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1. Greenberg PL, Lee SJ, Advani R, Tallman MS, Sikic BI, Letendre L, Dugan K, Lum B, Chin DL, Dewald G, Paietta E, Bennett JM, Rowe JM: Mitoxantrone, etoposide, and cytarabine with or without valspodar in patients with relapsed or refractory acute myeloid leukemia and high-risk myelodysplastic syndrome: a phase III trial (E2995). J Clin Oncol; 2004 Mar 15;22(6):1078-86
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  • [Title] Mitoxantrone, etoposide, and cytarabine with or without valspodar in patients with relapsed or refractory acute myeloid leukemia and high-risk myelodysplastic syndrome: a phase III trial (E2995).
  • PURPOSE: To determine whether adding the multidrug resistance gene-1 (MDR-1) modulator valspodar (PSC 833; Novartis Pharmaceuticals, Hanover, NJ) to chemotherapy provided clinical benefit to patients with poor-risk acute myeloid leukemia (AML) and high-risk myelodysplastic syndrome (MDS).
  • For patients who had not received prior intensive chemotherapy (ie, with secondary AML or high-risk MDS), the CR rate was increased--35% versus 15% for the remaining patients (P=.018); CR rates did not differ between treatment arms.
  • Population pharmacokinetic analysis demonstrated that the clearances of mitoxantrone and etoposide were decreased by 59% and 50%, respectively, supporting the empiric dose reductions in the PSC-MEC arm designed in anticipation of drug interactions between valspodar and the chemotherapeutic agents.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cyclosporins / administration & dosage. Genes, MDR. Myelodysplastic Syndromes / drug therapy

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  • [ErratumIn] J Clin Oncol. 2004 Jul 1;22(13):2747
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  • (PMID = 15020609.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / R01 CA092474; United States / NCI NIH HHS / CA / U10 CA013650; United States / NCI NIH HHS / CA / CA66636; United States / NCI NIH HHS / CA / U10 CA021115; United States / NCI NIH HHS / CA / CA13650; United States / NCI NIH HHS / CA / U10 CA017145; United States / NCI NIH HHS / CA / CA11083; United States / NCI NIH HHS / CA / U10 CA066636; United States / NCI NIH HHS / CA / CA17145; United States / NCRR NIH HHS / RR / M01 RR 00070; United States / NCI NIH HHS / CA / U10 CA023318; United States / NCI NIH HHS / CA / CA 52168; United States / NCI NIH HHS / CA / U10 CA011083; United States / NCRR NIH HHS / RR / M01 RR000070; United States / NCI NIH HHS / CA / CA21115; United States / NCI NIH HHS / CA / CA23318; United States / NCI NIH HHS / CA / U10 CA180816
  • [Publication-type] Clinical Trial; Clinical Trial, Phase III; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Cyclosporins; 04079A1RDZ / Cytarabine; 6PLQ3CP4P3 / Etoposide; BZ114NVM5P / Mitoxantrone; Q7ZP55KF3X / valspodar
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2. Rossi HA, O'Donnell J, Sarcinelli F, Stewart FM, Quesenberry PJ, Becker PS: Granulocyte-macrophage colony-stimulating factor (GM-CSF) priming with successive concomitant low-dose Ara-C for elderly patients with secondary/refractory acute myeloid leukemia or advanced myelodysplastic syndrome. Leukemia; 2002 Mar;16(3):310-5
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  • [Title] Granulocyte-macrophage colony-stimulating factor (GM-CSF) priming with successive concomitant low-dose Ara-C for elderly patients with secondary/refractory acute myeloid leukemia or advanced myelodysplastic syndrome.
  • Granulocyte-macrophage colony-stimulating factor (GM-CSF) can stimulate proliferation of leukemic blasts and sensitize these cells to the cytotoxic effects of S-phase-specific drugs.
  • This is the first report of safety and efficacy of GM-CSF prior to and during cytarabine in a low-dose, intermittent regimen for elderly patients with poor risk acute myelogenous leukemia or myelodysplastic syndrome.
  • Rates of CR and PR were 20% and 40%, respectively.
  • Many of the responding patients had been heavily pretreated prior to enrollment.
  • Our findings suggest that this novel combination of GM-CSF with sequential and concomitant low-dose cytarabine can benefit patients with poor risk myeloid malignancies.
  • [MeSH-major] Antimetabolites, Antineoplastic / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cytarabine / administration & dosage. Granulocyte-Macrophage Colony-Stimulating Factor / administration & dosage. Leukemia, Myeloid / drug therapy
  • [MeSH-minor] Acute Disease. Aged. Aged, 80 and over. Female. Humans. Male. Middle Aged. Neutropenia / chemically induced. Survival Rate. Thrombocytopenia / chemically induced. Treatment Outcome


3. Yin CC, Cortes J, Barkoh B, Hayes K, Kantarjian H, Jones D: t(3;21)(q26;q22) in myeloid leukemia: an aggressive syndrome of blast transformation associated with hydroxyurea or antimetabolite therapy. Cancer; 2006 Apr 15;106(8):1730-8
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  • [Title] t(3;21)(q26;q22) in myeloid leukemia: an aggressive syndrome of blast transformation associated with hydroxyurea or antimetabolite therapy.
  • BACKGROUND: The t(3;21)(q26;q22) translocation is associated with myeloid leukemias and results in a chimeric oncoprotein containing AML1/RUNX1 variably fused to EAP, MDS1, and/or EVI1.
  • RESULTS: In all 16 patients with chronic myeloproliferative disorders, including 14 with chronic myelogenous leukemia (CML), the occurrence of t(3;21) heralded myeloid blast transformation.
  • Among 10 cases of t(3;21)-associated acute myeloid leukemia, 8 were secondary tumors after chemotherapy for other neoplasms that had been treated with regimens including fludarabine and 5-fluorouracil in 3 patients each and etoposide in 2 patients.
  • The immunophenotype of the blasts in all 22 tested cases was similar, with uniform expression of myeloid markers and CD34 and variable expression of CD7 and CD9, but minimal morphological myeloid maturation.
  • Among patients with acute myeloid leukemia/myelodysplastic syndrome, 7 died of disease (at a median of 2 mos) and 2 had persistent leukemia with short follow-up.
  • CONCLUSIONS: Activation of AME through t(3;21) defines a highly aggressive, therapy-related leukemic blast syndrome.
  • Prior treatment with hydroxyurea or other antimetabolites is implicated as a contributory cause.
  • [MeSH-major] Antimetabolites, Antineoplastic / adverse effects. Antineoplastic Agents / adverse effects. Chromosomes, Human, Pair 21 / drug effects. Chromosomes, Human, Pair 3 / drug effects. Hydroxyurea / adverse effects. Leukemia, Myeloid / chemically induced. Leukemia, Myeloid / genetics. Lymphocyte Activation / drug effects. Myeloproliferative Disorders / drug therapy. Oncogene Proteins, Fusion / analysis. Translocation, Genetic / drug effects
  • [MeSH-minor] Adult. Aged. Bone Marrow / pathology. Core Binding Factor Alpha 2 Subunit / genetics. DNA-Binding Proteins / genetics. Female. Humans. Male. Middle Aged. Neoplasm Proteins / genetics. Proto-Oncogenes / genetics. Transcription Factors / genetics

