Refractory acute leukaemia in adults treated with sequential colaspase and high-dose methotrexate.

Thirty-nine adults with acute leukaemia who had relapsed when receiving extensive chemotherapy were treated with a combination of methotrexate and colaspase (L-asparaginase) given sequentially. Patients initially received 50-80 mg/m(2) methotrexate, followed three hours later by intravenous colaspase, 40 000 IU/m(2). Seven days later intravenous methotrexate, 120 mg/m(2) was given.

Chemotherapy of acute leukemia: a comparison of vincristine, cytarabine, and prednisone alone and in combination with cyclophosphamide or daunorubicin.

Adults (274) with acute leukemia (AML) were randomly assigned to one of three treatment regimens: vincristine, prednisone, cytarabine--(1) 100 mg/sq m/day with cyclophosphamide (COAP); (2) 100 mg/sq m/day with daunorubicin (DOAP); and 200 mg/sq m/day (OAP). Cytarabine was infused continuously for five days. Patients entering complete remission randomly received maintenance treatment with COAP or OAP.

Autologous bone marrow transplantation in patients with adult acute leukemia in relapse.

Nine patients with adult acute leukemia were treated in relapse with piperazinedione plus supralethal total body irradiation in conjunction with autologous marrow infusion. Bone marrow cells were collected and stored in first remission. Storage time varied from 3 to 23 months.

Disseminated BCG disease associated with immunotherapy by scarification in acute leukemia.

Disseminated BCG infection developed in a patient with acute leukemia receiving BCG immunotherapy by scarification. Predisposing factors included the underlying malignancy, intensive chemotherapy, and continuous high-dose corticosteroids. The scarification technique is safe; however, physicians should be alert to this syndrome as a cause of fever of unknown origin in cancer patients receiving BCG immunotherapy.

Randomized trial of protected environment--prophylactic antibiotics in 145 adults with acute leukemia.

One hundred and forty-five adults with acute leukemia were randomized to receive remission induction therapy in or out of a protected environment (PE) with prophylactic antibiotics orally (PA) or systemically (SA). Sixty-three patients were randomized in PE and 82 outside a PE. The proportion of patients who survived long enough to receive an adequate trial was higher in the PE (97%) than out (82%) (P = .

Isophosphamide therapy for hematologic malignancies in patients refractory to prior treatment.

Isophosphamide was administered to 27 patients with acute leukemia and to 15 patients with malignant lymphoma refractory to primary therapy. The starting dose of isophosphamide was 1200 mg/m2 administered as a daily continuous infusion x 5 days; the courses of treatment were repeated every 2-3 weeks. Of the 27 patients with acute leukemia, four achieved complete remission, two achieved partial remission, and two achieved hematologic improvement.

Effect of plasma exchange on circulating immune complexes and antibody formation in patients treated with cyclophosphamide and prednisone.

A patient with systemic lupus erythematosus (SLE) and a patient with an immune complex disease resembling Goodpasture's syndrome were treated with cyclophosphamide, prednisone and repeated plasma exchanges. Circulating immune complexes decreased, and symptoms of central nervous system disease remitted for up to 15 to 20 days after plasma exchange in the patient with SLE. In vitro lymphocyte blastogenic responses to antigens were also transiently increased on two occasions following treatment.

Pharmacologic studies of continuous infusion of arabinosylcytosine by liquid infusion system.

Arabinosylcytosine (ara-C) was administered by prolonged intravenous infusion with a portable liquid infusion system (LIS) to patients with acute myelogenous leukemia. With the use of tritiated ara-C and this portable system, pharmacologic studies were performed in 8 patients. Most of the plasma radioactivity is in the deaminated product, arabinosyluracil (ara-U).

Frequency of HLA antigens in chronic myelocytic leukemia.

Histocompatibility antigen (HLA) phenotypes of 34 patients with Ph1+ chronic myelogenous leukemia (CML) were evaluated for association with HLA antigens. Two control populations were compared to the CML patients: 142 normal volunteer platelet donors, and 160 normal donors of granulocyte transfusions. HLA typing was done by lymphocyte microcytotoxicity tests for nine antigens on sublocus A and 15 antigens on sublocus B.

The early detection of remission in acute myelogenous leukaemia by in vitro cultures.

Twenty-eight cases of acute myeloid leukaemia without normal myeloid colony growth in vitro were serially cultured by an in vitro agar culture method during remission induction therapy. Colony formation frequently returned before morphological evidence of remission. Without early return of colony formation drug induced aplasia was prolonged and fatal.

Current concepts in acute leukemia.

Using chemotherapeutic agents in combination instead of separately has significantly improved the outlook for patients with acute leukemia. The rate and duration of complete remission have both increased substantially. Immunotherapy, recently introduced for use with chemotherapy, appears to prolong survival.

A simplified in vitro classification for prognosis in adult acute leukemia: the application of in vitro results in remission-predictive models.

Previous classification in vitro of adult acute leukemia incorporating morphology has been complex and difficult to understand. We have devised a simplified classification based solely on leuekemic proliferation in vitro. Seventy-six patients with adult acute leukemia previously untreated were included in this study and received identical chemotherapy.