100 mg/m2/day x 5) (BHAC-EDM) for response-oriented individualized induction therapy. The patients achieving complete remission (CR) received the same 3 courses of consolidation therapy followed by 6 courses of maintenance/intensification therapy. M3 patients were excluded because all-trans retinoic acid was used. Of 667 patients registered, 655 were evaluable. The median age was 49 (range 15 to 85). CR rates were 77% in the BHAC-DM group and 75% in the BHAC-EDM group. In 173 M4 patients, CR rates were 86% and 69% (P = 0.009), and in 32 M5 patients, 80% and 77% (P = 0.810) in the BHAC-DM and the BHAC-EDM groups, respectively. The predicted 6-year overall survival rates were 30% and 38% (P = 0.925) for the BHAC-DM and BHAC-EDM groups, and the disease-free survival rates of CR patients were 25% and 35% (P = 0.352), respectively. Nonhematological toxicities after the first course of induction therapy were almost equal among the two groups, with the exception of a greater loss of hair (P = 0.024) and more frequent diarrhea (P = 0.013) in the BHAC-EDM group. We concluded that in the present study, the addition of etoposide to the standard individualized induction therapy showed no advantage in adult AML, even among M4 and M5 patients.

Topics: Acute Disease; Adult; Antineoplastic Combined Chemotherapy Protocols; Cytarabine; Daunorubicin; Etoposide; Female; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Prospective Studies; Remission Induction; Survival Analysis

The cure rate of acute myeloid leukemia might increase if G-CSF were given concurrently with repeated postremission chemotherapy. However, this therapy might cause severe complications, including depletion of normal hematopoietic progenitors as a long-term toxicity. Thus, we conducted a pilot study of this strategy. Twenty-six acute myeloid leukemia patients in a first complete remission (CR) were treated with two courses of consolidation chemotherapy (10-day BHAC-DMP, consisting of behenoyl cytosine arabinoside, daunorubicin, 6-mercaptopurine and prednisolone) and repeated maintenance-intensification therapy including eight cycles of six-day BHAC-DMP. G-CSF (filgrastim) was administered concurrently with these BHAC-DMP therapies. Toxicity during the therapeutic period was not significant in the study group compared with the historical control, treated with the same regimen without G-CSF. Neutrophil recovery after the consolidation therapy was more rapid in the study group than in the historical control (p = 0.066 and 0.024 for the first and second consolidation courses, respectively). Long-term toxicity, such as cytopenia, has not been seen in eight patients who have remained in CR for a long period (range: 39-58 months). At a median follow-up of 39 months, the predicted rate of 42-month CR duration for these 26 patients was 50% (95% confidence limits: 30% to 71%). We conclude that G-CSF-combined repeated BHAC-DMP postremission therapy is feasible. Full elucidation of the clinical benefit of this strategy will require further study.

Topics: Acute Disease; Adolescent; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Cytarabine; Daunorubicin; Female; Filgrastim; Granulocyte Colony-Stimulating Factor; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Pilot Projects; Prednisolone; Recombinant Proteins; Time Factors; Vincristine

High-dose, continuous infusion of intravenous mercaptopurine (HD 6MP) followed by intermediate-dose continuous cytarabine (ID Ara-C) has been shown to produce remissions in children with relapsed acute myeloid leukemia (AML). The purpose of this pilot study was to explore the feasibility of using this drug regimen as a component of treatment during the first remission of AML. Of 17 children with newly diagnosed AML registered in the study, 14 developed complete remission on conventional induction therapy and subsequently received the HD 6MP and ID Ara-C combination. The dosages of HD 6MP were escalated from 500 mg/m2 to 1250 mg/m2 in 24-hr infusions. The initial dosages of ID Ara-C were escalated from 250 mg/m2 to 650 mg/m2/24 hr and from 1 day to 4 days. Conventional treatment for AML was administered simultaneously. Seven of the 14 children remain in initial complete remission for 15 to 46 months and have completed treatment. Severe pancytopenia was observed in all patients, but there were no toxic deaths and no deaths during remission. The inclusion of HD 6MP and ID Ara-C in the treatment of AML in first remission appears to be feasible. Evaluation of its efficacy will require a comparative clinical trial.

Topics: Acute Disease; Adolescent; Antineoplastic Combined Chemotherapy Protocols; Child; Child, Preschool; Cytarabine; Dose-Response Relationship, Drug; Female; Humans; Infant; Leukemia, Myeloid; Male; Mercaptopurine; Treatment Outcome

We analyzed complete remission (CR), disease-free survival (DFS), and event-free survival (EFS) rates in two groups of patients treated with either N4-behenoyl-1-beta-D-arabinosylcytosine (BHAC) or cytarabine, and analyzed DFS with or without ubenimex, a biologic response modifier.. Newly diagnosed patients with acute myeloid leukemia (AML) were randomized to receive either BHAC or cytarabine as remission-induction combination chemotherapy and two courses of consolidation therapy. After maintenance/intensification therapy, patients in CR were randomized to receive either ubenimex and no drug.. Of 341 patients registered, 326 were assessable. The age of assessable patients ranged from 15 to 82 years (median, 48). The overall CR rate was 77%: 72% in the BHAC group and 81% in the cytarabine group, and there was a significant difference between the two groups (P = .035, chi 2 test). The predicted 55-month EFS rate of all patients was 30%: 23% in the BHAC group and 35% in the cytarabine group, with a significant difference between groups (P = .0253). The predicted 55-month DFS rate of all CR patients was 38% and that of CR patients less than 50 years of age was 47%. There was no significant difference in DFS between the ubenimex group and the group that did not receive ubenimex.. Analyses of our clinical trial showed that the use of BHAC in remission-induction therapy and in consolidation therapy resulted in poorer CR and EFS rates in adult AML patients compared with the use of cytarabine at the doses and schedules tested. Immunotherapy with ubenimex after the end of all chemotherapy did not improve DFS.

Topics: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Chi-Square Distribution; Cytarabine; Daunorubicin; Disease-Free Survival; Female; Follow-Up Studies; Humans; Leucine; Leukemia, Myeloid; Logistic Models; Male; Mercaptopurine; Middle Aged; Multivariate Analysis; Prednisolone; Prospective Studies; Remission Induction; Survival Rate; Treatment Outcome

The overall cure rate of adults with newly-diagnosed acute myelogenous leukemia (AML) treated with continuous infusion high-dose cytarabine (CIHDAC) is comparable to that with standard-dose ara-C plus anthracycline or amsacrine (AMSA). We tested whether the addition of AMSA to CIH-DAC improves the outcome of adults with untreated AML. 75 patients with untreated AML were treated with AMSA (75 mg/m2/day x 4) plus CIHDAC (1.5 g/m2/day x 4) for induction and, if in complete remission (CR), early and late intensification. Results were compared to those in 129 patients treated on a previous study with CIHDAC alone. The principal comparison in both groups was between those 117 patients (AMSA/CIHDAC n = 52, CIHDAC n = 65) who met the initial eligibility criteria for the AMSA/CIHDAC study (risk of early mortality < or = 1) and who were treated at a time when relatively few eligible patients were excluded (19% in the AMSA/CIHDAC group, 34% in the CIHDAC group). There was no difference between regimens in CR rate, remission duration, or survival in this cohort. When attention was turned to all 204 patients, outcome was superior with AMSA/CIHDAC very largely as a result of outcome in patients with APL. Aside from these patients, addition of amsacrine to CIHDAC did not appear to be productive.

Topics: Acute Disease; Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Amsacrine; Antineoplastic Combined Chemotherapy Protocols; Cytarabine; Daunorubicin; Female; Humans; Leukemia, Myeloid; Leukemia, Promyelocytic, Acute; Life Tables; Male; Mercaptopurine; Methotrexate; Middle Aged; Prednisone; Remission Induction; Survival Analysis; Treatment Outcome; Vincristine

Topics: Acute Disease; Adult; Antineoplastic Combined Chemotherapy Protocols; Cyclophosphamide; Cytarabine; Daunorubicin; Disease-Free Survival; Etoposide; Female; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Remission Induction; Russia; Survival Analysis; Time Factors

The risk for induction of epipodophyllotoxin-related acute myeloid leukemia (AML) depends largely on the schedule of drug administration and, to a lesser degree, the cumulative dose. Concomitant use of other genotoxic drugs, such as alkylating agents and cisplatin, can increase the hazard further. We have treated 154 consecutive higher-risk cases of acute lymphoblastic leukemia in our recent Total Therapy Study XIII with an intensive post-remission regimen of chemotherapy that included etoposide given every other week or less often-a schedule associated with a relatively low cumulative incidence of secondary AML in our Study XI. Unexpectedly, four patients have developed secondary AML at 12 to 23 months from the start of treatment (median, 16 months). The 2-year cumulative risk estimate significantly exceeds that for 185 historical controls in Study XI whose continuation regimen included epipodophyllotoxins every other week: 5.4% (95% confidence interval, 0-11%) compared with 1.1% (0-2.6%), P = 0.046. Compared to patients treated in Study XI, those enrolled in Study XIII receive fewer scheduled doses of epipodophyllotoxin (48 (all etoposide) vs 63 (30 etoposide, 33 teniposide)) but 16 to 19 additional doses of L-asparaginase and eight additional doses of high-dose methotrexate, all within the week preceding etoposide treatment. We attribute the apparently increased rate of secondary AML in Study XIII to the use of L-asparaginase immediately before etoposide administration. On this schedule, the enzyme could increase systemic exposure to etoposide or its catechol metabolites and reduce the ability of cells to repair DNA damage.

Topics: Acute Disease; Antineoplastic Combined Chemotherapy Protocols; Asparaginase; Child; Child, Preschool; Cyclophosphamide; Cytarabine; Daunorubicin; Drug Synergism; Etoposide; Humans; Infant; Karyotyping; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Neoplasms, Second Primary; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Prednisone

This phase I/II study was designed to explore the feasibility, toxicity, and potential efficacy of administering high-dose continuous intravenous mercaptopurine (6MP) followed by intermediate-dose continuous intravenous cytarabine (Ara-C) to children with relapsed or unresponsive acute leukemia.. Twenty-three children with relapsed or unresponsive acute leukemia (13 myeloid, 10 lymphoid) were entered onto the study. After initial hydration and alkalinization, 1,000 or 1,250 mg/m2 of 6MP was administered by continuous intravenous infusion over 24 hours. Following another period of hydration, 500 mg/m2 of Ara-C was administered by continuous intravenous infusion daily for 4 days. In 17 children, plasma concentrations of 6MP were measured at hours 4, 24, and 27 of the 6MP infusions. Plasma concentrations of Ara-C were measured at hours 8, 24, 48, 72, and 96 of the Ara-C infusions. Intracellular Ara-C triphosphate (Ara-CTP) concentrations were measured in peripheral-blood leukemia cells of the five patients with sufficient cells for measurement. Children who developed remission received repeated courses of this regimen every 3 to 4 weeks until relapse or completion of 12 courses.. Of 13 children with acute myeloid leukemia (AML), six developed complete remissions (CRs) lasting 7 months to nearly 4 years. Two children remain in CR with normal growth, development, and health 3 years after cessation of treatment. Of 10 children with acute lymphoid leukemia (ALL), one had a CR of 2 months' duration. Dose-limiting toxicity consisted of severe hematosuppression with fever, neutropenia, and serious infection. There were two toxic deaths. The mean steady-state plasma concentrations of 6MP were approximately 4 mumol/L and of Ara-C approximately 3 mumol/L. The median Ara-CTP concentration in peripheral-blood leukemia cells was 308 mumol/L at hour 8 of the Ara-C infusion.. High-dose continuous intravenous 6MP followed by intermediate-dose intravenous Ara-C produced CRs of longer than 6 months in approximately half of children with relapsed or unresponsive AML. Further study of this drug regimen is justified.

Topics: Acute Disease; Adolescent; Antineoplastic Combined Chemotherapy Protocols; Child; Child, Preschool; Cytarabine; Drug Administration Schedule; Feasibility Studies; Female; Humans; Infusions, Intravenous; Leukemia, Myeloid; Male; Mercaptopurine; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Recurrence; Treatment Outcome

Aclarubicin was evaluated in combination chemotherapy for adult acute myeloid leukemia in a randomized trial involving 58 institutions throughout Japan. Behenoyl cytosine arabinoside (BH-AC).daunorubicin, 6-mercaptopurine, and prednisolone (DMP) was compared with BH-AC.aclarubicin, 6-mercaptopurine, and prednisolone (AMP). In the 360 evaluable cases among the 433 cases enrolled, complete remission (CR) rates were 63.7% (116/182) for BH-AC.DMP and 53.9% (96/178) for BH-AC.AMP (P = 0.0587). Median survival periods and 7-year survival rates were 15.8 months and 19.3% for BH-AC.DMP and 9.5 months and 20.2% for BH-AC.AMP (P = 0.0091 according to the generalized Wilcoxon test [GW], P = 0.196 according the log-rank test [LR]). Median disease-free survival periods were 15.4 months for BH-AC.DMP and 14.1 months for BH-AC.AMP (P = 0.851 by GW, P = 0.439 by LR). Among the 346 cases of extramurally confirmed FAB subtypes, CR rates were 67.9% (19/28) with BH-AC.DMP and 31.8% (7/22) with BH-AC.AMP for subtype M3 (P = 0.011) and 63.3% (93/147) with BH-AC.DMP and 56.8% (84/148) with BH-AC.AMP (P = 0.254) for subtypes M1, M2, M4, and M5. Diarrhea, ileus, pneumonia, and renal failure were more frequent with BH-AC.AMP than with BH-AC.DMP. The results indicate, at least on the basis of the long-term outcome, that BH-AC.AMP has antileukemic effects on subtypes M1, M2, M4, and M5 that are comparable with those of BH-AC.DMP.