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  • [Copyright] 2006 American Cancer Society
  • (PMID = 16532439.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA16672
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0 / Antineoplastic Agents; 0 / Core Binding Factor Alpha 2 Subunit; 0 / DNA-Binding Proteins; 0 / MECOM protein, human; 0 / Neoplasm Proteins; 0 / Oncogene Proteins, Fusion; 0 / RUNX1 protein, human; 0 / Transcription Factors; X6Q56QN5QC / Hydroxyurea
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4. Cashen AF, Shah AK, Todt L, Fisher N, DiPersio J: Pharmacokinetics of decitabine administered as a 3-h infusion to patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS). Cancer Chemother Pharmacol; 2008 Apr;61(5):759-66
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  • [Title] Pharmacokinetics of decitabine administered as a 3-h infusion to patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS).
  • Plasma samples were obtained pre-dose and during the first 8-h dosing interval on each dosing day during Cycle 1, and at pre-dose and just prior to the end of infusion during Cycle 2.
  • CONCLUSIONS: Decitabine dosed at 15 mg/m2 iv every 8 h for 3 days resulted in a predictable and manageable toxicity profile in patients with MDS/AML.
  • The repeated dosing did not result in systemic accumulation of the drug, and decitabine PK remained unchanged from cycle to cycle.
  • [MeSH-major] Antimetabolites, Antineoplastic / pharmacokinetics. Azacitidine / analogs & derivatives. Leukemia, Myeloid, Acute / drug therapy. Myelodysplastic Syndromes / drug therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Area Under Curve. Bone Marrow / drug effects. Bone Marrow / pathology. Chromatography, High Pressure Liquid. Drug Administration Schedule. Female. Half-Life. Humans. Infusions, Intravenous. Male. Mass Spectrometry. Middle Aged. Sepsis / etiology. Tissue Distribution


5. Derolf AR, Kristinsson SY, Andersson TM, Landgren O, Dickman PW, Björkholm M: Improved patient survival for acute myeloid leukemia: a population-based study of 9729 patients diagnosed in Sweden between 1973 and 2005. Blood; 2009 Apr 16;113(16):3666-72
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  • [Title] Improved patient survival for acute myeloid leukemia: a population-based study of 9729 patients diagnosed in Sweden between 1973 and 2005.
  • We evaluated survival patterns for all registered acute myeloid leukemia (AML) patients diagnosed in Sweden in 1973 to 2005 (N = 9729; median age, 69 years).
  • In contrast, there was no improvement in survival in AML patients with a prior diagnosis of a myelodysplastic syndrome during 1993 to 2005 (n = 219).
  • New effective agents with a more favorable toxicity profile are needed to improve survival, particularly in the elderly.
  • [MeSH-major] Leukemia, Myeloid, Acute / mortality. Leukemia, Myeloid, Acute / therapy
  • [MeSH-minor] Adolescent. Adult. Age Factors. Aged. Aged, 80 and over. Child. Child, Preschool. Disease-Free Survival. Humans. Infant. Infant, Newborn. Male. Middle Aged. Myelodysplastic Syndromes / diagnosis. Myelodysplastic Syndromes / mortality. Myelodysplastic Syndromes / therapy. Retrospective Studies. Stem Cell Transplantation. Survival Rate. Sweden. Transplantation, Homologous

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  • (PMID = 19020306.001).
  • [ISSN] 1528-0020
  • [Journal-full-title] Blood
  • [ISO-abbreviation] Blood
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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6. Kokhno AV, Parovichnikova EN, Mikhaĭlova EA, Ustinova EN, Kaplanskaia IB, Dvirnyk VN, Ol'shanskaia IuV, Domracheva EV, Savchenko VG: [Efficiency of cyclosporin A therapy in patients with myelodysplastic syndrome]. Ter Arkh; 2010;82(8):48-53
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  • [Title] [Efficiency of cyclosporin A therapy in patients with myelodysplastic syndrome].
  • AIM: To evaluate the efficacy of cyclosporin A (CsA) in patients with myelodysplastic syndromes (MDS) and to identify determinants of a response to this therapy.
  • Thirty-two patients were given CsA as first-line therapy; 20 patients took the agent after prior therapy.
  • Baseline refractory anemia (RA) transformed to RA with excess blasts (RAEB) in 31% of cases; baseline RAEB did to acute myeloid leukemia in 34%.
  • CONCLUSION: CsA is the drug of choice in treating patients with MDS, including RA, RA with ringed sideroblasts, refractory cytopenia with multilineage dysplasia, with hypoplasia of hematopoiesis, with nodular polyclonal lymphoid infiltration in the BM, a normal karyotype or changes corresponding to a low or moderate IPSS risk.
  • [MeSH-major] Cyclosporine / therapeutic use. Immunosuppressive Agents / therapeutic use. Myelodysplastic Syndromes / drug therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Bone Marrow / pathology. Chromosome Aberrations. Dose-Response Relationship, Drug. Female. Humans. Kaplan-Meier Estimate. Karyotyping. Male. Middle Aged. Prognosis. Young Adult

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  • (PMID = 20873246.001).
  • [ISSN] 0040-3660
  • [Journal-full-title] Terapevticheskiĭ arkhiv
  • [ISO-abbreviation] Ter. Arkh.
  • [Language] rus
  • [Publication-type] Clinical Trial; English Abstract; Journal Article
  • [Publication-country] Russia (Federation)
  • [Chemical-registry-number] 0 / Immunosuppressive Agents; 83HN0GTJ6D / Cyclosporine
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7. Schroeder MA, Blum W: Evidence-based mini-review: Should patients over the age of 60 with INT-2 or high-risk myelodysplastic syndrome undergo allogeneic stem cell transplantation prior to progression to acute myelogenous leukemia? Hematology Am Soc Hematol Educ Program; 2010;2010:322-4
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  • [Title] Evidence-based mini-review: Should patients over the age of 60 with INT-2 or high-risk myelodysplastic syndrome undergo allogeneic stem cell transplantation prior to progression to acute myelogenous leukemia?
  • He was started on hypomethylating agent treatment and referred for consultation regarding the role of hematopoietic stem cell transplantation.

