Predictors and short-term outcomes of hyperleukocytosis in children with acute myeloid leukemia: a report from the Children's Oncology Group
Year: 2012
Type: article
Abstract: weeks of treatment with atorvastatin.Serum alanine aminotransferase and creatine kinase levels remained unchanged from baseline.Adverse events during the study included 4 acute pain episodes, 3 of which required hospitalization, equivalent to 1.59 hospitalizations per patientyear during enrollment on the study, this is the same as in SCA population statistics.One of these episodes involved transient mental status changes, a small pulmonary infiltrate and mild transient renal insufficiency, all of which resolved after transfusion of two units of packed red blood cells.This patient was removed from the study due to an exclusion criterion of transfusion within two weeks of entry or end point.Much has been written about the pleiotropic effects of statins in the general population to improve clinical outcomes related to vasculopathies such as atherosclerosis.Part of this activity derives from statin activation of NOS activity.It has been speculated that these vasculoprotective effects might be useful in SCA.[3][4][5] Our SCA clinical trial of atorvastatin at moderate doses with physiological outcome measures is a negative study for its primary purpose.However, there are still several findings of scientific value that emerge from this project: 1) reproducing previous baseline findings of nitric oxide resistance in SCA; 2) developing an enrichment strategy for recruitment that resulted in 100% of the SCA subjects having characteristics of nitric oxide resistance; 3) secondary outcome variables indicating some evidence that endothelial function is being impacted, albeit to a smaller degree than expected.This last finding raises the question as to whether higher doses of atorvastatin or earlier intervention for longer duration should be considered for future investigation to delay vascular dysfunction in SCA patients.
Source: Haematologica
Authors: L. Sung, R. Aplenc, T. A. Alonzo, R. B. Gerbing, A. S. Gamis, AAML0531/PHIS Group
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,157
Funders: University of Southern California, Children's Hospital of Philadelphia, University of Minnesota, St. Jude Children's Research Hospital, Arcadia Fund, Children’s Oncology Group, Hospital for Sick Children, National Institutes of Health, Canadian Institutes of Health Research, National Cancer Institute, NHLBI Division of Intramural Research
OpenAlex ID: W2061339243