Results of Treatment With Hyper-CVAD, a Dose-Intensive Regimen, in Adult Acute Lymphocytic Leukemia

Kantarjian, Hagop M.; O’Brien, Susan; Smith, Terry L.; Cortes, Jorge; Giles, Francis J.; Beran, Miloslav; Pierce, Sherry; Huh, Yang O.; Andreeff, Michael; Koller, Charles; Ha, Chul S.; Keating, Michael J.; Murphy, Samuel G.; Freireich, Emil J.

doi:10.1200/jco.2000.18.3.547

Cited by 706 publications

(549 citation statements)

References 66 publications

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“…Based on these findings as well as rather unsatisfactory results with current treatment protocols, we employed the hyper-CVAD chemotherapy protocol, used mainly for therapy of acute lymphocyte leukemia and high-grade lymphomas [3,4]. The first patient received eight courses of intensive chemotherapy (over four treatment cycles) using hyper-CVAD (fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone) alternating with high-dose methotrexate/cytarabine, with central nervous system prophylaxis using intrathecal methotrexate/cytarabine.…”

Section: Resultsmentioning

confidence: 99%

Complete remission in advanced blastic NK‐cell lymphoma/leukemia in elderly patients using the hyper‐CVAD regimen

et al. 2003

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Although its cell of origin is still controversial, the blastic NK-cell leukemia/lymphoma clearly represents a distinct type of hematopoietic neoplasm that is particularly clinically aggressive when it occurs in elderly patients as a disseminated, multi-organ disease. Consistently effective treatments have not been developed for this malignancy. The present report describes two elderly patients with widespread blastic NK-cell leukemia/ lymphoma involving the skin, bone marrow, peripheral blood, lymph nodes, and viscera.

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Section: Resultsmentioning

confidence: 99%

Complete remission in advanced blastic NK‐cell lymphoma/leukemia in elderly patients using the hyper‐CVAD regimen

et al. 2003

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“…Details of the regimen have been reported previously. 1 Supportive care with granulocyte-colony-stimulating factor (G-CSF) was given during the intensive chemotherapy cycles. Between January 1992 and July 1997, patients received G-CSF at a dose of 10 g/kg subcutaneously daily, starting 24 hours after chemotherapy (on Day 5 of the induction chemotherapy with the hyper-CVAD cycles and on Day 4 of the MTX/ Ara-C cycles) and continuing until the absolute granulocyte levels were at least 3 ϫ 10 9 /L.…”

Section: Therapymentioning

confidence: 99%

“…1 Hyperglycemia is a common side effect of steroid therapy and is not uncommon during the treatment of ALL.…”

mentioning

confidence: 99%

Relation between the duration of remission and hyperglycemia during induction chemotherapy for acute lymphocytic leukemia with a hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone/methotrexate–cytarabine regimen

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Cabanillas

Konopleva

et al. 2004

Cancer

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Objective To use juvenile dermatomyositis (DM) survey data and expert opinion to develop a small number of consensus treatment protocols, which reflect current initial treatment of moderately severe juvenile DM. Methods A consensus meeting was held in Toronto, Ontario, Canada on December 1–2, 2007. Nominal group technique was used to achieve consensus on treatment protocols, which represented typical management of moderately severe juvenile DM. Consensus was also reached as to which patients these protocols would be applicable (inclusion and exclusion criteria), which initial investigations should be done prior to initiating one of these protocols, which data should be collected to evaluate these protocols, and the concomitant interventions required or recommended. Results Three protocols that described the first 2 months of treatment were developed. All protocols included corticosteroids and methotrexate. One protocol also included intravenous gamma globulin. Consensus was achieved for all issues that were addressed by conference participants, although there were some areas of controversy. Conclusion Despite considerable variation in clinical practice, it is possible to achieve consensus on the initial treatment of juvenile DM. Once these protocols are extended beyond 2 months, these protocols will be available for clinical use. By using methods that account for differences between patients (confounding by indication), the comparative effectiveness of the protocols will be evaluated. In the future, the goal will be to identify the optimal treatment of moderately severe juvenile DM.

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“…Since 1999, guidelines for trimethoprim -sulphamethoxazole (TMP -SMX) prophylaxis have been utilised in patients receiving selected high-intensity chemotherapy protocols: hyper-CVAD (Kantarjian et al, 2000), VAD (Barlogie et al, 1984), CEVAD and FLAG (Estey et al, 1994). Adherence to the guidelines and frequency of chemoprophylaxis in other patients with haematological malignancy or solid tumours is unknown.…”

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confidence: 99%

An analysis of the utilisation of chemoprophylaxis against Pneumocystis jirovecii pneumonia in patients with malignancy receiving corticosteroid therapy at a cancer hospital

et al. 2005

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Pneumocystis jirovecii pneumonia (PCP) is associated with high mortality in immunocompromised patients without human immunodeficiency virus infection. However, chemoprophylaxis is highly effective. In patients with solid tumours or haematologic malignancy, several risk factors for developing PCP have been identified, predominantly corticosteroid therapy. The aims of this study were to identify the potentially preventable cases of PCP in patients receiving corticosteroid therapy at a tertiary care cancer centre and to estimate the frequency of utilisation of chemoprophylaxis in these patients. Two retrospective reviews were performed. Over a 10-year period, 14 cases of PCP were identified: no cases were attributable to failed chemoprophylaxis, drug allergy or intolerance. During a 6-month period, 73 patients received high-dose corticosteroid therapy (X25 mg prednisolone or X4 mg dexamethasone daily) for X4 weeks. Of these, 22 (30%) had haematologic malignancy, and 51 (70%) had solid tumours. Fewer patients with solid tumours received prophylaxis compared to patients with haematologic malignancy (3.9 vs 63.6%, Po0.0001). Guidelines for PCP chemoprophylaxis in patients with haematologic malignancy or solid tumours who receive corticosteroid therapy are proposed. Successful primary prevention of PCP in this population will require a multifaceted approach targeting the suboptimal prescribing patterns for chemoprophylaxis.

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Results of Treatment With Hyper-CVAD, a Dose-Intensive Regimen, in Adult Acute Lymphocytic Leukemia

Abstract: Hyper-CVAD therapy is superior to our previous regimens and should be compared with established regimens in adult ALL.

Cited by 706 publications

References 66 publications

Complete remission in advanced blastic NK‐cell lymphoma/leukemia in elderly patients using the hyper‐CVAD regimen

Complete remission in advanced blastic NK‐cell lymphoma/leukemia in elderly patients using the hyper‐CVAD regimen

Relation between the duration of remission and hyperglycemia during induction chemotherapy for acute lymphocytic leukemia with a hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone/methotrexate–cytarabine regimen

An analysis of the utilisation of chemoprophylaxis against Pneumocystis jirovecii pneumonia in patients with malignancy receiving corticosteroid therapy at a cancer hospital

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