84 research outputs found
Treatment of Older Patients with Mantle-Cell Lymphoma
BACKGROUND: The long-term prognosis for older patients with mantle-cell lymphoma is poor. Chemoimmunotherapy results in low rates of complete remission, and most patients have a relapse. We investigated whether a fludarabine-containing induction regimen improved the complete-remission rate and whether maintenance therapy with rituximab prolonged remission. METHODS: We randomly assigned patients 60 years of age or older with mantle-cell lymphoma, stage II to IV, who were not eligible for high-dose therapy to six cycles of rituximab, fludarabine, and cyclophosphamide (R-FC) every 28 days or to eight cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) every 21 days. Patients who had a response underwent a second randomization to maintenance therapy with rituximab or interferon alfa, each given until progression. RESULTS: Of the 560 patients enrolled, 532 were included in the intention-to-treat analysis for response, and 485 in the primary analysis for response. The median age was 70 years. Although complete-remission rates were similar with R-FC and R-CHOP (40% and 34%, respectively; P=0.10), progressive disease was more frequent with R-FC (14%, vs. 5% with R-CHOP). Overall survival was significantly shorter with R-FC than with R-CHOP (4-year survival rate, 47% vs. 62%; P=0.005), and more patients in the R-FC group died during the first remission (10% vs. 4%). Hematologic toxic effects occurred more frequently in the R-FC group than in the R-CHOP group, but the frequency of grade 3 or 4 infections was balanced (17% and 14%, respectively). In 274 of the 316 patients who were randomly assigned to maintenance therapy, rituximab reduced the risk of progression or death by 45% (in remission after 4 years, 58%, vs. 29% with interferon alfa; hazard ratio for progression or death, 0.55; 95% confidence interval, 0.36 to 0.87; P=0.01). Among patients who had a response to R-CHOP, maintenance therapy with rituximab significantly improved overall survival (4-year survival rate, 87%, vs. 63% with interferon alfa; P=0.005). CONCLUSIONS: R-CHOP induction followed by maintenance therapy with rituximab is effective for older patients with mantle-cell lymphom
Betrachtungen zur Herstellung von Methadon-nitril und Isomethadon-nitril sowie verwandten Verbindungen
The 2-chloro-1-dialkylamino-propanes 4a-d are reacted with diphenylacetonitrile under phase transfer conditions to give a mixture of the nitriles 1a-d and 2a-d. Both chloro-dialkylamino-1-phenyl-ethanes 7a-d and 8a-d lead to 4-dialkylamino-2,2,3-triphenyl-butyronitriles 6a-d
Sulfonylanaloge Spirohydantoine
New thiasubstituted sulfonyl analogues of spirohydantoins were synthesized and tested for their anticonvulsant effects. In low concentrations they had no anticonvulsant activities, in higher ones they were neurotoxic
1-(4-Biphenylyl)ethylnitramine, bioisostere Profene
Substituted 1-( 4-biphenylyl)ethylnitramines are synthesized from the 1-( 4-biphenylyl)ethanols 1a-d with ethyl N-nitro-carbamate in a Mitsunobu reaction [...
Dipeptidamide mit Süßstoffcharakter
Several L-Aspartyl-D-alanin-2-methylcycloalkylamides (9a-h) were synthesized and tested for their sweet quality
Antiplatelet-Eigenschaften von 4-Oxo-4H-pyrazol-1,2-dioxiden
New 4-oxo-4H-pyrazol-1,2-dioxides were tested for their antiplatelet effects. Compound 2i has the highest activity in the Born test with 200 nMol/L
Substituierte I-Isochromenyl-essigsäureethylester, verbrückte Stilbene
Substituted ethyl 1-methyl-3-phenyl-1-isochromenyl-acetates 4-6 are synthesized by reacting the earbonitriles 1-3 with Reformatzky reagent [...
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