Abstract:
:The Eastern Cooperative Oncology Group (ECOG) conducted a randomized trial in patients less than or equal to 65 years old (median, 44 years) to determine whether increasing the intensity of postremission therapy in acute myeloid leukemia (AML) would improve the outcome. After uniform induction therapy, patients in complete remission (CR) who were less than 41 years old and who had a histocompatible sibling underwent allogeneic bone marrow transplantation (alloBMT) (54 patients). The remainder of patients in CR were randomized to receive either 2 years of continuous outpatient maintenance therapy with cytarabine and 6-thioguanine (83 patients) or a single course of inpatient consolidation therapy consisting of 6 days of high-dose cytarabine plus 3 days of amsacrine (87 patients). The median duration of follow-up is now 4 years, and patients are included in the analyses of outcome regardless of whether they relapsed before starting the intended treatment. Four-year event-free survival (EFS) was 27% +/- 10% for consolidation therapy versus 16% +/- 8% for maintenance therapy (P = .068) and 28% +/- 11% versus 15% +/- 9% (P = .047) in patients less than 60 years old. The outcome for patients receiving alloBMT was compared with the subset of patients less than 41 years old who received consolidation therapy (N = 29) or maintenance therapy (N = 21). Four-year EFS was 42% +/- 13% for alloBMT, 30% +/- 17% for consolidation therapy, and 14% +/- 15% for maintenance therapy. AlloBMT had a significantly better EFS (P = .013) than maintenance therapy, but was not different from consolidation therapy. In patients less than 41 years old, 4-year survival after alloBMT (42% +/- 14%) did not differ from consolidation therapy (43% +/- 18%), but both were significantly better than maintenance therapy (19% +/- 17%), P = .047 and .043, respectively. The mortality rate for maintenance therapy was 0%, consolidation therapy, 21%; and alloBMT, 36%. Consolidation therapy caused an especially high mortality rate in the patients greater than or equal to 60 years old (8 of 14 or 57%). The toxicity of combined high-dose cytarabine and amsacrine is unacceptable, especially in older patients, and alternative approaches to consolidation therapy such as high-dose cytarabine alone need to be tested. In AML, a single course of consolidation therapy or alloBMT after initial CR produces better results than lengthy maintenance therapy. Although EFS and survival of alloBMT and consolidation therapy do not differ significantly, a larger number of patients need to be studied before concluding that they are equivalent.
journal_name
Bloodjournal_title
Bloodauthors
Cassileth PA,Lynch E,Hines JD,Oken MM,Mazza JJ,Bennett JM,McGlave PB,Edelstein M,Harrington DP,O'Connell MJsubject
Has Abstractpub_date
1992-04-15 00:00:00pages
1924-30issue
8eissn
0006-4971issn
1528-0020journal_volume
79pub_type
临床试验,杂志文章,随机对照试验相关文献
BLOOD文献大全abstract::Development of acute graft-versus-host disease (aGVHD) predisposes to chronic GVHD with autoimmune manifestations. A characteristic of experimental aGVHD is the de novo generation of autoreactive T cells. Central tolerance is dependent on the intrathymic expression of tissue-restricted peripheral self-antigens (TRA), ...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2012-12-474759
更新日期:2013-08-01 00:00:00
abstract::Although the rheologic behavior of sickle erythrocytes (SS cells) is highly dependent on oxygen tension (pO2) and temperature, very little data exist regarding the effects of deoxygenation and reoxygenation on the rheology of "individual" SS cells at body temperature. We have devised and assessed a new experiment syst...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1992-04-15 00:00:00
abstract::There is considerable interest in identifying nontoxic differentiation inducers for the treatment of various malignant and nonmalignant blood disorders, including inborn beta-chain hemoglobinopathies. Using the human leukemic K562 cell line as a model, we explored the efficacy of phenylacetate, an amino acid derivativ...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1992-09-15 00:00:00
abstract::In France, more than 80% of children with Burkitt's lymphoma or Burkitt's leukemia (ALL3) are now cured with the LMB (B-cell non-Hodgkin's lymphoma and B-ALL) protocols of the Société Française d'Oncologie Pédiatrique, but so far, poor results have been obtained in the few adult studies available. We have analyzed the...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1995-02-01 00:00:00
abstract::The relationship between platelet density and platelet age appears to vary between species with relatively few labeling studies in humans reported. In this study, irreversible monoamine oxidase (MAO) inhibitors were used to biochemically label the circulating platelet population in 15 humans. Platelet samples were the...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1989-04-01 00:00:00
