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  • 1
    ISSN: 1600-065X
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    Digitale Medien
    Digitale Medien
    Springer
    Hematology and cell therapy 38 (1997), S. 381-391 
    ISSN: 1279-8509
    Schlagwort(e): Leukemia (Acute myeloid) ; Bone marrow transplantation (Allogeneic and autologous) ; GM-CSF
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The GOELAM group conducted 2 consecutive trials on the treatment of de novo acute myeloblastic leukemia (AML) in adults. In the GOELAM1 protocol 786 patients aged 15–65 were randomized between two induction treatments (ARA-C 200 mg/m2/day for 7 days plus either Idarubicin 8 mg/m2/day for 5 days or Rubidazone 200 mg/m2/day for 4 days). Out of 731 evaluable patients, 521 (71%) achieved complete remission (CR) without significant difference between the 2 anthracyclines. For patients aged 51–65, the CR rate was significantly higher with Idarubicin (75%) than with Rubidazone (61%) (p=0,03). In this group of patients the post-remission therapy consisted in only one course of high dose ARA-C plus m-Amsa and the 6 year disease free survival (DFS) was 24% (intention to treat analysis). For patients aged 15–50 years, the post remission therapy was either allogeneic bone marrow transplantation (BMT) (patients up to 40 years of age with an HLA identical sibling) or a first course of intensive consolidation chemotherapy (ICC) followed by a randomization between autologous unpurged bone marrow transplantation (ABMT) and a second course of ICC. There was no significant difference in the 4 year DFS between allogeneic BMT (42%) and the other types of intensive post remission-therapy (40%). The 4 year DFS was 42% for ABMT and 38% for ICC (p=0.46) (intention to treat analysis). However the median duration of thrombocytopenia was much longer after ABMT (109.5 days versus 18.5 days p=0.0001). The GOELAM SA3 randomized placebo-controlled protocol tested the impact of GM-CSF given during and after induction treatment for elderly patients (55–75 years). In this study, 232 evaluable patients received induction chemotherapy (Idarubicin 8 mg/m2/day for 5 days plus ARA-C 100 mg/m2/day for 7 days) plus placebo or GM-CSF 5μg/kg/day from day 1 until the end of neutropenia. The CR rate was 61.5%. The median duration of neutropenia was shorter in the GM-CSF arm (22 days versus 27 days p=0.0001). There was no overall significant advantage for the GM-CSF arm, in terms of CR rate and survival. However for patients age 55–64 the 2 year DFS was significantly higher in the GM-CSF arm (43% vs 17% p=0.0013).
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 3
    Digitale Medien
    Digitale Medien
    Springer
    Hematology and cell therapy 38 (1997), S. 221-224 
    ISSN: 1279-8509
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Allogeneic hematopoietic stem cell transplantation is associated with a severe complication induced by the T-cells present in the graft: graft-vs-host disease (GVHD). While effectively preventing GVHD, ex vivo T-lymphocyte depletion of the graft unfortunately increases graft rejection and reduces the graft-vs-leukemia (GVL) effect. The ex vivo transfer of the herpes simplex thymidine kinase (HS-tk) suicide gene into T-cells before their infusion with the hematopoietic stem cells should allow for selective in vivo depletion of these T-cells with ganciclovir (GCV) if subsequent GVHD was to occur. In patients not experiencing GVHD, and therefore at a higher risk of relapse, one could preserve the beneficial effects of the donor T-cells on tumor control. Lastly, the early presence of donor T-cells in all patients should contribute to successful engraftment. We have demonstrated that retro-viral-mediated transfer of HS-tk and Neomycine resistance genes in T-lymphocytes, followed by G418 selection, results in T-cells specifically inhibited by GCV with no bystander effect. In a phase I study, escalating amounts of HS-tk expressing T-cells will be infused in conjunction with a T-cell depleted marrow graft to allogeneic HLA identical recipients. Toxicity, survival, alloreactivity and GCV-sensitivity of the gene-modified cells will be monitored. If successful, such an approach could significantly contribute to expanding the use of alloreactivity as a treatment modality.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 4
    Digitale Medien
    Digitale Medien
    Springer
    Hematology and cell therapy 42 (2000), S. 149-154 
    ISSN: 1279-8509
    Schlagwort(e): Allogeneic transplantation ; Bone marrow ; Acute myeloid leukemia ; Cost
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The aim of this economic evaluation was to assess the costs of the first year of genotypically identical HLA allogeneic bone marrow transplantation (BMT) for the treatment of adults patients with acute myeloid leukemia (AML) in first complete remission (CR1). During the first year of follow-up the following were assessed 1) variable direct medical (VDM) cost (drugs, blood products, lab tests, radiological procedures, hospital days) and the part of this cost paid by the Besançon Hospital from it own budget 2) the total cost. Ten consecutive patients from the Hematology Department of the Besançon University Hospital (France) transplanted from 1995 to 1996 for AML in CR1 were included in the analysis. This retrospective study was carried out using the French Health Care Insurance System (HCIS) perspective. Medical data were collected from the medical records of the patients. The overhead and logistics charges came from the analytic accounting report which was used to assess the mean cost of the first year of follow-up (in e and 1999 US$). The variable medical cost for the first year of follow-up for an allogeneic BMT amounted to 66,186 e (US$ 70,542). Total direct cost for the first year of follow-up was 111,454 e (US$ 118,459) (82,963 e, US$ 88,422 for the first six months). 95% of that cost was paid by the State Hospital from it own budget.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 5
    ISSN: 1279-8509
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 6
    ISSN: 1573-0646
    Schlagwort(e): ASTA Z 7557 ; autologous bone marrow transplantation ; acute leukemia
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Chemie und Pharmazie , Medizin
    Notizen: Summary The contamination of autologous marrow with clonogenic tumor cells has been the main argument against ABMT in acute leukemia. In a preclinical study we evaluated an active cyclophosphamide derivative named “ASTA Z 7557”. We observed that the toxic effect of this drug on CFU-GM growth was dependent on nucleated cell concentration as well as on red blood cell contamination. The potency of the drug was in close relationship with the incubation temperature. The growth of leukemic CFU was inhibited with an ASTA Z dose higher than 30 μg/ml. In our system, beyond 40 μg/ml more than 95% of committed stem cells are destroyed. Fifteen patients had autotransplant because of AML for 10 patients and because of ALL for 5 patients (4 patients were grafted in relapse and 11 patients in remission). We demonstrated that the marrow take was possible although the inoculum is CFU-GM depleted. Five of the 10 AML patients are alive and remain disease-free at 45 +, 65 +, 190 +, 345+ and 570 + days from ABMT without any maintenance treatment. Four of the 5 ALL patients are alive, three of them in complete remission (404+, 110+, 250+ days). The number of patients reported in this clinical study was relatively small and more cases should be evaluated to be conclusive. Nevertheless the feasibility of chemopurified ABMT was demonstrated.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 7
    Digitale Medien
    Digitale Medien
    Springer
    European journal of clinical microbiology & infectious diseases 6 (1987), S. 499-500 
    ISSN: 1435-4373
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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