Background: Although cure rates in pediatric acute lymphoblastic leukemia (ALL) are quite high with combined chemotherapy regimens, complete response (CR) and long-term survival rates in adults are 80–90 and 30–40%, respectively. Currently, combined chemotherapy regimens, such as Hyper-CVAD and PETHEMA, are used in patients with adult ALL. However, there has been no study comparing the results of Hyper-CVAD and PETHEMA ALL-93. Methods: In this retrospective single-center study, we evaluated the results of Hyper-CVAD and PETHEMA ALL-93 in 51 ALL patients treated between September 2008 and March 2017 at the Department of Hematology, Faculty of Medicine, Karadeniz Technical University. Results: Thirty-eight patients were treated with Hyper-CVAD and 13 with PETHEMA ALL-93. CR was obtained in 90 and 100% of patients, respectively. Survival estimates were comparable between Hyper-CVAD and PETHEMA ALL-93, with a median overall survival (OS) and a median disease-free survival (DFS) of 17.5 and 12.1 months, respectively, for Hyper-CVAD and of 18.6 and 12.9 months, respectively, for PETHEMA ALL-93. The 2-year OS rates for Hyper-CVAD and PETHEMA ALL-93 were 30 and 40%, respectively, and the 2-year DFS rates were 28 and 44%, respectively. PETHEMA ALL-93 resulted in more hepatotoxicity, hypofibrinogenemia, aspergillus infection, and skin rash than Hyper-CVAD. Conclusions: Although Hyper-CVAD and PETHEMA ALL-93 showed similar effects, Hyper-CVAD was tolerated better. Age and comorbidities should be taken into account before a chemotherapy regimen is determined for patients with ALL.
Ö ÖZ ZE ET T A Am ma aç ç: : Tüylü hücreli lösemi (THL) kemik iliği, periferik kan, dalak, karaciğer ve lenf nodlarının çevresel sitoplazmik uzantılı malign B hücrelerin infiltrasyonu ile karakterize klonal B hücre hastalığıdır. Kladribin ve pentostatin gibi pürin analogları öncesinde ortalama yaşam süresi 4 yıl iken, sonrasında bu süre 15 yıla kadar yükselmiştir. Bu makalede kliniğimizde takip edilen THL'li hastaların klinik özellikleri ve tedavi sonuçlarını değerlendirmeyi amaçladık. G Ge er re eç ç v ve e Y Yö ön n-t te em ml le er r: : Karadeniz Teknik Üniversitesi Tıp Fakültesi Hematoloji Bilim Dalında Ekim 2007 ile Haziran 2015 yılları arasında THL tanısı konulan ve kladribin alan hastaların klinik özellikleri ve tedavi sonuçları retrospektif olarak değerlendirildi. B Bu ul lg gu ul la ar r: : 16 hastanın 15'i erkek ve 1'i kadın olup ortanca tanı yaşı 54 (35-75) yıl idi. Kladribin ile 15 hastada (%94) tam hematolojik yanıt (THY), 1 hastada (%6) parsiyel yanıt (PY) gözlendi. Sekiz hastada (%50) relaps gelişti ve ortalama progresyonsuz yaşam süresi 78 ay idi. Hastaların relaps anındaki yaş ve komorbid durumları değerlendirildiğinde 4 hastaya tek ajan rituksimab, 2 hastaya kladribin uygulandı ve 5 hastada (%83) THY, 1 hastada (%17) PY izlendi. Ardından 3 hastada (%50) 2. relaps izlenmiş olup ortalama progresyonsuz yaşam süresi 54.7 ay idi. Tüm hastaların ortalama yaşam süresi 105 ay, 8 yıllık ortalama yaşam oranı %66 idi. S So on nu uç ç: : Kladribinin THL'de etkin ve güvenli bir tedavi seçeneği olduğu, relaps gelişiminde kladribin için uygun olmayan hastalarda rituksimab kullanılabileceği ve uygun vakalarda birlikte kullanımının tedavi etkinliğini artırabileceği kanaatine varıldı. A An na ah ht ta ar r K Ke el li im me el le er r: : Tüylü hücreli lösemi; kladribin; rituksimab; mortalite A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Hairy cell leukemia (HCL) is a clonal B-cell disorder characterized by infiltration of the bone marrow, peripheral blood, spleen, liver and lymph nodes by malignant B-cell with circumferential cytoplasmic projections. Median survival before purine analogues such as cladribine and pentostatin was only 4 years, but this subsequently increased to 15 years. The aim of this article was to evaluate the clinical characteristics and treatment outcome of patients with HCL. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : The clinical characteristics and treatment outcome of patients diagnosed with HCL and treated with cladribine at the Karadeniz Technical University, Faculty of Medicine, Department of Hematology between October 2007 to June 2015 were evaluated retrospectively. R Re es su ul lt ts s: : Fifteen out of 16 patients were males and 1 females and the median age was 54 (range 35-75) years.Fifteen patients (94%) achieved a complete hematologic response (CHR), 1 (6%) a partial response (PR) with cladribine. Eight patients (50%) relapsed and median progression-free survival was 78 months. When patients' age and comorbid conditions at time of relapse were analyzed,...
Akut promiyelositik lösemi (APL), farklı klinik ve biyolojik özelliğe sahip akut miyeloid lösemi (AML)'nin bir alt tipidir. Günümüzde all-trans retinoik asit (ATRA) ve antrasiklin bazlı kemoterapi APL tedavisinde standart tedavi yaklaşımıdır. Bu çalışmanın amacı APL'li hastaların klinik özelliklerini ve tedavi sonuçlarını değerlendirmektir.
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