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  • 1
    ISSN: 1432-0584
    Keywords: Key words Acute myeloid leukemia ; Myelodysplastic syndrome ; Secondary leukemia ; Interleukin-2 ; G-CSF
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Intensive chemotherapy followed by treatment with interleukin-2 (IL-2) was evaluated in a prospective, randomized, multicenter trial including 18 patients with refractory anemia with excess of blasts in transformation (RAEB-T), 86 patients with acute myeloid leukemia (AML) evolving from myelodysplastic syndromes, and six patients with secondary AML after previous chemotherapy. Median age was 58 years (range: 18–76 years). Forty-nine patients (45%) achieved a complete remission (CR) after two induction cycles with idarubicin, ara-C, and etoposide, 52% of them aged ≤60 years and 35% aged 〉60 years (p=0.06). After two consolidation courses, patients were randomized to four cycles of either high- or low-dose IL-2. Patients aged up to 55 years with an HLA-identical sibling donor were eligible for allogeneic bone marrow transplantation. The median relapse-free survival was 12.5 months, with a probability of ongoing CR at 6.5 years of 19%. Overall survival of all patients was 8 months, and 21 months for the CR patients. Median survival was significantly longer among patients aged ≤60 years than among the older patients (16 vs 6 months, p〈0.001). Median duration of survival and relapse-free survival were not statistically different in the two IL-2 treatment arms.
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  • 2
    ISSN: 1432-0584
    Keywords: Keywords CD 54 ; Immunoelectron microscopy ; Interferon-γ ; Acute myeloid leukemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The role of CD 54 in the homotypic interaction of normal monocytes and the blasts of five cases of acute myeloid leukemia (AML) was analyzed by immunoelectron microscopy (IEM). The cells were seeded on glass coverslips precoated with an electrontransparent melamine resin, which allowed their in situ labeling with monoclonal antibodies (MoAb) and subsequent analysis by whole mount immunoelectron microscopy (WM-IEM) or transmission immunoelectron microscopy (TIEM). Timed incubation of the cells in serum-free medium±interferon-γ (IFN-γ, 500 U/ml) induced a spreading of the monocytes and the blasts of four out of five leukemias, characterized by the development of numerous filopodia which led to initial cell–cell contacts. In parallel, an increase in CD 54 surface density in four out of five leukemias could be detected, while no evidence of a CD 54 redistribution (capping) on single cells could be observed. WM-IEM studies detected no CD 54 molecules in the "early" cell–cell contacts, while "later" cell–cell contacts displayed strong CD 54 positivity. These data indicate that CD 54 is not involved in initial cell–cell contacts but is shifted secondarily to the cell contact sides and may thereby stabilize the adjacent membrane areas. The absence of spreading of the CD 54 negative blasts in one out of five leukemias and the blockade of the cellular migration by an anti-CD 54 MoAb (Clone 84H10) in the remaining cases suggest that CD 54 expression is necessary for cellular locomotion. The observed inhibitory effect of the anti-CD 54 MoAb probably mimics a negative circuit that serves to control cellular migration.
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  • 3
    ISSN: 1432-0584
    Keywords: Key words Chronic myeloproliferative syndrome ; Eosinophilia ; Hypereosinophilic syndrome ; Translocation t(4;7)(q11;p13) ; Interferon alpha-2a ; Cytogenetic response
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  A female patient with eosinophilia and cardiac symptoms was found to have a unique chromosomal aberration [t(4;7)(q11;p13)] of bone-marrow precursors. The disorder was classified as a chronic myeloproliferative syndrome with eosinophilia. Due to a significant increase in the white blood cell and eosinophil count during initial treatment with prednisone and hydroxyurea, Interferon alpha-2a was administered at a dose of 3–5×106 I.U. s.c., five times per week, and induced a long-term complete haematological and cytogenetic response. The clinical features of this case are presented and discussed in the context of the current literature.
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  • 4
    ISSN: 1600-0668
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Architecture, Civil Engineering, Surveying , Medicine
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  • 5
    Electronic Resource
    Electronic Resource
    [S.l.] : American Institute of Physics (AIP)
    Journal of Applied Physics 90 (2001), S. 5027-5031 
    ISSN: 1089-7550
    Source: AIP Digital Archive
    Topics: Physics
    Notes: Vibrational modes introduced by the incorporation of N into GaAs and GaInAs have been studied by Raman spectroscopy on samples grown by molecular-beam epitaxy using a rf nitrogen plasma source. When proceeding from GaAs1−xNx to Ga1−yInyAs1−xNx with x≤0.04 and y≤0.12, the nitrogen-induced vibrational mode near 470 cm−1 observed in GaAsN was found to broaden and to split into up to three components with one component at a frequency higher than that of the Ga–N mode in GaAsN. This observation shows that the incorporation of In into GaAsN strongly affects the local bonding of the N atoms by changing the local strain distributions as well as the formation of a significant fraction of In–N bonds. The resonant enhancement in the scattering cross section of the Ga–N vibrational mode, observed in low N-content GaAs1−xNx (x(approximate)0.01) for incident photon energies matching the mostly N-related E+ transition at around 1.8 eV, was found to broaden significantly upon increasing N content as well as upon the addition of In to form GaInAsN. © 2001 American Institute of Physics.
