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1. Gopcsa L, Barta A, Bányai A, Dolgos J, Halm G, Pálóczi K: Salvage chemotherapy with donor lymphocyte infusion and STI 571 in a patient relapsing with B-lymphoblastic phase chronic myeloid leukemia after allogeneic bone marrow transplantation. Pathol Oncol Res; 2003;9(2):131-3
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  • [Title] Salvage chemotherapy with donor lymphocyte infusion and STI 571 in a patient relapsing with B-lymphoblastic phase chronic myeloid leukemia after allogeneic bone marrow transplantation.
  • Relapse is the main cause of treatment failure following hematopoietic stem cell transplantation for blastic phase chronic myeloid leukemia.
  • Treatment options including donor lymphocyte infusion, second transplantation, interferon- and re-induction chemotherapy are often unsuccessful.
  • We report a patient with blastic phase chronic myeloid leukemia relapsing after allogeneic stem cell transplantation.
  • The post-transplant leukemia was characterized with B-lymphoid markers and multiple genetic abnormalities including double Ph-chromosomes.
  • The disease was treated with three courses of salvage chemotherapy combined with donor lymphocyte infusion and bcr-abl tyrosine kinase inhibitor.
  • The leukemia proved to be non-responsive both to immune therapy and STI 571.
  • The presented case demonstrates the need for combination approaches in post-transplant relapsed leukemia and discusses the possible contributing mechanisms of STI-571 resistance.
  • [MeSH-major] Blast Crisis / therapy. Bone Marrow Transplantation. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy. Leukocyte Transfusion. Piperazines / therapeutic use. Pyrimidines / therapeutic use
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. B-Lymphocytes / pathology. Benzamides. Drug Resistance, Neoplasm. Enzyme Inhibitors / therapeutic use. Fusion Proteins, bcr-abl / antagonists & inhibitors. Humans. Imatinib Mesylate. Male. Middle Aged. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / therapy. Protein-Tyrosine Kinases / antagonists & inhibitors. Remission Induction. Salvage Therapy. Tissue Donors. Transplantation, Homologous. Treatment Outcome


2. Medeiros BC, Chun K, Kamel-Reid S, Lipton J: Inv (11)(p15q21) in donor-derived Ph-negative cells in a patient with chronic myeloid leukemia in relapse successfully treated with imatinib mesylate post allogeneic stem cell transplantation. Am J Hematol; 2007 Aug;82(8):758-60
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  • [Title] Inv (11)(p15q21) in donor-derived Ph-negative cells in a patient with chronic myeloid leukemia in relapse successfully treated with imatinib mesylate post allogeneic stem cell transplantation.
  • Imatinib mesylate (IM) is the standard first-line treatment for patients with chronic myeloid leukemia (CML).
  • We report a 56-year-old female who presented with a relapse from CML in September 2002.
  • She had received a matched related HSCT for CML in chronic phase.
  • Donor lymphocyte infusion was given 3 years post-HSCT for a relapse.
  • This observation reinforces the possibility that IM therapy may be casually linked to the phenomenon of secondary cytogenetic changes in diploid cells.
  • [MeSH-major] Chromosomes, Human, Pair 11 / genetics. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / genetics. Piperazines / therapeutic use. Pyrimidines / therapeutic use. Stem Cell Transplantation
  • [MeSH-minor] Adult. Benzamides. Female. Humans. Imatinib Mesylate. Karyotyping. Male. Middle Aged. Philadelphia Chromosome. Recurrence. Tissue Donors. Transplantation, Homologous


3. Serrano J, Prieto E, Mazarbeitia F, Román A, Llamas P, Tomás JF: Atypical chronic graft-versus-host disease following interferon therapy for chronic myeloid leukaemia relapsing after allogeneic BMT. Bone Marrow Transplant; 2001 Jan;27(1):85-7
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  • [Title] Atypical chronic graft-versus-host disease following interferon therapy for chronic myeloid leukaemia relapsing after allogeneic BMT.
  • We report a 54-year-old woman who received interferon alpha for haematological relapse of Ph-positive CML, 7 years after allogeneic BMT from an HLA-identical brother.
  • Eighteen months after relapse, cytogenetic and molecular remission was achieved.
  • She received interferon therapy for 25 months and it was discontinued when she developed skin lesions on her face and trunk, dysphagia and fever with respiratory failure and bilateral patchy airspace consolidation of the lung without microbiologic findings.
  • Histologic features showed discoid lupus erythematosis, oesophagitis with pseudomembranes and a mixed pattern of lymphocytic bronchiolitis involving the alveoli and interstitial spaces all compatible with chronic GVHD.
  • The patient was commenced on immunosuppressive therapy with complete clinical and radiological resolution.
  • The available evidence supports an atypical presentation of chronic GVHD and suggests a role for interferon alpha in the pathogenesis of GVHD.
  • To the best of our knowledge, this is the first case reported of severe chronic GVHD occurring during the course of interferon therapy for relapsed CML.
  • [MeSH-major] Graft vs Host Disease / chemically induced. Interferon-alpha / toxicity. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy
  • [MeSH-minor] Antineoplastic Agents / administration & dosage. Antineoplastic Agents / toxicity. Bone Marrow Transplantation. Chronic Disease. Female. Humans. Middle Aged. Recurrence. Transplantation, Homologous

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  • (PMID = 11244442.001).
  • [ISSN] 0268-3369
  • [Journal-full-title] Bone marrow transplantation
  • [ISO-abbreviation] Bone Marrow Transplant.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Interferon-alpha
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4. Olavarria E, Craddock C, Dazzi F, Marin D, Marktel S, Apperley JF, Goldman JM: Imatinib mesylate (STI571) in the treatment of relapse of chronic myeloid leukemia after allogeneic stem cell transplantation. Blood; 2002 May 15;99(10):3861-2
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  • [Title] Imatinib mesylate (STI571) in the treatment of relapse of chronic myeloid leukemia after allogeneic stem cell transplantation.
  • Donor lymphocyte infusion (DLI) can restore durable molecular remission in a high percentage of patients with chronic myeloid leukemia (CML) who have relapses after allogeneic stem cell transplantation, but for patients who do not respond survival is poor.
  • We report here a male patient who had a relapse to chronic phase after stem cell transplantation for CML, did not benefit from treatment with DLI, and then was administered STI571 at a dose of 400 mg daily.
  • There was a rapid, complete hematologic response, and complete restoration of donor-type hematopoiesis (100% 46, XX marrow metaphases) was achieved after 6 months of therapy, though RT-PCR studies still detected BCR-ABL transcripts in the blood at low level.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Hematopoietic Stem Cell Transplantation. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Neoplasm Recurrence, Local / drug therapy. Piperazines / therapeutic use. Pyrimidines / therapeutic use
  • [MeSH-minor] Adult. Benzamides. Cytogenetic Analysis. Enzyme Inhibitors / therapeutic use. Fusion Proteins, bcr-abl / antagonists & inhibitors. Humans. Imatinib Mesylate. Male. Transplantation, Homologous


5. Al-Anazi KA, Alshehri A, Al-Zahrani HA, Al-Mohareb FI, Maghfoor I, Ajarim D: Successful outcome of Langerhans cell histiocytosis complicated by therapy-related myelodysplasia and acute myeloid leukemia: a case report. Cases J; 2008;1(1):101

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  • [Title] Successful outcome of Langerhans cell histiocytosis complicated by therapy-related myelodysplasia and acute myeloid leukemia: a case report.
  • BACKGROUND: Various therapeutic options are available for the management of Langerhans cell histiocytosis.
  • However, treatment administered to control this disease may be complicated by acute leukemia.
  • Unfortunately, the cytotoxic chemotherapy and radiotherapy given to control the repeated relapses and exacerbations of the primary disease predisposed him to therapy-induced myelodysplastic syndrome which transformed into acute myeloid leukemia.
  • After achieving complete remission of his leukemia, the patient received an allogeneic hematopoietic stem cell transplant.
  • The allograft was complicated by chronic graft versus host disease that was controlled by various immunosuppressive agents and extracorporal photophoresis.
  • CONCLUSION: Management of complicated cases of histiocytosis requires various therapeutic modalities and a multidisciplinary approach.
  • Having complications of therapy eg myelodysplasia or acute leukemia make the outcome more dismal and the management options limited to aggressive forms of treatment.
  • High dose chemotherapy followed by an allograft may be a curative option not only for therapy-related myelodysplasia/acute leukemia, but also for frequently relapsing and poorly controlled Langerhans cell histiocytosis.

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  • (PMID = 18710527.001).
  • [ISSN] 1757-1626
  • [Journal-full-title] Cases journal
  • [ISO-abbreviation] Cases J
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2527498
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6. Wassmann B, Klein SA, Scheuring U, Pfeifer H, Martin H, Gschaidmeier H, Hoelzer D, Ottmann OG: Hematologic and cytogenetic remission by STI571 (Glivec) in a patient relapsing with accelerated phase CML after second allogeneic stem cell transplantation. Bone Marrow Transplant; 2001 Oct;28(7):721-4
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  • [Title] Hematologic and cytogenetic remission by STI571 (Glivec) in a patient relapsing with accelerated phase CML after second allogeneic stem cell transplantation.
  • We describe the clinical activity of the ABL kinase inhibitor STI571 in a patient with accelerated phase of chronic myeloid leukemia (CML) relapsing after a second allogeneic BMT and with minimal levels of donor chimerism.
  • STI571 induced sustained hematological and cytogenetic remission combined with controllable GvHD, therapeutic goals not achieved by two preceding allogeneic transplants and repeated donor lymphocyte transfusions (DLT).
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Bone Marrow Transplantation. Hematopoietic Stem Cell Transplantation. Leukemia, Myeloid, Accelerated Phase / drug therapy. Neoplasm Recurrence, Local / drug therapy. Piperazines / therapeutic use. Pyrimidines / therapeutic use. Salvage Therapy
  • [MeSH-minor] Antineoplastic Agents, Alkylating / therapeutic use. Benzamides. Colitis / chemically induced. Combined Modality Therapy. Enzyme Inhibitors / adverse effects. Enzyme Inhibitors / therapeutic use. Female. Graft Survival. Graft vs Host Disease / etiology. Graft vs Leukemia Effect. Humans. Hydroxyurea / therapeutic use. Imatinib Mesylate. Immunosuppression. Interferon-alpha / therapeutic use. Leukemia, Myeloid, Chronic-Phase / drug therapy. Leukemia, Myeloid, Chronic-Phase / therapy. Lymphocyte Transfusion. Middle Aged. Neoplasm, Residual. Neutropenia / chemically induced. Remission Induction. Transplantation Conditioning. Transplantation, Homologous

