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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery; VOL: 11; DOC01 /20121220/
    Publication Date: 2012-12-21
    Description: Fever during neutropenia may be a symptom of severe life threatening infection, which must be treated immediately with antibiotics. If signs of infection persist, therapy must be modified. Diagnostic measures should not delay treatment. If the risk of febrile neutropenia after chemotherapy is 〉=20%, then prophylactic therapy with G-CSF is standard of care. After protocols with a risk of febrile neutropenia of 10-20%, G-CSF is necessary, in patients older than 65 years or with severe comorbidity, open wounds, reduced general condition. Anemia in cancer patients must be diagnosed carefully, even preoperatively. Transfusions of red blood cells are indicated in Hb levels below 7-8 g/dl. Erythropoiesis stimulating agents (ESA) are recommended after chemotherapy only when hemoglobin levels are below 11 g/dl. The Hb-level must not be increased above 12 g/dl. Anemia with functional iron deficiency (transferrin saturation 〈20%) should be treated with intravenous iron, as oral iron is ineffective being not absorbed. Nausea or emesis following chemotherapy can be classified as minimal, low, moderate and high. The antiemetic prophylaxis should be escalated accordingly. In chemotherapy with low emetogenic potential steroids are sufficient, in the moderate level 5-HT3 receptor antagonists (setrons) are added, and in the highest level Aprepitant as third drug.
    Keywords: neutropenia ; febrile neutropenia ; documented infection ; antibiotic therapy ; G-CSF ; anemia ; erythropoiesis stimulating agents ; nausea and emesis after chemotherapy ; diarrhea ; ddc: 610
    Language: English
    Type: article
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  • 2
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  133. Kongress der Deutschen Gesellschaft für Chirurgie; 20160426-20160429; Berlin; DOC16dgch079 /20160421/
    Publication Date: 2016-04-22
    Keywords: ddc: 610
    Language: English
    Type: conferenceObject
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  • 3
    ISSN: 0375-9474
    Keywords: Nuclear reactions
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Physics
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-2307
    Keywords: Chronic myelogenous leukaemia ; Philadelphia chromosome ; FISH ; Megakaryocyte
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Histological examination of bone marrow biopsies shows that about one-third of chronic myeloid leukaemia (CML) patients exhibit an increase of megakaryocytes. The megakaryocytic predominance may be so striking that differentiation from other chronic myeloproliferative disorders (CMPD) may be difficult in some CML patients. Megakaryocytes in CML are clonal as demonstrated by loss of glucose-6-phosphate dehydrogenase isoenzymes. The Ph translocation, fusing the abl and bcr genes on chromosomes 9 and 22, however, obviously occurs as a second step in tumour development. So far, the Ph translocation has not been assigned explicitly to megakaryocytes. The question is whether the megakaryocytic cell lineage could harbour the bcr/abl fusion in those CML cases with striking proliferation of megakaryocytes but lack this genetic defect in cases with normal or decreased megakaryocyte counts. We therefore performed triple-colour fluorescence in situ hybridization (FISH) for portions of the bcr and abl genes flanking the breakpoint in CML in paraffin sections of CML cases with normal and with increased numbers of megakaryocytes. This method allows identification of the bcr/abl fusion in single, morphologically intact cells, whereas conventional cytogenetics requires lysis and thus destruction of the cell. Among the 21 CML patients examined by FISH, 10 were informative for bcr and abl genes and displayed distinct hybridization signals within nuclei of bone marrow cells. Besides the granulopoietic cells, megakaryocytes of all those patients (4 without and 6 with varying grades of megakaryocytic increase) displayed bcr/abl fusion signals indiciative of a Ph translocation. The lack of hybridization signals in the remaining 11 cases indicates that this technique is not of value diagnostically and should be reserved for scientific questions. Positive controls consisted of conventional chromosome preparations from bone marrow aspirates demonstrating the Ph chromosome in all patients examined, and negative controls of paraffin sections of bone marrow biopsies from non-CML patients. These showed no fusion signals in bone marrow cells, including megakaryocytes, using FISH. Our results demonstrate clearly that not only the transforming event but also the Ph translocation leading to the bcr/abl fusion happens prior to the differentiation of the pluripotent stem cell into different myeloid lineages. The megakaryocytic proliferation evident in some CML cases is probably a consequence of the disease progress.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Der Onkologe 3 (1997), S. S1 
