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  • 1
    Electronic Resource
    Electronic Resource
    HLA CLASS I AND CLASS II ANTIGEN ASSOCIATIONS IN ACUTE LEUKAEMIAS (1986)
    Oxford, UK : Blackwell Publishing Ltd
    International journal of immunogenetics 13 (1986), S. 0 
    Details
    ISSN: 1744-313X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Biology , Medicine
    Notes: HLA-A,B,C and DR antigen frequencies were determined in a group of 188 patients suffering from acute myeloid (AML) and acute lymphoid leukaemia (ALL). These antigen frequencies were compared with those obtained on a panel of normal individuals (n= 109) of the same ethnic origin. The significance of the differences in the antigen distribution and the strength of the associations between particular HLA antigens and the disease were then calculated. The resuks obtained show a decreased frequency of HLA-Awl9 in the overall group of patients and the group of patients with ALL. In addition, the antigen frequency of the HLA-B18 and DRS(DRw11) antigens was also decreased in the overall group of patients and in those patients with AML but not in the patients with ALL. The results suggest that the antigen Aw l9 may confer some degree of resistance to the development of ALL and that the HLA-B18 and/or DR5 antigens may be resistance factors for the development of AML.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1744-313X.1986.tb01087.x
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  • 2
    Electronic Resource
    Electronic Resource
    Incidence and outcome of critical illness amongst hospitalised patients with haematological malignancy: a prospective observational study of ward and intensive care unit based care (2005)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 60 (2005), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: To determine the incidence and outcome of critical illness amongst the total population of hospital patients with haematological malignancy (including patients treated on the ward as well as those admitted to the intensive care unit), consecutive patients with haematological malignancy were prospectively studied. One hundred and one of the 1437 haemato-oncology admissions (7%) in 2001 were complicated by critical illness (26% of all new referrals). Fifty-four (53%) of these critically ill patients survived to leave hospital and 33 (34%) were still alive after 6 months. The majority (77/101) were not admitted to the intensive care unit but were managed on the ward, often with the assistance of the intensive care team. Independent risk factors for dying in hospital included hepatic failure (odds ratio 5.3, 95% confidence intervals 1.3–21.2) and central nervous system failure (odds ratio 14.5, 95% confidence intervals 1.7–120.5). No patient with four or more organ failures or a Simplified Acute Physiology Score II ≥ 65 survived to leave hospital. There was close agreement between actual and predicted mortality with increasing Simplified Acute Physiology Score II for all patients, including those not admitted to intensive care.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.2005.04139.x
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  • 3
    Electronic Resource
    Electronic Resource
    Patterns of relapse and subsequent management following high-dose chemotherapy with autologous haematopoietic support in relapsed or refractory Hodgkin's lymphoma: A two centre study (2000)
    Springer
    Annals of oncology 11 (2000), S. 715-719 
    Details
    ISSN: 1569-8041
    Keywords: high dose ; Hodgkin's lymphoma ; patterns ; relapse
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:High-dose chemotherapy has an established role inrecurrent or refractory Hodgkin's lymphoma (HL) although a significantproportion of patients subsequently relapse. This manuscript describes theclinical characteristics of such patients and documents their furthermanagement at two major UK cancer centres. Patients and methods:Between 1987 and 1996 one hundred patientswith recurrent or refractory HL received high-dose chemotherapy (HDCT) withautologous haematopoietic rescue. All had recurred within 12 months of initialtherapy or had two or more recurrences. Results:With a median follow-up of 2 years, 56 patients arecurrently progression-free. There were six treatment-related deaths. Onepatient died of pneumonia in remission. Thirty-seven patients have relapsed,intrapulmonary disease being seen for the first time in 53% andrecurrence at previous sites of disease in 81%. Following recurrence,therapy was determined by circumstances: either one agent at a time was used(single sequential approach) or multiagent chemotherapy was chosen. There wasa survival advantage for those who achieved a symptomatic response (13 vs. 4months median, P = 0.0001). A trend towards longer survival was seenfor those whose disease recurred beyond six months following high-dosechemotherapy and in those who received combination chemotherapy. Conclusions:These results confirm that HDCT with autologoushaematopoietic support is inadequate for about half the patients who receiveit for high-risk HL. Relapse in the site of prior disease is the most likelypattern with intrapulmonary disease for the first time occurring frequently.It is possible to administer further chemotherapy after failure of HDCT, andboth objective as well as subjective benefit can be achieved. A few patientsappear to get long-term benefit from further treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008362700606