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  • (PMID = 11704799.001).
  • [ISSN] 0268-3369
  • [Journal-full-title] Bone marrow transplantation
  • [ISO-abbreviation] Bone Marrow Transplant.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Antineoplastic Agents, Alkylating; 0 / Benzamides; 0 / Enzyme Inhibitors; 0 / Interferon-alpha; 0 / Piperazines; 0 / Pyrimidines; 8A1O1M485B / Imatinib Mesylate; X6Q56QN5QC / Hydroxyurea
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7. Blau IW, Basara N, Bischoff M, Günzelmann S, Römer E, Kirsten D, Schmetzer B, Kiehl MG, Fauser AA: Second allogeneic hematopoietic stem cell transplantation as treatment for leukemia relapsing following a first transplant. Bone Marrow Transplant; 2000 Jan;25(1):41-5
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  • [Title] Second allogeneic hematopoietic stem cell transplantation as treatment for leukemia relapsing following a first transplant.
  • We report 27 patients with relapsed acute or chronic leukemia who underwent a second hematopoietic stem cell transplant (HSCT) from a related or unrelated donor.
  • Seventeen patients were diagnosed with acute myelogenous leukemia (AML), six with acute lymphocytic leukemia (ALL) and four with chronic myeloid leukemia (CML).
  • Relapse was diagnosed between 1 and 45 months after the first HSCT.
  • Chemotherapy was used as reinduction for relapse after HSCT in 16 patients who had received an autologous transplant and in three who had received an allogeneic transplant, since the latter did not respond to reduction of immunosuppression to induce a graft-versus-leukemia (GVL) reaction.
  • Five of these 19 patients (26%) achieved complete remission (CR), seven patients did not respond to chemotherapy and seven achieved a partial remission (PR).
  • One patient is alive and disease-free after two allogeneic transplants (day +1538), eight patients, who relapsed after an autologous transplant followed by an allogeneic transplant (days +248 to +1140), acute myeloid leukaemia (n = 6) and chronic myeloid leukemia (n = 2) are alive and disease-free.
  • It is suggested that a second HSCT is possible for patients with leukemia relapse following the first autologous transplant.
  • A second transplant might also be offered to patients relapsing after the first allogeneic HSCT.
  • [MeSH-major] Hematopoietic Stem Cell Transplantation. Leukemia / pathology. Leukemia / therapy
  • [MeSH-minor] Acute Disease. Adult. Chronic Disease. Female. Humans. Male. Middle Aged. Recurrence. Survival Analysis. Transplantation, Homologous

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  • (PMID = 10654013.001).
  • [ISSN] 0268-3369
  • [Journal-full-title] Bone marrow transplantation
  • [ISO-abbreviation] Bone Marrow Transplant.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] ENGLAND
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8. Fujimaki K, Maruta A, Yoshida M, Yamazaki E, Matsuzaki M, Fujisawa S, Kanamori H, Ishigatsubo Y: [Complete cytogenetic response obtained with unrelated donor lymphocyte infusion for relapse of chronic myeloid leukemia in blastic crisis after allogeneic bone marrow transplantation]. Rinsho Ketsueki; 2001 Mar;42(3):204-8
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  • [Title] [Complete cytogenetic response obtained with unrelated donor lymphocyte infusion for relapse of chronic myeloid leukemia in blastic crisis after allogeneic bone marrow transplantation].
  • A 35-year-old man with chronic myeloid leukemia (CML) in blastic crisis (BC) received an allogeneic bone marrow transplant from an unrelated donor in October 1998 after three cycles of chemotherapy.
  • BC relapse developed on day 349 after transplantation.
  • After one cycle of chemotherapy and treatment with interferon, the patient received donor lymphocyte infusion (DLI), and this resulted in a complete cytogenetic response 21 days later.
  • Grade III acute graft-versus-host disease developed on day 25 after DLI, but this was resolved after administration of prednisolone.
  • Disease relapse occurred at extramedullary sites on day 162 after DLI, and the patient died of sepsis after receiving chemotherapy.
  • This case illustrates that unrelated DLI can induce remission successfully in patients with relapse of CML in BC through a graft-versus-leukemia effect.
  • [MeSH-major] Blast Crisis. Bone Marrow Transplantation. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy. Lymphocyte Transfusion
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Humans. Male. Remission Induction. Tissue Donors


9. Grigg A, Kannan K, Schwarer AP, Spencer A, Szer J: Chemotherapy and granulocyte colony stimulating factor-mobilized blood cell infusion followed by interferon-alpha for relapsed malignancy after allogeneic bone marrow transplantation. Intern Med J; 2001 Jan-Feb;31(1):15-22
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  • [Title] Chemotherapy and granulocyte colony stimulating factor-mobilized blood cell infusion followed by interferon-alpha for relapsed malignancy after allogeneic bone marrow transplantation.
  • This property may also be used to enhance a graft-versus-leukaemia effect (GVL) after donor leucocyte infusion (DLI), a mode of therapy increasingly offered to patients relapsing after allo BMT.
  • AIM: The aims of the present study were to examine the efficacy and toxicity of IFN therapy administered after granulocyte colony-stimulating factor (G-CSF)-stimulated blood cells given as DLI in patients with acute myeloid leukaemia (AML), chronic myeloid leukaemia (CML), acute lymphoblastic leukaemia (ALL), acute undifferentiated leukaemia (AUL) and multiple myeloma relapsing after allo BMT.
  • METHODS: Between October 1996 and September 1999, 27 patients (16 AML, four ALL, three CML, three multiple myeloma, one AUL) who relapsed after allo BMT were treated with chemotherapy followed by DLI, collected after G-CSF stimulation in all but two cases.
  • RESULTS: Eighteen patients received IFN following DLI, 14 of whom developed significant GVHD (grade II-IV acute or extensive chronic); thereafter, GVHD resolved with cessation of IFN alone in four patients, but 10 required systemic immunosuppression.
  • Twenty-three patients were given chemotherapy and DLI as initial treatment of relapse; 10 achieved complete remission (CR), in four patients this was only after the onset of GVHD.
  • The other four patients received chemotherapy and DLI as a consolidation of a chemotherapy-induced remission.
  • The CR was durable only in patients with CML (3 of 3) and AML (4 of 8).
  • CONCLUSIONS: Treatment with IFN induced GVHD in the majority of patients receiving DLI.
  • [MeSH-major] Bone Marrow Transplantation. Granulocyte Colony-Stimulating Factor / therapeutic use. Interferon-alpha / therapeutic use. Leukocyte Transfusion
  • [MeSH-minor] Acute Disease. Adult. Female. Graft vs Host Disease / etiology. Graft vs Leukemia Effect / drug effects. Humans. Leukemia / drug therapy. Leukemia / therapy. Leukemia, Myeloid / drug therapy. Leukemia, Myeloid / therapy. Male. Middle Aged. Multiple Myeloma / etiology. Remission Induction. Survival Analysis. Treatment Outcome

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  • (PMID = 11478351.001).
  • [ISSN] 1444-0903
  • [Journal-full-title] Internal medicine journal
  • [ISO-abbreviation] Intern Med J
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] Australia
  • [Chemical-registry-number] 0 / Interferon-alpha; 143011-72-7 / Granulocyte Colony-Stimulating Factor
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10. Kiguchi T, Tauchi T, Ohyashiki K: [Molecular relapse of chronic myeloid leukemia after discontinuation of imatinib mesylate for maintaining complete molecular response for more than 2 years]. Rinsho Ketsueki; 2009 Jan;50(1):52-4
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  • [Title] [Molecular relapse of chronic myeloid leukemia after discontinuation of imatinib mesylate for maintaining complete molecular response for more than 2 years].
  • Although imatinib mesylate therapy is effective for chronic myeloid leukemia (CML) patients, there are still some unanswered questions.
  • It is unclear whether imatinib can actually cure CML and whether this therapy can be safely discontinued in patients showing complete cytogenetic and molecular responses.
  • This report describes the clinical outcome of a patient with chronic phase CML who discontinued imatinib therapy after achieving molecular remission.
  • This patient has shown a relapse based on transcription-mediated amplification-hybridization protection assay (TMA-HPA) to monitor BCR-ABL transcripts, highlighting the uncertainty of discontinuing imatinib therapy for five months.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Piperazines / administration & dosage. Pyrimidines / administration & dosage
  • [MeSH-minor] Benzamides. Biomarkers, Tumor / analysis. Genes, abl / genetics. Humans. Imatinib Mesylate. Male. Middle Aged. Nucleic Acid Amplification Techniques. RNA, Messenger / analysis. Recurrence. Remission Induction. Reverse Transcriptase Polymerase Chain Reaction. Time Factors

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  • (PMID = 19225231.001).
  • [ISSN] 0485-1439
  • [Journal-full-title] [Rinshō ketsueki] The Japanese journal of clinical hematology
  • [ISO-abbreviation] Rinsho Ketsueki
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Benzamides; 0 / Biomarkers, Tumor; 0 / Piperazines; 0 / Pyrimidines; 0 / RNA, Messenger; 8A1O1M485B / Imatinib Mesylate
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11. Vela-Ojeda J, García-Ruiz Esparza MA, Reyes-Maldonado E, Jiménez-Zamudio L, Moreno-Lafont M, García-Latorre E, Ramírez-Sanjuan E, Montiel-Cervantes L, Tripp-Villanueva F, García-León LD, Ayala-Sánchez M, Rosas-Cabral A, Aviña-Zubieta JA, Galindo-Rodríguez G, Vadillo-Buenfil M, Salazar-Exaire D: Donor lymphocyte infusions for relapse of chronic myeloid leukemia after allogeneic stem cell transplantation: prognostic significance of the dose of CD3(+) and CD4(+) lymphocytes. Ann Hematol; 2004 May;83(5):295-301
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  • [Title] Donor lymphocyte infusions for relapse of chronic myeloid leukemia after allogeneic stem cell transplantation: prognostic significance of the dose of CD3(+) and CD4(+) lymphocytes.
  • Between December 1993 and November 2001, 30 patients with chronic myeloid leukemia who relapsed after stem cell transplantation were studied.
  • Seventeen patients were not treated before donor lymphocyte infusion (DLI), eight patients received interferon-alpha (IFN-alpha), and five underwent chemotherapy.
  • The median time between DLIs was 6 weeks.
  • The median number of infusions was three; the median time from transplant to relapse was 17 months and from relapse to DLI 2 months.
  • Eleven patients (37%) were in molecular/cytogenetic relapse, 14 (47%) in chronic phase, and five (16%) in accelerated or blastic phase.
  • Seventeen patients (57%) developed acute graft-versus-host disease (GVHD).
  • Chronic GVHD was observed in 15 of 24 (62%) patients.
  • Four (13%) patients developed cytopenia after a median of 30 days.
  • Nineteen (63%) patients achieved response, 15 of them developed GVHD.
  • The response rate according to the disease phase was molecular or cytogenetic relapse: 91%, chronic phase: 57%, and accelerated or blastic phase: 20%.
  • The median time to response was 6 months.
  • Patients treated with IFN-alpha or no treatment as well as those who were in molecular/cytogenetic relapse and those who received a CD3(+) cell dose <1 x 10(8)/kg and CD4(+) <8 x 10(7)/kg had better survival.
  • In some patients IFN-alpha seems to be a good choice to potentiate the graft-versus-leukemia (GVL) effect.
  • [MeSH-major] Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy. Lymphocyte Transfusion. Neoplasm Recurrence, Local / therapy. Stem Cell Transplantation. Tissue Donors
  • [MeSH-minor] Adolescent. Adult. Antigens, CD3 / analysis. Antigens, CD4 / analysis. Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Female. Graft vs Host Disease / epidemiology. Humans. Incidence. Interferon-alpha / therapeutic use. Lymphocytes / immunology. Male. Multivariate Analysis. Prognosis. Survival Analysis. Transplantation, Homologous. Treatment Outcome


