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Cancer
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Elyce Cardonick, Charlotte Maggen, Puja Patel
Leukemic blasts can accumulate in peripheral blood causing significant leukocytosis which occludes the vasculature and can lead to respiratory or neurologic disease. This can be further aggravated by pregnancy. Treatment may require urgent leukapheresis at any gestational age [77]. Chemotherapy after the first trimester would be similar to regimens used for non-pregnant women including cytarabine and an anthracycline. For concerns with idarubicin mentioned previously, daunorubicin is recommended instead of idarubicin in pregnancy.
Differentiation Induction in Acute Promyelocytic Leukemia
Published in Gertjan J. L. Kaspers, Bertrand Coiffier, Michael C. Heinrich, Elihu Estey, Innovative Leukemia and Lymphoma Therapy, 2019
It is not clear if one anthracycline or the other is more effective for induction in APL. Fenaux et al. prospectively randomized patients to either rubidizone or amsacrine, each with ara-C, without observing a difference between the anthracyclines (19). There was a suggestion in a retrospective analysis that idarubicin was associated with an improved outcome, but no prospective randomized trial compared idarubicin with other anthracyclines (20). Although anthracyclines improve OS, early death from bleeding and high relapse rates characterize the predifferentiation era of APL treatment.
I
Published in Caroline Ashley, Aileen Dunleavy, John Cunningham, The Renal Drug Handbook, 2018
Caroline Ashley, Aileen Dunleavy, John Cunningham
A phase II study instilled 6.25–12.5 mg of idarubicin diluted in 45 mL of sodium chloride 0.9% (0.125–0.25 mg/mL) into the bladder of patients with resected recurrent bladder cancer although it may not be any more effective than doxorubicin or epirubicin and toxicity may limit its use. (Boccardo F, Cannata D, Cussotto M, et al. Intravesical idarubicin: a dose-finding study. Cancer Chemother Pharmacol. 1996; 38(1): 102-5.)
A review of treatment options employed in relapsed/refractory AML
Published in Hematology, 2023
Mohamed Zakee Mohamed Jiffry, Robert Kloss, Mohammad Ahmed-khan, Felipe Carmona-Pires, Nkechi Okam, Prabasha Weeraddana, Dinusha Dharmaratna, Mehndi Dandwani, Kayvon Moin
Patients with r/r AML are especially encouraged to participate in clinical trials investigating targeted therapies based on the mutation profile for the patient’s particular AML. Allogeneic HCT should be strongly considered for patients with r/r AML, although as previously discussed, transplant eligibility is contingent on several other factors such as patient’s age and comorbidities. Aggressive therapeutic regimens that may be considered for appropriate patients with r/r AML per the National Comprehensive Cancer Network (NCCN) guidelines are listed below [95]. These recommendations are category 2A unless otherwise indicated: CLAG ± idarubicin, CLAG-M.HiDAC (must not have previously received such treatment) ± mitoxantrone/idarubicin.FLAG, FLAG-IDA.MEC.Clofarabine +IDAC ± idarubicin.
Characteristics and prognosis of pediatric myeloid sarcoma in the cytogenetic context of t(8;21)
Published in Pediatric Hematology and Oncology, 2021
Guanhua Hu, Aidong Lu, Jun Wu, Yueping Jia, Yingxi Zuo, Mingming Ding, Leping Zhang
The 3-year OS rate of patients with t(8;21) was 86.8 ± 3.1% in this study, which is higher than that in studies reported by the International Berlin-Frankfurt-Münster Study Group (74.0 ± 1.5%)12 and Children’s Oncology Group (80.0%).13 The better prognosis may be due to the extended consolidation chemotherapy time and the application of harringtonine and idarubicin. In this study, the proportion of patients with t(8;21) AML with MS was 23.6%, which was close to the incidence of Japanese childhood MS reported by Kobayashi et al.5 The average age of patients in the MS group was 9.2 ± 3.5 years; there were no age differences between the AML groups with and without MS. The proportion of males in patients with MS was significantly higher than that in patients without MS (73% vs. 55%, p = 0.00), suggesting that males might be more likely to develop extramedullary lesions.
The role of circular RNA plasmacytoma variant translocation 1 as a biomarker for prognostication of acute myeloid leukemia
Published in Hematology, 2021
AML patients received standard IA or DA regimen for induction therapy according to the NCCN guideline (version 2. 2013) [14]. The IA regimen included idarubicin 12 mg/(m2*day), day 1–3, intravenous drip for 30 min, cytarabine (Ara-c) 200 mg/(m2*day), day 1-7, every 12 h (q12h), hypodermic injection. The DA regimen included daunorubicin 90 mg/(m2*day), day 1–3, intravenous drip for 30 min, Ara-c 200 mg/(m2*day), day 1–7, every 12 h (q12h), hypodermic injection. Response assessment was commonly performed between day 21 and 28 after the start of induction therapy. Meanwhile, remission status was assessed according to the criterion submitted by NCCN (version 2. 2013) [14], in which CR was defined as (meeting all the following conditions): absolute neutrophil count >1000/mcL, platelets ≥ 100,000/mcL, BM blasts less than 5%, transfusion independence and no residual evidence of extramedullary disease. Partial remission (PR) was defined as: decrease of at least 50% in the percentage of blasts to 5% to 25% in the BM aspirate and the normalization of blood counts, as noted above. After induction therapy, patients with CR continued the original regimen for consolidation therapy, followed by consolidation chemotherapy or hematopoietic stem cell transplantation (HSCT), and those without CR received reinduction therapy, followed by consolidation chemotherapy or HSCT.