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Biomedical subjects

J Carnot

Publications and source records attributed to J Carnot.

13 recordsLinked to original sources
PubMed1994

[Treatment of promyelocytic leukemia with retinoic acid: results in Cuba].

PURPOSE: To assess the results attained with all-trans-retinoic acid (ATRA) in a group of Cuban patients with acute promyelocytic leukaemia (PML). PATIENTS AND METHODS: Twenty-one patients with PML were studied. Their cytogenetic study was performed with G-band techniques. ATRA was given orally as a single dosis of 50 mg/m2 a day, or divided in two doses. After attaining complete remission (CR), ATRA was maintained for 1-3 months in association with minimal doses of Ara-C or alpha-interferon. A rotation of three therapeutic regimes (TRAP, POMP and DOAP) was subsequently administered. RESULTS: Twelve of the patients were women and 9 men; 15 were adults and 6 were children, the median age being 19 years (range: 6-60 years). Only two patients had leucocytosis, all others presented with leucopenia. Platelet count below 30 x 10(10)/L was found in 67% of the cases, while some sort of bleeding was present in 81% of them. Laboratory evidence of disseminated intravascular coagulation was seen in 52% of the cases, and t (15; 17) appeared in 67% of the evaluable cytogenetic studies. CR was attained in 17 patients (81%) within a mean of 40 days. Headache was the commonest untoward effect of the treatment. Eight patients developed leucocytosis during treatment, white-cell count being over 20 x 10(9)/L in six of them. Fever without infectious signs was present in 5 patients, and in 3 of them the temperature recovered with steroid therapy. Two patients had retinoic acid syndrome prior to achieving CR. Four patients relapsed and 13 (76%) have maintained CR after 1 to 24 months. CONCLUSIONS: The incidence of CR in this series is within the limits reported in the literature. The secondary effects of the treatment are the same than those reported by others, and they were transient and well tolerated. The response to steroids of those patients with fever secondary to ATRA is noteworthy. The efficacy of ATRA, in general terms, in the induction of CR in PML seems confirmed by these results.

Adolescent↗
PubMed1991

Improved results of an intensified therapy in adult acute lymphocytic leukemia.

Two consecutive studies for adult patients with acute lymphoblastic leukemia without previous treatment were analyzed and compared. Protocol ALL-79 included 137 patients treated with a 'standard therapy' consisting of prednisone, vincristine and daunomycin as induction, CNS prophylaxis with IT chemotherapy and maintenance with 6-mercaptopurine, methotrexate and pulses with vincristine and prednisone. Protocol ALL-82 included 145 patients treated with an 'intensive therapy' consisting of 8 weeks of induction with vincristine, prednisone, daunomycin and L-asparaginase, followed by 6-mercaptopurine, cyclophosphamide and cytosine arabinoside. At 3 months after induction, a 6-week consolidation therapy was given, with vincristine, adriamycin, dexamethasone and L-asparaginase, followed by cyclophosphamide, cytosine arabinoside and 6-mercaptopurine. Rates of complete remission were 80% and 78% for protocols ALL-79 and ALL-82 respectively. The probability of remaining in complete remission at 80 months was 20% and 34%, respectively (p = 0.0014). Median survival for protocol ALL-79 was 14 months, and 34 months for protocol ALL-82; at 80 months the probability of survival is 22% and 35% for the two protocols (P = 0.0024). In protocol ALL-82, the probability of remaining in CR for favorable prognosis patients (age = less than 35 years and WBC = less than 50.000) is 56% at 80 months, and only 8% at 50 months for the unfavorable group (age greater than 35 and/or WBC greater than 50.000) (P = 0.0012). The probability of survival was statistically superior in patients with favorable prognoses, with 54% of them still alive at 60 months compared to only 13% of patients with unfavorable prognoses (P = 0.0085).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Treatment of therapy-induced preleukemic syndrome.

Two young adult patients with therapy-induced preleukemic syndrome and Hodgkin's disease as primary malignancy were treated with aggressive antileukemic regimens before the establishment of leukemic conversion. Pretreatment clinical staging procedures did not reveal recurrence of Hodgkin's disease. One of the regimens consisted of an HLA-identical allogeneic bone marrow transplant and the other of high dose cytosine arabinoside. Both therapeutic approaches have proved successful in restoring normal hematopoiesis with reversal to normal karyotypes and unmaintained remissions 556 and 192 days post-treatment. The rationale for such a therapeutic approach in the preleukemic stage of therapy-induced leukemogenesis is discussed.

Adult↗