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  • (PMID = 21239813.001).
  • [ISSN] 1520-4383
  • [Journal-full-title] Hematology. American Society of Hematology. Education Program
  • [ISO-abbreviation] Hematology Am Soc Hematol Educ Program
  • [Language] ENG
  • [Grant] United States / NHLBI NIH HHS / HL / K12 HL087107-03; United States / NCI NIH HHS / CA / P50 CA140158; United States / NCI NIH HHS / CA / K23 CA120708; United States / NHLBI NIH HHS / HL / HL087107-03; United States / NCI NIH HHS / CA / P50 CA140158-01; United States / NCI NIH HHS / CA / P50-CA140158; United States / NCI NIH HHS / CA / K23CA120708; United States / NCI NIH HHS / CA / CA140158-01; United States / NCI NIH HHS / CA / K23 CA120708-01; United States / NHLBI NIH HHS / HL / K12 HL087107; United States / NCI NIH HHS / CA / CA120708-01
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Other-IDs] NLM/ NIHMS316044; NLM/ PMC3169102
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8. Dai MS, Lee SC, Ho CL, Chen YC, Kao WY, Chao TY: Impact of open lung biopsy for undiagnosed pulmonary infiltrates in patients with hematological malignancies. Am J Hematol; 2001 Oct;68(2):87-90
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  • The underlying diseases, prior treatment for presumptive pneumonia, the change in therapeutic approach after operation, and clinical outcome were reviewed retrospectively.
  • Diffuse pulmonary infiltrates were caused by infection in two patients and by noninfectious etiology such as alveolar proteinosis, idiopathic interstitial pneumonitis, leukemic involvement, and drug-induced alveolar damage in the others.
  • Four patients who had serious underlying hematologic diseases such as myelodysplastic syndrome, acute and chronic myeloid leukemia, and T cell lymphoma died.
  • Three patients with acute lymphoid leukemia survived.

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  • [Copyright] Copyright 2001 Wiley-Liss, Inc.
  • (PMID = 11559947.001).
  • [ISSN] 0361-8609
  • [Journal-full-title] American journal of hematology
  • [ISO-abbreviation] Am. J. Hematol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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9. Arana-Yi C, Block AW, Sait SN, Ford LA, Barcos M, Baer MR: Therapy-related myelodysplastic syndrome and acute myeloid leukemia following treatment of acute myeloid leukemia: possible role of cytarabine. Leuk Res; 2008 Jul;32(7):1043-8
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  • [Title] Therapy-related myelodysplastic syndrome and acute myeloid leukemia following treatment of acute myeloid leukemia: possible role of cytarabine.
  • Therapy-related myelodysplastic syndrome and acute myeloid leukemia (t-MDS/t-AML) have been reported only rarely following treatment of AML.
  • We report five patients treated for de novo AML who developed t-MDS/t-AML, all with chromosome 7 abnormalities, including -7, del(7)(q22q36) and del(7)(p11.22p22).
  • All had been treated with cytarabine, topoisomerase 2 inhibitors and granulocyte or granulocyte-monocyte colony-stimulating factor and three with alkylating agents as part of autologous transplant regimens.
  • Presence of chromosome 7 abnormalities in patients with and without prior alkylating agent therapy suggests possible association with the antimetabolite cytarabine.
  • [MeSH-major] Antineoplastic Agents / adverse effects. Cytarabine / adverse effects. Leukemia, Myeloid, Acute / chemically induced. Myelodysplastic Syndromes / drug therapy


10. Appelbaum FR: Immunobiologic therapies for myelodysplastic syndrome. Best Pract Res Clin Haematol; 2004 Dec;17(4):653-61
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  • [Title] Immunobiologic therapies for myelodysplastic syndrome.
  • Recent progress in understanding the pathobiology of the myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) have led to the development of various immunologically oriented therapies for these diseases.
  • The recognition that marrow suppression in MDS may, in part, be a T-cell mediated autoimmune process has stimulated various trials of antithymocyte globulin and other similar agents.
  • Gemtuzumab ozogamicin, an antibody against CD33 conjugated to the cytotoxic agent calicheamicin, is approved for use in AML and is currently being investigated as a potential therapeutic agent in MDS.
  • Clinical trials were conducted as either monotherapy or in combination with cytokines such as IL-11 and chemotherapeutic agents including idarubicin, fludarabine, and/or cytarabine.
  • Other antibodies are being developed as immunoconjugates with radioisotopes as part of conditioning regimens prior to bone marrow transplantation for AML or MDS.
  • Vaccines using overexposed self-antigens such as WT1 and PR1 are other attempts to induce a T-cell mediated response against MDS.
  • [MeSH-major] Immunotherapy / methods. Myelodysplastic Syndromes / therapy
  • [MeSH-minor] Animals. Combined Modality Therapy. Humans. Treatment Outcome

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  • (PMID = 15494301.001).
  • [ISSN] 1521-6926
  • [Journal-full-title] Best practice & research. Clinical haematology
  • [ISO-abbreviation] Best Pract Res Clin Haematol
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA-15704; United States / NCI NIH HHS / CA / CA-18029
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, P.H.S.; Review
  • [Publication-country] England
  • [Number-of-references] 40
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11. Giles FJ, Kantarjian HM, Cortes JE, Faderl S, Verstovsek S, Thomas D, Garcia-Manero G, Wierda W, Ferrajoli A, Kornblau S, Mattiuzzi GN, Tsimberidou AM, Albitar M, O'Brien SM, Estey E: Adaptive randomized study of idarubicin and cytarabine alone or with interleukin-11 as induction therapy in patients aged 50 or above with acute myeloid leukemia or high-risk myelodysplastic syndromes. Leuk Res; 2005 Jun;29(6):649-52
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  • [Title] Adaptive randomized study of idarubicin and cytarabine alone or with interleukin-11 as induction therapy in patients aged 50 or above with acute myeloid leukemia or high-risk myelodysplastic syndromes.
  • A higher complete remission (CR) rate was observed in patients with acute myeloid leukemia (AML) who, on a prior randomized study of induction therapy, received gemtuzumab ozogamicin (GO) plus interleukin-11 (IL-11) rather than GO alone.
  • An adaptive randomized phase III study of the addition of IL-11 to idarubicin and cytarabine (IA) induction in 100 patients >/=50 years of age with AML or high-risk myelodysplastic syndrome (MDS) was conducted.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cytarabine / administration & dosage. Idarubicin / administration & dosage. Interleukin-11 / administration & dosage. Leukemia, Myeloid, Acute / drug therapy. Myelodysplastic Syndromes / drug therapy


12. Howe R, Micallef IN, Inwards DJ, Ansell SM, Dewald GW, Dispenzieri A, Gastineau DA, Gertz MA, Geyer SM, Hanson CA, Lacy MQ, Tefferi A, Litzow MR: Secondary myelodysplastic syndrome and acute myelogenous leukemia are significant complications following autologous stem cell transplantation for lymphoma. Bone Marrow Transplant; 2003 Aug;32(3):317-24
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  • [Title] Secondary myelodysplastic syndrome and acute myelogenous leukemia are significant complications following autologous stem cell transplantation for lymphoma.
  • Secondary myelodysplastic syndrome (sMDS) and acute myelogenous leukemia (AML) have been recognized with increasing frequency following autologous stem cell transplantation (ASCT).
  • By univariate statistical analysis, male gender (P=0.01), prior alkylating agents (mechlorethamine for HL, P=0.001 and cyclophosphamide for NHL, P=0.05) and the number of prior treatment regimens (P=0.04) were significantly associated with the development of sMDS/AML.
  • [MeSH-major] Hematopoietic Stem Cell Transplantation / adverse effects. Leukemia, Myeloid, Acute / etiology. Lymphoma / therapy. Myelodysplastic Syndromes / etiology. Neoplasms, Second Primary / etiology


