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Table 6. Hematological Data of the VP-16/Platinol Regimen in NSCLC (2) Platelets Nadir Transfusion Course Onset Count Day RBC Plat. 1 283(240-389) 93(62-111) 13 1 0 2 201(182-365) 82(37-97) 12 2 0 3 363(119-617) 47(36-134) 13 1 0 4 244(119-283) 33(15-131) 13 1 0 5 228(182-561) 43(31-202) 2 2 0 6 149(100-263) 45(24-139) 2 2 1 *1 transfusion = 2 U of RBC or 10 U of Platelets. Table 7. Comparison of <strong>Marrow</strong> Harvest Methods: Outpatient/lnpatient Number WBC/ml GM-CFC/ml CD34 Method of Harvests X10 6 X10 3 % Outpatient 22 13.9 4.7 .72 (6.6-40.5) (0.5-10) (0.19-2.4) Inpatient 16 12.8 3.1 .92 (6.1-24.8) (0.82-6.5) (0.80-0.98) 278 SIXTH INTERNATIONAL SYMPOSIUM ON AUTOLOGOUS BONE MARROW TRANSPLANTATION
HIGH DOSE RADIOTHERAPY FOR NON-SMALL-CELL CANCER OF THE LUNG ShiaoY.Woo,M.D. Radiation Oncology, The Methodist Hospital, Baylor College of Medicine, Houston, TX It is established that for early stage resectable non-small-cell lung cancer, surgery is more effective than radiotherapy; however, radiotherapy alone has cured a small number of patients with potentially resectable but medically inoperable cancer.' 1 ' Postoperatively, radiotherapy has been used to treat the surgical bed in cases of close or positive margins, and to treat the regional lymph nodes in cases of positive mediastinal node metastasis. At least one randomized study showed an improved disease-free survival for radiotherapy in the latter situation.' 21 The most common application of radiotherapy in the therapy of nonsmall-cell lung cancer is to palliate symptomatic metastases or to treat the primary unresectable disease when there is no obvious distant metastasis. The long-term outcome of most patients with Stage III non-small-cell lung cancer is poor despite the comprehensive radiotherapy. Several radiotherapeutic regimens have been studied as attempts to improve the prognosis. In the 70's the Radiation Therapy Oncology Group (RTOG) performed a four-arm trial to establish a dose response relationship in the treatment of nonsmall-cell lung cancer.' 31 The patients were randomized to 4000 cGy split course (2000 cGy in 5 fractions, two weeks rest and then repeat 2000 cGy in 5 fractions), 4000 cGy continuous, 5000 cGy continuous, or 6000 cGy continuous treatment at 200 cGy per fraction. The two-year survival rate for 6000 cGy was better than that for 4000 cGy (19% versus 10%). Local control was 61% for 6000 cGy and 48% for 4000 cGy. This trial established the standard total radiation dose for conventional radiotherapy of non-small-cell lung cancer. Since clinical failure patterns' 41 and autopsy studies' 51 suggested that local tumor progression was an important element leading to death in these patients, it appeared logical to explore higher total dose of radiation to improve loco-regional control. Based on radiobiological principles, if one wants to increase the total radiation dose but not to increase late toxicities, one needs to reduce the radiation dose-per-fraction. If the radiation dose-per-fraction is reduced, more than one treatment per day can be delivered so that the overall treatment time is not unduly delayed. Such a radiotherapy schedule is called hyperfractionated radiotherapy. Hyperfractionated regimens using 120 cGy twice a day for the treatment of Stage III non-small-cell lung cancer were initiated in 1983 by the RTOG. Patients were randomized to receive minimal total doses of 6000,6480, 6960,7440, and 7920 cGy.' 61 For patients with favorable stage III disease (Karnofsky performance status 70-100, less than 6% weight loss) a dose response was found for survival: survival with 6960 cGy (median 13 months 2 year 29%) was significantly (P=0.02) better than the lower total doses. There was no differ- S/xTH INTERNATIONAL SYMPOSIUM ON AUTOLOGOUS BONE MARROW TRANSPLANTATION 179
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Autologous Bone Marrow Transplantat
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CONTENTS nviAum TMLHTA'I OTT! 7 A l
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AUTOLOGOUS BONE MARROW TRANSPLANTAT
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TREATMENT OF NONSMALL CELL LUNG CAN
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SUMMARY OF THE NON HODGKIN LYMPHOMA
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Session I: Leukemia
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TRIAL PROGRESS The trial opened in
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Table 1. Achievement of Second Remi
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ALLOGENEIC VERSUS AUTOLOGOUS BONE M
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pts). The other 56 pts are too earl
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Figure 1 EORTC-GIMEMA AML 8 A EORTC
