ABSTRACT
Thirty-one patients with acute non-lymphocytic leukemia (ANLL) were studied with Dicke's soft agar marrow culture to identify leukemic colony forming units. Eighteen of them had leukemic colony formation, in those patients, the average survival period was shorter (65d), and none of them achieved remission after chemotherapy. The remaining thirteen patients had no colony formation and had a longer survival period of 119.8 d. In the latter group four out of six who had undergone more than two courses of chemotherapy went into complete remission. Our study showed that patients who had leukemic colony formation had a worse prognosis than those who had no leukemic colony formation.
Subject(s)
Leukemia, Myeloid, Acute/pathology , Adolescent , Adult , Aged , Cell Division , Female , Humans , Male , Middle Aged , Prognosis , Tumor Cells, Cultured , Tumor Stem Cell AssayABSTRACT
Low dose Ara-C (LDAra-C, Ara-C 10-15 mg/12 h, i.m. x 14-21 days) was used in the treatment of 17 patients with ANLL, and from 14 patients blast cells were isolated before chemotherapy and cultured in the presence of Ara-C (10(-8) and 10(-7) mol/L), no definite induction of differentiation of leukemic cells was found. Of the 17 cases, 5 obtained CR, only one of them with M4 entered CR without pancytopenia or bone marrow aplasia during the LDAra-C treatment. For the rest, 4 with M2 obtained PR, and 8 did not respond. Toxic effects, including pancytopenia and bone marrow aplasia, were observed in most of the patients. Laboratory results showed that differentiation was not induced by Ara-C in low concentration in in vitro culture. LDAra-C is thought to be effective in the treatment of ANLL, and the mechanism may involve both the cytotoxicity and the induction of differentiation of leukemic cells, but the former is far more important.