Effective treatment of leukemia: A Synthesis of Findings from 35 Studies

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Original Abstract of the Article

Major Research Findings

Treatment of acute myeloid leukemia (AML) is often complicated by the heterogeneity of the disease and the mechanisms of disease progression. 27 . Standard treatment approaches can fail in particular cases, even with high-dose, multi-agent chemotherapy regimens. 27 . High-dose cytarabine appears to be a good option for patients with AML. 21 . Relapse remains the leading cause of death among patients with AML. 33 . The unselective effect of chemotherapy leads to high treatment-related toxicity and a heightened risk of infection during prolonged pancytopenia, hindering further dose escalation. 29 .

In children, levofloxacin appears to be safe to use during the induction phase of acute lymphoblastic leukemia (ALL). 35 . Levofloxacin was found to be safe to use in the induction phase of de novo ALL in children. 35 .

In adults with ALL, four courses of standard-dose consolidation therapy without maintenance therapy are more effective than three courses of standard-dose consolidation with maintenance therapy. 22 .

Treatment Summary

Treatments for AML include high-dose, multi-agent chemotherapy, bone marrow transplantation, and immunotherapy. 27 . High-dose cytarabine is a good option for patients with AML. 21 . Levofloxacin is safe to use in children during the induction phase of AML. 35 . In adults with ALL, four courses of standard-dose consolidation therapy without maintenance therapy are more effective than three courses of standard-dose consolidation with maintenance therapy. 22 .

Benefits and Risks

Benefits Summary

High-dose cytarabine is a good option for patients with AML. 21 . Levofloxacin is safe to use in children during the induction phase of AML. 35 . In adults with ALL, four courses of standard-dose consolidation therapy without maintenance therapy are more effective than three courses of standard-dose consolidation with maintenance therapy. 22 .

Risks Summary

The unselective effect of chemotherapy leads to high treatment-related toxicity and a heightened risk of infection during prolonged pancytopenia, hindering further dose escalation. 29 . Relapse remains the leading cause of death among patients with AML. 33 .

Comparison of Studies

Commonalities in Studies

Multiple studies highlight the substantial heterogeneity of AML. 27 . 29 . Multiple studies have demonstrated that relapse is the leading cause of death among patients with AML. 22 . 33 .

Differences in Studies

Some studies show promising results for specific treatments, while others offer no definitive conclusions regarding their effectiveness. 6 . 16 . 17 . 3 . 14 . 8 . 19 . 5 . 1 . 24 . 18 . 10 . 11 . 20 . 34 . 13 .

Consistency and Contradictions in Findings

Multiple studies highlight the substantial heterogeneity of AML. 27 . 29 . This means that the effectiveness of AML treatment can vary widely depending on the individual patient. The effectiveness of particular treatments can also be inconsistent across studies. Some studies show promising results for specific treatments, while others offer no definitive conclusions regarding their effectiveness. 6 . 16 . 17 . 3 . 14 . 8 . 19 . 5 . 1 . 24 . 18 . 10 . 11 . 20 . 34 . 13 .

Practical Application and Considerations

Treatment for AML can vary significantly from one patient to another. 27 . Therefore, the selection of AML treatment should be made carefully, taking into account the patient's individual condition and disease status. 27 . 29 . The unselective effect of chemotherapy leads to high treatment-related toxicity and a heightened risk of infection during prolonged pancytopenia, hindering further dose escalation. 29 . Therefore, chemotherapy should be used with caution, considering the patient's condition and disease status. 29 .

Current Research Limitations

Research on the effectiveness of AML treatments is still ongoing, and much remains to be learned. 6 . 16 . 17 . 3 . 14 . 8 . 19 . 5 . 1 . 24 . 18 . 10 . 11 . 20 . 34 . 13 . Further research is needed to refine our understanding of AML treatment effectiveness. 6 . 16 . 17 . 3 . 14 . 8 . 19 . 5 . 1 . 24 . 18 . 10 . 11 . 20 . 34 . 13 . Specifically, there is a need to develop treatments that consider the heterogeneity of AML. 27 . 29 .

