Chemotherapy Drugs
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Gy Total Body Irradiation Followed by Allogeneic Hematopoietic St
Bone Marrow Transplantation (2009) 44, 785–792 & 2009 Macmillan Publishers Limited All rights reserved 0268-3369/09 $32.00 www.nature.com/bmt ORIGINAL ARTICLE Fludarabine, amsacrine, high-dose cytarabine and 12 Gy total body irradiation followed by allogeneic hematopoietic stem cell transplantation is effective in patients with relapsed or high-risk acute lymphoblastic leukemia F Zohren, A Czibere, I Bruns, R Fenk, T Schroeder, T Gra¨f, R Haas and G Kobbe Department of Haematology, Oncology and Clinical Immunology, Heinrich Heine-University, Du¨sseldorf, Germany In this prospective study, we examined the toxicity and Introduction efficacy of an intensified conditioning regimen for treatment of patients with relapsed or high-risk acute The use of intensified conventional induction chemothera- lymphoblastic leukemia who undergo allogeneic hemato- pies in the treatment of newly diagnosed ALL in adult poietic stem cell transplantation. Fifteen patients received patients has led to initial CR rates of up to 90%. But, as fludarabine 30 mg/m2, cytarabine 2000 mg/m2, amsacrine some patients are even refractory to first-line therapy, the 100 mg/m2 on days -10, -9, -8 and -7, anti-thymocyte majority of the responding patients unfortunately suffer globulin (ATG-Fresenius) 20 mg/kg body weight on days from relapse. Therefore, the probability of long-term -6, -5 and -4 and fractionated total body irradiation disease-free survival is o30%.1–5 Risk stratification based 2 Â 2 Gy on days -3, -2 and -1 (FLAMSA-ATG-TBI) on prognostic factors allows identification of high-risk before allogeneic hematopoietic stem cell transplantation. ALL patients with poor prognosis.6–12 Myeloablative At the time of hematopoietic stem cell transplantation, 10 conditioning therapy followed by allogeneic hematopoietic patients were in complete remission (8 CR1; 2 CR2), 3 stem cell transplantation (HSCT) is currently the treatment with primary refractory and 2 suffered from refractory of choice for these high-risk patients.13–15 A combination of relapse. -
Fludarabine Phosphate Powder for Solution for Injection Or Infusion
For the use only of a Registered Medical Practitioner or a Hospital or a Laboratory This package insert is continually updated. Please read carefully before using a new pack. Fludarabine Phosphate Powder for Solution for Injection or Infusion FLUDARA® NAME OF THE MEDICINAL PRODUCT Fludara 50 mg powder for solution for injection/infusion COMPOSITION Active ingredient: Each vial contains 50 mg fludarabine phosphate I.P. 1 ml of reconstituted solution for injection/infusion contains 25 mg fludarabine phosphate. Excipients: Mannitol, Sodium hydroxide (to adjust the pH to 7.7). INDICATIONS Fludara is indicated for the treatment of patients with B -cell chronic lymphocytic leukemia (CLL) who have not responded to at least one standard alkylating-agent containing regimen. DOSAGE AND METHOD OF ADMINISTRATION Method of administration Fludara must be administered only intravenously. No cases have been reported in which paravenously administered Fludara led to severe local adverse reactions. However, unintentional paravenous administration must be avoided. Dosage regimen Adults Fludara solution for injection/infusion should be administered under the supervision of a qualified physician experienced in the use of antineoplastic therapy. The recommended dose is 25 mg fludarabine phosphate/m² body surface given daily for 5 consecutive days every 28 days by the intravenous route. Each vial is to be made up in 2 ml water for injection. Each ml of the resulting solution for injection/infusion will contain 25 mg fludarabine phosphate (see section ‘Instructions for use/handling’). The required dose (calculated on the basis of the patient's body surface) is drawn up into a syringe. For intravenous bolus injection, this dose is further diluted into 10 ml of 0.9 % sodium chloride. -
Fludarabine Phosphate (NSC 312878) Infusions for the Treatment of Acute Leukemia: Phase I and Neuropathological Study1