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PATIENTS AND METHODS Patients The B
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Thus, as the results of some ongoin
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COMPARISON OF INTENSIVE CONSOLIDATI
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over, 13 pts who had received ICC1
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Session II: Future Directions
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in a previous report 3 . Analysis a
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Engraftment of granulocyte, monocyt
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0.2 - 0.1 - ABMT with mAb purging f
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ENHANCED REGENERATION OF NATURAL KI
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RESULTS The in vivo immune effects
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16. Rizzoli V, Mangoni L, Carlo-Ste
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hydroperoxycyclophosphamide (4HC)-t
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survival in patients undergoing ABM
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IMMUNOTHERAPY OF AML AFTER ABMT - S
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Otherwise toxicity was mild to mode
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Therapy. Amsterdam Elsevier 1987;89
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200 IL6 in serum 44 SIXTH INTERNATI
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sodes), fewer days of i.v. antibiot
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Session III: Myeloma
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trary, in case of adequate collecti
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tion is considered, and all the mor
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Table 3: Cost effectiveness of high
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Session W: Lymphoma
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METHODS Selection of patients and t
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marrow treatment. Am J Med 85:829,1
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HIGH DOSE THERAPY WITH HEMATOPOIETI
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in TC 19 medium (Flobio), with an h
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progression for a long time after A
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Table 2. STATUS AT GRAFT Remission
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IL Figura 3 70 SIXTH INTERNATIONAL
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( 5 ) lowed by ABMT than refractory
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74 Figure 4 Low grade lymphoma - pr
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(range 15-55); 68 males and 32 fema
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our experience, this has a seven-ye
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30. Colombat P, Gorin NC, Lemonnier
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82 OVERALL SURUIWL from ABUT (accor
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PROGNOSTIC FACTORS IN ADVANCED STAG
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REFERENCES 1. Chopra R, Mc Millan A
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lished data to attempt to assess th
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1992;10:175-7. 3. McMillan A, Golds
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B. DAILY DAY AGENT DOSE -7 -6 -5 -4
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cohort with HR treated with BEC-2 i
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p R 0 P O R T I 0 N 1 0.9 0.8 0.7 0
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TABLE 3. TOXICITY BEC TAVe TMJ as 2
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ies. 10 Longer blood half-lives hav
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agents have been developed cautious
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Table 1. Radioisotopes for RIT. Pur
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The treatment criterion in this stu
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more than 80% of the cases. Patient
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Disease Free Survival 800 Time •
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Session VI: Breast Cancer
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achieved a complete remission survi
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acil, vincristine, prednisone (CMFV
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t: 3 en a in S « J •S •> c ai
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LONG TERM FOLLOW UP OF POOR PROGNOS
