Adult Nonlymphocytic Leukemia Research Articles

Childhood cancer in relation to indicators of magnetic fields from ground current sources

This study examines childhood cancer risk in relation to certain factors likely to indicate magnetic field exposure from ground currents in the home. Substantial ground currents are most often found in homes having conductive plumbing, in which an uninterrupted metallic path in the water pipes and water main connects the grounding systems of neighboring houses. Information on plumbing conductivity was obtained from water suppliers for the homes of 347 cases and 277 controls identified in an earlier study of magnetic field exposure and childhood cancer in the Denver area. An increased cancer risk was observed for children in homes with conductive plumbing: The matched odds ratio was 1.72 (1.03-2.88) and increased to 3.00 (1.33-6.76) when analysis was limited to cases and controls who were residentially stable from the reference date to the study date. A measurement metric likely to indicate active ground currents (measurements having above-median intensity and a nonvertical orientation of < 55 degrees from the horizontal) was identified. In contrast to measured field intensity alone, for which only modest associations with cancer have been reported, this metric shows a high and significant cancer risk [matched O.R. = 4.0 (1.6-10.0)] consistent over a range of intensity and angle cutpoints. Such elevated nonvertical fields were also associated with cancer in an independent data set, which was gathered to study adult nonlymphocytic leukemia in the Seattle area. The associations of cancer with conductive plumbing and with this exposure metric both suggest that cancer risk is increased among persons with elevated magnetic field exposure from residential ground currents.

Adult leukemia risk and personal appliance use: a preliminary study.

The hypothesis that use of personal electric appliances may be associated with increased risk of acute nonlymphocytic leukemia in adults was tested using interview data from a previously completed case-control study of 114 cases and 133 controls conducted between 1981 and 1984. Cases were obtained from a population-based cancer registry in western Washington state, and controls were obtained from the same area by random digit dialing. Of 32 electrical home appliances for which data on use were available for adult acute nonlymphocytic leukemia cases and controls, three motor-driven personal appliances (electric razors, hair dryers, and massage units) were selected a priori because their use represents exposure to higher peak magnetic fields than that from most other home appliances. When compared on an "ever used" versus "never used" basis, use of one or more of these appliances was not associated with increased risk of leukemia in the population studied (odds ratio (OR) = 0.71, 95% confidence interval (CI) 0.41-1.24). When the appliances were considered individually, massage units were more likely to have been used by cases than by controls (OR = 3.00, 95% CI 1.43-6.32), while hair dryers were more likely to have been used by controls than cases (OR = 0.38, 95% CI 0.22-0.66). There was a nonsignificant tendency for electric razor use to differentiate the cases from controls (OR = 1.33, 95% CI 0.80-2.23). When reported daily time of use was stratified, there was no overall increased risk with increased time of use except for electric razors (p < 0.05). In addition to the analysis of appliance use data from the case-control study, the authors obtained several models of these motor-driven personal appliances and characterized the magnetic fields they produce. Magnetic field flux density, or the B-field, and spectral measurements showed that partial body exposure from such appliances may exceed 0.5 mTesla (root mean squared) at rates-of-change exceeding 10 Tesla/sec. These epidemiologic data must be interpreted cautiously because the number of cases is limited and because of proxy reporting of appliance use for deceased cases. Nevertheless, the authors believe these data indicate that peak magnetic field exposure from personal appliances warrants further investigation as a possible risk factor for acute nonlymphocytic leukemia in adults.

Ubenimex in the treatment of acute nonlymphocytic leukemia in adults

A multi-institutional randomized study for the evaluation of ubenimex (Bestatin) in the treatment of adult acute nonlymphocytic leukemia was performed. One hundred and ninety-five patients were registered from February 1988 to December 1990. Patients who had reached complete remission by one or two courses of remission induction chemotherapy were divided into the ubenimex group or the control group by randomization. Patients of the ubenimex group started to receive 30 mg ubenimex orally once a day when maintenance therapy began and continued as long as possible. Remission duration and survival were analyzed based on the data as of August 31, 1991. Remission duration of the ubenimex group was superior to that of the control group (generalized Wilcoxon test: p = 0.0338). Fifty percent remission duration was 508 days in the ubenimex group and 386 days in the control group. There has been no statistical difference in survival between the two groups as yet.

