All-trans retinoic acid in association with low dose cytosine arabinoside in the treatment of acute myeoid leukemia in elderly patients

All-trans retinoic acid (ATRA) has shown a synergistic activity in combination with cytosine arabinoside in vitro in the treatment of acute myeloid leukaemia (AML). In this paper we report the results of treatment with low dose cytosine arabinoside (LDAC) with or without ATRA in 28 patients with acute myeloid leukaemia aged over 60 years: 14 patients received only LDAC and the other 14 LDAC + ATRA. The patients of the 2 groups showed similar clinical features: in 10 patients AML developed after a myelodysplastic form and 4 patients presented a previous malignancy. All the patients received subcutaneous (sc) LDAC (15 mg twice a day for 14 days) and in 14 patients oral ATRA (45 mg/sqm in the same days) was added to LDAC; the courses were repeated every 4 weeks from diagnosis to relapse. The treatment was well tolerated and the patients could self-administer sc LDAC and oral ATRA at home. No statistically significant differences were observed in complete remission rate (21% vs. 50%, respectively) and resistant rate (57% vs. 29%), but the patients treated with the combination of the 2 drugs had a better time to treatment failure (15 weeks vs. 30 weeks, respectively) (P = 0.045) and a longer survival (37 weeks vs. 66 weeks) (P = 0.019). Our experience, although with a low number of patients, confirms the efficacy of ATRA in combination with sc LDAC in the treatment of AML in elderly patients

Efficacy of a modified Stanford V regimen in patients with advanced Hodgkin's lymphoma.

We report treatment results obtained with a modified Stanford V regimen in 32 patients with advanced Hodgkin's lymphoma (stage II bulky disease, III, IV). Treatment results were not superior to those achieved with conventional treatment (ABVD) in terms of complete remission and survival rates (progression-free survival and overall survival at 3 years: 66% and 91%, respectively)

DAP-kinase hypermethylation in the bone marrow of patients with follicular lymphoma.

We studied whether DAP-kinase hypermethylation plays a role as a prognostic marker in patients with follicular lymphoma (FL). We found that DAP-kinase was frequently hypermethylated in bone marrow (BM) samples of 52 FL patients at diagnosis (71%) and identified patients with worse progression-free survival (p=0.06). In particular, patients with histologically proven BM infiltration and DAP-kinase hypermethylation had a poorer outcome (p=0.037). In a total of 170 BM samples obtained at diagnosis or during follow-up, DAP-kinase hypermethylation and the bcl2/IgH rearrangement gave concordant results in 67% of samples (48% both positive, 19% both negative). Both mrakers were independent predictors of the disease status (p<0.001)