13. Crump M, Hedley D, Kamel-Reid S, Leber B, Wells R, Brandwein J, Buckstein R, Kassis J, Minden M, Matthews J, Robinson S, Turner R, McIntosh L, Eisenhauer E, Seymour L: A randomized phase I clinical and biologic study of two schedules of sorafenib in patients with myelodysplastic syndrome or acute myeloid leukemia: a NCIC (National Cancer Institute of Canada) Clinical Trials Group Study. Leuk Lymphoma; 2010 Feb;51(2):252-60
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  • [Title] A randomized phase I clinical and biologic study of two schedules of sorafenib in patients with myelodysplastic syndrome or acute myeloid leukemia: a NCIC (National Cancer Institute of Canada) Clinical Trials Group Study.
  • In this randomized phase I study, eligible patients had relapsed/refractory acute myeloid leukemia (AML), and one prior induction regimen, or were age >65 with untreated myelodysplastic syndrome (MDS) or secondary AML.
  • Forty-two patients were enrolled (median age 71 [37-82]; prior chemotherapy: 22).
  • [MeSH-major] Benzenesulfonates / therapeutic use. Leukemia, Myeloid / drug therapy. Myelodysplastic Syndromes / drug therapy. Pyridines / therapeutic use
  • [MeSH-minor] Abdominal Pain / chemically induced. Acute Disease. Adult. Aged. Aged, 80 and over. Area Under Curve. Diarrhea / chemically induced. Dose-Response Relationship, Drug. Drug Administration Schedule. Extracellular Signal-Regulated MAP Kinases / metabolism. Female. Humans. Male. Metabolic Clearance Rate. Middle Aged. Nausea / chemically induced. Niacinamide / analogs & derivatives. Phenylurea Compounds. Phosphorylation / drug effects. Protein Kinase Inhibitors / adverse effects. Protein Kinase Inhibitors / pharmacokinetics. Protein Kinase Inhibitors / therapeutic use. Treatment Outcome


14. Sampat KR, Garcia-Gutierrez V, Rossi A, Pierce S, Cortes J, Kantarjian H, Garcia-Manero G: Prevalence and therapeutic relationships of pericardial effusions in patients with leukemia. J Clin Oncol; 2009 May 20;27(15_suppl):7067

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  • [Title] Prevalence and therapeutic relationships of pericardial effusions in patients with leukemia.
  • : 7067 Background: Little is known regarding the prevalence and natural history of pericardial disease in patients with leukemia.
  • Although a direct causal relationship has not been established yet, this complication may have a significant impact for the future development of this class of drugs.
  • To study this issue, we retrospectively analyzed a large cohort of patients with leukemia, who were evaluated at MD Anderson Cancer Center (MDACC), to determine the prevalence, timing, and characteristics of PEf in leukemia.
  • METHODS: We reviewed 3,327 patients with acute myeloid leukemia (AML, N = 1,809, 54%), acute lymphocytic leukemia (ALL, N = 494, 15%), or myelodysplastic syndrome (MDS, N =1,024, 31%), who were seen at MDACC from August 2003 to July 2008.
  • Data regarding diagnosis, timing, effusion size, and prior therapy was collected in the 401 patients (20.2%) that had echocardiographic evidence of PEf.
  • CONCLUSIONS: PEf are relatively common in patients with leukemia at initial presentation and are usually asymptomatic.
  • Their incidence increases with therapy administration although it appears that this is not a process related to specific classes of treatment or type of leukemia.

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  • (PMID = 27961462.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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15. Crump M, Leber B, Kassis J, Hedley D, Minden M, Buckstein R, McIntosh L, Eisenhauer E, Seymour L: A randomized phase I clinical and biologic study of two schedules of BAY 43-9006 in patients with myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML): A National Cancer Institute of Cancer Clinical Trials Group Study. J Clin Oncol; 2004 Jul 15;22(14_suppl):6611

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  • [Title] A randomized phase I clinical and biologic study of two schedules of BAY 43-9006 in patients with myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML): A National Cancer Institute of Cancer Clinical Trials Group Study.
  • METHODS: Pts with AML or MDS (1 prior regimen or elderly or secondary high risk AML) were randomized to BAY for 28 days (continuous) or 14 days followed by a 14-day rest period, escalated at 100, 200 and 400 mg bid orally.
  • RESULTS: 36 pts have been enrolled (4 MDS, 32 AML; median age 70 range 50-82; prior chemotherapy: 17 pts) and received 100 mg bid (7 pts); 200 mg bid (12 pts); 400 mg bid (17 pts).
  • Biologic activity (inhibition of pERK in SCF stimulated PB blasts) has been assessed in 14 pts and shows drug-related inhibition in 5/14, all at 400 mg bid.
  • Early clinical and biological activity is evident.

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  • (PMID = 28016333.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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16. Su JY, Chang CK, Zhang X, Zhou LY, Song LQ, Xu L, Wu LY, He Q, Li X: [Efficacy of induction chemotherapy for patients with high-risk myelodysplastic syndrome (MDS) or MDS-transformed acute myeloid leukemia with CHG regimen and its comparison with regimen GAG and HA]. Zhongguo Shi Yan Xue Ye Xue Za Zhi; 2009 Apr;17(2):459-63
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  • [Title] [Efficacy of induction chemotherapy for patients with high-risk myelodysplastic syndrome (MDS) or MDS-transformed acute myeloid leukemia with CHG regimen and its comparison with regimen GAG and HA].
  • This study was aimed to investigate the efficacy of moderate intensity regimen, CHG (homoharringtonine, cytarabine and granulocyte colony-stimulating factor (G-CSF)) on the patients with high-risk MDS or MDS-transformed acute myeloid leukemia.
  • Homoharringtonine and Ara-C were injected intravenously at doses of 1 mg and 25 mg daily for 14 consecutive days respectively, G-CSF was injected subcutaneously once daily at a dose of 300 microg on 12 hours prior to chemotherapy and continued given until the end of chemotherapy or when the peripheral WBC count reached > 20 x 10(9)/L.
  • The results showed that (1) 14 patients achieved complete remission (CR) (46.67 %) and 7 patients achieved partial remission (PR) (23.33 %) with one course of CHG regimen, total effective rate was 70%; 14 patient achieved CR (42.4%) and 9 patients achieved PR (27.3%) with one course of CAG regimen, total effective rate was 69.7%; 7 patient achieved CR (33.3%) and 3 patients achieved PR (9.1%) with one course of HA regimen, total effective rate was 42.4%.


