VI Autologous Bone Marrow Transplantation.pdf - Blog Science ...

More documents

Recommendations

Info

ence in survival among the three highest total dose arms. Comparison with results in similar patients treated with 6000 cGy in 30 fractions of 200 cGy, 5 days per week for six weeks suggests a benefit from hyperfractionated radiation therapy with 6960 cGy. There was no significant increase in toxicity at total dose of 6960 cGy. This encouraging result has lead to a three-arm phase III study comparing hyperfractionated radiotherapy, conventional fractionation radiotherapy alone and conventional radiotherapy combined with systemic chemotherapy. As attempts to control microscopic distant metastases and to compliment radiotherapy so as to improve loco-regional control, several trials have been performed testing the addition of chemotherapy before, during or after radiotherapy in Stage III non-small-cell lung cancer. The most provocative results came from the Cancer and Leukemia Group B (CALGB) study (7) and from the Radiotherapy and Lung Cancer Cooperative Groups of the European Organization for Research and Treatment of Cancer (EORTC) (8) . The CALGB study randomized the patient with Stage III disease and with excellent performance status and minimal weight loss between pre-radiotherapy chemotherapy using cisplatin and vinblastine followed by standard radiotherapy and standard radiotherapy to 6000 cGy over six weeks. Median survival, two-year survival and three-year survival were all significantly better in the chemotherapy treated arm. Of note, is that the one-year and two-year survival figures for combined chemo/ radiotherapy were similar to those of the similar patients in the RTOG trial using 6960 cGy hyperfractionated radiotherapy. The EORTC trial randomized patients to one of three arms: radiotherapy for two weeks (300 cGy x 10,5 fractions/ week, followed by three-week rest, and then radiotherapy of 250 cGy x 10 five times per week), radiotherapy on the same schedule combined with 30 mg of cisplatin per square meter of body surface given on the first day of each treatment week, or radiotherapy of the same schedule combined with 6 mg of cisplatin per square meter given daily before radiotherapy. Survival was found to be significantly better in the radiotherapy-daily cisplatin group as compared to the radiotherapy group (P=0.009). The one-year and two-year survival rates for the radiotherapy-daily cisplatin group were 54% and 26% respectively, again similar to the figures in the RTOG and CALGB trials. One logical study based on all of these observations is to test the combination of radiosensitizing chemotherapy concurrent with high dose hyperfractionated radiotherapy. We have initiated such a trial of high dose cisplatin, VP-16 chemotherapy concurrent with hyperfractionated radiotherapy in a split-course fashion (in order to reduce acute toxicity). The availability of growth factors will most probably allow us to deliver the treatment cycles on schedule and not to reduce the intensity of therapy. Recently there have been significant technologic advances in radiotherapy, particularly in the availability of three-dimensional conformal radiotherapy planning and delivery systems. These systems will allow better delivery of high dose radiotherapy to the tumor and will at the same time improve sparing of normal tissues. These technologies are being actively integrated into the treatment of lung cancer. Although radiotherapy is not the most optimal treatment modality for lung cancer, it continues to play a significant role. It remains to be seen if new regi- 180 SIXTH INTERNATIONAL SYMPOSIUM ON AUTOLOGOUS BONE MARROW TRANSPLANTATION
