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  • 1
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 1992
    In:  Annals of Hematology Vol. 65, No. S1 ( 1992-1), p. A1-A146
    In: Annals of Hematology, Springer Science and Business Media LLC, Vol. 65, No. S1 ( 1992-1), p. A1-A146
    Type of Medium: Online Resource
    ISSN: 0939-5555 , 1432-0584
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 1992
    detail.hit.zdb_id: 1458429-3
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  • 2
    Online Resource
    Online Resource
    Wiley ; 2006
    In:  International Journal of Cancer Vol. 118, No. 2 ( 2006-01-15), p. 498-504
    In: International Journal of Cancer, Wiley, Vol. 118, No. 2 ( 2006-01-15), p. 498-504
    Type of Medium: Online Resource
    ISSN: 0020-7136 , 1097-0215
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2006
    detail.hit.zdb_id: 218257-9
    detail.hit.zdb_id: 1474822-8
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  • 3
    In: Leukemia & Lymphoma, Informa UK Limited, Vol. 47, No. 2 ( 2006-01), p. 369-371
    Type of Medium: Online Resource
    ISSN: 1042-8194 , 1029-2403
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2006
    detail.hit.zdb_id: 2030637-4
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  • 4
    Online Resource
    Online Resource
    Future Science Ltd ; 1998
    In:  BioTechniques Vol. 25, No. 6 ( 1998-12), p. 1058-1064
    In: BioTechniques, Future Science Ltd, Vol. 25, No. 6 ( 1998-12), p. 1058-1064
    Abstract: To detect t(14;18)-positive cells present in human lymphoma tissue, bone marrow aspirates and peripheral blood mononuclear cells (PBMNC), we have established an automated, real-time quantitative PCR using double-labeled fluorogenic probes. In relation to t(14;18)-positive genomic DNA or a cloned t(14;18)-DNA fragment, highly reproducible results can be obtained with initial copy numbers between 10 to 10 5 . The detection of single copies has been verified by the stochastic multiple-tube approach. PBMNC cells obtained during clinical follow-up of patients with follicular lymphoma were analyzed by the one-step, real-time quantitative PCR and a two-step, semi-nested PCR combined with a limiting dilution assay. The quantitative results obtained by both assays correlate very well. Real-time quantitative PCR has several advantages: (i) it involves less critical pipetting steps, (ii) is less timeconsuming and (iii) UTP, in combination with uracil-N-glycosylase, can be used to control carryover contamination. The higher specificity is due to optimized primer annealing conditions and MgCl 2 concentration and the use of AmpliTaq Gold™. The sensitivity is at least as high as by the two-step PCR. Real-time quantitative PCR will be very helpful in large epidemiological studies and in research for molecular staging and the detection of minimal residual tumor cells, including the analysis of blood stem-cell preparations to be used for transplantation after myelo-ablative therapy.
    Type of Medium: Online Resource
    ISSN: 0736-6205 , 1940-9818
    Language: English
    Publisher: Future Science Ltd
    Publication Date: 1998
    detail.hit.zdb_id: 1496354-1
    SSG: 12
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  • 5
    Online Resource
    Online Resource
    Informa UK Limited ; 2005
    In:  Pediatric Hematology and Oncology Vol. 22, No. 8 ( 2005-01), p. 699-703
    In: Pediatric Hematology and Oncology, Informa UK Limited, Vol. 22, No. 8 ( 2005-01), p. 699-703
    Type of Medium: Online Resource
    ISSN: 0888-0018 , 1521-0669
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2005
    detail.hit.zdb_id: 2001806-X
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  • 6
    In: International Journal of Cancer, Wiley, Vol. 124, No. 4 ( 2009-02-15), p. 958-963
    Abstract: The t(14;18) translocation is a common genetic aberration that can be seen as an early step in pathogenesis of follicular lymphoma (FL). The significance of low level circulating t(14;18)‐positive cells in healthy individuals as clonal lymphoma precursors or indicators of risk is still unclear. We determined the age dependent prevalence and frequency of BCL2/IgH rearrangements in 715 healthy individuals ranging from newborns to octo‐ and nonagenarians. These results were compared with number of circulating t(14;18)‐positive cells in 108 FL patients at initial presentation. The overall prevalence of BCL2/IgH junctions in this large sample was 46% (327/715). However, there was a striking dependence upon age. Specifically, among individuals up to 10 years old, none had detectable circulating t(14;18)‐positive cells. In the age groups representing 10–50 years old, we found a steady elevation in the prevalence of BCL2/IgH junctions up to a prevalence of 66%. Further increases of the prevalence in individuals older than 50 years were not seen. The mean frequency of BCL2/IgH junctions in healthy individuals ≥40 years (18–26 × 10 −6 ) was significantly higher than in younger subjects (7–9 × 10 −6 ). Four percent (31/715) of individuals carried more than one t(14;18)‐positive cell per 25,000 peripheral blood mononuclear cells (PBMNCs). In comparison, 108 stage III/IV FL patients had a median number of circulating t(14;18)‐positive malignant FL cells of about 9200/1 million PBMNCs (range 7–1,000,000). These findings will further improve the understanding of the relevance of t(14;18)‐positive cells in healthy individuals as a risk marker toward the development into lymphoma precursors. © 2008 Wiley‐Liss, Inc.