12. Vettenranta K, Hovi L, Saarinen-Pihkala UM: Adoptive immunotherapy as consolidation of remission in pediatric AML relapsing post-transplant. Pediatr Transplant; 2003 Dec;7(6):446-9
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  • [Title] Adoptive immunotherapy as consolidation of remission in pediatric AML relapsing post-transplant.
  • Treatment of acute leukemia relapse following an allogeneic transplantation is a challenge.
  • We reinduced three pediatric patients with acute myeloid leukemia (AML) relapsing after a marrow transplantation from a sibling donor into remission with chemotherapy and used donor lymphocyte infusions (DLIs) as consolidation.
  • Subsequently, all the three developed (acute grade III-IV or chronic extensive) GVHD and remain in remission with a good quality of life 19, 15 and 14 months post-relapse.
  • We consider an active approach in the treatment of pediatric AML relapsing post-transplant justified.
  • [MeSH-major] Bone Marrow Transplantation. Immunotherapy, Adoptive / methods. Leukemia, Myeloid, Acute / therapy
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Female. Humans. Recurrence. Remission Induction. T-Lymphocytes / transplantation. Treatment Outcome

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  • [CommentIn] Pediatr Transplant. 2003 Dec;7(6):419-21 [14870887.001]
  • (PMID = 14870891.001).
  • [ISSN] 1397-3142
  • [Journal-full-title] Pediatric transplantation
  • [ISO-abbreviation] Pediatr Transplant
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Denmark
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13. Telek B, Rejtó L, Kiss A, Batár P, Reményi G, Rák K, Udvardy M: [Experience with fludarabine treatment and review of the literature]. Orv Hetil; 2002 Jun 16;143(24):1459-65
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  • [Title] [Experience with fludarabine treatment and review of the literature].
  • PATIENTS, RESULTS, CONCLUSIONS: In our institute 47 patients were treated with fludarabine or fludarabine based combination chemotherapy.
  • Fludarabine was given in 19 patients with chronic lymphocytic leukaemia (CLL), complete remission (CR) was achieved in one case, partial remission (PR) was obtained in 10 patients.
  • Fludarabine was more effective in patients who received less intensive chemotherapy prior to fludarabine therapy and in those patients who had less advanced diseases.
  • Elderly patients (over sixty years of age) also responded to fludarabine therapy.
  • Fludarabine + mitoxantrone (Novantrone) + dexamethasone (FND) regimen was administered in nine patients who were previously heavily treated (one patient with B-CLL, one with T-CLL, one with peripheral T-cell lymphoma and six with indolent B-cell lymphoma).
  • FLAG-IDA (fludarabine, high dose Ara-C, granulocyte colony-stimulating factor, idarubicin) was applied in 16 acute leukaemia patients with poor prognosis including therapy refractory and relapsing cases.
  • Three CR and two PR, one CR and three PR was achieved in nine patients with acute myeloid leukaemia and in seven patients with acute lymphoid leukaemia, respectively.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy. Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy. Vidarabine / analogs & derivatives. Vidarabine / therapeutic use
  • [MeSH-minor] Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cyclophosphamide / administration & dosage. Cytarabine / administration & dosage. Dexamethasone / administration & dosage. Female. Filgrastim. Granulocyte Colony-Stimulating Factor / administration & dosage. Humans. Idarubicin / administration & dosage. Immunophenotyping. Male. Middle Aged. Mitoxantrone / administration & dosage. Recombinant Proteins. Remission Induction. Treatment Outcome

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  • (PMID = 12138643.001).
  • [ISSN] 0030-6002
  • [Journal-full-title] Orvosi hetilap
  • [ISO-abbreviation] Orv Hetil
  • [Language] hun
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Hungary
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Recombinant Proteins; 04079A1RDZ / Cytarabine; 143011-72-7 / Granulocyte Colony-Stimulating Factor; 7S5I7G3JQL / Dexamethasone; 8N3DW7272P / Cyclophosphamide; BZ114NVM5P / Mitoxantrone; FA2DM6879K / Vidarabine; P2K93U8740 / fludarabine; PVI5M0M1GW / Filgrastim; ZRP63D75JW / Idarubicin; Ida-FLAG protocol
  • [Number-of-references] 43
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14. Platzbecker U, Thiede C, Freiberg-Richter J, Helwig A, Mohr B, Prange G, Füssel M, Köhler T, Ehninger G, Bornhäuser M: Treatment of relapsing leukemia after allogeneic blood stem cell transplantation by using dose-reduced conditioning followed by donor blood stem cells and GM-CSF. Ann Hematol; 2001 Mar;80(3):144-9
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  • [Title] Treatment of relapsing leukemia after allogeneic blood stem cell transplantation by using dose-reduced conditioning followed by donor blood stem cells and GM-CSF.
  • Ten patients with high-risk acute myeloid leukemia (AML), chronic myeloid leukemia (CML), and myelodysplastic syndrome (MDS) relapsing early (< 1 year, n = 8) or late (> or = 1 year, n = 2) after allogeneic transplantation were treated with cytoreductive chemotherapy followed by unmanipulated peripheral blood stem cell transplantation (PBSCT) from related (n = 3) and unrelated donors (n = 7).
  • In order to enhance the graft-versus-leukemia effect, patients received no graft-versus-host disease (GVHD) prophylaxis and granulocyte-macrophage colony-stimulating factor (GM-CSF) was given at a dose of 60 micrograms/m2 after transplant.
  • Eight out of ten patients achieved complete remission: one out of two patients with AML and late relapse is in good condition with limited chronic GVHD more than 1 year after the second PBSCT.
  • Of the remaining five patients, three died of infectious complications on days +36, +70, and +27, one patient died with extramedullary relapse on day +35, and one from multi-organ failure in association with acute GVHD on day +32 after the second PBSCT.
  • Although several patients achieved complete remission, the high risk of GVHD and treatment-related mortality should be kept in mind, especially when a second transplant is considered during a period of less than 12 months after the first procedure.
  • Monitoring of minimal residual disease might predict relapse thus preventing high doses of cytotoxic drugs for reconditioning.
  • The potential of GM-CSF to enhance the graft-versus-leukemia reactivity after cytoreductive therapy for allogeneic transplantation warrants further investigation.
  • [MeSH-major] Graft vs Leukemia Effect. Hematopoietic Stem Cell Transplantation. Leukemia, Myeloid / therapy. Myelodysplastic Syndromes / therapy
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Female. Graft vs Host Disease. Granulocyte-Macrophage Colony-Stimulating Factor. Humans. Karyotyping. Male. Middle Aged. Recurrence. Transplantation Conditioning. Transplantation, Homologous

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  • (PMID = 11320898.001).
  • [ISSN] 0939-5555
  • [Journal-full-title] Annals of hematology
  • [ISO-abbreviation] Ann. Hematol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 83869-56-1 / Granulocyte-Macrophage Colony-Stimulating Factor
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15. Platzbecker U, Thiede C, Füssel M, Geissler G, Illmer T, Mohr B, Hänel M, Mahlberg R, Krümpelmann U, Weissinger F, Schaich M, Theuser C, Ehninger G, Bornhäuser M: Reduced intensity conditioning allows for up-front allogeneic hematopoietic stem cell transplantation after cytoreductive induction therapy in newly-diagnosed high-risk acute myeloid leukemia. Leukemia; 2006 Apr;20(4):707-14
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Reduced intensity conditioning allows for up-front allogeneic hematopoietic stem cell transplantation after cytoreductive induction therapy in newly-diagnosed high-risk acute myeloid leukemia.
  • There is substantial need to improve the outcome of patients with high-risk acute myeloid leukemia (AML).
  • The clinical trial reported here investigated a new approach of up-front allogeneic hematopoietic stem cell transplantation (HSCT), provided a median of 40 days (range 22-74) after diagnosis, in twenty-six consecutive patients with newly-diagnosed high-risk AML characterized by poor-risk cytogenetics (n = 19) or inadequate blast clearance by induction chemotherapy (IC, n = 7).
  • All patients achieved rapid engraftment and went into remission with complete myeloid and lymphatic chimerism.
  • Grades II to IV acute GvHD occurred in 14 (56%) and extensive chronic GvHD was documented in 8 (35%) patients.
  • The probability of disease-free survival was 61% with only three patients relapsing 5, 6 and 7 months after transplantation, respectively.
  • Up-front allogeneic HSCT as part of primary induction therapy seems to be an effective strategy in high-risk AML patients and warrants further investigation.
  • [MeSH-major] Hematopoietic Stem Cell Transplantation. Leukemia, Myeloid / therapy. Transplantation Conditioning / methods
  • [MeSH-minor] Acute Disease. Adolescent. Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chimerism. Female. Graft vs Host Disease / prevention & control. Graft vs Host Disease / therapy. Humans. Male. Middle Aged. Recurrence. Remission Induction. Risk Factors. Survival Rate. Transplantation, Homologous. Treatment Outcome

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  • (PMID = 16482208.001).
  • [ISSN] 0887-6924
  • [Journal-full-title] Leukemia
  • [ISO-abbreviation] Leukemia
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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16. Savani BN, Montero A, Kurlander R, Childs R, Hensel N, Barrett AJ: Imatinib synergizes with donor lymphocyte infusions to achieve rapid molecular remission of CML relapsing after allogeneic stem cell transplantation. Bone Marrow Transplant; 2005 Dec;36(11):1009-15
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  • [Title] Imatinib synergizes with donor lymphocyte infusions to achieve rapid molecular remission of CML relapsing after allogeneic stem cell transplantation.
  • Donor lymphocyte infusions (DLI) have been the mainstay of treatment for chronic myeloid leukemia (CML) relapsing after allogeneic stem cell transplantation (allo-SCT).
  • However, advanced phase relapse (APRel) responds poorly with either treatment.
  • To test the possibility that combinations of DLI and IM might be more effective, 37 patients with CML relapsing after allo-SCT between August 1994 and May 2004 were studied.
  • Ten had molecular relapse (MRel), 14 hematological relapse (HRel) and 13 APRel.
  • Thirty (81%) patients responded (actuarial survival and current leukemia-free survival of 80.6 +/- 6.7% and 69.1 +/- 7.7%).
  • Of 30 patients, 26 are in molecular remission (MR), median follow-up of 1,226 days (range 249-3257) since relapse.
  • [MeSH-major] Hematopoietic Stem Cell Transplantation. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy. Lymphocyte Transfusion. Piperazines / administration & dosage. Pyrimidines / administration & dosage
  • [MeSH-minor] Adolescent. Adult. Aged. Benzamides. Drug Synergism. Female. Humans. Imatinib Mesylate. Male. Middle Aged. Recurrence. Remission Induction / methods. Retrospective Studies. Survival Analysis. Transplantation, Homologous

