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Clinical Lymphoma & Myeloma Mar 2009In Waldenström's macroglobulinemia, treatment is currently reserved for symptomatic patients. For many years, conventional treatment consisted of alkylating agents with... (Review)
Review
In Waldenström's macroglobulinemia, treatment is currently reserved for symptomatic patients. For many years, conventional treatment consisted of alkylating agents with or without steroids. In the past decade, fludarabine has proved to be effective in untreated and previously treated patients, even in those who experience primary treatment failure with alkylating agents. Based on in vitro evidence of synergistic effects and on the promising results obtained in other lymphoproliferative disorders, attempts have been made to combine alkylating agents with purine analogues. Encouraging results with high responses have been observed with the association of fludarabine and cyclophosphamide. The addition of an effective and nonmyelosuppressive therapeutic agent such as rituximab to fludarabine-based therapy ameliorates the quality and the response rates. Despite the lack of randomized trials, the recent consensus report indicates that combination therapy either with nucleoside analogues and alkylating agents or with nucleoside analogues and rituximab are reasonable choices for primary therapy.
Topics: Antineoplastic Combined Chemotherapy Protocols; Humans; Vidarabine; Waldenstrom Macroglobulinemia
PubMed: 19362977
DOI: 10.3816/CLM.2009.n.017 -
Acta Haematologica 2014
Topics: Antineoplastic Combined Chemotherapy Protocols; Cytarabine; Drug Resistance, Neoplasm; Etoposide; Female; Humans; Leukemia, Myeloid, Acute; Male; Salvage Therapy; Vidarabine
PubMed: 24296429
DOI: 10.1159/000355134 -
Cancer Treatment and Research 1999The efficacy of graft-vs.-leukemia induction to treat relapses after allogeneic progenitor cell transplant in a variety of hematologic malignancies suggest that it may... (Review)
Review
The efficacy of graft-vs.-leukemia induction to treat relapses after allogeneic progenitor cell transplant in a variety of hematologic malignancies suggest that it may be possible to use the graft versus leukemia as primary therapy for these malignancies without the need of myeloablative therapy. This type of strategy should be explored initially in patients considered ineligible for conventional myeloablative therapies either because of age or concurrent medical conditions. GVHD remains a major obstacle that needs to be overcome. Although a potentially lower level of inflammatory cytokines may be present after non-myeloablative therapies, fatal GVHD still occurs. Methods to diminish GVHD after allogeneic transplant include selective T-cell depletion (39-43) and transduction of donor T-cells with Herpes simplex virus thymidine kinase which renders these cells sensitive to ganciclovir treatment (see chapter 16). We and others have demonstrated that nonablative chemotherapy using fludarabine combinations is sufficiently immunosuppressive to allow engraftment of allogeneic blood progenitor cells. Patients could then receive graded doses of donor lymphocytes without rejection, to mediate GVL. Ideally, this therapy could be titrated to levels of residual malignant cells using sensitive detection techniques. This novel approach to therapy would reduce the toxicity of the transplant procedure, allow it to be administered more safely to debilitated patients and possibly extend the use of transplantation to older patients who are not presently eligible for BMT procedures. Other possible indications include treatment of non-malignant disorders and induction of tolerance for solid organ transplantation.
Topics: Graft vs Host Disease; Graft vs Leukemia Effect; Hematologic Neoplasms; Hematopoietic Stem Cell Transplantation; Humans; Immunosuppressive Agents; Vidarabine
PubMed: 10800646
DOI: No ID Found -
Drug Intelligence & Clinical Pharmacy Jan 1984A report of hematologic abnormalities associated with administration of vidarabine in a neonate is presented. High doses of vidarabine (30 mg/kg/d) for the treatment of...
A report of hematologic abnormalities associated with administration of vidarabine in a neonate is presented. High doses of vidarabine (30 mg/kg/d) for the treatment of herpes simplex infection may have caused a decrease in hematocrit and platelet count. This case demonstrates the need to monitor hematologic indices during administration of vidarabine. The use of doses greater than 15 mg/kg/d is questioned.
Topics: Female; Hematologic Diseases; Herpes Simplex; Humans; Infant, Newborn; Vidarabine
PubMed: 6692746
DOI: 10.1177/106002808401800116 -
Viruses Apr 2021Viral infections are one of the leading causes in human mortality and disease. Broad-spectrum antiviral drugs are a powerful weapon against new and re-emerging viruses....
Viral infections are one of the leading causes in human mortality and disease. Broad-spectrum antiviral drugs are a powerful weapon against new and re-emerging viruses. However, viral resistance to existing broad-spectrum antivirals remains a challenge, which demands development of new broad-spectrum therapeutics. In this report, we showed that fludarabine, a fluorinated purine analogue, effectively inhibited infection of RNA viruses, including Zika virus, Severe fever with thrombocytopenia syndrome virus, and Enterovirus A71, with all IC values below 1 μM in Vero, BHK21, U251 MG, and HMC3 cells. We observed that fludarabine has shown cytotoxicity to these cells only at high doses indicating it could be safe for future clinical use if approved. In conclusion, this study suggests that fludarabine could be developed as a potential broad-spectrum anti-RNA virus therapeutic agent.
Topics: Animals; Antiviral Agents; Cell Line; Cell Survival; Cells, Cultured; Enterovirus A, Human; Humans; Phlebovirus; RNA Viruses; Vidarabine; Virus Replication; Zika Virus
PubMed: 33925713
DOI: 10.3390/v13050774 -
Archives of Neurology Jun 1981A 33-year-old woman had an excellent response to vidarabine therapy after contracting herpes encephalitis. A dramatic tremor developed during the course of therapy but...
