About 100,000 people are diagnosed with acute leukemia, 5.2 million are diagnosed with myeloid leukemia, and 1.4 million with chronic myeloid leukemia each year in the United States. The rate of all acute leukemias is approximately 1.4 per 100,000 inhabitants per year. Myeloid leukemia occurs more often in adults than in adolescents.
This condition is a group of diseases in which the bone marrow is affected and blood cells fail to grow normally. Its main features are fever, feeling tired, shortness of breath, loss of appetite and weightlessness. It is the second most common form of lymphoproliferative disease, after [chronic lymphocytic leukemia](https://www.withpower.com/clinical-trials/chronic-lymphocytic-leukemia), and typically affects middle-aged and elderly males. It may occur sporadically (idiopathic leukemias) or be inherited as an autosomal hereditary disease or as part of the genetic defects in the DNA repair machinery. All of these types of leukemias may share a number of clinical features.
At present, there is insufficient evidence that a cure exists for acute leukemias. Patients with acute lymphoblastic leukaemia should be offered only curative therapy with a curative intent; curative therapy in those with acute myeloid leukaemia should include a curative intent; and curative therapy in patients with acute promyelocytic leukaemia should be used with the aim of cure.
A number of factors appear to cause leukemia. Chronic inflammation in the intestines can trigger a number of blood disorders, including acute leukemia. Stressful situations can trigger several types of leukemia. Alcohol can harm the body's cells by disrupting the functioning of genes. Poor nutrition can cause disease through various biochemical pathways, including the pathways that use carbohydrates and fats as fuel. Finally, certain types of infections can cause acute disease, the most common forms of which are the Epstein-Barr virus and HIV.
Abnormal findings on routine blood tests are common in patients with leukemia. In leukemia with neutrophilia, the neutrophil count should be measured as it may show a leukemic response. Acute lymphocytic leukemia that is treated with standard chemotherapy usually produces no detectable changes in lab tests. Monoclonal gammopathy of undetermined significance is an ominous sign that requires further evaluation for possible malignancy.
The vast majority of patients with leukemias, myelodysplastic syndromes, and acute myeloid leukemias will receive systemic chemotherapy. Novel small molecule inhibitors of JAK-STAT signaling may serve as a potential treatment for acute myeloid leukemia.
Patients with a current diagnosis of leukemia, myeloid, acute, and/or high-risk chronic myelogenous leukemia are at higher risk for developing a second primary leukemia. Follow-up of these patients requires careful attention to hematologic evaluation and careful consideration of initiating antileukemia therapy in patients with secondary disease.
Data from a recent study of this study suggest that the inclusion of liposomal daunorubicin with conventional cytarabine is a promising approach for the enhancement of antitumor activity. Data from a recent study provide the basis for the use of liposomal ara-A in combination with conventional ara-C in phase II/III clinical trials.
Encapsulation of ARA-C, as in LBX-1288, has proved to be feasible and effective. In a recent study, findings obtained are consistent with other anticancer agents undergoing similar treatments and showing promising results with LBX-1288. The lipid envelope of ARA-C permits it to penetrate into a cell more efficiently, but the intracellular distribution is unaffected by liposome encapsulation. Moreover, LD50(tox) was greatly increased in the LDP-ara-C group whereas only LD50(tox) decreased slightly with the same dose in controls.
When evaluated as part of a safety trial that included DaunoCyt at 3.5 mg/m2 for 3 cycles, liposome-encapsulated DaunoCyt was safe and well tolerated. The most common infusion-related adverse events were myelosuppression and hypotension. For both groups, the most commonly occurring grade 2 reactions to DaunoCyt were febrile neutropenia, a decrease in neutrophil count, and grade 1 and grade 2 reactions including nausea and fatigue. Because liposome-encapsulated DaunoCyt is more well tolerated than free daunorubicin, it may increase the chance of remission.
This first study suggests patients with multiple myeloma and relapsing AML could safely receive this new DaunoCel LIPO regimen with a manageable side effect profile, and with evidence of clinical activity at least as good as that observed currently with the use of LipoDaunoCel in first line clinical practice.
The relative incidence of ALL and AML was 1.3 and 6.8/100 000/year, respectively. The incidence of each was similar in all age groups, but it increased substantially with advancing age, with the highest cumulative rate of ALL of 5.3/100 000/year in the elderly and AML of 11.9/100 000/year for those >45 years old. Among ALL/AML patients, age was the sole predictor of survival, with a hazard ratio of 1.8/year (95% CI, 0.95 to 3.