abstract::Adult-onset hemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening disease of immune hyperactivation. Unlike pediatric HLH, adult HLH is rarely driven by germline genetic variants. Although numerous precipitating etiologies have been identified, the reason that HLH occurs in only a subset of individuals ...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood.2020008206
更新日期:2020-12-24 00:00:00
abstract::Patients aged ≥60 years with treatment-naive Hodgkin lymphoma (HL) have few treatment options and inferior survival due to treatment-related toxicities and comorbidities. This phase 2, nonrandomized, open-label study evaluated brentuximab vedotin (BV) monotherapy (results previously reported), BV plus dacarbazine (DTI...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2017-06-787200
更新日期:2017-12-28 00:00:00
abstract::Families with 3 different syndromes characterized by autosomal dominant inheritance of low platelet count and giant platelets were studied. Fechtner syndrome is an autosomal-dominant variant of Alport syndrome manifested by nephritis, sensorineural hearing loss, and cataract formation in addition to macrothrombocytope...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:2000-11-15 00:00:00
abstract::Setdb1, also known as Eset, is a methyltransferase that catalyzes trimethylation of H3K9 (H3K9me3) and plays an essential role in the silencing of endogenous retroviral elements (ERVs) in the developing embryo and embryonic stem cells (ESCs). Its role in somatic stem cells, however, remains unclear because of the earl...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2016-01-694810
更新日期:2016-08-04 00:00:00
abstract::Alteration of lineage-specific transcriptional programs for hematopoiesis causes differentiation block and promotes leukemia development. Here, we show that AML1/ETO, the most common translocation fusion product in acute myeloid leukemia (AML), counteracts the activity of retinoic acid (RA), a transcriptional regulato...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2006-09-045781
更新日期:2007-05-15 00:00:00
abstract::The Bcl-2 proto-oncogene was discovered at the t(14;18) breakpoint found in most follicular B-cell lymphomas and some diffuse large-cell lymphomas. Bcl-2 is unique among proto-oncogenes, being localized to mitochondria and extending cell survival by blocking programmed cell death. We examined Bcl-2 protein expression ...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1991-08-15 00:00:00
abstract::Macrophages infiltrating solid tumors exhibit a tumor-supporting phenotype and are critical for tumor development. Little is known which tumor-derived signal provokes this phenotype shift and how these signals are interpreted in macrophages to support tumor growth. We used the supernatant of apoptotic cells and notice...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2009-01-201889
更新日期:2009-09-03 00:00:00
abstract::AALL07P2 evaluated whether substitution of Erwinia asparaginase 25000 IU/m(2) for 6 doses given intramuscularly Monday/Wednesday/Friday (M/W/F) to children and young adults with acute lymphoblastic leukemia and clinical allergy to pegaspargase would provide a 48-hour nadir serum asparaginase activity (NSAA) ≥ 0.10 IU/...
journal_title:Blood
pub_type: 临床试验,杂志文章
doi:10.1182/blood-2013-01-480822
更新日期:2013-07-25 00:00:00
abstract::Adoptive transfer of patient-derived T cells modified to express chimeric antigen receptors (CARTs) has demonstrated dramatic success in relapsed/refractory pre-B-cell acute lymphoblastic leukemia (ALL), but response and durability of remission requires exponential CART expansion and persistence. Tumors are known to a...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2017-12-815548
更新日期:2018-11-01 00:00:00
abstract::Ecotropic viral integration site 1 (Evi1) is one of the master regulators in the development of acute myeloid leukemia (AML) and myelodysplastic syndrome. High expression of Evi1 is found in 10% of patients with AML and indicates a poor outcome. Several recent studies have indicated that Evi1 requires collaborative fa...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2011-07-368654
更新日期:2013-05-16 00:00:00
abstract::Factor V Leiden (factor V Arg506Gln), the genetic defect underlying resistance to activated protein C, is the most common risk factor for venous thrombosis. The relationship between this genetic abnormality and arterial disease is still unresolved. To assess whether factor V Leiden increases the risk of myocardial inf...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1997-04-15 00:00:00
abstract::Thirty-two patients treated on consecutive Southwest Oncology Group (SWOG) protocols for malignant lymphoma were subsequently diagnosed as having lymphoblastic lymphoma. Combination chemistry, usually adriamycin-based, produced complete responses (CR) in 17 patients (53%). Median survival was 15 mo. Patients achieving...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1981-01-01 00:00:00
abstract::With the introduction of genomic technologies, more hereditary cancer syndromes with hematologic malignancies are being described. Up to 10% of hematologic malignancies in children and adults may be the result of an underlying inherited genetic risk. Managing these patients with hereditary hematologic malignancies, in...
