Smoldering acute granulocytic leukemia. Observations on its natural history and morphologic characteristics

Slyck, Ellis J. Van; Rebuck, John W.; Waddell, Caroline C.; Janakiraman, Nalini

doi:10.1001/archinte.143.1.37

Cited by 9 publications

(4 citation statements)

References 24 publications

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“…Smoldering AML has been described as having slower clinical progression and longer survival than overt AML. 16,17 The majority of our patients (n ¼ 14) presented with normal or low blood WBC, many (n ¼ 11) having no peripheral blood blasts. It is conceivable that some of the patients in our study had smoldering leukemia, which as a selection bias might improve overall survival.…”

Section: Discussionmentioning

confidence: 88%

Treatment of acute myelogenous leukemia with outpatient azacitidine

Sudan

Rossetti

Shadduck

et al. 2006

Cancer

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BACKGROUNDPatients older than 55 years of age with acute myelogenous leukemia (AML) are less likely to achieve complete remission and more likely to experience toxicity with conventional induction chemotherapy than younger patients. Azacitidine administered in the outpatient setting is well tolerated and can induce complete hematological remission in patients with myelodysplastic syndromes (MDS). At higher doses, azacitidine has activity in AML.METHODSTwenty patients were retrospectively identified who had been treated with azacitidine with bone marrow blast counts between 21 and 38%. Patients with blast counts up to 29% were initially treated as MDS, but by WHO now meet criteria for AML. Patients with blast counts over 29% were treated with azacitidine after being deemed poor candidates for induction chemotherapy. Azacitidine 75 mg/m2/day was administered subcutaneously for 7 days every 4 weeks, which was defined as 1 cycle.RESULTSThe overall response rate was 60% (12/20): complete response (CR; n = 4; 20%); partial response (PR; n = 5; 25%); hematologic improvement (HI; n = 3; 15%). The median survival of responders was 15+ months compared with 2.5 months for nonresponders (P = .009). During therapy, responders had an Eastern Cooperative Oncology Group (ECOG) performance status of 1 or 0. The most common toxic event was infection (n = 8). Four patients were hospitalized during the first cycle of treatment.CONCLUSIONSAzacitidine administered in the outpatient setting can induce remission in AML. The therapy is well tolerated and might be an alternative for patients unlikely to tolerate standard induction chemotherapy. Cancer 2006. © 2006 American Cancer Society.

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Section: Discussionmentioning

confidence: 88%

Treatment of acute myelogenous leukemia with outpatient azacitidine

Sudan

Rossetti

Shadduck

et al. 2006

Cancer

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“…Whether the same would apply in patients in various cytogenetic subsets, or, particularly, in patients with poor performance status is open to question. In noncomparative trials, the median survival in patients given palliative care has been reported to vary from 3–9 months,25, 26 undoubtedly depending on the patients included in the relevant series. Very occasionally, patients with untreated AML can survive for more than a year; this possibility would exist only in patients with low white blood cell (WBC) counts.…”

Section: Standard Therapy Of Amlmentioning

confidence: 99%

Therapeutic options for acute myelogenous leukemia

Estey

2001

Cancer

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BACKGROUND General therapeutic options for patients with acute myelogenous leukemia (AML) are reviewed and specific new therapies are described. METHODS Data in this review came from the published literature and the M. D. Anderson Cancer Center's acute leukemia database. RESULTS Outcome following standard therapy of AML is so variable that is best to speak of a range of outcomes determined by various prognostic factors. Therapy can (and usually does) fail because of treatment‐induced mortality or (more usually) resistance to therapy. Performance status and age are the principal predictors of early death, whereas cytogenetics, a history of abnormal blood counts, and MDR1 expression are predictors of resistance. Using this information, physicians can categorize patients into those in whom 1) standard therapy is indicated, 2) either standard or investigational therapy is appropriate, and 3) investigational therapy is indicated. The majority of even newly diagnosed patients belong to Group 3. The availability of allogeneic or autologous transplantation does not alter this conclusion. Investigational therapies have been developed that are directed against the CD33 surface antigen, the multidrug‐resistant MDR1 protein, and other targets. Because of the number of new therapies clinical research in AML should emphasize pilot trials rather than traditionally large Phase III studies. CONCLUSIONS Most patients with newly diagnosed AML should be offered investigational regimens. Cancer 2001;92:1059–73. © 2001 American Cancer Society.

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“…The term smoldering (oligoblastic) acute leukemia was introduced several years ago [18] to distinguish a subleukemic panmyelopathy whose characteristics are: (a) hypercellular bone marrow showing maturation arrest and some other features of ANLL, although with an accumulation of marrow blast cells lower than that ob served in conventional acute leukemias; (b) in most cases the bone marrow ineffec tive dyshemopoiesis leads to a pancytopenic blood picture without leukemic ex pression or with a minimal number of pe ripheral blast cells, and (c) this condition usually occurs in elderly people (preferen t i a l males) with an indolent course [7,8,10,14,23].…”

Section: Discussionmentioning

confidence: 99%

Biological Significance of Nonlymphocytic Oligoblastic Leukemia

Sánchez-Fayos¹,

Outeiriño²,

Calabuig³

et al. 1984

Acta Haematol

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Kinetic studies of marrow dividing granulocytic precursors (mitotic index and flash labeling index with ³H-TDR) were carried out in 11 patients with oligoblastic leukemia (OBL). The results were compared with similar data from cases of conventional acute non-lymphocytic leukemia (ANLL). The cytokinetic results were as follows: MI (%) in OBL, mean = 0.75; MI (%) in ANLL, mean = 0.66; p > 0.7; LI (%) in OBL, mean= 15.0; LI (%) in ANLL, mean= 15.4, p > 0.7. The lack of cytokinetic differences between these two groups of patients stands in favor of the hypothesis that OBL might represent a special type of smoldering leukemia with a ‘plateau’ of blast cell accumulation established at a subleukemic level.

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Smoldering acute granulocytic leukemia. Observations on its natural history and morphologic characteristics

Cited by 9 publications

References 24 publications

Treatment of acute myelogenous leukemia with outpatient azacitidine

Treatment of acute myelogenous leukemia with outpatient azacitidine

Therapeutic options for acute myelogenous leukemia

Biological Significance of Nonlymphocytic Oligoblastic Leukemia

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