Journal ArticleDOI
Subacute pulmonary failure complicating therapy with high-dose ara-C in acute leukemia
Borje S. Andersson,Brad M. Cogan,Michael J. Keating,Elihu H. Estey,Kenneth B. McCredie,Emil J. Freireich +5 more
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TLDR
The high‐dose Ara‐C regimen should be used with awareness of possible drug‐induced pulmonary toxicity, and the increase in toxicity with increasing number of doses is significant.Abstract:
Seventy-four adult patients with acute leukemia in relapse were studied. They received high-dose intravenous boluses of cytosine arabinoside (Ara-C) according to the following schedules: 3 g/m2 over 2 hours, every 12 hours for 4 to 12 consecutive doses, or a continuous infusion over 5 days at 200, 400, or 800 mg/m2/day. The patients' ages ranged from 16 to 68 years (median, 35). Subacute pulmonary failure attributable to Ara-C was observed in 16 of 72 evaluable patients (22%) and appeared 2 to 21 days (median, 6) after the first dose. None of the 28 patients who received up to six doses experienced any toxicity. With repeated courses or more than six doses in the first course there was a sharp increase in the incidence of toxicity. Thus, subacute pulmonary failure developed in 6 of 24 patients who received 9 doses and 6 of 19 patients who received 12 doses. The increase in toxicity with increasing number of doses is significant (P = 0.03). This suggests that the high-dose Ara-C regimen should be used with awareness of possible drug-induced pulmonary toxicity.read more
Citations
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Cardiotoxicity of chemotherapeutic agents: incidence, treatment and prevention.
Vinita B. Pai,Milap C. Nahata +1 more
TL;DR: Cardiotoxicity can be prevented by screening and modifying risk factors, aggressively monitoring for signs and symptoms as chemotherapy is administered, and continuing follow-up after completion of a course or the entire treatment.
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Injury to the lung from cancer therapy: Clinical syndromes, measurable endpoints, and potential scoring systems
TL;DR: The development of staging systems for acute and late toxicity is discussed and a new staging system for Late Effects in Normal Tissues (LENT) is proposed.
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Septicemia and Shock Syndrome Due to Viridans Streptococci: A Case-Control Study of Predisposing Factors
TL;DR: In this paper, the incidence of viridans streptococcal bacteremia at the University of Texas M D Anderson Cancer Center in Houston increased from one case per 10,000 admissions to 47 cases per 1000 admissions.
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Bacteremia due to viridans streptococci in neutropenic patients: A review
TL;DR: Case-control studies have identified the following risk factors: severe neutropenia (< 100 neutrophils/mm3), prophylactic antibiotic treatments with quinolone or co-trimoxazole, absence of intravenous antibiotics at the time of bacteremia, high doses of cytosine arabinoside, oropharyngeal mucositis, and heavy colonization by viridans streptococci.
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Bacteremia Due to Viridans Streptococcus in Neutropenic Patients with Cancer: Clinical Spectrum and Risk Factors
TL;DR: Multivariate analysis of predisposing factors showed that high doses of cytosine arabinoside, the presence of mucositis, and the absence of previous therapy with parenteral antibiotics were independent risk factors for the development of viridans streptococcal bacteremia.
References
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Journal ArticleDOI
High dose cytosine arabinoside (HDARAC) in refractory acute leukemia
Seth A. Rudnick,Edwin C. Cadman,Robert L. Capizzi,Roland T. Skeel,Joseph R. Bertino,Sue McIntosh +5 more
TL;DR: Thirteen leukemic patients with disease refractory to conventional chemotherapy were treated with 1.0 to 7.5 g/m2 of Cytosine Arabinoside (Ara‐C) over 29 drug cycles, and three or four dose cycles were given at 2‐ to 30‐day intervals to establish single dose tolerance.
Journal ArticleDOI
Lethal pulmonary reactions associated with the combined use of amphotericin B and leukocyte transfusions
TL;DR: Amphotericin B is used increasingly in high-risk patients with profound neutropenia and suspected sepsis and leukocyte transfusions and may cause changes in the lungs that amplify the acute toxicity of amphotericin, thereby permitting severe pulmonary reactions.
Journal ArticleDOI
High remission-induction rate in acute myeloid leukæmia
RobertPeter Gale,M.J. Cline +1 more
TL;DR: These induction results are superior to those reported in most studies and indicate that disease remission can be achieved in a high proportion of patients with A.M.L. treated with an intensive multi-agent chemotherapeutic regimen, provided support facilities are adequate.
Journal ArticleDOI
Central nervous system toxicity of high-dose systemic cytosine arabinoside
TL;DR: Systemic cytarabine doses less than 54 g/m2 can be administered with minimal CNS side‐effects, and CNS toxicity was dose‐related since patients treated for 12 consecutive doses of 4.5 g/M2 had significantly greater CNS toxicity than 12 successive doses at 3 g/ m2(P< 0.04).