2-Chlorodeoxyadenosine produces a high rate of complete hematologic remission in relapsed acute myeloid leukemia.

Santana, Víctor M.; Mirro, J; Kearns, Cristin; Schell, MJ; Crom, William R.; Blakley, Raymond L.

doi:10.1200/jco.1992.10.3.364

Cited by 139 publications

(67 citation statements)

References 11 publications

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“…3 For pediatric patients, it is known that intensive second-line treatment induces remission in a proportion of patients and at least some of the children may have a chance of cure. 4,5 In reports on experimental therapies evaluating drugs in phase II studies [6][7][8] patient numbers are usually small and long-term follow-up is rarely reported. Therefore no conclusions for the prognosis of children with relapsed AML can be drawn.…”

Section: Introductionmentioning

confidence: 99%

Duration of first remission predicts remission rates and long-term survival in children with relapsed acute myelogenous leukemia

Stahnke

Boos²,

Bender‐Götze³

et al. 1998

Leukemia

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Although treatment of childhood acute myelogenous leukemia (AML) has substantially improved in the last 15 years, in nearly half of the patients disease recurs. The aim of this study was to establish the prognosis of relapsed childhood AML and to identify prognostic factors for achievement of second remission and survival. From February 1988 to July 1996, 134 children with first relapse of AML were reported to the study center of the AML-BFM group. 102 patients treated intensively to induce second remission were prospectively followed. With various regimens, complete remission was achieved in 52 of 102 patients (51%), 27 children were alive in median 2.5 years (range, 0.4-7 years) after relapse. Disease-free survival was observed in seven of 16 patients transplanted from a matched sibling donor, one of four after matched unrelated bone marrow transplantation, 10 of 22 after autologous transplantation and five of nine patients after chemotherapy alone (two patients were lost to follow-up). Time until relapse reflecting the duration of first remission is the only variable correlating CR and survival rates. Defining early relapse as less than 1.5 years from diagnosis to relapse resulted in a 5-year survival of 10%, s.e. 5% for early relapses and 40%, s.e. 10% for late relapses (P-logrank test, 0.0001). Duration of first remission is a strong predictor for achievement of second CR and survival. It should be considered in reporting results of experimental therapies.

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Section: Introductionmentioning

confidence: 99%

Duration of first remission predicts remission rates and long-term survival in children with relapsed acute myelogenous leukemia

Stahnke

Boos²,

Bender‐Götze³

et al. 1998

Leukemia

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“…The most impressive responses have been observed in patients with hairy-cell leukemia, in whom complete response rates of 90% with prolonged remission can be achieved [23,24]. In children, the use of 2-CdA has been restricted almost exclusively to the treatment of acute myeloid leukemia, where a response rate of 59% has been documented [25]. Based on preclinical data that showed that the killing of lymphocytes in culture is time-dependent [26], a continuous infusion schedule over 5À7 days was used in early clinical trials [18,27,28].…”

Section: Discussionmentioning

confidence: 99%

Treatment of children with Langerhans cell histiocytosis with 2‐chlorodeoxyadenosine

et al. 2002

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Langerhans cell histiocytosis (LCH) is a disorder characterized by proliferation of activated Langerhans cells. Immune dysregulation is believed to be part of the pathogenesis. Although current therapies are very effective at inducing remission, multiple recurrences and long-term sequelae are common for patients with low-risk disease, and a signi®cant proportion of young patients die of their disease. More effective therapies based on the pathogenesis of LCH are needed. We investigated the use of 2-chloro-deoxyadenosine (2-CdA), a purine analogue with an antiproliferative effect on histiocytes and lymphocytes, in patients with recurrent or high-risk LCH. Six patients with recurrent LCH received 2-CdA (5±7 mg/m 2 /day for 5 days, repeated every 21±28 days). All patients achieved remission. With a median follow-up of 15 months (range, 3±25 months), 5 patients remain in remission. A patient with multisystem disease who recurred after 13 months, achieved a second remission with 2-CdA. Hematologic toxicity was minimal, and no infectious complications were documented. 2-CdA is among the most effective drugs for the treatment of LCH, and this is probably due to both its anti-proliferative and immunomodulatory effects. 2-CdA needs to be considered for the treatment of recurrent LCH. However, its incorporation into front-line treatment of patients with multi-system LCH needs further study. Am.

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“…In comparison with other salvage regimens in AML, infectious mortality (7/30) is similar 12,30 or superior. 17,[31][32][33] Nephrotoxicity is a serious cause of concern when using CBDCA. In order to avoid this problem, some authors 34 have recently recommended that the CBDCA dosage be based on renal function with promising results.…”

Section: Discussionmentioning

confidence: 99%

Carboplatin plus cytarabine in the treatment of high-risk acute myeloblastic leukemia

et al. 1999

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Thirty-one patients (20 male and 11 female; median age 51 years (16-79)) with high-risk acute myeloblastic leukemia (AML) (20 refractory AML and 11 secondary AML (s-AML) (four to myelodysplastic syndrome, five to chemo/radiotherapy, one to aplastic anemia and one blastic chronic myelogenous leukemia (B-CML)) were treated with CBDCA (300 mg/m 2 /day ؋ 5 days in continuous i.v. infusion) plus intermediate-dose Ara-C (500 mg/m 2 /day ؋ 3 days in rapid i.v. infusion). Nine patients (29%) achieved CR (five s-AML (three myelodysplastic syndromes, one CML and one ALL) and four refractory AML) and 11 patients had resistant disease. There were 11 early deaths (35%). Median disease-free survival of the nine responders was 4 months. The main toxicity was hematological, febrile episodes took place in nearly all the patients (96%). The CBDCA plus Ara-C regimen showed an evident antileukemic activity in high-risk leukemia. However, the lack of long-term disease-free survivors shows the need for innovative postremission strategies. The high initial response rate seen in AML secondary to myelodysplastic syndromes (MDS) warrants further investigation of CBDCA in combination regimens for MDS patients.

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2-Chlorodeoxyadenosine produces a high rate of complete hematologic remission in relapsed acute myeloid leukemia.

Abstract: 2-CDA given by prolonged continuous infusion has clinically significant activity against AML and merits further testing in multidrug regimens for this disease.

Cited by 139 publications

References 11 publications

Duration of first remission predicts remission rates and long-term survival in children with relapsed acute myelogenous leukemia

Duration of first remission predicts remission rates and long-term survival in children with relapsed acute myelogenous leukemia

Treatment of children with Langerhans cell histiocytosis with 2‐chlorodeoxyadenosine

Carboplatin plus cytarabine in the treatment of high-risk acute myeloblastic leukemia

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