mitobronitol and Leukemia--Myeloid

Topics: Anticoagulants; Antineoplastic Agents; Busulfan; Chromosomes, Human, 21-22 and Y; Clone Cells; Combined Modality Therapy; Humans; Hydroxyurea; Immunotherapy; Leukapheresis; Leukemia, Myeloid; Mitobronitol; Splenectomy

Topics: Adult; Antineoplastic Agents; BCG Vaccine; Busulfan; Drug Therapy, Combination; Female; Hematopoietic Stem Cell Transplantation; Humans; Leukemia, Myeloid; Middle Aged; Mitobronitol; Pancytopenia; Prednisone; Pulmonary Fibrosis; Splenectomy; Transplantation, Autologous; Vincristine

In a prospective, randomized trial the effectiveness of dibromomannitol (DBM), a brominated sugar alcohol derivative, was compared to busulfan in previously untreated patients. One hundred thirty-one patients were evaluated for response and survival. The effective dose of DBM was 4 mg/kg. The persistence of sensitivity to either DBM or busulfan was shown in a quantified fashion. Despite initial reports of the alleged unique effectiveness of DBM in treating chronic myeloid leukemia (CML), this study did not disclose any advantage of DBM over busulfan. Multivariate analysis investigating the importance of prognostic factors in CML indicated that age, sex, splenomegaly, and initial platelet count were important for predicting survival. Determination of such factors in CML are valuable in deciding those patients who could benefit from alternative forms of therapy. It also insures that study results are related to treatment rather than selection of patients with favorable or unfavorable prognostic factors.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Busulfan; Child; Child, Preschool; Clinical Trials as Topic; Female; Humans; Leukemia, Myeloid; Leukocyte Count; Leukopenia; Male; Mannitol; Middle Aged; Mitobronitol; Prognosis; Prospective Studies; Random Allocation; Thrombocytopenia

To obtain information relevant to the question of bone marrow transplantation, we examined the prognostic significance of disease features recorded at the time of diagnosis among 625 patients, aged 5 to 45, with Philadelphia chromosome-positive, nonblastic chronic granulocytic leukemia. The actuarial death rate for this population was 5% during the first year after diagnosis, 12% during the second year, and averaged 22.5% per year during the next eight years. Multivariable regression analysis of features recorded in nearly all cases indicated that sex, spleen size, hematocrit, platelet count, and percentage of circulating blasts were significant prognostic indicators. Analyses of additional data available in 113 to 421 cases suggested that serum lactic dehydrogenase activity, percentage of blasts in marrow, nucleated RBCs in blood, and percentage of basophils plus eosinophils might also provide useful prognostic information. A Cox model, generated with five variables representing features recorded regularly (the first five listed), permitted segregation of these patients into three groups with significantly different survival patterns. The high-risk group exhibited an actuarial mortality of 30% during the first two years after diagnosis and an annual risk of 30% thereafter. In contrast, the most favorable group had a two-year actuarial mortality of 9% and an average risk thereafter of 17% per year, with a median survival of 5 1/2 years. We conclude that it should be possible to classify potential candidates for bone marrow transplantation according to risk with conventional therapy. Such information may be useful in making decisions regarding early v deferred marrow transplantation.

Topics: Adolescent; Adult; Bone Marrow Transplantation; Busulfan; Child; Female; Humans; Leukemia, Myeloid; Male; Middle Aged; Mitobronitol; Prognosis

In a preliminary study on five patients with accelerated CGL, transplantation of allogeneic matched bone marrow was shown to be feasible without whole-body irradiation. Animal experiments and studies with cells cultured in vitro suggest that the cytocastic drug used to kill leukaemic clones (Myelobromol-Chinoin) does not injure haemopoietic stroma. The administration of this protocol is cheap and easy. Our preconditioning does not, in itself, eradicate the malignant CGL clone immediately: 15-20% of marrow mitoses were Ph1+ one month after transplantation. For this reason, additional cytostatic therapy was given in the course of the 3rd to 6th post-transplant months. No Ph1+ cells were observed from the fourth post-transplant month onwards. Very few severe acute complications were seen and two out of three matched transplanted patients are disease-free 27 + and 13 + months later. On the basis of the developing normal spleen architecture and the changing pattern of circulating NAP score values, particularly the months-long persistence of distinctly low scores, and then the delayed emergence of normal levels, we put forward a hypothesis, emphasizing the role of environmental factors, including the formation of a normal haemopoietic stroma in the successfully transplanted CGL patient.

Topics: Adolescent; Adult; Alkaline Phosphatase; Bone Marrow Transplantation; Cyclophosphamide; Cytarabine; Humans; Leukemia, Myeloid; Male; Mannitol; Mitobronitol; Neutrophils; Premedication; Splenectomy; Whole-Body Irradiation

Topics: Adolescent; Adult; Aged; Ambulatory Care; Antineoplastic Agents; Aziridines; Blood Cell Count; Busulfan; Drug Evaluation; Drug Resistance; Female; Humans; Leukemia, Myeloid; Male; Middle Aged; Mitobronitol; Organothiophosphorus Compounds; Time Factors

A survey is given on the present state of the standard therapy of chronic myeloleucosis as well as on some newer tendencies of treatment. Since in the therapy of the chronic phase of the disease and also of the blast crisis despite application of combinations of cytostatics no decisive success is to be recorded, some newer techniques--the splenectomy as well as the various kinds of the transplantation of bone marrow (autologous, syngenic, allogenic)--and their chances for success are briefly discussed.

Topics: Bone Marrow Transplantation; Busulfan; Humans; Leukemia, Myeloid; Mitobronitol; Splenectomy

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

Topics: Adolescent; Adult; Aged; Busulfan; Female; Humans; Leukemia, Myeloid; Male; Middle Aged; Mitobronitol; Splenectomy

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

Topics: Humans; Leukemia, Myeloid; Mannitol; Mitobronitol; Remission, Spontaneous

Topics: Aged; Busulfan; Drug Administration Schedule; Drug Therapy, Combination; Humans; Leukemia; Leukemia, Myeloid; Mitobronitol; Zinostatin

The effect of hydroxyurea in 35 patients with chronic granulocytic leukemia (CGL), who either had entered an accelerated phase of the disease or had experienced excessive myelosuppression following alkylating agents, was studied. By either intravenous or oral administration, the drug was successful in reducing peripheral leukocyte and blast counts in all cases and in reducing splenomegaly in 13 of 17 patients. The median duration of disease control was 75 days in myeloproliferative acceleration and 27 days in frank blastic transformation. Mild nausea and vomiting were experienced by most patients, but reversible bone marrow suppression occured in only three patients. The drug proved useful in 19 patients who demonstrated myeloproliferative acceleration, especially in controlling excessive leukocytosis and/or thrombocytosis. Rapid reduction of an elevated blast cell count was achieved in nine patients who presented in blastic crisis, in an attempt to eliminate the associated risk of cerebral vascular leukostasis. Five patients who required treatment for their disease following splenectomy in the chronic phase were also well controlled. Hydroxyurea appears to have a definite role in the management of these hematologic complications of CGL.

Topics: Busulfan; Humans; Hydroxyurea; Leukemia, Myeloid; Leukocyte Count; Leukocytosis; Mitobronitol; Splenectomy; Splenomegaly; Thrombocytopenia; Thrombocytosis

Topics: Amenorrhea; Antineoplastic Agents; Female; Humans; Leukemia; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukemia, Myeloid; Leukocytosis; Mitobronitol

Topics: Antineoplastic Agents; Humans; Leukemia; Leukemia, Myeloid; Mannitol; Mitobronitol; Neoplasms