Future Research Directions

Further research is needed to refine our understanding of AML treatment effectiveness. 6 . 16 . 17 . 3 . 14 . 8 . 19 . 5 . 1 . 24 . 18 . 10 . 11 . 20 . 34 . 13 . Specifically, there is a need to develop treatments that consider the heterogeneity of AML. 27 . 29 .

Conclusion

AML is a highly heterogeneous disease. 27 . Therefore, AML treatments can vary significantly from one patient to another. 27 . Research on the effectiveness of AML treatments is still ongoing, and much remains to be learned. 6 . 16 . 17 . 3 . 14 . 8 . 19 . 5 . 1 . 24 . 18 . 10 . 11 . 20 . 34 . 13 . Further research is needed to refine our understanding of AML treatment effectiveness. 6 . 16 . 17 . 3 . 14 . 8 . 19 . 5 . 1 . 24 . 18 . 10 . 11 . 20 . 34 . 13 . Specifically, there is a need to develop treatments that consider the heterogeneity of AML. 27 . 29 .

Treatment List

High-dose, multi-agent chemotherapy, bone marrow transplantation, immunotherapy, cytarabine, levofloxacin, consolidation therapy, maintenance therapy

Keywords
Benefit Keywords
Improved survival for acute myeloid leukemia
1
Effective leukemia treatment
Improved remission rate
2
Reduced infections
3
Complete remission
4
Leukemia treatment
5
ALL remission
Allogeneic BMT efficacy
6
T-ALL remission
7
AML remission
Survival improvement
8
Hairy cell leukemia treatment
9
ALL treatment
10
AML treatment
11
Improved disease-free survival
Shorter therapy duration
12
ALL survival improvement
13
Chemotherapy regimens
14
Long-term remission
Prolonged remission duration
15
Leukemia treatment
16
Complete remission in leukemia
17
Leukemia treatment
18
ALL remission
Reduced neutropenia
19
Improved leukemia survival
20
Improved leukemia-free survival
Improved survival
21
AML treatment
22
Apoptosis induction
23
Myelodysplastic syndromes treatment
24
Disease-free survival
Improved survival
Reduced relapse
25
Improved CLL treatment
26
Predictable outcomes
27
APL treatment
28
AML treatment
29
CLL treatment
Maintenance approaches
30
Improved prognostic stratification
31
Hairy cell leukemia treatment
32
AML and MDS treatment
33
AML treatment
Improved survival
Reduced relapse
34
Risk Keywords
Intercurrent infection
Leukemic cell resistance
4
Chemotherapy side effects
Radiation exposure
5
Early relapse
Toxic death
6
CNS relapse
Testicular relapse
7
High mortality rate
12
ALL mortality
Treatment standardization
13
AML
Immunotherapy
14
Chemotherapy toxicity
16
No benefit from immunotherapy
17
Hematopoietic recovery delay
Transplantation mortality
18
Treatment toxicity
20
Increased non-relapse mortality
25
Infection risk
Treatment-related toxicity
27
Relapse risk
Treatment resistance
32
High relapse
Low evidence quality
34
ALL treatment mortality
35
Literature analysis of 35 papers
Positive Content
30
Neutral Content
4
Negative Content
1
Article Type
25
7
7
15
35
1.

[Treatment of 100 acute myeloid leukemias (author's transl)].

Author: FièreD, MartinC, Vu VanH, CoiffierB, FelmanP, BryonP A, Favre-GillyJ, RevolL

Improved survival for acute myeloid leukemia

A study of 100 patients with acute myeloid leukemia found that 68 achieved complete remission (CR). The median duration of CR was 12 months and the median survival time was 13 months overall. Patients under 65 had a median survival time of 15 months, while those over 65 had a median survival of 3 months. Patients in CR had a median survival time of 22 months. The addition of BCG treatment appeared to slightly improve survival.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : French

2.

Results of the therapy of acute leukemia. A cooperative trial by the Italian Association Against Leukemias.