    Type of Medium: Online Resource
    ISSN: 0020-7136 , 1097-0215
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2009
    detail.hit.zdb_id: 218257-9
    detail.hit.zdb_id: 1474822-8
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  • 7
    In: Blood, American Society of Hematology, Vol. 114, No. 22 ( 2009-11-20), p. 3921-3921
    Abstract: Abstract 3921 Poster Board III-857 The t(14;18)(BCL2/IgH) translocation is the genetic hallmark of follicular lymphoma (FL). Circulating t(14;18)-positive cells can not only be detected in FL patients but also in healthy subjects without lymphoma. Several epidemiological and molecular studies suggest that these t(14;18)-positive cells might represent lymphoma precursor cells and are associated with known FL risk factors like age and geographical differences in lymphoma incidence. We used epidemiological data and blood samples of a population-based study to verify associations of FL risk factors and t(14;18)-positive cells reported so far and to test for new associations. The study of health in Pomerania (SHIP) collects epidemiological data, a basic health status and blood samples from 4310 randomly selected inhabitants of the study region in the northeastern part of Germany. We tested buffy coat-DNA samples from 4152 study participants (median age 50 years, range 20-81 years, 2100 women) by real-time PCR for the presence and frequency of t(14;18)-positive cells. t(14;18)-PCR results were evaluable from 2620 subjects, 1533 subjects were tested positive (58.1%, median number of t(14;18)-positive cells in positive subjects 3.9 per million nucleated cells, range 0.6 – 9299 per million nucleated cells). t(14;18)-prevalence was lowest in the age group 20-29 years (42.2%) and increased up to the group 50-59 years (67.0%) but did not further increase up to the age of 81 years. In accordance with previous reports there was a significant increase of the t(14;18)-frequency with age up to the age of 69 years (linear regression, p 〈 0.0001) in this study. In the SHIP cohort, t(14;18)-prevalence was lower in females compared to males (53.2% versus 63.5%, p 〈 0.0001), but there was no significant difference in t(14;18)-frequency between males and females. Smoking status (current, former and never smoker) had no influence on t(14;18)-prevalence or frequency. This study confirms the association of t(14;18)-prevalence with age and shows for the first time that the t(14;18)-prevalence in females is lower than in males. The later finding parallels the observation of a lower FL incidence in females. In contrast to previous studies, smoking was not associated with detection of t(14;18)-positive cells when the analysis was adjusted for age and sex. In summary, this study confirms that the prevalence of t(14;18)-positive cells in non-lymphoma subjects is associated with established FL risk factors. Thus our report adds to the accumulating evidence that circulating t(14;18)-positive cells in non-lymphoma subjects may represent a biomarker of FL risk. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2009
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  • 8
    In: Blood, American Society of Hematology, Vol. 114, No. 22 ( 2009-11-20), p. 20-20
    Abstract: Abstract 20 Introduction We have shown in a monocenter study (ASH 2005, abstract # 428) that routine prophylactic platelet (plt) transfusions are not necessary in patients (pts) with acute myeloid leukemia (AML). Therefore, we started a multicenter randomized study comparing the routine prophylactic (morning trigger: plts ≤ 10/nl, arm P) with a therapeutic platelet transfusion strategy (arm T). Methods Diagnosis of AML and feasability of intensive chemotherapy within standard protocols was required (M3 only in CR). In arm T transfusions were given only when clinically relevant bleeding (more than petechiae) happened regardless of the morning plt count. For safety reasons prophalyctic plts were transfused in case of invasive aspergillosis, sepsis syndrom and repeated or continous headache. In case of headache pts in arm T received a ct-scan. The experimental transfusion strategy startet at day 8 of induction and at day 1 of consolidation. Primary endpoint was the reduction of plt transfusions by 20%; secondary endpoints were bleeding complications, red blood cell transfusions, side effects, duration of thrombocytopenia and hospital stay. Results Until July 2009 175 pts have been randomized. Full data were evaluable for 161 pts (79 arm P and 82 arm T). Median age was 52 years (20-78). We registered 251 induction and 112 consolidation cycles. Mean duration of thrombocytopenia ( 〈 20/nl or 〈 10/nl) was 17 and 8 days, respectively. Duration of thrombocytopenia was significantly