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  • 11
    Electronic Resource
    Electronic Resource
    High-dose chemotherapy and reinfusion of haematopoietic stem cells advanced germ cell tumours with poor prognosis in 1996 (1997)
    Springer
    Der Urologe 36 (1997), S. 561-564 
    Details
    ISSN: 1433-0563
    Keywords: Key words Germ cell tumours • High dose chemotherapy (HDCT) • Risk factors • Stem cell separation • Stem cell reinfusion ; Schlüsselwörter Keimzelltumoren • Hochdosischemotherapie (HDCT) • Risikofaktoren • Stammzellseparation • Stammzellreinfusion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Hochdosischemotherapie (HDCT) ist für Patienten mit prognostisch ungünstigen Keimzelltumoren eine vielversprechende Behandlungsform. Für den erstbehandelnden Urologen besteht die Schwierigkeit, Patientengruppen zu selektionieren, die für diese Therapie in Betracht kommen und profitieren können. Entsprechend sorgfältig müssen die Indikationen herausgearbeitet werden. Die Ausschlußkriterien beziehen sich vor allem auf beeinträchtigte Organreserven. Vor einer HDCT werden nach vorangegangenen konventionell dosierten Chemotherapiezyklen hämatopoetische Stammzellen mit G- oder GM-CSF-Unterstützung gewonnen. Für die HDCT werden Kombinationen von Carboplatin, Etoposid und Ifosfamid oder Cyclophosphamid eingesetzt. Hämatologische Überwachung und der Einsatz aller erforderlichen supportiven Maßnahmen sind unabdingbare Voraussetzungen, um Patienten nicht zu Schaden kommen zu lassen. Deshalb wird empfohlen, eine HDCT nur an geeigneten Zentren durchzuführen.
    Notes: Summary High-dose chemotherapy (HDCT) is a promising treatment for patients with germ cell tumours and a poor prognosis. The selection of patients who may profit from this intervention is challenging for the urologist, as the indication has to be carefully established. Exclusion criteria primarily concern impaired organ functions. Prior to HDCT haematopoietic stem cells are obtained after the administration of conventional-dose chemotherapy plus G- or GM-CSF stimulation. HDCT consists of a combination of carboplatin, etoposide and ifosfamide or cyclophosphamide. After HDCT, haematologic monitoring and maximal supportive care are essential. It is therefore recommended that HDCT only be administered at specialized centres.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001200050138
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  • 12
    Electronic Resource
    Electronic Resource
    Salvagetherapie rezidivierter und refraktärer Hodentumoren (1998)
    Springer
    Der Onkologe 4 (1998), S. 541-546 
    Details
    ISSN: 1433-0415
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Die Therapie der Patienten, die auf eine eine cisplatinhaltige Primärtherapie nicht oder nur inkomplett ansprechen oder bei denen ein Rezidiv auftritt, besteht in der „Salvage”- Therapie, unabhängig davon, ob diese bei primär refraktären Patienten oder bei Patienten im ersten oder nachfolgenden Rezidiv eingesetzt wird. Heilungen sind selbst bei dieser prognostisch ungünstigeren Patientengruppe möglich, erfordern jedoch den vollen Einsatz interdisziplinärer onkologischer Maßnahmen. In den vergangenen Jahren wurden große Anstrengungen unternommen, die Ergebnisse der Salvagechemotherapie zu verbessern und neben der Einführung neuerer Substanzen wird zunehmend die Hochdosischemotherapie untersucht.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007610050236
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  • 13
    Electronic Resource
    Electronic Resource
    Treatment intensification in disseminated germ-cell tumors (1994)
    Springer
    World journal of urology 12 (1994), S. 207-213 
    Details
    ISSN: 1433-8726
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Despite major improvements in the treatment of germ cell tumors the results remain unsatisfactory in patients with “poor risk” initial presentation, with inadequately responding or relapsed disease. The alternating use of noncrossresistant drugs or dose-intensified treatment regimens have not proved to be superior to conventional regimens, although the role of early treatment intensification with the use of hematopoetic growth factors or hematopoetic stem cell reinfusion warrants further investigation. In phase I/II trials patients considered incurable with conventional treatment regimens have been successfully salvaged by high-dose chemotherapy and autologous stem cell reinfusion. Several phase III trials to define the role of this novel approach are planned or ongoing in the USA and Europe.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00185676
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  • 14
    Electronic Resource
    Electronic Resource
    German-austrian multicenter trial for aggressive non-Hodgkin lymphomas: COP-BLAM/IMVP-16 chemotherapy with randomized adjuvant radiotherapy (1988)
    Springer
    Annals of hematology 56 (1988), S. 139-142 
    Details
    ISSN: 1432-0584
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00320022
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  • 15
    Electronic Resource
    Electronic Resource
    Apparent decrease and elimination of BCR/ABL mRNA-expressing residual cells in patients with chronic myelogenous leukemia after allogeneic bone marrow transplantation (1991)
    Springer
    Annals of hematology 63 (1991), S. 189-194 