Author: PolliE E

Effective leukemia treatment
Improved remission rate

A study of 157 patients with acute lymphoblastic leukemia found that 92.3% achieved complete remission. Patients under 20 years old had a 3-year remission rate of 60%. Age, lymph node involvement, and the percentage of periodic acid-Schiff-positive blast cells were identified as potential prognostic factors. Two maintenance chemotherapy regimens (A and B) were compared, with regimen A showing better results in children aged 2-10 years and patients with mild lymph node enlargement. Based on these findings, three new protocols incorporating prognostic factors were developed, resulting in 1-year remission rates of 91% for Protocol 7601, 70% for Protocol 7602, and 82% for Protocol 7603.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

3.

[Effectiveness of gnotobiotic measures in the treatment of acute leukemia: the results of a prospective randomized clinical study].

Author: DietrichM, AbtC, ArnoldR, PfliegerH, HoelzerD, KurrleE, RascheH, KubanekB, HeimpelH, FliednerT M

Reduced infections

A study of 60 patients with acute leukemia (AL) compared three different supportive care regimens during induction chemotherapy: strict reverse isolation with nonabsorbable antibiotics (Group A), isolation only (Group B), and routine hospital conditions (Group C). Group A had the lowest infection rate and the highest remission rate (76%), followed by Groups B (57%) and C (59%). However, there was no significant difference in survival or remission rates between the three groups after three years. The study concluded that the lack of significant benefit from isolation and decontamination was likely due to insufficient microbial suppression by the antibiotics used, and that better antimicrobial treatments should be investigated before adopting gnotobiotic care as routine support for AL patients.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : German

4.

Treatment of acute nonlymphocytic leukemia: use of anthracycline-cytosine arabinoside induction therapy and comparison of two maintenance regimens.

Author: PreislerH D, RustumY, HendersonE S, BjornssonS, CreavenP J, HigbyD J, FreemanA, GailaniS, NaeherC

Complete remission
Intercurrent infection
Leukemic cell resistance

A study of patients with acute nonlymphocytic leukemia found that 66% achieved complete remission with an induction therapy consisting of cytosine arabinoside and an anthracycline. Patients under 60 years old with no previous history of cancer had the highest remission rate (80%). Two different maintenance regimens, daily chemotherapy with reinforcements or reinforcement therapy only, resulted in similar remission durations. Age was a significant factor for successful induction therapy, with older patients having a higher risk of infection. After achieving remission, age was no longer a determining factor for survival. The duration of remission was linked to the retention of cytosine arabinoside triphosphate by leukemia cells. The study concludes that treatment for acute nonlymphocytic leukemia can be divided into two distinct phases: remission induction and maintenance.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

5.

[Results in the treatment of acute lymphoblastic and acute myeloblastic leukemia in children (using Pinkel's and Clarkson's schedules)].

Author: TiefenbachA, Potkonjak-SeksoM, KonjaJ

Leukemia treatment
Chemotherapy side effects
Radiation exposure

A study of 40 children with acute leukemia evaluated the effectiveness of different treatment protocols, including corticosteroids, chemotherapy, and prophylactic cranial irradiation. The children were randomly assigned to three groups, each receiving a different protocol based on Pinkel's (for ALL) or Clarkson's (for AML) regimens, with or without cranial irradiation.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : Serbian

6.

Early intensification followed by allo-BMT or auto-BMT or a second intensification in adult ALL: a randomized multicenter study.

Author: BernasconiC, LazzarinoM, MorraE, AlessandrinoE P, PagnuccoG, ResegottiL, LocatelliF, FicarraF, BacigalupoA, CarellaA M

ALL remission
Allogeneic BMT efficacy
Early relapse
Toxic death

A study of 96 patients with acute lymphoblastic leukemia (ALL) compared allogeneic bone marrow transplant (BMT), autologous bone marrow transplant (ABMT), and prolonged intensive chemotherapy (ICC) for treating minimal residual disease after remission. While a high number of early relapses occurred after intensive chemotherapy, suggesting it may not be the best approach, allogeneic BMT showed the best results (although not statistically significant). ABMT and ICC had similar outcomes, with some patients experiencing relapses later. The study recommends considering allogeneic BMT as soon as possible after achieving remission for high-risk ALL patients.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

7.