Topics: Aclarubicin; Acute Disease; Adolescent; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Cytarabine; Daunorubicin; Female; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Prednisolone; Prospective Studies; Survival Analysis

Topics: Acute Disease; Adult; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Communicable Diseases; Cytarabine; Daunorubicin; Granulocyte Colony-Stimulating Factor; Humans; Leukemia, Myeloid; Mercaptopurine; Prednisolone; Recombinant Proteins; Recurrence; Remission Induction; Survival Analysis; Time Factors; Vincristine

It was assessed whether addition of vincristine (VCR) to remission induction therapy would increase the complete remission (CR) rate, and, secondarily, whether 12 courses of maintenance-intensification therapy would produce longer survival than 4 courses in adult acute myeloid leukemia (AML).. A randomized comparison of individualized induction therapy was conducted between daunorubicin, behenoyl cytarabine, 6-mercaptopurine, and prednisolone with or without VCR. After 3 courses of intensive consolidation therapy, maintenance-intensification therapy was randomized to 4 or 12 courses given every 6 weeks.. Of 265 patients registered, 252 were evaluable. CR was obtained in 78%; 80% in 205 patients of age younger than 60 years, and 65% in 47 of age 60 years or older. Addition of VCR reduced the CR rate significantly (84% to 70%, P = 0.007). Predicted 4-year survival, continuing CR, and disease-free survival (DFS) rates of 196 CR patients are 45%, 41%, and 35%, respectively. Patients receiving 12 courses of maintenance-intensification showed better DFS. By multivariate analyses, significant factors for achievement of CR were performance status 0 to 2, age younger than 60 years, and no VCR; and those for longer DFS were achievement of CR by one course, age younger than 50 years, and French-American-British (FAB) classification M3 or M5. Among 131 patients randomized to the maintenance, the administration of 12 courses was the most important factor (P = 0.0040) for longer DFS, followed by FAB M3 or M5, and by achievement of CR by one course.. Addition of VCR in remission induction therapy was harmful, and longer intensive maintenance therapy prolonged DFS in adult AML.

Topics: Acute Disease; Adolescent; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Cytarabine; Daunorubicin; Drug Administration Schedule; Female; Follow-Up Studies; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Prednisolone; Prospective Studies; Remission Induction; Survival Rate; Time Factors; Vincristine

Topics: Acute Disease; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Cyclophosphamide; Cytarabine; Daunorubicin; Drug Resistance; Female; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Remission Induction; Time Factors

We asked 2 questions in this study. First was the additional effect of VCR in induction therapy, and the second was the duration of maintenance therapy. Adult AML were treated by an individualized response-oriented induction therapy with behenoyl Ara-C 200 mg/m2 daily + 6MP 70 mg/m2 daily + prednisolone 40 mg/m2 on days 1-4 + DNA 40 mg/m2 on days 1-3 and additionally on days 7, 8, 11, 12 (for M3, DNR 50 mg/m2 daily) (BHAC-DMP) until bone marrow became severely hypoplastic with less than 5% of blasts. Patients were randomized to BHAC-DMP or BHAC-DMP + VCR 0.35 mg/m2 on days 1-4. After obtaining CR, 3 courses of intensive consolidation therapy were given together with I.T. MTX+Ara-C+PSL. Maintenance intensification therapy was randomized to either 4 or 12 courses given every 2 months. Patients of age greater than or equal to 60 received about 2/3 reduced doses. From June 1987 to Sept. 1989, 265 consecutive adult AML were registered from 19 institutions and 258 were evaluable. Age ranged from 15 to 79 (med., 48). Out of 258, 200 (77.5%) achieved CR (80% in 209 of age less than 60 and 65% in 49 of age greater than or equal to 60). Unexpectedly, addition of VCR reduced the high CR rate of BHAC-DMP significantly (84% to 70%, p = 0.007). At the median follow-up of 37 mo., overall survival is 37%, and event-free survival (EVS) 27%. Survival, continuing CR and disease-free survival (DFS) rates of 200 CR cases are 45%, 40% and 35%, respectively. Patients received 12 courses of maintenance therapy showed better DFS (P = 0.0555). The VCR group had significantly worse EFS. By multivariate analysis, significant prognostic factors for the achievement of CR were age less than 60, PS 0-2 and no addition of VCR. Significant factors for longer DFS were induction of CR by one course, FAB M3 or M5 and age less than 50. The present multi-institutional study confirmed the high CR rates of the response-oriented individualized therapy reported from several centers in Japan, but failed to support an additional effect of VCR reported from one center.

Topics: Acute Disease; Adolescent; Adult; Age Factors; Aged; Antineoplastic Combined Chemotherapy Protocols; Cytarabine; Daunorubicin; Drug Administration Schedule; Female; Humans; Japan; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Prednisolone; Remission Induction; Vincristine

From 1975 to 1981, 92 patients with newly diagnosed Ph'-positive chronic granulocytic leukemia entered two consecutive studies. The initial trial (Study I, 1975-1978) tested the efficacy of hydroxyurea (HU) as single agent in 45 consecutive patients. In an effort to improve results obtained with HU alone, from 1978 to 1981, 47 new patients entered a second trial (Study II), which consisted of a continuous treatment with a combination of HU and 6-mercaptopurine (6-MP), at doses adjusted so as to maintain the leukocyte counts between 4 and 12 X 10(9)/L. The aim of this second study was to prolong the duration of chronic phase (CP) by the addition of 6-MP to HU and by a stricter continuous control of the size of the total granulocytic mass (TGM). Both regimens were well tolerated. Median duration of CP was 43 months in Study I and 41 months in Study II. Median survival was 51.5 months and 45 months respectively. These data indicate that neither the addition of 6-MP to HU alone, nor the effort to keep a smaller TGM, play a substantial role in postponement of blastic transformation in CGL.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Clinical Trials as Topic; Female; Humans; Hydroxyurea; Leukemia, Myeloid; Leukocyte Count; Male; Mercaptopurine; Middle Aged

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

Sixteen patients in an acute blast crisis of chronic myeloid leukaemia (CML) were treated with a combination of vincristine, 6-mercaptopurine, hydroxyurea and prednisone. Only two of these patients had complete remission on this treatment, while four had partial remission. This experience, comparable to that reported by others, suggests that aggressive treatment in the terminal phase of CML is justified only as part of a prospective and well-controlled study.

Topics: Adolescent; Adult; Aged; Drug Therapy, Combination; Female; Humans; Hydroxyurea; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Middle Aged; Prednisone; Prospective Studies; Remission, Spontaneous; Switzerland; Vincristine

Topics: Animals; BCG Vaccine; Cytarabine; Daunorubicin; Drug Therapy, Combination; Humans; Immunotherapy; Leukemia L1210; Leukemia, Myeloid; Mercaptopurine; Mice; Mycobacterium bovis; Neuraminidase; Thioguanine

Topics: Adolescent; Adult; Alanine Transaminase; Blood Cell Count; Clinical Trials as Topic; Drug Therapy, Combination; Female; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Prednisolone; Remission, Spontaneous; Ribonucleosides; Time Factors

Topics: Acute Disease; Adult; Antineoplastic Agents; Clinical Trials as Topic; Daunorubicin; Female; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Methotrexate; Middle Aged; Prednisone; Prospective Studies; Remission, Spontaneous; Time Factors; Vincristine

Topics: Adolescent; Adult; Drug Synergism; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Prednisone

Topics: Adolescent; Adult; Aged; Blood; Clinical Trials as Topic; Humans; In Vitro Techniques; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Middle Aged; Prednisone; Prognosis; Statistics as Topic

Topics: Adult; Clinical Trials as Topic; Humans; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Prednisone; Vincristine

Disease-stabilizing therapy with the histone deacetylase inhibitor valproic acid and all-trans retinoic acid (ATRA) has been investigated in acute myelogenous leukemia (AML) in a number of trials. Experimental studies suggest that valproic acid induces a broad chemoresistant phenotype in human AML cells; however, clinical observations combining valproic acid with conventional therapy in a disease-stabilizing setting have not been reported that would confirm this as a clinical issue. We describe five patients receiving oral treatment with low-dose oral 6-mercaptopurin and/or hydroxyurea together with ATRA+valproric acid+theophylline. Hyperleukocytosis was controlled by low doses of the cytotoxic drugs, no unexpected toxicity appeared and the increases in normal peripheral blood cell counts induced by ATRA+valproic acid+theophylline were maintained during therapy. In two patients increasing blast counts later occurred during chemotherapy; a change to the alternative cytotoxic drug was then effective in controlling hyperleukocytosis. We conclude that valproic acid+ATRA+theophylline combined with 6-mercaptopurin or hydroxyurea can be safe and effective in palliative treatment of human AML.

Topics: Acute Disease; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Female; Histone Deacetylase Inhibitors; Humans; Hydroxyurea; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Treatment Outcome; Valproic Acid

We present the unusual case of a 16-year-old girl with T-cell acute lymphoblastic leukemia (ALL) with an early thymocyte immunophenotype without myeloid markers, who after 13 months of complete hematological remission relapsed as acute myelogenous leukemia (AML) with minimal differentiation and died of her disease. Whether the AML represented a relapse with lineage switch of the original immature T-cell clone or a new secondary malignancy, could not be proven due to the absence of molecular or clonal markers. This report suggests that a subset of CD7+ T-cell leukemias without mature T-cell antigens (CD4-, CD8-) are minimally differentiated and can relapse as AML.

Topics: Acute Disease; Adolescent; Antigens, CD7; Antigens, Differentiation, T-Lymphocyte; Antigens, Neoplasm; Antineoplastic Combined Chemotherapy Protocols; Asparaginase; Bone Marrow; Cell Differentiation; Cell Lineage; Core Binding Factor Alpha 2 Subunit; Cyclophosphamide; Cytarabine; Daunorubicin; Dexamethasone; Diagnosis, Differential; Doxorubicin; Etoposide; Fatal Outcome; Female; Gene Dosage; Histone-Lysine N-Methyltransferase; Humans; Immunophenotyping; Karyotyping; Leukemia-Lymphoma, Adult T-Cell; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Myeloid-Lymphoid Leukemia Protein; Neoplasms, Second Primary; Neoplastic Stem Cells; Proto-Oncogenes; Recurrence; T-Lymphocyte Subsets; Vincristine

The introduction of the United Kingdom Medical Research Council's 10th AML trial (MRC AML 10) protocol incorporating high-dose anthracycline therapy has improved outcome of children with acute myeloid leukemia (AML). In this study, we review the results of childhood AML therapy in a Singapore university hospital over the last 17 years emphasizing toxicity and outcome.. Retrospective analysis revealed 34 children with AML between 1988 and 2003. Prior to September 1996, therapy consisted of: POG-8498 (n = 10), others (n = 9). From September 1996, all but one of 15 children received MRC AML 10 treatment.. At the time of analysis, 17 had died from disease, and 17 patients were alive among whom 2 had relapsed. MRC AML 10-treated patients (n = 14) had significantly better 3-year overall, event-free, and disease-free survival (74% vs. 35%, 77% vs. 20%, 83% vs. 31%; P = 0.019, P = 0.002, and P = 0.010, respectively) and were likelier to achieve complete remission (CR) than non-MRC AML 10 patients (P = 0.102). Among patients who achieved CR, MRC AML 10-treated patients were significantly more likely to achieve CR after only one cycle of chemotherapy (P = 0.016). Hematologic toxicity was similar among the different regimens (P = 0.9).. These findings suggest that MRC AML 10 treatment results in significantly superior survival, without excess toxicity. Future studies should attempt to elucidate the relative importance of individual MRC AML 10 components and reduce the high cumulative anthracycline dose without compromising outcome.

Topics: Acute Disease; Amsacrine; Antineoplastic Combined Chemotherapy Protocols; Azacitidine; Chemical and Drug Induced Liver Injury; Child; Child, Preschool; Cytarabine; Daunorubicin; Developing Countries; Disease-Free Survival; Drug Evaluation; Etoposide; Female; Gastrointestinal Diseases; Heart Diseases; Hematologic Diseases; Humans; Infant; Infections; Kaplan-Meier Estimate; Leukemia, Myeloid; Male; Mercaptopurine; Methotrexate; Mitoxantrone; Prednisone; Remission Induction; Retrospective Studies; Singapore; Survival Analysis; Thioguanine; Treatment Outcome; Vincristine

We describe a 69-year-old Japanese male with acute leukemia with a CD7+ and CD56+ immunophenotype presenting with multiple lymphadenopathy. He was treated with idarubicin and cytosine arabinoside. Although the leukemia showed partial response, the patient did not achieve complete remission. He died of sepsis due to severe neutropenia after the third course of chemotherapy. His autopsy revealed blast infiltration in the lymph nodes, liver, spleen and vertebral bone marrow. Recently, CD7+ and CD56+ myeloid/natural killer precursor acute leukemia has been associated with a poor prognosis. Our case illustrates that myeloid/natural killer cell precursor acute leukemia shows some response to intensive chemotherapy for acute myeloid leukemia, but such therapy is insufficient to effect a cure. To overcome the resistance of this disease to chemotherapy, further studies should explore other treatment strategies.