17. Bloomfield CD, Archer KJ, Mrózek K, Lillington DM, Kaneko Y, Head DR, Dal Cin P, Raimondi SC: 11q23 balanced chromosome aberrations in treatment-related myelodysplastic syndromes and acute leukemia: report from an international workshop. Genes Chromosomes Cancer; 2002 Apr;33(4):362-78
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  • [Title] 11q23 balanced chromosome aberrations in treatment-related myelodysplastic syndromes and acute leukemia: report from an international workshop.
  • Among 511 patients with therapy-related myelodysplastic syndrome or acute leukemia (t-MDS/t-AL) and balanced chromosome aberrations, 162 (32%) had translocations involving 11q23.
  • Patients in the 11q23 subgroup had a sole cytogenetic abnormality more often than those in the 21q22, inv(16), Rare, and Unique subgroups, and a complex karyotype or -5/del(5q) and/or -7/del(7q) less often than patients in the 21q22, Rare, and Unique subgroups.
  • Clinically, 11q23 patients had acute lymphoblastic leukemia (ALL) more often as their primary disease and a shorter latency from start of treatment for the primary disease to their t-MDS/t-AL diagnosis, except when compared with the inv(16) subgroup.
  • With regard to prior therapy, 11q23 patients, compared with other patients, received radiotherapy less often as their sole therapy and chemotherapy more often.
  • Patients in the 11q23 subgroup more often received alkylating agents (AAs) (86% vs. 59-82% for the other subgroups), and topoisomerase II inhibitors (TIs) (84% vs. 49-75%), and they more often reported exposure to AAs plus TIs without radiotherapy (33% vs. 12-21%), except in comparison with the 21q22 subgroup (36%).
  • [MeSH-major] Chromosome Aberrations / chemically induced. Chromosome Aberrations / statistics & numerical data. Chromosomes, Human, Pair 11 / genetics. Leukemia, Myeloid, Acute / chemically induced. Leukemia, Myeloid, Acute / epidemiology. Myelodysplastic Syndromes / chemically induced. Myelodysplastic Syndromes / epidemiology

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  • (PMID = 11921271.001).
  • [ISSN] 1045-2257
  • [Journal-full-title] Genes, chromosomes & cancer
  • [ISO-abbreviation] Genes Chromosomes Cancer
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA16058; United States / NCI NIH HHS / CA / CA21765; United States / NCI NIH HHS / CA / CA31946; United States / NCI NIH HHS / CA / CA40046; United States / NCI NIH HHS / CA / CA77658
  • [Publication-type] Comparative Study; Congresses; Multicenter Study; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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18. Andersen MK, Larson RA, Mauritzson N, Schnittger S, Jhanwar SC, Pedersen-Bjergaard J: Balanced chromosome abnormalities inv(16) and t(15;17) in therapy-related myelodysplastic syndromes and acute leukemia: report from an international workshop. Genes Chromosomes Cancer; 2002 Apr;33(4):395-400
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  • [Title] Balanced chromosome abnormalities inv(16) and t(15;17) in therapy-related myelodysplastic syndromes and acute leukemia: report from an international workshop.
  • The Workshop identified 48 unselected patients with therapy-related myelodysplastic syndrome or acute myeloid leukemia (t-MDS/t-AML) and inv(16), and 41 patients with t(15;17) after chemotherapy (CT) and/or radiotherapy (RT) for a malignant or nonmalignant disease.
  • The general type of previous therapy was RT only in 10 patients with an inv(16) and in 12 patients with a t(15;17), alkylating agents plus topoisomerase II inhibitors in 24 patients with an inv(16) and in 18 patients with a t(15;17), topoisomerase II inhibitors only in 5 patients with an inv(16) and in 2 patients with a t(15;17), alkylating agents only in 6 patients in each subgroup, and other types of chemotherapy in 3 patients in each subgroup.
  • Trisomy of chromosomes 8, 21, and 22 and del(7q) were the most frequent additional abnormalities in the inv(16) subgroup, whereas +8, -5, and del(16q) were most frequent in the t(15;17) subgroup.
  • The study supports the observation that t-MDS/t-AML with inv(16) and t(15;17) is often associated with prior therapy with topoisomerase II inhibitors; however, a notable finding was the high frequency of treatment with only radiotherapy, 29% of t(15;17) and 21% of inv(16).
  • Response rates to intensive chemotherapy in this study were comparable to those of de novo disease.
  • [MeSH-major] Chromosome Aberrations / chemically induced. Chromosome Inversion. Chromosomes, Human, Pair 15 / genetics. Chromosomes, Human, Pair 16 / genetics. Chromosomes, Human, Pair 17 / genetics. Leukemia, Myeloid, Acute / chemically induced. Myelodysplastic Syndromes / chemically induced. Translocation, Genetic / genetics


19. Cashen AF, Schiller GJ, O'Donnell MR, DiPersio JF: Multicenter, phase II study of decitabine for the first-line treatment of older patients with acute myeloid leukemia. J Clin Oncol; 2010 Feb 1;28(4):556-61
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  • [Title] Multicenter, phase II study of decitabine for the first-line treatment of older patients with acute myeloid leukemia.
  • PURPOSE: Older patients with acute myeloid leukemia (AML) have limited treatment options because of the lack of effectiveness and the toxicity of available therapies.
  • We investigated the efficacy and toxicity of the hypomethylating agent decitabine as initial therapy in older patients with AML.
  • PATIENTS AND METHODS: In this multicenter, phase II study, patients older than 60 years who had AML (ie, > 20% bone marrow blasts) and no prior therapy for AML were treated with decitabine 20 mg/m(2) intravenously for 5 consecutive days of a 4-week cycle.
  • The response rate was consistent across subgroups, including in patients with poor-risk cytogenetics and in those with a history of myelodysplastic syndrome.
  • [MeSH-major] Antimetabolites, Antineoplastic / therapeutic use. Azacitidine / analogs & derivatives. Leukemia, Myeloid, Acute / drug therapy. Myelodysplastic Syndromes / drug therapy. Neoplasm Recurrence, Local / drug therapy


20. Otsuka Y, Konishi T, Nara S, Furushima K, Nakajima K, Shimada H: Secondary myelodysplastic syndrome after small cell lung cancer and esophageal cancer. J Gastroenterol Hepatol; 2005 Sep;20(9):1318-21
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  • [Title] Secondary myelodysplastic syndrome after small cell lung cancer and esophageal cancer.
  • He had past history of small cell lung cancer treated with chemoradiation therapy 10 years prior.
  • Esophagectomy accompanying postoperative chemotherapy was applied, but he died of secondary myelodysplastic syndrome with its acute myeloblastic transformation.
  • Risk evaluation revealed a high incidence of esophageal cancer after radiation therapy and hematological malignancies after chemoradiation therapy in usual regimen with topoisomerase inhibitor or alkylating agents.
  • In post-therapeutic follow up of patients with such past therapeutic histories, we should be cautious about secondary malignancies even if primary malignant disease was evaluated as complete remission in long past history.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Carcinoma, Squamous Cell / therapy. Esophageal Neoplasms / therapy. Myelodysplastic Syndromes / etiology. Radiotherapy / adverse effects
  • [MeSH-minor] Carcinoma, Small Cell / therapy. Esophagectomy. Fatal Outcome. Humans. Leukemia, Myeloid, Acute / etiology. Lung Neoplasms / therapy. Male. Middle Aged. Neoplasms, Second Primary / therapy. Treatment Outcome


