ISSN:1040-8746    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Analysis of chromosomal abnormalities present in the malignant cells of patients with leukemia has provided much information of diagnostic and prognostic importance. The cloning of genes rearranged by translocation breakpoints has provided insights into both the regulation of normal cell growth and differentiation and the pathogenesis of human malignancies. This article reviews recent analyses of the association of specific karyotypic changes with other disease characteristics, including treatment outcome. Also covered is the substantial progress that has been made in the molecular analysis of genetic abnormalities in leukemia, with emphasis on those changes produced by chromosomal rearrangements. The use of information derived from these latter studies to develop polymerase chain reaction and fluorescent in situ hybridization assays for clinical use is also summarized.

ISSN:1040-8746    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Successful immunotherapy for cancer and, in particular, monoclonal antibody-based therapy are most likely to succeed first for the hematopoietic neoplasms because of their biology and because of the pharmacology of monoclonal antibodies. Ten years of steady development in the field, including identification of better antigen-antibody systems, genetic engineering of humanized monoclonal antibodies, construction of new toxin and radionuclide conjugates, and better understanding of the interactions of monoclonal antibodies with cytokines,eg,interleukin-2, has led to a series of recent trials showing significant activity of monoclonal antibodies in leukemias. This activity encompasses the ablation of large masses of cells prior to bone marrow transplantation, as well as the elimination of minimal diseasein vivoand exvivo.

ISSN:1040-8746    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The Ph chromosome, the abnormality characteristic of chronic myelogenous leukemia, was discovered in 1963. However, the events responsible for the pathogenesis and transformation to accelerated and blastic phases are still unknown at the molecular level and are subjects of ongoing research. The positive outcome in a subset of patients with interferon therapy and the potential for cure with bone marrow transplantation have evoked controversy regarding the best approach for different groups of patients according to prognostic characteristics. At the same time, new therapies with promising results are being developed, both in the setting of chemotherapy and biologic therapy and in bone marrow transplantation. Homoharringtonine chemotherapy, the use of matched unrelated donors for bone marrow transplantation, and new modalities of purging for autologous bone marrow transplantation are some examples. Sensitive molecular techniques that allow for the detection of small numbers of bcr-abl/-positive hematopoietic cells may provide new means of assessing the results of current and future therapies.

ISSN:1040-8746    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Myelodysplasia or myelodysplastic syndromes represent a heterogeneous group of bone marrow disorders characterized by dysmaturation, cytopenias, and a propensity for leukemic transformation. Although universally adopted, the French-American-British classification still has several limitations and an inability to categorize all patients. Refinements in morphologic and histologic interpretation in addition to the use of scoring systems may improve diagnostic and prognostic capability. Cytogenetics and molecular genetic abnormalities are providing clues to the fundamental pathogenesis of myelodysplastic syndromes. However, the lesions responsible for initiation or disease progression are as yet unresolved. Although chemotherapy and allogeneic transplantation may be used in selected patients, the mainstay of therapy remains supportive care, with differentiating therapy being largely disappointing so far and the role of hematopoietic growth factors remaining unresolved.

ISSN:1040-8746    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:1040-8746    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The mortality associated with multiple myeloma is due to the progressive accumulation of a clonal population of plasma cells in the bone marrow. Tumor cells may also be found in the blood and other extramedullar sites, especially in the terminal stages of the disease. During disease progression, numerous effects lead to significant morbidity, including immunosuppression, increased bone turnover, anemia, and renal deterioration. For more than two decades it has been realized that chemotherapy and radiotherapy could provide effective temporary relief from the pain and suffering associated with this malignancy. Unfortunately, these benefits are usually short lived, and essentially all patients experience recurrent disease that is usually refractory to additional therapy.

ISSN:1040-8746    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:1040-8746    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:1040-8746    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Recent advances in the management of pituitary tumors have included diagnostic tests that approach 100% sensitivity and specificity. Although pharmacologic agents with greater specificity and, therefore, greater therapeutic efficacy have been developed, transsphenoidal surgery with microneurosurgical technique remains the primary means of treating these tumors. Stereotactic radiosurgery, which serves to either augment or supersede surgical management, has shown great promise as possibly a curative treatment for these tumors. This technology has been enhanced by the advent of magnetic resonance imaging stereotactic localization, which can accurately visualize small microadenomas as well as the optic apparatus. Further follow-up is necessary to assess the long-term tumor control rate, endocrinologic effects, and postradiosurgery morbidity, which may include hypopituitarism and delayed-onset optic neuropathy.

ISSN:1040-8746    

出版商:OVID    

年代:1994

数据来源: OVID