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tors both for progression-free surv
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222 INDUCTION PHASE ESTROGEN RECEPT
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THE PHARMACOLOGY OF INTENSIVE CYCLO
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PK VARIABILITY OF CPA/CDDP/BCNU Whe
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5. Groshow LB, Piantadosi S, Santos
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- Tn'üTiifi'.m'jii.'yjKJiHtyiwiT T
Page 159 and 160: normal CD34+ progenitor cells
Page 161 and 162: sequence analysis of the human haem
Page 163 and 164: Bielefeld, FRG) or control medium w
Page 165 and 166: 3. Koeffler HP, and Golde DW: Chron
Page 167 and 168: ply infected with supernatants from
Page 169 and 170: controls must be carefully matched
Page 171 and 172: Fig. IB: GPI isozyme analysis of 2
Page 173 and 174: PROCESSING OF STEM CELLS FOR TRANSP
Page 175 and 176: in progress using marker genes to l
Page 177 and 178: Table 1. Factors Affecting Quality
Page 179: Figure 2 .2 A Refractory/Relapsed L
Page 183 and 184: HIGH DOSE CHEMOTHERAPY IN GERM CELL
Page 185 and 186: carboplatin and etoposide with auto
Page 187 and 188: HIGH DOSE THERAPY IN GERM CELL TUMO
Page 189 and 190: Confusing data come out from early
Page 191: Session Mill: Lung Cancer
Page 194 and 195: Of the 14 limited stage patients in
Page 196 and 197: esponses with persistent nodular di
Page 198 and 199: hanced, detection of initial failur
Page 200 and 201: Cellules. Bull Cancer 1987;74:587-5
Page 202 and 203: 30 36 42 48 54 60 66 72 78 84 12 18
Page 204 and 205: Table 2: Toxicity of CBP Regimen fo
Page 206 and 207: TREATMENT OF NONSMALL CELL LUNG CAN
Page 208 and 209: Table 1. Combination Chemotherapy R
Page 212 and 213: ence in survival among the three hi
Page 215: Session IX: Ovarian Cancer
Page 218 and 219: lymph node involvement or parenchym
Page 220 and 221: higher frequencies of neurotoxicity
Page 222 and 223: 12. Ovarian Cancer Meta-Analysis Pr
Page 224 and 225: Table 2. Randomized Trials Employin
Page 226 and 227: BONE MARROW TRANSPLANTATION FOR OVA
Page 228 and 229: 1). Data from the survey was combin
Page 230 and 231: carboplatinum and ifosfamide. The s
Page 233: Session X: Sarcoma
Page 236 and 237: ated doses in a recent Pediatric On
Page 238 and 239: cytokines to reduce hospitalization
Page 240 and 241: TABLE 2 Dose Escalation Schedule Do
Page 243 and 244: CHRONIC MYELOGENOUS LEUKEMIA WITH B
Page 245 and 246: DISCUSSION In this study, the use o
Page 247 and 248: AUTOGRAFTING IN CHRONIC MYELOID LEU
Page 249 and 250: Table 1 Remission Deaths Graft Hema
Page 251 and 252: 16 (800 mg/m2 per day for two conse
Page 253: Session XII: CNS
Page 256 and 257: 1.2 Description of the study The tr
Page 258 and 259: 3. Conclusion In conclusion, treatm
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3. Conclusion Hematological toxicit
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Session XIII: Peripheral Stem Cells
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Crouse, 1992). In the present repor
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with no evidence of systemic diseas
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Administration of rhSCF at doses of
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In summary, the ligand for c-kit ha
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AUTOGRAFTING WITH G-CSF-MOBILIZED B
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cells and CD34+ cells observed in t
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6. Brugger W, Bross K, Frisch J, et
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100 -l Collection Efficiency Figure
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MATERIALS AND METHODS PATIENTS. Pat
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None of the patients included in ar
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9. Aurer I, Ribas A, Gale RP. What
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246 o 0.6 b 0.1 B1 Figure 2 p = 0.0
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AUTOLOGOUS BONE MARROW TRANSPLANTAT
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SUMMARY OF THE NON HODGKIN LYMPHOMA
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SUMMARY: AUTOLOGOUS MARROW TRANSPLA
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mor. The obverse of this coin is po
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treated at Memorial Hospital in New
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Contributors and Participants Tause
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Leonard Kalman, Hematology/Oncology
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D.R. Sutherland, Oncology Research,
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