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  • 1
    ISSN: 1432-0584
    Keywords: Key words HCL ; 2-CdA ; Long-term outcome ; Histology ; Bone-marrow clearing ; Retreatment with 2-CdA
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The long-term results of both pretreated and previously untreated patients with hairy cell leukemia (HCL) using uniformly a single 7-day course of 2-chlorodeoxyadenosine (2-CdA) by continuous infusion are reported. In addition, the probability of obtaining another response with this drug in patients who relapsed after 2-CdA treatment will be addressed. Forty-two consecutive patients (32 men, 10 women) with a median age of 56 years (range 32–75) at the time of initiation of 2-CdA treatment were analyzed. Ten patients were pretreated with either splenectomy (n=6) or interferon a (n=8) or deoxycoformycin (dCF) (n=3) or with all procedures in sequence. Two patients who did not respond to dCF did respond to 2-CdA. Median time to start of 2-CdA treatment of the ten pretreated patients was 47 months (10–160); 41 of the 42 (98%) achieved CR, and one patient reached a good partial response with a single cycle of 2-CdA. Ten of the 42 patients had no toxicities at all. Toxicities (WHO grades I–IV) were mainly of grades I and II; in one patient with a preexisting brain injury grade III neurotoxicity was seen, and one patient suffered a grade-IV infectious complication. Bone marrow biopsies were performed at the time of recovery of hematopoiesis, thereafter at 2- to 3-month intervals, then at 6 months, and finally annually in all 42 patients. Median follow-up is 32 months (2–72). Disease-free survival from start of 2-CdA treatment is 75% at 6 years; 6/42 patients relapsed. Three of these patients were treated with 2-CdA again. All three patients reached another CR (+1, +2, +13). Four of the 42 patients had a second malignancy (carcinomas of the bladder, breast, cervix, prostate gland) before receiving 2-CdA. One patient died in CR due to the second malignancy. 2-CdA is a safe and effective treatment of HCL, inducing complete remissions in the majority of patients with only a single cycle of 2-CdA and a paucity of toxities. Responses are durable and long lasting. Patients relapsing following a treatment with 2-CdA seem to respond to this drug again.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 57 (1979), S. 921-926 
    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
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