    Details
    ISSN: 1432-0584
    Keywords: Chronic myelogenous leukemia ; Allogeneic bone marrow transplantation ; Minimal residual disease ; BCR/ABL mRNA
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A modified two-step polymerase chain reaction (PCR) was used for the amplification of BCR/ABL mRNA in 16 patients with Philadelphia chromosomepositive (Ph+) chronic myelogenous leukemia (CML) following allogeneic bone marrow transplantation (BMT). At different intervals after BMT, patient cells were assessed for the presence of BCR/ABL mRNA by two subsequent rounds of PCR amplification; this procedure increased the sensitivity for the detection of one Ph+ cell in 104–5 to one cell in 105–6. Eight of 16 patients were negative by two-step PCR 1–39 months after BMT, suggesting an elimination of Ph-positive cells or a decrease below the threshold of detection. Although five patients showed negative results by the one-step PCR only, they were tested positive when nested primers were used, indicating a substantial decrease in the amount of BCR/ABL target mRNA compared with earlier pre- or post-transplant analyses. One patient who was still PCR positive 27 months after BMT became negative 12 months later. Persistence of BCR/ABL mRNA-expressing cells correlated with subsequent clinical relapse only when the transplantation was performed during blast crisis. All patients who underwent transplantation in chronic phase, including those with BCR rearrangement by PCR, are in clinical and hematological remission between 24 and 95 months after BMT. We conclude that aggressive chemotherapy combined with total body irradiation is unable to completely eradicate the malignant clone in all CML patients, and it might be speculated that other mechanisms (e.g., graft versus host reaction [GVHD] or graft versus leukemia effect [GVL]) may effectively eliminate residual leukemic cells.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01703441
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  • 16
    Electronic Resource
    Electronic Resource
    Aerosol amphotericin B inhalations for prevention of invasive pulmonary aspergillosis in neutropenic cancer patients (1995)
    Springer
    Annals of hematology 71 (1995), S. 287-291 
    Details
    ISSN: 1432-0584
    Keywords: Key words Aspergillosis ; Amphotericin B ; Inhalation ; Neutropenia ; Prophylaxis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  To determine the value of aerosol amphotericin B inhalations for prevention of invasive pulmonary aspergillosis (IPA), we initiated a prospective randomized multicenter trial. The scheduled intent-to-treat interim analysis included 115 patients (30%) with prolonged neutropenia after chemotherapy for acute myeloid leukemia, acute lymphoblastic leukemia/high-grade non-Hodgkin's lymphoma, or solid tumors undergoing autologous stem cell transplantation. Sixty-five patients had been randomized to receive prophylactic aerosol amphotericin B inhalations at a dose of 10 mg twice daily (group A); for the remaining 50 patients no aerosol amphotericin B prophylaxis was used (group B). No serious side effects from amphotericin B inhalations occurred, but coughing (54%), bad taste (51%), and nausea (37%) caused early cessation of aerosol amphotericin B prophylaxis in 23% (15/65) of courses. In group A, the incidence of proven, probable, or possible IPA was 5% (3/65) as compared with 12% (6/50) in group B (p〉0.05). Microbiologically documented bacterial pneumonias were observed in 5/65 (8%) patients in group A and in 1/50 (2%) patients in group B (p〉0.05). Thus, no reduction in incidence of IPA from use of prophylactic aerosol amphotericin B inhalations was found in this interim analysis. As there were no serious side effects from aerosol amphotericin B prophylaxis, accrual in the study will continue for a total of 380 patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01697981
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  • 17
    Electronic Resource
    Electronic Resource
    Fibroblasten-Interferon-Therapie (Hu IFN-β) bei Non-Hodgkin-Lymphomen (NHL) mit niedrigem Malignitätsgrad: Vorläufige Ergebnisse (1982)
    Springer
    Annals of hematology 44 (1982), S. 121-124 
    Details
    ISSN: 1432-0584
    Keywords: Interferon ; Non-Hodgkin lymphoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Preliminary results of a cooperative pilot study on the effect of fibroblast interferon in 10 patients with NHL of low-grade malignancy are presented. In eight patients lymphoma progression forced a discontinuation of therapy. At the end of interferon treatment one patient with CBCC showed a stable disease, one patient with CBCC a minor partial remission.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00320101
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  • 18
    Electronic Resource
    Electronic Resource
    Detection of allelic loss within the β1-interferon gene in childhood acute lymphoblastic leukemia using differential PCR (1994)
    Springer
    Annals of hematology 68 (1994), S. 171-174 
    Details
    ISSN: 1432-0584