Randomized controlled study of chemoimmunotherapy with bestatin of acute nonlymphocytic leukemia in adults

A new immunomodulating agent, bestatin (INN: Ubenimex has low toxicity even after long-term oral administration and has significant modifications in immunological response. A cooperative randomized controlled study of bestatin immunotherapy in combination with remission maintenance chemotherapy for adult acute nonlymphocytic leukemia (ANLL) was performed. After induction of complete remission, patients were randomized to the bestatin group (30 mg bw per os (po) daily) and the control group. The 101 eligible cases (bestatin: 48, control: 53) were analyzed; the bestatin group achieved longer remission than the control group and a statistically significant longer survival. Though this prolongation of remission was not significant in the bestatin group compared to the control group in the 15–49 yr age group, in the 50–65 yr age group it was significantly longer. Bestatin is shown to be a clinically useful drug for immunotherapy of adult ANLL, since it has prolonged survival and remission especially in elderly patients, with few side-effects.

Results and Prognosis of Acute Non-Lymphocytic Leukemia in Adults

Between 1977-87, 319 patients with AML were admitted to Hannover Medical School. At all 41 of these patients were not treated (median duration of survival 0.6 months). Among the 278 treated patients, there was a CR rate of 53.6%, the median duration of remission was 10.1 months and the median duration of survival 7.0 months. The patients with FAB-classification M4-M5 had a worse prognosis than those with M1-M3. Patients under 50 years of age had a significant higher remission rate and survival time than those over 50 years. In the last 10 years, the remission rate rose from 37.3% to 61.0% (p = 0.1776). There was a rise in median duration of survival from 5.9 months (1977-79) to 8.0 months (1984-85) (p less than 0.001). The median remission time decreased from 15.8 months (1977-79) to 12.0 months (1984-85) (p less than 0.001). After the first reinduction therapy, the remission rate (46.6%), duration of remission (5.3 months), and duration of survival (4.1 months) was lower than after primary therapy. After the second reinduction therapy the CR rate was 69.2%, and the remission time 2.9 months. The CR rate after the third reinduction therapy was 22.2%.

Acute nonlymphocytic leukemia in adults: pathophysiology, status of current therapy, and new approaches.

Recent information concerning the cell biology of leukemias has provided new insights into the pathophysiology and pathogenesis of acute leukemia, involving the detection of leukemia viruses, oncogenes and their products, and the discovery of factors supporting clonal leukemic growth. Murine, avian, and cat leukemia viruses are well characterized. To date, only HTLV I appears to be a likely candidate as a human leukemia virus. For both avian and murine viruses, there is a fundamental classification distinction between long-latency viruses (LLV) and acute transforming viruses (ATV). The ATV are replication defective and must be propagated with a helper virus. They have within their genome an identifiable oncogene. The LLV do not contain such an oncogene and presumably act by “promotor insertion”, e.g., a retroviral long terminal repeat (LTR inserted 5’ to the cellular oncogene. Acutely appearing neoplasms are probably not clonal, but reflect infection of multiple target cells. Long-latency neoplasms, however, are clonal and probably reflect expansion of a random oncogenic event. There are usually differences between in vitro and in vivo target cell specificities for these viruses. Furthermore, pathogenicity in the animal is greatly affected by animal age, inoculum route, and the genetics of the recipients. Target cell specificities will hopefully be classified by new in vitro culture techniques for hematopoietic cells. Three avian ATV are interesting because of their apparent target cell specificity:AEV (erythroblastosis virus), AMV (myeloblastosis virus), and MC 29 (myelocytomatosis virus). Relative numbers of target cells appear to differ for these viruses: 50 for AEV, 700 for AMV, and 3500 for MC 29. AEV (V-erb B) affects erythroid precursors (presumably BFU-E), AMV (Vmyb), early myeloid precursors, and MC 29 (V-myc), macrophage-like cells. In vitro AEV and MC 29, but not AMV, transform fibroblasts.KeywordsAcute Myeloid LeukemiaHairy Cell LeukemiaCytosine ArabinosideAcute Myeloblastic LeukemiaErythroblastosis VirusThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Immunotherapy with bestatin for acute nonlymphocytic leukemia in adults. A cooperative bestatin chemoimmunotherapy group study

Immunotherapy with bestatin for acute nonlymphocytic leukemia in adults. A cooperative bestatin chemoimmunotherapy group study

Acute nonlymphocytic leukemia in adults. When diagnosis and pretreatment assessment can't wait.

Because adults with acute nonlymphocytic leukemia (ANLL) frequently present with vague complaints and nonspecific findings, it is usually the primary care physician who sees them first. The initial clinical evaluation of such patients should include making the diagnosis, beginning to characterize the leukemia, and assessing the overall medical condition of the patient. All phases of this evaluation should be completed with a sense of urgency because immediate medical intervention is often necessary. Prompt assessment and institution of therapy take on added importance now that effective chemotherapy is available. Currently, a large majority of patients with ANLL respond to treatment and 15% to 20% are probably cured. With the use of various clinical and laboratory studies, the physician can rapidly confirm a suspected diagnosis of ANLL and systematically evaluate the patient's condition prior to arranging for appropriate treatment.