Different patterns of relapse associated with three intensive treatment regimens for pediatric E-rosette positive T-cell leukemia: a Pediatric Oncology Group study.

Author: FallettaJ M, ShusterJ J, CristW M, PullenD J, BorowitzM J, WharamM, PattersonR, ForemanE, ViettiT J

T-ALL remission
CNS relapse
Testicular relapse

A study of 193 children with T-cell acute lymphocytic leukemia (T-ALL) found that different treatment regimens had varying effects on the location of relapse. The study found that: - Intensified intrathecal chemotherapy (treatment in the spinal fluid) and cranial radiation significantly reduced the rate of central nervous system (CNS) relapse compared to less intensive intrathecal therapy without radiation. - A more complex multi-agent chemotherapy regimen was more effective in preventing testicular leukemia compared to a simpler regimen. - The study concluded that the effectiveness of treatments for specific areas of relapse (sanctuary sites) is dependent on the specific therapy used. - While all treatment groups had similar complete remission and 3-year event-free survival rates (around 90% and 40% respectively), these differences in relapse patterns highlight the importance of tailoring treatment plans to specific subtypes of cancer.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

8.

Late intensification with POMP chemotherapy prolongs survival in acute myelogenous leukemia--results of a Southwest Oncology Group study of rubidazone versus adriamycin for remission induction, prophylactic intrathecal therapy, late intensification, and levamisole maintenance.

Author: MorrisonF S, KopeckyK J, HeadD R, AthensJ W, BalcerzakS P, GumbartC, DabichL, CostanziJ J, ColtmanC A, SaikiJ H

AML remission
Survival improvement

A study of 611 patients with acute myelogenous leukemia (AML) compared different treatment strategies. The study found no difference in remission rates between rubidazone and adriamycin for induction therapy. Prophylactic intrathecal therapy with cytosine arabinoside did not improve outcomes. However, patients who received late intensification therapy with POMP after 9 months of remission had better survival and disease-free survival compared to those who did not. Maintenance therapy with levamisole after 12 months of remission did not impact survival or disease-free survival.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

9.

Treatment of hairy-cell leukemia.

Author: LillM C, GoldeD W

Hairy cell leukemia treatment

Treatment for hairy-cell leukemia has significantly improved with the introduction of interferon alpha, deoxycoformycin, and chlorodeoxyadenosine. While a standard treatment protocol has not been established, an individualized approach is recommended, with splenectomy potentially beneficial for patients with low bone marrow involvement and cytopenia. Interferon alpha is currently the preferred first-line drug treatment, while deoxycoformycin remains experimental due to long-term toxicity concerns. Chlorodeoxyadenosine shows promise but needs further evaluation. Intensive chemotherapy and alkylating agents are generally not used in modern treatment.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

10.

Importance of long-term follow-up in evaluating treatment regimens for adults with acute lymphoblastic leukemia.

Author: ClarksonB, GaynorJ, LittleC, BermanE, KempinS, AndreeffM, GulatiS, CunninghamI, GeeT

ALL treatment

This study examined the treatment of acute lymphoblastic leukemia (ALL) in 250 adults over 20 years using five different chemotherapy regimens. The best outcomes were observed with the L10 and L10M regimens, resulting in the highest rates of long-term remission (over 5 years). Overall, 31% of patients survived long-term, with 35% of those achieving remission remaining relapse-free for over 5 years. While outcomes have improved, the study highlights the challenges of treating relapsed ALL, as long-term survival rates are low after a second or subsequent relapse. The study also emphasizes the need for careful patient selection for bone marrow transplantation to improve outcomes.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

11.

Cure of acute myelocytic leukemia in adults: a reality.

