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  • 11
    ISSN: 1432-0584
    Keywords: Key words Myelodysplastic syndrome ; Hemoglobin F ; Fetal erythropoiesis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Reactivation of fetal hemoglobin synthesis in adulthood can be seen in hematological disorders affecting the erythropoietic system. The objective of the present study was to evaluate the incidence and prognostic significance of increased hemoglobin F in patients with myelodysplastic syndrome. Hemoglobin F concentrations and Gγ/Gγ+Aγ-globin chain ratios were determined in 26 patients with primary myelodysplastic syndrome. Median age of the patients was 65 years; all FAB subtypes were included. Increased hemoglobin F concentration of up to 20% of total hemoglobin (normal: below 2%) was seen in 16 patients; ten patients had normal values. There was a significant relation between hemoglobin F concentration and the course of disease, e.g., 12 of the 16 patients with elevated hemoglobin F survived at least 1 year after the examination, in contrast to only three of the ten patients with normal hemoglobin F (p〈0.025). All of six patients with hemoglobin F above 5% survived at least 1 year. There was no significant difference in the hemoglobin F concentration between patients with and without cytogenetic anomalies. The Gγ/Gγ+Aγ-globin chain ratio was slightly elevated in all patients, with a weak correlation to the degree of hemoglobin F elevation. The values were not of additional prognostic significance. The data of the present study suggest that the hemoglobin F concentration may be a prognostic parameter in myelodysplastic syndrome; increased hemoglobin F concentration may indicate a better prognosis.
    Type of Medium: Electronic Resource
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  • 12
    ISSN: 1432-0584
    Keywords: Key words Acute myeloid leukemia ; Plasmacytosis IL-6
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  An increased plasma cell count in the bone marrow occurs in a subgroup of patients with acute myeloid leukemia (AML). The pathogenic mechanism for this plasmacytosis is unclear. In this report we describe two patients with AML and plasmacytosis who shared some features of their diseases. The morphological subtypes were AML M4 and M4eo; the leukemias were secondary to cytotoxic pretreatment, and complex cytogenetic changes were found in the leukemic cells of both patients. There was a marked increase in the number of bone marrow plasma cells in both cases and no monoclonal immunoglobulin was detectable. The IgH-CDR3 gene scan depicted a monoclonal IgH rearrangement in the bone marrow cells of one patient. Analysis of the cytokine production of the leukemic cells showed a high production of IL-6 of the leukemic blast cells in the in vitro cell culture and a high cytoplasmic IL-6 in the leukemic cells as revealed by immunocytology. We describe the clinical picture of a type of secondary AML with FAB M4 morphology associated with bone marrow plasmacytosis. We suggest that paracrine growth stimulation of plasma cells by paraneoplastic IL-6 production of the leukemic blast cells contributes to the plasmacytosis observed in patients with AML.
    Type of Medium: Electronic Resource
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  • 13
    ISSN: 1432-0584
    Keywords: Key words G-CSF ; AML ; Cytosine arabinoside ; Refractory disease ; Salvage therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Patients with primary refractory or relapsed acute myeloid leukemia (AML) who undergo intensive salvage chemotherapy carry a high risk of treatment failure due to infectious complications and early relapses. The study presented here assessed the effect of granulocyte colony-stimulating factor (G-CSF) on the duration of post-treatment neutropenia, the incidence of infection-related deaths, and the disease-free and overall survival. Sixty-eight evaluable patients with relapsed and refractory AML received G-CSF 5 μg/kg per day subcutaneously starting 2 days after the completion of salvage treatment with the S-HAM regimen, consisting of high-dose cytosine arabinoside twice daily on days 1, 2, 8, and 9 and mitoxantrone on days 3, 4, 10, and 11. Ninety-one patients who were treated with the identical S-HAM regimen but without G-CSF support during a preceding study served as controls. The application of G-CSF resulted in a significant shortening of critical neutropenia of less than 500 μl (36 vs. 40 days;p=0.008), which translated into a trend towards a lower early death rate (21% vs. 30%) and an increase of complete remissions (56% vs. 47%, p=0.11). In patients younger than 60 years a significant prolongation of time to treatment failure (159 vs. 93 days, p=0.038) and of duration of disease-free survival (203 vs. 97 days, p=0.003) was observed. These results indicate a beneficial effect of G-CSF on early mortality as well as on long-term outcome when administered after S-HAM salvage therapy for advanced AML.
    Type of Medium: Electronic Resource
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  • 14
    ISSN: 1432-1289
    Keywords: Schlüsselwörter Mikrometastasen ; Minimal Residual Disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Zum Thema Während der Nachweis von disseminierten Tumorzellen von erheblicher prognostischer Bedeutung ist, sind die Konsequenzen aus diesen Beobachtungen bisher für die Therapie nur bedingt verwertbar. Denkbar sind neue Strategien bei minimaler Tumorlast, z.B. bei Patientinnen mit Mammakarzinom nach erfolgreicher Primärbehandlung. Die frühzeitige Rezidivbehandlung profitiert ebenfalls vom Nachweis niedriger Tumorlast, nachgewiesen für Patienten mit chronischer myeloischer Leukämie und akuter Promyelozytenleukämie. Die modernen Möglichkeiten, disseminierte Tumorzellen als Ausdruck einer minimalen Resterkrankung festzustellen, sind eine wichtige Bereicherung für das Staging, die Prognose, die Therapie und zugleich das Verständnis maligner Erkrankungen.