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  • 4
    Electronic Resource
    Electronic Resource
    High-dose therapy with autologous haematopoietic support in patients with transformed follicular lymphoma: A study of 27 patients from a single centre (1998)
    Springer
    Annals of oncology 9 (1998), S. 865-869 
    Details
    ISSN: 1569-8041
    Keywords: autologous bone marrow transplantation ; transformed follicular lymphoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The prognosis of patients with transformed follicular lymphoma (FL-t) is poor. The use of high-dose therapy (HDT) with autologous haematopoietic support was therefore evaluated as consolidation of remission. Patients and methods: Twenty-seven patients received high-dose cyclophosphamide and total body irradiation (cyclo + TBI) with autologous bone marrow (BM; n = 24) or peripheral blood progenitor cell support (PBPC; n = 3). BM was treated in vitro with anti-B cell antibodies and complement. Nineteen of 27 patients were treated in first stable remission following transformation. Eight other patients with a history of transformation were treated following a subsequent recurrence of follicular lymphoma (FL). Results: With a median follow-up of 2.4 years, 14 of 27 patients remain alive and in remission; five are alive and free of disease at more than four years. The median survival is 8.5 years. There were two ‘early’ treatment-related deaths of respiratory failure, and two ‘late’ deaths of myelodysplastic syndrome (MDS) in remission of lymphoma at 2.8 and 8.5 years. Seven of nine patients having had a recurrence underwent re-biopsy. In two, histology revealed FL, in five, transformed follicular lymphoma. One of the patients with recurrent FL is alive without further therapy, and two of five patients with recurrent FL-t are alive and in remission after further chemotherapy. Conclusions: It is appropriate to consider HDT for younger patients with FL-t in remission. Repeat biopsy should be considered for patients with recurrent disease. There is a risk of late MDS in patients undergoing this treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008349427337
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  • 5
    Electronic Resource
    Electronic Resource
    Low-dose continuous chemotherapy (LBCMVD-56) for refractory and relapsing lymphoma (2000)
    Springer
    Annals of oncology 11 (2000), S. 857-860 
    Details
    ISSN: 1569-8041
    Keywords: low-dose continuous chemotherapy ; lymphoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:Although lymphoid malignancies are generallychemosensitive, relapse is common. The use of high-dose therapy can makesubsequent cytotoxic therapy intolerable. There is a need to develop regimenswith low acute toxicity which are suitable for use in patients post-high dosetherapy and following the failure of standard protocols. Patients and methods:Twenty-six patients with lymphomas, fifteenof whom had received high-dose therapy, were treated with a novel regimenconsisting of low-dose lomustine, chlorambucil, daily subcutaneous bleomycin,vincristine and methotrexate with dexamethasone on an eight-week cycle(LBCMVD-56). A median of three cycles was given. Results:The overall response rate at 12 weeks was 67%(21% complete remission (CR)) with a median overall survival of 13months. A symptomatic response was seen in 72%. Previous high-dosetherapy did not compromise the response rate. Toxicity was acceptable withgrade 3–4 haematological toxicity seen in 27% of cycles,gastrointestinal toxicity seen in 11% and pulmonary toxicity seen in8%. Thirty-one percent of patients required hospitalisation at somepoint during this treatment most commonly for neutropenic sepsis. Conclusions:LBCMVD-56 is an inexpensive, outpatient-based regimenwith low acute toxicity and a high response rate in this heavily pre-treatedgroup of patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008355417445
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  • 6
    Electronic Resource
    Electronic Resource
    Treatment of mantle-cell lymphoma with Rituximab (chimeric monoclonal anti-CD20 antibody): Analysis of factors associated with response (2000)
    Springer
    Annals of oncology 11 (2000), S. 117-121 
    Details
    ISSN: 1569-8041
