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  • 1
    Electronic Resource
    Electronic Resource
    Ausbildung in Onkologie (1999)
    Springer
    Der Onkologe 5 (1999), S. 637-641 
    Details
    ISSN: 1433-0415
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Die onkologischen Erkrankungen gehören wegen ihrer Häufigkeit und ihrer Bedeutung für Morbidität und Mortalität zu den wesentlichen Herausforderungen, denen sich Absolventen des Medizinstudiums heute und in der Zukunft zu stellen haben. Die altersstandardisierte krebsspezifische Mortalität liegt in Deutschland bei 280/100.000 Einwohner jährlich; dies entspricht 250.000 Krebstodesfällen pro Jahr. Da etwa jede zweite Krebserkrankung geheilt wird, ist die Zahl der jährlich neudiagnostizierten Fälle etwa doppelt so hoch. Aufgrund des steilen Anstiegs des Krebsrisikos nach dem 60. Lebensjahr ist, trotz aller Bemühungen um eine verbesserte Primärprävention, mit weiter steigender Lebenserwartung eine weitere Zunahme wahrscheinlich. Globale Angaben zur Prävalenz sind nicht verfügbar und sagen wegen der unterschiedlichen natürlichen Prognose verschiedener Krebsformen wenig aus. Zweifellos ist unabhängig von der Inzidenzentwicklung jedoch auch hier mit einem weiteren Anstieg zu rechnen, da die Zahl der für viele Jahre erfolgreich palliativ behandelbaren, aber nicht geheilten Krebspatienten zunimmt. Die Onkologie ist weltweit ein Schwerpunktthema und bedarf der. Gestaltung eines onkologischen Curriculums in der ärztlichen Ausbildung.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007610050419
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  • 2
    Electronic Resource
    Electronic Resource
    Autologous platelet transfusion in alloimmunized patients with acute leukemia (1995)
    Springer
    Annals of hematology 71 (1995), S. 169-173 
    Details
    ISSN: 1432-0584
    Keywords: Autologous transfusion ; Platelets ; Immunization ; Acute leukemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Seventy-eight transfusions of autologous platelets were given to eight alloimmunized patients receiving curative chemotherapy for acute leukemia. Platelets were collected at regeneration of hematopoiesis after a chemotherapy cycle, cryopreserved with 5% dimethylsulfoxide in liquid nitrogen, and retransfused during bone marrow aplasia following the next treatment cycle. The in vitro platelet recovery after freezing, thawing, and washing was 85 ±4%. The in vivo corrected count increment 1 h after autologous platelet transfusions was 11±5×109/l. With the exception of moderate urticaria and slight nausea each after one transfusion, no immediate or chronic side effects occurred. The bleeding time was shortened and hemorrhage during bone marrow aplasia was prevented in all alloimmunized patients by autologous platelet transfusions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01910313
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  • 3
    Electronic Resource
    Electronic Resource
    Autologous platelet transfusion in alloimmunized patients with acute leukemia (1995)
    Springer
    Annals of hematology 71 (1995), S. 169-173 
    Details
    ISSN: 1432-0584
    Keywords: Key words Autologous transfusion ; Platelets ; Immunization ; Acute leukemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Seventy-eight transfusions of autologous platelets were given to eight alloimmunized patients receiving curative chemotherapy for acute leukemia. Platelets were collected at regeneration of hematopoiesis after a chemotherapy cycle, cryopreserved with 5% dimethylsulfoxide in liquid nitrogen, and retransfused during bone marrow aplasia following the next treatment cycle. The in vitro platelet recovery after freezing, thawing, and washing was 85±4%. The in vivo corrected count increment 1 h after autologous platelet transfusions was 11±5×109/l. With the exception of moderate urticaria and slight nausea each after one transfusion, no immediate or chronic side effects occurred. The bleeding time was shortened and hemorrhage during bone marrow aplasia was prevented in all alloimmunized patients by autologous platelet transfusions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01910313
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  • 4
    Electronic Resource
    Electronic Resource
    Obituary — Jan Neuwirt (1995)
    Springer
    Annals of hematology 71 (1995), S. 205-205 
    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/BF01910320
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  • 5
    Electronic Resource
    Electronic Resource
    Allogenic bone marrow transplantation of chemotherapy for patients with acute myeloid leukemia in first complete remission: a decision analysis approach (1996)
    Springer
    Annals of hematology 72 (1996), S. 223-230 
    Details
    ISSN: 1432-0584
    Keywords: Key words Acute myeloid leukemia ; Bone marrow transplantation ; Decision analysis ; Decision-making
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The methodology of decision analysis was originally developed to improve clinical decisions of physicians for individual patients. However, it is also well suited to support consensus procedures. We have used this methodology to analyse the question whether allogeneic bone marrow transplantation (BMT) or consolidation chemotherapy (CCT) should be used as first line postremission treatment in patients with acute myeloid leukemia. Main risk factors relevant for the outcome after BMT and CCT are therapy-related mortality and leukemic relapse, respectively. If the possibility of salvage BMT for patients relapsing after CCT is included, the outcomes of the two strategies come rather close. However, they are clearly different in subtypes of leukemia with high or low risk of relapse, and in patients at high risk for BMT-related mortality. Sensitivity analysis considering the variation of more than one risk factor provides valuable information for decision making for both individual patients and particular subgroups of patients with acute myeloid leukemia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002770050164
