A Brief History Behind The MS-275 Successfulness
  • We aimed also to look for all possible predictive factors of Differentiation Syndrome (DS) which were first described in 1992 by Frankel et al. [4] MS-275 chemical structure and represented the major complication through this disease course: studies had reported conflicting results about this [5]?and?[6]. In addition we will compare our data to other areas of the world. Twenty-nine patients with APL confirmed by molecular study were treated from August 2005 to June 2011 at King Fahad Medical City, Riyadh, Saudi Arabia. Laboratory studies at diagnosis included: hemogram of liver and renal function tests, bone marrow studies (cytogenetics, flowcytometry, FISH, and PML-RAR�� by RT-PCR analysis). CBC and coagulation parameter were monitored daily and coagulopathy was treated. All patients with fibrinogen levels <100?mg/dl �Cwith or without active bleeding�C received cryoprecipitate to maintain the fibrinogen above this level without the routine use of prophylactic heparin. Platelets were transfused to maintain the platelet count about 30,000/��L in patients not actively bleeding and above 50,000/��L in patients actively bleeding. Fresh frozen plasma was administered to patients actively bleeding with prolonged PT and PTT, but not to patients without active bleeding. Management of fever and neutropenia was according to our leukemia unit guidelines. Packed red cell <a href="http://www.selleckchem.com/products/GDC-0449.html">GDC-0449 mw transfusion was given if hemoglobin was less than 8?gm/dl. The treatment regimen consisted of [7]: I. Induction: Differentiation Syndrome was diagnosed based on the following clinical features: respiratory distress, Quinapyramine pulmonary infiltrate, fever, weight gain, pleural effusion, renal impairment, pericardial effusion, and hypotension. Once we diagnosed it, we discontinued ATRA and dexamethasone (10?mg IV bid) was given for a minimum of 3?days with or without Lasix for reducing body weight. ATRA treatment was resumed once symptoms of Differentiation Syndrome resolved. All other complications at presentation and during treatment course were recorded. Patients were classified according to the risk of relapse (PETHEMA) on the basis of WBC and platelet counts (PLT) at diagnosis: Low risk WBC?<?10?��?109/L and PLT?>?40?��?109/L; Intermediate risk WBC?<?10?��?109/L and PLT?<?40?��?109/L, and High risk WBC?>?10?��?109/L [8]. We calculated the body mass index (BMI) with the following categories: Underweight?=?<18.5, Normal weight?=?18.5�C24.9, Overweight?=?25�C29.9 and Obesity?=?BMI of 30 or greater. Complete Remission (CR) required patients to have ANC?>?1.5?��?109/L, platelet count of more than 100?��?109/L and normo to hypocellular bone marrow with <5% blasts plus promyelocytes. Survival time was calculated from the time of diagnosis to the last follow-up. Resistant disease is defined as: the persistence of greater than 5% leukemic promyelocytes 56?days after the start of ATRA treatment.</div>

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