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None of the patients included in arm A experienced such an evolution, WBC and PMN reaching a plateau in one step. Platelet recovery differed dramatically between the two arms :the median time to achieve 50 x 10 9 /1 was short in arm A (11 days, range 6 to 85 days), whereas severe thrombocytopenia was much more longer for patients who received PBSC in arm B (60,254,365 days). The patient grafted with marrow had a 8-day thrombocytopenia. This patient was kept in her arm of randomization for the analysis of the haematological recovery, though she was eventually grafted with marrow. Despite an improvement of data of recovery in arm B, difference in the kinetics of WBC and of PMN are statistically significant between arm A and B. When looking at the haematological recovery of 10 historical patients who had been autografted with PBSC collected during the recovery phase from aplasia without growth factor support after transplantation, no history of a secondary drop of the neutrophil count was reported, and the duration of severe neutropenia was found comparable to that of arm A. DISCUSSION Based on preliminary data showing that PBSC circulation peaked during the haematological recovery phase from aplasia
sion in this arm. The evolution of WBC and PMN counts is remarkable since following a first wave of neutrophils which occurred within the same time than the complete recovery in arm A, a secondary aplasia developed, unresponsive to a reintroduction of rh GM-CSF given subcutaneously. Prolonged thrombocytopenia was observed in these patients, without the first wave observed on the WBC and PMN curves. The history of these three patients was uninspired when looking at parameters such as age, CBC parameters before graft, history of prior marrow involvement, duration of previous chemotherapy, prior radiotherapy which could have generated a marrow micro-environment impairment. Opposite, the recovery from neutropenia and of thrombocytopenia was peculiarly rapid and steady in arm A, whereas the number of cells grafted were comparable in terms of nucleated cells and CFU-GM. The absence of difference between the two groups of patients in terms of clinical parameters, therapeutic procedures and number of CPU GM grafted suggests that PBSC collected in arm B are more mature than in arm A. The number of 7-day CFU GM assay does not reflect the number of pluripotent stem cells and is dependent of the harvesting procedure. CONCLUSION Rh GM-CSF can mobilize PBSC for collection by cytapheresis. Nevertheless, mobilization of pluripotent stem cells is dependent on the duration of stimulation by growth factors. One must be cautious when comparing the number of PBSC collected with various harvesting procedures evaluated by the 7-day CFU GM assay. REFERENCES 1. Verdonck LF, Dekker AW, Van Kempen ML et al. Intensive cytotoxic therapy followed by autologous bone marrow transplantation for non-Hodgkin's lymphoma of high grade malignancy. Blood, 1985,65,894-989. 2. Kessinger A, Armitage JO, Landark et al. Autologous peripheral hematopoietic stem cell transplantation restores hematopoietic function following marrow ablative therapy. Blood 1988, 71,723-727. 3. Kessinger A, Armitage JO, Landark et al. Reconstitution of human hematopoietic function with autologous cryopreserved circulating stem cells. Exp Hematol 1986, 71, 723-727. 4. Kotasek D, Shepherd KM, Sage RE et al. Factors affecting blood stem cell collections following high-dose cyclophosphamide mobilization in lymphoma, myeloma and solid tumors. Bone Marrow Transplantation 1992,9,11-17. 5. Kessinger A, Armitage JO. High dose therapy with autologous peripheral blood stem cell transplantation for patients with lymphoma metastatic to bone marrow. Proceedings of the 24th ASCO meeting. J Clin Oncol 1988,7,223. 6. Reiffers J, Leverger G, Marit Get al. Haematopoietic reconstitution after autologous blood stem cell transplantation: current controversies (Gale RP, Champlin eds) Allan Liss, New York, 1988,313-320. 7. Morstyn G, Campbell L, Souza LM et al. Effect of recombinant granulocyte-macrophage colony stimulating factor on neutropenia induced by cytotoxic chemotherapy. Lancet 1988, ii, 667-672. 8. Brandt S J, Peters WP, Atwater SK et al. Effects of recombinant granulocyte-macrophage colony stimulating factor on haematopoietic reconstitution after high dose chemotherapy and autologous transplantation. N Eng J Med 1988,318,869-876. SIXTH INTERNATIONAL SYMPOSIUM ON AUTOLOGOUS BONE MARROW TRANSPLANTATION 243
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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
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normal CD34+ progenitor cells
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sequence analysis of the human haem
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Bielefeld, FRG) or control medium w
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3. Koeffler HP, and Golde DW: Chron
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ply infected with supernatants from
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controls must be carefully matched
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Fig. IB: GPI isozyme analysis of 2
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PROCESSING OF STEM CELLS FOR TRANSP
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in progress using marker genes to l
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Table 1. Factors Affecting Quality
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Figure 2 .2 A Refractory/Relapsed L
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HIGH DOSE CHEMOTHERAPY IN GERM CELL
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carboplatin and etoposide with auto
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HIGH DOSE THERAPY IN GERM CELL TUMO
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Confusing data come out from early
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Session Mill: Lung Cancer
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Of the 14 limited stage patients in
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esponses with persistent nodular di
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hanced, detection of initial failur
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Cellules. Bull Cancer 1987;74:587-5
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30 36 42 48 54 60 66 72 78 84 12 18
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Table 2: Toxicity of CBP Regimen fo
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TREATMENT OF NONSMALL CELL LUNG CAN
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Table 1. Combination Chemotherapy R
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Table 6. Hematological Data of the
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ence in survival among the three hi
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Session IX: Ovarian Cancer
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lymph node involvement or parenchym
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higher frequencies of neurotoxicity
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12. Ovarian Cancer Meta-Analysis Pr
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Table 2. Randomized Trials Employin
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BONE MARROW TRANSPLANTATION FOR OVA
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1). Data from the survey was combin
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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 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,
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