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  • 6
    Electronic Resource
    Electronic Resource
    High levels of thrombopoietin in sera of patients with essential thrombocythemia: Cause or consequence of abnormal platelet production? (1998)
    Springer
    Annals of hematology 77 (1998), S. 211-215 
    Details
    ISSN: 1432-0584
    Keywords: Key words Thrombopoietin ; Essential thrombocythemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Thrombopoietin (TPO) is the most important regulator of megakaryocyte development and platelet production. Platelet production is thought to be regulated by a negative regulatory feed back loop. In an attempt to evaluate the role of TPO in the pathobiology of essential thrombocythemia (ET), we have examined levels of TPO and other cytokines with thrombopoietic activity (interleukin-6 and interleukin-11) in sera obtained from 25 patients with ET (ten treated, 15 untreated) and 117 healthy control subjects. TPO serum levels were assessed using a sandwich-antibody ELISA that utilizes a polyclonal rabbit antiserum for both capture and signal. The mean serum TPO level in 25 ET patients was significantly elevated (545±853 pg/ml) as compared with that in healthy controls (95.3±54.0 pg/ml,p〈0.001). The difference in TPO serum levels between ten treated (781±1229 pg/ml) and 15 untreated ET patients (388±458 pg/ml) did not reach statistical significance (p=0.09). We conclude that either consumption or production of TPO is altered in ET. Failure of appropriate feedback regulation and continued megakaryocyte stimulation by an elevated TPO may play an important role in the pathobiology of ET.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002770050445
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  • 7
    Electronic Resource
    Electronic Resource
    Chronic myelogenous leukemia in blast crisis: retrospective analysis of prognostic factors in 90 patients (1996)
    Springer
    Annals of hematology 73 (1996), S. 225-230 
    Details
    ISSN: 1432-0584
    Keywords: Key words Chronic myelogenous leukemia ; Blast crisis ; Prognosis ; Karyotypic findings
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Ninety patients with Philadelphia chromosome-positive chronic myelogenous leukemia in blast crisis were reviewed to identify significant prognostic associations. At diagnosis of blast crisis the main clinical, laboratory, and cytogenetic data were recorded and evaluated for prognostic significance. At the time of the analysis 89 patients had died, with a median survival of 11 weeks from diagnosis of blast crisis. Patient characteristics demonstrated in the univariate analysis to have significant association with shorter survival were: thrombocythemia, leukocyte count above 20×109, Karnofsky index 〈50%, nonlymphoid blast cell morphology, cytogenetic clonal evolution, the presence of a double Philadelphia chromosome or trisomy 8, and no response to therapy. In 17 of 59 patients (29%) evaluable for response to therapy a complete or partial remission was achieved. These responders had a significantly longer median survival (25 weeks) as compared with nonresponders (9 weeks). Response to therapy was significantly better in lymphoid blast crisis and in patients without clonal evolution. In a multivariate analysis containing all significant variables of the univariate analysis two parameters retained their prognostic significance: response to therapy and trisomy 8. In spite of the short overall survival in blast crisis, the determination of prognostic factors may be a useful tool for the clinician planning therapy, especially new therapeutic approaches.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002770050233
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  • 8
    Electronic Resource
    Electronic Resource
    High-dose cytosine arabinoside and daunorubicin postremission therapy in adults with de novo acute myeloid leukemia Long-term follow-up of a prospective multicenter trial (1995)
    Springer
    Annals of hematology 71 (1995), S. 219-225 
    Details
    ISSN: 1432-0584
    Keywords: Key words De novo AML ; Adults ; HD-Ara-C/DNR consolidation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  A total of 149 consecutive de novo AML patients aged 50 years or less (median age = 37 years) were enrolled in this prospective multicenter trial initiated in May 1985. All patients received the same induction and early consolidation therapy with daunorubicin (DNR), cytosine arabinoside (Ara-C), and etoposide (DAV). High-dose Ara-C/DNR therapy included Ara-C at 3 g/m2, in 12 doses (HD-Ara-C/DNR I) and eight doses (HD-Ara-C/DNR II), followed by DNR 30 mg/m2 for 3 days. A complete remission (CR) was achieved in 104 (70%) patients; 61 complete responders received at least one cycle with HD-Ara-C/DNR. If those patients who were transplanted in first CR (n = 26), were not considered, the median relapse-free-survival (MRFS) of the remaining 78 patients was 15 months, with a probability of relapse-free survival (RFS) at 116 months of 30% (95% CI, 20–40%) after a median follow-up of 95 months. The