    Keywords: anti-CD20 ; chimeric monoclonal antibody ; mantle-cell lymphoma ; R.E.A.L. Classification ; Rituximab
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:A retrospective analysis was performed to delineatethe factors associated with response, and to determine the duration ofresponse, in 87 patients with CD20–positive mantle-cell lymphoma (MCL) treatedwith Rituximab (chimeric monoclonal anti-CD20 antibody) in two prior studies. Patients and methods:Patients with newly-diagnosed MCL (MCL1,n = 37), and previously-treated MCL (MCL2, n = 50), receivedsingle-agent Rituximab, in the context of two multicentre clinical studiesusing different schedules and doses, conducted in 1996 and 1997. A follow-upanalysis was performed at the end of 1998, including all 81 patients whocompleted therapy. Statistical modeling of factors associated with responsewas performed using ordered logistic regression. The duration of complete (CR)and partial response (PR), and the time to disease progression (TTP), werealso derived. Results:The overall response rate (RR) was 34% (30 of 87)(81 evaluable patients, RR 37%; CR 14%), and was equivalent forMCL1 and MCL2. On univariate analysis, elevated LDH (P = 0.004);prior therapy with alkylating agents (P = 0.01) or fludarabinephosphate (P = 0.04); WHO performance status = 2 (P = 0.02);MCL2 refractory to last prior therapy (P = 0.04); and splenomegaly(P = 0.04), each at the time of treatment with Rituximab, weresignificantly associated with a lower RR. On multivariate analysis, only LDH(P = 0.007) and prior alkylating agents (P = 0.03) retainedstatistical significance. At a median follow-up of 1.4 years, the median TTP was 7 months. The medianduration of response was one year, and was significantly longer for patientsachieving CR vs. PR (P = 0.04). Conclusions:Rituximab is active in MCL, and can induce completeresponses in a minority of patients. Elevated LDH at the time of therapy, andprior therapy with alkylating agents, are associated with a significantlylower RR. The duration of response of one year is similar to that previouslyreported in follicular lymphoma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008309405678
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  • 7
    Electronic Resource
    Electronic Resource
    Generation of cytotoxic T lymphocytes from peripheral blood of leukaemic patients (1993)
    Springer
    Cancer immunology immunotherapy 37 (1993), S. 47-53 
    Details
    ISSN: 1432-0851
    Keywords: Leukaemia ; IL-2 ; TIL ; LAK
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Peripheral blood mononuclear cells from 13 patients with acute leukaemia were used to establish long-term interleukin-2-dependent cytotoxic T lymphocytes. Cells were grown in RPMI medium containing interleukin-2 (IL-2, 100 U/ml) and 2.5% conditioned medium prepared by activating normal lymphocytes with phytohaemagglutinin. Proliferation of IL-2-dependent CD3-positive lymphocytes was seen in 1 of 2 acute lymphocytic leukaemia cases (ALL), 1 of 4 acute myelogeneous leukaemia cases (AML) (M1) and 8 of 8 more differentiated AML. In 2 cases with detectable leukaemic cell markers (1 ALL and 1 AML) passageable cells were developed, that expressed normal T cell phenotypes (namely CD3, CD4, and CD8) at the expense of leukaemic cells. In 1 of 2 cases, long-term IL-2-cultured cells showed specific cytotoxic activity against autologous leukemic cells. The percentage killing against autologous and two allogeneic target cell lines at a 50/1 effector/target (E/T) ratio was 42%, 9% and 19% respectively. Similarly the cytotoxic activity of IL-2 activated from 4 different individuals against conventional tumour targets K562 and Daudi at a ratio of 50/1 was 29%–68% (median=55%) and 34%–78% (median=61%) respectively. It was also found that this killing potential of the activated cells was maintained for as long as culture was continued (median 23 days, range 17–75 days). The mechanism(s) of T cell proliferation at the expense of leukaemic blast cells in the case of a minority of leukaemic patients and the possible clinical therapeutic potential of these cells following in vitro IL-2 activation deserve further investigation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01516941
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  • 8
    Electronic Resource
    Electronic Resource
    Acute promyelocytic leukaemia: a retrospective analysis of patients treated at St. Bartholomew's Hospital 1969–1995 (1999)
    Springer
    Annals of hematology 78 (1999), S. 131-137 
    Details
    ISSN: 1432-0584