21. Verstovsek S, Tefferi A, Cortes J, O'Brien S, Garcia-Manero G, Pardanani A, Akin C, Faderl S, Manshouri T, Thomas D, Kantarjian H: Phase II study of dasatinib in Philadelphia chromosome-negative acute and chronic myeloid diseases, including systemic mastocytosis. Clin Cancer Res; 2008 Jun 15;14(12):3906-15
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  • [Title] Phase II study of dasatinib in Philadelphia chromosome-negative acute and chronic myeloid diseases, including systemic mastocytosis.
  • The tyrosine kinase (TK) inhibitor dasatinib is 325-fold more potent against Bcr-Abl TK than imatinib in vitro, significantly inhibiting wild-type KIT and platelet-derived growth factor receptor beta TKs, and is active against cells carrying the mutant KIT-D816V gene.
  • EXPERIMENTAL DESIGN: In this phase 2, open-label study, the efficacy of dasatinib (140 mg/d) was investigated in 67 patients with various Ph- myeloid disorders, including SM (n = 33; 28 KIT-D816V positive).
  • Only two patients, one with SM-myelofibrosis and one with SM-chronic eosinophilic leukemia, achieved complete response (elimination of mastocytosis) lasting for 5 and 16 months, respectively.
  • Both patients were negative for KIT-D816V mutation, had low tryptase levels, abnormal WBC counts, and anemia, and had failed prior therapy with erythropoietin.
  • Complete responses were achieved in two other patients (acute myeloid leukemia and hypereosinophilic syndrome).
  • No responses were observed among patients with myelodysplastic syndromes and primary myelofibrosis.
  • [MeSH-major] Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Leukemia, Myeloid, Acute / drug therapy. Mastocytosis, Systemic / drug therapy. Pyrimidines / therapeutic use. Thiazoles / therapeutic use
  • [MeSH-minor] Adult. Aged. Antineoplastic Agents / adverse effects. Antineoplastic Agents / therapeutic use. Dasatinib. Female. Humans. Male. Middle Aged. Philadelphia Chromosome. Remission Induction. Treatment Outcome


22. Side LE, Curtiss NP, Teel K, Kratz C, Wang PW, Larson RA, Le Beau MM, Shannon KM: RAS, FLT3, and TP53 mutations in therapy-related myeloid malignancies with abnormalities of chromosomes 5 and 7. Genes Chromosomes Cancer; 2004 Mar;39(3):217-23
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  • [Title] RAS, FLT3, and TP53 mutations in therapy-related myeloid malignancies with abnormalities of chromosomes 5 and 7.
  • Oncogenic mutations in the KRAS2, NRAS, or FLT3 gene are detected in more than 50% of patients with de novo acute myeloid leukemia (AML).
  • RAS mutations are also prevalent in de novo myelodysplastic syndrome (MDS), especially chronic myelomonocytic leukemia and juvenile myelomonocytic leukemia.
  • However, few studies have examined these genetic lesions in therapy-related myeloid malignancies.
  • Monosomy 7/del(7q) and monosomy 5/del(5q) represent the most common cytogenetic abnormalities in therapy-related MDS and AML (t-MDS/t-AML) and are strongly associated with prior exposure to alkylating agents.
  • RAS and FLT3 mutations, which are thought to stimulate the proliferation of leukemia cells, appear to be less common in t-MDS/t-AML than in de novo AML, whereas TP53 mutations are more frequent.
  • [MeSH-major] Chromosome Aberrations. Chromosomes, Human, Pair 5 / genetics. Chromosomes, Human, Pair 7 / genetics. Leukemia, Myeloid / genetics. Neoplasms, Second Primary / genetics. Proto-Oncogene Proteins / genetics. Proto-Oncogene Proteins p21(ras) / genetics. Receptor Protein-Tyrosine Kinases / genetics. Tumor Suppressor Protein p53 / genetics
  • [MeSH-minor] Acute Disease. Adolescent. Adult. Aged. Child. Child, Preschool. Female. Humans. Male. Middle Aged. fms-Like Tyrosine Kinase 3

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  • [Copyright] Copyright 2004 Wiley-Liss, Inc.
  • (PMID = 14732923.001).
  • [ISSN] 1045-2257
  • [Journal-full-title] Genes, chromosomes & cancer
  • [ISO-abbreviation] Genes Chromosomes Cancer
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA40046
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Proto-Oncogene Proteins; 0 / Tumor Suppressor Protein p53; EC 2.7.10.1 / FLT3 protein, human; EC 2.7.10.1 / Receptor Protein-Tyrosine Kinases; EC 2.7.10.1 / fms-Like Tyrosine Kinase 3; EC 3.6.5.2 / HRAS protein, human; EC 3.6.5.2 / Proto-Oncogene Proteins p21(ras)
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23. Linassier C, Barin C, Calais G, Letortorec S, Brémond JL, Delain M, Petit A, Georget MT, Cartron G, Raban N, Benboubker L, Leloup R, Binet C, Lamagnère JP, Colombat P: Early secondary acute myelogenous leukemia in breast cancer patients after treatment with mitoxantrone, cyclophosphamide, fluorouracil and radiation therapy. Ann Oncol; 2000 Oct;11(10):1289-94
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  • [Title] Early secondary acute myelogenous leukemia in breast cancer patients after treatment with mitoxantrone, cyclophosphamide, fluorouracil and radiation therapy.
  • BACKGROUND: The topoisomerase II-targeted drugs, epipodophyllotoxins and anthracyclines, have been shown to induce therapy-related AML (t-AML) characterized by a short latency period after chemotherapy, the absence of prior myelodysplastic syndrome and stereotyped chromosome aberrations.
  • PATIENTS AND METHODS: We retrospectively analyzed patients referred to our hospital for AML with a past history of polychemotherapy for breast cancer, including mitoxantrone, either as adjuvant (8 patients)/neoadjuvant (1 patient) therapy or for metastatic disease (1 patient).
  • As described in t-AML following treatment with epipodophyllotoxins or anthracyclines, we found a majority of FAB M4, M5 and M3 phenotypes (7 of 10), and characteristic karyotype abnormalities that also can be found in de novo AML: breakpoint on chromosome 11q23 (3 patients), inv(16)(p13q22) (2 patients), t(15;17)(q22;q11) (1 patient), t(8;21)(q22;q22) (1 patient) and del(20q)(q11) (1 patient).
  • CONCLUSIONS: The combination of mitoxantrone with cyclophosphamide, fluorouracil, and radiation therapy can induce t-AML, as with other topoisomerase II-targeted drugs.