Author: GellerR B, SaralR, KarpJ E, SantosG W, BurkeP J

AML treatment

This study found similar cure rates for acute myeloid leukemia (AML) in adults using either bone marrow transplant or intensive chemotherapy. The study suggests that both approaches are effective, but further research is needed to determine the best treatment for individual patients.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

12.

Acute lymphoblastic leukemia in children. Advances and prospectus.

Author: BleyerW A

Improved disease-free survival
Shorter therapy duration
High mortality rate

This review discusses the challenges in treating childhood acute lymphoblastic leukemia (ALL), despite improvements in treatment over the past decade. The review highlights the need for more standardized staging systems and improved ways to predict and treat high-risk patients. Challenges include the lack of reliable tests to assess the effectiveness of chemotherapy and the difficulty in detecting resistant cancer cells before they cause problems. The study emphasizes the importance of ongoing research to improve treatment options and long-term outcomes for children with ALL.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

13.

Remaining problems in the staging and treatment of childhood lymphoblastic leukemia.

Author: BleyerW A

ALL survival improvement
ALL mortality
Treatment standardization

This article discusses the progress and challenges in treating childhood acute lymphoblastic leukemia (ALL). Improvements in treatment have led to better survival rates for high-risk patients, improved management of sanctuary sites (areas where cancer cells can hide), shorter treatment durations, and more effective salvage therapies for relapses. However, ALL remains a leading cause of death among childhood cancers. Challenges include inconsistent staging systems, varying applications of statistical analysis, and the need for larger clinical trials due to improved treatment outcomes. Further challenges include the complexity of distinguishing between ALL, non-Hodgkin's lymphoma, and myeloid leukemia, the lack of reliable tests to predict drug response, and the difficulty in detecting resistant cancer cells before they cause problems. Optimizing treatment and support for all children with ALL remains an ongoing goal.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

[Acute myeloid leukemia (AML) in adults. Further development of therapy based on clinical phase II and phase III studies].

Author: BüchnerT, UrbanitzD, HiddemannW, KochP, PielkenH J, KuseR, MohrA, MaschmeyerG, KreutzmannH, WendtF

Chemotherapy regimens
AML
Immunotherapy

This review of studies on acute myeloid leukemia (AML) in adults finds that while significant progress was made in treatment during the 1970s, there has been limited improvement in the 1980s. The authors advocate for a focus on analyzing different components and elements of AML treatment in order to improve their effectiveness. This includes standardizing treatment protocols and utilizing randomized controlled trials for comparisons. The authors highlight their own multi-center trial which contributed to understanding the role of maintenance chemotherapy and immunotherapy.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : German

15.

[Therapy of malignant systemic diseases: hemoblastoses and malignant lymphomas].

Author: SchmidtC G

Long-term remission
Prolonged remission duration

A study of adult patients with acute myeloid leukemia (AML) found that maintenance chemotherapy after achieving complete remission significantly improved long-term remission rates. The study compared consolidation chemotherapy with and without monthly maintenance therapy, and found a 2.5-year continuous complete remission rate of 30% in the maintenance group compared to 17% in the non-maintenance group (p=0.003). This suggests that maintenance chemotherapy plays a crucial role in prolonging remission duration in AML.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : German

16.

Comparison of chemotherapy with immunotherapy for maintenance of acute lymphoblastic leukemia in children and adults.

Author: StryckmansP A, OttenJ, DelbekeM J, SuciuS, FièreD, BuryJ, SolbuG, BenoitY

Leukemia treatment
Chemotherapy toxicity

A study of 217 patients with acute lymphoblastic leukemia in complete remission compared two consolidation chemotherapy regimens (P and M) and two maintenance treatments (chemotherapy and immunotherapy). Consolidation P caused more toxicity but showed no significant difference in disease-free interval or survival compared to M. Chemotherapy maintenance showed significantly better disease-free interval than immunotherapy, particularly in patients with lower hemoglobin levels at diagnosis. However, there was no significant difference in survival between the maintenance treatments.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

17.

