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  • 1
    Electronic Resource
    Electronic Resource
    Acute myeloid leukemia in the elderly: biological features and search for adequate treatment (1991)
    Springer
    Annals of hematology 63 (1991), S. 179-188 
    Details
    ISSN: 1432-0584
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary AML in elderly patients is a heterogeneous disease which is characterized by a number of unfavorable features such as development, cytogenetics, blast cell differentiation, and poor treatment response. Specifically, the association between a higher incidence of unfavorable cytogenetic abnormalities in elderly patients and poor prognosis has been well documented. Low treatment response may be due to the specific biology of AML in this patient group, but also to host-specific factors such as higher treatment-related morbidity and mortality. Treatment tolerance cannot be judged on grounds of chronological age alone; risk factor analysis with regard to performance status, organ function, and underlying systemic disease need to be considered as well. For effective induction treatment in elderly patients, instant and intensive chemotherapy appears to be necessary, while delayed treatment or administration of supportive care alone provide unsatisfactory results. Standard-dose ara-C/anthracycline-containing regimens are the treatment of choice in patients with good performance status. However, patients with a WHO grading of 〉3 might rather benefit from reduced regimens such as low-dose ara-C. At present, greatest improvement of AML treatment in elderly patients can be expected from an improvement of supportive care.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01703440
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  • 2
    Electronic Resource
    Electronic Resource
    Age and the biology of acute myeloid leukemia (1992)
    Springer
    Annals of hematology 64 (1992), S. 157-159 
    Details
    ISSN: 1432-0584
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Conclusion Both normal and leukemic myeloid clones are apparently characterized in the elderly by the same two biological features: (a) Increased cell proliferation [2, 13, 15] and (b) decreased cell differentiation [4, 5, 7, 12], which consequently have serious therapeutic implications for elderly AML patients. Low-dose cytarabine therapy has several advantages over conventional intensive chemotherapy in elderly AML patients, including: 1. The early death rate is significantly lower [18]. 2. Remission induction rates (complete + long lasting partial remissions) [18] are comparable. 3. Survival duration rates [18] are comparable. 4. Low-dose cytarabine not only decreases the cell proliferation of normal and leukemic myeloid clones as conventional intensive chemotherapy does; it also increases the cell differentiation of both normal [3] and leukemic [1, 11, 14, 17] myeloid clones. 5. Low-dose cytarabine therapy could be effective after the failure of conventional intensive chemotherapy in AML patients [16].
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01697405
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  • 3
    Electronic Resource
    Electronic Resource
    Phase-II study of treatment of refractory acute leukemia with intermediate-dose cytosine arabinoside and amsacrine (1993)
    Springer
    Annals of hematology 66 (1993), S. 131-134 
    Details
    ISSN: 1432-0584
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Twenty-five consecutive leukemia patients (21 AML, 4 ALL) with either primary resistance (n=22) or resistant relapse (n=3) of all FAB subtypes were treated with 1 or 2 cycles of ID-ara C (1 g/m2 i.v. q 12 h, days 1–6) and AMSA (120 mg/m2 i.v., days 5–7). Patients reaching CR received 1 cycle of intensive consolidation using ara C 3 g/m2 i.v. q 12 h, days 1–4 and AMSA 120 mg/m2 i.v., day 5. Two patients received an allograft thereafter and are still alive and in CCR. CR was achieved in 12/25 patients (48%), ten after 1 cycle of induction and two after 2 cycles; 10/22 patients with primary resistant disease reached CR, and 2/3 with resistant relapse. Nine patients remained refractory (36%) and four died during hypoplasia (16%). Median DFS of the 12 responders was 2.9 months, median survival from time of CR 8.9 months. Median overall survival of responders and nonresponders was 6 months from time of resistance. Survival advantage of responding patients (n=12) as compared with nonresponders (n=13) was 10.7 vs 3.2 months (p=0.002). Toxicity of chemotherapy was acceptable: one patient experienced pulmonary edema due to ara C; two patients developed life-threatening systemic fungal infections, one of whom died while in CR.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01697622
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  • 4
    Electronic Resource
    Electronic Resource
    Zum gegenwärtigen Stand der internistischen Therapie des Mammacarcinoms (1979)
    Springer
    Journal of molecular medicine 57 (1979), S. 921-926 
    Details
    ISSN: 1432-1440
    Keywords: Breast cancer ; Adjuvant chemotherapy ; Chemoimmunotherapy ; Combination chemotherapy ; Mamma-Ca ; Adjuvante Chemotherapie ; Chemoimmuntherapie ; Polychemotherapie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Für die postoperative adjuvante Chemotherapie gibt es bisher keine genau definierte Risikogruppe, bei der die Rezidiv- oder Metastasierungsrate sicher vermindert werden kann. Weitere kontrollierte Studien müssen die Indikation für diese Therapie erst noch detaillierter herausarbeiten. Von einer generellen, unkontrollierten Anwendung der adjuvanten Chemotherapie wird abgeraten. Ähnliches gilt für die unspezifische Immunstimulation, die auch keinen gesicherten positiven Effekt hat. Für die palliative Polychemotherapie, eventuell in Kombination mit einer Antiöstrogentherapie, werden 4 verschiedene Therapie-Protokolle, die sich in unseren Händen gut bewährt haben, mit ihren Indikationen vorgestellt: Adriamycin/Cyclophosphamid (AC), Cyclophosphamid/Methotrexat/5-Fluorouracil (CMF), CMF/Vincristin/Prednison (CMFVP) und die Kombination von Adriamycin/Vincristin (AV) mit CMF auf der Basis einer Dauertherapie mit Tamoxifen.
