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ID 14109
Eprint ID
14109
FullText URL
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Title Alternative
Acute leukemia in the aged : Chemotherapeutic effect of aclarubicin on acute nonlymphocytic leukemia
Author
Nakamura, Tohru
Abstract
To investigate clinical management of acute nonlymphocytic leukemia (ANLL) in the aged, the chemotherapeutic effects of aclarubicin (ACR) were studied in 20 ANLL patients (M1 5, M2 3, M4 5, M5b 6, M6 1). All patients were over 70 years old. The ratio of male to female was 16 : 4 and age ranged from 70 to 84 years old (mediam : 76y/o). Nineteen patients were untreated, one case had previous treament and 2 patients showed hypoplastic marrow on admission. ACR was administered by intravenous drip infusion at a dose of 14mg/m2/day for 7-10 days and repeated after recovery of myelosuppression. Eight patients (40%) obtained complete remission (CR) : 1 of 5 M1 (20%), 3 of 5 M4 (60%), 4 of 6 M5b (66.7%) and none of M2 or M6. CR ratio was 44% in 18 typical ANLL patients excluding the two patients with hypoplastic marrow, who did not attain CR. The duration of CR was from 1.3 to 11.3 months (median : 7.3 months) and survial time ranged from 6.6 to 15.6 months (median : 11.8 months) in patients with CR. Although side effects on the digestive system such as nausea, vomiting and anorexia were seen in 11 of 20 patients, these effects were controllable. None of the patients showed cardiac toxicity. ACR is expected to be useful in the clinical management of ANLL in patients over 70 years old, especially for M4 and 5 in the aged.
Keywords
acute leukemia in the aged
antileukemic chemotherapy
aclarubicin
Note
原著
Published Date
1994
Publication Title
岡山医学会雑誌
Publication Title Alternative
Journal of Okayama Medical Association
Volume
volume106
Issue
issue5-6
Publisher
岡山医学会
Publisher Alternative
Okayama Medical Association
Start Page
587
End Page
598
ISSN
0030-1558
NCID
AN00032489
Content Type
Journal Article
Official Url
https://www.jstage.jst.go.jp/article/joma1947/106/5-6/106_5-6_587/_article/-char/ja/
Related Url
http://www.okayama-u.ac.jp/user/oma/index.html
References
1) OhnoR, Kobayashi T, Tanimoto M, Hiraoka A, Imai K, Asou N, Tomonaga M, Tsubaki K, Takahashi I, Kodere Y, Yoshida M, Murakami H, Naoe T, Shimoyama M, Tsukada T, Takeo T, Teshima H, Onozawa Y, Fujimoto K, Kuriyama K, Horiuchi A, Kimura I, Minami S, Miura Y, Kageyama S, Tahara T, Masaoka T, Shirakawa S and Saito H : Randomized study of individualized induction therapy with or without vincristine, and of maintenance-intensification therapy between 4 or 12 courses in adult acute myeloid leukemia. Cancer (1993) 71, 3888-3895.
2) 宇塚善郎, 斉藤淑子 : 成人急性非リンパ性白血病のIndividualized Chemotherapy. 癌と化学療法 (1990) 17, 1473-1480.
3) Ohno R : Recent progress in the treatment of adult acute leukemia. Acta Haematol Jpn (1989) 52, 1287-1293.
4) Wolff SN, Marion J, Stein RS, Flexner JM, Lazarus HM, Spitzer TR, Phillips GL, Herzig RH and Herzig GP : High-dose cytosine arabinoside and daunorubicin as consolidation therapy for acute nonlymphocytic leukemia in first remission-a pilot study-. Blood (1985) 65, 1407-1411.
5) Skipper HE, Schabel FM and Weilcox WS : Experimental evaluation of potential antitumor agents. ⅩⅢ. On the crieria and kinetics assoiciated with "Curability" of experimental leukemia. Cancer Chemother Rep (1964) 35, 1-111.
6) 内田耕三郎, 厚井文一, 依光聖一, 高橋 功, 喜多嶋康一, 木村郁郎 : Bestatinによるcyclophosphamide誘発骨髄抑制からの回復促進効果. 癌と化学療法 (1982) 9, 220-224.
7) 太田和雄, 栗田宗次, 山田一正, 正岡 徹, 宇塚善郎, 小川暢男 : ベスタチンによる成人急性非リンパ性白血病の免疫療法の追跡調査成績. 癌と化学療法 (1986) 13, 1017-1025.