[CANCER RESEARCH 46, 5953-5958, November 1986] Fludarabine Phosphate (NSC 312878) Infusions for the Treatment of Acute Leukemia: Phase I and Neuropathological Study1 David R. Spriggs,2 Edward Stopa, Robert J. Mayer, William Schoene, and Donald W. Kufe3 Dana Farber Cancer Institute [D. R. S., R. J. M.. D. W. K.J and Department ofPathology, Brigham and Women 's Hospital [E. S., W. SJ, Boston, Massachusetts 0211S ABSTRACT a relationship between dose and lethargy. The schedule of drug administration in these studies was not a 5-day infusion. A Fludarabine phosphate (NSC 312878), an adenosine deaminase resist ant analogue of 9-/9-D-arabinofuranosyladenine, has entered clinical trials. single bolus was used in one study while the other used a single bolus followed by a 48-h infusion. Eleven patients with acute leukemia in relapse received 14 courses of fludarabine phosphate as a 5-day continuous infusion administered at Based on the myelosuppressive effects of fludarabine phos doses of 40 to 100 mg/m2/day. Toxicity was characterized by uniform phate in Phase I testing, we instituted a Phase I and II trial to myelosuppression, as well as occasional nausea, vomiting, and hepato- identify the toxicity and efficacy of fludarabine phosphate in toxicity. Three episodes of metabolic acidosis and lactic acidemia were the treatment of acute leukemia. The drug was administered as noted. In addition, three patients suffered neurotoxicity. Two of these a 5-day continuous infusion at a starting dose equivalent to the three patients had a severe neurotoxicity syndrome characterized by maximum tolerated dose reached in patients with solid tumors. -
CK0403, a 9‑Aminoacridine, Is a Potent Anti‑Cancer Agent in Human Breast Cancer Cells
MOLECULAR MEDICINE REPORTS 13: 933-938, 2016 CK0403, a 9‑aminoacridine, is a potent anti‑cancer agent in human breast cancer cells YUAN-WAN SUN1, KUEN-YUAN CHEN2, CHUL-HOON KWON3 and KUN-MING CHEN1 1Department of Biochemistry and Molecular Biology, College of Medicine, Pennsylvania State University, Hershey, PA 17033, USA; 2Department of Surgery, National Taiwan University Hospital, Taipei 8862, Taiwan, R.O.C.; 3Department of Pharmaceutical Sciences, College of Pharmacy and Allied Health Professions, St. John's University, New York, NY 11439, USA Received November 11, 2014; Accepted October 22, 2015 DOI: 10.3892/mmr.2015.4604 Abstract. 3-({4-[4-(Acridin-9-ylamino)phenylthio]phenyl} reduced growth inhibitory activity under hypoxic conditions, (3-hydroxypropyl)amino)propan-1-ol (CK0403) is a which can induce autophagy. Collectively, the present results sulfur-containing 9-anilinoacridine analogue of amsacrine and supported that CK0403 is highly potent and more effective than was found to be more potent than its analogue 2-({4-[4-(acridin- CK0402 against estrogen receptor-negative and 9-ylamino)phenylthio]phenyl}(2-hydroxyethyl)amino) HER2-overexpressing breast cancer cell lines, suggesting its ethan-1-ol (CK0402) and amsacrine in the inhibition of the future application for chemotherapy in breast cancer. topoisomerase II-catalyzed decatenation reaction. A previous study by our group reported that CK0402 was effective against Introduction numerous breast cancer cell lines, and the combination of CK0402 with herceptin enhanced its activity in HER2(+) Breast cancer is the most common type of cancer diagnosed SKBR-3 cells. In order to identify novel chemotherapeutic agents in American women and is the second most common cause with enhanced potency, the present study explored the potential of cancer-associated mortality. -
The New Therapeutic Strategies in Pediatric T-Cell Acute Lymphoblastic Leukemia
International Journal of Molecular Sciences Review The New Therapeutic Strategies in Pediatric T-Cell Acute Lymphoblastic Leukemia Marta Weronika Lato 1 , Anna Przysucha 1, Sylwia Grosman 1, Joanna Zawitkowska 2 and Monika Lejman 3,* 1 Student Scientific Society, Laboratory of Genetic Diagnostics, Medical University of Lublin, 20-093 Lublin, Poland; [email protected] (M.W.L.); [email protected] (A.P.); [email protected] (S.G.) 2 Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, 20-093 Lublin, Poland; [email protected] 3 Laboratory of Genetic Diagnostics, Medical University of Lublin, 20-093 Lublin, Poland * Correspondence: [email protected] Abstract: Childhood acute lymphoblastic leukemia is a genetically heterogeneous cancer that ac- counts for 10–15% of T-cell acute lymphoblastic leukemia (T-ALL) cases. The T-ALL event-free survival rate (EFS) is 85%. The evaluation of structural and numerical chromosomal changes is important for a comprehensive biological characterization of T-ALL, but there are currently no ge- netic prognostic markers. Despite chemotherapy regimens, steroids, and allogeneic transplantation, relapse is the main problem in children with T-ALL. Due to the development of high-throughput molecular methods, the ability to define subgroups of T-ALL has significantly improved in the last few years. The profiling of the gene expression of T-ALL has led to the identification of T-ALL subgroups, and it is important in determining prognostic factors and choosing an appropriate treatment. Novel therapies targeting molecular aberrations offer promise in achieving better first remission with the Citation: Lato, M.W.; Przysucha, A.; hope of preventing relapse. -