A 33-year-old woman had an excellent response to vidarabine therapy after contracting herpes encephalitis. A dramatic tremor developed during the course of therapy but resolved after the drug was stopped.
Topics: Adult; Encephalitis; Female; Herpes Simplex; Humans; Tremor; Vidarabine
PubMed: 7236071
DOI: 10.1001/archneur.1981.00510060086019 -
The Journal of Infectious Diseases Jul 1982Seven marrow transplant recipients were treated with human leukocyte interferon and vidarabine for cytomegalovirus pneumonia. Although the mean virus titer in biopsy and...
Seven marrow transplant recipients were treated with human leukocyte interferon and vidarabine for cytomegalovirus pneumonia. Although the mean virus titer in biopsy and autopsy lung specimens from five patients decreased from 5 x 10(4) to 1 x 10(2) 50% tissue culture infective doses, there was little clinical evidence of efficacy and only one patient survived. Treatment was stopped in four patients because of declining neutrophil counts, and two of these four patients also showed severe neurotoxicity. The combination of these agents was neither safe nor effective for the treatment of cytomegalovirus pneumonia after marrow transplantation.
Topics: Bone Marrow Transplantation; Cytomegalovirus Infections; Drug Therapy, Combination; Humans; Interferons; Leukocyte Count; Neutrophils; Pneumonia, Viral; Postoperative Period; Vidarabine
PubMed: 6177806
DOI: 10.1093/infdis/146.1.80 -
Leukemia & Lymphoma Sep 2005Non-myeloablative preparative regimens have reduced regimen-related toxicities after allogeneic hematopoietic cell transplantation (HCT), which allows for the treatment... (Review)
Review
Non-myeloablative preparative regimens have reduced regimen-related toxicities after allogeneic hematopoietic cell transplantation (HCT), which allows for the treatment of patients not eligible for myeloablative HCT. The reduced non-relapse mortality associated with non-myeloablative HCT is in part explained by the decreased incidence and severity of acute graft-vs-host disease (GVHD). Compared with conventional HCT, the onset of acute GVHD is delayed, and some patients may present with signs and symptoms characteristic of acute GVHD after day 100, in the absence of hallmarks of chronic GVHD. In contrast to the overall negative impact of acute GVHD on outcome, the net effects of chronic GVHD after non-myeloablative HCT appear to be beneficial, translating into improved progression-free survival among patients with different hematological malignancies. One obvious explanation for this beneficial effect is the strong association between chronic GVHD and protection against recurrent malignancy (graft-vs-tumor effect). Future strategies are aimed at reducing the risk of acute GVHD, in particular "early-onset" GVHD (before day 50), which is associated with increased non-relapse mortality and decreased overall survival, and at decreasing the corticosteroid dependence among patients who require immunosuppressive treatment for clinically established GVHD.
Topics: Graft vs Host Disease; Hematologic Neoplasms; Hematopoietic Stem Cell Transplantation; Humans; Immunosuppression Therapy; Middle Aged; Time Factors; Transplantation Conditioning; Vidarabine
PubMed: 16109601
DOI: 10.1080/10428190500125754 -
The Journal of Hospital Infection Jun 1991Rigorous clinical trials have established that both acyclovir and vidarabine favourably alter the clinical course of herpes zoster and chicken-pox in immunocompromised... (Review)
Review
Rigorous clinical trials have established that both acyclovir and vidarabine favourably alter the clinical course of herpes zoster and chicken-pox in immunocompromised patients. In one comparative study, acyclovir was shown to be superior to vidarabine for zoster in bone marrow transplant recipients. These data, plus the fact that acyclovir is easier to administer than vidarabine, and perhaps less toxic, have made intravenous acyclovir the recognized drug of choice for treatment of herpes zoster in immunocompromised patients. Acyclovir sodium sterile powder received Federal Drug Administration (FDA) approval for this indication in 1990 in the United States. Since complications of zoster occur in only a minority of immunocompromised patients, most physicians would prefer to initiate therapy with an orally-administered drug and avoid the cost and inconvenience of hospitalization. Future studies will compare the efficacy and safety of orally administered bromovinyl arabinosyl uracil and acyclovir in treatment of varicella-zoster virus infections.
Topics: Acyclovir; Administration, Oral; Adult; Aged; Chickenpox; Child; Clinical Trials as Topic; Herpes Zoster; Humans; Immunologic Deficiency Syndromes; Infusions, Intravenous; Vidarabine
PubMed: 1679798
DOI: 10.1016/0195-6701(91)90038-a -
Investigative Ophthalmology & Visual... Jun 1977The endothelial surface of rabbit corneas was perfused with vidarabine monophosphate (with and without adenosine deaminase inhibitor), vidarabine (with and without...
The endothelial surface of rabbit corneas was perfused with vidarabine monophosphate (with and without adenosine deaminase inhibitor), vidarabine (with and without adenosine deaminase inhibitor), and ara-Hx. In concentrations 10 times to 1,500 times higher than those that have been obtained in the aqueous humor following topical, subconjunctival, or systemic administration, none of the compounds had any effect on corneal endothelial cell function or ultrastructure for the duration of the experimental model.
Topics: Animals; Cornea; Endothelium; Rabbits; Vidarabine
PubMed: 863615
DOI: No ID Found