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

More documents

Recommendations

Info

Otherwise toxicity was mild to moderate and dominated by musculoskeletal discomfort, fatigue, fever, skin rashes and nausea. An increase in NK cell (CD 16+, and CD 56 + CD3-) numbers was observed during the treatment periods with lower numbers recorded before and after the treatment (Figure 1 and 2). NK cell activity measured as killing of K562 cells as well as LAK cell activity measured as killing of Daudi cells were increased in individual patients (Figure 3). In individual cycles increases in monocyte and T cell numbers were also observed. Increased production in individual treatment cycles of TNF alpha, IL-1 and interferon gamma has been reported previously 27 . To these observations have now been added the measurements of IL-6 in serum before, during and after treatment. Figure 4 shows that increases of IL-6 could be demonstrated during the treatment. Comparative studies underway The knowledge of the importance of the immune function for the risk of relapse of AML together with the data on the immunomodulatory properties of Linomide as well as the safety of this compound formed the rationale for two different prospective randomized studies aiming to determine if Linomide can reduce the risk of relapse of AML after ABMT. One study is active in ten European countries and one is in the US, Canada and Australia. Both of the studies include patients with AML in complete remission eligible for autologous bone marrow transplantation, regardless of prior antileukemic therapy. Taken together the two studies have recruited almost 200 patients who are treated with Linomide 0.2 mg/kg twice weekly or placebo. Time to relapse, relapse rate, overall survival will be recorded as well as safety and immune parameters. Toxicity has so far been manageable and dominated by musculoskeletal discomfort, nausea, vomiting, edema, skin rash and diarrhea. No efficacy data is available since the studies are blinded. Conclusion The high rates of remission as well as of relapse in acute myeloid leukemia indicate that the most important opportunities for improvement of the cure rate of this disorder lies in successful prevention of relapse. The experiences from allogeneic bone marrow transplantation indicate that the immune function is of importance for the relapse rate in this disorder. A variety of agents including Linomide modulate immune functions in such a way that clinical studies are warranted, where the aim is to determine if the relapse rate of AML can be decreased by use of such agents. Results from currently ongoing clinical studies will have to be awaited before the role of immunomodulatory agents in acute myeloid leukemia can be defined. REFERENCES 1. Rowe JM et al. Clinical trials in adults with acute myelogenous leukemia: The ECOG experience in Acute Myelogenous Leukemia: Progress and Controversies, ed RP Gale. New York, Wiley-Liss, 1990. 2. Schiffer CA, Mayer RJ. Cancer and leukemia Group B studies in acute myeloid leukemia. In Acute Myelogenous Leukemia. Progress and Controversies, ed RP 40 SIXTH INTERNATIONAL SYMPOSIUM ON AUTOLOGOUS BONE MARROW TRANSPIANTATION
Gale, New York, Wiley-Liss, 1990. 3. Bishop JF et al. Etoposide in acute nonlymphocytic leukemia. Blood 1990,75:25. 4. Philips GL et al. High dose cytarabine and daunorubicin induction and postremission chemotherapy for the treatment of acute myelogenous leukemia in adults. Blood 1991; 77:1429. 5. Clift RA, Buckner CD, Thomas ED et al. The treatment of acute nonlymphoblastic leukemia by allogeneic marrow transplantation. Bone Marrow Transplant 1987; 2:243-58. 6. Santos GW, Tutschka PJ, Brookmeyer R et al. Marrow transplantation for acute nonlymphocytic leukemia after treatment with busulfan and cyclophosphamide. N Engl J Med 1983; 309:1354-57. 7. Kersey JK, Weisdorf D, Nesbit ME et al. Comparison of autologous and allogeneic bone marrow transplantation for treatment of high-risk refractory acute lymphoblastic leukemia. N Engl J Med 1987;317:461-67. 8. Bearman SI, Appelbaum FR, Buckner CD et al. Regimen-related toxicity in patients undergoing bone marrow transplantation. J Clin Oncol 1988;6:1562-68. 9. Sullivan KM, Fefer A, Witherspoon R et al. Graft-versus leukemia in man: relationship of acute and chronic graft-versus-host disease to relapse of acute leukemia following allogeneic bone marrow transplantation. In: Truitt RL, Gale RP, Bortin MM (eds). Cellular Immunotherapy of Cancer, Allan R. Liss, Inc., New York 1987, pp 391-99. 10. Horowitz MM, Gale RP, Sondel PM et al. Graft-versus-leukemia reactions after bone marrow transplantation. Blood 1990; 75:555-62. 11. Fefer A, Sullivan KM, Weien P. Graft-versus leukemia effect in man: the relapse rate of acute leukemia is lower after allogeneic than after syngeneic marrow transplantation. Prog Clin Biol Res 1987;244:401-08. 12. Weisdorf D], Nesbit ME, Ramsay NKC et al. Allogeneic bone marrow transplantation for acute lymphoblastic leukemia in remission: prolonged survival associated with acute graft-versus-host disease. J Clin Oncol 1987;5:1348-55. 13. Bacigalupo A, Van Lint MT, Occhini D et al. Increased risk of leukemia relapse with high-dose Cyclosporine A after allogeneic marrow transplantation for acute leukemia. Blood 1991;77:1423-28. 14. Marmont AM, Horowitz MM, Gale RP et al. T-cell depletion of HLA-identical transplants in leukemia. Blood 1991;78:2120-30. 15. Keever CA, Welte K, Sullivan M, O'Reilly RJ. Phenotype of functional characterization of NK and LAK cells following T-depleted bone marrow transplantation. In: Truitt RL, Gale RP, Bortin MM (eds). Cellular Immunotherapy of Cancer. A.R. Liss, New York 1987; 423-32. 16. Archimbaul E, Bailly M, Dore J-F. Inducibility of lymphokine activated killer (LAK) cells in patients with acute myelogenous leukemia in complete remission and its clinical relevance. Br J Haematol 1991; 77:328-34. 17. Adler A, Albo V, Blatt J et al. Interleukin-2 induction of lymphokine-activated killer (LAK) activity in the peripheral blood and bone marrow of acute leukemia patients: II Feasibility of LAK generation in children with active disease and in remission. Blood 1989; 74:1690-97. 18. Sorskaar D. Forre O, Albrechtsen D, et al. Decreased natural killer cell activity versus normal natural killer cell markers in mononuclear cells from patients with smouldering leukemia. Scand J Haematol 1986; 37:154-61. 19. Pizzolo G, Trentin L, Vinante F, et al. Natural killer cell function and lymphoid subpopulations in acute non-lymphoblastic leukemia in complete remission. Br J Cancer 1988;58:268-72. 20. Hamilton TA, Adams DO. Mechanisms of macrophage-mediated tumor injury, in Den Otter W, Ruitenberg EJ (eds): Tumor immunology: Mechanisms, Diagnosis, SIXTH INTERNATIONAL SYMPOSIUM ON AUTOLOGOUS BONE MARROW TRANSPLANTATION 41
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 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 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
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?