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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Mainz//2011; 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi); 20110926-20110929; Mainz; DOC11gmds360 /20110920/
    Publication Date: 2011-09-20
    Keywords: Allogene Stammzelltransplantation ; Körperliche Leistungsfähigkeit ; Quality of Life ; Fatigue ; ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
    ISSN: 1432-0584
    Keywords: Hodgkin's disease ; High-dose therapy ; Bone marrow transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Fifty-one consecutive patients with Hodgkin's disease (HD) have been treated with high-dose chemotherapy (HDT) and transplantation of autologous bone marrow (BM) (n=44), autologous BM plus peripheral blood stem cells (PBSC) (n=2), PBSC (n=1), syngeneic (n=1), or allogeneic BM (n=3). All patients had received standard salvage chemotherapy prior to HDT and were classified as sensitive (n=33) or resistant (n=17) to this treatment; one patient was in untreated relapse prior to BMT. The preparative regimens for patients receiving autologous BM and/or PBSC consisted of cyclophosphamide, VP 16, and BCNU (CVB) (n=44) or BCNU, etoposide, ara-C, and melphalan (BEAM) (n=3). The patients receiving allogeneic transplants were treated with the CVB regimen (n=2) or busulfan (16 mg/kg body wt.) and cyclophosphamide (200 mg/kg body wt.). With a median follow-up of 12 months, overall survival for 44 patients grafted with autologous BM is 61%±9%, progression-free survival for patients with sensitive disease is 44%±11%; no patient with resistant relapse survived beyond 1 year post transplant. Two of three patients grafted with allogeneic BM still survive 15 and 24 months after BMT with Karnofsky performance scores of 70% and 100%, respectively. The main toxicity encountered with the CVB regimen was interstitial pneumonia (IP), seen in four of 15 patients (27%) receiving ≥600 mg/m2 of BCNU. Three of these patients have died. The results show that HDT followed by hematopoietic stem cell rescue may effectively salvage an important fraction of patients with relapsed HD who respond to standard chemotherapy. The same approach is largely unsuccessful in patients with proven refractoriness to standard chemotherapy. Whether HDT followed by BMT or PBSC support is superior to intensive chemotherapy without stem cell support can be answered only by a prospectively randomized trial.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1569-8041
    Keywords: CLL ; therapy ; stem-cell transplantation ; prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:The use of myeloablative intensive therapy followedby autologous or allogeneic stem-cell transplantation (SCT) for treatment ofchronic lymphocytic leukemia (CLL) has largely increased over the last years. Design:The present overview updates the available clinicalresults and discusses important aspects of SCT in patients with CLL includingthe type of SCT (autologous vs. allogeneic), myeloablative regimens, purging,the predictive value of molecular monitoring of residual disease, andprognostic factors for the outcome of transplant approaches. Results:With appropriate supportive care, autologous SCT is safeand can induce long-lasting clinical and molecular remissions, which mayimprove the prognosis of patients with CLL. Feasibiliy and efficacy ofautologous SCT appears to be best early during the course of the disease, butit is still unclear if autotransplantation can cure the disease even in thisfavorable subgroup. The role of purging is still unclear. The better diseasecontrol observed after allografting appears to be due tograft-versus-leukemia activity and may allow cure in at least asubset of poor-risk patients. Due to the extraordinarily hightreatment-related mortality, however, the outcome after allogeneic SCT isstill inferior to that after autologous SCT. Conclusions:Autologous transplantation is a valuable treatmentoption for younger patients with early or sensitive poor-risk CLL. Selectedpatients with advanced poor-risk disease and low probability of successfulauto-SCT should be considered for allografting. However, it must be kept inmind that both autologous and allogeneic stem-cell transplantation are stillexperimental procedures and clinical trials further elucidating their valuein the treatment of patients with CLL are warranted.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1569-8041
    Keywords: Mantle cell lymphonia ; pbpc ; therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Mantle cell lymphoma (MC) is not curable with conventionalchemotherapy. To improve the prognosis of patients with this disease, weprospectively studied an intensive sequential therapy consisting of theDexa-BEAM regimen (dexamethasone, BCNU, etoposide, ara-C, melphalan) followedby myeloablative therapy with autologous stem cell reinfusion. Patients and methods: Nine consecutive patients with stage III/IV MC wereincluded. Two had untreated disease, four were in first remission, whereasthree had more advanced disease. All patients underwent one to two cycles ofDexa-BEAM chemotherapy to reduce the tumor load and to mobilize peripheralblood progenitor cells (PBPC). Subsequently, patients were treated withhigh-dose radiochemotherapy followed by PBPC reinfusion and were prospectivelyanalyzed for residual disease by clinical methods as well as by PCRamplification clonal CDRIII rearrangements. Results: With an overall response rate of 100%, the initialDexa-BEAM cycles effectively reduced the tumor load. All patients proceededto high-dose therapy and subsequent stem cell rescue. Engraftment was prompt,and procedure-related deaths did not occur. With a median follow-up of 12(3–33) months post transplant, all patients are alive in continuingclinical and molecular remission. Conclusions: Sequential intensive therapy consisting of Dexa-BEAM andhigh-dose radiochemotherapy appears to be a highly effective treatment forpatients with MC. However, the data are still preliminary, and larger patientnumbers and a longer follow-up are required.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1569-8041
    Keywords: CLL ; cytogenetics ; infection ; pathogenesis ; therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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