mens that incorporate biological principles and technical advances would truly lead to improved prognosis for the majority of patients with unresectable nonsmall-cell lung cancer. REFERENCES 1. Caldwell WL, Bagshaw MA: Indications for and results of irradiation of carcinoma of the lung. Cancer 11:999-1004,1968. 2. Israel L, Bonadonna G, Sylvester R: Controlled study with adjuvant radiotherapy, chemotherapy, inununotherapy, and chemoimmunotherapy in operable squamous carcinoma of the lung. In Muggia F and Rozencweig M, editor; Lung Cancer, vol II, Progress in therapeutic research, New York, 19879, Raven Press. 3. Perez CA, Stanley K, Grundy G, et al: Impact of irradiation technique and tumor extent in tumor control and survival of patients with unresectable non-oat cell carcinoma of the lung. Cancer 50:1091-1099,1982. 4. Stanley K, Cox JD3D, Petrovich A, et al: Patterns of failure in patients with inoperable carcinoma of the lung. Cancer 47:2725-2729,1981. 5. Cox JD, Yesnet R, Mietlowski W, et al: Influence of cell type on failure pattern after irradiation for locally advanced carcinoma of the lung. From the Veterans Administration Lung Group VALG. Cancer 44:94-98,1979. 6. Cox JD, Azarnia N, Byhardt RW, et al: A randomized phase I/II trial of hyperfractionated radiation therapy with total doses of 60.0 Gy to 79.2 Gy: Possible survival benefit with > 69.6 Gy in favorable patients with Radiation Therapy Oncology Group stage III non-small-cell lung carcinoma: Report of Radiation Therapy Oncology Group 83-11. J Clin Oncol 8(9):1543-1555,1990. 7. Dillman RO, Seagren SL, Propert KJ, et al: A randomized trial of induction chemotherapy plus high-dose radiation versus radiation alone in Stage III non-small-cell lung cancer. N Eng J Med 323:940-945,1990. 8. Schaake-Konning C, Van Den Bogaert W, Dalesio O, et al: Effects of concomitant cisplatin and radiotherapy on inoperable non-small-cell lung cancer. N Engl J Med 326:524-530,1992. SIXTH INTERNATIONAL SYMPOSIUM ON AUTOLOGOUS BONE MARROW TRANSPLANTATION 181
Page 1:
Autologous Bone Marrow Transplantat
Page 5 and 6:
CONTENTS nviAum TMLHTA'I OTT! 7 A l
Page 7 and 8:
AUTOLOGOUS BONE MARROW TRANSPLANTAT
Page 9 and 10:
TREATMENT OF NONSMALL CELL LUNG CAN
Page 11:
SUMMARY OF THE NON HODGKIN LYMPHOMA
Page 15:
Session I: Leukemia
Page 18 and 19:
TRIAL PROGRESS The trial opened in
Page 20 and 21:
Table 1. Achievement of Second Remi
Page 22 and 23:
ALLOGENEIC VERSUS AUTOLOGOUS BONE M
Page 24 and 25:
pts). The other 56 pts are too earl
Page 26 and 27:
Figure 1 EORTC-GIMEMA AML 8 A EORTC
Page 28 and 29:
PATIENTS AND METHODS Patients The B
Page 30 and 31:
Thus, as the results of some ongoin
Page 32 and 33:
COMPARISON OF INTENSIVE CONSOLIDATI
Page 34 and 35:
over, 13 pts who had received ICC1
Page 37:
Session II: Future Directions
Page 40 and 41:
in a previous report 3 . Analysis a
Page 42 and 43:
Engraftment of granulocyte, monocyt
Page 44 and 45:
0.2 - 0.1 - ABMT with mAb purging f
Page 46 and 47:
ENHANCED REGENERATION OF NATURAL KI
Page 48 and 49:
RESULTS The in vivo immune effects
Page 50 and 51:
16. Rizzoli V, Mangoni L, Carlo-Ste
Page 52 and 53:
hydroperoxycyclophosphamide (4HC)-t
Page 54 and 55:
survival in patients undergoing ABM
Page 56 and 57:
IMMUNOTHERAPY OF AML AFTER ABMT - S
Page 58 and 59:
Otherwise toxicity was mild to mode
Page 60 and 61:
Therapy. Amsterdam Elsevier 1987;89
Page 62 and 63:
200 IL6 in serum 44 SIXTH INTERNATI
Page 64 and 65:
sodes), fewer days of i.v. antibiot
Page 67:
Session III: Myeloma