Topics: Acute Disease; Aged; Antigens, CD; Antigens, CD7; Antigens, Differentiation, Myelomonocytic; Antigens, Neoplasm; Antineoplastic Combined Chemotherapy Protocols; CD56 Antigen; Cytarabine; Daunorubicin; Diagnosis, Differential; Etoposide; Fatal Outcome; Humans; Idarubicin; Killer Cells, Natural; Leukemia, Myeloid; Leukemic Infiltration; Lymphoma, Non-Hodgkin; Male; Mercaptopurine; Mitoxantrone; Myeloid Cells; Neoplastic Stem Cells; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Sarcoma, Myeloid; Sialic Acid Binding Ig-like Lectin 3

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

To clarify the characteristics of de novo acute myeloid leukemia (AML) among the elderly, we reviewed 112 patients over 60 years old (median age 72 years) who were treated at hospitals in Nagasaki Prefecture with a population of 1.5 million between 1987 and 1994. Reclassification of morphological diagnosis revealed that the proportion of M3 was lower but that of M6 and the incidence of cases with trilineage dysplasia (TLD), known as poor prognostic features, were higher in the elderly than in patients less than 60 years old. Similarly, chromosomal data showed a lower frequency of favorable karyotypes such as t(8;21) and t(15;17) in the elderly. The overall survival of all 112 patients was 10.3% at 5 years. Multivariate analysis indicated that good performance status (PS), low WBC at diagnosis, standard dose multi-drug chemotherapy and all-trans retinoic acid (ATRA) treatment for M3 patients, and morphological findings without TLD were significantly correlated with longer survival. Most of the long-term survivors were found among those who received standard dose therapy in this series, although no consensus has been established how to treat elderly AML patients. We propose that a prospective controlled trial is necessary to confirm the role of standard dose chemotherapy for elderly patients with de novo AML.

Topics: Acute Disease; Aged; Aged, 80 and over; Aging; Antineoplastic Combined Chemotherapy Protocols; Cytarabine; Daunorubicin; Female; Humans; Karyotyping; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Prognosis; Treatment Outcome; Tretinoin

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Histocytochemistry; Humans; Leukemia, Myeloid; Leukemia, Promyelocytic, Acute; Male; Mercaptopurine; Methotrexate; Testicular Neoplasms; Tretinoin

We report a patient who developed CD7+ therapy-related acute myeloid leukemia (t-AML) with trisomy 8 after chemotherapy for AML.

Topics: Antigens, CD7; Biomarkers, Tumor; Chromosomes, Human, Pair 8; Cytarabine; Daunorubicin; Diagnosis, Differential; Female; Humans; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Mercaptopurine; Middle Aged; Neoplasms, Second Primary; Prednisolone; Trisomy

We describe a patient with leukocytosis with all the stages of neutrophilic series, peripheral dominant myeloblast proliferation, marked dysplasia of myeloid and erythroid series, and extramedullary hematopoiesis of the lymph nodes. A cytogenetic study of the bone marrow cells showed normal karyotype, and molecular analysis of the leukemic cells showed negative for BCR-ABL by RT-PCR. After chemotherapy, the patient went into complete remission with a normal blood and bone marrow profile with no dysplasia. On relapse, the hematological findings showed a typical bone marrow dominant acute myeloid leukemia, with the leukemic cells having a chromosomal abnormality. The patient exhibited the combined features of myeloproliferative disorder, myelodysplastic syndrome, peripheral dominant myeloblast proliferation (so-called peripheral leukemia) and typical acute myeloid leukemia throughout the clinical course. This is thought to be a rare overlapping disease involving these distinct hematological conditions that do not usually occur in the same patient.

Topics: Acute Disease; Antineoplastic Combined Chemotherapy Protocols; Bone Marrow; Cytarabine; Daunorubicin; Disease Progression; Hematopoiesis, Extramedullary; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Myelodysplastic Syndromes; Myeloproliferative Disorders; Prednisolone; Preleukemia; Remission Induction

Bone marrow aspirates from 60 patients with acute myeloid leukemia (AML) were investigated using 95% ethanol fixation Papanicolaou stained preparations. The blasts were grouped into those with a clear halo around nucleoli (BCHN) and those without a clear halo. The patients were classified into three groups according to the degree of persistent BCHN at the end of induction therapy: group 1, no BCHN; group 2, less than 1% BCHN; and group 3, 1% or more BCHN. All patients in groups 1 (17 cases) and 2 (12 cases), and 12 of 31 cases in group 3 achieved complete remission (CR). Of 17 patients in group 1, two underwent bone marrow transplantation and two died from infection. Of the 37 patients who achieved CR, relapse was observed in two of 13 patients in group 1, and in all patients in groups 2 and 3. As to the patients treated with N4-behenoyl-1-beta-D-arabinofuranosyl-cytosine + daunorubicin + 6-mercaptopurine + prednisolone (BHAC-DMP) protocol, the percentages and number of BCHN at the diagnosis of AML in group 1 were significantly lower than those of groups 2 and 3. The percentage and number of BCHN at the diagnosis of AML were significant factors for the achievement of CR and for the prediction of long-term outcome. The reduction of BCHN to less than 1% at the end of induction therapy is a good indicator for the achievement of CR, and the disappearance of BCHN is a useful target for a long-lasting first CR; conversely, the persistence of BCHN is a major adverse factor for relapse.

Topics: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Bone Marrow Cells; Cell Nucleolus; Child; Child, Preschool; Cytarabine; Daunorubicin; Disease-Free Survival; Humans; Immunoenzyme Techniques; Ki-67 Antigen; Leukemia, Myeloid; Mercaptopurine; Middle Aged; Neoplasm Recurrence, Local; Prednisolone; Remission Induction; Retrospective Studies; Vincristine

A 67 year old male developed a therapy related myelodysplastic process culminating in acute myeloid leukemia 16 years following initial treatment for a large cell lymphoma. A second relapse of this leukemia showed 12% blasts including numerous giant blasts. The presence of giant blasts suggested the possibility of relapsed malignant lymphoma, however, flow cytometry and immunohistochemistry identified them as myeloid and chromosomal analysis revealed a near-tetraploid cell line. No evidence of lymphoma was seen. Although remission was induced with chemotherapy he subsequently relapsed with marrow and/or CNS involvement and was maintained on palliative therapy until he developed sepsis and died, 13 months following the observation of tetraploidy and 33 months following the onset of acute leukemia.

Topics: Acute Disease; Aged; Antineoplastic Combined Chemotherapy Protocols; Blast Crisis; Chromosome Aberrations; Combined Modality Therapy; Cyclophosphamide; Fatal Outcome; Humans; Immunophenotyping; Karyotyping; Leukemia, Myeloid; Leukemia, Radiation-Induced; Lymphoma, Large B-Cell, Diffuse; Male; Mercaptopurine; Methotrexate; Neoplasms, Second Primary; Neoplastic Stem Cells; Palliative Care; Polyploidy; Prednisone; Procarbazine; Recurrence; Vincristine

Forty-four adults with AML (n = 18) or ALL (n = 26) beyond first remission underwent unpurged (n = 39) or purged (n = 5) autografting after 110-140 mg/m2 melphalan and 1050 cGy TBI. ALL patients were eligible to receive maintenance chemotherapy with 6-mercaptopurine and methotrexate for 2 years after hematologic recovery. The duration of first remission was 1-167 months (median 11). The median time to 50 x 10(9)/I platelets was 76 days, and that to 0.5 x 10(9)/I neutrophils 31 days. Eight patients died of transplant-related toxicity; seven within 1 year. Twenty-two patients relapsed at 1-20 months (median 2.5 months). The 3-year probabilities (95% CI) of relapse and disease-free survival are 58% (43-75%) and 31% (17-45%), respectively. The duration of the first remission (< 1 year vs > or = 1 year) and the stage of transplant (second remission vs other) had no effect on relapse or disease-free survival. There was a trend towards higher relapse rates (76 vs 34%) and poorer disease-free survival (19 vs 49%) among ALL patients compared with AML which did not reach significant levels due to small patient numbers. We conclude that melphalan-TBI is a suitable conditioning regimen for autografting in advanced leukemia. The outcome of AML patients is comparable to standard regimens, but the outcome of ALL patients is poor and measures to enhance the anti-leukemic efficacy are necessary.

Topics: Acute Disease; Adolescent; Adult; Antineoplastic Combined Chemotherapy Protocols; Bone Marrow Purging; Bone Marrow Transplantation; Combined Modality Therapy; Disease-Free Survival; Female; Humans; Leukemia; Leukemia, Myeloid; Male; Melphalan; Mercaptopurine; Methotrexate; Middle Aged; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Prospective Studies; Salvage Therapy; Survival Analysis; Transplantation Conditioning; Transplantation, Autologous; Treatment Outcome; Whole-Body Irradiation

We report a case of essential thrombocythemia (ET) that climaxed in acute myeloid leukemia after developing into refractory anemia. The male patient had ET that was stable for 8 years on carboquone therapy. However, at the age of 72 years he developed an acute terminal illness that was characterized by severe pancytopenia, circulating myeloblasts, extensive bone marrow infiltration by myeloblasts, and an abnormal karyotype [46, XY, t(8q-; 20q+)]. He subsequently died of severe bilateral pneumonia and heart failure. This case suggests that ET may be similar to polycythemia vera; progression to leukemia is unusual except after chemotherapy. Therefore, treatment of patients with asymptomatic ET may not be advisable.

Topics: Aged; Anemia, Refractory; Antineoplastic Combined Chemotherapy Protocols; Carbazilquinone; Cytarabine; Daunorubicin; Humans; Karyotyping; Leukemia, Myeloid; Male; Mercaptopurine; Prednisolone; Thrombocythemia, Essential

We have measured the serum levels of soluble CD4, CD8 and IL-2R in 43 patients with AML in complete remission (AML-CR). The sCD8 levels of AML-CR patients (443.9 +/- 224.4 u/ml) were significantly high as compared to that of the normal controls (177.1 +/- 76.3 u/ml), p < 0.01. The sIL-2R levels of AML-CR patients were 715.0 +/- 646.3 u/ml, which significantly differed when compared to 322.1 +/- 65.7 u/ml for the normal controls, p < 0.01. However, the sCD4 levels of AML-CR patients were 9.6 +/- 4.7 u/ml, which did not differ from the 8.3 +/- 2.6 u/ml of the normal controls. The AML-CR patients showed significantly increased sCD8 and sIL-2R levels at all ranges during the remission from one to 188 months. The sCD8 levels and sIL-2R levels of the AML-CR patients showed a close correlation, p < 0.01. Further, the sCD8 levels and lymphokine activated killer cell cytotoxic activity showed a close correlation, p < 0.05. The presence of the activation of anti-tumor immunity may be related to the continuance of the remission in the AML-CR patients.

Topics: Adolescent; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Biomarkers; CD4 Antigens; CD8 Antigens; Cytarabine; Cytotoxicity, Immunologic; Daunorubicin; Female; Humans; Immunophenotyping; Interleukin-2; Killer Cells, Lymphokine-Activated; Killer Cells, Natural; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Prednisolone; Remission Induction

The treatment of acute myeloid leukemia (AML) in children with Down's syndrome (DS) has engendered considerable controversy. Because of the concerns for toxicity and increased rate of infections, treatment approaches varied considerably in the past with mixed results. However, experience on the recently completed Pediatric Oncology Group (POG) 8498 AML study suggests that DS children with AML constitute a distinct subgroup that responds well to therapy. Twelve of 285 children on POG 8498 (protocol for newly diagnosed AML) had DS. Children with DS and AML were predominantly male (9 of 12) and were quite younger at diagnosis (< 24 months in 10). The white blood cell count was less than 50 x 10(3)/microL in all 12 and French-American-British types M6 and M7 were frequent (5 of 12). An abnormal cytogenetic marker, in addition to constitutional trisomy 21, was present in 9 of 12 and involved chromosome 8 in 4 of 9. All cases studied (n = 5) were positive for myeloid cell surface markers (CD33, CD13, or CD11b) and, interestingly, were also positive for the CD7 antigen. Chemotherapy included daunorubicin, cytarabine (Ara-C), and 6-thioguanine for remission induction and featured high-dose Ara-C (3 g/m2 per dose) with or without L-asparaginase early in remission. Compared with children without DS, children with DS had a superior event-free survival (EFS at 4 years 100% v 28% +/- 6.2%; P = .003). The EFS remained superior even when compared with non-DS children less than 2 years of age with a white blood cell count less than 10 x 100,000/microL (100% v 48% +/- 17.3%; P = .01).

Topics: Acute Disease; Adolescent; Adult; Antigens, CD; Antineoplastic Combined Chemotherapy Protocols; Asparaginase; Azacitidine; Child; Chromosome Aberrations; Chromosome Disorders; Cytarabine; Daunorubicin; Down Syndrome; Etoposide; Female; Follow-Up Studies; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Methotrexate; Prednisone; Remission Induction; Thioguanine; Vincristine

Forty-one consecutive adult patients with acute myeloid leukemia (AML) were treated with an intensive individualized induction therapy of behenoyl cytarabine, daunorubicin, and 6-mercaptopurine, 29 patients (71%) achieved complete remission (CR). Patients then received three courses of intensive consolidation therapy, including intermediate-dose continuous cytarabine (400 mg/m2, for 5 days) and non-cross resistant drugs such as mitoxantron, etoposide and vincristine. During the course of the consolidation therapy, three patients died of infections and one died of myocardial infarction. Four patients underwent allogeneic bone marrow transplantation. The patients then received six courses of moderately intensive maintenance therapy for 1 year. The predicted 5-year continuing CR and disease-free survival rates of the CR patients were 62% (95% confidence limit, 41% to 83%) and 53% (33% to 73%), respectively. Although the number of patients in this study is small, the present study indicated that it may be possible to cure a fairly large proportion of AML patients by chemotherapy alone, if intensive induction therapy is followed by intensive consolidation therapy.