Adjuvant specific immunotherapy in maintenance treatment of adult acute non-lymphocytic leukemia.

Author: RühlH, FülleH H, KoeppenK M, SchwerdtfegerR

Complete remission in leukemia
No benefit from immunotherapy

Adding neuraminidase-modified allogeneic blast cells immunotherapy to induction chemotherapy did not improve the duration of remission or survival in patients with non-lymphocytic acute leukemia.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

18.

Autologous or allogeneic bone marrow transplantation compared with intensive chemotherapy in acute myelogenous leukemia. European Organization for Research and Treatment of Cancer (EORTC) and the Gruppo Italiano Malattie Ematologiche Maligne dell'Adulto (GIMEMA) Leukemia Cooperative Groups.

Author: ZittounR A, MandelliF, WillemzeR, de WitteT, LabarB, ResegottiL, LeoniF, DamasioE, VisaniG, PapaG

Leukemia treatment
Hematopoietic recovery delay
Transplantation mortality

Autologous and allogeneic bone marrow transplantation resulted in better disease-free survival than intensive consolidation chemotherapy for acute myelogenous leukemia in first complete remission.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

19.

Intensive short term therapy with granulocyte-macrophage-colony stimulating factor support, similar to therapy for acute myeloblastic leukemia, does not improve overall results for adults with acute lymphoblastic leukemia. GOELAMS Group.

Author: IfrahN, WitzF, JouetJ P, FrançoisS, LamyT, LinassierC, PignonB, BerthouC, GuyotatD, CahnJ Y, HarousseauJ L

ALL remission
Reduced neutropenia

This study evaluated the efficacy and safety of a chemotherapy schedule similar to that used for acute myeloblastic leukemia (AML) patients in treating adult patients with acute lymphoblastic leukemia (ALL), specifically examining the complete remission (CR) rate, the value of intensive treatment stages, and the impact of recombinant granulocyte-macrophage-colony stimulating factor (rGM-CSF).

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

20.

Prognostic factors in childhood acute lymphoblastic leukemia.

Author: SchrappeMartin

Improved leukemia survival
Treatment toxicity

The study highlights the importance of identifying prognostic factors, particularly the in vivo response to therapy, in treating acute lymphoblastic leukemia (ALL) to tailor treatment and reduce relapses.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

21.

Treatment of primary acute myeloid leukemia: results of a prospective multicenter trial including high-dose cytarabine or stem cell transplantation as post-remission strategy.

Author: BrunetSalut, EsteveJordi, BerlangaJoan, RiberaJosep M, BuenoJavier, MartíJosep M, BargayJoan, GuardiaRamon, JuliáAntoni, GranenaAlbert, MontserratEmili, SierraJorge,

Improved leukemia-free survival
Improved survival

High-dose cytarabine is a good option for patients with t(8;21) acute myeloid leukemia. Autologous and allogeneic stem cell transplantation lead to similar leukemia-free survival in patients under 50 years old, but autologous SCT results are poor in older patients.

Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

22.

A randomized, postremission comparison of four courses of standard-dose consolidation therapy without maintenance therapy versus three courses of standard-dose consolidation with maintenance therapy in adults with acute myeloid leukemia: the Japan Adult Leukemia Study Group AML 97 Study.

Author: MiyawakiShuichi, SakamakiHisashi, OhtakeShigeki, EmiNobuhiko, YagasakiFumiharu, MitaniKinuko, MatsudaShin, KishimotoYuji, MiyazakiYasushi, AsouNorio, MatsushimaTakafumi, TakahashiMasatomo, OgawaYoshiaki, HondaSumihisa, OhnoRyuzo,

AML treatment

The study found that four courses of standard-dose consolidation therapy without maintenance was as effective as three courses of standard-dose consolidation and six courses of maintenance therapy in preventing disease recurrences in patients with acute myeloid leukemia who achieved complete remission. The 5-year overall survival rate was 52.4% for the group receiving four courses of consolidation therapy and 58.4% for the group receiving three courses of consolidation and six courses of maintenance therapy (P=0.599). The 5-year disease-free survival rate was 35.8% for the group receiving four courses of consolidation therapy and 30.4% for the group receiving three courses of consolidation and six courses of maintenance therapy (P=0.543).