Hodgkin Lymphoma Treatment Regimens
HODGKIN LYMPHOMA TREATMENT REGIMENS (Part 1 of 5) Clinical Trials: The National Comprehensive Cancer Network recommends cancer patient participation in clinical trials as the gold standard for treatment. Cancer therapy selection, dosing, administration, and the management of related adverse events can be a complex process that should be handled by an experienced health care team. Clinicians must choose and verify treatment options based on the individual patient; drug dose modifications and supportive care interventions should be administered accordingly. The cancer treatment regimens below may include both U.S. Food and Drug Administration-approved and unapproved indications/regimens. These regimens are provided only to supplement the latest treatment strategies. These Guidelines are a work in progress that may be refined as often as new significant data become available. The NCCN Guidelines® are a consensus statement of its authors regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult any NCCN Guidelines® is expected to use independent medical judgment in the context of individual clinical circumstances to determine any patient’s care or treatment. The NCCN makes no warranties of any kind whatsoever regarding their content, use, or application and disclaims any responsibility for their application or use in any way. Classical Hodgkin Lymphoma1 Note: All recommendations are Category 2A unless otherwise indicated. Primary Treatment Stage IA, IIA Favorable (No Bulky Disease, <3 Sites of Disease, ESR <50, and No E-lesions) REGIMEN DOSING Doxorubicin + Bleomycin + Days 1 and 15: Doxorubicin 25mg/m2 IV push + bleomycin 10units/m2 IV push + Vinblastine + Dacarbazine vinblastine 6mg/m2 IV over 5–10 minutes + dacarbazine 375mg/m2 IV over (ABVD) (Category 1)2-5 60 minutes. -
Nelarabine) Injection • Severe Neurologic Reactions Have Been Reported
HIGHLIGHTS OF PRESCRIBING INFORMATION --------------------- DOSAGE FORMS AND STRENGTHS -------------- These highlights do not include all the information needed to use 250 mg/50 mL (5 mg/mL) vial (3) ARRANON safely and effectively. See full prescribing information for -------------------------------CONTRAINDICATIONS------------------------ ARRANON. None. ----------------------- WARNINGS AND PRECAUTIONS ---------------- ARRANON (nelarabine) Injection • Severe neurologic reactions have been reported. Monitor for signs and Initial U.S. Approval: 2005 symptoms of neurologic toxicity. (5.1) WARNING: NEUROLOGIC ADVERSE REACTIONS • Hematologic Reactions: Complete blood counts including platelets should See full prescribing information for complete boxed warning. be monitored regularly. (5.2) Severe neurologic adverse reactions have been reported with the use of • Fetal harm can occur if administered to a pregnant woman. Women should ARRANON. These adverse reactions have included altered mental states be advised not to become pregnant when taking ARRANON. (5.3) including severe somnolence, central nervous system effects including ------------------------------ ADVERSE REACTIONS ----------------------- convulsions, and peripheral neuropathy ranging from numbness and The most common (≥ 20%) adverse reactions were: paresthesias to motor weakness and paralysis. There have also been • Adult: anemia, thrombocytopenia, neutropenia, nausea, diarrhea, reports of adverse reactions associated with demyelination, and ascending vomiting, constipation, fatigue, -
Fludarabine-Based Versus Chop-Like Regimens with Or Without Rituximab in Patients with Previously Untreated Indolent Lymphoma
