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  • 1
    ISSN: 1432-1440
    Keywords: Germ cell tumors ; Gonadal toxicity ; Chemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 65 (1987), S. 773-780 
    ISSN: 1432-1440
    Keywords: Streptococci ; Septicemia ; Acute leukemia ; High dose cytosine arabinoside
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Twenty-nine adult patients with acute myelogenous leukemia AML who received 40 treatment courses with high dose cytosine arabinoside (HD-A), alone or combined with other cytotoxic drugs, for remission induction (RI) or postremission intensive consolidation (IC) were retrospectively analysed for types and severity of infectious complications. In this paper, we report the unusually high rate of streptococcal septicemia in our patients. Of 13 bacteremic infections in a total of 45 infectious episodes, 10 were caused by streptococci (9 viridans streptococci, 1 group B hemolytic streptococcus). Three of them were lethal. After reviewing all documented cases of streptococcal septicemia in the same study period, four additional cases among adult patients with AML were identified. Three of them have had antileukemic chemotherapy without HD-A, while one have had HD-A as a conditioning regimen for bone marrow transplantation. Only three cases were documented to occur in adult patients with AML. Patients treated with HD-A for RI or IC had a significantly lower risk of streptococcal septicemia during previous chemotherapy-associated febrile neutropenic episodes (1/55 vs 10/45;P=0.01). Neither prophylactic regimens including trimethoprim-sulfamethoxazole nor those without it were effective in preventing streptococcal septicemia. Further studies are needed to confirm these data before the value of additional or alternative prophylactic antibiotics is proven necessary.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0584
    Keywords: akute LeukÄmie ; Infektionsprophylaxe ; antimikrobielle ; Dekontamination ; reverse Isolation ; Remissionsraten ; Acute leukemia ; Prevention of infection ; Antimicrobial decontamination ; Reverse isolation ; Remission rates
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The efficiency of strict reverse isolation and antimicrobial decontamination in remission induction therapy of acute leukemia was studied retrospectively in 47 patients who were treated with a standardized aggressive chemotherapy of daunorubicin and cytosine arabinoside. Twenty-two patients were treated in strict reverse isolation with antimicrobial decontamination and 25 patients in the open ward without any measures against infections. In the patients in isolation the incidence of new infections per patient was 0.77 compared to 1.42 in the control group. The rate of complete remissions was 77% in the patients in isolation vs. 56 % in the control patients.
    Notes: Zusammenfassung Die Wirksamkeit von strikter reverser Isolation und antimikrobieller Dekontamination bei der Induktionstherapie der akuten LeukÄmie wurde retrospektiv bei 47 Patienten untersucht. Alle Patienten erhielten eine standardisierte aggressive Chemotherapie mit Daunorubicin und Cytosin-Arabinosid. Zweiundzwanzig Patienten wurden in strikter reverser Isolation mit antimikrobieller Dekontamination behandelt, 25 Patienten auf normalen Krankenstationen ohne Ma\nahmen zur Infektionsprophylaxe. Die HÄufigkeit neuer Infektionen pro Patient war 0,77 bei den isolierten Patienten und 1,42 in der Kontrollgruppe. Die Rate kompletter Remissionen betrug bei den isolierten Patienten 77% im Vergleich zu 56% bei den Patienten auf den normalen Krankenstationen.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Annals of hematology 53 (1986), S. 279-286 
    ISSN: 1432-0584
    Keywords: Non-Hodgkins Lymphoma ; Burkitt's Lymphoma ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary From 6/79 until 2/86, 9 patients (median age 39) with Burkitt's lymphoma were treated. Stage D disease was seen in 7 cases, stage C in two and stage A in one. The main symptom was abdominal pain or a rapidly progressing abdominal tumor. Three patients had bone marrow involvement and two had a Burkitt's leukemia. Three had typical chromosomal aberrations. Therapy consisted of a variety of chemotherapy regimens plus additional radiotherapy and/or bulk surgery. Two patients achieved complete remissions (of 6 and 20+ months duration), and 4 partial remissions were obtained. The remaining patients had either progressive, drug resistant disease or died early. One patient is currently alive and in complete remission at 20+ months. A second patient is alive at 20+ months in partial remission with traces of IgM-paraprotein still detectable. The main causes of death were tumor-lysis syndrom (4 patients) and therapy related sepsis with progressive tumor (3 patients). This poor outcome is probably due to a high proportion of high-risk patients and suboptimal therapy for this rapidly proliferating tumor.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 59 (1981), S. 1075-1079 
    ISSN: 1432-1440
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-1440
    Keywords: Acute leukaemia ; Infection prophylaxis ; Selective decontamination
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In a prospective study the efficacy of two regimens for selective decontamination of the digestive tract was studied in patients with acute leukaemia during remission induction therapy. Seventy-eight patients were randomized to receive either a combination of cotrimoxazole, polymyxin B and nystatin (group A) or a combination of nalidixic acid, polymyxin B, neomycin and nystatin. With both regimens the gastrointestinal tract could be decontaminated equally effectively from potential pathogens. In the oropharyngeal region the decontamination from Enterobacteriaceae was significantly better in group A (P〈0.01). In both groups less than 10% of the acquired infections were caused by gram-negative bacilli and no gram-negative septicaemia occurred in either group. The median time interval until the first acquired infection was 17 days in group A and 36 days in group B, respectively (P〈0.05). It is concluded that regimen A might be more effective than regimen B though both regimens prevent reliably severe gram-negative infections.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-1440