longer in arm T. Depite the longer duration, the number of platelet transfusions in arm T was significantly reduced, by about 25% (p 〈 0.001). Number of red blood cell transfusions were not different (p = 0.95). Days in hospital and side effects were not different in both groups. Bleeding complications (more than petechial) were significantly increased in arm T showing a 2.3 times higher risk compared to arm P. This is clearly correlated with bleeding being the trigger for plt transfusion in arm T. Majority of hemorrhages were of minor or moderate significance that could all be treated effectively by plt transfusion. Most important was the observation that we registered 5 minor and 2 major cerebral hemorrhages in arm T and none in arm P. Minor cerebral hemorrhages with headache were not registered in arm P since we did not perform ct-scans routinely in arm P in case of headache. Minor cerebral complications were 2 sub-/epidural bleedings after vasovagal collapses of pts at plt counts of 53 and 96/nl, respectively, and 3 spontanuous minor subarachnidal/ intracerebral hemorrhages at plt counts of between 15 and 〈 5/nl. All 5 minor cerebral complications were detected by ct-scan performed due to headache. All pts recovered after plt transfusion without any sequelae.The two other pts died following fatal cerebral bleeding. One pt. had repeated headache since several days. At a plt count of 11/nl fatal bleeding happened. A ct-scan revealed intracerebral mass bleeding. The pt was randomized to the experimental strategy but even following standard transfusion strategy the pt would not have been transfused prophylactically. The only fatal cerebral bleeding that must be clearly attributed to the therapeutic strategy was a female pt with a pulmonary fungal infection that improved under antifungal treatment. She had a morning platelet count of 〈 5/nl. During the following night she woke up with severe headache. Despite timely platelet transfusions she died of progressive mass bleeding. Unfortunately, we could not perform an autopsy to see whether the patient had fungal involvement of the brain. 1-2 % of fatal cerebral bleedings are reported in AML trials despite a prophylactic strategy. Whether these two complications happened by chance in arm T or were the consequence of the experimental strategy cannot be answered by our study. To give proof of this important question one would need about 2000 pts in both arms for statistical reasons. Conclusions A therapeutic platelet transfusion strategy according to our protocol is feasible in AML pts during intensive chemotherapy and can reduce the number of platelet transfusions significantly. An increased risk of fatal cerebral bleeding cannot be excluded by this study. An international collaboration would be necessary to set up a study large enough to determine the final safety. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2009
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    detail.hit.zdb_id: 80069-7
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  • 9
    In: Blood, American Society of Hematology, Vol. 114, No. 22 ( 2009-11-20), p. 1612-1612
    Abstract: Abstract 1612 Poster Board I-638 Cytogenetically normal AML (CN-AML) is a heterogeneous disease with molecular markers impacting considerably on survival. Acquired gene mutations such as the internal tandem duplication (ITD) of the FLT3 gene has been shown to be associated with poor prognosis. Furthermore, it has been shown that the poor prognosis in the group of patients with high risk cytogenetics could be improved, when a consolidation therapy with allogeneic stem cell transplantation (HCT) was performed. To investigate the importance of a postremission consolidation therapy in CN-AML patients according their mutational status for the FLT3-ITD mutation we compared the clinical outcome in these patients on an intention to treat analysis. A total of 800 patients have been entered into two OSHO (East German study group for hematology and oncology) studies between 1997 and now. The first protocol (AML 96) compared two different induction schedules employing different schedules of intermediate AraC and Idarubicin. The second protocol (AML 2002) studied the role of two different induction therapies in patients failing to reach CR after the first induction therapy. From the 800 patients treated within these protocols 338 pts. had a normal karyotype. Complete remissions were obtained in 277 patients after one or two induction cycles. Out of these patients 78 pts received a consolidation therapy by allogeneic HCT whereas 169 pts were further treated by conventional chemotherapy or by autologous transplantation. HCT was performed after conditioning with cytoxan