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  • (PMID = 16205732.001).
  • [ISSN] 0268-3369
  • [Journal-full-title] Bone marrow transplantation
  • [ISO-abbreviation] Bone Marrow Transplant.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Benzamides; 0 / Piperazines; 0 / Pyrimidines; 8A1O1M485B / Imatinib Mesylate
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17. Sadiq SA, Rammal M, Sara G: Chronic myeloid leukemia associated with mitoxantrone treatment in a patient with MS. Mult Scler; 2008 Mar;14(2):272-3
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  • [Title] Chronic myeloid leukemia associated with mitoxantrone treatment in a patient with MS.
  • We report the first case of chronic myeloid leukemia (CML) in a patient with multiple sclerosis (MS) diagnosed within two years of receiving mitoxantrone therapy.
  • Previously only acute forms of leukemia particularly acute promyelocytic leukemia (APL) have been associated with mitoxantrone treatment in MS.
  • This underscores the need for only using mitoxantrone in severe treatment-unresponsive cases of MS.
  • [MeSH-major] Antineoplastic Agents / adverse effects. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / chemically induced. Mitoxantrone / adverse effects. Multiple Sclerosis, Relapsing-Remitting / drug therapy

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  • (PMID = 17986509.001).
  • [ISSN] 1352-4585
  • [Journal-full-title] Multiple sclerosis (Houndmills, Basingstoke, England)
  • [ISO-abbreviation] Mult. Scler.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; BZ114NVM5P / Mitoxantrone
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18. Rea D, Legros L, Raffoux E, Thomas X, Turlure P, Maury S, Dupriez B, Pigneux A, Choufi B, Reman O, Stéphane D, Royer B, Vigier M, Ojeda-Uribe M, Recher C, Dombret H, Huguet F, Rousselot P, Intergroupe Français des Leucémies Myéloïdes Chronique, Group for Research in Adult Acute Lymphoblastic Leukemia: High-dose imatinib mesylate combined with vincristine and dexamethasone (DIV regimen) as induction therapy in patients with resistant Philadelphia-positive acute lymphoblastic leukemia and lymphoid blast crisis of chronic myeloid leukemia. Leukemia; 2006 Mar;20(3):400-3
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  • [Title] High-dose imatinib mesylate combined with vincristine and dexamethasone (DIV regimen) as induction therapy in patients with resistant Philadelphia-positive acute lymphoblastic leukemia and lymphoid blast crisis of chronic myeloid leukemia.
  • Imatinib combined with high-dose chemotherapy is now becoming the gold standard for treatment of Philadelphia chromosome-positive acute leukemias.
  • Thirty-one patients (18 relapsing or refractory Ph+ acute lymphoblastic leukemias and 13 lymphoid blast crisis chronic myelogenous leukemias) were enrolled.
  • Complete remission (CR) was obtained in 28 out of 30 assessable patients.
  • Median time to neutrophil recovery was 21 days.
  • Nine out of 19 patients under 55 years received allogenic stem cell transplantation after a median time of 78 days post-CR.
  • Patients older than 55 years experienced a 90% CR rate without additional toxicities, suggesting the DIV regimen may also be proposed as a front line therapy in older patients.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Blast Crisis / drug therapy. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • [MeSH-minor] Benzamides. Dexamethasone / administration & dosage. Disease-Free Survival. Dose-Response Relationship, Drug. Drug Resistance, Neoplasm. Humans. Imatinib Mesylate. Pilot Projects. Piperazines / administration & dosage. Pyrimidines / administration & dosage. Vincristine / administration & dosage


19. Worth A, Rao K, Webb D, Chessells J, Passmore J, Veys P: Successful treatment of juvenile myelomonocytic leukemia relapsing after stem cell transplantation using donor lymphocyte infusion. Blood; 2003 Mar 1;101(5):1713-4
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  • [Title] Successful treatment of juvenile myelomonocytic leukemia relapsing after stem cell transplantation using donor lymphocyte infusion.
  • Juvenile myelomonocytic leukemia (JMML) is a rare pediatric malignancy.
  • However, relapse after SCT remains the major cause of treatment failure.
  • Unlike most other pediatric malignancies, JMML may be susceptible to a graft-versus-leukemia (GVL) effect, although, unlike chronic myeloid leukemia, reports of response to donor lymphocyte infusions (DLIs) remain scanty.
  • This is the first report that describes the successful treatment of relapsed JMML with DLI in the absence of further chemotherapy and provides definite proof of a GVL effect in JMML.
  • [MeSH-major] Bone Marrow Transplantation. Graft vs Leukemia Effect. Leukemia, Myelomonocytic, Acute / therapy. Lymphocyte Transfusion
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Humans. Immunosuppression. Infant. Recurrence. Remission Induction. Salvage Therapy. Transplantation Conditioning


20. Fischer T: [Results up to now of administration of STI-571 (Glivec) in recurrence after allogenic and autologous stem cell transplantation in chronic myeloid leukemia]. Med Klin (Munich); 2002 Jan 15;97 Suppl 1:22-7
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  • [Title] [Results up to now of administration of STI-571 (Glivec) in recurrence after allogenic and autologous stem cell transplantation in chronic myeloid leukemia].
  • This report describes the preliminary results in patients relapsing post autologous or allogeneic peripheral blood stem cell transplantation.
  • THERAPY AND RESULTS: 18 of 18 patients with cytogenetic and/or hematologic relapse in chronic phase CML post autologous stem cell transplantation achieved a complete hematologic remission upon therapy with Gleevec.
  • After allogeneic stem cell transplantation, patients in cytogenetic or hematologic relapse also experienced high hematologic and cytogenetic response rates upon therapy with Gleevec.
  • No symptoms of chronic extensive or > grade I acute GvHD could be observed.
  • CONCLUSION: These results show a new approach in treatment of patients with Philadelphia-chromosome-positive leukemia relapsing post autologous or allogeneic stem cell transplantation.
  • The data suggest that early start of STI-571 therapy in MRD-positive patients is a promising approach.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Enzyme Inhibitors / therapeutic use. Hematopoietic Stem Cell Transplantation. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Piperazines / therapeutic use. Pyrimidines / therapeutic use
  • [MeSH-minor] Adolescent. Adult. Benzamides. Child. Clinical Trials as Topic. Female. Humans. Imatinib Mesylate. Male. Middle Aged. Remission Induction. Treatment Outcome


21. Falchi L, Rege-Cambrin G, Fava C, Donti E, Luzi D, Giugliano E, Gubbiotti M, Schippa M, Liberati AM: Sustained molecular remissions are achievable with tyrosine kinase inhibitor therapy in patients with chronic myeloid leukemia and additional cytogenetic clonal evolution. Cancer Genet Cytogenet; 2010 Jun;199(2):139-42
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  • [Title] Sustained molecular remissions are achievable with tyrosine kinase inhibitor therapy in patients with chronic myeloid leukemia and additional cytogenetic clonal evolution.
  • Little is known regarding the activity of tyrosine kinase inhibitors (TKis) on chronic myeloid leukemia (CML) clonal evolution (CE).
  • We treated 10 CE CML patients in either hematologic chronic (8 cases) or accelerated (2 cases) phase with imatinib or second generation TKi.
  • Major or complete molecular remission (CMR) was obtained in four CCyR patients after 21, 25, 22, and 12 months, as well as in a fifth patient who started nilotinib because of suboptimal response after 75 months of imatinib treatment.
  • One patient received nilotinib due to imatinib intolerance after 56 months of therapy while on CMR, and maintained such status.
  • After a median follow-up of 82 months (range, 3-116), six patients are alive, five of which are in continuous CCyR while one patient is in his third CCyR on dasatinib after relapsing on imatinib and nilotinib.
  • Although a small number of patients was studied, our results suggest that long-term cytogenetic and molecular remission can be achieved in CML CE patients with TKis treatment.
  • [MeSH-major] Clone Cells / drug effects. Clone Cells / pathology. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / genetics. Piperazines / therapeutic use. Protein Kinase Inhibitors / therapeutic use. Pyrimidines / therapeutic use
  • [MeSH-minor] Adult. Benzamides. Female. Humans. Imatinib Mesylate. Karyotyping. Male. Middle Aged. Remission Induction. Treatment Outcome

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  • [Copyright] Copyright 2010 Elsevier Inc. All rights reserved.
  • (PMID = 20471518.001).
  • [ISSN] 1873-4456
  • [Journal-full-title] Cancer genetics and cytogenetics
  • [ISO-abbreviation] Cancer Genet. Cytogenet.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Benzamides; 0 / Piperazines; 0 / Protein Kinase Inhibitors; 0 / Pyrimidines; 8A1O1M485B / Imatinib Mesylate
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22. Ocheni S, Iwanski GB, Schafhausen P, Zander AR, Ayuk F, Klyuchnikov E, Zabelina T, Fiedler W, Schnittger S, Hochhaus A, Brümmendorf TH, Kröger N, Bacher U: Characterisation of extramedullary relapse in patients with chronic myeloid leukemia in advanced disease after allogeneic stem cell transplantation. Leuk Lymphoma; 2009 Apr;50(4):551-8
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  • [Title] Characterisation of extramedullary relapse in patients with chronic myeloid leukemia in advanced disease after allogeneic stem cell transplantation.
  • Recently, higher extramedullary relapse rates following allogeneic stem cell transplantation (SCT) in myeloid malignancies were reported e.g. because of selection of poor-risk patients.
  • We analysed five consecutive patients with post-transplant extramedullary relapse of chronic myeloid leukemia (CML) out of a total of 24 patients (21%) undergoing allo-SCT.
  • All five patients with extramedullary relapse had clonal evolution and a history of blast phase (BP).
  • In particular, 56% of the patients in BP had extramedullary relapse with no extramedullary relapse in patients with chronic/accelerated phase.
  • Most frequent manifestation sites were the skeletal system, the muscles/subcutaneous tissue and the central nervous system.
  • Combined approaches were performed including irradiation (n = 4), chemotherapy (n = 2), IM (n = 2), dasatinib (n = 4), nilotinib (n = 1), a novel aurora-kinase-inhibitor (n = 1), donor lymphocytes (n = 2) or a second allo-SCT (n = 2).
  • Research should focus on prospective studies aiming to improve treatment of extramedullary relapse in stem cell recipients with CML with a special focus on the role of second generation tyrosine kinase inhibitors.
  • [MeSH-major] Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy. Stem Cell Transplantation / methods
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Benzamides. Cytarabine / administration & dosage. Dasatinib. Dexamethasone / administration & dosage. Female. Humans. Imatinib Mesylate. Immunotherapy, Adoptive. Male. Middle Aged. Piperazines / administration & dosage. Pyrimidines / administration & dosage. Radiotherapy. Recurrence. Thiazoles / administration & dosage. Transplantation, Homologous. Treatment Outcome