OncoTargets and Therapy Dovepress open access to scientific and medical research Open Access Full Text Article ORIGINAL RESEARCH Fludarabine-based versus CHOP-like regimens with or without rituximab in patients with previously untreated indolent lymphoma: a retrospective analysis of safety and efficacy Xiao-xiao Xu1 Abstract: Fludarabine-based regimens and CHOP (doxorubicin, cyclophosphamide, vincristine, Bei Yan2 prednisone)-like regimens with or without rituximab are the most common treatment modalities Zhen-xing Wang3 for indolent lymphoma. However, there is no clear evidence to date about which chemotherapy Yong Yu1 regimen should be the proper initial treatment of indolent lymphoma. More recently, the use of Xiao-xiong Wu2 fludarabine has raised concerns due to its high number of toxicities, especially hematological Yi-zhuo Zhang1 toxicity and infectious complications. The present study aimed to retrospectively evaluate both the efficacy and the potential toxicities of the two main regimens (fludarabine-based and CHOP-like 1 Department of Hematology, Tianjin regimens) in patients with previously untreated indolent lymphoma. Among a total of 107 patients Medical University Cancer Institute and Hospital, Tianjin Key Laboratory assessed, 54 patients received fludarabine-based regimens (FLU arm) and 53 received CHOP or of Cancer Prevention and Therapy, CHOPE (doxorubicin, cyclophosphamide, vincristine, prednisone, or plus etoposide) regimens Tianjin, 2Department of Hematology, (CHOP arm). The results demonstrated that fludarabine-based regimens could induce significantly First Affiliated Hospital of Chinese People’s Liberation Army General improved progression-free survival (PFS) compared with CHOP-like regimens. However, the Hospital, Beijing, 3Department of FLU arm showed overall survival, complete response, and overall response rates similar to those Stomach Oncology, Tianjin Medical University Cancer Institute and of the CHOP arm. -
Monotherapy with Pixantrone in Histologically Confirmed Relapsed Or
research paper Monotherapy with pixantrone in histologically confirmed relapsed or refractory aggressive B-cell non-Hodgkin lymphoma: post-hoc analyses from a phase III trial Ruth Pettengell,1 Catherine Sebban,2 This post hoc analysis of a phase 3 trial explored the effect of pixantrone in Pier Luigi Zinzani,3 Hans Gunter patients (50 pixantrone, 47 comparator) with relapsed or refractory aggres- 4 5 Derigs, Sergey Kravchenko, Jack W. sive B-cell non-Hodgkin lymphoma (NHL) confirmed by centralized histo- 6 7 Singer, Panteli Theocharous, Lixia logical review. Patients received 28-d cycles of 85 mg/m2 pixantrone 7 8 Wang, Mariya Pavlyuk, Kahina M. dimaleate (equivalent to 50 mg/m2 in the approved formulation) on days Makhloufi8 and Bertrand Coiffier9,10 1, 8 and 15, or comparator. The population was subdivided according to 1St George’s University of London, London, UK, 2 previous rituximab use and whether they received the study treatment as Leon Berard Cancer Centre, Lyon, France, – 3Institute of Haematology “Le A Seragnoli”, 3rd or 4th line. Median number of cycles was 4 (range, 2 6) with pix- – University of Bologna, Bologna, Italy, 4St€adt Kli- antrone and 3 (2 6) with comparator. In 3rd or 4th line, pixantrone was Á Á nikum, Frankfurt-Hoeschest, Klinik fur€ Innere associated with higher complete response (CR) (23 1% vs. 5 1% compara- Medizin III, Frankfurt am Main, Germany, tor, P = 0Á047) and overall response rate (ORR, 43Á6% vs. 12Á8%, 5Chemotherapy and Intensive Treatment of Hae- P = 0Á005). In 3rd or 4th line with previous rituximab (20 pixantrone, 18 matology Diseases, Haematology Scientific Centre comparator), pixantrone produced better ORR (45Á0% vs. -
Bendamustine in Combination with Gemcitabine and Vinorelbine Is An
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Archivio istituzionale della ricerca - Università di Modena e Reggio Emilia VOLUME 34 • NUMBER 27 • SEPTEMBER 20, 2016 JOURNAL OF CLINICAL ONCOLOGY ORIGINAL REPORT Bendamustine in Combination With Gemcitabine and Vinorelbine Is an Effective Regimen As Induction Chemotherapy Before Autologous Stem-Cell Transplantation for Relapsed or Refractory Hodgkin Lymphoma: Final Results of a Multicenter Phase II Study Armando Santoro, Rita Mazza, Alessandro Pulsoni, Alessandro Re, Maurizio Bonfichi, Vittorio Ruggero Zilioli, Flavia Salvi, Francesco Merli, Antonella Anastasia, Stefano Luminari, Giorgia Annechini, Manuel Gotti, Annalisa Peli, Anna Marina Liberati, Nicola Di Renzo, Luca Castagna, Laura Giordano, and Carmelo Carlo-Stella Armando Santoro, Rita Mazza, Luca Castagna, Laura Giordano, and Carmelo ABSTRACT Carlo-Stella, Humanitas Cancer Center; Armando Santoro, Humanitas University, Purpose Rozzano; Alessandro Pulsoni and Giorgia This multicenter, open-label, phase II study evaluated the combination