8) 大野竜三 : 白血病癌治療におけるG-CSFの応用. BIOTHERAPY (1991) 5, 89-95.
9) Schwarts ED, Brown BJ, Nierenburg M, Marsh JC and Sartorelli AC : Evaluation of some anthracycline antibiotics in an in vivo model for studying druginduced human leukemia cell differen-tiation. Cancer Res (1983) 43, 2725-2730.
10) Sakurai M, Sampi K and Hozumi K : Possible differentiation of human acute myelocblastic leukemia cells by daily and intermittent administration of aclacinomycin-A. Leuk Res (1983) 7, 139-143.
11) Bennett JM, Catovsky D, Daniel MT, Flandrin G, Galton DAG, Gralnick HR and Sultan AC : Proposed revised criteria for the classification of acute myeloid leukemia ; a report of the French-American-British Cooperative Group. Ann Intern Med (1985) 103, 620-625.
12) 木村橲代二 : 造血器腫瘍における化学療法の効果判定に関して ; 癌化学療法・癌免疫療法の効果判定基準と制癌剤開発, 斉藤達雄編, サイエンスフォーラム, 東京 (1981) pp 54-66.
13) 勝沼英宇, 仙場敬三, 宮本佳則, 桜井博文, 新 弘一, 田村彰彦, 清水伸哉 : 高齢者白血病の病態と治療. 医学にあゆみ (1984) 128, 1101-1107.
14) 森眞由美 : 高齢者の白血病とそ治療. 内科 (1985) 55, 848-853.
15) Kahn SB, Begg CB, Mazza JJ, Bennet JM, Bonner H and Glick JH : Full dose versus attenuated dose daunorubicin, cytosine arabinoside, and 6-thioguanine in the treatment of acute nonlym-phocytic leukemia in the elderly. J Clin Oncol (1984) 2, 865-870.
16) 高橋 功, 原 雅通, 高岡和子, 植田育寛, 福本光弘, 稲垣登稔, 滝沢道弘, 大本英次郎, 小田康広, 藤本修逸, 遠藤 裕, 頼 敏裕, 厚井文一, 喜多嶋康一, 木村郁郎, 真田 浩, 時岡正明, 依光聖一 : 高齢者血液疾患に関する検討 第3報 ; 高齢者急性非リンパ性白血病の化学療法効果. 日老医誌 (1984) 21, 17-19.
17) Takahashi I, Hara M, Adachi T, Takaoka K, Sakano M, Lai M, Kohi F, Yorimitsu S, Tokioka M, Kitajima K, Kimura I and Sanada H : Treatment of refractory acute leukemia with aclacinomycin-A. Acta Med Okayama (1980) 34, 349-354.
18) 原 雅通 : 急性白血病寛解導入療法に関する研究. 第2編 急性非リンパ性白血病寛解導入における daunor-ubicin, cytosine arabinoside 併用療法ならびに aclarubicin, cytosine arabinoside併用療法の比較検討. 岡山医誌 (1986) 98, 255-264.
19) Liu Yin JA, Johnson PRE, Davies JM, Flanagan NG, Gorst DW and Lewis MJ : Mitozantrone and cytosine arabinoside as first-line therapy in elderly patients with acute myeloid leukaemia. Br J Haematol (1991) 79, 415-420.
20) Reiffers J, Raynal F and Broustet A : Acute myeloblastic leukemia in elderly patients : treatment and prognostic factors. Cancer (1980) 45, 2816-2820.
21) Keating MJ, McCredie KB, Benjamin RS, Bodey GP, Zander A, Smith TL and Freireich EJ : Treatment of patients over 50 years of ago with acute myelogenous leukemia with a combination of rubidazone and cytosine arabinoside, vincristine and prednisone (ROAP). Blood (1981) 58, 584-591.
22) 吉川治哉, 村山知行, 平岩明和, 直江知樹, 田原 徹, 赤尾幸博, 吉川 敏, 寺尾充宏, 長田紘一郎, 丸尾國造 : 高齢者(60歳以上)急性非リンパ性白血病における多剤併用療法の検討ー2例の治療とPADOC療法の総括ー. 癌と化学療法 (1981) 8, 1425-1433.
23) 森眞由美, 村井善郎, 黒沢晋一郎, 倉田寛一, 平井真希子, 熊川寿郎, 川上睦美, 堀  久 : 高齢者急性非リンパ性白血病の治療. 日老会誌 (1989) 26, 494-498.