    Type of Medium: Electronic Resource
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  • 15
    Electronic Resource
    Electronic Resource
    Springer
    Der Internist 39 (1998), S. 1115-1122 
    ISSN: 1432-1289
    Keywords: Schlüsselwörter Tumortherapie ; Stammzelltransplantation ; Hochdosistherapie ; Stammzelltransplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Zum Thema Pluripotente hämatopoetische Stammzellen machen weniger als 1% aller Knochenmarkzellen aus. Durch Zytokine wird ihre Ausschwemmung ins periphere Blut gefördert, aus dem sie vor einer Hochdosistherapie durch Blutzellseparation (Leukapherese) gewonnen werden. Danach werden sie auf kleines Volumen reduziert und in flüssigem Stickstoff asserviert. 24–48 h nach Ende der hochdosierten Tumortherapie werden die eingefrorenen Stammzellen aufgetaut und reinfundiert. Mit großer Zuverlässigkeit führt die autologe Stammzelltransplantation nach 8–10 Tagen aus der kritischen Zytopenie zu raschem Anstieg der Thrombo- und Leukozytenzahlen. Die kombinierte Hochdosistherapie und Stammzelltransplantation hat sich besonders bei malignen Erkrankungen des hämatopoetischen Systems bewährt. Über die Ergebnisse dieser Behandlung auch bei soliden Tumoren wird in dieser Arbeit berichtet.
    Type of Medium: Electronic Resource
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  • 16
    ISSN: 1432-1289
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Auf dem VIII. Internationalen Symposium “Acute Leukemias”, das vom 27.2.–3.3.99 in Münster stattfand, widmenten sich 107 internationale Experten und 1100 Kongreßteilnehmer in neun Hauptsitzungen, sechs Satellitensymposien und zwei Postersitzungen den Themenschwerpunkten “Prognostische Faktoren” und “Therapiestrategien” für Patienten mit akuten Leukämien und diskutierten neue Ergebnisse und Analysen aktueller klinischer Studien und Grundlagen-orientierter Forschungsvorhaben.
    Type of Medium: Electronic Resource
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  • 17
    Electronic Resource
    Electronic Resource
    Springer
    Journal of cancer research and clinical oncology 116 (1990), S. 507-512 
    ISSN: 1432-1335
    Keywords: Flow cytometry ; DNA aneuploidy ; DNA/RNA analysis ; RNA index ; Acute myeloid leukemia ; Acute lymphoblastic leukemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In the present study bone marrow samples from 573 patients with newly diagnosed acute myeloid (AML) and lymphoblastic or undifferentiated leukemias (ALL/AUL), were analysed for their cellular DNA und DNA/RNA content, respectively, by means of flow cytometry. From 237 patients with AML 35.4% revealed aneuploid DNA stemlines. While no relation of DNA aneuploidy with other pretherapeutic parameters, including FAB subtype, white blood cell count, lactate dehydrogenase, S-phase index and percentage of blasts in the bone marrow, was observed, cases with aneuploid DNA stemlines revealed a tendency towards longer remission duration. In ALL/AUL 21.8% of 280 patients expressed DNA aneuploidies, which were less frequently found in T-cell ALL (11.1%) as compared to common(C)-ALL (21.4%) or null-cell(null)-ALL (23.5%). DNA aneuploidy was not related with other clinically defined risk factors such as age, white blood cell count, and rapid achievement of remission. Patients with DNA indices 〈1.0, however, tended to have shorter remissions. A significant difference in RNA indices was observed between AML and ALL/AUL with median values of 14.4 and 10.1, respectively (P〈0.05). These data indicate the usefulness of flow cytometric analyses of cellular DNA and RNA content for the characterization and classification of acute leukemias, complementing the identification of clinical risk factors, immuno-phenotyping and cytogenetics.
