| Efficacy and toxicity of eflornithine for treatment of Trypanosoma brucei gambiense sleeping sickness. | |
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MedLine Citation:
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PMID: 1355219 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The usual first-line treatment for Trypanosoma brucei gambiense sleeping sickness is melarsoprol, but when that fails the outlook has hitherto been grim. The polyamine synthesis inhibitor eflornithine (difluoromethylornithine, DFMO) has emerged as an alternative therapy. 207 patients with late-stage T b gambiense sleeping sickness were treated in rural Zaire with three different regimens of DFMO in an open-trial design. During treatment, trypanosomes disappeared from the CSF of all 87 patients in whom parasites had been seen before DFMO administration, and there was a sharp fall in CSF white cell count from a mean of 186/microliters to 21/microliters. 152 patients have been followed for at least a year after DFMO treatment, and only 13 (9%) have relapsed. Treatment failures were more common in children less than 12 years, among patients treated with oral DFMO only, and among patients who received DFMO as the initial treatment of their recently diagnosed trypanosomiasis. Toxicity was acceptable. Only 4 patients died during or shortly after treatment. Bone marrow suppression resulting in anaemia (43%) or leucopenia (53%) was common but bore little consequence. This open trial shows that DFMO is as active as and possibly less toxic than melarsoprol. For economic and logistic reasons DFMO may not be the first-choice therapy in rural Africa but for the vast majority of patients who relapse after melarsoprol DFMO will be curative. |
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Authors:
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F Milord; J Pépin; L Loko; L Ethier; B Mpia |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Lancet Volume: 340 ISSN: 0140-6736 ISO Abbreviation: Lancet Publication Date: 1992 Sep |
Date Detail:
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Created Date: 1992-10-01 Completed Date: 1992-10-01 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 2985213R Medline TA: Lancet Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 652-5 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, University of Sherbrooke, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Oral Animals Cerebrospinal Fluid / cytology, parasitology Democratic Republic of the Congo / epidemiology Diarrhea / chemically induced, epidemiology Eflornithine / administration & dosage, adverse effects, therapeutic use* Female Hematologic Diseases / chemically induced, epidemiology Hospitals, Rural Infusions, Intravenous Leukocyte Count / drug effects Male Recurrence Seizures / chemically induced, epidemiology Trypanosoma brucei gambiense* Trypanosomiasis, African / diagnosis, drug therapy*, epidemiology |
| Chemical | |
Reg. No./Substance:
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70052-12-9/Eflornithine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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