3 research outputs found
Unrelated marrow transplantation for adult patients with poor-risk acute lymphoblastic leukemia: strong graft-versus-leukemia effect and risk factors determining outcome
Between 1988 and 1999, 127 patients with poor-risk acute lymphoblastic
leukemia (ALL) received a matched unrelated donor transplant using marrow
procured by National Marrow Donor Program (NMDP) collection centers and
sent out to 46 transplant centers worldwide. Poor risk was defined by the
presence of the translocations t(9;22) (n = 97), or t(4;11) (n = 25), or
t(1;19) (n = 5). Sixty-four patients underwent transplantation in first
remission (CR1), 16 in CR2 or CR3, and 47 patients had relapsed ALL or
primary induction failure (PIF). Overall survival at 2 years from
transplant was 40% for patients in CR1, 17% in CR2/3, and 5% in PIF or
relapse. Treatment-related mortality (TRM) and relapse mortality,
estimated as competing risk factors, were 54% and 6%, respectively, in
CR1, 75% and 8% in CR2/3, and 64% and 31% in PIF or relapse. Currently 23
CR1 patients are alive and free of disease with a median follow-up of 24
months (range, 3-97). Multivariable analysis showed that CR1, shorter
interval from di
Comparison of chop chemotherapy with autologous bone marrow transplantation for slowly responding patients with aggressive non-Hodgkin's lymphoma
High-dose chemoradiotherapy combined with autologous bone marrow transplantation can cure patients with disseminated, aggressive non-Hodgkin's lymphoma in whom first-line chemotherapy has failed. In contrast, cure is rare with second-line chemotherapy. It has been suggested that patients with slow responses to the initial phase of first-line chemotherapy are at high risk for relapse. Therefore, such patients are potential candidates for early bone marrow transplantation
Vincristine, doxorubicin and dexamethasone (VAD) administered as rapid intravenous infusion for first-line treatment in untreated multiple myeloma
We examined the feasibility of achieving a rapid response in patients with previously untreated multiple myeloma by administering vincristine 0.4 mR and doxorubicin 9 mg/m2 as a rapid intravenous infusion for 4 d together with intermittent high-dose dexamethasone 40 mg (VAD) for remission induction treatment in patients who were scheduled to receive high-dose therapy. 139 patients (86 male, 53 female; median age 53 years, range 32-65 years; Durie and Salmon stage IIA: 42, IIB: one, IIIA: 89, IIIB: seven) were included in a prospective multicentre study in which VAD was administered as remission induction treatment and was followed by intensified treatment. The response was evaluated according to the criteria of the Eastern Cooperative Oncology Group (ECOG). The results of treatment were evaluable in 134 patients. Five patients died before evaluation. 86 patients (62%) achieved a partial response (PR) and seven patients (5%) achieved a complete response (CR), which equates to a response rate of 67%. The main side-effect was mild neurotoxicity, which was observed in 18% of the patients. Fever or infections were reported in 27% of the patients. VAD administered as an outpatient regimen, based on rapid intravenous infusion, is an effective induction regimen for untreated myeloma with a 67% response rate and acceptable toxicity