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  • 1
    Electronic Resource
    Electronic Resource
    High-dose therapy followed by stem cell transplantation in partial response after first-line induction therapy for aggressive non-Hodgkin's lymphoma (1998)
    Springer
    Annals of oncology 9 (1998), S. 5-8 
    Details
    ISSN: 1569-8041
    Keywords: aggressive non-Hodgkin's lymphoma ; autologous stem cell transplantation ; high-dose therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Patients with aggressive non-Hodgkin's lymphoma who fail to achieve a complete remission (CR) with standard induction therapy have a poor prognosis with conventional-dose salvage therapy alone. Retrospective series have suggested that early introduction of high-dose salvage therapy with autologous stem cell transplantation (ASCT) may benefit partial-responder (PR) patients. However, two randomized studies (of 69 and 51 patients with partial clinical responses) failed to demonstrate any advantage of intensive therapy. By contrast, the GELA comparative study on 94 PR-patients (residual disease being histologically documented in 53 patients) suggested that high-dose therapy with ASCT improves survival. Interpretation of all these results is complicated by the heterogeneity of patient populations with respect to initial prognostic factors, induction regimens and, in particular, the criteria used to define partial response. Gallium CT scan and magnetic resonance imaging are now used to better explore residual masses. In the future, early restaging with these imaging techniques might be used to delineate patients who are likely to achieve CR from those who will fail to induction treatment and could be candidates for experimental treatments.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008291723029
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  • 2
    Electronic Resource
    Electronic Resource
    Is the International Prognostic Index for aggressive lymphomas useful for low-grade lymphoma patients? Applicability to stage III–IV patients (1997)
    Springer
    Annals of oncology 8 (1997), S. 49-52 
    Details
    ISSN: 1569-8041
    Keywords: index ; lymphoma ; low grade ; prognostic factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The International Prognostic Index (IPI) is widely usedto predict outcome of patients with aggressive lymphomas. Our goal was toassess the prognostic value of this index for low-grade lymphoma. Patients and methods: One hundred eighty-two patients withdisseminated (stage III or IV) low-grade lymphoma were enrolled in aprospective multicenter trial. According to the initial features, treatmenteither was started immediately or was deferred until indicated by diseaseprogression. Patients received the same polychemotherapy regimen, givenmonthly for six cycles. They were assigned to one of four risk groupsaccording to the number of presenting risk factors: low-risk (0 or 1),low-intermediate-risk (2), high-intermediate-risk (3), high-risk groups (4). Results: Survival curves (Kaplan–Meier method) demonstrated ahigh significant difference for the four groups (log-rank: P 〈0.0001). Median survival for the low-risk group has yet to be reached, whilethat for the three other groups are, respectively, 65, 34, and 12 months. Conclusions: In this study, the IPI has been found to be an importantprognostic tool in low-grade lymphoma and may be used in the selection ofappropriate therapeutic approaches for individual patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008297632358
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Cost analysis of allogeneic bone marrow transplantation (2000)
    Springer
    Hematology and cell therapy 42 (2000), S. 149-154 
    Details
    ISSN: 1279-8509
    Keywords: Allogeneic transplantation ; Bone marrow ; Acute myeloid leukemia ; Cost
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s00282-000-0149-2
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  • 4
    Electronic Resource
    Electronic Resource
    Low dose T-cell lymphocyte infusion combined with marrow T-cell depletion as prophylaxis of acute graft vs host disease for HLA identical sibling bone marrow transplantation (1999)
    Springer
    Hematology and cell therapy 41 (1999), S. 31-37 
    Details
    ISSN: 1279-8509
    Keywords: Bone marrow transplantation ; Chimerism ; Graft versus host disease ; Leukemia ; Lymphoma ; T-cell depletion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract T-cell depletion (TCD) of the bone marrow graft remains the most effective method to prevent severe graft versus host disease after allogeneic bone marrow transplantation. Early studies of HLA-identical sibling transplants showed that although T-cell depletion decreased GVHD, T-cell depleted transplants had higher risks of graft failure and leukemia relapse, leukemia free survival (LFS) was not improved compared to non-T-cell depleted transplants. In order to avoid graft failure and increased risk of relapse associated with this approach, we initiated a pilot study of T-cell depletion of the marrow graft combined with reinfusion of a fixed quantity of CD2+ peripheral blood T-cells. Depletion technique consisted in negative purging using CD2 and CD7 monoclonal antibodies (MoAbs) followed by rabbit complement cytolysis. This approach was associated with an intensified conditioning regimen using total body irradiation, high-dose cytosine arabinoside and melphalan (TAM) for all but one patient. Twenty-one patients were included with a mean age of 40 years. Only one acute severe Graft Versus Host Disease (GVHD) was observed and all patients engrafted. At 63 months, probability of survival is 42.86% with a relapse risk of 19.89%, two patients died from B-cell lymphoproliferative disease, seven other died from the procedure partially because of the use of the TAM as pretransplant regimen. This approach is being pursued by a gene therapy trial using herpes-simplex − 1 thymidine kinase gene expressing peripheral donor T-cells.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s00282-999-0031-9
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    Paper (German National Licenses)
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