Recognition of drug resistance during remission induction therapy for acute non-lymphocytic leukemia: Utility of day 6 bone marrow biopsy

Preisler, Harvey D.; Barcos, Maurice; Reese, Peter A.; Priore, Roger L.; Pothier, Lillian

doi:10.1016/0145-2126(83)90059-0

Cited by 40 publications

(21 citation statements)

References 10 publications

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“…Several studies have addressed the significance of a day 10–14 bone marrow, without regard to subsequent therapy that was given 26–30 . The issue addressed in the present study is what happens to patients who have residual leukemia on day 10–14, receive a second cycle of induction therapy at that point and subsequently achieve CR.…”

Section: Discussionmentioning

confidence: 99%

Adult patients with acute myeloid leukemia who achieve complete remission after 1 or 2 cycles of induction have a similar prognosis

Rowe

Kim

Cassileth

et al. 2010

Cancer

101

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Background Patients with newly diagnosed acute myeloid leukemia (AML) often have residual leukemia in the bone marrow on day 10–14 after the start of induction therapy. Some cooperative groups administer a second cycle of similar induction therapy on day 14 if there is residual leukemia. It is common perception that the presence of residual leukemia at that point predicts for a worse prognosis, irrespective of therapy given. The purpose of this study was to determine if patients who require a second cycle of induction to achieve complete remission (CR), given on or about day 14, have a worse prognosis than patients who achieve CR after only one cycle, since a worse prognosis might alter postremission therapy. Methods Patients registered to 6 consecutive studies for AML conducted by the Eastern Cooperative Oncology Group (ECOG) between 1983 to 1993 were treated with induction therapy. If the day 14 bone marrow had residual leukemia, patients were to receive a second cycle of identical induction therapy. All patients who achieved CR after one or two cycles, received the identical post-remission therapy. Results In each of the 6 studies the long-term outcome was similar for patients requiring one or two cycles of induction to achieve CR and this was independent of other prognostic variables such as age or karyotype. In conclusion The presence of residual leukemia in a day 10–14 bone marrow does not predict for a worse prognosis if a second similar cycle of induction therapy is administered and CR is achieved.

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Section: Discussionmentioning

confidence: 99%

Adult patients with acute myeloid leukemia who achieve complete remission after 1 or 2 cycles of induction have a similar prognosis

Rowe

Kim

Cassileth

et al. 2010

Cancer

101

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“…Whenever possible, patients failing to respond to treatment were classified according to the guidelines proposed by H. Preisler et al [12]:…”

Section: Materials a N D Methodsmentioning

confidence: 99%

Treatment of acute nonlymphocytic leukemia in the elderly with intermediate high‐dose cytosine arabinoside

Letendre

Niedringhaus

Therneau

et al. 1989

Med. Pediatr. Oncol.

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Effective treatment of the elderly patients (greater than or equal to 65 years) with acute nonlymphocytic leukemia (ANLL) remains elusive and controversial. In the present study, single-agent Cytosine Arabinoside (ARA-C) was administered at an intermediate dose level (500 mg/m2 intravenously [I.V.] 1-hour infusion q12 hours for 12 doses) to 30 newly diagnosed and previously untreated patients. Complete remission was achieved in seven patients after the initial cycle of treatment, in two patients after retreatment, and in one patient after delayed recovery of his peripheral count over a 6-month period. The toxicity of this schedule was primarily hematologic, and the response rate was in keeping with that reported by other groups using aggressive multiagent regimens.

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“…At day 6 of a 7-day course of cytosine-arabinoside/daunorubicin/vincristine or cytosine-arabinoside/amsacrine, the presence of 420% malignant cells in a bone marrow aspirate significantly predicted the failure to achieve complete remission (140). Others have used a bone marrow cellularity of 462.5%, a blast count of 440%, a reduction of o50% of blasts, or marrow cellularity at day 6 as evidence of resistant disease (141)(142)(143). However, doubt has been raised about the value of early marrow studies in AML.…”

Section: Residual Bone Marrow Diseasementioning

confidence: 96%

Hematologic aspects of myeloablative therapy and bone marrow transplantation

Riley

Idowu

Chesney

et al. 2005

Clinical Laboratory Analysis

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The transplantation of bone marrow cells or isolated hematopoietic stem cells from the bone marrow or peripheral blood is a widely utilized form of therapy for patients with incurable diseases of the hematopoietic and immune systems. Successful engraftment of the transplanted stem cells in an adequately prepared recipient normally leads to bone marrow reconstitution over a period of several weeks, accompanied by more gradual reconstitution of the immune system. Since the recipient is profoundly ill during the initial treatment period, laboratory data is critical for monitoring engraftment, detecting residual/recurrent disease, and identifying problems that may delay bone marrow reconstitution or lead to other medical complications. Accurate blood cell counts are imperative, and most bone marrow transplantation patients undergo periodic monitoring with bone marrow aspirates and biopsies with cytogenetic, molecular, and multiparametric flow cytometric studies. The potential complications of bone marrow transplantation include engraftment failure and delayed engraftment, infection, residual bone marrow disease, acute and chronic graft versus host disease, myelofibrosis, therapy-related acute leukemia, post-transplant lympho-proliferative disorders, and toxic myelopathy.

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Recognition of drug resistance during remission induction therapy for acute non-lymphocytic leukemia: Utility of day 6 bone marrow biopsy

Cited by 40 publications

References 10 publications

Adult patients with acute myeloid leukemia who achieve complete remission after 1 or 2 cycles of induction have a similar prognosis

Adult patients with acute myeloid leukemia who achieve complete remission after 1 or 2 cycles of induction have a similar prognosis

Treatment of acute nonlymphocytic leukemia in the elderly with intermediate high‐dose cytosine arabinoside

Hematologic aspects of myeloablative therapy and bone marrow transplantation

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