Michael Low

Publications (2)3.52 Total impact

• Article: High-dose cytarabine (24g/m(2) ) in combination with idarubicin (HiDAC-3) results in high first cycle response with limited gastrointestinal toxicity in adult acute myeloid leukaemia.

  Michael Low, Denise Lee, John Coutsouvelis, Sushrut Patil, Stephen Opat, Patricia Walker, Anthony Schwarer, Hatem Salem, Sharon Avery, Andrew Spencer, Andrew Wei
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  ABSTRACT: Background and Aim:  Although induction chemotherapy comprising high-dose cytarabine in combination with idarubicin and etoposide or "ICE" for adult acute myeloid leukaemia (AML) produces a complete remission rate of nearly 80%, gastrointestinal toxicity is significant. Omission of etoposide may produce similar clinical outcomes with potentially less gastrointestinal toxicity. Methods:  53 consecutive patients aged 15-60 with newly diagnosed AML receiving high dose cytarabine induction at the Alfred Hospital Melbourne, were retrospectively analysed. Regimens included HiDAC-3 (Idarubicin 12mg/m(2) day 1-3, Cytarabine 3gm/m(2) bd day 1,3,5,7) or ICE (Idarubicin 9mg/m(2) day 1-3, Cytarabine 3g/m(2) bd day 1,3,5,7, Etoposide 75mg/m(2) day 1-7). Toxicity was assessed using Common Terminology Criteria for Adverse Events (CTCAE) version 4.03. Results:  31 patients received HIDAC-3 and 22 patients ICE induction. HiDAC-3 was better tolerated than ICE in terms of lower frequency of grade 3-4 nausea (0% vs 41%; p<0.01), grade 3-4 diarrhoea (26% vs 55%; p=0.05), lower rates of radiologically-evident enterocolitis (6% vs 32% p=0.03) and less cumulative days of total parenteral nutrition use (1.2 vs 7.3 days; p<0.01). Times to haematologic recovery were similar between the two regimens. 30-day mortality was 0% for HIDAC-3 and 9% for ICE. 84% of HiDAC-3 treated patients achieved complete remission after the first cycle of therapy, compared to 77% with ICE. No differences in survival were evident between the two regimens. Conclusions:  HiDAC-3 is a clinically effective induction regimen for adult AML, producing a high rate of first cycle complete remission with less treatment related gastrointestinal toxicity than ICE.
  Internal Medicine Journal 07/2012; · 1.54 Impact Factor
• Article: Ophthalmological manifestations of Fabry disease: a survey of patients at the Royal Melbourne Fabry Disease Treatment Centre.

  Thanh T Nguyen, Trevor Gin, Kathy Nicholls, Michael Low, Jason Galanos, Andrew Crawford
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  ABSTRACT: Fabry disease is a rare X-linked inborn error of glycosphingolipid metabolism. The aim of this study was to document the ophthalmological manifestations of patients attending the Royal Melbourne Hospital Fabry disease treatment centre. Patients at the treatment centre had full ophthalmological examination performed. This included best corrected visual acuity, ocular motility examination and examination of the adnexae. Patients also underwent slit-lamp examination looking for the presence of features of Fabry disease, particularly examining the bulbar conjunctiva, cornea, lens and fundus. Thirty-four hemizygous male and 32 heterozygous female patients were recruited. The mean age of the hemizygous male patients was 37.7 years (range 18-57 years). The mean age of the heterozygous female patients was 34.6 years (range 1-78 years). Visual acuity was not affected. 97.1% of the hemizygotes and 78.1% of the heterozygotes had vascular abnormalities of the bulbar conjunctiva. Cornea verticillata was noted in 94.1% of the hemizygotes and 71.9% of the heterozygotes. 41.2% of the hemizygotes and 9.4% of the heterozygotes had anterior cataract formation. Posterior lens opacities were observed in 11.8% of the hemizygotes and none of the heterozygotes. Retinal vascular tortuosity was observed in 76.5% of the hemizygotes and 18.8% of the heterozygotes. Conjunctival vascular tortuosity was the most common manifestation in this series. Conjunctival and retinal vessel tortuosity, and corneal verticillata are frequently observed in Fabry disease. The incidence of lenticular changes is not consistently reported, but in this series and many others, it is much less common than that of corneal, conjunctival and retinal changes.
  Clinical and Experimental Ophthalmology 05/2005; 33(2):164-8. · 1.98 Impact Factor