ISSN:1040-8746    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Animal experimentation has advanced the understanding of cellular events in the afferent and efferent phases of graft-versus-host disease. New immunosuppressive agents such as FK-506, deoxyspergualin, and interleukin-1 receptor antagonist have shown successful prevention and treatment of graft-versus-host disease in rats and mice. Pretransplant and posttransplant immunosuppressive regimens capable of enhancing engraftment of T-cell-depleted marrow have been defined in murine marrow transplantation. Evidence has begun to emerge indicating that engraftment can be enhanced by T cells that do not cause graft-versus-host disease. Finally, investigations have begun to define approaches for enhancing graft-versus-leukemia effects not only in allogeneic marrow transplantation but also in autologous transplantation.

ISSN:1040-8746    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

A greater understanding of the underlying mechanisms of hematopoiesis and leukemogenesis in the clinical management of acute myeloid and lymphoblastic leukemia has led to an improvement in survival from what were invariably fatal diseases. Bone marrow transplantation is increasingly becoming an accepted form of therapy for acut myeloid leukemia and acute lymphoblastic leukemia in certain situations. This review seeks to address some of the recent advances and controversies including whether bone marrow transplantation is more efficacious than modern intensive chemotherapy, the role of autologous bone marrow transplantation and matched-unrelated donor transplants, the graft-versus-leukemia effect, and the role of purging in autologous bone marrow transplantation. Furthermore, advances in supportive therapy including the introduction of hematopoietic growth factors is critically evaluated. Finally, the appropriate timing and role of bone marrow transplantation is discussed in the context of previous ongoing and future clinical trials.

ISSN:1040-8746    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

It is generally accepted that patients with chronic myelogenous leukemia in chronic phase under the age of 50 years who have HLA-identical siblings, should be offered bone marrow transplantation within the first year of diagnosis. The projected disease-free survival for these patients is 70% to 80% at 4 years, and most of these will prove to have been cured. Results of bone marrow transplantation for patients with more advanced disease are less promising. For transplant conditioning there is no important difference between cyclophosphamide plus total-body irradiation and busulphan plus cyclophosphamide. Nonenlarged spleens require neither splenectomy nor additional radiotherapy. The use of cyclosporine and methotrexate is currently the optimal approach to graft-versus-host disease prevention. Fewer good results are obtained with “matched” volunteer marrow donors. Use of the polymerase chain reaction to monitor residual BCR-ABL transcripts after bone marrow transplantation may prove useful in identifying patients at increased risk for relapse. Autografting may offer the prospect of prolonged life or even cure for patients without suitable allogeneic donors.

ISSN:1040-8746    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The success of hematoablative dosages of cytotoxic therapy followed by stem cell transplantation depends on the disease response to the intensive drug dose and the ability of the transplant to provide durable hematopoietic reconstitution. In autologous stem cell transplantation, patients' own bone marrow or peripheral blood is used for hematopoietic engraftment. In several diseases the bone marrow is involved, and in such situations, the success of autologous stem cell transplantation may improve if the hematopoietic elements are enriched (positive selection) or if the contaminating cancer cells are purged by negative selection. In patients undergoing allogeneic bone marrow transplantation, the T lymphocytes of the donor cells contribute to the development of graft-versus-host disease with significant morbidity and mortality. Selective purging of T lymphocytes has dramatically decreased the incidence of graft-versus-host disease. In this paper, various methods for purging hematopoietic stem cells are detailed with emphasis on treatment planning. Exciting new possibilities include growing stem cells from a small amount of bone marrow, enhancing immune surveillance, and decreasing drug resistance by genetic engineering.

ISSN:1040-8746    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Recent studies in autologous bone marrow or peripheral blood transplantation in solid tumors are discussed. The toxicity and activity of high-dose cisplatin or carboplatin combined with etoposide and other drugs are described. The results of trials in nonseminomatous germ cell tumors, neuroblastoma, ovarian cancer, and brain tumors are detailed and discussed. The impressive antitumor activities noted in certain subgroups should lead to an early application of these strategies before drug resistance becomes prevalent.

ISSN:1040-8746    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

There will be an estimated 180,000 new cases of breast cancer this year with 46,000 deaths. Adjuvant chemotherapy is now firmly established as a valuable modality in breast cancer, improving both disease-free and overall survival in appropriate patients. Unfortunately, chemotherapy has yielded little improvement in the survival of patients with metastatic breast cancer.

ISSN:1040-8746    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:1040-8746    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

In the year under review, studies showed the effects of smoking on the occurrence of lung cancer outside North America; currently, China is a country of considerable interest. A number of studies were also reported on occupational factors in lung cancer etiology, with risks confirmed in the steel industry. Increasing interest, mostly generated by the tobacco industry, relates to passive smoking and lung cancer. Attempts continue to refine prognostic factors, especially in small cell lung cancer.

ISSN:1040-8746    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The incidence of lung cancer continues to rise worldwide with major increases in incidence observed in Third World countries. Unfortunately, the overall survival of patients with this disease has remained unchanged in the past 2 decades. In spite of this, there have been major advances in understanding the biologic properties of both small cell and non-small cell lung cancer, including the definition of specific autocrine growth factors, molecular advances associated with the pathogenesis of this disease, and determinants of the mechanism of drug resistance. Here we review the most recently recognized important biologic properties of lung cancer cellsin vitroandin vivoand discuss the clinical relevance of application of these biologic properties in the management of patients with this disease.

ISSN:1040-8746    

出版商:OVID    

年代:1992

数据来源: OVID