    Type of Medium: Electronic Resource
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  • 18
    Electronic Resource
    Electronic Resource
    Springer
    Journal of cancer research and clinical oncology 118 (1992), S. 349-360 
    ISSN: 1432-1335
    Keywords: Pleomorphic myofibrosarcoma ER 15-P ; Morphological heterogeneity ; Lung metastases ; Metastatic potential
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary At clinical presentation, the majority of malignant tumors are composed of multiple clonal subpopulations of tumor cells with different phenotypic characteristics. Using the experimental tumor model ER 15-P, a methylcholanthrene-induced pleomorphic sarcoma of the C57 Bl6J mouse, we studied a system of long-term in vivo passages of this primary tumor for cell morphological changes, and alterations in the potential for spontaneous lung metastases. Transplants from the primary after the 4th, 20th, 40th and 80th i.m. passage (referred to as T4, T20, T40, and T80 respectively) together with their lung metastases were investigated by light microscopy, immunohistochemistry, and electron microscopy. In addition, the potential for metastasis to the lungs in each group was determined and compared with that of the parent T4 tumors. T4 tumors were mainly composed of spindle-shaped tumor cells with the ultrastructural features of fibroblasts and myofibroblasts, often arranged in a storiform or fasciculated growth pattern, and intermingled with tumor giant cells. Some small areas contained polygonal or rounded tumor cells, ultrastructurally undifferentiated, and sometimes arranged in a hemangiopericytoma-like growth pattern. Although electron-microscopical findings clearly demonstrated the mesenchymal origin of these tumor cells, immunostaining with a polyclonal antibody to vimentin was unspecific in all tumor cells and normal mouse tissue. Monoclonal antibodies to vimentin from different sources were completely negative in tumor cells and murine stromal components. In contrast, myofibroblast-like tumor cells showed immunohistochemically, a moderate to strong co-expression with monoclonal antibodies to desmin, muscle actin and α-smooth muscle actin. On the basis of these morphological findings, the primary ER 15-P was classified as a pleomorphic myofibrosarcoma. The lung metastases of T4 tumors were mainly composed of undifferentiated round to polygonal tumor cells, while the number of desmin-positive, muscle- and α-smooth muscle-actin-positive cells was reduced. The morphological features of T20 tumors and their lung metastases were the same as in T4, indicating a relative stability of the phenotype up to that stage. In contrast, T40 and T80 tumors and their lung metastases were found to contain almost exclusively undifferentiated tumor cells and many tumor giant cells. While fibroblast-like tumor cells were seen only occasionally, myofibroblast-like tumor cells had almost completely disappeared. The potential for lung metastases was nearly constant in all groups, suggesting metastatic stability. Obviously, the undifferentiated tumor cells of this model are associated with a higher metastatic potential.
    Type of Medium: Electronic Resource
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  • 19
    Electronic Resource
    Electronic Resource
    Springer
    Journal of cancer research and clinical oncology 121 (1995), S. 338-342 
    ISSN: 1432-1335
    Keywords: Stem-cell factor ; Interlecukin-3 ; Erythropoietin ; Myelodysplastic syndromes ; Anemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract An inherent defect of erythroid differentiation at the colony-forming unit blast (CFU-blast) compartment and (or) an impaired response of early erythroid progenitors (BFU-E) to growth stimulation are both considered to contribute to anemia in myelodysplastic syndromes (MDS). With the intention of improving survival and growth of early erythroid progenitors we investigated the effect of stem-cell factor (SCF) and interleukin-3 (IL-3) alone and in combination with erythropoietin, on the in vitro erythropoiesis of 13 patients with MDS and of three normal controls. SCF and IL-3 alone did not promote erythroid colony growth in MDS, while 3 cases responded to erythropoietin alone. In each of these, BFU-E colony growth could be increased by SCF, which was also found in all normal bone marrows. Altogether 6 cases showed a significant enhancement of BFU-E colony numbers by the combination of SCF and erythropoietin as compared to erythropoietin alone (P=0.036). Out of the 6 responding cases, 5 belonged to the FAB-classified subgroups refractory anemia (RA) and refractory anemia with ringed sideroblasts (RA/RS) (5/5), while 1 patient was classified as having refractory anemia with excess of blasts (RAEB) (1/4). No patient with refractory anemia with excess of blasts in transformation (RAEB-T) (0/4) responded. In spite of these positive effects, the absolute number of BFU-E colonies remained reduced in all MDS cases when compared to normal controls. IL-3 proved ineffective in increasing the response to erythropoietin in MDS although it increased erythropoietin-induced BFU-E formation in normal controls significantly. We conclude that the striking synergistic effect of SCF and erythropoietin on erythroid colony formation seen with normal bone marrow is conserved in most cases with RA and RA/RS. In RAEB and RAEB-T the intrinsic defect of the erythroid differentiation pathway cannot be overcome by SCF.
    Type of Medium: Electronic Resource
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  • 20
    ISSN: 1569-8041
    Keywords: CD34+ progenitor cells ; chronic lymphocytic leukemia ; trisomy 12
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract B-cell chronic lymphocytic leukemia (B-CLL) is a slowly progressive disease resulting from the clonal expansion of mature B lymphocytes. The most frequent chromosomal abnormality is trisomy 12. Recently more aggressive therapeutic approaches using myeloablative therapy and autologous stem-cell support have been developed. Phase I/II studies have resulted in molecular remission and prolonged survival. One cause of relapse may be tumor-cell contamination of the transplant. We asked whether immunophenotypically identified hematopoietic progenitor cells are part of the malignant cell population in B-CLL. In a patient with trisomy 12, two subpopulations of hematopoietic progenitor cells, CD34+/CD38+ andCD34+/CD38− cells, were isolated by fluorescence-activated-cell-sorting; the sort purity was 98%. Trisomy12 was detected in 13% of CD34+/38+ cells and in 34% ofCD34+/38− cells. These data suggest that CD34+ cells are involved in the malignant clone of patients with B-CLL. The results are of significance for future strategies using autologous stem-cell transfusion.
    Type of Medium: Electronic Resource
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