Topics: Acute Disease; Antineoplastic Combined Chemotherapy Protocols; Cytarabine; Daunorubicin; Etoposide; Female; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Mitoxantrone; Vinca Alkaloids

Topics: Aclarubicin; Adult; Antineoplastic Combined Chemotherapy Protocols; Cytarabine; Female; Humans; Leukemia, Myeloid; Lymph Nodes; Mercaptopurine; Prednisolone

Topics: Child; Cleidocranial Dysplasia; Female; Humans; Leukemia, Myeloid; Mercaptopurine

We describe a patient who developed pyoderma gangrenosum during the remission phase of acute myeloid leukaemia whilst receiving maintenance therapy with methotrexate and 6-mercaptopurine. The spontaneous resolution of these skin lesions following discontinuation of chemotherapy suggests that these drugs may be of major significance in the aetiology of pyoderma gangrenosum. Nevertheless, 27 months later, a relapse of the leukaemia followed. Although pyoderma gangrenosum occurred during clinical remission, we cannot rule out a synergism of leukaemia and chemotherapy in its pathogenesis.

Topics: Adult; Gangrene; Humans; Immunosuppression Therapy; Leukemia, Myeloid; Male; Mercaptopurine; Methotrexate; Pyoderma

Nine children with juvenile chronic myelogenous leukemia (JCML) were diagnosed in an 8-year period from 1977 to 1984. The clinical courses and outcomes of five patients who received minimal or no chemotherapy were compared with that of four patients who were treated with intensive acute nonlymphoblastic leukemia (ANLL) combination chemotherapy. None of the five patients in the former group achieved clinical remission and their survivals were 1, 4, 4, 7, and 29 months, respectively. All four patients in the latter group achieved clinical remissions that lasted 11, 21, 21, and 27 + months, respectively. The durations of their survival (21, 26, 30, and 32 + months) were significantly better than the five patients who received minimal or no chemotherapy (P less than .05). Despite hospitalizations for chemotherapy and for treatment of chemotherapy-associated complications, the clinical status and quality of life of the children who achieved clinical remission were superior to those who remained in relapse. Although intensive chemotherapy induced lengthy remissions, three of the four patients have relapsed. Cytogenetic and cell culture data indicated that the monocytic-macrophage cells characteristic of JCML appeared to be suppressed during remission rather than totally eliminated. We recommend that ANLL-type combination chemotherapy be used as the initial treatment of JCML because of its promptness in effecting clinical remissions. Improved maintenance and consolidation protocols have to be developed to produce durable remissions and cures. Alternatively, bone marrow transplantation may be a useful option soon after remission is achieved with chemotherapy.

Topics: Antineoplastic Combined Chemotherapy Protocols; Azacitidine; Child, Preschool; Cytarabine; Daunorubicin; Etoposide; Female; Humans; Infant; Leukemia, Myeloid; Male; Mercaptopurine; Mitoxantrone; Thioguanine

A case of juvenile chronic myelogenous leukaemia is presented. The clinical and haematological responses to courses of cytosine arabinoside, 6-mercaptopurine and prednisolone are described. Although there was some satisfactory response to the treatment and remission lasting over an unusually long period of time, the patient died of a rapidly progressive hypersplenism with severe sequestration of transfused blood and platelets. The nonaggressive and easily administered regimen of drugs described here is recommended for children with this disease where bone marrow transplant facilities are unavailable.

Topics: Antineoplastic Combined Chemotherapy Protocols; Cytarabine; Humans; Hypersplenism; Infant; Leukemia, Myeloid; Male; Mercaptopurine; Prednisolone

Topics: Administration, Topical; Antineoplastic Combined Chemotherapy Protocols; Cytarabine; Daunorubicin; Dinoprostone; Female; Humans; Leukemia, Myeloid; Mercaptopurine; Middle Aged; Mouth Mucosa; Prednisolone; Prostaglandins E; Stomatitis

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Cytarabine; Daunorubicin; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Prednisolone; Shock, Cardiogenic

Topics: Antineoplastic Combined Chemotherapy Protocols; Busulfan; Drug Administration Schedule; Female; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Vincristine

The metabolism of 6-mercaptopurine (6-MP) in L-1210 mouse leukemia cells and human chronic myelocytic leukemia cells (CML cells) was examined. The acid-soluble fractions obtained from cells incubated with [8-14C]6-MP were chromatographed on a Dowex-1 formate resin column using a formic acid linear gradient elution system. Chromatography of the extract of L-1210 cells revealed four principal radioactive peaks. The fraction containing the third peak was hydrolyzed by snake venom 5'-nucleotidase (Crotalus adamanteus). Cellulose thin layer chromatography revealed that the radioactive peak of the hydrolysate corresponded to 6-thioguanosine. The results showed that 6-MP was converted to 6-thioinosinic acid (6-TIMP) and 6-thioguanylic acid (6-TGMP) in L-1210 cells. In order to elucidate the pathway of 6-MP conversion to 6-TGMP, we examined the interaction of [8-14C]6-TIMP and purified IMP dehydrogenase. It was found by DEAE-cellulose thin layer chromatography that the IMP dehydrogenase converted 6-TIMP to 6-thioxanthylic acid (6-TXMP). Dowex-1 chromatography of the acid-soluble extract of human CML cells incubated with [8-14C]-6-MP also revealed a radioactive peak corresponding to 6-TGMP. These results suggest that 6-MP is metabolized to 6-TGMP by serial conversion to 6-TIMP and 6-TXMP through the de novo GMP synthetic pathway in L-1210 cells and human CML cells.

Topics: Animals; Cells, Cultured; Chromatography; Chromatography, DEAE-Cellulose; Guanine Nucleotides; Guanosine; Humans; IMP Dehydrogenase; Kinetics; Leukemia L1210; Leukemia, Myeloid; Mercaptopurine; Mice; Thionucleosides; Thionucleotides

Eight patients with chronic myeloid leukemia in blast crisis were treated with a combination of vindesine and prednisone. Complete remission was achieved in three patients; partial remission was achieved in three. All six responders received maintenance treatment with hydroxyurea and 6-mercaptopurine. The median duration of survival was 9 months. Two patients had long-term survival: one survived 32 months and the other is alive after 30 months. These data suggest that vindesine-prednisone polychemotherapy might improve the prognosis of blast crisis in chronic myeloid leukemia.

Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Bone Marrow; Drug Administration Schedule; Female; Humans; Hydroxyurea; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Prednisone; Time Factors; Vinblastine; Vindesine

Topics: Aged; Diagnosis, Differential; Female; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Prognosis

Topics: Antineoplastic Agents; Aphidicolin; Bone Marrow; Bone Marrow Cells; Cell Differentiation; Cells, Cultured; Cytarabine; Diterpenes; DNA Replication; Formamides; Hematopoietic Stem Cells; Humans; Leukemia, Myeloid; Mercaptopurine; Myeloproliferative Disorders; Reference Values; Tretinoin

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 woman developed a leukaemic infiltrate at the site of a smallpox vaccination; the lesion subsequently regressed spontaneously. 9 years later she developed a generalised myeloproliferative disorder.

Topics: Adult; Bone Marrow; Cytarabine; Daunorubicin; Female; Humans; Leukemia, Myeloid; Mercaptopurine; Skin Manifestations; Time Factors

Fifty-six consecutive patients affected by the non-lymphoblastic-like crisis of chronic myelogenous leukemia were the subjects of this study. The cytologic and cytochemical features, together with the extension of clinical involvement, were investigated in all the patients. The most frequent cytologic variant was the "myeloid" one (60% of the patients). All the patients received a standard treatment (hydroxyurea, 6-mercaptopurine +/- prednisone). The overall median survival was 5.1 months; however, 22% of the patients survived for one year or more. The length of survival was independent of the cytologic variety and clinical conditions (previous splenectomy, organomegalies, etc.). There was no correlation between drug dosage and length of survival, whereas the disappearance of blast cells from the peripheral blood appeared to be directly correlated with a longer survival. The treatment was well tolerated (slight hematologic and hepatic toxicity) and allowed a reasonably good quality of life: most of the patients were treated on an out-patient basis.

Topics: Adolescent; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Bone Marrow; Child; Female; Humans; Hydroxyurea; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Neoplasm Staging; Prednisone; Time Factors

Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Cytarabine; Daunorubicin; Female; Humans; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Middle Aged; Prednisolone

Topics: Aged; Chromosome Aberrations; Colloids; Diagnosis, Differential; Female; Humans; Hydroxyurea; Indium; Leukemia, Myeloid; Male; Mercaptopurine; Monocytes; Phagocytosis; Podophyllotoxin

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

Contrarily to what happens in acute leukemia, the incidence of osteolytic lesions in chronic leukemia is exceedingly low. Three patients with chronic myeloid leukemia (CML) who developed such lesions during the chronic phase of their disease form the basis of this report. Osteolytic lesions appearing during the chronic phase of CML are different from those appearing during acute leukemia or during the acute terminal phase of CML, and the differences between both types of osteolysis are briefly reviewed. In the present cases the appearance of osteolytic lesions during the chronic phase of CML preceded for a variable period the terminal acute blastic phase. Therefore this complication must be considered as a sign of poor prognosis as it relates to the subsequent course of the leukemia. Even though other authors advise local radiotherapy as the treatment of choice of osteolytic lesions, only cytostatic therapy was given to the present patients, with good results as it regards the lesions per se.

Topics: Adult; Aged; Bone Neoplasms; Bone Resorption; Busulfan; Female; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Osteolysis; Pipobroman; Prednisone; Prognosis; Radiography; Vincristine

A woman with myasthenia gravis and a thymoma did not respond sufficiently to thymectomy. She was treated with 6-mercaptopurine. Withdrawal of this treatment was several times followed by an aggravation of myasthenic symptoms. After more than 12 1/2 years treatment she developed Ph1-positive chronic myeloid leukemia (CML). No other case of CML following immunosuppressive treatment has been described. Because the therapeutic agent is potentially leukemogenic, the possibility cannot be definitely excluded that the development of CML is not a mere coincidence.

Topics: Chromosomes, Human, 21-22 and Y; Female; Humans; Immunosuppressive Agents; Leukemia, Myeloid; Mercaptopurine; Middle Aged; Myasthenia Gravis; Thymectomy

Topics: Bone Marrow; Cells, Cultured; Clone Cells; Diagnosis, Differential; Etoposide; Humans; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Mercaptopurine; Muramidase; Prognosis; Transcobalamins

Thirteen adult patients with histologically confirmed lymphoblastic lymphoma were treated with an intensive chemotherapy program consisting of induction with cyclophosphamide, adriamycin, vincristine, and prednisone (modified CHOP); consolidation and central nervous system (CNS) prophylaxis with methotrexate intrathecally and by high-dose intravenous injection, citrovorum factor and L-asparaginase; reinforcement with CHOP; and maintenance with 6-mercaptopurine and methotrexate. Treatment duration was 1 yr. A 14th patient with T-cell acute lymphoblastic leukemia was also treated at presentation by the same regimen. Thirteen patients had at least a mediastinal mass or abnormal cells in the bone marrow; one presented with CNS disease. The median age was 22 yr (range 16--50), and male--female ratio was 2.5:1. All patients had a rapid complete clinical response. Of the 13 patients without initial CNS disease, 4 have relapsed, 3 with primary CNS relapse and 1 with a recurrent abdominal mass. Five patients have died, 2 from drug toxicity, 2 from CNS relapse, and 1 from chronic myelogenous leukemia, which was diagnosed simultaneously with the lymphoblastic lymphoma. The median follow-up is 19 mo, and all patients have completed their planned therapy. At 3 yr, the actuarial survival is 61% and relapse-free survival is 56%.

Topics: Adolescent; Adult; Asparaginase; Central Nervous System Diseases; Cyclophosphamide; Doxorubicin; Female; Humans; Leucovorin; Leukemia, Myeloid; Lymphoma, Non-Hodgkin; Male; Mercaptopurine; Methotrexate; Middle Aged; Prednisone; Vincristine

In an attempt to retard the appearance of blastic transformation 11 patients recently diagnosed with chronic granulocytic leukaemia were given courses of vincristine and 6-mercaptopurine after stabilization of the disease by busulfan. In 4 of the patients a marked thrombocytosis developed shortly after the administration of such courses. When we compared the clinical and biological features at the moment of diagnosis, the patients in whom thrombocytosis developed after vincristine and 6-mercaptopurine courses showed higher platelet counts and a smaller spleen size than the other ones, although no statistical significance was reached. A possible thrombocytopoietic effect of vincristine is discussed.

Topics: Adolescent; Adult; Aged; Female; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Thrombocytosis; Vincristine

9 patients with chronic granulocytic leukemia were treated sequentially with busulfan, 6-mercaptopurine, and trimethylcolchicinic acid methyl ether d-tartrate (TMCA; NSC-36354). Smoothness of control of the disease was similar with busulfan and 6-mercaptopurine, but it was significantly poorer with TMCA. Toxic effects of therapy and median survival were similar to those observed with conventional therapy.