    Keywords: Differential PCR ; Β1-IFN gene loss ; Acute lymphoblastic leukemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Deletion of the short arm of chromosome 9p involving the Β1-interferon (IFN) gene has been implicated in the process of malignant transformation in lymphomas and acute lymphoblastic leukemias. Since cytogenetic analysis is frequently unsuccessful in clinical samples, we used a recently described differential PCR technique to detect losses within the Β1-IFN gene in 86 acute leukemias. Using differential PCR, no Β1-IFN deletion was detected in 44 acute myeloid leukemia (AML) and eight control samples. However, five of 42 acute lymphoblastic leukemia (ALL) probes (12%) exhibited loss of the Β1-IFN gene (three common ALL, two T-ALL). Cytogenetic analysis was performed independently in three of these five cases and revealed abnormalities of chromosome 9p in two samples. Two of five T-ALL cases exhibited a loss within the Β1-IFN gene, compared with 3/29 c-ALLs, suggesting a predominance of IFN gene loss in T-ALLs. These data indicate that PCR can be used for rapid detection of gene dosage phenomena in clinical leukemia samples.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01834362
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  • 19
    Electronic Resource
    Electronic Resource
    Autografting with blood progenitor cells: predictive value of preapheresis blood cell counts on progenitor cell harvest and correlation of the reinfused cell dose with hematopoietic reconstitution (1995)
    Springer
    Annals of hematology 71 (1995), S. 227-234 
    Details
    ISSN: 1432-0584
    Keywords: PBPC autografting ; Apheresis results ; Hematopoietic recovery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract One hundred and nine patients suffering from various malignancies underwent 285 apheresis procedures for PBPC collection. A median of two leukaphereses (range: 2–5) resulted in median numbers of 4.6×108 MNC/kg, 14.1×104 CFU-GM/kg, and 6.0×106 CD34+ cells/kg. Preleukapheresis peripheral blood CD34+ cells correlated significantly with collected CD34+ cells/kg (r=0.94;p〈0.0001) and with CFU-GM/kg (r=0.52;p〈0.0001). A value 〉4×104 CD34+ cells/ml was highly predictive for a collection yield 〉2.5×106 CD34+ cells/kg harvested by a single leukapheresis. Sixty patients were evaluated for hematologic reconstitution and engrafted in a median time of 10 days for WBC 〉1.0×109/l (range: 7–21 days), 10 days for ANC 〉0.5×109/l (7–20) and 11 days for PLT 〉20×109/l (7–62). Reinfused CD34+ cells/kg correlated significantly with hematologic engraftment (r=0.44–0.52 andp〈0.006–0.001) as well as CFU-GM/ kg (r=0.36–0.44 andp〈0.007–0.001). A progenitor cell dose 〉2.5×106 CD34+ cells/kg or 〉8.0×104 CFU-GM/kg led to a significantly faster recovery for WBC, ANC, and PLT when compared with patients receiving 〈2.5×106 CD34+ cells/kg or 〈 8.0×104 CFU-GM/kg. We conclude that rapid hematopoietic engraftment after high-dose therapy and PBPC reinfusion correlates well with a progenitor cell dose 〉2.5×106 CD34+ cells/kg or 〉8.0×104 CFU-GM/kg, and that above a preleukapheresis threshold of 4×104 CD34+ cells/ml a PBPC autograft containing 〉2.5×106 CD34+ cells/kg can be collected by a single leukapheresis. We suggest that patients recovering from myelosuppression should be monitored for CD34+ cells in serial blood samples to determine the course of circulating hematopoietic progenitor cells. This issue will help to define the optimal time point to start apheresis and to predict a PBPC autograft harvested by a single leukapheresis, which will lead to rapid and stable hematopoietic reconstitution following transplantation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01744372
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  • 20
    Electronic Resource
    Electronic Resource
    Aerosol amphotericin B inhalations for prevention of invasive pulmonary aspergillosis in neutropenic cancer patients (1995)
    Springer
    Annals of hematology 71 (1995), S. 287-291 
    Details
    ISSN: 1432-0584
    Keywords: Aspergillosis ; Amphotericin B Inhalation ; Neutropenia ; Prophylaxis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To determine the value of aerosol amphotericin B inhalations for prevention of invasive pulmonary aspergillosis (IPA), we initiated a prospective randomized multicenter trial. The scheduled intent-to-treat interim analysis included 115 patients (30%) with prolonged neutropenia after chemotherapy for acute myeloid leukemia, acute lymphoblastic leukemia/high-grade non-Hodgkin's lymphoma, or solid tumors undergoing autologous stem cell transplantation. Sixty-five patients had been randomized to receive prophylactic aerosol amphotericin B inhalations at a dose of 10 mg twice daily (group A); for the remaining 50 patients no aerosol amphotericin B prophylaxis was used (group B). No serious side effects from amphotericin B inhalations occurred, but coughing (54%), bad taste (51%), and nausea (37%) caused early cessation of aerosol amphotericin B prophylaxis in 23% (15/65) of courses. In group A, the incidence of proven, probable, or possible IPA was 5% (3/65) as compared with 12% (6/50) in group B (p〉0.05). Microbiologically documented bacterial pneumonias were observed in 5/65 (8%) patients in group A and in 1/50 (2%) patients in group B (p〉0.05). Thus, no reduction in incidence of IPA from use of prophylactic aerosol amphotericin B inhalations was found in this interim analysis. As there were no serious side effects from aerosol amphotericin B prophylaxis, accrual in the study will continue for a total of 380 patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01697981
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