24. Kropff MH, Lang N, Bisping G, Dominé N, Innig G, Hentrich M, Mitterer M, Südhoff T, Fenk R, Straka C, Heinecke A, Koch OM, Ostermann H, Berdel WE, Kienast J: Hyperfractionated cyclophosphamide in combination with pulsed dexamethasone and thalidomide (HyperCDT) in primary refractory or relapsed multiple myeloma. Br J Haematol; 2003 Aug;122(4):607-16
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  • Four patients with prior myeloma therapy > 50 months developed myelodysplastic syndrome or secondary acute myeloid leukaemia 2-4 months after study entry.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Multiple Myeloma / drug therapy
  • [MeSH-minor] Acute Disease. Adolescent. Adult. Aged. Brain Ischemia / chemically induced. Cyclophosphamide / administration & dosage. Cyclophosphamide / adverse effects. Dexamethasone / administration & dosage. Dexamethasone / adverse effects. Disease-Free Survival. Drug Administration Schedule. Female. Follow-Up Studies. Hematologic Diseases / chemically induced. Humans. Leukemia, Myeloid / chemically induced. Male. Middle Aged. Myelodysplastic Syndromes / chemically induced. Neoplasms, Second Primary / chemically induced. Opportunistic Infections / chemically induced. Recurrence. Survival Analysis. Survival Rate. Thalidomide / administration & dosage. Thalidomide / adverse effects. Treatment Outcome. Venous Thrombosis / chemically induced

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  • (PMID = 12899716.001).
  • [ISSN] 0007-1048
  • [Journal-full-title] British journal of haematology
  • [ISO-abbreviation] Br. J. Haematol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study
  • [Publication-country] England
  • [Chemical-registry-number] 4Z8R6ORS6L / Thalidomide; 7S5I7G3JQL / Dexamethasone; 8N3DW7272P / Cyclophosphamide; hyperCDT protocol
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25. Giles FJ, Kantarjian HM, Kornblau SM, Thomas DA, Garcia-Manero G, Waddelow TA, David CL, Phan AT, Colburn DE, Rashid A, Estey EH: Mylotarg (gemtuzumab ozogamicin) therapy is associated with hepatic venoocclusive disease in patients who have not received stem cell transplantation. Cancer; 2001 Jul 15;92(2):406-13
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  • BACKGROUND: Mylotarg (Wyeth-Ayerst Laboratories, St. Davids, PA) is the brand name for a calicheamicin-conjugated humanized anti-CD33 monoclonal antibody (gemtuzumab ozogamicin, CMA-676) and has been approved recently for the treatment of a subset of elderly patients who have relapsed acute myeloid leukemia (AML).
  • RESULTS: A cohort of 119 (61 previously untreated, 58 with relapsed disease) patients with AML (92 patients), advanced myelodysplastic syndrome (25 patients), or chronic myeloid leukemia in blast phase (2 patients), received Mylotarg-based regimens.
  • Five (36%) of 14 patients with VOD had received no prior antileukemic cytotoxic therapy, including 2 patients who received single-agent Mylotarg therapy.
  • CONCLUSIONS: Mylotarg was shown to be associated with the development of potentially fatal VOD in patients with leukemia who had not received SCT.
  • VOD occurred when Mylotarg was used either as a single agent or when it was given with other cytotoxic agents.
  • VOD occurred in Mylotarg-treated patients who had received no prior cytotoxic therapy.
  • [MeSH-major] Anti-Bacterial Agents / adverse effects. Antibodies, Monoclonal / adverse effects. Antineoplastic Agents / adverse effects. Hepatic Veno-Occlusive Disease / diagnosis. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Myelodysplastic Syndromes / drug therapy


26. Ganti AK, Landmark JD, Kessinger A, Smith LM, Tarantolo SR: Vincristine-laden platelet transfusion for patients with refractory thrombocytopenia. In Vivo; 2006 Jul-Aug;20(4):559-63
Hazardous Substances Data Bank. VINCRISTINE .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Vincristine (1 mg) was added to the platelets and incubated for one hour prior to transfusion.
  • Serial platelet counts following vincristine-laden platelet transfusion and units of platelets transfused in the week prior to and the week after transfusion of vincristine-laden platelets were evaluated.
  • RESULTS: The underlying diseases of the patients were lung cancer (n =4), breast cancer following autologous hematopoietic stem cell transplantation and acute myeloid leukemia (n=3 each), myelodysplastic syndrome (n=2), acute lymphoid leukemia, chronic lymphoid leukemia, chronic myeloid leukemia, multiple myeloma, ovarian cancer, aspergillosis, cytomegalovirus infection and systemic lupus erythematosus (n = 1 each).
  • The median change in the number of units of platelets transfused in the week following vincristine-laden platelet transfusion was -1.5 as compared to the week prior to the transfusion (p=0.031).
  • [MeSH-major] Antineoplastic Agents, Phytogenic / therapeutic use. Platelet Transfusion / methods. Thrombocytopenia / drug therapy. Vincristine / therapeutic use

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  • (PMID = 16900790.001).
  • [ISSN] 0258-851X
  • [Journal-full-title] In vivo (Athens, Greece)
  • [ISO-abbreviation] In Vivo
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 5J49Q6B70F / Vincristine
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27. Dann EJ, Rowe JM: Biology and therapy of secondary leukaemias. Best Pract Res Clin Haematol; 2001 Mar;14(1):119-37
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Secondary leukaemias are common, accounting for more than 40% of all patients with acute myeloid leukaemia (AML) or myelodysplastic syndrome (MDS).
  • A clinical history of exposure to haematotoxins or radiation is helpful; however, many older patients are diagnosed with leukaemia with no antecedent history of exposure.
  • These patients' disease show a remarkably similar phenotype to classic therapy-related leukaemia.
  • The specific cytogenetic abnormalities common to MDS, alkylating-agent-related AML and poor-prognosis AML (3q-, -5, 5q-, -7, 7q-, +8, +9, 11q-, 12p-, -18, -19,20q-, +21, t(1;7), t(2;11)), probably reflect a common pathogenesis distinct from that of other de novo AMLs, although the pathogenetic pathway has yet to be elucidated.
  • Typically, these patients are either elderly or have a history of exposure to alkylating agents or environmental exposure 5-7 years prior to diagnosis.
  • Another distinct entity affects the mixed lineage leukaemia (MLL) gene located on 11q23.
  • These account for about 3% of patients with therapy-related leukaemia and have a short latency period from exposure, usually to an inhibitor of topoisomerase II.
  • Other therapy-related patients with t(8:21), inv16 or t(15;17) translocations should be treated as any other de novo AML with similar cytogenetics.
  • In summary, the major prognostic factor is related to the pathogenetic mechanisms of the leukaemia.
  • Cytogenetics and molecular features are a better predictor of outcome than patient history.
  • [MeSH-major] Leukemia / chemically induced. Neoplasms, Second Primary / etiology. Neoplasms, Second Primary / therapy
  • [MeSH-minor] Cytogenetics. Humans. Myelodysplastic Syndromes / chemically induced. Myelodysplastic Syndromes / etiology. Myelodysplastic Syndromes / therapy. Risk Factors

