autologous blood and marrow transplantation - Blog Science ...

730 Chapter 16: Summaries
Table 1. Continued from previous page
Barrier Strategies
9) Competition with
community physicians:
will we see enough
patients to do
our research?
10) High cost of research:
will the care of our
patients be reimbursed?
» Explore new strategies
1
Treat high risk patients
• Extend indications or HDRx options
' Reduce research costs: shorten hospital stays
blood or marrow transplants. Although the table is long and appears to be
complicated, it should be easy to follow. Further, although hoped to be nearly
complete, it cannot be counted on to be comprehensive, exhaustive, or all-
inclusive. Columns 1-3 present barriers to success, potential (but not all possible)
strategies to overcome the barriers, and a limited number of examples pursuing
specific strategies.
Each solid tumor session abstract usually recognized one (but sometimes more
than one) barrier to success and presented data exploring one of the methods to
pursue a potential strategy to overcome the barrier. The fourth column lists the last
name of the first author of each abstract on the same line as the strategy that the
abstract's authors were pursuing or the strategy about which the presenter made his
or her most salient comments. Although many strategies appear to remain
unexplored, it should be remembered that the symposium had only a limited
number of invited investigators to discuss their work.
THEMATIC AREAS FOR CONSIDERATION
During the course of listening to the oral presentations in both scientific sessions,
the author recognized four major questions that had been discussed but remained
unresolved, predominantly because of limitation of time. Table 2 is the author's
attempt to crystallize these questions and formulate concise, logical answers that
pertain to the circumstances which represent the current state-of-the-art.
Tables 3 and 4 are necessary to complete the author's response to the fourth
question: "Should just phase III trials be done?" Table 3 presents the meanings of
phase I, phase II, and phase III trials for high-dose therapy and hematopoietic
progenitor cell transplant. Table 4 presents the author's recommendation of what
type of study to do under what set of conditions. Consideration of 7) issues about
the ease of doing the study (number of patients needed, expected accrual rate of