Special Clinical Concerns/ Problems in the Management of MDS and Sedondary Acute Myeloid Leukemias
Management of patients with myelodysplastic syndromes (MDS) and acute myeloid leukemias arising from pre-existing MDS (Secondary AML, sAML) presents many unique problems to the treating physician. These patients are often elderly and are at high risk for life threatening complications of treatment. Recurrent infections and a history of multiple blood product transfusions complicate the clinical management and compromise their ability to tolerate therapy. Drug resistance and the frequent occurrence of cytogenetic abnormalities result in lower remission rates and decreased long term responses. This chapter will review these unique aspects of management of these patients.
KeywordsAcute Myeloid Leukemia Acute Myelogenous Leukemia Cytosine Arabinoside Gemtuzumab Ozogamicin Secondary Acute Myeloid Leukemia
Unable to display preview. Download preview PDF.
- Burnett AK, Goldstone AH, Stevens RM (1998) Randomized comparison of addition of autologous bone-marrow transplantation to intensive chemotherapy for acute myeloid leukemia in first remission: Results of MRC AML 10 trial. UK Medical Research Council Adult and Children’s Leukemia Working Parties.Lancet351:700–708.PubMedCrossRefGoogle Scholar
- Extrov Z, Kurzrock R, Wetzler M, Kantarjian H, Blake M, Harris D, Gutterman J, Talpaz M (1991) Suppression of chronic myelogenous leukemia colony growth by interleukin-1 (ILl) receptor antagonist and soluble IL-1 receptors; a novel application for inhibitors of IL-1 activity.Blood78 (6):1476.Google Scholar
- Mamani, D, Venugopal P, Coon J, Preisler H., (2001): Immunophenotypic profile of leukemic cells from acute myeloid leukemia (AML) patients at diagnosis and after a three-day course of cytokine administration. Proceedings of the American Society of Clinical Oncology.Google Scholar
- Preisler H, Venugopal P, Sivaraman S, Manson S (2000b) Abnormalities of Poliferation control in AML:Blood96: abstract #4428.Google Scholar
- Preisler H, Larson RA, GoldbergJTricot G, Raza A, Venugopal P, Gregory S, Adler A.,(1999) The administration of retinoic acid/alpha-interferon between courses of cemotherapy results in very long remissions and a high proportion of apparent cures in AML:Blood95: abstract # 1306.Google Scholar
- Rambaldi A, Torcia M, Bettoni S, Vannier E, Barbui T, Shaw A, Dinarello C, Cozzolino (1991) Modulation of cell proliferation and cytokine production in acute myeloblastic leukemia by interleukin-1 receptor antagonist and the lack of its expression by leukemic cells.Blood78: 3248.PubMedGoogle Scholar
- Raza A, Lisam L, Andrews C, Little L, Muzammil M, Alvi S, Mazzoran L, Zorat F, Akber A, Ekbal M, Razvi S, Venugopal P., (1999) Thalidomide produces transfusion independence in patieints with long-standing refractory anemias and myelodysplastic syndromes (MDS).Blood94:661a, abstract #2935.Google Scholar
- Sievers EL, Applebaum FR, Spielberger RT, Forman SJ, Flowers D, Smith FO, shannon-Dorcy K, Berger MS, Bernstein ID (1999a) Selective ablation of acute myeloid leukemia using antibody-targetsd chemotherap: a phase I Study of an anti-CD33 calicheamicin immunocojugate.Blood93: 3678–3684.Google Scholar
- Sievers EL, Larson RA, Estery E, Stadtmauer EA, Erba HP, Roy DC, Tarantolo S, Spielberger R, Berger MS, Eten C, Manley L, Stone A, Bernstein I, Applebaum FR ,(1999b): Efficacy and safety of CMA-676 inpatients with AML in first relapse.Blood94:abst#307a.Google Scholar
- Tao M, Li B, NayiniJSivaraman S, Song S, Larson A, Toofanfard M, Chen H, Venugopal P, Preisler H, (2000) Regulation of serum cytokines following 1L-4 and IL-10 therapy in patients with acute myelogenous leukemia.Blood96:abstract #1403.Google Scholar
- Walters RS, Kantarjian HM, Keating MJ (1998) Mitoxantrone and high-dose cytosine arabinoside in refractory acute myelogenous leukemia.Cancer15:677–82.Google Scholar