By E. D. Thomas (auth.), Prof. Dr. T. Büchner, Prof. Dr. W. Hiddemann, Priv. Doz. Dr. B. Wörmann, Prof. Dr. G. Schellong, Prof. Dr. J. Ritter (eds.)
The premiums of acute leukemia remedy have progressively more desirable over the past decade. medical research effects mirror the effect of chemotherapy depth and length, the function of lengthy upkeep, intensified consolidation or very early intensification. extra development has additionally been accomplished in bone marrow trans plantation, and up to date potential experiences and meta-analyses have contributed comparisons of the excessive antileukemic efficacy of bone marrow transplantation to that of more advantageous chemotherapy. this enables a extra winning combining of the 2 kinds of therapy. New prognostic components have emerged from either cytogenetic and molecular genetic learn. therefore, the Philadelphia chromosome translocation and the bcr/abl gene rearrangement have confirmed to be the dominating hazard consider acute lymphoblastic leukemia. because the frequency raises with age, modifications in diagnosis among kids and adults may be defined. review of molecular and immunologic leukemia mobile markers has supplied a greater knowing of residual leukemia in medical remission, as a prognostic issue and in tracking the effectiveness of the antileukemic process. fresh paintings on leukemic telephone biology has led to novel healing techniques corresponding to terminal differentiation by means of all-trans-retinoic acid, modulation of chemotherapy by way of hematopoietic development elements similar to GM-CSF and enhancement of immunologic regulate by way of cytokines reminiscent of interleukin 2. New antimicrobial medications and the applying of ordinarily empiric anti-infectious recommendations have helped decreasing the healing danger. therefore, a couple of contemporary achievements have supplied us with new recommendations within the administration of sufferers with acute leukemias.
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Additional info for Acute Leukemias IV: Prognostic Factors and Treatment Strategies
Biondi A, Rambaldi A, Alcalay M, Pandolfi PP, Lo Coco F, Diverio D, Rossi Y, Mencarelli A, Longo L, Zangrilli D, Masera G, Barbui T, Mandelli F, Grignani F, Pelicci PG (1991) RAR-oc gene rearrangements as a genetic marker for diagnosis and monitoring in acute pro myelocytic leukemia. Blood 77: 1418-1422 14 37. Biondi A, Rambaldi A, Pandolfi PP, Rossi Y, Giudici G, Alcaly M, Lo Coco F, Diverio D, Pogliani EM, Lanzi EM, Mandelli F, Masera G, Barbui T, Pelicd PG (1992) Molecular monitoring of the myl/RAR-oc fusion gene in acutepromyelocytic leukemia by polymerase chain reaction.
In these three studies, which included 1546 patients, a total of 14 cases of t-MDS and of 19 cases oft-AML were observed (Table 1). The relative risk of leukemia in studies I-III varied between 34 and 175 and the cumulative risk of t-MDS and t-AML increased from 2 years and up to more than 8 years after start of alkylating agents by approximately 1% per year (Fig. 1). In all three studies many patients had received high voltage radiotherapy towards major Table 1. Risk of t-MDS and t-AML in seven cohort studies from the Copenhagen series No.
33. 34. 35. intravascular coagulation. Br 1 Haematol 24: 255-259 Bennett 1M, Catovsky D, Daniel MT, Flandrin G, Galton DAG, Gralnick HR, Sultan C (1976) Proposals for the classification of the acute leukemias. Br J Haematol 33:451-458 Rowley JD, Golomb HM, Dougherty C (1977) 15/17 translocation, a consistent chromosomal change in acute promyelocytic leukemia Lancet i: 549-550 Borrow 1, Goddard AD, Sheer D, Solomon E (1990) Molecular analysis of acute promyelocytic leukemia breakpoint cluster region on chromosome 17.
Acute Leukemias IV: Prognostic Factors and Treatment Strategies by E. D. Thomas (auth.), Prof. Dr. T. Büchner, Prof. Dr. W. Hiddemann, Priv. Doz. Dr. B. Wörmann, Prof. Dr. G. Schellong, Prof. Dr. J. Ritter (eds.)