Topics: Adolescent; Adult; Aged; Bone Marrow; Busulfan; Colchicine; Drug Therapy, Combination; Female; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged

A 34% response was obtained in 202 evaluable patients in the terminal phase of chronic granulocytic leukemia using combinations of hydroxyurea, 6-mercaptopurine, and corticosteroids. Twelve percent of responses were complete and 22% partial. Overall median survival was 12 wk. A 30 wk median survival for responding patients was statistically superior to the 7-wk survival for nonresponders (p less than 0.001). Response was inversely correlated with toxicity. No responses were obtained in patients sustaining both severe infectious and bleeding complications. No benefit could be demonstrated from the addition of vincristine in induction and daunorubicin for consolidation. Although the response frequency and duration of survival with this combination chemotherapy were generally superior to those previously reported by our group, the terminal phase of chronic granulocytic leukemia still remains a formidable and generally refractory disease.

Topics: Daunorubicin; Dexamethasone; Drug Therapy, Combination; Gastrointestinal Diseases; Hemorrhage; Humans; Hydroxyurea; Infections; Leukemia, Myeloid; Mercaptopurine; Prednisone; Remission, Spontaneous; Terminal Care

Topics: Clinical Enzyme Tests; Cytarabine; Humans; Infant, Newborn; Leukemia, Myeloid; Male; Mercaptopurine; Monocytes; Muramidase; Naphthol AS D Esterase

It is referred to the possibility of the splenectomy in the early phase of the chronic myelosis in the time of the first remission. The intervention cannot be recommended generally and should be used only now and then in centres which have rooms at their disposal which are poor in germs. Own experiences speak for the fact to extend the polychemotherapy of the blast crisis of the chronic myelosis to its prephase, when an increasing therapy resistance occurs, the spleen becomes clearly larger, the number of blasts in the bone-marrow increases and single blasts may be proved in the peripheral blood. Combinations of two or three medicaments, such as Busulfan, Myelobromol, Merkaleukin, Methotrexat, Hydroxyurea, Alexan, Vinkristin or Rubomycin seem to be favourable.

Topics: Busulfan; Cytarabine; Daunorubicin; Humans; Hydroxyurea; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Mitobronitol; Prognosis; Splenectomy; Vincristine

On the basis of five observations of adult patients with the clinical feature of mature cellular leukaemia which proved to be therapy-refractory and which was characterized by a rapid course is referred to the necessity of the differentiation of such cases from the classical myeloic leukaemia. The cardinal symptoms of this type of disease, which probably is identified with the cases described in literature as atypical chronic myelosis, as paraneutrophil leukaemia or as acute myelofibrosis, and also shows common features with the juvenile chronic myelosis, are, apart from the mature cellular differential blood picture a short life expectancy (less than 1 year), an initial thrombocytopenia, a normal or increased activity of the alkaline granulocyte phosphatase, the lack of Ph1-chromosome as well as the bad therapeutic reaction to busulfan. The observation of the simultaneously existing fibroses of the bone marrow as well as of the final increase of immature blasts induced the classification of the clinical picture as a special form of the myeloproliferative syndrome.

Topics: Acute Disease; Adult; Azathioprine; Bone Marrow Examination; Fetal Hemoglobin; Hematopoietic Stem Cells; Humans; Leukemia, Myeloid; Mercaptopurine; Myeloproliferative Disorders; Primary Myelofibrosis

Cytogenetic studies of chronic myelogenous leukemia (CML) have shown that the majority of hemopoietic cells originate from pluripotential stem cells affected in this disease. Evidence that lymphocytes are also progeny of these stem cells, however, has been indirect. Philadelphia-chromosome-positive leukemic blasts from a 4 10/12-yr-old boy with CML in blast crisis had features characteristic of pre-B leukemic cells, including expression of cytoplasmic IgM and absence of surface immunoglobulin. Additional immunologic, enzymatic, and pharmacologic characterization of these cells supported their pre-B-cell phenotype. Together, these features provide direct evidence for CML stem cell ancestry to lymphocytes of the B-cell lineage.

Topics: B-Lymphocytes; Cell Transformation, Neoplastic; Child; Chromosomes, Human, 21-22 and Y; Humans; Hydroxyurea; Leukemia; Leukemia, Myeloid; Male; Mercaptopurine; Methotrexate; Phenotype; Prednisone; Time Factors; Vincristine

A 46-month-old boy with juvenile chronic granulocytic leukemia was treated intensively with hydroxyurea, dimethyl myleran, cyclophosphamide, and total body irradiation. He then received a marrow transplant from an HL-A matched brother. Thirty-two months after the transplantation, he is hematologically normal and remains disease free on no-maintenance therapy. The successful outcome of this case suggests that a bone marrow transplant for any patient with a suitable histocompatible donor should be considered in the treatment of this disease.

Topics: Bone Marrow Transplantation; Busulfan; Child, Preschool; Cyclophosphamide; Humans; Hydroxyurea; Leukemia, Myeloid; Male; Mercaptopurine; Methotrexate; Transplantation, Homologous

Topics: Adolescent; Adult; Cyclophosphamide; Cytarabine; Daunorubicin; Drug Therapy, Combination; Female; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Prednisolone; Splenectomy

For the purpose of preventing a relapse of acute leukemia which is currently the major problem in the successful treatment of the disease, repeated consolidation or intensification therapy during the first year following remission is important. To evaluate these therapies, we investigated the serial changes in CFU-C's of the marrow cells from 12 patients with acute nonlymphocytic leukemia in remission and tried to estimate the relationship between the intensity of consolidation or intensification therapy and the duration of remission, utilizing the degree of reduction in CFU-C's seven days after these treatments as an indicator. As a result, after 21 out of 22 courses of therapy where CFU-C's were reduced significantly after the therapy, the patients were still in remission at the time of the next intensificiation therapy (at most for about 100 days). On the other hand, after five out of ten courses where CFU-C's were not reduced significantly, the patients were in relapse at the time of the next intensification therapy. From these results, it may be inferred that cases whose CFU-C's are not reduced significantly should be treated intensively again within a short period.

Topics: Acute Disease; Adult; Child; Colony-Forming Units Assay; Cytarabine; Daunorubicin; Drug Therapy, Combination; Female; Humans; Leukemia; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Middle Aged; Prednisolone; Remission, Spontaneous

Three cases of the juvenile type of chronic myeloid leukemia are described, all of which have shown a clinical and hematologic response to repeated cycles of sequential subcutaneous cytarabine and oral mercaptopurine. It appears that this regime, as described, may afford some control of a disease process previously supposed to be unresponsive to chemotherapy. This control, however, is likely to be reflected in an improvement in well-being, rather than overall survival time. Patient 1 survived 26 mo from diagnosis, and patients 2 and 3 are alive and well 12 and 9 mo from diagnosis, respectively.

Topics: Administration, Oral; Cytarabine; Female; Humans; Infant; Injections, Subcutaneous; Leukemia, Myeloid; Life Expectancy; Mercaptopurine; Quality of Life

The incidence of amoeboid movement configuration (AMC), a cell shape suggestive of cell locomotion at the moment of fixation, has been studied in the tumour cells of bone marrow smears from leukaemia patients at the time of diagnosis. The groups of patients with CML (n = 8), ALL (n = 5) and CLL (n = 9) were small, and the incidences of AMC were close to those found in the corresponding cell lines from healthy probands. In 39 patients with AML, the incidence of AMC was higher than in the other cell lines investigated. A positive skew distribution of AMC values and a positive significant correlation between incidence of AMC were found at the time of diagnosis and subsequent survival of the patients with AML, in spite of differences in treatment. It is suggested that this positive correlation may be due to an immune reaction of the patients against their tumour cells.

Topics: Adolescent; Adult; Aged; Aminopterin; Bone Marrow; Cell Line; Cell Movement; Child, Preschool; Female; Humans; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Middle Aged; Prednisolone; Prognosis; Vincristine

Topics: Central Nervous System Diseases; Child; Child, Preschool; Diagnosis, Differential; Female; Humans; Immunotherapy; Injections, Spinal; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Prednisolone; Remission, Spontaneous; Vincristine

Topics: Adult; Chromosome Aberrations; Chromosomes, Human, 21-22 and Y; Cytarabine; Drug Therapy, Combination; Female; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Mitobronitol; Prednisone

A 3 months old girl presented with significant enlargement of liver, spleen and lymphnodes, with moderate anemia, thrombopenia and leucocytosis. In the differential count there was a shift to the left and an increase of monocyte-like cells (35%). Differential diagnosis included leucemoid reaction, infectious mononucleosis, myelo-proliferative disorder with a missing C chromosome and chronic myeloid leucemia. Clinical symptoms, cytochemistry and caryotype of bone marrow cells suggested infantile chronic myeloic leucemia and normal ALP index and possibly normal HbF. Treatment with 6-mercaptopurine was followed by partial remission. The therapeutic consequences of exact differential diagnosis are discussed.

Topics: Anemia; Chromosome Aberrations; Chromosome Disorders; Diagnosis, Differential; Humans; In Vitro Techniques; Infant; Infectious Mononucleosis; Leukemia, Myeloid; Leukocytosis; Liver Diseases; Lymphatic Diseases; Mercaptopurine; Myeloproliferative Disorders; Splenic Diseases; Thrombocytopenia

Survival and response to chemotherapy were evaluated in 84 adults with granulocytic leukemia (AGL) and 22 with acute lymphocytic leukemia (ALL). Twenty-two of the 84 patients with AGL reveived no chemotherapy (untreated group). The median survival for patients with AGL who achieved complete remission (CR) was 17.1 months, compared to 6.5 months for those who achieved partial remission (PR (p less than 0.05), 2.8 months for those who failed chemotherapy (p less than 0.01), and 2.1 months for the untreated group (p less than 0.01). The median survival for patients with ALL who achieved a CR was 18.2 months, compared to 7.3 months for those who achieved a PR and 7.0 months for those who failed chemotherapy. Of patients with AGL who reveived an adequate trial of chemotherapy, 43% achieved a CR and 16% a PR; 75% of patients with ALL achieved a CR and 13% a PR. Improved survival depends on the induction of a complete or partial remission with the use of aggressive chemotherapy.

Topics: Acute Disease; Adolescent; Adult; Aged; Child; Cyclophosphamide; Daunorubicin; Drug Therapy, Combination; Humans; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Middle Aged; Prednisone; Thioguanine; Thioinosine; Vincristine

Eleven adults with refractory leukemia treated with a combination of 6-mercaptopurine and Adriamycin developed hepatic dysfunction manifested by elevations of serum total bilirubin, alkaline phosphatase, and glutamic oxaloacetic transaminase. Liver tissue obtained at necropsy showed intrahepatic cholestasis (eight cases), hepatocellular necrosis (ten cases), leukemic infiltration (two cases), and fatty change (nine cases). Neither this frequency nor severity of hepatocellular destruction has hitherto been associated with 6-mercaptopurine at the dose levels used in this study, nor has Adriamycin previously been found to be hepatotoxic. It is postulated that Adriamycin potentiated the hepatotoxicity of 6-mercaptopurine in these patients.

Topics: Adult; Chemical and Drug Induced Liver Injury; Doxorubicin; Drug Synergism; Drug Therapy, Combination; Humans; Hyperbilirubinemia; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Liver Diseases; Mercaptopurine

In three patients with malignant disease HBsAg was detected in the serum at least 6 months before the development of acute hepatitis type B, which in each case followed a fulminant course to death. It is suggested that suppression of the normal immunological responses to hepatitis-B viral antigens by cytotoxic drug therapy permitted widespread infection of hepatocytes. Subsequently, upon withdrawal of these drugs, recovery of immunocompetence resulted in rapid destruction of all infected hepatocytes and massive liver damage. Screening for HBsAg before cytotoxic drug therapy, careful monitoring of liver function during its withdrawal, and prompt treatment with corticosteroids should abnormalities occur may prevent this unfortunate sequence of events.

Topics: Adult; Antineoplastic Agents; Chlorambucil; Choriocarcinoma; Cyclophosphamide; Dactinomycin; Female; Hepatitis B; Hepatitis B Antigens; Humans; Immunosuppression Therapy; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Male; Mercaptopurine; Methotrexate; Prednisolone; Pregnancy; Substance Withdrawal Syndrome; Vincristine

After a chronic phase, the average duration of which in this series was 38 months, the acute phase of myeloid leukemia was very short, not exceeding 7 months. The clinical signs which suggest an acute exacerbation are, in order of importance, increase in the volume of the spleen, changes in general health, fever. The blood signs, which are often found later than the clinical signs, are increased white cell count, anemia and marrow leukoblastosis higher than 20%. The laboratory criteria of acute exacerbation are of lesser importance. Chemotherapy gives very poor results at this stage.

Topics: Alkaline Phosphatase; Female; Fever; Humans; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukocytes; Male; Mercaptopurine; Methotrexate; Middle Aged; Prednisone; Splenomegaly

Topics: Adult; Bone Marrow Cells; Bone Marrow Transplantation; Cytarabine; Daunorubicin; Drug Therapy, Combination; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Prednisolone; Transplantation, Homologous

The juvenile type of chronic myelogenous leukemia (CML) is characterized by hemorrhagic diathesis, hepatosplenomegaly, generalized enlargement of lymph nodes, reduced erythro- and thrombopoiesis, leukemic infiltration of bone marrow, and decreased activity of leukocyte alkaline phosphatase. The disorder differs from the adult type by the early manifestation of anemia and thrombocytopenia, the minor degree of leucocytosis, the failure to demonstrate the Philadelphia chromosome, and the presence of fetal markers in the patients' erythrocytes. The persistence of fetal markers in erythrocytes and the clinical manifestation in infancy and early childhood suggest that the disease is congenital in origin. The occurrence of CML of the juvenile type in an 8-year-old boy, which is reported in this paper, favors a postnatal acquisition of the disorder. The significance of hematological and cytogenetic findings and new aspects of nosological classification are discussed.

