Table 1.
Summary of clinical efficacy of TPA in patients with myelocytic leukemia who were refractory to chemotherapy
| Patient no. | Dose of TPA | Bone marrow myeloblasts (% of total cells)
|
Peripheral myeloblasts (% of white cells)
|
Patient condition after TPA | Duration of remission | ||
|---|---|---|---|---|---|---|---|
| Before TPA | After TPA | Before TPA | After TPA | ||||
| 1 | 1 mg per week for 2 weeks | 30 | 2.5 | 5 | 0 | Partial recovery | 5 months |
| 2 | 1 mg per week for 5 weeks | 36 | 3 | 6 | 0 | Returned to normal lifestyle | 3 months |
| 3 | 1 mg per week for 7 weeks | 90 | 2 | 8 | 0 | Returned to normal lifestyle and work | 26 days |
| 4 | 1 mg per week for 7 weeks | 67.5 | 0 | 5 | 0 | Returned to normal lifestyle and work | 3 months |
| 5 | 1 mg per week for 2 weeks | 27.5 | 0.5 | 33 | 0 | Returned to normal lifestyle and work | >1 month |
| 6 | 1 mg per week for 3 weeks | 48 | 3 | 10 | 0 | Returned to normal lifestyle and work | 8 months |
| 7 | 0.5 mg twice a week for 11 weeks | 10 | 4 | 6 | 0 | Partial recovery | — |
| 8 | 0.5 mg twice a week for 3 weeks | 81 | 17 | — | — | Returned to almost normal lifestyle | 2 months |
| 9 | 0.25 mg given once | — | — | 4* | 0† | — | — |
| 10 | 0.5 mg once and 0.25 mg 2 days later | TPA treatment increased megakaryocytes in bone marrow more than 10-fold; no effect on % blasts | — | — | Patient stopped treatment because of chills and fever | — | |
| 11 | 0.25 mg every other day for five doses | 77 | 20 | — | — | Patient was very nervous before and during TPA treatment; attempted suicide | — |
| 12 | 1 mg once | 80 | 60 | — | — | Patient returned home because of family request | — |
Patients 1–6 received TPA, Ara C, and vitamin D3. Patient 7 received TPA, Ara C, and 1α,25-dihydroxyvitamin D3. Patients 8–12 received only TPA. Five patients (1, 6, 8, 11, and 12) had acute myelocytic leukemia, six patients (2–5, 9, and 10) had chronic myelocytic leukemia with blast crisis, and one patient (no. 7) had myelodysplastic syndrome with refractory anemia. A description of each patient is given in the text. Bone marrow and peripheral blood analyses were done 1–2 days after the last Ara C or TPA administration (or as indicated in the text). A dash indicates that no data were available.
Data were obtained 2 days after TPA administration.
Data were obtained 5 days after TPA administration.