    Keywords: Key words APML ; Survival ; Remission ; Recurrence ; Cytogenetics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Seventy-two patients with acute promyelocytic leukemia (APML) were treated at St.Bartholomew's Hospital (SBH) over a 25-year period. Improvements in supportive care and the use of more intensive chemotherapy have led to an increase in the complete remission rate from 14 to 58%. Similarly, the median survival has increased from 3 weeks to 2 years; the median duration of remission, which was 7 months in 1974, has not yet been reached. There was also a significant difference in survival from first recurrence, compared with that of patients with other subtypes of acute myeloid leukemia. RT-PCR analysis on bone marrow samples from 14 patients confirmed the presence of the PML/RARA fusion; 13 of the 14 patients achieved 'molecular remission' after therapy. The one patient who remained persistently positive experienced recurrence within 4 months. In seven of the eight patients in whom the disease recurred, the translocation was identified by RT-PCR at the time of relapse, whilst in one patient it was noted 4 months prior to morphological recurrence. These results illustrate the improvement in prognosis that occurred over a 25-year period in patients with APML treated at a single centre.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002770050489
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  • 9
    Electronic Resource
    Electronic Resource
    Mitoxantrone and cytosine arabinoside as treatment for acute myeloblastic leukemia in older patients (1995)
    Springer
    Annals of hematology 71 (1995), S. 35-39 
    Details
    ISSN: 1432-0584
    Keywords: Acute myeloid leukemia ; Cytosine arabinoside ; Elderly ; Mitoxantrone
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The majority of patients with acute myeloid leukemia (AML) are elderly, and their response to chemotherapy is poorer than that of younger patients. The combination of mitoxantrone (MTN) and cytosine arabinoside (Ara-C) is a possible alternative to an anthracycline/Ara-C combination for the treatment of AML in these patients. Of 52 older patients (〉 59 years) referred over a 3.5-year period, 33 patients (age range 60–78 years, median 67 years) received MTN and Ara-C as therapy for newly diagnosed AML. MTN was administered at a dose of 12 mg/m2/day, intravenously, for 3 days (23 patients), or 10 mg/m2/day for 5 days (10 patients), and Ara-C at a dose of 100 mg/m2 twice daily, intravenously, for 7 days. Complete remission (CR) was achieved in 16/33 patients (48%). The median remission duration was 6 months (range 1–37 months). The median survival was 14 months for those who achieved CR compared with 9 months for those with resistant disease. Two patients remain in first CR after 13 and 37 months, but three patients died whilst receiving consolidation therapy. In selected elderly patients with AML, the combination of MTN and Ara-C provides an acceptable alternative to an anthracycline/ Ara-C regimen, with a higher CR rate than historical controls. However, the CR rate and remission duration remain low compared with those of younger patients, supporting the need to investigate new approaches to treatment in this population.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01696230
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  • 10
    Electronic Resource
    Electronic Resource
    Mitoxantrone and cytosine arabinoside as treatment for acute myeloblastic leukemia in older patients (1995)
    Springer
    Annals of hematology 71 (1995), S. 35-39 
    Details
    ISSN: 1432-0584
    Keywords: Key words Acute myeloid leukemia ; Cytosine arabinoside ; Elderly ; Mitoxantrone
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The majority of patients with acute myeloid leukemia (AML) are elderly, and their response to chemotherapy is poorer than that of younger patients. The combination of mitoxantrone (MTN) and cytosine arabinoside (Ara-C) is a possible alternative to an anthracycline/Ara-C combination for the treatment of AML in these patients. Of 52 older patients (〉59 years) referred over a 3.5-year period, 33 patients (age range 60–78 years, median 67 years) received MTN and Ara-C as therapy for newly diagnosed AML. MTN was administered at a dose of 12 mg/m2/day, intravenously, for 3 days (23 patients), or 10 mg/m2/day for 5 days (10 patients), and Ara-C at a dose of 100 mg/m2 twice daily, intravenously, for 7 days. Complete remission (CR) was achieved in 16/33 patients (48%). The median remission duration was 6 months (range 1–37 months). The median survival was 14 months for those who achieved CR compared with 9 months for those with resistant disease. Two patients remain in first CR after 13 and 37 months, but three patients died whilst receiving consolidation therapy. In selected elderly patients with AML, the combination of MTN and Ara-C provides an acceptable alternative to an anthracycline/ Ara-C regimen, with a higher CR rate than historical controls. However, the CR rate and remission duration remain low compared with those of younger patients, supporting the need to investigate new approaches to treatment in this population.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01696230
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