Topics: Adolescent; Age Factors; Alkaline Phosphatase; Autopsy; Child; Child, Preschool; Diagnosis, Differential; Drug Therapy, Combination; Female; Hemoglobins; Hemorrhagic Disorders; Hepatomegaly; Humans; Infant; Infant, Newborn; Iron; L-Lactate Dehydrogenase; Leukemia, Myeloid; Liver; Male; Mercaptopurine; Prednisone; Splenomegaly; Transaminases; Vincristine

Remission induction was assessed by clinical and cell-culture criteria for 65 patients with acute myelogenous leukemia (AML), 11 patients with chronic myelogenous leukemia (CML) in blast crisis and 19 patients with acute lymphoblastic leukemia (ALL). Cyclophosphamide, cytosine arabinoside and vincristine (CAV) therapy resulted in complete remission in 23 of 50 previously untreated patients with AML and in 3 of the 11 patients with CML. Fourteen patients with ALL responded to vincristine-prednisone induction therapy and two to induction therapy with CAV. The median duration of survival of the responding patients was 2.2 years, compared with 4 months for the patients who did not respond to treatment. Granulopoietic colony formation, assessed by assay of colony-forming units dependent on colony-stimulating activity in culture (CFU-C), was abnormal in 37 of 42 bone marrow aspirates from patients with AML before treatement. CFU-C concentration increased when leukocyte-conditioned medium (LCM) was added to the cultures; 13 cultures had normal or elevated CFU-C concentration with LCM. Marrow cells of patients with ALL or CML in blast crisis demonstrated a similar pattern. Serial studies of marrow CFU-C concentration of 31 patients with AML demonstrated a change to a normal pattern with successful remission induction. Results of this study suggest that administration of purified LCM to leukemic patients might increase granulocyte production from potential but unstimulated granulopoietic precursors. This therapy would lessen the probability of death from infection during remission induction.

Topics: Acute Disease; Adolescent; Adult; Aged; Bone Marrow; Bone Marrow Cells; Cell Division; Cells, Cultured; Clone Cells; Culture Media; Cyclophosphamide; Cytarabine; Drug Administration Schedule; Drug Therapy, Combination; Female; Granulocytes; Humans; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukocytes; Male; Mercaptopurine; Methotrexate; Middle Aged; Prednisone; Remission, Spontaneous; Vincristine

Topics: Busulfan; Drug Therapy, Combination; Humans; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Prednisone

Topics: Drug Antagonism; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Splenectomy; Thrombelastography; Thrombophlebitis; Time Factors; Warfarin

Topics: Adolescent; Bone Marrow; Child; Child, Preschool; Cyclophosphamide; Cytarabine; Female; Humans; Immunodiffusion; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Immunoglobulins; Infant; Leukemia; Leukemia, Myeloid; Lymphocytes; Male; Mercaptopurine; Methotrexate; Prednisone; Vincristine

Topics: Adult; Asparaginase; Betamethasone; Cytarabine; Daunorubicin; Drug Therapy, Combination; Humans; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Spinal Cord Compression; Spinal Neoplasms

Topics: Asparaginase; Child; Humans; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Mercaptopurine; Methotrexate; Prednisone; Prognosis; Remission, Spontaneous; Vincristine

Topics: Autoradiography; Bone Marrow Cells; Cell Adhesion; Cell Division; Cell Separation; Cells, Cultured; Culture Media; Cytarabine; Daunorubicin; Freezing; Humans; Lectins; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukocytes; Male; Mercaptopurine; Middle Aged; Prednisone; Radiation Effects; Thymidine; Tritium; Ultrafiltration

Topics: Asparaginase; Daunorubicin; Doxorubicin; Humans; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Vincristine

Topics: Busulfan; Female; Humans; Leukemia, Myeloid; Leukocytosis; Mannitol; Mercaptopurine; Pregnancy; Pregnancy Complications, Hematologic; Splenectomy; Thioguanine

Topics: Adolescent; Asparaginase; Blood Platelets; Blood Transfusion; Cephalosporins; Child; Child, Preschool; Drug Therapy, Combination; Female; Gentamicins; Humans; Infant; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Prednisolone; Prognosis; Radiotherapy; Remission, Spontaneous; Vincristine

Topics: Adolescent; Adult; Aged; Busulfan; Histocytochemistry; Humans; Leukemia; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukocytes; Mercaptopurine; Methotrexate; Middle Aged; Tetrahydrofolate Dehydrogenase

Topics: Acute Disease; Bone Marrow Examination; Cell Transformation, Neoplastic; Dexamethasone; Drug Therapy, Combination; Glucocorticoids; Humans; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Prednisolone; Prednisone; Remission, Spontaneous; Vincristine

Topics: Adrenal Cortex Hormones; Anemia; Autopsy; Bone Marrow Examination; Dyspnea; Female; Hemorrhage; Humans; Leukemia, Myeloid; Lung; Mercaptopurine; Middle Aged; Pulmonary Alveolar Proteinosis; Radiography; Splenomegaly

Topics: Adolescent; Adult; Age Factors; Aged; Blood Platelets; Blood Transfusion; Cytarabine; Daunorubicin; Female; Humans; Hydrazines; Hyperplasia; Leukemia, Myeloid; Leukocyte Count; Leukopenia; Male; Mercaptopurine; Methotrexate; Middle Aged; Remission, Spontaneous; Thrombocytopenia; Time Factors

Topics: Acute Disease; Adult; Child; Cyclophosphamide; Cytarabine; Humans; Hydroxyurea; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Mercaptopurine; Methotrexate; Prednisolone; Thioguanine; Vincristine

Topics: Adenine; Adolescent; Adult; Aged; Antimetabolites; Drug Resistance; Female; Guanine; Humans; Hypoxanthines; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukocytes; Male; Mercaptopurine; Mutation; Pentosyltransferases; Remission, Spontaneous; Thioguanine

Topics: Cytarabine; Drug Synergism; Humans; Leukemia, Erythroblastic, Acute; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Mercaptopurine

Topics: Abortion, Spontaneous; Abortion, Therapeutic; Adult; Blood Coagulation Tests; Blood Platelets; Blood Transfusion; Female; Humans; Labor, Induced; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Mercaptopurine; Prednisolone; Pregnancy; Pregnancy Complications, Hematologic

Topics: Adolescent; Adult; Aged; Busulfan; Chromosome Aberrations; Daunorubicin; Female; Fever; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Prednisone; Splenomegaly; Time Factors

Topics: Adolescent; Agranulocytosis; Anemia; Bone Marrow; Bone Marrow Cells; Child; Child, Preschool; Cyclophosphamide; Cytarabine; Daunorubicin; Drug Synergism; Female; Hemorrhage; Humans; Infant; Injections, Intravenous; Leukemia, Lymphoid; Leukemia, Myeloid; Male; Mercaptopurine; Neutrophils; Prednisolone; Thrombocytopenia; Vincristine

Topics: Bone Marrow Examination; Bronchitis; Child, Preschool; Chromosome Aberrations; Chromosome Disorders; Chromosomes, Human, 6-12 and X; Cytoplasmic Granules; Female; Hepatomegaly; Histocytochemistry; Humans; Intellectual Disability; Karyotyping; Leukemia, Myeloid; Leukocytes; Mercaptopurine; Peroxidases; Prednisone; Rhinitis; Xanthomatosis

Topics: Autopsy; Child, Preschool; Electrophoresis, Starch Gel; Erythrocytes; Erythropoiesis; Female; Fetal Hemoglobin; Fetus; Humans; Leukemia, Myeloid; Mercaptopurine; Potassium; Prednisone; Sodium; Spleen

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Cyclophosphamide; Cytarabine; Daunorubicin; Female; Humans; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Middle Aged; Vincristine

Topics: Age Factors; Antilymphocyte Serum; Antineoplastic Agents; Blood Cell Count; Busulfan; Chlorambucil; Humans; Hydroxyurea; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Prednisone; Prognosis; Remission, Spontaneous

Topics: Alkaline Phosphatase; Busulfan; C-Reactive Protein; Cytarabine; Daunorubicin; Female; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Prednisolone

Topics: Abortion, Therapeutic; Adolescent; Busulfan; Chronic Disease; Female; Humans; Leukemia, Myeloid; Leukocyte Count; Long-Term Care; Mercaptopurine; Myelography; Pregnancy; Pregnancy Complications, Hematologic; Splenectomy; Splenomegaly

Topics: Acute Disease; Administration, Oral; Adolescent; Adult; Age Factors; Aged; Amino Sugars; Antibiotics, Antineoplastic; Antineoplastic Agents; Cytarabine; Drug Synergism; Female; Follow-Up Studies; Glycosides; Humans; Injections, Intravenous; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Middle Aged; Prednisolone; Pregnancy; Remission, Spontaneous; Time Factors

Topics: Abscess; Antineoplastic Agents; Histocytochemistry; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Necrosis; Prednisone; Shwartzman Phenomenon; Skin Manifestations

Topics: Adolescent; Adrenal Cortex Hormones; Adult; Aged; Aminoisobutyric Acids; Asparagine; Child; Female; Hodgkin Disease; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Middle Aged; Thymine; Vinblastine

Topics: Anemia, Hemolytic, Autoimmune; Anti-Bacterial Agents; Antimetabolites; Blood Specimen Collection; Bone Marrow Diseases; Busulfan; Chromosome Aberrations; Diuretics; Hodgkin Disease; Humans; Karyotyping; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukemoid Reaction; Mercaptopurine; Prednisone; Specimen Handling; Thrombocytopenia; Time Factors

Topics: Antineoplastic Agents; Bronchial Neoplasms; Carcinoma, Bronchogenic; Drug Tolerance; Glycine; Humans; Leukemia; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Mercaptopurine; Purines; Sulfides; Valerates

Topics: Antineoplastic Agents; Bone Marrow; Child; Child, Preschool; Cytidine; Drug Tolerance; Humans; Leukemia; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukocyte Count; Leukocytes; Mercaptopurine; Prednisone; Remission, Spontaneous; Thiazines; Vincristine

Topics: Adolescent; Adult; Aged; Blood Cell Count; Blood Platelets; Bone Marrow Diseases; Busulfan; Child; Cobalt Isotopes; Female; Hemoglobins; Humans; Hydroxyurea; Leukemia, Myeloid; Leukocyte Count; Male; Mercaptopurine; Middle Aged; Radiotherapy; Remission, Spontaneous; Spleen; Time Factors

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: Antineoplastic Agents; Asparaginase; Busulfan; Chromatography, Ion Exchange; Cobalt Isotopes; Cytarabine; Humans; Leukemia, Myeloid; Leukocyte Count; Mercaptopurine; Protein Binding; Serum Globulins; Vitamin B 12

Topics: Adolescent; Adult; Aged; Bromine; Busulfan; Clinical Enzyme Tests; Humans; Leukemia, Myeloid; Leukocyte Count; Leukocytes; Mannitol; Mercaptopurine; Micrococcus; Middle Aged; Muramidase; Spleen

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: Adult; Blood Platelets; Blood Transfusion; Child; Female; Hematopoiesis; Humans; In Vitro Techniques; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukocyte Count; Leukocytes; Male; Mercaptopurine; Middle Aged

Topics: Leukemia, Myeloid; Mercaptopurine; Prognosis

Topics: Aged; Anemia, Aplastic; Antineoplastic Agents; Blood Transfusion; Bone Marrow Examination; Busulfan; Hemorrhagic Disorders; Humans; Leukemia, Myeloid; Male; Megakaryocytes; Mercaptopurine; Mitosis; Prednisone

Topics: Adolescent; Animals; Antineoplastic Agents; Asparaginase; Bone Marrow; Bone Marrow Cells; Child; Cytarabine; Daunorubicin; Disease Models, Animal; Humans; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Mice; Remission, Spontaneous; Vincristine

Topics: Busulfan; Female; Humans; Leukemia, Myeloid; Male; Mercaptopurine

Topics: Acute Disease; Adolescent; Adult; Antibiotics, Antineoplastic; Antilymphocyte Serum; Antineoplastic Agents; Asparaginase; Child; Child, Preschool; Cyclophosphamide; Cytarabine; Drug Synergism; Female; Humans; Immunotherapy; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Prednisone; Vincristine

Topics: Antibiotics, Antineoplastic; Blood Cells; Blood Transfusion; Bone Marrow Cells; Bone Marrow Examination; Chromosome Aberrations; Culture Techniques; Female; Humans; Infant; Karyotyping; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Prednisone

Topics: Adolescent; Adult; Autoradiography; Cell Differentiation; Cytarabine; DNA, Neoplasm; Female; Histocytochemistry; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Methotrexate; Middle Aged; Prednisolone; Thymidine; Thymidine Kinase; Tritium

Topics: Adult; Aged; Antineoplastic Agents; Bone Marrow Examination; Busulfan; Cytarabine; Female; Humans; Leukemia, Myeloid; Leukocytosis; Male; Mannitol; Mercaptopurine; Middle Aged; Nitrosourea Compounds; Prednisone; Remission, Spontaneous; Splenic Neoplasms; Splenomegaly; Vincristine

