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  • 1
    ISSN: 1432-1440
    Keywords: Bone marrow transplantation ; Aplastic anaemia ; Knochenmarktransplantation ; Aplastische Anämie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Im Rahmen der Arbeitsgemeinschaft Knochenmarktransplantation — München (AG-KMT) wurden vom März 1975 bis Mai 1980 insgesamt 12 Patienten wegen schwerer, aplastischer Anämie mit Knochenmarktransplantation (KMT) behandelt. Sechs Patienten überleben derzeit mit normalem Blutbild und Knochenmark zwischen 10 Monaten und mehr als 5 Jahren nach KMT von HLA-identischen Geschwistern, eine Patientin steht noch in ambulanter Behandlung wegen lokalisierter, chronischer Graft-versus-Host Krankheit (GvHK), fünf Patienten sind klinisch gesund. Sechs Patienten starben, ein Patient starb am Tag vor KMT mit Hirnblutung, drei Patienten 32, 40 und 55 Tage nach KMT an den Folgen der Transplantatabstoßung, einer an schwerer GvHK 85 Tage nach KMT und einer 87 Tage nach KMT vermutlich an interstitieller Pneumonie nach Hirnblutung. Drei von 6 Patienten, die nur mit Cyclophosphamid (CY) vorbehandelt waren, starben infolge Abstoßung des Transplantates. Zwei erwachsene Patienten, die mit CY und „total lymphoid irradiation“ vorbehandelt waren, und drei Kinder, die nach KMT unbestrahlte Leukocytenkonzentrate von Knochenmarkspender erhalten hatten, stießen das Transplantat nicht ab. Die Ergebnisse der AG-KMT sind vergleichbar denen großer, spezialisierter Zentren für KMT und zeigen die Möglichkeiten einer Heilung schwerer aplastischer Anämien durch KMT von HLA-identischen Geschwistern. Die Erfolge sind besser bei frühzeitiger KMT.
    Notes: Summary From March 1975 until May 1980 twelve patients with severe aplastic anemia were grafted with bone marrow from HLA-identical siblings by the Munich Cooperative Group for Bone Marrow Transplantation. Six patients are alive between 10 months and more than 5 years after grafting with normal blood values and marrow. One patient is treated as an out patient for chronic localized graft-versus-host disease (GvHD), five patients are well and without treatment. Six patients have died, one patient with a cerebral hemorrhage the day before transplantation, three patients following rejection of grafts 32, 40 and 55 days after grafting, one patient with severe GvHD 85 days after grafting and one patient, probably with interstitial pneumonia, following cerebral hemorrhage. Three of 6 patients who were conditioned with Cyclophosphamide (CY) only died following rejection of the graft. Two adults who were conditioned with CY and “total lymphoid irradiation” and three children, who were given unirradiated leukocyte concentrates from the marrow donor after grafting, did not reject their grafts. The results of the Munich-Cooperative Group for Bone Marrow Transplantation are comparable to those of large, specialized centers for bone marrow transplantation, they indicate possibilities of cure of severe aplastic anemia by marrow grafts from HLA-identical siblings. They confirm that better results are obtained with earlier transplantation in the course of the disease.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 66 (1988), S. 614-623 
    ISSN: 1432-1440
    Keywords: Acute myeloid leukemia ; Acute lymphoblastic leukemia ; Postremission-therapy ; Bone marrow transplantation ; Intensified chemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The impact of bone marrow transplantation and chemotherapy on remission duration and survival in acute leukemia is controversial. Most studies on either procedure deal with selected patients and lack randomized or concurrent controls; many exclude high-risk subgroups. There are only a few preliminary reports on the direct comparison between bone marrow transplantation and intensive chemotherapy. Considerable controversy remains as to whether patients with AML in first remission who have an HLA identical sibling should receive a bone marrow transplant at that time or whether the transplant should be delayed until relapse or second remission. In patients under the age of 25 years, results of bone marrow transplantation are considered to be