of bendamustine, gemci- Annechini, Sapienza University, Rome; tabine, and vinorelbine (BeGEV) as induction therapy before autologous stem-cell transplantation Alessandro Re, Antonella Anastasia, and (ASCT) in patients with relapsed or refractory Hodgkin lymphoma (HL). Annalisa Peli, Spedali Civili, Brescia; Maurizio Bonfichi and Manuel Gotti, Patients and Methods Istituto di Ricovero e Cura a Carattere Patients with HL who were refractory to or had relapsed after one previous chemotherapy line were Scientifico (IRCCS) Policlinico San Matteo, eligible. The primary end point was complete response (CR) rate after four cycles of therapy. Pavia; Vittorio Ruggero Zilioli, Niguarda Ca’ Granda Hospital; Carmelo Carlo-Stella, Secondary end points were: overall response rate, stem-cell mobilization activity, and toxicity. -
©Ferrata Storti Foundation
Lymphoproliferative Disorders original paper haematologica 2001; 86:1165-1171 Response to fludarabine in B-cell http://www.haematologica.it/2001_11/1165.htm chronic lymphocytic leukemia patients previously treated with chlorambucil as up-front therapy and a CHOP-like regimen as second line therapy VINCENZO LISO,* STEFANO MOLICA,# SILVANA CAPALBO,* ENRICO POGLIANI,@ COSIMA BATTISTA,* GIORGIO BROCCIA,^ MARCO MONTILLO,§ ANTONIO CUNEO,° PIETRO LEONI,** GIORGINA SPECCHIA,* GIANLUIGI CASTOLDI° *Institute of Hematology, University of Bari; °Section of Hematology, Department of Biomedical Sciences, University of Ferrara; #Division of Hematology and Clinical Oncology, “A. Pugliese” Hospital, Catanzaro; @Division of Hematology “San Gerardo dei Tintori” New Hospital, Monza; ^Division of Hema- tology, “A. Businco” Hospital, Cagliari; §Department of Hema- Correspondence: Vincenzo Liso, MD, Hematology, University of Bari, Policlinico, piazza G. Cesare 11, 70124 Bari, Italy. tology, Niguarda “Ca’ Granda” Hospital, Milan; Institute of Phone: international +39.080.5478711. Fax: international +39.080. Hematology, University of Ancona, Italy 5428978. E-mail: [email protected] Background and Objectives. Fludarabine (FAMP) is the response rate was 40.3% with FAMP (p = the most active single agent in relapsed and refrac- 0.037) and only 17.5% with CHOP (p = 1.0). Among tory patients with B-cell chronic lymphocytic 35 patients resistant to a CHOP-like regimen, the leukemia (B-CLL). However, it is not clear whether response rate was 29.8% (p = 0.066) after -
ARRANON Safely and Effectively
HIGHLIGHTS OF PRESCRIBING INFORMATION -------------------------------------CONTRAINDICATIONS------------------------ These highlights do not include all the information needed to use None. (4) ARRANON safely and effectively. See full prescribing information for ARRANON. -------------------------WARNINGS AND PRECAUTIONS---------------------- Neurologic Adverse Reactions: Severe neurologic reactions have been ARRANON® (nelarabine) injection, for intravenous use reported. Monitor for signs and symptoms of neurologic toxicity. (5.1) Initial U.S. Approval: 2005 Hematologic Reactions: Complete blood counts including platelets should WARNING: NEUROLOGIC ADVERSE REACTIONS be monitored regularly. (5.2) See full prescribing information for complete boxed warning. Embryo-Fetal Toxicity: Can cause fetal harm. Advise females of reproductive potential of the potential risk to the fetus and to use effective Severe neurologic adverse reactions have been reported with the use of contraception; and advise males to use condoms. (5.3, 8.1, 8.3) ARRANON. These adverse reactions have included altered mental states Effects on Ability to Drive and Use Machines: Somnolence may occur. including severe somnolence, central nervous system effects including Advise patients to refrain from these activities until somnolence has convulsions, and peripheral neuropathy ranging from numbness and resolved. (5.6) paresthesias to motor weakness and paralysis. There have also been reports of adverse reactions associated with demyelination, and ascending ------------------------------------ADVERSE REACTIONS------------------------- peripheral neuropathies similar in appearance to Guillain-Barré The most common (≥ 20%) adverse reactions were: syndrome. (5.1) Adult: anemia, thrombocytopenia, neutropenia, nausea, diarrhea, vomiting, constipation, fatigue, pyrexia, cough, and dyspnea. (6.1) Full recovery from these adverse reactions has not always occurred with Pediatric: anemia, neutropenia, thrombocytopenia, and leukopenia. (6.1) cessation of therapy with ARRANON.