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aReceived later chemotherapy with hydroxyurea to control peripheral blood blast count.
aReceived later chemotherapy with hydroxyurea or 5-mercaptopurin to control the blood blast count.
Those with a peripheral blood blast count >30.0 × 10/L were treated with hydroxyurea until it was ≤30.0 × 10/L.
If cytarabine could not control hyperleukocytosis it was replaced by hydroxyurea or 6-mercaptopurin to keep the peripheral blood blast count below 50×10/L/L.
Based on results of infants enrolled onto preceding BFM studies, all infants received a 7-day prednisone prophase with stratification into standard- and high-risk groups determined by day 8 peripheral blood blast count (⩾1000 cells/μl, respectively).
If cytarabine could not control hyperleukocytosis, it was replaced by hydroxyurea or 6-MP to maintain the peripheral blood blast count below 50 x 10/l and to avoid symptoms of leukostasis [ 97].
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CR/CRi was seen only in patients who had white blood cell counts <10,000/μL and peripheral blood blast counts <1,000/μL.
In a previous clinical study we described an effect of ATRA, valproic acid and theophylline on peripheral blood blast counts for a subset of AML patients [ 15, 46].
The dosages of both these drugs were adjusted to the minimal dose to keep the peripheral blood blast counts below 50 × 10/L.
Increasing peripheral blood blast counts should be regarded as progression, and thus only eight of our nine patients (not patients SD7, see Table 3) with hematological improvement fulfilled the MDS definition of stable disease.
For patients with rapidly increasing peripheral blood blast counts exceeding or expected to exceed 50 × 10/L, all three drugs were started on day 1, but the doses and duration of treatment were similar to those described above.
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