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  • 1
    Electronic Resource
    Electronic Resource
    Reduction of systemic fungal infections in patients with hematological malignancies, neutropenia, and prolonged fever by early amphotericin B therapy (1988)
    Springer
    Journal of molecular medicine 66 (1988), S. 1010-1014 
    Details
    ISSN: 1432-1440
    Keywords: Leukemia ; Lymphoma ; Fever ; Neutropenia ; Mycosis ; Antibiotics, antifungal ; Autopsy ; Retrospective studies ; Comparative studies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A rate on autopsy of up to 30% systemic fungal infections and difficulties in diagnosing systemic mycosis antemortem have led to the empiric use of amphotericin B in patients with hematological malignancies, prolonged fever, and neutropenia. Routine empiric antifungal treatment was initiated in our institution in 1982. Amphotericin B was given to granulocytopenic patients with hematological malignancies with (a) unremitting fever after 48–72 h of antibiotic treatment, (b) recurrent fever during antibiotic treatment, or (c) with newly detected pulmonary infiltrates, sinusitis, skin and retinal lesions suggestive of a fungal infection. With this approach the rate of systemic fungal infections decreased significantly from 10% (27 of 270 patients; 1973–1981) to 4% (6 of 153 patients; 1982–1986,P〈0.02). The reduction of systemic fungal infections was most prominent in patients with acute myelogenous leukemia, where its proportion decreased from 16% (16 of 98 patients; 1973–1981) to 4% (2 of 50 patients; 1982–1986,P〈0.023). Our data support the hypothesis that the incidence of systemic fungal infections in patients with hematological malignancies and especially in acute myelogenous leukemia can be reduced significantly by empirical treatment with amphotericin B.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01733443
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  • 2
    Electronic Resource
    Electronic Resource
    Novel approaches to the treatment of small-cell lung cancer (1999)
    Springer
    Cellular and molecular life sciences 55 (1999), S. 1585-1598 
    Details
    ISSN: 1420-9071
    Keywords: Key words. Antisense; antibodies; growth factor inhibitors; chemotherapy; gene therapy; radiation therapy; small-cell lung cancer.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract. Small-cell lung cancer (SCLC) is characterized by its initial responsiveness to chemotherapy and the appearance of early metastases. Although combination chemotherapy, in some instances together with radiation, has improved the prognosis of this disease, in most patients SCLC ultimately recurs in a drug-resistant form. Several new strategies for the eradication of SCLC are being explored at the preclinical level. The identification of selective target molecules on the surface of SCLC cells, together with the progress made in antibody engineering, have provided new generations of antibodies and immunoconjugates as well as growth factor antagonists and inhibitors. In addition, recent advances in understanding the biology of SCLC have stimulated new investigations searching to counter the molecular basis underlying the increased proliferation and the apoptosis deficiency of SCLC cells. This can be achieved using antisense oligodeoxynucleotides that repress the expression of growth factor receptors and anti-apoptosis genes, or by gene replacement to compensate for the loss or inactivation of tumor suppressor genes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s000180050398
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  • 3
    Electronic Resource
    Electronic Resource
    Selection and immunomagnetic purging of peripheral blood CD34+ cells for autologous transplantation in B-cell non-Hodgkin's lymphomas (1998)
    Springer
    Annals of oncology 9 (1998), S. 51-54 
    Details
    ISSN: 1569-8041
    Keywords: B-cell lymphomas ; CD34+ HPC's ; immunomagnetic purging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Clonogenic tumor cells in the hematopoietic progenitor cell harvest may contribute to relapse after high dose therapy for B-cell malignancies. Purging of the HPC harvest requires large amounts of anti-B-cell antibodies, whereas CD34-selection enriches self renewing HPC's but malignant cells are still detectable in many CD34+ fractions. Patients and methods: We examined the feasability and safety of a CD34-selection followed by purging with anti-B-cell antibodies in 11 patients with B-cell non-Hodgkin's lymphomas undergoing high-dose therapy with cyclophosphamide, BCNU and etoposide with retransfusion of autologous HPC's. Results: A mean number of 340 × 108 mononuclear cells was used for CD34-selection and immunomagnetic purging. CD34+ cells were enriched from a mean of 1.7% (range 0.2%–4.5%) to a mean of 68% (range 49%–87%) with a mean recovery of 27% (range 15%–43%). The mean number of retransfused CD34+ cells was 1.2 × 106/kg (range 0.6–2.2 × 106/kg) body weight with a median of 11 days (range 10–13 days) to neutrophil recovery of 0.5 × 109/l and 17 days (range 13–25 days) to platelet recovery of 50 × 109/l. Mean number of intravenous antibiotics and inpatient days were 8 (range 0–14) and 22 (range 19–26) respectively. Major toxicity consisted in four septicemias. Conclusions: CD34-selected and purged HPC's are safe and mediate rapid hematological recovery after high dose therapy for B-cell non-Hodgkin's lymphomas.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008251507768
