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    BACKGROUND:The efficacy of azacitidine for the treatment of high-risk myelodysplastic syndromes has prompted the issue of its potential role even in the treatment of acute myeloid leukemia (AML).METHODS:The authors analyzed 82 patients with AML who were diagnosed according to World Health Organization criteria. The median patient age was 72 years (range, 29-87 years), and 27 patients (33%) had secondary AML. Of 62 patients with evaluable cytogenetics, 18 patients (29%) had a poor-risk karyotype, and 44 patients (71%) had an intermediate karyotype. Thirty-five patients (43%) received azacitidine as front-line treatment, and 47 patients (57%) had previously received 1 or more line of chemotherapy.RESULTS:The overall response rate was 32% (26 of 82 patients) and included 12 (15%) complete remissions (CRs), 4 (5%) CRs with incomplete blood count recovery (CRi), and 10 (12%) partial responses (PRs). Responses were observed more frequently among untreated patients compared with pretreated patients; in fact, 17 of 35 untreated patients (48%) responded, including 11 responses (31%) classified as CR/CRi. Conversely, only 9 of 47 pretreated patients (19%) responded, including 5 responses (11%) that were classified as CR/Cri. The response rate was significantly higher for untreated patients (P = .006) and those who had white blood cell counts <10 × 109/L (P = .006). For untreated patients who achieved a response, the median overall response duration was 13 months, and the 1-year and 2-years overall survival rates were 58% and 24%, respectively.CONCLUSIONS:The current results indicated that azacitidine promises to be an effective therapy for elderly patients with untreated AML and with white blood cell counts <10 × 109/L. Cancer 2011;. © 2011 American Cancer Society.dx.doi.org


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    (Scripps Research Institute) Scientists at The Scripps Research Institute have shown that a particular white blood cell plays a direct role in the development and spread of cancerous tumors.
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    Cocaine's Newest Risks

    Scientific American 305, 30 (2011). doi:10.1038/scientificamerican0911-30

    Author: Francie Diep

    A new drug contaminant is causing frightening outbreaks of blackened skin and low white blood cell counts

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    A pandemic of ailments called the "allergic march" -- the gradual acquisition of overlapping allergic diseases that commonly begins in early childhood -- has frustrated both parents and physicians. Now scientists have identified that expression of the protein TSLP may influence susceptibility to multiple allergic diseases by regulating the maturation of basophils, an uncommon type of white blood cell.
    feeds.sciencedaily.com   ...Read On

    July 08, 2011
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    By Helen Albert
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    Contaminated cocaine use can cause painful, necrotic skin purpura
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    By
    Springer
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    MedWire News: Using cocaine contaminated with the animal de-worming drug levamisole can result in painful, necrotic purple skin lesions and low levels of white blood cells, report US researchers.

    "We've seen a lot of cases in Rochester alone, so it is important to alert the gatekeepers of medicine, the primary care physicians who are in the trenches every day, of this diagnosis," said study author Mary Gail Mercurio from the University of Rochester in New York.

    "This is one of those entities that with familiarity and recognition, can go a long way in helping physicians to quickly make a diagnosis and intervene without embarking on an elaborate workup where nothing will pan out," she said.

    Co-author Noah Craft (University of California, Los Angeles) and colleagues describe a series of six patients with remarkably similar dermatological symptoms after cocaine use, treated in clinics in New York and California over the past few months.

    Symptoms included net-like purple skin discoloration or purpura on the body, which included painful eruptions, skin necrosis, and scabbing, all occurring after cocaine use.

    In addition, all the patients had positive perinuclear antineutrophil cytoplasmic antibody values, a common feature of many autoimmune conditions. Three also had a low white blood cell count (neutropenia), which can significantly increase infection risk.

    The study authors believe that the cause of these symptoms is contamination of the cocaine with levamisole, rather than cocaine use per se, as the symptoms of purpura and neutropenia have been observed before in connection with levamisole-contaminated cocaine use.

    Craft et al explain that levamisole-contaminated cocaine has been in use in the USA since 2003, and resulting toxic reactions have increased dramatically since 2008.

    "When we first started seeing these patients they all had a similar clinical picture, but they were really an enigma because they weren't falling into any other pattern we'd seen before. When a colleague at the National Institutes of Health mentioned levamisole contamination, we did toxicity screens and lo-and-behold, all the patients came up positive for cocaine," said Mercurio.

    She concluded: "We believe these cases of skin reactions and illnesses linked to contaminated cocaine are just the tip of the iceberg in a looming public health problem posed by levamisole."

    The results of this study are published in the Journal of the American Academy of Dermatology.

    MedWire (http://www.medwire-news.md/ ) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
    hepatitiscnewdrugs.blogspot.com


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