The CancerWeb Report, What's New In Cancer: February, 1997
Hematologic Malignancy

• Acute promyelocytic leukemia: is cytarabine necessary? - A study carried out at the M.D. Anderson Cancer Center in Houston raises doubts as to whether cytarabine should be included in the complex regimen used to treat promyelocytic leukemia. As published in the February, 1997 issue of the Journal of Clinical Oncology, induction of remission with all-trans retinoic acid and idarubicin, followed by idarubicin alternated with mercaptopurine, vincristine, methotrexate and prednisone (POMP regimen) gave a complete remission rate of 77%, the same as the earlier cytarabine-containing regimens (cytarabine, doxorubicin and amsacrine). However the probability of a 2.5-year disease-free survival was 80% for the new regimen versus 20% for the older one. (Estey, J Clin Oncol 15:483, 1997)

  ---

• Blood stem cell transplants better than bone marrow transplants, but only in the short term - The European Group for Blood and Marrow Transplantation looked at their data and concluded that using blood rather than marrow as a source of actively-dividing cells (stem cells) to replenish the recipient's bone marrow was better only in the short term. Hematologic recovery occurred faster with the blood cells and mortality was lower, but overall survival was the same, and relapse rates were higher for blood cell than for marrow transplantation (49.2% versus 42% for non-Hodgkin's lymphoma, and 58.6% versus 40% for Hodgkin's disease). (Majolino, J Clin Oncol 15:509, 1997)

  ---

• A rare case of a spontaneous remission of chronic myelocytic leukemia - Clinicians at the Hokkaido University School of Medicine in Japan reported in the January 30, 1997 issue of the New England Journal of Medicine details of an example of complete spontaneous remission in a patient with chronic myelocytic leukemia. The patient was found to have the disease by a full cytological workup in January, 1985. By April, 1985 white blood cell and platelet counts and enlarged spleen and liver had returned to normal. No treatment was ever given, and the patient was well as of January 1996. The abnormal Philadelphia chromosome, a marker for the disease, had disappeared and other RNA probes also were negative. Only a handful of such cases have ever been reported. (Musashi, New Engl J Med 336:337, 1997)