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  • [Copyright] Copyright 2001 Harcourt Publishers Ltd.
  • (PMID = 11355927.001).
  • [ISSN] 1521-6926
  • [Journal-full-title] Best practice & research. Clinical haematology
  • [ISO-abbreviation] Best Pract Res Clin Haematol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 102
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28. Marsh JC, Ganser A, Stadler M: Hematopoietic growth factors in the treatment of acquired bone marrow failure states. Semin Hematol; 2007 Jul;44(3):138-47
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Conflicting results have been reported concerning whether G-CSF increases the known risk of myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML) after IST; follow-up of at least 10 years is required, lacking in many clinical studies reported to date.
  • In several uncontrolled and controlled studies, especially in low-risk MDS, high-dose erythropoietin (EPO) or its glycosylated derivative darbepoetin (DPO), alone or in combination with G-CSF, increased hemoglobin levels and diminished the need for red blood cell transfusions, in selected patients with prior transfusion frequency of less than 2 units per month and EPO levels below 500 IU/L.
  • G-CSF is used in supportive care of MDS to improve neutropenia during infectious complications, but to date there is no compelling evidence for a survival benefit or alteration of the course of the disease through the use of HGFs in MDS.
  • [MeSH-major] Anemia, Aplastic / drug therapy. Hematopoietic Cell Growth Factors / therapeutic use. Myelodysplastic Syndromes / drug therapy. Neutropenia / drug therapy. Thrombocytopenia / drug therapy
  • [MeSH-minor] Hematologic Neoplasms / complications. Hematologic Neoplasms / drug therapy. Humans. Prospective Studies. Randomized Controlled Trials as Topic. Retrospective Studies


29. Laurenti L, Chiusolo P, Garzia MG, Zini G, Sorà F, Piccirillo N, Piccioni P, Zollino M, Leone G, Sica S: Periodic morphologic, cytogenetic and clonality evaluation after autologous peripheral blood progenitor cell transplantation in patients with lymphoproliferative malignancies. Haematologica; 2002 Jan;87(1):59-66
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • BACKGROUND AND OBJECTIVES: Myelodysplastic syndrome (MDS), secondary acute myeloid leukemia (sAML) and clonal karyotypic abnormalities, have been recognized as relatively frequent and potentially serious complications of autologous peripheral blood progenitor cell transplantation (PBPCT) for Hodgkin's disease (HD), non-Hodgkin's lymphoma (NHL) or multiple myeloma (MM).
  • DESIGN AND METHODS: We analyzed 66 patients, undergoing PBPCT for HD, NHL, MM or chronic lymphocytic leukemia (CLL).
  • Patients reported in this study had to be in continuous complete remission after transplantation without receiving chemo-radiotherapy or other biological response modifiers, had to show absence of cytogenetic abnormalities and myelodysplastic features at transplantation and had to have at least 12 months of follow-up.
  • INTERPRETATION AND CONCLUSIONS: The occurrence of MDS/sAML depends on a variety of risk factors such as the number and type of prior courses of chemo-radiotherapy, total body irradiation in conditioning regimen, cytogenetic and morphologic alterations prior to transplant.
  • We consider that the use of stringent morphologic criteria, especially during the first period after PBPCT, combined with cytogenetic, clonality and FISH analyses are necessary for a correct diagnosis of MDS and to overcome the limitations of the FAB and WHO classifications in this setting.
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bone Marrow / pathology. Cell Lineage. Chromosome Deletion. Chromosomes, Human, Pair 10 / ultrastructure. Chromosomes, Human, Pair 5 / ultrastructure. Combined Modality Therapy. DNA, Neoplasm / genetics. Erythropoiesis. Female. Follow-Up Studies. Graft Survival. Hematopoiesis. Hematopoietic Stem Cell Mobilization. Hodgkin Disease / drug therapy. Hodgkin Disease / genetics. Hodgkin Disease / pathology. Hodgkin Disease / therapy. Humans. Karyotyping. Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy. Leukemia, Lymphocytic, Chronic, B-Cell / genetics. Leukemia, Lymphocytic, Chronic, B-Cell / pathology. Leukemia, Lymphocytic, Chronic, B-Cell / therapy. Lymphoma, Non-Hodgkin / drug therapy. Lymphoma, Non-Hodgkin / genetics. Lymphoma, Non-Hodgkin / pathology. Lymphoma, Non-Hodgkin / radiotherapy. Lymphoma, Non-Hodgkin / therapy. Male. Middle Aged. Multiple Myeloma / drug therapy. Multiple Myeloma / genetics. Multiple Myeloma / pathology. Multiple Myeloma / therapy. Neoplasm Proteins / genetics. Neoplastic Cells, Circulating. Receptors, Androgen / genetics. Retrospective Studies. Transplantation Conditioning. Transplantation, Autologous. Y Chromosome

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  • (PMID = 11801466.001).
  • [ISSN] 0390-6078
  • [Journal-full-title] Haematologica
  • [ISO-abbreviation] Haematologica
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / AR protein, human; 0 / DNA, Neoplasm; 0 / Neoplasm Proteins; 0 / Receptors, Androgen
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30. Hagenbeek A: Radioimmunotherapy for NHL: experience of 90Y-ibritumomab tiuxetan in clinical practice. Leuk Lymphoma; 2003;44 Suppl 4:S37-47

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Within the 54 follicular lymphoma patients, an overall response (OR) rate of 74% and a complete response (CR) rate of 15% were achieved, despite patients having received a median of 4 prior therapies and 73% having tumors > or = 5 cm in diameter.
  • In addition, 90Y-ibritumomab tiuxetan therapy was not shown to increase the risk of developing secondary malignancies (myelodysplastic syndrome/acute myeloid leukemia), or preclude subsequent therapy upon relapse.
  • Current investigations are focussing on the potential role of 90Y-ibritumomab tiuxetan earlier in the treatment algorithm, including as single-agent therapy for relapsed diffuse large B-cell lymphoma patients not eligible for transplantation, and consolidation treatment for low-grade NHL patients after first-line, alkylating agent-based therapy.

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  • (PMID = 15154741.001).
  • [ISSN] 1042-8194
  • [Journal-full-title] Leukemia & lymphoma
  • [ISO-abbreviation] Leuk. Lymphoma
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Yttrium Radioisotopes; 0 / ibritumomab tiuxetan
  • [Number-of-references] 50
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