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  • 1
    ISSN: 1432-1440
    Keywords: Acute leukemia ; Reverse isolation ; Remission rates ; Survival ; Age differences
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary 202 patients with acute leukemia (156 myeloid-AML, 46 lymphatic and undifferentiated-ALL/AUL) were studied retrospectively for the efficiency of different treatment schedules. Other variables we analysed were the influence of infection prevention with reverse isolation in laminar air flow units and of the age as a prognostic factor. 34% of all AML-patients achieved complete remission. Therapy with Adriamycin, Cytosine-Arabinoside and Vincristine resulted in 25 complete remissions in 51 patients (49%). The median duration of remission was 8 months and the median survival 19 months. The remission rate was improved by treatment with Cytosine-Arabinoside, 6-Thioguanine and Daunomycin (11 of 17 patients). Remission rate was significantly higher in patients up to 30 years of age than in patients older than 50 years (p〈0.008). Survival and remission duration were not different in respect to the age. Reverse isolation with total enteral and topical decontamination resulted in a higher remission rate (p=0.06 not significant) in AML-patients, compared with the control-group. Survival lasted longer with infection prevention. In ALL/AUL-patients the rate of complete remissions was 16 of 34 patients (47%), with a median survival of 17 months. Patients up to the age of 30 had a higher remission rate than those older than 50 years (p=0.017). Patients with ALL/AUL younger than 31 years had a median duration of remission of 16 months and a survival probability of 0.66 after 43 months.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1440
    Keywords: Bone marrow transplantation ; Acute leukemia ; Recurrent leukemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Twenty-one patients with acute leukemia in second to fifth remission were treated with bone marrow transplantation: 19 patients with transplants from HLA-matched siblings and two with transplants from identical twins. Twelve patients survived from 15 to 1,625 days after transplantation: six of 11 in the ALL group and six of 10 in the AML group. Recurrence of leukemia after marrow transplantation occurred in five patients. The cause of death in five patients was infection, in two patients combined with graft-versushost disease. Long-term disease-free survival can probably be achieved in 30%–35% of all patients with acute leukemia who receive a marrow transplant in second or subsequent remission.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1440
    Keywords: Bone marrow transplantation ; Acute leukemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Between October 1979 and March 1982, bone marrow transplantations were performed by the Tübingen Group for BMT on 19 patients with acute leukemia in remission and on one patient with chronic myelocytic leukemia in chronic phase. The conditioning regimen consisted of 2×60 mg cyclophosphamide/kg and 10 Gy whole-body irradiation with the linear accelerator. The lung dose was limited by shielding to 8 Gy. In 15 patients, the bone marrow cell suspension of the donor was preincubated with antihuman T-cell globulin (AHTCG) for prophylaxis of graft-versus-host disease (GVHD). All patients showed prompt engraftment of donor cells with good hemopoietic function and complete chimerism. Under reverse isolation in sterile units, no severe bacterial or fungal infections were seen in the phase of bone marrow aplasia. Twelve in twenty patients survived between 25 and 900 days. A severe GVHD was seen only in two patients — one after preincubation with AHTCG. One patient died from relapse of his leukemia, another patient had a testicular relapse which was treated with local radiotherapy. Major problems were seen with chronic GVHD (six patients) and infectious complications, most importantly interstitial pneumonia, in the late post-transplant period.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-0584
    Keywords: Acute leukemia ; Bone marrow transplantation ; Anti-T-cell-globulin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Anti-human-thymocyte globulin (AHTZG) was applied to prevent GvHD in clinical bone marrow transplantation. AHTZG produced by absorption with several cell preparations reacted specifically with T-lymphocyte populations and was no longer inhibitory to human CFUc and bone marrow growth in diffusion chambers. Marrow grafts of 14 patients with ALL were incubated in vitro with AHTZG and transferred to the recipients conditioned with antileukemic chemotherapy and total body irradiation of 1000 rad. Ten patients were transplanted after relaps, four patients during remission. The patients tolerated the marrow without side effects and a hemopoietic engraftment was seen in 12 cases. Three patients showed signs of GvHD on the skin, two of them showed later on also manifestations in the liver. In the other cases no GvHD could be detected. Five out of 14 patients are still alive between 144 and 964 days post transplantation in remission.
    Type of Medium: Electronic Resource
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