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The use of modified MidAC regimen in the treatment of adult patients with de novo Acute Myeloid Leukemia in Baghdad Teaching Hospital

Authors: Mazin Abbas Shubber --- Ali Almothaffar
Journal: Iraq Joural of Hematology المجلة العراقية لامراض الدم ISSN: 20728069/25432702 Year: 2011 Volume: 1 Issue: 1 Pages: 13-21
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Consolidation chemotherapy is an important concern in maintaining remissionin acute myeloid leukemia (AML) .Objectives: We intended to evaluate the efficacy of using modified MidAC regimen in thetherapy of adult AML patients .Patients & Methods :Twenty-six patients (mean age, 25 years; range, 17 to 45 years) with denovo AML were given induction regimen according to the AML subtype .Patientswho failed induction, were received modified MidAC as salvage therapy .All patientswho achieved complete remission (CR) were assigned to receive 3 successivecourses of modified MidAC as a consolidation treatment .Results :A total of 21 (80%) patients went into CR after one induction regimen .In the rest 5(20%), 3 (60 )%of them enter CR after re-induction with modified MidAC, and 2(40 )%died .Total 24 patients assigned for consolidation therapy .After completingthe 3 consolidation courses, 21 (88 )%of them were maintained in remission while 3(12 %)died .The median duration of follow up was 11.7 months .At the end of thestudy, 13 patients) 54 )%were in CR and 8 (38 )%relapsed .The median overallsurvival) OS )is 20 months and the 2 years OS is 41.%Median disease-free survival(DFS )is 17 months and the 2 years DFS is 37 .%Median survival after relapse was2.5 months .Main toxicities after modified MidAC regimen were myelosuppression,GIT complications and sepsis .Conclusion :Modified MidAC regimen is an option as a consolidation or as a salvage therapyin the treatment of adult AML patients with minimal difference in the rate of toxicitywhen compared with other high-dose regimens .

Keywords

AML treatment --- consolidation --- MidAC


Article
Assessment of IL-6 Serum Level in Patients With Acute Myeloid Leukemia
تقييم معدل الانترلوكين 6 في مصول مرضى acute myeloid leukemia

Author: Sura Dhafir Dawood سرى ظافر داود
Journal: Iraqi Journal of Cancer and Medical Genetics المجلة العراقية للسرطان والوراثة الطبية ISSN: 20786123 Year: 2011 Volume: 4 Issue: 1 Pages: 22-28
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Interleukin-6(IL-6) is a pleiotropic cytokine that plays a major role in response to injury orinfections and involved in immune response, inflammation and haematopoiesis. It is produced by a variety ofcell types in response to variety of stimulants. Also deregulation impacts to numerous disease states, includingmany types of cancer. Elevated IL-6 levels have been observed in most types of cancer and it’s implicated inthe pathogenesis of several disease such as acute myeloid leukemia, multiple myeloma, lymphoma and it maybe a prognostic factor for solid tumors, such as prostate cancer.Objectives: Estimation of the serum levels of IL-6 in patients with AML in different stages of the disease andassess their prognostic value and study its relationship with bacteremia, total leukocyte count ,and hemoglobinconcentration.Materials and Methods: Forty patients of AML in different stages in National centre of hematology-Baghdadwere studied immunologically for the detection of serum IL-6 by Enzyme Linked Immune SorbentAssay(ELISA) kit. Specimen of blood collected from AML in relapse stage with episode of fever, were subjectedto well known established microbiological methods for diagnosis and identification of isolates and datawere compared with 20 healthy donors.Results: Newly diagnosed and in relapse stage patients with AML had significantly higher serum levels ofIL-6 compared with both control group and leukemic patients in remission stage P<0.05,in addition there wasa positive correlation of IL-6 with the presence of fever due to bacterial infection .The clinical specimen resultin(8) isolates, from which (6) were coagulase negative and (2) were staphylococcus aureus ,all isolates showhigh sensitivity to erythromycin and high resistant to chloromphenicol .Also IL-6 level correlated positivelywith total leukocyte count (TLC) and inversely with hemoglobin (Hb) concentration in AML at diagnostic andrelapse stage.Conclusion: Serum levels of Interleukin-6 can be used as prognostic serum markers at diagnosis of adultsacute myeloid leukemia and it could be used as follow up parameters for early detection of relapse stage, inaddition it seem to be a good markers to detect patients with bacteremia.

تجابة المناعية والالتهابات وتكون أو تولد الدم .وينتج من قبل �� تجابة للإصابات والعدوى وكذلك في الاس �� ي في الاس �� المقدمة: يلعب الانترلوكين 6 دور أساسمختلف الخلايا نتيجة الاستجابة لمختلف المنبهات.بالإضافة إلى انه AML, Multiple myeloma, lymphoma رطانات وله تأثير في أمراضية أنواعا كثيرة منها �� ارتفاع معدل الانترلوكين 6 لوحظ في معظم السقد يلعب دور كعامل منبه لانواعا أخرى مثل سرطان البروستات.ة علاقته مع ارتفاع الحرارة �� في مراحله المختلفة من المرض وتقييم قيمته التنبوئية وكذلك دراس AML ر معدلات الانترلوكين 6 في مصول المرضى �� دف: تقدي

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