There fore it will seem that the efficacy of the two drug reg imen was comparable towards the single agent routine. Having said that because of the tiny amount of individuals and hetero geneity from the patient groups it is actually unattainable to draw any conclusions. A bigger examine can be needed to reply this query. A different question is why cisplatin has not been employed to any degree during the therapy of acute leukemia. Clearly there is in vitro data exhibiting that some leukemia cell lines are delicate to cisplatin Full remissions have also been reported in relapsed and refractory AML patients handled with carboplatin. Undoubtedly there may very well be a reluctance to work with an agent that leads to renal and electrolyte abnormalities inside a group of sufferers who are at higher threat of these issues from their disease and supportive care. However with cur rently available supportive measures these problems are quickly managed.
From the latest examine various sufferers with high white blood cell counts had rapid reductions in their peripheral counts. It was our impression the reduction in peripheral selleckchem SAR302503 counts was additional speedy using the addition of cisplatin than with temo zolomide alone, suggesting that the former is an energetic agent in this disease. MGMT expression is definitely an essential mechanism of resist ance to temozolomide. This has become demonstrated in gli omas also as in leukemia. Brandwein et al carried out a phase II examine of temozolomide in poor prognosis AML individuals 60 many years of age or older. Of 46 patients handled there were three finish remissions and 2 finish remissions with out platelet recovery for an overall response price of 11%. In previously untreated patients the general response rate was 22%. Twenty eight samples had been obtained for MGMT evaluation.
The frequency of MGMT negativity was greater in previously untreated sufferers than in previously treated patients. Absent MGMT expression was substantially correlated with greater probability of response to temozolomide. The overall response rate was 60% CHIR258 Dovitinib for individuals who had been MGMT neg ative compared to 6% for individuals with expression of MGMT. From the previously taken care of sufferers there was only one patient with no MGMT expression and that patient was the only one to attain finish remission. Caporaso et al have also added the MGMT inhibitor lomeguatrib to patients with refractory leukemia obtaining temozolo mide. Patients also received IL 2 subsequent to their chemotherapy. In this study six of eight heavily pretreated individuals showed partial or complete disappearance of blast cells from the peripheral blood or bone marrow. Conclusion On this phase I research in patients with relapsed/refractory acute leukemia, remedy was nicely tolerated up to the maximal doses of temozolomide 200 mg/m2/d occasions seven days and cisplatin 100 mg/m2 on day 1.