24) Walters RS, Kantarjian HM, Keating MJ, Estey EH, McCredie KB and Freireich EJ : Intensive treatment of acute leukemia in adults 70 years of age and older. Cancer (1987) 60, 149-155.
25) Ishikura H, Sawada H, Okazaki T, Mochizuki T, Izumi Y, Yamagishi M and Uchino H : The effect of low dose Ara-C in acute nonlymphoblastic leukaemias and atypical leukaemia. Br J Haematol (1984) 58, 9-18.
26) Wisch JS, Griffin JD and Kufe DW : Response of preleukemic syndromes to continuous infunsion of low-dose cytarabine. N Engl J Med (1983) 309, 1599-1602.
27) 河野友子, 長井一浩, 塚崎邦弘, 陣内逸郎, 朝長万左男, 一丸道人, 田川真須子 : 急性白血病, RAEBに対するAra-C少量療法の効果. 臨床血液 (1989) 30, 638-643.
28) 沖田浩之 : 非定型的白血病の病態並びに治療に関する研究. 第2編 非定型的白血病の治療に関する検討 : 4N-behenoyl-1-β-D-arabinofuranosyl cytosine (BHAC) 少量療法の臨床効果. 岡山医誌 (1993) 105, 437-445.
29) 木村郁郎, 高橋 功 : 高齢者白血病. 臨床と研究 (1988) 65, 405-408.
30) 西村正隆 : 急性白血病並びに類縁疾患における造血幹細胞動態に関する検討. 第1編 急性白血病におけるLeukemic Blast Progenitors由来コロニー形成能並びにパターンの検討. 岡山医誌 (1991) 103, 1147-1155.
31) Huang ME, Ye YC, Chen SR, Chai JR, Lu JX, Zhoa L, Gu LJ and Sang ZY : Use of all-trans retinoic acid in the treatment of acute promyelocytic leukemia. Blood (1988) 72, 567-572.
32) Castaigne S, Chomiennne C, Daniel MT, Ballerini P, Bergger R, Fenaux P and Degos L : All-trans retinoic acid as a differentiation therapy for acute promyelocytic leukemia. Ⅰ. Clinical results Blood (1990) 76, 1704-1709.
33) Sebban C, Archimbaud E, Coiffier B, Guyatat D, Treille-Ritouet D, Maupas J and Fiere D : Treatment of acute myeloid leukemia in elderly patients. Cancer (1988) 61, 227-231.
34) Yates J, Glidewell O, Wiernik P, Cooper MR, Steinberg D, Dosik H, Levy R, Hoagland C, Henry P, Gottleib A, Cornell C, Berenberg J, Huchison JL, Raich P, Nissen N, Ellison RR, Robert F, James GW, Falkson G, Silver RT, Haurani F, Green M, Henderson E, Loone L and Holland JF : Cytosine arabinoside with daunorubicin or adriamycin for therapy of acute myelocytic leukemia. Blood (1982) 60, 454-462.
35) 依光聖一 : 急性白血病寛解導入療法に関する研究. 第1報 溶連菌製剤OK-432の造血能に及ぼす影響並びに化学療法における併用の意義について. 岡山医誌 (1985) 97, 277-287.
36) Ohno R, Tomonaga M, Kobayashi T, Kanamura A, Shirakawa S, Masaoka T, Omine M, Oh H, Nomura T, Sakai Y, Hirano M, Yokomaku S, Nakayama S, Yoshida Y, Miura AB, Morishima Y, Dohy H, Niho Y, Hamajima N and Takaku F : Effect of granulocyte colony-stimulating factor after intensive induction therapy in relapsed or refractory acute leukemia. N Engl J Med (1990) 323, 871-877.
37) Hanazono Y, Miyazono K, Piao YF, Taketazu F, Chiba S, Miyagawa K, Hirai H, Sakamoto S, Miura Y, Yazaki Y and Takaku F : Treatment of acute nonlymphocytic leukemia by combina-tion of recombinant human granulocyte colony-stimulating factir and cytotoxic agenets : A report of six cases. Int J Hematol (1992) 55, 243-248.
38) Ohno R, Hiraoka A, Tanimoto M, Asou N, Kuriyama K, Kobayashi T, Yoshida M, Teshima H, Saito H and Fujimoto K : No increase of leukemia relapse in newly diagnosed patiens with acute myeloid leukemia who received granulocyte conlony-stimulating factor for life-threatening infection during remission induction and consolidation therapy. Blood (1993) 81, 561-567.
language
日本語
Copyright Holders
岡山医学会
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Refereed
True
Eprints Journal Name
joma