mitobronitol and Thrombocytopenia

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

Topics: Blood Transfusion; Hematopoiesis; Hepatomegaly; Humans; Mannitol; Mitobronitol; Pancytopenia; Polycythemia; Prednisone; Primary Myelofibrosis; Remission, Spontaneous; Splenomegaly; Thrombocytopenia; Thrombocytosis

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