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  • Akute Leukämie  (2)
  • Blast crisis  (2)
  • Gonadal toxicity  (2)
  • 1
    Digitale Medien
    Digitale Medien
    Verlauf und prognostische Kriterien bei Patienten mit „Präleukämie“ (1979)
    Springer
    Journal of molecular medicine 57 (1979), S. 21-29 
    Details
    ISSN: 1432-1440
    Schlagwort(e): Preleukemia ; Acute leukemia ; Prospective study ; Präleukämie ; Akute Leukämie ; Prospektive Studie
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Zusammenfassung In einer prospektiven, multizentrischen Studie wurde der Verlauf bei 33 Patienten mit Präleukämie verfolgt. Kriterien für die Aufnahme in die Studie waren eine Anämie mit Granulo- und/oder Thrombozytopenie bei normal oder erhöht zellreichem Knochenmark und Ausschluß einer für diese Veränderungen verantwortlichen Grunderkrankung oder externen Noxe. Die kürzeste Nachbeobachtungszeit nach Stellung der Diagnose „Präleukämie“ betrug 3 Jahre. Die mediane Überlebenszeit war 26 Monate nach Ersterfassung und 36 Monate nach Erstsymptom der Erkrankung. Remissionen wurden nicht beobachtet. Bei 40% der Patienten wurde innerhalb von 2 Jahren nach Ersterfassung eine akute Leukämie diagnostiziert. Unter den geprüften prognostischen Faktoren sprachen vor allem Chromosomenaberrationen und ein erhöhter Blastenanteil für den Übergang in eine akute Leukämie.
    Notizen: Summary The natural course of disease was followed in 33 patients with so-called preleukemia by a prospective multicentric protocol. Patients with the following criteria were included: Anaemia with granulocytopenia and/or thrombocytopenia, normal or increased cellularity of the bone marrow and exclusion of a known diagnosis of underlying disease. Follow up after assumption of “preleukemia” was 3 years or more. Median survival was 26 months after diagnosis of preleukemia and 36 months after the first unequivocal symptoms of the blood dyscrasia. 40% of the patients changed to the picture of leukemia within 2 years. The most important parameters suggesting subsequent transition to overt leukemia where chromosomal abberations and an increased blast count of the bone marrow.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01476978
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  • 2
    Digitale Medien
    Digitale Medien
    Vergleich zwischen cytologischer und cytochemischer Klassifizierung bei 47 Fällen von akuter Leukämie (1972)
    Springer
    Journal of molecular medicine 50 (1972), S. 498-503 
    Details
    ISSN: 1432-1440
    Schlagwort(e): Acute leucaemia ; Cytochemistry ; Akute Leukämie ; Cytochemie
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Zusammenfassung Bei 47 Patienten mit akuter Leukämie wurden die Ergebnisse einer voneinander unabhängigen Klassifizierung aufgrund der panoptischen Färbung einerseits und dem Ausfall cytochemischer Reaktionen andererseits (Peroxydase, PAS-Reaktion, Naphthol-AS-Acetat-Esterase) sowie das Ansprechen auf eine adäquate Induktionstherapie in den cytologisch und cytochemisch definierten Gruppen miteinander verglichen. In 42 Fällen stimmte die cytologische und cytochemische Differenzierung miteinander überein. Hinsichtlich des Ansprechens auf Therapie ergeben sich keine signifikanten Unterschiede, gleichgültig, ob man die AL nach cytologischen oder cytochemischen Kriterien gruppiert. Eine Ausnahme bildet der bei undifferenzierten AL cytochemisch charakterisierbare PAS-Typ, bei dem ein besseres Ansprechen auf Therapie als bei den Fällen ohne diagnostisch verwendbare cytochemische Aktivität wie auch bei den granulocytär differenzierten AL gefunden wurde. Hinsichtlich des Ansprechens auf Therapie verhalten sich die Erwachsenen mit PAS-Typ ähnlich günstig wie die Kinder.
