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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
5-6
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pubmed:dateCreated |
1998-1-27
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pubmed:abstractText |
Relapse in acute myeloid leukemia (AML) following intensive chemotherapy bears a bad prognosis. We treated 18 children with relapsed AML on two separate protocols that included continuous infusion (CI) of cytosine arabinoside (ara-C) (total dose 4gr-6gr/m2) over 96-120 hours. In an attempt to increase the fraction of blasts in S-phase and render them more sensitive to cell-cycle specific agents such as ara-C, 10 patients received 5mcg/kg rhG-CSF twice daily beginning 48 hours before and continuing through the duration of the CI ara-C (POG #9192 study). The percentage of cells is S phase before and after G-CSF administration was determined. In a second group of patients (n = 8) who received ara-C alone, endogenous concentrations of G-CSF and serial blood counts were measured (St Jude's R4 study). The rationale of the St Jude's R4 was to optimize the schedule of the second course of ara-C at a time when the patient's endogenous G-CSF concentration was increased and thus maximize the percent of cells captured in S phase. Four out of 8 patients receiving CI ara-C alone and 4 out of 10 patients receiving CI ara-C with rhG-CSF achieved a complete remission (CR) after 1 cycle of therapy. Four patients in CR underwent marrow transplantation (2 allogeneic and 2 autologous). Cell cycle analysis of blast cells cultured in vitro with or without G-CSF showed a two fold increase in the percentage of cells in S phase (P = 0.03) whereas cells obtained from patients before and after G-CSF administration showed no difference in cell cycling. Correlation between G-CSF concentrations and ANC showed a negative association indicating that the regulatory mechanisms for G-CSF production remained intact. In our relatively small series, CI ara-C achieved a CR rate of 44% with rhG-CSF having no effect on the remission rate. Although in vitro rhG-CSF increased the percentage of blasts in S phase significantly, in vivo effects were not observed. Larger studies with combinations of different hematopoietic growth factors and cell-cycle active drugs are needed to evaluate the role of these cytokines in the therapy of recurrent AML.
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pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
IM
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pubmed:chemical | |
pubmed:status |
MEDLINE
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pubmed:month |
Aug
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pubmed:issn |
1042-8194
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:volume |
26
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
589-93
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pubmed:dateRevised |
2006-4-24
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pubmed:meshHeading |
pubmed-meshheading:9389365-Acute Disease,
pubmed-meshheading:9389365-Adolescent,
pubmed-meshheading:9389365-Antineoplastic Combined Chemotherapy Protocols,
pubmed-meshheading:9389365-Child,
pubmed-meshheading:9389365-Child, Preschool,
pubmed-meshheading:9389365-Cytarabine,
pubmed-meshheading:9389365-Female,
pubmed-meshheading:9389365-Granulocyte Colony-Stimulating Factor,
pubmed-meshheading:9389365-Humans,
pubmed-meshheading:9389365-Infusions, Intravenous,
pubmed-meshheading:9389365-Leukemia, Myeloid,
pubmed-meshheading:9389365-Male,
pubmed-meshheading:9389365-Pilot Projects,
pubmed-meshheading:9389365-Recombinant Proteins,
pubmed-meshheading:9389365-S Phase
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pubmed:year |
1997
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pubmed:articleTitle |
A pilot study of continuous infusion Ara-C in combination with rhG-CSF in relapsed childhood acute myeloid leukemia.
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pubmed:affiliation |
Pediatric Oncology Group, Chicago, IL, USA.
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pubmed:publicationType |
Journal Article,
Clinical Trial
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