Acute myelogenous leukemia treatment

A detailed study of the 0-linked oligosaccharides present on the surface of normal granulocytes, chronic myelogenous leukemia cells, and acute myelogenous leukemia cells has been completed. Structures were elucidated by f.a.b.-m.s. after permethylation, and methylation analysis before and after specific exo-glycosidase treatments. Some of the components were shown by f.a.b.-m.s. to be poly(N-acetyllactosaminyl) oligosaccharides, for example, 29. 

Topotecan inhibits topoisomerase I to cause single-strand breaks in DNA. The pharmacokinetics of topotecan can be described by a two-compartment model, with a terminal half-life of 80 to 180 minutes, with renal clearance accounting for approximately 70% of the clearance.19 Topotecan has shown clinical activity in the treatment of ovarian and lung cancer, myelodysplastic syndromes, and acute myelogenous leukemia. The intravenous infusion may be daily for 5 days or once weekly. Side effects include myelosuppression, mucositis, and diarrhea. 

Prophylaxis and treatment of hyperuricemia associated with tumor lysis syndrome. ALL, acute lymphoblastic leukemia AML, acute myelogenous leukemia IV, intravenous. (Data from refs. 32 and 33.)... 

Cytarabine (cytosine arabinoside, ara-C, Cytosar-U) is an analogue of the pyrimidine nucleosides cytidine and deoxycytidine. It is one of the most active agents available for the treatment of acute myelogenous leukemia. Cytarabine kills cells in the S-phase of the cycle by competitively inhibiting DNA polymerase. The drug must... 

Cytarabine is used in the chemotherapy of acute myelogenous leukemia, usually in combination with an anthracycline agent, thioguanine, or both. It is less useful in acute lymphoblastic leukemia and the lymphomas and has no known activity against other tumors. It has been used intrathecally in the treatment of meningeal leukemias and lymphomas as an alternative to methotrexate. 

H. Other considerations Leukine has been designated an orphan product for use in the treatment of neutropenia associated with bone marrow transplantation, leukemia, graft failure and delay of engraft-ment, promotion of early engraftment, and to decrease the incidence of death due to infection in patients with acute myelogenous leukemia. 

In view of cytarabine s S phase specificity, the drug is highly schedule-dependent and must be given either by continuous infusion or every 8-12 hours for 5-7 days. Its activity is limited almost entirely to treatment of acute myelogenous leukemia, for which it is a major drug. Adverse effects are listed in Table 55-3. 

Advice for treatment decisions based on specific genetic conditions were found in four Pis, namely that prolastin (a 1-proteinase inhibitor) is not indicated in patients with certain otl -antitrypsin deficiency phenotypes, trastuzumab indicated only in patients with overexpression of the HER2 protein, tretinoin, and imatinib are to be given only in patients with either a specific subtype of acute myelogenous leukemia or Philadelphia chromosome-positive chronic myeloid leukemia, respectively. 

Aldesleukin is indicated for the treatment of metastatic renal cell carcinoma in adults. It is also indicated for the treatment of metastatic melanoma in adults. Research is under way on the use of aldesleukin for the tieatmcni of various cancers (including head and neck cancers), treatmeni of acute myelogenous leukemia, and adjunct therapy in the treatment of Kapasi s sarcoma. Renal and hepatic Unction is typically impaired during therapy with aldesleukin, so interaction with other drugs that undergo elimination by these organs is po.ssible. 

Radioimmunotherapy is generally well tolerated. The major acute toxicities with both radioimmunoconjugates are infusion-related reactions and myelosuppression. I-tositumomab can also cause thyroid dysfunction. The primary concern with radioimmunotherapy is the development of treatment-related myelodysplastic syndrome or acute myelogenous leukemia. ... 

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