The importance of cytogenetic studies in adult acute lymphocytic leukemia

Article Abstract:

Cytogenetic studies involve the analysis of a karyotype, a photographic representation of a single cell at a stage in cell division that shows the chromosomes in descending order by size. Chromosomes are structures within the cell nucleus that carry genetic information. Cytogenetic studies have been used to examine disease variation and to determine the prognosis of several types of cancer. One study showed that specific abnormalities in the karyotype were associated with rates of remission and prognosis in patients with adult acute lymphocytic leukemia (ALL), a type of blood cancer. In this study, the usefulness of cytogenetic studies in determining the prognosis of 103 patients with ALL was assessed. Patients were classified into cytogenetic groups based on analysis of their karyotype. Certain classifications were associated with a poor prognosis, including diploid, hyperdiploid, pseudodiploid, and hypodiploid karyotypes; whereas classifications of Philadelphia chromosome-positive, B-cell, and 6q- or 14q+ abnormalities were associated with a less favorable outcome. Patients with a good prognosis had an average remission rate of 89 percent after chemotherapy; an average remission of 26 months; an average survival of 25 months; and an overall survival rate of 45 percent at three years. Patients with a poor prognosis had a response rate to chemotherapy of 65 percent; an average duration of response of seven months; an average survival of eight months; and an overall survival rate of less than 10 percent at three years. These findings suggest that analysis of bone marrow cell karyotype helps to evaluate and predict the outcome of patients with adult ALL. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Analysis, Genetic aspects, Karyotypes, Lymphocytic leukemia, Human cytogenetics

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Proposal for a simple synthesis prognostic staging system in chronic myelogenous leukemia

Article Abstract:

Chronic myelogenous leukemia (CML) is a cancer of the blood, characterized by the presence of a genetic abnormality called the Philadelphia chromosome and the overgrowth of a type of white blood cell, the granulocyte, in the bone marrow. A fatal outcome is estimated in 25 percent of patients within two years and in another 25 percent in five years. Differences in the survival rates may be related to differences in patient and tumor characteristics. Prognostic models, which are intended to predict the outcome of the disease, are used to classify patients into different risk groups based on pretreatment or therapy-related factors. However, current models lack validity because they are based on inappropriate population studies, include factors that are not common to the disease, and involve complex mathematical formulas. A similar type of classification procedure, the staging system, classifies tumors based on the degree of tumor differentiation or development, the effects of therapy on the tumor, and an analysis of prognostic factors. Four CML staging systems tested in large population studies were developed to classify patients into different risk groups. This study examined the effectiveness of these staging systems to predict the outcomes of 406 CML patients, and also attempted to develop a simple staging system that could be applied to clinical practice. The results show that three of four previous staging systems were effective in predicting the prognosis of CML in the patients; a new and improved staging system has also been developed that is superior to two of the three effective staging systems.

Models, Evaluation, Tumor staging, Cancer staging, Myeloid leukemia, Philadelphia-positive, Philadelphia-positive myeloid leukemia

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Efficacy of fludarabine, a new adenine nucleoside analogue, in patients with prolymphocytic leukemia and the prolymphocytoid variant of chronic lymphocytic leukemia

Article Abstract:

Prolymphocytic leukemia (PLL) is a type of cancer of the blood cells that is associated with proliferation of prolymphocytes, a type of white blood cell, in the blood and bone marrow; involvement of the spleen; less frequent accumulation of cancer cells in the lymph nodes and liver; and a poor outcome. An intermediate form of PLL is chronic lymphocytic leukemia (CLL-Pro), in which there is a lower percentage of prolymphocytes as compared with that in PLL. Patients with more than 30 percent prolymphocytes had a higher death rate than patients with fewer prolymphocytes. The anticancer agents chlorambucil, cyclophosphamide, and fludarabine monophosphate, and steroids have been used to treat patients with CLL. The effectiveness of fludarabine in treating 17 patients with PLL and CLL-Pro was assessed. Remission was complete in three patients and partial in three other patients, producing an overall response rate of 35 percent. The response to treatment was enduring and evident in all affected tissues. Patients with anemia (decreased numbers of red blood cells), thrombocytopenia (abnormal decrease in blood platelets, involved in clotting), advanced cancer, and initial resistance to prior therapy were less responsive to treatment with fludarabine. Side effects of fludarabine were few and included the development of fever. These results show that fludarabine may be beneficial in treating patients with PLL and CLL-Pro, and should be tested in additional studies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Antineoplastic agents, Chemotherapy, Fludarabine, Chronic lymphocytic leukemia

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