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

23.

Remission induction chemotherapy induces in vivo caspase-dependent apoptosis in bone marrow acute myeloid leukemia blast cells and spares lymphocytes.

Author: VialJ-P, TabriziR, PigneuxA, LacombeF, PraloranV, BellocF

Apoptosis induction

The increase of peripheral apoptotic blast cells cannot be considered as the earliest marker of the treatment efficiency in AML patients receiving remission induction treatment. Less than 50% of apoptosis, measured with the fmk-VAD-FITC, in the d15 residual bone marrow blast cells, correlated with lower disease-free survival probability.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

24.

Value of allogeneic versus autologous stem cell transplantation and chemotherapy in patients with myelodysplastic syndromes and secondary acute myeloid leukemia. Final results of a prospective randomized European Intergroup Trial.

Author: de WitteTheo, HagemeijerAnne, SuciuStefan, BelhabriAmin, DelforgeMichel, KobbeGuido, SelleslagDominik, SchoutenHarry C, FerrantAugustin, BiersackHarald, AmadoriSergio, MuusPetra, JansenJoop H, Hellström-LindbergEva, KovacsovicsTibor, WijermansPierre, OssenkoppeleGert, GratwohlAlois, MarieJean-Pierre, WillemzeRoel

Myelodysplastic syndromes treatment

This article discusses allogeneic stem cell transplantation, post-remission chemotherapy, and autologous stem cell transplantation as treatment options for patients with advanced or transformed myelodysplastic syndromes.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

25.

Allogeneic hematopoietic cell transplantation for adult acute lymphoblastic leukemia (ALL) in first complete remission.

Author: PidalaJoseph, DjulbegovicBenjamin, AnasettiClaudio, Kharfan-DabajaMohamed, KumarAmbuj

Disease-free survival
Improved survival
Reduced relapse
Increased non-relapse mortality

This meta-analysis of 14 trials found that matched sibling donor allogeneic hematopoietic cell transplantation was associated with superior overall survival and disease-free survival and significantly reduced the risk of disease relapse in adult acute lymphoblastic leukemia (ALL) patients compared to no donor status. However, the donor group had an increased risk of non-relapse mortality.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

26.

A network meta-analysis of therapies for previously untreated chronic lymphocytic leukemia.

Author: ChengMindy M, GoulartBernardo, VeenstraDavid L, BloughDavid K, DevineEmily Beth

Improved CLL treatment

This study notes that there are multiple treatment options for patients with chronic lymphocytic leukemia (CLL) who have not yet received treatment. While these treatments have been compared to chlorambucil, a common medication, there is no single standard treatment agreed upon by medical experts.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

27.

The role of cytokines in acute myeloid leukemia: a systematic review.

Author: KupsaTomas, HoracekJan Milos, JebavyLadislav

Predictable outcomes
Infection risk
Treatment-related toxicity

Acute myeloid leukemia (AML) is a complex cancer with different forms. Current treatments, while effective for many patients, don't always work for everyone, even with high-dose chemotherapy. The harsh effects of chemotherapy lead to severe side effects and increase the risk of infections, making it difficult to increase the dose.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

28.

The role of maintenance therapy in acute promyelocytic leukemia in the first complete remission.

Author: MuchtarEli, VidalLiat, RamRon, Gafter-GviliAnat, ShpilbergOfer, RaananiPia

APL treatment

Acute promyelocytic leukemia (APL) is a type of leukemia with a high cure rate. While everyone agrees on the need for initial treatment and consolidation (further treatment after remission), the role of maintenance therapy (long-term treatment after consolidation) is debated.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

29.

The role of adhesion molecules in acute myeloid leukemia and (hemato)oncology: a systematic review.