Topics: Adolescent; Adult; Aged; Anemia; Blood Platelets; Blood Transfusion; Blood Urea Nitrogen; Bone Marrow Cells; Bone Marrow Examination; Chromosome Aberrations; Cytomegalovirus; Female; Fever; Hemorrhage; Humans; Jaundice; Leukemia, Myeloid; Leukocyte Count; Leukocytes; Leukopenia; Male; Mercaptopurine; Methotrexate; Middle Aged; Nocardia Infections; Pneumonia; Prednisone; Proteus Infections; Pseudomonas Infections; Sepsis; Thrombocytopenia; Vincristine

Topics: Adult; Aneuploidy; Blood Cell Count; Bone Marrow; Bone Marrow Cells; Bone Marrow Examination; Busulfan; Chromosome Aberrations; Female; Humans; Karyotyping; Leukemia, Myeloid; Liver; Mercaptopurine; Prednisone; Spleen

Topics: Adult; Afibrinogenemia; Aged; Anemia; Antineoplastic Agents; Child; Cytarabine; Daunorubicin; Humans; Hydroxyzine; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukopenia; Mercaptopurine; Methotrexate; Middle Aged; Polycythemia Vera; Prednisone; Primary Myelofibrosis; Splenomegaly; Vincristine

Topics: Chronic Disease; Cyclophosphamide; Deoxyuridine; DNA; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukocyte Count; Leukocytes; Ligases; Mercaptopurine; Methotrexate; Nucleosides; Nucleotides; Phosphotransferases; Tetrahydrofolate Dehydrogenase; Thymidine Kinase

Topics: Cerebrospinal Fluid; Chromosome Aberrations; Karyotyping; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Neurologic Manifestations; Prednisone; Vincristine

Topics: Adolescent; Adult; Bone Diseases; Bone Marrow; Bone Marrow Cells; Child; Female; Gallbladder Diseases; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Myocardium; Pancreatic Diseases; Pericardial Effusion; Prednisone; Splenic Diseases; Time Factors; Vincristine

Topics: Acute Disease; Aged; Aneuploidy; Bone Marrow Diseases; Busulfan; Cell Transformation, Neoplastic; Chromosome Aberrations; Chromosome Disorders; Chronic Disease; Female; Humans; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Prednisolone; Vincristine

Topics: Antimetabolites; Blood Cells; Cell Line; Culture Techniques; Cytarabine; Fluorouracil; Humans; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Mercaptopurine; Methotrexate; Mitosis; Neoplasms

Mitochondrial DNA's from the peripheral blood of 14 patients with granulocytic leukemia contained a circular dimer form. No such structure could be found in M DNA's from three patients with nonmalignant proliferations of granulocytes. The frequency of the circular dimer form is reduced upon treatment with antileukemic drugs. The above results suggest that a significant relation exists between the formation and presence of the circular dimer M DNA form and granulocytic leukemia in man.

Topics: Busulfan; DNA; Humans; Leukemia, Myeloid; Leukemoid Reaction; Leukocytes; Mercaptopurine; Methods; Methotrexate; Microscopy, Electron; Mitochondria; Primary Myelofibrosis

Topics: Chromosome Aberrations; Chromosomes, Human, 16-18; Chromosomes, Human, 21-22 and Y; Chromosomes, Human, 6-12 and X; Humans; Karyometry; Leukemia, Myeloid; Mercaptopurine

Topics: Animals; Antineoplastic Agents; Burkitt Lymphoma; Culture Techniques; Humans; Leukemia; Leukemia L1210; Leukemia, Experimental; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukocytes; Mercaptopurine; Methotrexate; Mice; Prednisolone; Vincristine

Topics: Bone Marrow; Female; Humans; Infant; Leukemia, Myeloid; Leukocyte Count; Mercaptopurine; Radiography; Ribs; Thoracic Neoplasms

Topics: Adult; Aged; Blood Platelet Disorders; Blood Platelets; Busulfan; Female; Humans; Leukemia, Lymphoid; Leukemia, Myeloid; Male; Megakaryocytes; Mercaptopurine; Middle Aged; Prednisolone

Topics: Adult; Blood Cell Count; Bone Marrow Examination; Brain Neoplasms; Carotid Arteries; Cobalt Isotopes; Craniotomy; Electroencephalography; Humans; Intracranial Pressure; Leukemia, Myeloid; Lymphoma; Male; Mercaptopurine; Methotrexate; Microscopy, Phase-Contrast; Prednisolone; Radiography

Topics: Acute Disease; Antineoplastic Agents; Asparaginase; Chronic Disease; Cyclophosphamide; Daunorubicin; Humans; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Prednisone; Vincristine

Topics: Antineoplastic Agents; Hematologic Diseases; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Multiple Myeloma; Polycythemia Vera; Prednisone; Vincristine; Waldenstrom Macroglobulinemia

Topics: Bone Marrow; Child; Child, Preschool; Humans; Infant; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Prednisone; Vincristine

Topics: Asparaginase; Busulfan; Chlorambucil; Cyclophosphamide; Cytarabine; Humans; Hydroxyurea; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Mercaptopurine; Methotrexate; Pipobroman; Prednisolone; Vincristine

Topics: Adult; Aged; Busulfan; Cell Transformation, Neoplastic; Chromosome Aberrations; Clone Cells; Female; Glyoxylates; Humans; Karyotyping; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Prednisone

Topics: Aged; Blood Cell Count; Blood Transfusion; Bone Marrow Examination; Busulfan; Female; Humans; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Middle Aged; Prednisolone; Prognosis

Topics: Adenocarcinoma; Adult; Aged; Anti-Bacterial Agents; Breast Neoplasms; Carcinoma; Female; Fluorouracil; Humans; Leukemia, Myeloid; Lymphatic Metastasis; Mastectomy; Mercaptopurine; Methotrexate; Middle Aged

Topics: Animals; Busulfan; Chronic Disease; Leukemia, Myeloid; Mercaptopurine; Mitomycins; Rats

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Biopsy; Blood Protein Electrophoresis; Blood Sedimentation; Blood Transfusion; Busulfan; Congo; Female; gamma-Globulins; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Lymphoma; Male; Mercaptopurine; Middle Aged; Prednisone

Topics: Adolescent; Adrenocorticotropic Hormone; Child, Preschool; Chlorambucil; Corneal Opacity; Female; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Strontium Isotopes; Xanthogranuloma, Juvenile; Xanthomatosis

Topics: Child; Child, Preschool; Humans; Infant; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Prednisone; Vincristine

Topics: Adolescent; Adult; Aged; Cyclophosphamide; Female; Humans; Leukemia, Myeloid; Male; Mercaptopurine

Topics: Adult; Female; Humans; Leukemia, Myeloid; Mercaptopurine; Pregnancy; Pregnancy Complications, Hematologic

Topics: Antineoplastic Agents; Busulfan; Cyclophosphamide; Female; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Lymphoma; Lymphoma, Non-Hodgkin; Male; Mercaptopurine; Methotrexate; Prednisone; Vincristine

Topics: Adrenal Cortex Hormones; Adult; Antimetabolites; Antineoplastic Agents; Blood Transfusion; Child; Hodgkin Disease; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Plasmacytoma; Prednisone; Vincristine

Topics: Adolescent; Adrenal Cortex Hormones; Blood Transfusion; Bone Marrow; Bone Marrow Cells; Bone Marrow Examination; Busulfan; Child; Child, Preschool; Female; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Vitamin B 12

Topics: Bone Marrow Cells; Drug Therapy; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Prognosis; Statistics as Topic; Toxicology

Topics: Antineoplastic Agents; Child; Chlorambucil; Cyclophosphamide; Drug Therapy; Ganglioneuroma; Gastrointestinal Diseases; Hodgkin Disease; Leukemia; Leukemia, Myeloid; Liver Neoplasms; Lymphoma; Mechlorethamine; Mercaptopurine; Methotrexate; Neoplasms; Pathology; Radiation Injuries; Stomach; Toxicology; Vinblastine; Vincristine; Wilms Tumor

Topics: Alkylating Agents; Aminopterin; Busulfan; Hodgkin Disease; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Lymphoma; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Mechlorethamine; Mercaptopurine; Methotrexate; Multiple Myeloma; Neoplasms; Pathology; Primary Myelofibrosis; Sarcoma; Triethylenemelamine; Tuberculosis; Tuberculosis, Pulmonary; Urethane

Topics: Adolescent; Adrenal Cortex Hormones; Child; Drug Therapy; Geriatrics; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Lymphocytes; Mercaptopurine; Microscopy, Electron, Scanning Transmission

Topics: Antineoplastic Agents; Bone Marrow Cells; Drug Therapy; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Pathology; Prednisone; Toxicology; Vincristine

Topics: Drug Therapy; Guanidines; Humans; Leukemia; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Mercaptopurine; Mitoguazone; Pyruvaldehyde; Toxicology

Topics: Adolescent; Black People; Bone Marrow Examination; Busulfan; Child; Chromosome Aberrations; Cyclophosphamide; Drug Therapy; Genetics, Medical; Humans; Infant; Leukemia; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Mortality; Pathology; Psychotherapy; Social Conditions; Statistics as Topic; Steroids; United Kingdom; Vincristine; Virus Diseases; White People

Topics: Adolescent; Antineoplastic Agents; Busulfan; Child; Cyclophosphamide; Drug Therapy; Humans; Infant; Leukemia; Leukemia, Myeloid; Melphalan; Mercaptopurine; Multiple Myeloma; Neoplasms; Phosphorus Isotopes; Prednisone

Topics: ABO Blood-Group System; Adolescent; Adrenocorticotropic Hormone; Adult; Antigen-Antibody Reactions; Erythrocytes; Female; Hemagglutination Tests; Humans; Immune Sera; Leukemia, Myeloid; Male; Mercaptopurine; Prednisone

Topics: Adolescent; Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Adult; Bone Marrow; Female; Humans; In Vitro Techniques; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged

In the United States, the Acute Leukemia Task Force has been studying ways to achieve chemical control over the acute leukemias. It was found that L1210 mouse leukemia is an excellent predictive model for childhood acute leukemia. Examination of the kinetics of cell generation led to the conclusions that a single cell could multiply to a lethal number of cells in a relatively short time, and that therapy must destroy every cell. Extension of these hypotheses to childhood leukemia has permitted estimates of generation time of human leukemic cells; the size of the leukemic cell population at clinical relapse and the fractional destruction of cells by individual drugs. By the use of combinations of antileukemic drugs complete cell destruction has been approached in a few patients with early leukemia.

Topics: Animals; Antineoplastic Agents; Child; Child, Preschool; Cyclophosphamide; Drug Synergism; Humans; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Mice; Vincristine

Topics: Adolescent; Adult; Aldehydes; Blood Cell Count; Bone Marrow; Cerebrospinal Fluid; Female; Fibrinogen; Humans; Leukemia, Lymphoid; Leukemia, Myeloid; Male; Mercaptopurine; Methotrexate; Middle Aged; Vincristine

Topics: Adult; Blood Transfusion; Child; Child, Preschool; Female; Humans; Leukemia, Lymphoid; Leukemia, Myeloid; Male; Mercaptopurine; Methotrexate; Middle Aged; Prednisone; Prognosis

Topics: Adenine; Animals; Guanine; Humans; Hypoxanthines; In Vitro Techniques; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Mice; Nucleotidyltransferases

Topics: Alkylating Agents; Antimetabolites; Antineoplastic Agents; Busulfan; Colchicine; Cyclophosphamide; Humans; Hydrocortisone; In Vitro Techniques; Leukemia, Myeloid; Leukocytes; Mercaptopurine; Oxygen Consumption; Uracil Mustard; Vinblastine

Topics: Adolescent; Adult; Glucose; Glycolysis; Humans; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukocytes; Mercaptopurine; Middle Aged; Oxygen

Topics: Anilides; Child; Child, Preschool; Cyclophosphamide; Female; Humans; Leucovorin; Leukemia, Lymphoid; Leukemia, Myeloid; Male; Mercaptopurine; Methotrexate; Prednisone; Urethane; Vincristine

Topics: Aneuploidy; Bone Marrow Examination; Child; Chromosome Aberrations; Chromosome Disorders; Chromosomes; Cyclophosphamide; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Microscopy, Electron, Scanning Transmission; Neoplasms; Pathology; Prednisone

Topics: Clinical Enzyme Tests; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Leukocyte Count; Mercaptopurine; Metabolism; Phosphotransferases; Pyrophosphatases

Topics: Guanidines; Humans; Leukemia; Leukemia, Myeloid; Mercaptopurine; Mitoguazone; Pyruvaldehyde; Toxicology

Topics: Alkaline Phosphatase; Antineoplastic Agents; Bone Marrow Examination; Busulfan; Cell Division; Chromosome Aberrations; Colchicine; Humans; Hydrogen-Ion Concentration; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukemia, Myeloid; Leukocyte Count; Leukocytes; Mercaptopurine; Philadelphia Chromosome; Vinblastine

Topics: Antineoplastic Agents; Blood Platelets; Busulfan; Chlorambucil; Factor Analysis, Statistical; Hemoglobinometry; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukemia, Myeloid; Leukocyte Count; Mercaptopurine; Phosphorus Isotopes; Toxicology; Triethylenemelamine