    Notizen: Summary The leukaemic blast cells of 47 cases of acute leukaemia have been independently subclassified on the basis of panoptic stains on the one side and cytochemical reactions (peroxydase, PAS, naphthol-AS-acetate-esterase) on the other. In 42 cases the results of the cytochemistry were concordant to those of the panoptic stains. The percentage of responders to adaequate inductive chemotherapy failed to show any differences between the groups defined according to the different criteria. However, within the group of acute leukaemias which on the basis of panoptical staining could not be attributed to one of the normal cell lines, patients with PAS-positive leukaemic cells seem to have a better response than all other cases. This may be true for adults as well as for children.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01487293
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  • 3
    Digitale Medien
    Digitale Medien
    Blast crisis of Philadelphia chromosome-positive chronic myelocytic leukemia (CML) (1988)
    Springer
    Annals of hematology 57 (1988), S. 131-137 
    Details
    ISSN: 1432-0584
    Schlagwort(e): Chronic myeloproliferative syndrome ; Chronic myelocytic leukemia ; Blast crisis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary We have studied the clinical courses of 69 patients with blastic crises of Philadelphia chromosome positive CML to identify parameters that were associated with an increased response rate or survival. Cytogenetic analysis at the time of blastic transformation revealed additional chromosome changes in 70% of the patients tested. Bone marrow fibrosis was detected in 58% of evaluable patients. Lymphoblastic transformation was seen in 28% of the patients tested with cell surface marker analysis. The value of 5'-nucleotidase as a marker for distinguishing lymphoid from non-lymphoid blast crisis was confirmed. Of 57 evaluable patients, 23 (40%) responded to therapy (CR/PR longer than 14 days). Median survival was 75 days. Longer survival was related to the following factors: Ph1-chromosome as the only detectable cytogenetic abnormality; lymphoblastic transformation; no bone marrow fibrosis; high percentage of blasts and promyelocytes in the bone marrow, and response to therapy. No prognostic significance was associated with age, sex, Tdt, LDH, spleen size, duration of the chronic phase of the disease, white blood cell count, Hb, platelet count and percentages of basophils, eosinophils, erythroblasts and blasts and promyelocytes in the peripheral blood. These data confirm the poor prognosis of patients with blastic crisis of CML treated by conventional chemotherapy.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00320153
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  • 4
    Digitale Medien
    Digitale Medien
    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
    Schlagwort(e): Key words Chronic myelogenous leukemia ; Blast crisis ; Prognosis ; Karyotypic findings
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: 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.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/s002770050233
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  • 5
    Digitale Medien
    Digitale Medien
    Reversible Keimzelltoxizität nach aggressiver Chemotherapie bei Patienten mit Hodentumoren: Ergebnisse einer prospektiven Studie (1989)
    Springer
    Journal of molecular medicine 67 (1989), S. 367-378 
    Details
    ISSN: 1432-1440
    Schlagwort(e): Germ cell tumors ; Gonadal toxicity ; Chemotherapy
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary The impact of aggressive chemotherapy on reproductive and endocrine gonadal function was prospectively studied in 44 patients with germ cell tumors. Diagnostic procedures to determine gonadal toxicity consisted of hormone determinations, semen analyses, interviews with a standardized questionnaire, and gonadal histology. After chemotherapy all patients showed elevated serum levels of follicle-stimulating hormone (FSH) and azoospermia due to germ cell and stem cell loss. Recovery of spermatogenesis, as indicated by normalization of serum FSH levels and sperm density, occurred in 77% of the patients 25–60 months after cessation of chemotherapy. In all patients serum testosterone and luteinizing hormone (LH) values remained within normal limits after therapy indicating resistance of Leydig cells to cytotoxic drugs. Three patients fathered four healthy children after completion of chemotherapy. These data suggest significant reproductive dysfunction in all men treated for germ cell tumors. However, most patients showed late and complete recovery of spermatogenesis. In contrast, endocrine gonadal function was unaffected after chemotherapy in all patients. FSH and LH are feasible markers to assess drug-induced gonadal toxicity.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01711264
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  • 6
    Digitale Medien
    Digitale Medien
    Reproductive and endocrine gonadal capacity in patients treated with COPP chemotherapy for Hodgkin's disease (1987)
    Springer
    Journal of cancer research and clinical oncology 113 (1987), S. 260-266 
    Details
    ISSN: 1432-1335
    Schlagwort(e): Gonadal toxicity ; Hodgkin's disease ; COPP chemotherapy
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary Testicular and ovarian functions were assessed in 33 patients with Hodgkin's disease 1 to 17 years after cessation of COPP chemotherapy with cyclophosphamide, vincristine, procarbazine, prednisone. Diagnostic procedures consisted of hormone measurements, interviews, and semen analyses. In women serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), 17β-estradiol, progesterone, prolactin, and in men FSH, LH, 17β-estradiol, testosterone, and prolactin were determined. Semen analyses were performed in all men. Information concerning pregnancies, pregnancy outcome, future fertility wishes, sexual functions, menstrual pattern, and incidence of premature menopausal symptoms was ascertained by interview and questionnaire. Nineteen of 19 (100%) men showed elevated serum FSH levels between 715 and 1910 (median 1095) ng/ml and azoospermia, 1 to 11 years afters therapy. Serum levels of testosterone were within normal limits in 18/19 (95%) of the men, and LH values were normal in all men. Permanent ovarian failure occurred in 8/14 (57%) women, causing infertility and premature menopausal symptoms. The incidence of ovarian failure in women over 24 years was 86% (6/7) versus 28% (2/7) in those under 24 years at the time of treatment. In women receiving estrogen replacement, incidence and severity of these symptoms were significantly reduced. Of 14 women 3(21%) became pregnant and delivered 5 healthy children after treatment. Our results suggest irreversible sterility and normal Leydig cell function after COPP chemotherapy in all men. Druginduced ovarian failure was age-related and caused premature menopausal symptoms, detracting from the quality of the patient's life. To reduce premature menopausal symptoms and to prevent adverse cardiovascular and metabolic late sequelae, hormonal replacement is indicated. Pregnancies ending in normal live births can be achieved after COPP chemotherapy in young women. In both men and women, serum FSH and LH levels proved to be feasible markers to determine degree and duration of endocrine and reproductive gonadal injury after chemotherapy.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00396383
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