Page 70 and 71:
trary, in case of adequate collecti
Page 72 and 73:
tion is considered, and all the mor
Page 74 and 75:
Table 3: Cost effectiveness of high
Page 77:
Session W: Lymphoma
Page 80 and 81:
METHODS Selection of patients and t
Page 82 and 83:
marrow treatment. Am J Med 85:829,1
Page 84 and 85:
HIGH DOSE THERAPY WITH HEMATOPOIETI
Page 86 and 87:
in TC 19 medium (Flobio), with an h
Page 88 and 89:
progression for a long time after A
Page 90 and 91:
Table 2. STATUS AT GRAFT Remission
Page 92 and 93:
IL Figura 3 70 SIXTH INTERNATIONAL
Page 94 and 95:
( 5 ) lowed by ABMT than refractory
Page 96 and 97:
74 Figure 4 Low grade lymphoma - pr
Page 98 and 99:
(range 15-55); 68 males and 32 fema
Page 100 and 101:
our experience, this has a seven-ye
Page 102 and 103:
30. Colombat P, Gorin NC, Lemonnier
Page 104 and 105:
82 OVERALL SURUIWL from ABUT (accor
Page 107 and 108:
PROGNOSTIC FACTORS IN ADVANCED STAG
Page 109 and 110:
REFERENCES 1. Chopra R, Mc Millan A
Page 111 and 112:
lished data to attempt to assess th
Page 113 and 114:
1992;10:175-7. 3. McMillan A, Golds
Page 115 and 116:
B. DAILY DAY AGENT DOSE -7 -6 -5 -4
Page 117 and 118:
cohort with HR treated with BEC-2 i
Page 119 and 120:
p R 0 P O R T I 0 N 1 0.9 0.8 0.7 0
Page 121 and 122:
TABLE 3. TOXICITY BEC TAVe TMJ as 2
Page 123 and 124:
ies. 10 Longer blood half-lives hav
Page 125 and 126:
agents have been developed cautious
Page 127 and 128:
Table 1. Radioisotopes for RIT. Pur
Page 129 and 130:
The treatment criterion in this stu
Page 131 and 132:
more than 80% of the cases. Patient
Page 133 and 134:
Disease Free Survival 800 Time •
Page 135:
Session VI: Breast Cancer
Page 138 and 139:
achieved a complete remission survi
Page 140 and 141:
acil, vincristine, prednisone (CMFV
Page 142 and 143:
t: 3 en a in S « J •S •> c ai
Page 144 and 145:
LONG TERM FOLLOW UP OF POOR PROGNOS
Page 146 and 147:
tors both for progression-free surv
Page 148 and 149:
222 INDUCTION PHASE ESTROGEN RECEPT
Page 150 and 151:
THE PHARMACOLOGY OF INTENSIVE CYCLO
Page 152 and 153:
PK VARIABILITY OF CPA/CDDP/BCNU Whe
Page 154 and 155:
5. Groshow LB, Piantadosi S, Santos
Page 157 and 158:
- 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 210 and 211: Table 6. Hematological Data of the
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
Page 260 and 261: 3. Conclusion Hematological toxicit
Page 263:
Session XIII: Peripheral Stem Cells
Page 266 and 267:
Crouse, 1992). In the present repor
Page 268 and 269:
with no evidence of systemic diseas
Page 270 and 271:
Administration of rhSCF at doses of
Page 272 and 273:
In summary, the ligand for c-kit ha
Page 274 and 275:
AUTOGRAFTING WITH G-CSF-MOBILIZED B
Page 276 and 277:
cells and CD34+ cells observed in t
Page 278 and 279:
6. Brugger W, Bross K, Frisch J, et
Page 280 and 281:
100 -l Collection Efficiency Figure
Page 282 and 283:
MATERIALS AND METHODS PATIENTS. Pat
Page 284 and 285:
None of the patients included in ar
Page 286 and 287:
9. Aurer I, Ribas A, Gale RP. What
Page 288 and 289:
246 o 0.6 b 0.1 B1 Figure 2 p = 0.0
Page 291 and 292:
AUTOLOGOUS BONE MARROW TRANSPLANTAT
Page 293 and 294:
SUMMARY OF THE NON HODGKIN LYMPHOMA
Page 295 and 296:
SUMMARY: AUTOLOGOUS MARROW TRANSPLA
Page 297 and 298:
mor. The obverse of this coin is po
Page 299 and 300:
treated at Memorial Hospital in New
Page 301 and 302:
Contributors and Participants Tause
Page 303 and 304:
Leonard Kalman, Hematology/Oncology
Page 305:
D.R. Sutherland, Oncology Research,
show all

VI Autologous Bone Marrow Transplantation.pdf - Blog Science ...

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?