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  • 6
    ISSN: 1432-1335
    Keywords: Key words Bendamustine ; Alkylating agents ; Chemotherapy ; Phase I study ; Solid tumours ; AbbreviationsCMF cyclophosphamide, methotrexate, 5-fluorouracil
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose: The cytotoxic agent bendamustine combines a purine-like benzimidazol and bifunctionally alkylating nitrogen mustard group. The drug has clinical antitumour activity in lymphoma, myeloma and breast cancer. In earlier dose-finding studies, the clinically tolerated dose for single-bolus bendamustine was 215 mg/m2; for fractionated therapy on 4 consecutive days it was 85 mg/m2. Anticholinergic symptoms, myelosuppression and cardiac dysrhythmia were dose-limiting. Our trial was designed to define the maximum tolerated dose of a short infusion schedule and to establish a recommended dose for ongoing and future clinical studies. Methods: Patients with refractory malignant tumours qualified for the trial after written informed consent had been obtained. Bendamustine was given as a 30-min iv. infusion on days 1 and 8 of a 4 week cycle, with a starting dose of 100 mg/m2 and an increment per group of 20 mg/m2. Results: Nineteen patients (13 male, 6 female; median age 57 years, range 37–74 years) were treated for one to two cycles with up to 180 mg/m2 bendamustine. At 160 mg/m2, fatigue grade 3 (NCI Common Toxicity Criteria) and dryness of the mouth grade 3 occurred in 2 patients, diarrhoea grade 3 in 1 patient; another patient with a history of myocardial infarction and arrhythmia developed a reversible total atrioventricular block after the first administration of 160 mg/m2 bendamustine. Other events, such as nausea/vomiting, loss of appetite, fever or chills, were not dose-limiting. Haematological toxicity was mild, except for sudden and long-lasting grade 3–4 lymphocytopenia, which occurred in all treatment cycles. Opportunistic infections were not observed. Conclusions: The maximum tolerated dose of a days-1 and -8 schedule of bendamustine, given as a 30-min i.v. infusion, is 160 mg/m2; mouth dryness and fatigue are dose-limiting. The recommended dose for future trials is 140 mg/m2.
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  • 7
    ISSN: 1569-8041
    Keywords: alkylating agents ; bendamustine ; chemotherapy ; phase I study ; solid tumours ; weekly chemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:The cytotoxic agent bendamustine combines apurine-like benzimidazol and alkylating nitrogen mustard group. The clinicallytolerated dose for single bolus bendamustine is 215 mg/m2, forfractionated therapy on four consecutive days 85 mg/m2. The maximumtolerated dose of a day 1 and 8 (q4w) 30 min infusion schedule was recentlyfound to be 160 mg/m2, mouth dryness and fatigue weredose-limiting. Our current phase I trial was designed to define therecommended dose of a new weekly short infusion schedule. Patients and methods:Patients with refractory malignant tumoursqualified for the trial after written informed consent was obtained.Bendamustine was given as a 30-min i.v. infusion weekly for up to eightconsecutive weeks. Results:Twelve patients (8 male, 4 female, median age 57.5 years,range 42–64) were enrolled in this trial. At the starting dose of 80mg/m2, two patients had dose-limiting toxicity (fatigue grade 3,mouth dryness grade 3, fever grade 4 Common Toxicity Criteria). Nodose-limiting events were observed in six patients treated at 60mg/m2. An intermediate dose level of 70 mg/m2 wasstudied in three younger, less heavily pre-treated patients, was welltolerated and not associated with dose-limiting events. Haematologicaltoxicity was mild except for grade 3–4 lymphocytopenia, occurring in 11of 12 patients. Bendamustine was found to induce long-lastingpanlymphocytopenia with predominant B-cell cytotoxicity. Conclusions:The maximum tolerated dose of weekly bendamustinegiven as a 30-min i.v. infusion is 80 mg/m2, mouth dryness, fatigueand fever are dose-limiting. The recommended dose for phase II trials is 60mg/m2.
