Effect of granulocyte colony-stimulating factor after intensive induction therapy in relapsed or refractory acute leukemia

Article Abstract:

Advances is chemotherapy and bone marrow transplantation have dramatically increased the success rate in the treatment of leukemia. However, the toxic effects of the treatment on the normal bone marrow limit the intensity of the chemotherapy which may be used. The depression of neutrophils, a type of granulocyte, by the chemotherapeutic drugs leaves the patient open to infection during recovery. For other forms of cancer, the use of granulocyte colony-stimulating factor has been shown to decrease the time needed for the recovery of neutrophil numbers as well as reduce the number of infections experienced during recovery. The use of granulocyte colony-stimulating factor, or CSF, in acute leukemia has been approached with great caution, however, since the granulocyte CSF stimulates not only normal granulocytes, but the leukemic cells as well. In a controlled study of the use of granulocyte CSF during intensive chemotherapy for acute leukemia, it has now been shown that the stimulation of the leukemic cells is apparently of little clinical significance and that the substance, which is now available in large amounts through molecular cloning, improves the recovery of the neutrophil populations in the treated patients. In a study involving 108 patients with either relapsed or refractory leukemia, treatment with granulocyte CSF reduced the time of recovery of the neutrophils by about a week. Furthermore, although the number of bouts of fever was the same in both the patients receiving CSF and the controls, the actual number of demonstrated infections was lower among the patients receiving granulocyte CSF. The remission rate was 50 percent among the patients receiving granulocyte CSF who could be evaluated, and 36 percent among the controls. The relapse rate appeared to be the same in both groups. Although the authors caution that the results need to be replicated in further studies, the indications are that the use of granulocyte colony-stimulating factor in patients with acute leukemia is both safe and effective. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Drug therapy, Granulocyte colony-stimulating factor, Acute leukemia

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A combination trial of human lymphoblastoid interferon and bestrabucil (KM2210) for adult T-cell leukemia-lymphoma

Article Abstract:

Adult T-cell leukemia-lymphoma appears to be related to the human T-cell leukemia virus type 1, or HTLV-1. The disorder is most common in Japan, the Caribbean, and Central Africa. Unfortunately, this form of leukemia is resistant to current chemotherapeutic treatments. Since the disease is associated with HTLV-1, attempts have been made to treat the condition with interferon, but the successes achieved have only been short-lived. A study was conducted to evaluate the effectiveness of interferon in combination with bestrabucil. Bestrabucil is a chemical conjugate of two substances, beta-estradiol and chlorambucil. A total of 13 patients with adult T-cell leukemia-lymphoma were treated, and 12 patients were available for evaluation. There were no complete responses, and partial responses were obtained in nine cases. The responses were of short duration, ranging from four to 108 weeks; the median duration of response was nine weeks. The treatment technique caused no serious side effects, however, and it may be possible, therefore, to combine this regimen with other treatments to achieve control of this particularly aggressive form of leukemia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Lymphomas, Leukemia, Drug therapy, Combination, Combination drug therapy, Interferon

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Effect of matching of class I HLA alleles on clinical outcome after transplantation of hematopoietic stem cells from an unrelated donor

Article Abstract:

Better matching of donor and recipient could lower the risk of complications after stem cell transplants. Stem cells are the precursor of all blood cells and are used to treat many blood diseases. Researchers used DNA analysis to determine incompatibilities between 440 stem cell recipients and their unrelated donors. Those whose HLA-A or HLA-C genes were not compatible were more likely to develop graft-versus-host disease. This occurs when the transplanted cells attack the recipient's immune system. HLA-C incompatibility was also associated with leukemia relapse.

Analysis, Organ transplant recipients, HLA histocompatibility antigens, HLA antigens, Hematopoietic stem cells, Hematopoietic stem cell transplantation

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