23. Shvidel L, Shtalrid M, Bairey O, Rahimi-Levene N, Lugassy G, Shpilberg O, Polliack A, Berrebi A, Israeli Study Group on CLL: Conventional dose fludarabine-based regimens are effective but have excessive toxicity in elderly patients with refractory chronic lymphocytic leukemia. Leuk Lymphoma; 2003 Nov;44(11):1947-50
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  • [Title] Conventional dose fludarabine-based regimens are effective but have excessive toxicity in elderly patients with refractory chronic lymphocytic leukemia.
  • The best approach to elderly patients with relapsing chronic lymphocytic leukemia (CLL) or disease refractory to conventional therapy with alkylating agents has not yet been established.
  • Fludarabine and its combination with mitoxantrone and/or cyclophosphamide, which is the most effective treatment in younger patients, has not been extensively utilized in the elderly CLL.
  • Here we report our results with fludarabine-based chemotherapy in 32 previously treated patients over the age of 65 years.
  • The median time to progression of disease was 7 months.
  • Only 10 patients completed the entire treatment program, because of poor compliance due to toxicity.
  • Eight patients developed neutropenic fever, 14 severe bacterial infections and 2 patients showed progressive encephalopathy.
  • For comparison, in a younger group of patients with refractory CLL (< 65 years), 38 of 50 patients completed the treatment plan, and the ORR was 80% (10 CR, 11 PR-nodular, 19 PR) with a median response of 12 months.
  • In conclusion, fludarabine-based chemotherapy is effective for refractory CLL, however, excessive toxicity such as severe infections and neurological complications, do not allow completion of treatment in the majority of the elderly patients.
  • Because maintenance of a good quality of life should be the main goal in the elderly CLL population, dose reduction of fludarabine and the appropriate use of myeloid growth factors and prophylactic antibiotics appear mandatory in this group of patients.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy. Salvage Therapy. Vidarabine / analogs & derivatives
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Cyclophosphamide / administration & dosage. Dose-Response Relationship, Drug. Drug-Related Side Effects and Adverse Reactions. Female. Humans. Male. Middle Aged. Mitoxantrone / administration & dosage. Remission Induction. Survival Rate. Treatment Outcome

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  • (PMID = 14738148.001).
  • [ISSN] 1042-8194
  • [Journal-full-title] Leukemia & lymphoma
  • [ISO-abbreviation] Leuk. Lymphoma
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 8N3DW7272P / Cyclophosphamide; BZ114NVM5P / Mitoxantrone; FA2DM6879K / Vidarabine; P2K93U8740 / fludarabine
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24. Lin JT, Lee MY, Hsiao LT, Yang MH, Chao TC, Chen PM, Chiou TJ: Pulmonary nocardiosis in a patient with CML relapse undergoing imatinib therapy after bone marrow transplantation. Ann Hematol; 2004 Jul;83(7):444-6
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  • [Title] Pulmonary nocardiosis in a patient with CML relapse undergoing imatinib therapy after bone marrow transplantation.
  • We describe a case of pulmonary nocardiosis in a female patient with graft-versus-host disease (GVHD) underwent therapy with imatinib mesylate for a relapse of chronic myeloid leukemia (CML) after allogeneic bone marrow transplantation (BMT).
  • The patient developed chronic GVHD 8 months after the use of imatinib and was on corticosteroid therapy.
  • Three months after the development of chronic GVHD, she acquired pulmonary nocardiosis and a computed tomography (CT) scan of the chest showed multiple nodular lesions with cavitations over both lungs.
  • Our case indicated that pulmonary nocardiosis could occur in patients with GVHD undergoing imatinib and corticosteroid therapy and might be treated by single-agent TMP/SMX.
  • [MeSH-major] Bone Marrow Transplantation. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / complications. Nocardia Infections / etiology. Nocardia asteroides / isolation & purification. Piperazines / therapeutic use. Pneumonia, Bacterial / etiology. Pyrimidines / therapeutic use
  • [MeSH-minor] Adrenal Cortex Hormones / adverse effects. Adrenal Cortex Hormones / therapeutic use. Adult. Anti-Bacterial Agents / therapeutic use. Benzamides. Bronchiolitis Obliterans / etiology. Female. Graft vs Host Disease / complications. Humans. Imatinib Mesylate. Immunosuppressive Agents / adverse effects. Immunosuppressive Agents / therapeutic use. Lung / radiography. Tomography, X-Ray Computed. Transplantation, Homologous. Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use

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  • (PMID = 14689232.001).
  • [ISSN] 0939-5555
  • [Journal-full-title] Annals of hematology
  • [ISO-abbreviation] Ann. Hematol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Adrenal Cortex Hormones; 0 / Anti-Bacterial Agents; 0 / Benzamides; 0 / Immunosuppressive Agents; 0 / Piperazines; 0 / Pyrimidines; 8064-90-2 / Trimethoprim, Sulfamethoxazole Drug Combination; 8A1O1M485B / Imatinib Mesylate
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25. Wassmann B, Scheuring U, Thiede C, Pfeifer H, Bornhäuser M, Griesinger F, Hochhaus A, Schleyer E, Gschaidmeier H, Hoelzer D, Ottmann OG: Stable molecular remission induced by imatinib mesylate (STI571) in a patient with CML lymphoid blast crisis relapsing after allogeneic stem cell transplantation. Bone Marrow Transplant; 2003 Apr;31(7):611-4
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  • [Title] Stable molecular remission induced by imatinib mesylate (STI571) in a patient with CML lymphoid blast crisis relapsing after allogeneic stem cell transplantation.
  • We report the response to the ABL kinase inhibitor imatinib mesylate (STI571) in a patient with chronic myeloid leukemia (CML) who relapsed twice after dose-reduced allogeneic stem cell transplantation (alloSCT) for B lymphoid blast crisis (BC) and failed to develop an antileukemic response despite grade 3 graft-versus-host disease (GvHD).
  • Complete hematologic, cytogenetic and molecular responses were achieved within 9 weeks of therapy and are maintained after 27 months.
  • Extensive chronic skin GvHD necessitating immunosuppressive therapy developed after 14 months.
  • This case illustrates the ability of imatinib to induce sustained hematologic and molecular remissions in some patients relapsing with advanced stage CML after alloSCT.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Blast Crisis / drug therapy. Hematopoietic Stem Cell Transplantation. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Piperazines / administration & dosage. Pyrimidines / administration & dosage

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  • (PMID = 12692630.001).
  • [ISSN] 0268-3369
  • [Journal-full-title] Bone marrow transplantation
  • [ISO-abbreviation] Bone Marrow Transplant.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Benzamides; 0 / Piperazines; 0 / Pyrimidines; 8A1O1M485B / Imatinib Mesylate
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26. Hiçsönmez G, Cetin M, Yenicesu I, Olcay L, Koç A, Aktaş D, Tunçbilek E, Tuncer M: Evaluation of children with myelodysplastic syndrome: importance of extramedullary disease as a presenting symptom. Leuk Lymphoma; 2001 Aug;42(4):665-74
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  • Three patients with juvenile myelomonocytic leukemia (JMML) and 2 patients with chronic myelomonocytic leukemia (CMML) presented with pleural effusion.
  • Pyoderma gangrenosum, relapsing polychondritis were the initial findings in another two cases with JMML.
  • Since high-dose methylprednisolone (HDMP, 20-30 mg/kg/day) has been shown to induce differentiation and apoptosis of myeloid leukemic cells in children with different morphological subtypes of acute myeloid leukemia in vivo and in vitro, 25 children with de novo MDS were treated with combined HDMP and cytotoxic chemotherapy.
  • Dramatic improvement of EMD and decrease in blast cells both in the peripheral blood and bone marrow were obtained following administration of short-course HDMP treatment alone as observed in children with AML.
  • In addition, the beneficial effect of HDMP combined with more intensive chemotherapy should be explored as alternative therapy in children with MDS not suitable for bone marrow transplantation.
  • [MeSH-major] Myelodysplastic Syndromes / drug therapy. Myelodysplastic Syndromes / pathology
  • [MeSH-minor] Adolescent. Anti-Inflammatory Agents / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Child. Child, Preschool. Diagnosis, Differential. Female. Humans. Infant. Leukemia, Myelomonocytic, Chronic / diagnosis. Leukemia, Myelomonocytic, Chronic / drug therapy. Male. Methylprednisolone / administration & dosage. Prospective Studies. Remission Induction. Sarcoma, Myeloid / diagnosis. Sarcoma, Myeloid / drug therapy. Treatment Outcome


27. Blair A, Goulden NJ, Libri NA, Oakhill A, Pamphilon DH: Immunotherapeutic strategies in acute lymphoblastic leukaemia relapsing after stem cell transplantation. Blood Rev; 2005 Nov;19(6):289-300
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  • [Title] Immunotherapeutic strategies in acute lymphoblastic leukaemia relapsing after stem cell transplantation.
  • Acute lymphoblastic leukaemia (ALL) responds well to chemotherapy and the majority of children and a significant proportion of adults are cured of their disease after primary therapy.
  • However, a number of patients relapse and allogeneic transplantation following conditioning with chemotherapy and radiotherapy offers the possibility of long-term survival in a proportion of these patients.
  • A significant number of patients with ALL develop disease that is refractory to further therapy.
  • The infusion of unmodified donor lymphocytes (DLI) following relapse after allogeneic transplantation has been shown to be curative in patients with chronic myeloid leukaemia (CML).
  • Other approaches include exploiting the expression of leukaemia-specific antigens such as the proteinase PR-3 or the zinc finger transcription factor Wilms tumour-1 protein (WT-1) to stimulate CTL responses.
  • In vivo studies to date suggest that educated T-cells may have a role to play in the treatment of relapsed and refractory ALL in the future.
  • [MeSH-major] Immunotherapy, Adoptive. Lymphocyte Transfusion. Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy. Stem Cell Transplantation. Transplantation Conditioning
  • [MeSH-minor] Adult. Child. Child, Preschool. Dendritic Cells / immunology. Dendritic Cells / transplantation. Female. Graft vs Leukemia Effect / immunology. Humans. Male. Neoplasm Proteins / immunology. Secondary Prevention. T-Lymphocyte Subsets / immunology. T-Lymphocyte Subsets / transplantation. T-Lymphocytes, Cytotoxic / immunology. T-Lymphocytes, Cytotoxic / transplantation. Transplantation, Homologous