Topics: Blood Chemical Analysis; Blood Platelets; Busulfan; Child; Chromosome Aberrations; Erythrocyte Count; Hematocrit; Humans; Leukemia; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukemia, Myeloid; Leukocyte Count; Male; Mercaptopurine; Neoplasms; Pathology; Priapism; Splenomegaly

Topics: Adolescent; Busulfan; Cyclophosphamide; Geriatrics; Leukemia; Leukemia, Lymphoid; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukemia, Myeloid; Mercaptopurine; Nitrogen Mustard Compounds; Phenothiazines; Toxicology; Uracil Mustard

Topics: Adrenal Cortex Hormones; Blood Cell Count; Blood Transfusion; Bone Marrow Examination; Eosinophils; Hemostatics; Humans; Leukemia; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Mercaptopurine; Pathology; Tetracycline; Thrombin; Vitamin B Complex

Topics: Autopsy; Bone Marrow Examination; Busulfan; Diabetes Insipidus; Diabetes Insipidus, Neurogenic; Humans; Leukemia; Leukemia, Myeloid; Mercaptopurine; Polyuria; Prednisone; Vasopressins

Topics: Black People; Blood Cell Count; Bone Marrow Examination; Child; Cyclophosphamide; Drug Therapy; Humans; Leukemia; Leukemia, Myeloid; Mercaptopurine; Methylprednisolone; Prednisone; Sarcoma, Myeloid; Vincristine

Topics: Alkaline Phosphatase; Erythromycin; Female; Fluorescence; Humans; Leukemia; Leukemia, Myeloid; Leukocytes; Maternal-Fetal Exchange; Mercaptopurine; Microscopy; Microscopy, Fluorescence; Oxytetracycline; Placenta; Prednisone; Pregnancy; Pregnancy Complications; Pregnancy Complications, Hematologic; Quinacrine

Topics: Aziridines; Blood Platelets; Bone Marrow; Busulfan; Cell Division; Colchicine; Erythropoiesis; Hematopoiesis; Hodgkin Disease; Leukemia; Leukemia, Myeloid; Mercaptopurine; Pharmacology; Rats; Research; Reticulocytes; Vinblastine

Topics: Animals; Bone Marrow Transplantation; Hematopoietic System; Leukemia; Leukemia, Experimental; Leukemia, Myeloid; Lymphoma; Mercaptopurine; Mice; Neoplasms; Neoplasms, Experimental; Organotherapy; Pharmacology; Research

Topics: Animals; Anti-Bacterial Agents; Antibiotics, Antineoplastic; Antineoplastic Agents; Busulfan; Carcinoma, Ehrlich Tumor; Leukemia; Leukemia, Myeloid; Lymphoma; Lymphoma, Non-Hodgkin; Mercaptopurine; Mice; Neoplasms, Experimental; Nitrogen Mustard Compounds; Olivomycins; Pharmacology; Research; Sarcoma 180; Thiotepa; Toxicology

Topics: Busulfan; Drug Therapy; Helminthiasis; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine

Topics: Afibrinogenemia; Blood Cell Count; Bone Marrow Examination; Drug Therapy; Factor V Deficiency; Fibrinogen; Humans; Hypoprothrombinemias; Leukemia; Leukemia, Myeloid; Leukemia, Promyelocytic, Acute; Mercaptopurine; Pathology; Statistics as Topic; Thrombocytopenia

Topics: Adolescent; Blood; Calcium; Calcium, Dietary; Creatine; Creatinine; Humans; Hypercalcemia; Leukemia; Leukemia, Myeloid; Mercaptopurine; Potassium; Prednisone; Urea

Topics: Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Alkylating Agents; Anemia; Anemia, Hemolytic, Autoimmune; Busulfan; Chlorambucil; Cyclophosphamide; Folic Acid Antagonists; Hemorrhage; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Neoplasms; Nitrogen Mustard Compounds; Phosphorus Isotopes; Splenectomy; Thioguanine; Triethylenemelamine

Topics: Adrenal Cortex Hormones; Antineoplastic Agents; Asian People; Busulfan; DNA; DNA, Neoplasm; Epidemiology; Formates; Geriatrics; Humans; Infant; Japan; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Mitomycin; Neoplasms; Prednisolone; RNA; RNA, Neoplasm

Topics: Child; Drug Therapy; Humans; Leukemia; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Pathology; Prednisolone

Topics: Animals; Bone Marrow Examination; Hemagglutination Inhibition Tests; Interferons; Leukemia; Leukemia, Myeloid; Lymph Nodes; Mercaptopurine; Neoplasms; Neutralization Tests; Newcastle disease virus; Orthomyxoviridae; Spleen; Tissue Culture Techniques; Vertebrates; Viruses

Topics: Adenine Nucleotides; Bone Marrow; Cyclophosphamide; DNA; Formates; Guanine Nucleotides; Humans; In Vitro Techniques; Leukemia; Leukemia, Myeloid; Leukocytes; Mercaptopurine; Metabolism; Mitomycin; Mitomycins; Pharmacology; Prednisolone; Rabbits; Research; RNA; Thymine

Topics: Adolescent; Child; Humans; Infant; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Neoplasms; Prednisone; Prognosis

Topics: Abnormal Karyotype; Blood Cell Count; Bone Marrow Examination; Busulfan; Chromosome Aberrations; Chromosome Disorders; Geriatrics; Gout; Hemoglobinometry; Humans; Kidney Calculi; Leukemia; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukemia, Myeloid; Mercaptopurine; Nephrectomy; Prednisone

Topics: Abnormalities, Drug-Induced; Blood Transfusion; Dental Enamel; Female; Humans; Infant; Infant, Newborn; Leukemia; Leukemia, Myeloid; Mercaptopurine; Prednisone; Pregnancy; Pregnancy Complications; Pregnancy Complications, Hematologic; Tetracycline; Tooth Discoloration; Tooth, Deciduous; Toxicology

Topics: Bone Marrow Examination; Brain Neoplasms; Cerebrospinal Fluid Proteins; Humans; Leukemia; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Meninges; Mercaptopurine; Methotrexate; Neoplasms; Prednisone

Topics: Busulfan; Chlorambucil; Cyclophosphamide; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Mustard Plant; Neoplasms; Splenomegaly; Steroids; Uracil

Topics: Adolescent; Child; Hematoma; Hematoma, Epidural, Cranial; Hematoma, Subdural; Humans; Hydrocephalus; Leucovorin; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Meninges; Mercaptopurine; Methotrexate; Pathology; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Prednisone; Radiography; Subarachnoid Hemorrhage; Vinblastine

Topics: Adrenal Cortex Hormones; Azaserine; Busulfan; Diagnosis, Differential; Drug Therapy; Humans; Leukemia; Leukemia, Erythroblastic, Acute; Leukemia, Myeloid; Liver; Lymph Nodes; Mercaptopurine; Neoplasms; Pathology; Spleen

Topics: Enzyme Activation; Enzyme Activators; Enzyme Inhibitors; Formates; Kinetics; Leukemia; Leukemia, Myeloid; Ligases; Liver; Mercaptopurine; Metabolism; Rats; Research; Transferases

Topics: Adrenal Cortex Hormones; Alkaline Phosphatase; Blood Cell Count; Bone Marrow Examination; Busulfan; Child; Chromosome Aberrations; Drug Therapy; Hemoglobins; Humans; Infant; Leukemia; Leukemia, Myeloid; Mercaptopurine; Splenomegaly; Thrombocytopenia

Topics: Cerebral Hemorrhage; Geriatrics; Leukemia; Leukemia, Myeloid; Mercaptopurine; Neurologic Manifestations; Pathology

Topics: Busulfan; Chromosome Aberrations; Chromosome Disorders; Eosinophilia; Humans; Hypereosinophilic Syndrome; Leukemia; Leukemia, Myeloid; Mercaptopurine; Methylprednisolone; Prednisone

Topics: Biopsy; Bone Marrow Cells; Carcinoma; Humans; Leukemia; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Lymphoma; Mercaptopurine; Multiple Myeloma; Myositis; Neoplasms; Polymyositis; Prednisone; Sarcoma

Topics: Adolescent; Adrenal Cortex Hormones; Child; Drug Therapy; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Neoplasms; Prednisone

Topics: Child; Drug Therapy; Humans; Hydrocortisone; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Periodicity; Prednisone; Prognosis; Statistics as Topic; Stem Cells

Topics: Antineoplastic Agents; Drug Therapy; Humans; Leukemia; Leukemia, Myeloid; Mercaptopurine; Prognosis; Purines

Topics: Adrenal Cortex Hormones; Female; Leukemia; Leukemia, Myeloid; Mercaptopurine; Pregnancy; Pregnancy Complications, Hematologic

Topics: Anti-Bacterial Agents; Child; Colchicine; Female; Humans; Leukemia, Myeloid; Mercaptopurine; Mycoses; Prednisolone; Pregnancy; Time Factors

Topics: Antineoplastic Agents; Glyoxal; Humans; Leukemia; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Mercaptopurine

Topics: Busulfan; Humans; Leukemia; Leukemia, Myeloid; Mercaptopurine; Prednisone

Topics: Dexamethasone; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Lymphocytes; Mercaptopurine; Methylprednisolone; Prednisolone; Prednisone

Topics: Busulfan; Chlorambucil; Cyclophosphamide; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Prednisone; Triamcinolone

Topics: Blood Platelet Disorders; Busulfan; Child; Humans; Leukemia; Leukemia, Myeloid; Leukocytosis; Lymph Nodes; Mercaptopurine; Prednisone; Primary Myelofibrosis; Radiotherapy; Thrombocytopenia; Triamcinolone

Topics: Busulfan; Hodgkin Disease; Inflammation; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Leukocyte Count; Lymphoma; Lymphoma, Non-Hodgkin; Mercaptopurine; Nitrogen Mustard Compounds; Skin Tests; Skin Window Technique

Topics: Adrenocorticotropic Hormone; Gangrene; Humans; Leukemia; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Mercaptopurine; Penicillins; Prednisolone; Skin

Topics: Adrenal Cortex Hormones; Alkaloids; Antineoplastic Agents; Child; Cyclophosphamide; Humans; Injections, Intravenous; Leukemia; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Prognosis; Toxicology; Vincristine

Topics: Alkylating Agents; Blood Chemical Analysis; Busulfan; Deoxyribonuclease I; DNA; Humans; Leukemia; Leukemia, Myeloid; Leukocyte Count; Mechlorethamine; Mercaptopurine; Neoplasms; Ribose

Topics: Alkaline Phosphatase; Antineoplastic Agents; Busulfan; Chromosome Aberrations; Colchicine; Humans; Hydrogen-Ion Concentration; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukemia, Myeloid; Leukocytes; Mercaptopurine; Nucleosides; Vinblastine

Topics: Adrenocorticotropic Hormone; Antineoplastic Agents; Blood Cells; Busulfan; Electrons; Geriatrics; Leukemia; Leukemia, Myeloid; Mercaptopurine; Microscopy; Microscopy, Electron; Prednisone

Topics: Adrenal Cortex Hormones; Antineoplastic Agents; Busulfan; Folic Acid Antagonists; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Neoplasms; Nitrogen Mustard Compounds

Topics: Busulfan; Child; Chlorambucil; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Neoplasms; Phosphorus Isotopes; Prednisolone; Prednisone; Urethane

Topics: Adolescent; Adrenal Cortex Hormones; Anti-Bacterial Agents; Antimetabolites; Antineoplastic Agents; Blood Transfusion; Cerebral Hemorrhage; Child; Hemorrhagic Disorders; Humans; Infant; Leukemia; Leukemia, Myeloid; Mercaptopurine; Neoplasms; Photomicrography; Sepsis; Toxicology; Vitamins

Topics: Animals; Blood Protein Electrophoresis; Busulfan; Complement System Proteins; Erythrocytes; Guinea Pigs; Hydrazines; Leukemia; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukemia, Myeloid; Leukocyte Count; Mercaptopurine; Prednisolone; Sheep

Topics: Blood Transfusion; Busulfan; Cortisone; Erythrocyte Count; Hemoglobinometry; Humans; Leukemia; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukemia, Myeloid; Leukocyte Count; Mercaptopurine; Nitrogen Mustard Compounds; Prednisolone; Prednisone; Uracil Mustard

Topics: Dermatology; Diagnosis; Geriatrics; Leukemia; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Mercaptopurine; Prednisolone

Topics: Busulfan; Disease Management; Leukemia; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukemia, Myeloid; Mercaptopurine

Topics: Leukemia; Leukemia, Myeloid; Mercaptopurine

Topics: Humans; Leukemia; Leukemia, Myeloid; Mercaptopurine

Topics: Busulfan; Hematinics; Leukemia; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukemia, Myeloid; Mercaptopurine; Vitamin B 12

Topics: Humans; Leukemia; Leukemia, Myeloid; Mercaptopurine

Topics: Acute Disease; Adrenal Cortex Hormones; Leukemia; Leukemia, Myeloid; Mercaptopurine

Topics: Busulfan; Humans; Leukemia; Leukemia, Myeloid; Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative; Mercaptopurine

Topics: Humans; Leukemia; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Mercaptopurine; Monocytes

Topics: Acute Disease; Female; Humans; Leukemia; Leukemia, Myeloid; Mercaptopurine; Pregnancy

Topics: Cortisone; Leukemia; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Mercaptopurine; Purines

Topics: Humans; Leukemia; Leukemia, Myeloid; Mercaptopurine; Purines

Topics: Humans; Leukemia; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukemia, Myeloid; Mercaptopurine

Topics: Leukemia; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Mercaptopurine; Purines