    Keywords: Bone marrow transplantation ; Aplastic anaemia ; Acute leukaemia ; Chronic granulocytic leukaemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary From 1972–1983 53 patients underwent bone marrow transplantation. The median age was 18 years (3–41). 27 patients suffered from severe aplastic anaemia, 22 patients had acute leukaemia and 4 patients had chronic granulocytic leukaemia in chronic phase. Out of 22 patients with acute leukaemia, 2 had florid leukaemia, 2 had an early relapse and 18 patients were in first or second remission of their disease. 2/53 patients received a syngeneic transplant, 51/53 patients an allogeneic transplant. 47/51 patients had a HLA-A, B, C-identical, MLC-negative sibling donor, 1/51 had a HLA-A, B-C-identical, MLC-positive sibling donor, 2/51 a HLA-phaenotypical identical parental donor and 1/51 a HLA-identical, MLC-negative unrelated donor. The comparison of the results obtained in patients with severe aplastic anaemia transplanted from 1972–1979 with those transplanted from 1980–1983 shows that the bone marrow transplantation has to be performed in an early stage of the disease before the patients become multiple transfused, sensitized and severely infected and that the conditioning regimen for polytransfused patients has to be more intensive than in untransfused patients. From the patient group transplanted 1972–1979, only 1/14 patients is a long-term survivor in contrast to 8/13 patients transplanted from 1980–1983. 11/22 patients with acute leukaemia are alive between more than 5 years and 14 days after bone marrow transplantation. Only 1/4 patients, who were transplanted not in remission, is alive. For patients with acute leukaemia the bone marrow transplantation should be performed in an early stage of their disease when the tumor burden is small and when the patients are in good clinical condition. 2/4 patients with CGL are alive between 12 months and 3 months after bone marrow transplantation. In our patient group graft versus host disease was the most important problem with a high mortality due to GvHD associated infections.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Annals of hematology 38 (1979), S. 383-389 
    ISSN: 1432-0584
    Keywords: Diffusionskammertechnik ; periphere Blutzellen ; Normalwerte ; Diffusion chambers ; Peripheral blood cells ; Normal values
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Growth of mononuclear cells from human peripheral blood from 10 normal individuals was tested in diffusion chamber culture over a period up to 17 or 21 days. After an initial decrease during the first few days an increase of the total cell number was observed with maximal values on day 13. In all individuals growth of undifferentiated blast cells, lymphocytes, plasma cells, immature and mature granulopoietic cells, macrophages, and megakaryocytes occurred. In all individuals the different cell types had similar growth patterns in diffusion chamber culture. The considerable numerical variations which were seen in the granulopoietic cells were probably due to different stem cell concentrations in the peripheral blood of the investigated individuals. The results indicate that the diffusion chamber technique is a valuable method for the detection of haemopoietic stem cells and the culture of lymphocytic cells in man.
    Notes: Zusammenfassung Das Wachstum mononukleärer Zellen des peripheren Blutes in der Diffusionskammerkultur wurde bei 10 Normalpersonen über einen Zeitraum von 17 bis 21 Tagen untersucht. Während der Kultur kam es nach einem initialen Abfall zu einem Anstieg der Gesamtzellzahl mit einem Maximum am 13. Tag. Bei allen untersuchten Individuen zeigte sich eine gute übereinstimmung in den Wachstumsmustern der einzelnen Zellarten. Erhebliche numerische Schwankungen wurden jedoch bei den granulopoetischen Zellen beobachtet, wo sie auf unterschiedliche Stammzellkonzentrationen im Blut der untersuchten Personen zurückgeführt werden müssen. Die Ergebnisse zeigen, da\ die Diffusionskammertechnik eine wertvolle Methode zum Nachweis hämopoetischer Stammzellen und zur Kultur lymphatischer Zellen beim Menschen darstellt.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Annals of hematology 67 (1993), S. 127-128 
    ISSN: 1432-0584
    Keywords: Myelodysplastic syndrome ; Reticulocytes ; Erythrocyte abnormalities
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A patient with a myelodysplastic syndrome (MDS) and reticulocytosis of 〉50% in the absence of a correspondingly increased erythrocyte turnover is reported. Evaluation of the kinetics of erythrocyte turnover revealed a decreased erythrocyte life span of 44 days. From these data a prolongation of the reticulocyte maturation time to 〉20 days can be concluded. The patient's erythrocytes lacked the increase of mean corpuscular volume and a significant increase of erythrocyte enzymes that would be expected in marked reticulocytosis. This finding suggests that the reticulocytes represented not newly formed red blood cells, but “pseudoreticulocytes”, i.e., mature erythrocytes that retained their substantia reticulofilamentosa.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-0584
    Keywords: Thrombotic thrombocytopenic purpura ; Pregnancy ; Plasma exchange ; Plasma infusions ; Antiplatelet agents
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Thrombotic thrombocytopenic purpura (TTP) is a hematologic disorder which is clinically characterized by thrombocytopenia, microangiopathic hemolytic anemia, fever, neurologic symptoms, and cardiac and renal involvement. The pathogenic mechanisms of this disease are poorly understood. It is well known that TTP is associated with pregnancy and that prognosis for the mother and child is poor. We present the first case of a severe TTP diagnosed in the first trimester of pregnancy (13th week of gestation) with maternal survival and birth of a healthy child which required continuous and intensive treatment with plasmatherapy until delivery. During a period of 24 weeks several attempts to discontinue plasma therapy failed because of continuous active disease, and it became evident that plasma infusions were not as effective as plasma exchanges. The fact that the patient entered into remission soon after delivery of a healthy child by cesarean section in the 37th gestational week shows that in this case pregnancy activated an unknown factor which does not cross the placenta and which can be removed by plasmapheresis.
    Type of Medium: Electronic Resource
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