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  • (PMID = 16275419.001).
  • [ISSN] 0268-960X
  • [Journal-full-title] Blood reviews
  • [ISO-abbreviation] Blood Rev.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] Scotland
  • [Chemical-registry-number] 0 / Neoplasm Proteins
  • [Number-of-references] 89
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28. Lange T, Deininger M, Brand R, Hegenbart U, Al-Ali H, Krahl R, Poenisch W, Uharek L, Leiblein S, Gentilini C, Petersdorf E, Storb RF, Niederwieser D: BCR-ABL transcripts are early predictors for hematological relapse in chronic myeloid leukemia after hematopoietic cell transplantation with reduced intensity conditioning. Leukemia; 2004 Sep;18(9):1468-75
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  • [Title] BCR-ABL transcripts are early predictors for hematological relapse in chronic myeloid leukemia after hematopoietic cell transplantation with reduced intensity conditioning.
  • Kinetics of BCR-ABL transcript elimination and its prognostic implications on relapse were analyzed in patients with chronic myeloid leukemia (CML) after reduced intensity hematopoietic cell transplantation (HCT).
  • In all, 19 CML patients were conditioned with 2 Gy total-body irradiation in combination with (n=14) or without (n=3) fludarabine 3 x 30 mg/m(2) (Flu) or 4.5 Gy total lymphoid irradiation (TLI) with Flu and OKT3 3 x 5 mg (n=2) and were treated with cyclosporine (CSP) and mycophenolate mofetil after allogeneic HCT.
  • BCR-ABL transcripts were analyzed by nested RT-PCR and Taqman((R)) RT-PCR on days +28, +56 and +84 after HCT and were evaluated for their association with relapse.
  • Predictors for relapse were advanced disease stage (P=0.02) and slow reduction of BCR-ABL transcripts at day 28 (P=0.006) and day 56 (P=0.047) post-transplant.
  • We conclude that a complete clearance of BCR-ABL transcripts is achievable within 4 weeks from HCT even after minimal conditioning and that early kinetics of BCR-ABL transcripts significantly correlate with the probability of hematological relapse.
  • [MeSH-major] Fusion Proteins, bcr-abl / genetics. Hematopoietic Stem Cell Transplantation. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / diagnosis. Mycophenolic Acid / analogs & derivatives. Neoplasm Recurrence, Local / diagnosis. RNA, Messenger / analysis. Transplantation Conditioning. Vidarabine / analogs & derivatives
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Cyclosporine / administration & dosage. Female. Hematopoietic System / drug effects. Hematopoietic System / radiation effects. Humans. Male. Middle Aged. Prognosis. RNA, Neoplasm / genetics. RNA, Neoplasm / metabolism. Reverse Transcriptase Polymerase Chain Reaction. Sensitivity and Specificity. Transplantation, Homologous. Whole-Body Irradiation


29. Olavarria E, Ottmann OG, Deininger M, Clark RE, Bandini G, Byrne J, Lipton J, Vitek A, Michallet M, Siegert W, Ullmann A, Wassmann B, Niederwieser D, Fischer T, Chronic Leukaemia Working Party of the European Group of Bone and Marrow Transplantation (EBMT): Response to imatinib in patients who relapse after allogeneic stem cell transplantation for chronic myeloid leukemia. Leukemia; 2003 Sep;17(9):1707-12
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  • [Title] Response to imatinib in patients who relapse after allogeneic stem cell transplantation for chronic myeloid leukemia.
  • We studied 128 patients with chronic myeloid leukemia (CML) relapsing after allogeneic stem cell transplantation (SCT).
  • Disease at the time of treatment with Imatinib was in chronic phase (CP) in 51 patients, accelerated phase (AP) in 31 and blastic crisis (BC) in 46.
  • The median interval between relapse and Imatinib therapy was 5 months (0-65).
  • A total of 50 patients had failed treatment with donor lymphocyte infusions prior to Imatinib.
  • The overall hemato-logical response rate was 84% (98% for patients relapsing in CP).
  • We conclude that Imatinib has significant activity against CML in relapse after allogeneic SCT.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Hematopoietic Stem Cell Transplantation / adverse effects. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Neoplasm Recurrence, Local / drug therapy. Piperazines / therapeutic use. Pyrimidines / therapeutic use
  • [MeSH-minor] Adult. Aged. Benzamides. Female. Graft vs Leukemia Effect. Humans. Imatinib Mesylate. Male. Middle Aged. Retrospective Studies. Salvage Therapy. Survival Rate. Transplantation, Homologous. Treatment Outcome


30. Pawson R, Potter MN, Theocharous P, Lawler M, Garg M, Yin JA, Rezvani K, Craddock C, Rassam S, Prentice HG: Treatment of relapse after allogeneic bone marrow transplantation with reduced intensity conditioning (FLAG +/- Ida) and second allogeneic stem cell transplant. Br J Haematol; 2001 Dec;115(3):622-9
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  • [Title] Treatment of relapse after allogeneic bone marrow transplantation with reduced intensity conditioning (FLAG +/- Ida) and second allogeneic stem cell transplant.
  • Acute leukaemias in relapse after allogeneic stem cell transplantation (SCT) respond poorly to donor leucocyte infusions (DLI) compared with chronic myeloid leukaemia (CML), at least in part because of faster disease kinetics.
  • Fludarabine-containing 'non-myeloablative' chemotherapy followed by further allo SCT may offer more rapid and effective disease control.
  • We report 14 patients with relapse after allo SCT for acute leukaemia [seven acute myeloid leukaemia (AML), five acute lymphoblastic leukaemia (ALL)] or refractory anaemia with excess blasts in transformation (RAEB-t, n = 2) treated with fludarabine, high-dose cytosine arabinoside (ara-C) and granulocyte colony-simulating factor (G-CSF) with (n = 10) or without (n = 2) idarubicin (FLAG +/- Ida) or DaunoXome (FLAG-X) (n = 2) and second allo SCT from the original donor.
  • Transplants were well tolerated with no treatment-related deaths.
  • The major complication was graft-versus-host disease (GvHD, acute >/= grade II-2 cases, chronic - eight cases, two limited, six extensive) although there have been no deaths attributable to this.
  • FLAG +/- Ida and second allo SCT is a safe and useful approach and may be more effective than DLI in the treatment of acute leukaemias relapsing after conventional allo SCT.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Bone Marrow Transplantation. Cytarabine / administration & dosage. Granulocyte Colony-Stimulating Factor / administration & dosage. Idarubicin / administration & dosage. Leukemia / therapy. Transplantation Conditioning / methods. Vidarabine / administration & dosage. Vidarabine / analogs & derivatives
  • [MeSH-minor] Acute Disease. Adult. Anemia, Refractory, with Excess of Blasts / therapy. Child. Child, Preschool. Disease-Free Survival. Female. Filgrastim. Graft vs Host Disease / immunology. Graft vs Host Disease / prevention & control. Humans. Leukemia, Myeloid / therapy. Male. Middle Aged. Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy. Recombinant Proteins. Recurrence. Reoperation. Retrospective Studies. Survival Rate. Transplantation, Homologous

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  • (PMID = 11736947.001).
  • [ISSN] 0007-1048
  • [Journal-full-title] British journal of haematology
  • [ISO-abbreviation] Br. J. Haematol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Recombinant Proteins; 04079A1RDZ / Cytarabine; 143011-72-7 / Granulocyte Colony-Stimulating Factor; FA2DM6879K / Vidarabine; PVI5M0M1GW / Filgrastim; ZRP63D75JW / Idarubicin; Ida-FLAG protocol
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31. Pascual AM, Téllez N, Boscá I, Mallada J, Belenguer A, Abellán I, Sempere AP, Fernández P, Magraner MJ, Coret F, Sanz MA, Montalbán X, Casanova B: Revision of the risk of secondary leukaemia after mitoxantrone in multiple sclerosis populations is required. Mult Scler; 2009 Nov;15(11):1303-10
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  • [Title] Revision of the risk of secondary leukaemia after mitoxantrone in multiple sclerosis populations is required.
  • The objective in this paper is to compare the cumulative incidence and incidence density of therapy-related acute myeloid leukaemia in two cohorts of patients with multiple sclerosis treated with mitoxantrone, and with previously reported data in the literature.
  • Six new cases of acute myeloid leukaemia were observed by prospectively following two Spanish series of 142 and 88 patients with worsening relapsing multiple sclerosis and secondary-progressive disease treated with mitoxantrone.
  • A literature review shows 32 further cases of acute myeloid leukaemia reported, 65.6% of which are therapy-related acute promyelocytic leukaemia.
  • Five cases in the cohorts fulfilled the diagnostic criteria for acute promyelocytic leukaemia, and one patient was diagnosed with pre-B-acute lymphoblastic leukaemia.
  • Acute myeloid leukaemia latency after mitoxantrone discontinuation was 1 to 45 months.
  • The real incidence of acute myeloid leukaemia after mitoxantrone therapy in the multiple sclerosis population could be higher as evidenced by the growing number of cases reported.
  • [MeSH-major] Antineoplastic Agents / adverse effects. Leukemia, Myeloid, Acute / chemically induced. Leukemia, Myeloid, Acute / epidemiology. Mitoxantrone / adverse effects. Multiple Sclerosis / complications
  • [MeSH-minor] Adolescent. Adult. Aged. Anti-Inflammatory Agents / therapeutic use. Child. Cohort Studies. Female. Humans. Interferon Type I / therapeutic use. Male. Mediterranean Region / epidemiology. Methylprednisolone / therapeutic use. Middle Aged. Multiple Sclerosis, Chronic Progressive / complications. Multiple Sclerosis, Chronic Progressive / drug therapy. Multiple Sclerosis, Relapsing-Remitting / complications. Multiple Sclerosis, Relapsing-Remitting / drug therapy. Prospective Studies. Recombinant Proteins. Risk Assessment. Young Adult

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  • (PMID = 19825889.001).
  • [ISSN] 1477-0970
  • [Journal-full-title] Multiple sclerosis (Houndmills, Basingstoke, England)
  • [ISO-abbreviation] Mult. Scler.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Anti-Inflammatory Agents; 0 / Antineoplastic Agents; 0 / Interferon Type I; 0 / Recombinant Proteins; BZ114NVM5P / Mitoxantrone; X4W7ZR7023 / Methylprednisolone
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32. Bourgeois E, Caulier MT, Rose C, Dupriez B, Bauters F, Fenaux P: Role of splenectomy in the treatment of myelodysplastic syndromes with peripheral thrombocytopenia: a report on six cases. Leukemia; 2001 Jun;15(6):950-3
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  • [Title] Role of splenectomy in the treatment of myelodysplastic syndromes with peripheral thrombocytopenia: a report on six cases.
  • Platelets counts ranged from 5000 to 30,000/mm3 and did not durably respond to other treatments.
  • Three of the patients has a relapse of platelet counts, concomitantly required platelet transfusion due to recurrent blending, whereas three had anemia (two required erythrocyte transfusion) and four had neutropenia.
  • Three patients had a relapse of platelet counts, concomitant with progression to AML in two of them, whereas the third relapsing case achieved normal platelet counts with further danazol.
  • [MeSH-minor] Acute Disease. Adrenal Cortex Hormones / therapeutic use. Adult. Aged. Anemia, Refractory / blood. Anemia, Refractory / drug therapy. Anemia, Refractory / surgery. Anemia, Refractory, with Excess of Blasts / blood. Anemia, Refractory, with Excess of Blasts / drug therapy. Anemia, Refractory, with Excess of Blasts / surgery. Autoimmune Diseases / etiology. Blood Platelets / pathology. Cell Aging. Cerebral Hemorrhage / etiology. Cerebral Hemorrhage / mortality. Combined Modality Therapy. Danazol / therapeutic use. Disease Progression. Female. Follow-Up Studies. Humans. Immunoglobulins, Intravenous / therapeutic use. Interleukin-3 / therapeutic use. Leukemia, Myeloid / mortality. Leukemia, Myelomonocytic, Chronic / blood. Leukemia, Myelomonocytic, Chronic / drug therapy. Leukemia, Myelomonocytic, Chronic / surgery. Male. Middle Aged. Neutropenia / etiology. Platelet Count. Recurrence. Retrospective Studies. Sjogren's Syndrome / etiology. Treatment Outcome. Treatment Refusal. Vasculitis / etiology