equivalent or superior to those achieved with chemotherapy. Because of a high lethality rate few results suggest that survival of patients transplanted during first remission is not superior to that obtained by intensified chemotherapy; however, the relapse incidence is decreased. In recent years, results in adult ALL, treated with various intensified programs, have improved considerably and are nearly comparable to those obtained in childhood ALL. Therefore, allogeneic bone marrow transplantation is usually performed in standard risk patients during second remission and, if relapse occurs within the first three years. It is not clear at present whether ALL highrisk patients will benefit from bone marrow transplantation during first remission.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1440
    Keywords: Bone marrow transplantation ; Acute leukaemia ; Knochenmarktransplantation ; akute Leukämie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Im Rahmen der Arbeitsgemeinschaft Knochenmarktransplantation München wurden von August 1975 bis Juni 1980 insgesamt 17 Patienten mit rezidivierter, akuter Leukämie mit Knochenmark von HLA-identischen Geschwistern transplantiert. Die antileukämische und immunsuppressive Vorbehandlung bestand aus BCNU, Cytosin-Arabinosid, Cyclophosphamid in hoher Dosierung und Ganzkörperbestrahlung mit etwa 9 Gy Körpermitteldosis an einer60Co-Doppelbestrahlungsanlage. Die Prophylaxe einer Graft-versus-Host Krankheit (GvHK) wurde in allen Fällen mit Methotrexat durchgeführt, bei neun Patienten wurde als zusätzliche GvHK-Prophylaxe das Knochenmark mit Anti-T-Zell-Globulin inkubiert, von dem die Antikörper gegen hämopoetische Stammzellen absorbiert waren. Zwei von fünf auswertbaren Patienten, die unbehandeltes Knochenmark erhalten hatten, entwickelten chronische GvHK, während kein Patient nach ATCG-Inkubation des Knochenmarkes eindeutige GvH-Krankheit bekam. Sechs Patienten leben in Vollremission zwischen einem und 33 Monaten nach Knochenmarktransplantation (KMT). Fünf Patienten starben mit Rezidiven zwischen 3 1/2 und 24 Monaten nach KMT, drei Patienten mit interstitieller Pneumonie innerhalb von 3 Monaten nach KMT und drei Patienten innerhalb von 4 Wochen ohne ausreichende Knochenmarkfunktion. Vier von 13 Patienten, die vor mehr als 6 Monaten transplantiert wurden, überleben zur Zeit 11, 14, 19 und 33 Monate in Vollremission. Unsere Ergebnisse bestätigen, daß selbst in fortgeschrittenen Stadien akuter Leukämie durch KMT noch langfristige Remissionen erreichbar sind.
    Notes: Summary Seventeen patients with relapsed, acute leukemia were grafted with bone marrow from HLA-identical siblings by the ‘Munich Cooperative Group for Bone Marrow Transplantation’ during the period from August 1975 to June 1980. The antileukemic and immunosuppressive conditioning treatment consisted of high doses of Bischlorethyl nitrosourea, Cytosine-Arabinoside and Cyclophosphamide, as well as, total body irradiation of about 9 Gy (midline body dose) from dual60Cobalt sources. Methotrexate was given to all patients for prophylaxis of graft-versus-host disease (GvHD). Nine patients received marrow that was treated with anti-T-cell globulin (ATCG) “in vitro”. — Crossreacting antibodies against hemopoietic stem cells were removed by absorption. Two of 5 evaluable patients given untreated marrow developed chronic GvHD, while patients given ATCG-treated marrow did not show unequivocal symptoms of GvHD. Six patients are in complete remission one to 33 months following bone marrow transplantation (b.m.t.) Five patients died with relapses of leukemia between 3 1/2 and 24 months following b.m.t., 3 patients died with interstitial pneumonia within 3 months of b.m.t. and 3 patients died with insufficient graft function within 4 weeks of b.m.t. Four of thirteen patients that were grafted more than 6 months ago are presently alive and in continuous complete remission at 11, 14, 29 and 33 months following b.m.t. Our results confirm that longterm remissions can be obtained with b.m.t. in patients with acute leukemia in advanced stage.
    Type of Medium: Electronic Resource
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