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  • 8
    ISSN: 1435-1420
    Keywords: Key words Bone marrow transplantation ; respiratory failure ; mechanical ventilation ; patient outcome assessment ; Score Systems ; Schlüsselwörter Knochenmark- ; transplantation ; Respiratorische Insuffizienz ; Beatmung ; Score Systeme
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Prognose von Patienten, die mit malignen Erkrankungen auf Intensivstationen behandelt werden müssen, ist schlecht. Die Krankenhausmortalität von beatmeten onkologischen Patienten reicht von 70–90% bei Patienten mit soliden Tumoren zu 75–90% bei Patienten mit hämatologischen Neoplasien und bis zu 95% bei Patienten nach Knochenmarktransplantation. Durch Verbesserungen der allgemeinen onkologischen Therapien nimmt die Zahl der auf Intensivstationen verlegten onkologischen Patienten jedoch zu. Diese Situation führt immer wieder zu kontroversen Diskussionen über den Sinn intensivmedizinischer Therapien bei diesen Patienten. Da die individuelle Prognose der Patienten vor Einleitung der Intensivtherapie nicht verlässlich vorhergesagt werden kann, erscheint es nicht gerechtfertigt onkologischen Patienten generell eine intensivmedizinische Behandlung zu verwehren. Sinnvoll und praktikabel erscheint indes eine Reevaluation des Patienten nach Einleitung der Intensivtherapie zu vordefinierten Zeitpunkten und nach vordefinierten Kriterien. Für Patienten, die nach einer Knochenmarktransplantation beatmungspflichtig werden, gilt, daß die Patienten, die für längere Zeit mit Vasopressoren behandelt werden müssen und/oder ein kombiniertes Leber- und Nierenversagen entwickeln, nicht überleben werden. Für diese Patienten kann die Beendigung der intensivtherapeutischen Maßnahmen erwogen werden. Bei Patienten, die diese Kriterien nicht erfüllen, ist die Fortführung der Intensivtherapie sinnvoll. Die Therapieergebnisse sind denen bei nicht-onkologischen Patienten vergleichbar. Für andere Patienten mit onkologischen Erkrankungen kann die Anwendung eines neueren, speziell für onkologische Patienten entwickelten Score Systems Hilfestellung in der klinischen Entscheidung geben.
    Notes: Summary The prognosis of patients with malignant diseases requiring treatment on intensive care units is poor. The hospital mortality for mechanically ventilated patients ranges from 70–90% in patients with solid tumors to 75–90% in patients with hematological malignancy and up to 95% in patients after bone marrow transplantation. The number of patients referred to intensive care units is however increasing, due to improvements in the general treatment of malignant diseases. This results in controversies about the utilization of intensive care treatment in these patients. Since the individual outcome can not be predicted prior to initiation of intensive care therapy a general refusal of intensive care treatment seems not justified. A reevaluation of the patients status after initiation of intensive care treatment based on predefined criteria may however be useful in the decision about continuing intensive care measures. Patients requiring mechanical ventilation after bone marrow transplantation will not survive if prolonged treatment with vasopressors is necessary and/or sustained hepatic and renal failure is present. For these patients a withdrawal of further life support may be considered. Intensive care treatment should be continued in patients not fulfilling these criteria and treatment results are comparable to those in patients without malignant diseases. For other patients with malignant diseases the use of a new score system developed for patients with cancer can be helpful in the clinical decision making.
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  • 9
    Electronic Resource
    Electronic Resource
    Woodbury, NY : American Institute of Physics (AIP)
    Applied Physics Letters 80 (2002), S. 2081-2083 
    ISSN: 1077-3118
    Source: AIP Digital Archive
    Topics: Physics
    Notes: The bonding of nitrogen in low N-content AlxGa1−xAs1−yNy with x≤0.05 and y≤0.04 has been studied by Raman spectroscopy. Upon the addition of Al to GaAsN, additional vibrational modes are observed at around 450 cm−1, which is below the GaN-like longitudinal optical (LO) phonon mode centered at 470 cm−1. These modes are attributed to the formation of Al and N containing complexes with Al-to-N bonding. With increasing Al content the Al–N related modes gain intensity at the expense of the GaN-like mode, and they become the dominant N-related feature for an Al-content of 5% at a fixed N content of 1%. On the other hand, increasing the N content from 0% up to 4% at a constant Al concentration of 5% results first in the appearance and eventual saturation in intensity of the AlN-like modes, accompanied by a steep increase in intensity and eventual dominance of the GaN-like vibrational mode. Simultaneously the AlAs-like LO2 phonon mode shows a drastic decrease in intensity for N contents exceeding 2%. All these observations strongly indicate that there is a preferential formation of Al(Single Bond)N bonds in low N- and Al-content AlGaAsN, which is in direct contrast to GaInAsN, where even after thermal annealing the GaN-like mode remains dominant in the Raman spectrum compared to the InN-like modes. © 2002 American Institute of Physics.
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  • 10
    ISSN: 1077-3118
    Source: AIP Digital Archive
    Topics: Physics
    Notes: Quaternary pseudomorphically strained GaInAsN films and double-quantum wells were grown by plasma assisted molecular-beam epitaxy on an InP substrate. The In content ranged from 53% to 70% while the N content was varied between 0% and 2.4%. A reduction of compressive strain and a low-energy shift of photoluminescence (PL) peak position was observed with increasing N concentration, accompanied by a reduction in PL peak intensity and increase in linewidth. The net effect of N incorporation on the GaInAsN band gap energy was calculated from the measured PL peak energies. The thus obtained composition dependent GaInAsN band gap energy was fitted using the band anticrossing model, yielding values for the interaction parameter CMN for high In-containing GaInAsN being only slightly smaller than that reported for low In-content GaInAsN on GaAs. © 2002 American Institute of Physics.
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