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  • 4
    Electronic Resource
    Electronic Resource
    Index of pretreatment intensity predicts outcome of high-dose chemotherapy and autologous progenitor cell transplantation in chemosensitive relapse of Hodgkin's disease (1997)
    Springer
    Annals of oncology 8 (1997), S. 785-790 
    Details
    ISSN: 1569-8041
    Keywords: ABMT ; high-dose therapy ; Hodgkin's disease ; PBSCT ; prognostic factor
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose: To identify prognostic factors in patients with chemosensitiverelapsed Hodgkin's disease treated by high-dose chemotherapy with autologousprogenitor cell transplantation (HDC) and to compare the duration oftreatment-free remission prior to HDC with the progression-free survivalafter HDC in individual patients. Patients and methods: Forty-five consecutive patients were analyzedretrospectively. We devised an index of pretreatment intensity (IPTI) basednumber of different chemo- and radiotherapy regimens given between diagnosisand HDC and on the duration of disease. Results: With a medianfollow-up of 47 months the post-transplant event-free survival (EFS) was44% and the overall survival (OAS) was 62% at four years. TheIPTI allowed to discriminate between a low and a high-risk group with afour-year post-transplant EFS of 66% and 11% and a OAS of87% and 28%, respectively (P = 0.0001). Of the 39 patientswith sufficient follow-up after HDC, post-transplant EFS lasted on ≥18.5months longer than the pretransplant treatment-free remission. Conclusions: HDC with the CBV regimen confers significant benefit topatients with chemosensitive relapsed Hodgkin's disease. The IPTI may help toselect patients with a good response to HDC and to identify poor prognosispatients suitable for experimental protocols or palliative care only.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008281916057
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  • 5
    Electronic Resource
    Electronic Resource
    Single-agent gemcitabine versus cisplatin–etoposide: Early results of a randomised phase II study in locally advanced or metastatic non-small-cell lung cancer (1997)
    Springer
    Annals of oncology 8 (1997), S. 525-529 
    Details
    ISSN: 1569-8041
    Keywords: cisplatin ; etoposide ; gemcitabine ; non-small-cell lung cancer ; randomised phase II study
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: This randomised study was designed to determine the responserate, survival and toxicity of single-agent gemcitabine andcisplatin–etoposide in chemo-naïve patients with locally advancedor metastatic non-small-cell lung cancer. Patients and methods: Gemcitabine 1,000 mg/m2 was given asa 30 min intravenous infusion on days 1, 8, 15 of a 28-day cycle, cisplatin100 mg/m2 on day 1, and etoposide 100 mg/m2on days 1 (following cisplatin), 2 and 3. Major eligibility criteria includedhistologically confirmed non-small-cell lung cancer, measurable disease,Zubrod PS 0–2; no prior chemotherapy, no prior radiation of the measuredlesion, and no CNS metastases. Results: 146 patients were enrolled, 71 patients on gemcitabine and 75patients on cisplatin–etoposide. Patient characteristics were wellmatched across both arms. Sixty-six gemcitabine patients and 72cisplatin–etoposidepatients were evaluable. Partial responses were seen in 12 gemcitabinepatients (18.2%; 95% CI: 9.8–30) and 11cisplatin–etoposide patients (15.3%; 95% CI:7.9–25.7).Early indications show no statistical differences between the two treatmentswith respect to time to disease progression or survival. Haematological andlaboratory toxicity were moderate and manageable. However, hospitalisationbecause of neutropenic fever was required for 6 (8%)cisplatin–etoposide patients but not for any gemcitabine patients.Non-haematological toxicity was more pronounced with significant differencesin nausea and vomiting (grade 3 and 4: 11% gemcitabine vs. 29%cisplatin–etoposide; despite the allowance for 5-HT-3antiemetics during the first cycle of cisplatin–etoposide), and alopecia(grade 3 and 4: 3% gemcitabine vs. 62%cisplatin–etoposide). Conclusions: In this randomised study, single-agent gemcitabine was atleast as active but better tolerated than the combinationcisplatin–etoposide.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008207731111
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