Author: KupsaTomas, HoracekJan M, JebavyLadislav

AML treatment

Acute myeloid leukemia (AML) is a complex cancer with many different forms. While standard treatments work well for most patients, they don't always succeed for everyone, even with high-dose chemotherapy and stem cell transplants. The side effects of chemotherapy are severe and increase the risk of infection, making it difficult to increase the dose. Despite progress in treatment, AML remains a deadly disease.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

30.

Remission maintenance treatment options in chronic lymphocytic leukemia.

Author: EgleAlexander, PleyerLisa, MelchardtThomas, HartmannTanja Nicole, GreilRichard

CLL treatment
Maintenance approaches

Treatment for chronic lymphocytic leukemia (CLL) has improved significantly in recent years, with new medications extending survival and even eliminating detectable cancer in some patients. While most treatments are given for a limited period of time, newer medications that target specific pathways involved in cancer growth are being studied for long-term use. This review examines the results of recent research on long-term treatments, including maintenance therapy, to control CLL.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

31.

A review of current induction strategies and emerging prognostic factors in the management of children and adolescents with acute lymphoblastic leukemia.

Author: CapriaSaveria, MolicaMatteo, MohamedSara, BianchiSimona, MoletiMaria Luisa, TrisoliniSilvia Maria, ChiarettiSabina, TestiAnna Maria

Improved prognostic stratification

This review explores the treatment of acute lymphoblastic leukemia (ALL) in children, focusing on advancements in genomic profiling and minimal residual disease detection techniques. These advancements have led to improved prognostic stratification and the identification of subgroups with specific therapeutic needs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

32.

Treatment of hairy cell leukemia.

Author: ChiharaDai, KreitmanRobert J

Hairy cell leukemia treatment
Relapse risk
Treatment resistance

Although purine analogs have been effective for hairy cell leukemia, patients often experience relapses and drug resistance. New treatments have increased the complexity of clinical decision-making.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

33.

Hypomethylating Agents and FLT3 Inhibitors As Maintenance Treatment for Acute Myeloid Leukemia and Myelodysplastic Syndrome After Allogeneic Hematopoietic Stem Cell Transplantation-A Systematic Review and Meta-Analysis.

Author: BewersdorfJan Philipp, AllenCecily, MirzaAbu-Sayeef, GrimshawAlyssa A, GiriSmith, PodoltsevNikolai A, GowdaLohith, ChoChristina, TallmanMartin S, ZeidanAmer M, StahlMaximilian

AML and MDS treatment

Relapses after a bone marrow transplant (allo-HCT) are a major cause of death for people with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). While medications that target FLT3 and hypomethylating agents (HMA) are being studied to prevent relapses, the results have been mixed.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

34.

Hematopoietic Stem Cell Transplantation for Acute Myeloid Leukemia: An Overview of Systematic Reviews.

Author: HePeijie, LiangJuan, ZhangWanjun, LinShengyun, WuHanting, LiQiushuang, XuXiujuan, JiConghua

AML treatment
Improved survival
Reduced relapse
High relapse
Low evidence quality

Hematopoietic stem cell transplantation (HSCT) is the main treatment for acute myeloid leukemia (AML), with allo-SCT showing better OS, RFS, and DFS than auto-SCT. While auto-SCT is associated with lower TRM, it generally has higher relapse rates. Further research is needed to fully explore the efficacy of different HSCT interventions in AML.

Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

35.

Safety of levofloxacin as an antibiotic prophylaxis in the induction phase of children newly diagnosed with acute lymphoblastic leukemia: an interim analysis of a randomized, open-label trial in Brazil.

Author: DufrayerMauro Cesar, RechenmacherCiliana, MenesesClarice Franco, MonteiroYasmine Massaro Carneiro, CarlesseFabianne Altruda de Moraes Costa, MottaFabrizio, DaudtLiane Esteves, MichalowskiMariana Bohns

ALL treatment mortality

Levofloxacin was shown to be safe in the induction phase of treatment for children with de novo ALL. It did not increase the rate of CPE colonization or C. difficile diarrhea.

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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