    Notes: Summary There is no well defined group of patients with primary breast cancer which benefits from combination chemotherapy as an adjuvant treatment, since, at present, the effect of this therapy in respect to the duration of disease-free interval, survival, and possible long-term side effects remain unknown. Therefore, controlled studies need to be initiated. Similarly, there seems to be no beneficial effect from unspecific immunotherapy. As far as combination chemotherapy in advanced breast cancer is concerned, we review on four different protocols which proved to be quite successful in our hands: adriamycine/cyclophosphamide (AC), cyclophosphamide/methotrexate/5-fluorouracil (CMF), CMF/vincristine/prednisone (CMFVP), and adriamycine/vincristine plus CMF plus Tamoxifen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01478548
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  • 5
    Electronic Resource
    Electronic Resource
    Das Burkitt-like Lymphom: Differentialdiagnose, Klinik und Therapie (1979)
    Springer
    Journal of molecular medicine 57 (1979), S. 1089-1096 
    Details
    ISSN: 1432-1440
    Keywords: Burkitt-like lymphoma ; Serum lactic dehydrogenase ; Clinical features ; Response to Chemotherapie ; Burkitt-like Lymphom ; Serum-lactatdehydrogenase ; Klinik ; Chemotherapie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Das Burkitt-like Lymphom (BLL) ist insgesamt sehr selten. Es zeigt im Vergleich zum afrikanischen Burkitt-Lymphom (BL) häufiger einen Befall des Abdomen und tritt in höheren Altersgruppen auf. Beides ist prognostisch ungünstig. Dadurch mag auch die schlechtere therapeutische Ansprechbarkeit des BLL bedingt sein. Jede zytostatische Therapie sollte Cyclophosphamid als wesentlichen Bestandteil beinhalten. Die Serum-Lactatdehydrogenase hat sich als zuverlässiger Verlaufsparameter sowohl hinsichtlich der klinischen Ausbreitung als auch der Wirksamkeit einer Therapie dieses Lymphoms herausgestellt. An Therapie-bedingten Komplikationen sind vor allem die Hyperkaliämie, Lactatacidose, Anurie und tödliche Lungenembolie zu erwähnen. — Im Unterschied zum BL zeigt das BLL keine Assoziation mit dem Epstein-Barr-Virus, während bei beiden malignen Lymphomen die Translokation von Chromosom 14q ein sicherer Marker ist.
    Notes: Summary The Burkitt-like lymphoma is extremely rare. It shows a predominance of presentation in abdominal and pelvic sites and an older median age as compared to the endemic Burkitt's lymphoma. Both are independent prognostic determinants and reflect a poor prognosis. This might be the reason for the low response rate to cytotoxic treatment. Cyclophosphamide is a substantial part of any chemotherapeutic regimen used. Serum lactic dehydrogenase (LDH) levels are closely correlated with the extent of tumor mass and the response to therapy. Chemotherapy might be associated with serious metabolic complications including hyperkalemia, lactic acidosis, anuria, and sudden death from lethal embolization of the lung. In contrast to Burkitt's lymphoma, the Burkitt-like tumor has no association with the Epstein-Barr-virus. In both lymphomas a translocation from the 8q onto 14q chromosome occurs being a characteristic marker for these malignancies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01481489
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  • 6
    Electronic Resource
    Electronic Resource
    Zum gegenwärtigen Stand der internistischen Therapie des Mammacarcinoms (1979)
    Springer
    Journal of molecular medicine 57 (1979), S. 913-920 
    Details
    ISSN: 1432-1440
    Keywords: Breast cancer ; Endocrine therapy ; Mamma-Ca ; Hormonbehandlung
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Hormontherapie des Mamma-Ca hat in jüngster Zeit durch den Nachweis von Hormonrezeptoren an den Tumorzellen und die gezielte Beeinflussung des Tumorwachstums durch kompetitive Hemmung der Rezeptoren mit Antiöstrogenen große Wandlungen erfahren. Einige der herkömmlichen hormonellen Maßnahmen haben nur noch historische Bedeutung, andere werden in Zukunft nicht mehr zur Anwendung gelangen. Ob mit einem methodisch verbessertem Nachweis und somit vertieftem Verständnis der Steroidhormonrezeptoren auf das Tumorwachstum das derzeit noch stark schematisierte Vorgehen bei der Auswahl der verschiedenen Therapieschritte zukünftig Bestand haben wird, ist fraglich.
    Notes: Summary A renewal of interest in endocrine therapy of breast cancer is resulting from the demonstration of steroid hormone receptors in tumor cells sensitive to antiestrogens and the possibility for predicting endocrine responsiveness. Therefore new therapeutical concepts have been developed and some of the established endocrine regimens have been reduced to historical interest. It is more than doubtful that the present schematization in selecting the proper kind of endocrine treatment has any future as methodical difficulties in demonstrating hormone receptors will be overcome and the understanding of their biological function will increase.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01478547
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