MRFS of the HD-Ara-C/DNR consolidated patients was 25 months, with a probability of RFS at 116 months of 37% (95% CI, 24–50%). If all patients who were transplanted (n = 44) were not considered, the median survival time (MST) was 18 months with a probability of being alive at 118 months of 24% (95% CI, 16–33%). MST of the HD-Ara-C/DNR consolidated patients was 58 months with a survival probability of 46% (95% CI, 31–60%) at 118 months. Prognostic factor analysis did not reveal any significant influence of age, sex, FAB subtype, white blood cell count, hemoglobin level, thrombocyte count, LDH, or response to the first induction course on RFS of the HD-Ara-C/DNR consolidated patients. In summary, HD-Ara-C/DNR consolidation can improve the long-term outcome of a subgroup of de novo AML patients. Further improvement of the outcome seems to depend on the identification of patients with an inferior outcome under that strategy who might benefit from alternative treatment strategies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01744371
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  • 9
    Electronic Resource
    Electronic Resource
    High-dose cytosine arabinoside and daunorubicin postremission therapy in adults with de novo acute myeloid leukemia (1995)
    Springer
    Annals of hematology 71 (1995), S. 219-225 
    Details
    ISSN: 1432-0584
    Keywords: De novo AML ; Adults ; HD-Ara-C/DNR consolidation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A total of 149 consecutive de novo AML patients aged 50 years or less (median age = 37 years) were enrolled in this prospective multicenter trial initiated in May 1985. All patients received the same induction and early consolidation therapy with daunorubicin (DNR), cytosine arabinoside (Ara-C), and etoposide (DAV). High-dose Ara-C/DNR therapy included Ara-C at 3 g/m2, in 12 doses (HD-Ara-C/DNR I) and eight doses (HD-Ara-C/DNR II), followed by DNR 30 mg/m2 for 3 days. A complete remission (CR) was achieved in 104 (70%) patients; 61 complete responders received at least one cycle with HD-Ara-C/DNR. If those patients who were transplanted in first CR (n=26), were not considered, the median relapsefree-survival (MRFS) of the remaining 78 patients was 15 months, with a probability of relapse-free survival (RFS) at 116 months of 30% (95% CI, 20–40%) after a median follow-up of 95 months. The MRFS of the HD-Ara-C/DNR consolidated patients was 25 months, with a probability of RFS at 116 months of 37% (95% CI, 24–50%). If all patients who were transplanted (n=44) were not considered, the median survival time (MST) was 18 months with a probability of being alive at 118 months of 24% (95% CI, 16–33%). MST of the HD-Ara-C/DNR consolidated patients was 58 months with a survival probability of 46% (95% CI, 31–60%) at 118 months. Prognostic factor analysis did not reveal any significant influence of age, sex, FAB subtype, white blood cell count, hemoglobin level, thrombocyte count, LDH, or response to the first induction course on RFS of the HD-Ara-C/DNR consolidated patients. In summary, HD-Ara-C/DNR consolidation can improve the long-term outcome of a subgroup of de novo AML patients. Further improvement of the outcome seems to depend on the identification of patients with an inferior outcome under that strategy who might benefit from alternative treatment strategies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01744371
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  • 10
    Electronic Resource
    Electronic Resource
    The abundant presence of Söderström bodies in cytology smears of fine-needle aspirates contributes to distinguishing high-grade non-Hodgkin's lymphoma from carcinoma and sarcoma (1997)
    Springer
    Annals of hematology 74 (1997), S. 175-178 
    Details
    ISSN: 1432-0584
    Keywords: Key words Söderström bodies ; Cytology smears ; Non-Hodgkin's lymphoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Söderström bodies, also termed lymphoglandular bodies (LGB) and detectable in fine-needle aspiration cytology smears, have long been accepted as indicative of lymphoid tissues. To investigate the validity of this association, we examined 588 cytologic smears from high-grade non-Hodgkin's lymphoma (NHL), carcinoma, and sarcoma. Slides with lymphocytes in the vicinity of carcinoma and sarcoma cells had been excluded. Two independent observers scored smears to number, size, color, form, and smear background of the LGB. In 68 of 359 (19%) nonlymphoid malignancies rare (defined as 〈1 LGB per high-power field) or occasional LGB (defined as 1–20 LGB per high-power field) were detectable. Half of these tumors consisted of melanomas, small cell lung carcinomas, and teratomas; the other half encompassed undifferentiated sarcomas. However, none of the smears obtained from carcinoma or sarcoma tissue had abundant LGB (defined as 〉20 LGB per high-power field). When number of LGB was estimated to be abundant, the sensitivity for diagnosing a lymphoma was 54%; however, specificity was 100%. The difference in showing LGB between high-grade NHL and carcinoma/sarcoma was highly significant (p=0.0001). The presence of abundant LGB in cytologic smears strongly suggests the diagnosis of lymphoma, while the absence of LGB nearly excludes this diagnosis. No trends were observed with the other criteria which were tested. LGB in aspiration cytology smears from malignant tumors thus represent a useful tool to distinguish high-grade NHL from carcinoma and sarcoma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002770050278
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