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  • (PMID = 11417482.001).
  • [ISSN] 0887-6924
  • [Journal-full-title] Leukemia
  • [ISO-abbreviation] Leukemia
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Adrenal Cortex Hormones; 0 / Immunoglobulins, Intravenous; 0 / Interleukin-3; N29QWW3BUO / Danazol
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33. Riera L, Koziner B: [Donor lymphocyte infusions as adoptive immunotherapy in patients with relapsed hematologic neoplasms post-allogenic transplant of hematopoietic progenitor cells]. Medicina (B Aires); 2000;60(2):259-69
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  • An increasing body of literature has documented the usefulness of donor lymphocyte infusions in inducing remissions in patients relapsing post allogeneic hematopoietic progenitor cell transplantation.
  • Efficacy was shown to depend on the disease entity; the best results have been reported in chronic myeloid leukemia in chronic phase, where the remission rate varied between 60 and 80%.
  • In acute myeloid leukemia and myelodysplastic syndromes the remission rate ranged between 20 and 40% and in multiple myeloma the response rate was approximately 40%.
  • In contrast, results have been poor in acute lymphoid leukemia with only 10-20% and even lower reported responses.
  • Considering the efficacy of donor lymphocyte infusions in inducing responses in several hematologic neoplasias post allogeneic transplantation, as will be described in detail in this review, it is justified to anticipate an increasing role for this modality of treatment in relapsed non transplanted patients and as maintenance of the responses achieved with chemotherapy at conventional or high doses.
  • [MeSH-major] Hematologic Neoplasms / etiology. Hematologic Neoplasms / therapy. Hematopoietic Stem Cell Transplantation. Immunotherapy, Adoptive / methods. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy. Lymphocyte Transfusion / methods
  • [MeSH-minor] Humans. Killer Cells, Natural / immunology. Multiple Myeloma / therapy. Recurrence. T-Lymphocytes / immunology. Tumor Lysis Syndrome / immunology

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  • (PMID = 10962823.001).
  • [ISSN] 0025-7680
  • [Journal-full-title] Medicina
  • [ISO-abbreviation] Medicina (B Aires)
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] ARGENTINA
  • [Number-of-references] 87
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34. Depil S, Deconinck E, Milpied N, Sutton L, Witz F, Jouet JP, Damaj G, Yakoub-Agha I, Société Française de Greffe de Moelle et Thérapie cellulaire: Donor lymphocyte infusion to treat relapse after allogeneic bone marrow transplantation for myelodysplastic syndrome. Bone Marrow Transplant; 2004 Mar;33(5):531-4
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  • [Title] Donor lymphocyte infusion to treat relapse after allogeneic bone marrow transplantation for myelodysplastic syndrome.
  • Donor lymphocyte infusion has become established as a salvage therapy for patients with hematological disorders relapsing after allogeneic bone marrow transplantation (BMT).
  • Between July 1993 and October 2001, 14 patients with MDS relapsing after allogeneic BMT received DLI as salvage therapy.
  • At the time of BMT, one patient had RA, nine had RAEB, of whom three were in CR after induction-type chemotherapy, two had RAEB-T, one had CMML and one had AML.
  • At the time of relapse, the median marrow blast count was 9%.
  • With a median follow-up of 49 months, six patients were alive, of whom two were in CR after DLI alone and remained disease-free, two were in CR after a second BMT and two had active disease.
  • Although DLI alone seems to be effective in a small number of patients with MDS, other treatment strategies, including prior debulking chemotherapy, deserve investigation.
  • [MeSH-major] Bone Marrow Transplantation. Lymphocyte Transfusion. Myelodysplastic Syndromes / immunology. Myelodysplastic Syndromes / therapy
  • [MeSH-minor] Acute Disease. Adult. Anemia, Refractory, with Excess of Blasts / therapy. Female. Graft vs Host Disease. Humans. Leukemia, Myeloid / therapy. Leukemia, Myelomonocytic, Chronic / therapy. Male. Middle Aged. Recurrence. Tissue Donors. Transplantation, Homologous. Treatment Outcome


35. Wu HX, Qian SX, Hong M, Zhang YP, Lu H, Zhang R, Zhang XY, Chen LJ, Lu RN, Zhang SJ, Liu P, Ge Z, Fan L, Wang L, Xu J, Tian T, Zhu Y, Qiu HX, Xu W, Sheng RL, Li JY: [Allogeneic peripheral blood stem cell transplantation for 75 cases of hematologic malignancies]. Zhongguo Shi Yan Xue Ye Xue Za Zhi; 2008 Dec;16(6):1330-3
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  • 75 patients included 35 patients with chronic myeloid leukemia (CML), 30 patients with acute myeloid leukemia, 5 patients with severe aplastic anemia, 3 patients with acute lymphocytic leukemia, one patients with multiple myeloma and one patients with paroxysmal nocturnal hemoglobinuria.
  • Relapsing patients after transplantation received DLI and/or chemotherapy.
  • The median time for the initial hematopoietic reconstitution was 15 (5-25) days.
  • Among 29 dead patients, 9 died of disease relapse, 7 died of III-IV grade of acute GVHD and 7 died of severe infection (2 patients developed interstitial pneumonia).
  • 9 out of 14 patients received haploidentical transplantation were alive, and the time of event-free survival was 30 (6-53) months, the mean survival time of 5 died patients was 7 (2-17) months.
  • It is concluded that allo-PBSCT is effective to treat refractory hematologic diseases, and DLI/or chemotherapy should be used in the patients relapsing after transplantation.

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  • (PMID = 19099638.001).
  • [ISSN] 1009-2137
  • [Journal-full-title] Zhongguo shi yan xue ye xue za zhi
  • [ISO-abbreviation] Zhongguo Shi Yan Xue Ye Xue Za Zhi
  • [Language] CHI
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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36. de Lima M, van Besien K, Gajewski J, Khouri I, Andersson B, Korbling M, Champlin R, Giralt S: High-dose melphalan and allogeneic peripheral blood stem cell transplantation for treatment of early relapse after allogeneic transplant. Bone Marrow Transplant; 2000 Aug;26(3):333-8
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  • [Title] High-dose melphalan and allogeneic peripheral blood stem cell transplantation for treatment of early relapse after allogeneic transplant.
  • Patients with acute leukemias relapsing within 1 year of an allogeneic BMT have a poor prognosis.
  • We studied the use of melphalan 180 mg/m2 followed by allogeneic peripheral blood stem cells (PBSC) as salvage treatment for patients relapsing after related (n = 7) or matched unrelated transplants (n = 3).
  • Diagnoses were AML (n = 4), ALL (n = 3), biphenotypic acute leukemia (n = 2) and CML in blast crisis (n = 1).
  • Eight patients were beyond first relapse and none were in remission.
  • The median time from previous transplant to relapse was 146 days (range 66-206).
  • The median time to an absolute neutrophil count >0.5 x 10(9)/l and to a platelet count >20 x 10(9)/l was 11 and 13 days, respectively.
  • Acute GVHD grades II-III occurred in two subjects, and chronic GVHD in four.
  • Seven patients achieved CR, but relapsed at a median of 116 days (range 56-614).
  • Leukemia was the cause of death in eight patients.
  • This treatment produced responses in the majority of this poor prognosis group.
  • However, durable remissions were not observed, and new treatments to consolidate the responses achieved in this setting are needed.
  • [MeSH-major] Antineoplastic Agents, Alkylating / therapeutic use. Bone Marrow Transplantation. Hematopoietic Stem Cell Transplantation. Leukemia, Myeloid, Acute / therapy. Melphalan / therapeutic use. Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy
  • [MeSH-minor] Acute Disease. Adult. Child. Chronic Disease. Combined Modality Therapy. Dose-Response Relationship, Drug. Female. Graft vs Host Disease / etiology. Humans. Male. Middle Aged. Pilot Projects. Remission Induction. Transplantation Chimera


37. Au WY, Lie AK, Ma SK, Wan TS, Liang R, Chan EC, Kwong YL: Tyrosine kinase inhibitor STI571 in the treatment of Philadelphia chromosome-positive leukaemia failing myeloablative stem cell transplantation. Bone Marrow Transplant; 2002 Oct;30(7):453-7
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  • [Title] Tyrosine kinase inhibitor STI571 in the treatment of Philadelphia chromosome-positive leukaemia failing myeloablative stem cell transplantation.
  • Eight patients with Philadelphia chromosome-positive (Ph(+)) leukaemia relapsing from stem cell transplantation (SCT) (one syngeneic and seven allogeneic) were treated with the tyrosine kinase inhibitor STI571.
  • Five patients relapsing as chronic myeloid leukaemia (CML) in chronic phase achieved a complete haematological response, with complete and major cytogenetic responses occurring in four and one cases, respectively.
  • Three patients relapsed as acute leukaemia (two CML in myeloblastic crisis and one Ph(+) acute lymphoblastic leukaemia), all of whom achieved haematological and cytogenetic responses.
  • However, pancytopenia and graft-versus-host disease led to cessation of treatment in the remaining two cases, which was followed by disease recurrence refractory to further STI treatment.
  • Our results showed that Ph(+) leukaemic relapses after SCT might respond well to STI571 therapy.
  • [MeSH-major] Hematopoietic Stem Cell Transplantation. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Piperazines / administration & dosage. Pyrimidines / administration & dosage. Salvage Therapy / methods
  • [MeSH-minor] Adolescent. Adult. Benzamides. Drug Evaluation. Female. Fusion Proteins, bcr-abl / genetics. Humans. Imatinib Mesylate. Male. Middle Aged. Myeloablative Agonists. RNA, Neoplasm / analysis. Recurrence. Remission Induction. Transplantation Conditioning / methods. Transplantation, Homologous. Treatment Outcome