and 1200 cGy total body irradiation followed by GvH-D prophylaxis with cyclosporine and methotrexate. Material at the time of diagnosis to analyse the presence of a FLT3-ITD mutation was available in 116 pts. Of those, 70 patients received conventional chemotherapy whereas 46 pts. were transplanted from an allogeneic donor as postremission therapy. Data were analyzed on an intend-to-treat-analysis in 116/277 patients being in CR1 after induction therapy from whom a FLT3-ITD mutation analysis was available. The EFS in this cohort of 116 patients was 38% after 5 years. Within the subgroup of patients (n=46) who received a HCT from an allogeneic donor the EFS was 44% compared to 33% (p=0.19) within the subgroup of conventional treated patients(n=70). As previously described, the detection of a FLT3-ITD mutation had a negative impact on event free survival which was calculated with 25% after 5 years in contrast to 46% in FLT3-ITD negative patients (p=0.06). In a further step EFS was analyzed according to the FLT3 status and the postremission treatment given. The EFS in conventional treated patients was significantly different (FLT3-ITD negative: LFS=50% vs. FLT3-ITD positive: LFS=19%; p=0.05). But, allogeneic HCT in first complete remission equalizes this difference (FLT3-ITD negative: LFS=50% vs. FLT3-ITD positive: LFS=35%; p=0.58). Major significant differences were seen in relapse incidences (RI) between the four subgroups of patients (FLT3-ITD positive and negative, conventional postremission therapy or allogeneic HCT; p=0.003). FLT3-ITD positive patients treated with conventional chemotherapy had a RI of 80% that could be reduced to a RI of 48% in the group of HCT patients. Within the two different treatment groups of FLT3-ITD negative patients the RI in the conventional treated group was 55% compared to 26% in HCT patients. To conclude, the worse prognostic impact of the presence FLT3-ITD mutation on the outcome of CN-AML pts. can be improved by allogeneic HCT performed in first complete remission after two courses of induction therapy. Allogeneic HCT reduces the relapse incidence in FLT3-ITD positive as well as in FLT3-ITD negative pts. Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2009
    detail.hit.zdb_id: 1468538-3
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  • 10
    In: Blood, American Society of Hematology, Vol. 108, No. 11 ( 2006-11-16), p. 484-484
    Abstract: Introduction: Rituximab plus chemotherapy has been proved to be the gold - standard in treating advanced follicular lymphoma. Here we report the 4-year-follow-up data of our phase III trial comparing MCP - chemotherapy vs rituximab + MCP both followed by interferon maintenance in advanced symptomatic follicular lymphoma. Methods: Previously untreated patients with advanced stage (III + IV) symptomatic CD 20-positive indolent NHL and mantle cell lymphoma (n=358) were randomized to receive either MCP-chemotherapy (mitoxantrone 8 mg/m² d1+2, chlorambucil 3x3 mg/m² d 1–5, prednisolone 25 mg/m² d 1–5 x 8 q 4 weeks) or MCP + rituximab (375 mg/m² d −1). Here we report the results of the ITT population of patients with follicular lymphoma (FL) (grade 1+2), who represented the majority of patients and for whom the sample size primarily was calculated, so this is not a subgroup analysis. Study endpoints included overall and complete response rate (RR + CR), progression free survival (PFS), event free survival (EFS), time to next treatment (TTNT), overall survival (OS) and toxicities. Results: with a median follow - up of nearly 4 years (47 months) we are able to provide relatively mature data. Concerning toxicities there was no striking difference, but there was a significantly increased risk to experience a CTC grade III or IV toxicity for leukocytes in the R-MCP arm, however this did not increase the risk of infections. For the FL - ITT population the results are given in the table. Conclusions: Concerning all end points rituximab plus MCP is significantly superior to MCP alone in the treatment of advanced follicular lymphoma. Special attention should be drawn to the fact, that after a median follow-up of 47 months we can demonstrate a clinically and statistically significant survival advantage for the immunochemotherapy. Results R-MCP (n=105) MCP (n=96) p-value Response rate 92,4% 75% .0004 Complete Response 49,5% 25% .0009 PFS median n.r. 29 months & lt; .0001 PSF 4 years 71% 40% EFS median n.r. 26 months & lt; .0001 EFS 4 years 69% 35,5% TTNT median n.r. 29,4 months .0002 OS median n.r. n.r. .0096 OS 4 years 87% 74%
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2006
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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