0000000000246688
AUTHOR
W.-d. Ludwig
Salvage Therapy of Adult ALL
In a first study (1986 to 1992) the German Relapsing ALL Study Group (GRALLSG) has treated 67 adult patients with a first relapse of ALL. A first phase of induction consisted of vindesine, daunorubicin, asparaginase, and prednisone, a second phase of high-dose cytosine-arabinoside (Hd ara-C) and VP16. Results: 45 CR, 2 PR, 13 failures, 7 early death. 25 patients received a BMT. 10 had an allogeneic BMT in CR, 5 after another relapse or with refractory disease. Of 10 with autologous BMT 8 have been in 2nd CR. Only 4 of all 67 patients are surviving without relapse: One after unrelated BMT (36+mo), two after autologous BMT in 2nd CR (46+, 64+mo), and one after chemotherapy (61+mo). One patien…
Phase I/II Trial of High-Dose Cytosine Arabinoside and Mitoxantrone in Adult Refractory Acute Myeloid Leukemia
In spite of a high initial response rate of 60% –80% the vast majority of adult patients with acute myeloid leukemia (AML) still cannot be cured of the disease and ultimately die from recurrent and refractory leukemia. The development of new therapeutic approaches and of more effective drugs therefore seems warranted.
FS-HAI for Relapsed AML
Treatment results in patients with refractory and relapsed acute myeloid leukemia (AML) need to be improved. The current study aimed at enhancing the anti-leukemic efficacy of the sequential high-dose AraC and idarubicin (S-HAI) regimen by the addition of fludarabine as a chemo-modulator. High-dose AraC was applied q 12 hours on days on days 1, 2, 8, and 9 and idarubicin on days 3, 4, 10, and 11. Patients were randomized to receive fludarabine q 12 hours on days 1, 2, 8, and 9 in addition to S-HAI or S-HAI alone. Of 179 patients having entered the study 120 are fully evaluable at the present time (median age 55 years, range 20–77). Thirty-eight percent of the patients had refractory disease…
Randomized Comparison of Sequential High-Dose Cytosine Arabinoside and Idarubicin (S-HAI) with or without Chemo-Modulation by Fludarabine in Refractory and Relapsed Acute Myeloid Leukemia
In order to assess the value of the addition of fludarabine as a chemo-modulator to a high-dose AraC based salvage regimen for patients with refractory and relapsed acute myeloid leukemia the German AML Cooperative Group initiated a prospective randomized comparison between fludarabine q 12 hours on days 1,2,8, and 9 in addition to the S-HAI regimen, consisting of high-dose AraC q 12 hours on days 1, 2, 8, and 9 and idarubicin on days 3,4,10, and 11, as compared with S-HAI alone. Ninety-one patients have entered the ongoing study, 66 of whom are fully evaluable at the present time (median age 54 years, range 20-75). Twentyfive patients had refractory disease or early relapses, 39 patients h…
Abnormal Marker Expression in Acute Leukemia (AL) Characterized by Monoclonal Antibodies and Flow Cytometry
The application of refined immunologic and enzymatic markers to conventional morphologic and cytochemical techniques has revealed an unexpected heterogeneitiy in acute leukemia (AL). Since the development of monoclonal antibodies (MoAbs) to lineage specific differentiation markers, there have been several reports of AL patients whose blast cells represent relatively homogeneous populations with phenotypic features of more than one cell line [1–5] or are characterized by the coexistence of separate cell populations each demonstrating either lymphoid or myeloid features [6–10].
The addition of rituximab to front-line therapy with CHOP (R-CHOP) results in a higher response rate and longer time to treatment failure in patients with lymphoplasmacytic lymphoma: results of a randomized trial of the German Low-Grade Lymphoma Study Group (GLSG)
Lymphoplasmacytic lymphoma (LPL) is an indolent lymphoma with moderate sensitivity to conventional chemotherapy. This study investigated whether the addition of rituximab to standard chemotherapy improves treatment outcome in LPL and the subgroup of LPL patients fulfilling the criteria of Waldenstroem's macroglobulinemia (WM). A total of 69 patients with previously untreated LPL were enrolled into the trial; 64 patients were evaluable for treatment outcome. In all, 48 of the 64 LPL patients fulfilled the criteria of WM. Patients were randomly assigned to R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone, n=34) or CHOP (n=30). R-CHOP resulted in significantly highe…
Surface Marker Analysis by Monoclonal Antibodies: A Valuable Technique in Childhood Acute Myeloid Leukemia
A considerable number of monoclonal antibodies (MoAbs) with myeloid activity have been described during the last few years (summarized in [1]). These MoAbs have been applied to the study of normal myeloid differentiation, as well as to the surface marker analysis of acute myeloid leukemia (AML) [2–6]. Although there is a strong tendency for morphological differentiation to correspond to surface antigen differentiation of malignant myeloid cells [2, 3], a recent report has failed to correlate the FAB classification system with immunologic categories of AML [6].