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  • (PMID = 12368958.001).
  • [ISSN] 0268-3369
  • [Journal-full-title] Bone marrow transplantation
  • [ISO-abbreviation] Bone Marrow Transplant.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Benzamides; 0 / Myeloablative Agonists; 0 / Piperazines; 0 / Pyrimidines; 0 / RNA, Neoplasm; 8A1O1M485B / Imatinib Mesylate; EC 2.7.10.2 / Fusion Proteins, bcr-abl
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38. Hasselbalch HC, Birgens H, Dufva IH, Dalseg AM, Brown Pde N, Jensen MK, Vangsted A: [Novel medical treatment modalities in hematology]. Ugeskr Laeger; 2008 Jun 9;170(24):2115-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Novel medical treatment modalities in hematology].
  • Today several monoclonal antibodies, including the anti-CD20 antibody (rituximab), the anti-CD52 antibody (alemtuzumab) and the anti-CD33 antibody (gemtuzumab ozogamacin) are all integrated in the therapeutic armamentarium of patients with malignant lymphoma, chronic lymphocytic leukaemia and acute myelogenous leukaemia, respectively.
  • Rituximab has also been shown to be highly effective in the treatment of refractory autoimmune haemolytic anemias, idiopathic thrombocytopenia, and relapsing thrombotic thrombocytopenic purpura.
  • New signal transduction inhibitors, dasatinib and nilotinib, are being used in patients with chronic myelogeneous leukaemia who develop resistance to imatinib.
  • [MeSH-major] Antibodies, Monoclonal / therapeutic use. Antineoplastic Agents / therapeutic use. Hematologic Diseases / drug therapy. Immunologic Factors / therapeutic use. Leukemia / drug therapy. Lymphoma / drug therapy
  • [MeSH-minor] Aminoglycosides / therapeutic use. Anemia, Hemolytic / drug therapy. Antibodies, Monoclonal, Humanized. Antibodies, Monoclonal, Murine-Derived. Benzamides. Benzoates / therapeutic use. Boronic Acids / therapeutic use. Bortezomib. Carbazoles / therapeutic use. Carrier Proteins / therapeutic use. Cyclophosphamide / therapeutic use. Dasatinib. Humans. Hydrazines / therapeutic use. Imatinib Mesylate. Indoles / therapeutic use. Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy. Leukemia, Myeloid, Acute / drug therapy. Multiple Myeloma / drug therapy. Myelodysplastic Syndromes / drug therapy. Piperazines / therapeutic use. Purpura, Thrombocytopenic / drug therapy. Pyrazines / therapeutic use. Pyrazoles / therapeutic use. Pyrimidines / therapeutic use. Receptors, Fc / therapeutic use. Recombinant Fusion Proteins. Rituximab. Thalidomide / analogs & derivatives. Thalidomide / therapeutic use. Thiazoles / therapeutic use. Thrombopoietin. Vidarabine / analogs & derivatives. Vidarabine / therapeutic use

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  • (PMID = 18565291.001).
  • [ISSN] 1603-6824
  • [Journal-full-title] Ugeskrift for laeger
  • [ISO-abbreviation] Ugeskr. Laeg.
  • [Language] dan
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Denmark
  • [Chemical-registry-number] 0 / 4-methyl-N-(3-(4-methylimidazol-1-yl)-5-(trifluoromethyl)phenyl)-3-((4-pyridin-3-ylpyrimidin-2-yl)amino)benzamide; 0 / Aminoglycosides; 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Antineoplastic Agents; 0 / Benzamides; 0 / Benzoates; 0 / Boronic Acids; 0 / Carbazoles; 0 / Carrier Proteins; 0 / Hydrazines; 0 / Immunologic Factors; 0 / Indoles; 0 / Piperazines; 0 / Pyrazines; 0 / Pyrazoles; 0 / Pyrimidines; 0 / Receptors, Fc; 0 / Recombinant Fusion Proteins; 0 / Thiazoles; 0 / eltrombopag; 0 / gemtuzumab; 0 / romiplostim; 4F4X42SYQ6 / Rituximab; 4Z8R6ORS6L / Thalidomide; 639089-54-6 / VX680; 69G8BD63PP / Bortezomib; 8A1O1M485B / Imatinib Mesylate; 8N3DW7272P / Cyclophosphamide; 9014-42-0 / Thrombopoietin; A3ULP0F556 / eculizumab; DO989GC5D1 / lestaurtinib; F0P408N6V4 / lenalidomide; FA2DM6879K / Vidarabine; P2K93U8740 / fludarabine; RBZ1571X5H / Dasatinib
  • [Number-of-references] 40
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39. Gambacorti-Passerini C, Barni R, le Coutre P, Zucchetti M, Cabrita G, Cleris L, Rossi F, Gianazza E, Brueggen J, Cozens R, Pioltelli P, Pogliani E, Corneo G, Formelli F, D'Incalci M: Role of alpha1 acid glycoprotein in the in vivo resistance of human BCR-ABL(+) leukemic cells to the abl inhibitor STI571. J Natl Cancer Inst; 2000 Oct 18;92(20):1641-50
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  • BACKGROUND: Chronic myeloid leukemia is caused by a chromosomal translocation that results in an oncogenic fusion protein, Bcr-Abl.
  • Bcr-Abl is a tyrosine kinase whose activity is inhibited by the antineoplastic drug STI571.
  • This drug can cure mice given an injection of human leukemic cells, but treatment ultimately fails in animals that have large tumors when treatment is initiated.
  • Cells recovered from relapsing animals were used for in vitro experiments.
  • Relapsed animals did not respond to further STI571 treatment, and their Bcr-Abl kinase activity in vivo was not inhibited by STI571, despite high plasma concentrations of the drug.
  • However, tumor cells from resistant animals were sensitive to STI571 in vitro, suggesting that a molecule in the plasma of relapsed animals may inactivate the drug.
  • When animals bearing large tumors were treated with STI571 alone or with a combination of STI571 and erythromycin, greater tumor reductions and better long-term tumor-free survival (10 of 12 versus one of 13 at day 180; P:<.001) were observed after the combination treatment.
  • Molecules such as erythromycin that compete with STI571 for binding to AGP may enhance the therapeutic potential of this drug.
  • [MeSH-major] Antineoplastic Agents / pharmacology. Fusion Proteins, bcr-abl / drug effects. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / metabolism. Orosomucoid / drug effects. Orosomucoid / metabolism. Piperazines / pharmacology. Protein-Tyrosine Kinases / antagonists & inhibitors. Pyrimidines / pharmacology
  • [MeSH-minor] Animals. Benzamides. Blotting, Western. Drug Resistance, Neoplasm. Drug Synergism. Drug Therapy, Combination. Enzyme Inhibitors / pharmacology. Erythromycin / pharmacology. Female. Humans. Imatinib Mesylate. Mice. Mice, Nude. Phosphorylation / drug effects. Time Factors. Tumor Cells, Cultured

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  • [CommentIn] J Natl Cancer Inst. 2000 Oct 18;92(20):1626-7 [11036101.001]
  • (PMID = 11036109.001).
  • [ISSN] 0027-8874
  • [Journal-full-title] Journal of the National Cancer Institute
  • [ISO-abbreviation] J. Natl. Cancer Inst.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Benzamides; 0 / Enzyme Inhibitors; 0 / Orosomucoid; 0 / Piperazines; 0 / Pyrimidines; 63937KV33D / Erythromycin; 8A1O1M485B / Imatinib Mesylate; EC 2.7.10.1 / Protein-Tyrosine Kinases; EC 2.7.10.2 / Fusion Proteins, bcr-abl
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40. Fassas AB, Rapoport AP, Cottler-Fox M, Chen T, Tricot G: Encouraging preliminary results in 12 patients with high-risk haematological malignancies by omitting graft-versus-host disease prophylaxis after allogeneic transplantation. Br J Haematol; 2000 Nov;111(2):662-7
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  • Immunosuppressive therapy, routinely given after allogeneic transplantation to modulate graft-versus-host disease (GVHD) may have an adverse effect on the graft-versus-tumour (GVT) effect.
  • Prompt haematological recovery [absolute neutrophil count (ANC) > 1.0 x 109/l] was observed (median time 9 d).
  • All patients developed grade III-IV GVHD (median onset 9 d), involving the skin (11), intestine (five) and liver (three).
  • Of nine evaluable patients, seven developed chronic GVHD [extensive (six), limited (one)].
  • Three patients died from treatment-related complications, two from acute GVHD and one from relapsing disease.
  • [MeSH-major] Bone Marrow Transplantation. Graft vs Tumor Effect. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / surgery. Leukemia, Myeloid / surgery. Lymphoma, B-Cell / surgery
  • [MeSH-minor] Acute Disease. Adult. Female. Follow-Up Studies. Glucocorticoids / therapeutic use. Graft vs Host Disease / drug therapy. Humans. Leukemia-Lymphoma, Adult T-Cell / immunology. Leukemia-Lymphoma, Adult T-Cell / surgery. Lymphoma, Mantle-Cell / immunology. Lymphoma, Mantle-Cell / surgery. Male. Middle Aged. Multiple Myeloma / immunology. Multiple Myeloma / surgery. Pilot Projects. Prednisone / therapeutic use. Transplantation, Homologous


41. Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Rieckmann P: [Escalating immunomodulatory therapy of multiple sclerosis. Update (September 2006)]. Nervenarzt; 2006 Dec;77(12):1506-18
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  • [Title] [Escalating immunomodulatory therapy of multiple sclerosis. Update (September 2006)].
  • Monoclonal antibodies provide considerable improvement of treatment, but their use in basic therapy is restricted by their side effect profile.
  • Thus, for the time being, natalizumab is only approved for monotherapy after basic treatment has failed or for rapidly progressive relapsing-remitting MS.
  • In contrast, long-term data on recombinant beta-interferons and glatiramer acetate (Copaxone) show that even after several years no unexpected side effects occur and that a prolonged therapeutic effect can be assumed which correlates with the dose or frequency of treatment.
  • Recently IFN-beta1b (Betaferon) was approved for prophylactic treatment after the first attack (clinically isolated syndrome, CIS).
  • During treatment with beta-interferons, neutralizing antibodies can emerge with possible loss of effectivity.
  • In contrast, antibodies play no role in treatment with glatiramer acetate.
  • During or after therapy with mitoxantrone, serious side effects (cardiomyopathy, acute myeloid leukemia) appeared in 0.2-0.4% of cases.
  • Plasmapheresis is limited to individual curative attempts in escalating therapy of a severe attack.
  • [MeSH-major] Evidence-Based Medicine. Immunologic Factors / therapeutic use. Multiple Sclerosis, Chronic Progressive / drug therapy. Multiple Sclerosis, Relapsing-Remitting / drug therapy
  • [MeSH-minor] Antibodies, Monoclonal / adverse effects. Antibodies, Monoclonal / therapeutic use. Antibodies, Monoclonal, Humanized. Dose-Response Relationship, Drug. Drug Administration Schedule. Drug Approval. Europe. Glatiramer Acetate. Humans. Interferon Type I / adverse effects. Interferon Type I / therapeutic use. Interferon beta-1b. Interferon-beta / adverse effects. Interferon-beta / therapeutic use. Mitoxantrone / adverse effects. Mitoxantrone / therapeutic use. Natalizumab. Neurologic Examination / drug effects. Peptides / adverse effects. Peptides / therapeutic use. Randomized Controlled Trials as Topic. Recombinant Proteins. Registries

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  • (PMID = 17136556.001).
  • [ISSN] 0028-2804
  • [Journal-full-title] Der Nervenarzt
  • [ISO-abbreviation] Nervenarzt
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article; Practice Guideline
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; 0 / Immunologic Factors; 0 / Interferon Type I; 0 / Natalizumab; 0 / Peptides; 0 / Recombinant Proteins; 145155-23-3 / Interferon beta-1b; 5M691HL4BO / Glatiramer Acetate; 77238-31-4 / Interferon-beta; BZ114NVM5P / Mitoxantrone
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