    ISSN: 1433-0415
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Die Übertragung von Knochenmark und Blutstammzellen nach myeloablativer Therapie hat sich im letzten Jahrzehnt zu einem Standardtherapieverfahren für viele maligne Erkrankungen entwickelt. Hämatopoetische Stammzellen können aus Blut, Knochenmark oder Nabelschnurblut gewonnen werden. Autologe Stammzellen werden dem Patienten selbst, allogene Zellen einem HLA-identischen oder kompatiblen Familien- oder nicht-verwandtem Spender entnommen. Je nach Erkrankung und Krankheitsstadium kann mit hochdosierter und myeloablativer Chemotherapie und der anschließenden Transplantation hämatopoetischer Stammzellen eine langfristige Krankheitsfreiheit oder eine Heilung erreicht werden. Bei den akuten Leukämien liegt die Chance der Krankheitsfreiheit nach 5–8 Jahren bei 50–80%, bei malignen Lymphomen bei 40–60% und bei der chronischen myeloischen Leukämie bei 40–70%. Die Dauer der absoluten Knochemarkinsuffizienz kann durch Blutstammzellen deutlich verkürzt werden. Es werden deshalb zunehmend auch Patienten ohne Heilungsaussicht behandelt, bei denen jedoch die Krankheitsprogredienz signifikant verzögert und die Überlebenszeit verlängert wird. Dies gilt bereits für die autologe Transplantation bei chronischer myeloischer Leukämie und multiplem Myelom. Es zeichnet sich ab, daß Patientinnen mit Mammakarzinom und Lymphknotenmetastasen in den Achselhöhlen von einer hochdosierten Chemotherapie mit autologer Stammzelltransplantation profitieren.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-0584
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Annals of hematology 54 (1987), S. 360-360 
    ISSN: 1432-0584
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-0584
    Keywords: Acute myeloid leukemia ; induction therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Of 119 patients with acute myeloid leukemia, 69 were treated with Adriamycin, Vincristine and Cytosine Arabinoside (Therapy 1) and 50 with Daunorubicin, Cytosine Arabinoside and 6-Thioguanine (Therapy 2) as well as a consolidation therapy. The maintenance therapy with Cytosine Arabinoside and 6-Thioguanine was the same for both groups. The complete remission rate was 44% for Therapy 1 and 68% for Therapy 2 (p〈0.05). — The median values for remission duration were 7 and 13 months respectively (p=0.10); for survival time the median values were 18 and 19 months. These figures show in retrospect that high remission rates can be attained through intensive induction therapy and that longer remission duration is correlated with more aggressive induction therapy. A mild form of maintenance therapy seems to have little effect on the duration of complete remission.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-0584
    Keywords: Chronic myelogenous leukemia ; Interferon-antibodies ; Interferon alpha-2 b ; Natural human interferon alpha
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A patient with Philadelphia-chromosome positive chronic myelogenous leukemia developed interferon antibodies on treatment with recombinant interferon alpha-2 b. Clinically this event corresponded with progressive disease. No cross-reactivity of antibodies with human leukocyte interferon was found by Western blot. Treatment was switched to human leukocyte interferon with an obvious clinical effect: WBC was reduced and platelet count stabilized, but the effect was transient and no hematologic remission was achieved. Human leukocyte interferon may be an alternative in CML-patients with neutralizing antibodies to recombinant interferon alpha.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-0584
    Keywords: BMT ; Recombinant human erythropoietin ; Regeneration of erythropoiesis ; Erythrocyte transfusion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The hematologic effects of recombinant human erythropoietin after allogeneic bone marrow transplantation (BMT) were studied. Nineteen patients received 150 U/kg/day of C127 mouse-cell-derived recombinant human erythropoietin (rHu EPO) as a daily continuous intravenous infusion until hematocrit exceeded 35%. These data were compared with a treatment-matched historical control group of 43 patients. RHu EPO-treated patients recovered erythropoiesis more rapidly and became independent from erythrocyte transfusions after a median of 17 days, which was 7 days earlier than the control patients.
    Type of Medium: Electronic Resource
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