journal_title:Blood
pub_type: 杂志文章,评审
doi:10.1182/blood-2016-06-716704
更新日期:2016-11-24 00:00:00
abstract::Acute myeloid leukemia (AML) cells are characterized by unlimited self-renewal and an impaired capacity to undergo terminal differentiation. The MUC1 oncoprotein is aberrantly expressed in AML cells; however, there has been no evidence for involvement of MUC1 in myeloid leukemogenesis. Cell-penetrating peptide inhibit...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2010-10-296632
更新日期:2011-05-05 00:00:00
abstract::Direct sequencing of VWF genomic DNA in 21 patients with type 3 von Willebrand disease (VWD) failed to reveal a causative homozygous or compound heterozygous VWF genotype in 5 cases. Subsequent analysis of VWF mRNA led to the discovery of a deletion (c.221-977_532 + 7059del [p.Asp75_Gly178del]) of VWF in 7 of 12 white...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2008-08-173278
更新日期:2009-07-30 00:00:00
abstract::The immunoreceptors NKG2D and NKp46 are known for their capacity to activate natural killer (NK) cell cytotoxicity and secretory responses in the contexts of tumors and infections, yet their roles in NK cell education remain unclear. Here, we provide the first characterization of mice deficient for both NKG2D and NKp4...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2012-12-471607
更新日期:2013-06-20 00:00:00
abstract::Large granular lymphocytes (LGL) are defined as nonadherent mononuclear cells with cytoplasmic azurophilic granules, avid receptors for the Fc portion of IgG, and cytotoxic functions (NK or ADCC activities). In the present study, the granules of LGL isolated from human peripheral blood have been analyzed by enzyme cyt...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1982-02-01 00:00:00
abstract::Professional antigen-presenting cells (APCs) are sentinel cells of the immune system that present antigen to T lymphocytes and mediate an appropriate immune response. It is therefore surprising that knowledge of the professional APCs in human lymph nodes is limited. Using 3-color immunohistochemistry, we have identifi...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2008-06-165266
更新日期:2009-02-05 00:00:00
abstract::CD44 is a widely distributed cell surface glycoprotein whose principal ligand has been identified as hyaluronic acid (HA), a major component of the extracellular matrix (ECM). Recent studies have demonstrated that activation through CD44 leads to induction of effector function in T cells and macrophages. In the curren...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1997-04-15 00:00:00
abstract::A hairy cell leukemia population was used as a clonal model for studying the direct immunomodulatory effects of recombinant interferon-alpha A (rIFN-alpha A) and rIFN-gamma on human B-cell proliferation. The leukemic cell population KON was notably quiescent when incubated in medium alone but was induced to significan...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1988-11-01 00:00:00
abstract::Intensive leukapheresis has been used as the initial treatment of chronic granulocytic leukemia (CGL) in six patients. The number of leukaphereses ranged from 3 in 7 days to 13 in 39 days (mean, 8 in 22 days). The procedures were well tolerated, and in all patients there was improvement in hematologic values, in most ...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1975-12-01 00:00:00
abstract::Juvenile chronic myelocytic leukemia (JCML) is a rare disorder of early childhood. Characteristic of JCML are the progressive appearance of high levels of fetal hemoglobin (HbF), reflecting a true reversion to a fetal type of erythropoiesis, and the presence of colony-forming cells able to grow in vitro spontaneously ...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1995-07-01 00:00:00
abstract::Using data from ARISTOTLE, we describe the periprocedural management of anticoagulation and rates of subsequent clinical outcomes among patients chronically anticoagulated with warfarin or apixaban. We recorded whether (and for how long) anticoagulant therapy was interrupted preprocedure, whether bridging therapy was ...
journal_title:Blood
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1182/blood-2014-08-595496
更新日期:2014-12-11 00:00:00
abstract::We tested baseline positron emission tomography (PET)/computed tomography (CT) as a measure of total tumor burden to better identify high-risk patients with early-stage Hodgkin lymphoma (HL). Patients with stage I-II HL enrolled in the standard arm (combined modality treatment) of the H10 trial (NCT00433433) with avai...
journal_title:Blood
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1182/blood-2017-07-795476
更新日期:2018-03-29 00:00:00
abstract::Mitochondrial DNA (mtDNA) copy number is increased in patients with chronic lymphocytic leukemia (CLL), in Burkitt lymphoma and Epstein-Barr virus-transformed lymphoblastoid cell lines, and in T cells activated via the T-cell receptor. We hypothesized that having a higher mtDNA copy number in peripheral white blood ce...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2008-05-157974
更新日期:2008-11-15 00:00:00