Absence of predictive parameters for CNS involvement in adult non-lymphocytic leukaemia at time of diagnosis.

13 patients with adult non-lymphocytic leukemia (ANLL) who developed central nervous system (CNS) involvement during the course of their illness are reported and compared with a control group of 26 ANLL patients without CNS involvement. The incidence of CNS involvement was 13/510 patients (2.5%). Initial symptoms and signs and routine laboratory data were not helpful in predicting which patients would ultimately develop CNS involvement. Almost 1/2 of the patients were in clinical and haematological remission at the time of the diagnosis of CNS involvement. Specific treatment to the CNS including intrathecal cytotoxic drugs and/or radiotherapy failed to increase the survival rate significantly. Whether the establishment of an early diagnosis of CNS involvement and the institution of appropriate treatment may improve the prognosis of this complication is a question which presently remains unanswered.

High-dose cytosine arabinoside in the treatment of refractory acute nonlymphocytic leukemia in adults: Results of two six-day regimens

High-dose cytosine arabinoside (Ara-C) was used in adult patients with refractory acute nonlymphoblastic leukemia, either alone (3 g/m2 every 12 h X 12 doses) or with 3 additional days of anthracycline antibiotics. The systemic toxicities were similar for both groups without an increase in the group receiving anthracyclines. Bone marrow recovery was also similar for these groups. The antileukemic effect was not statistically increased in the group receiving anthracyclines, but when a comparison of the complete remission late in resistant patients is made, there is a trend toward a greater number of complete remissions when anthracyclines are included in the regimen (p = 0.09). High-dose Ara-C is effective therapy for refractory leukemia; the addition of anthracyclines may enhance the effect of the Ara-C.

Relation between age and chromosomal aberrations at diagnosis of adult non-lymphocytic leukemia

Relation between age and chromosomal aberrations at diagnosis of adult non-lymphocytic leukemia

Acute nonlymphocytic leukemia in adults: correlations with Q-banded chromosomes

Chromosome banding patterns were obtained for 50 of 55 consecutive adult patients with acute nonlymphocytic leukemia during a 5-yr period. Twenty-two of the 50 cases were diagnosed as acute myelocytic leukemia (AML), 24 as acute myelomonocytic leukemia (AMMol), 2 as acute promyelocytic leukemia (APL), and 2 as erythroleukemia. Twenty-five patients had initial chromosome abnormalities during the course of the disease. The median survival of patients with normal chromosomes initially (group I) was 10 mo, whereas that of patients with abnormal chromosomes initially (group II) was 2 mo. Similar times were obtained for treated patients with AML and AMMol. However, when the AML patients were separated into those with and those without a chromosome abnormality, the median survival times were markedly different (2 mo versus 18 mo, respectively). Patients with AMMol demonstrated no difference in median survival times when subgrouped according to the presence or absence of chromosome abnormalities. The treated group II patients whose marrow samples had only abnormal metaphases had a poorer response (10% complete remission) and median survival (2 mo) than the group II patients who had at least one normal metaphase (42% complete remission with a median survival of 9 mo). The two cases of APL demonstrated a deletion of the long arm of No. 17 which occurred in the same region of the chromosome in each case. Both patients had similar clinical histories, with disseminated intravascular coagulation, and neither responded to therapy.

Acute Nonlymphocytic Leukemia in Adults: Correlations With Q-Banded Chromosomes

Chromosome banding patterns were obtained for 50 of 55 consecutive adult patients with acute nonlymphocytic leukemia during a 5-yr period. Twenty-two of the 50 cases were diagnosed as acute myelocytic leukemia (AML), 24 as acute myelomonocytic leukemia (AMMol), 2 as acute promyelocytic leukemia (APL), and 2 as erythroleukemia. Twenty-five patients had initial chromosome abnormalities during the course of the disease. The median survival of patients with normal chromosomes initially (group I) was 10 mo, whereas that of patients with abnormal chromosomes initially (group II) was 2 mo. Similar times were obtained for treated patients with AML and AMMol. However, when the AML patients were separated into those with and those without a chromosome abnormality, the median survival times were markedly different (2 mo versus 18 mo, respectively). Patients with AMMol demonstrated no difference in median survival times when subgrouped according to the presence or absence of chromosome abnormalities. The treated group II patients whose marrow samples had only abnormal metaphases had a poorer response (10% complete remission) and median survival (2 mo) than the group II patients who had at least one normal metaphase (42% complete remission with a median survival of 9 mo). The two cases of APL demonstrated a deletion of the long arm of No. 17 which occurred in the same region of the chromosome in each case. Both patients had similar clinical histories, with disseminated intravascular coagulation, and neither responded to therapy.