Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:2.1.1.69 (BMT)
 2,655 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In first BM relapsed non-T/non-B ALL, the outcome is not significantly different after radio-chemotherapy compared with allogeneic BMT. Therefore, radio-chemotherapy is convenient af first late BM relapse and BMT may be performed not before a second BM relapse had occurred. Only a small subgroup of children with isolated BM relapse and peripheral blast cells > or = 10,000/microliter at diagnosis of first relapse has a dismal prognosis after radio-chemotherapy and might benefit from BMT.
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PMID:Allogeneic BMT vs. chemotherapy in late bone marrow relapsed childhood non-T/non-B ALL: results of BFM ALL relapse studies. BFM Relapse Study Group. 893 94

The development of chemotherapy in childhood ALL has been the leader of the success story of paediatric oncology. At least 2/3 of the children can be cured nowadays at the first attempt of treatment. From the remaining again 1/3 can be treated successfully for the relapse of their disease with conventional therapeutic strategies. This means, however, that there is no chance for cure with chemotherapy alone for 20 to 25% of the children. BMT has been shown for a long time to be an alternative therapy especially in those cases in which conventional chemotherapy fails. In spite of the fact that many children with ALL have been transplanted during recent years there is still no general agreement on the question which children need BMT. However a few statements can be made: The value of ABMT in ALL is probably not better than that of chemotherapy alone. In 1st CR a group of children can be defined, which might benefit from BMT. In 2nd CR the value of chemotherapy depends very much from the duration of 1st remission. Allogeneic BMT is the only chance for cure in very early relapses, superior to chemotherapy in early and late relapses and possibly equal to chemotherapy in very late relapses. The paper tries to summarise our current knowledge about the situation.
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PMID:Which children do benefit from bone marrow transplant? The EBMT Paediatric Diseases Working Party. 893 98

Paroxysmal nocturnal haemoglobinuria (PNH) terminating in acute leukaemia (AL) is an infrequent condition. In several cases, flow cytometric analysis of glycosylphosphatidylinositol anchored membrane proteins such as DAF and CD59/MACIF has suggested the leukaemic cells to be derived from the PNH clone, thereby implicating PNH as a potential preleukaemic disease. In the present paper, we review the data for one patient treated in our hospital and 20 cases reported in the literature from 1969 to 1993. The sex ratio is 1 female/2 males, mean age at diagnosis of PNH was 46 years and the mean interval between the diagnoses of PNH and AL was 53 months. AL type was AML M6 in 8 patients, other types of AML in 12 and ALL in one, with a mean survival of 7.1 months following diagnosis of AL. In all cases analyzed, the PNH phenotype of erythrocytes disappeared with progression of AL, whereas reappearance of this phenotype with complete remission of AL was inconstant. PNH would thus appear to be a potential preleukemic disease. When this disorder terminates in AL, the type is often AML M6, although ALL is also possible. The prognosis of AL in PNH is poor as for other secondary leukaemias. Apart from marrow aplasia, leukaemic transformation is another life threatening complication of PNH which may justify allogeneic bone marrow transplantation (allo-BMT) and potential leukaemic transformation can therefore be an additional argument in favour of allo-BMT when pancytopenia develops in PNH patients.
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PMID:Acute leukaemia in paroxysmal nocturnal haemoglobinuria. Case report and review of the literature. 897 94

Early reports would suggest that closely matched UD BMT is an adequate substitute for MSD BMT in children with relapsed ALL. Protagonists of BMT might suggest that UD BMT be used in the absence of a MSD in all cases of BM relapse of ALL. However, recent improvements in chemoradiotherapy schedules have reduced the benefits of BMT in terms of overall survival, particularly in children with a long first remission, and a more sensible approach would be to advocate UD BMT in early relapsing aggressive disease, prospectively compare UD BMT to chemotherapy in less aggressive disease, and not utilize UD BMT for low-risk disease. The best prognostic indicators for relapsing disease depend on the site of relapse and duration of first remission. Recommendations for the use of UD BMT in children with relapsed ALL based on these criteria are given in Table 1.
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PMID:The role of unrelated bone-marrow transplantation in childhood acute leukaemia. 901 20

Donor leukocyte infusion (DLI) was carried out on a 12-year-old girl with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) who received allogeneic bone marrow transplantation from an HLA-identical sibling. This is the first report of DLI use before the onset of hematological relapse monitored by the results of RT-PCR. This patient has been in CR for 11 months after BMT, suggesting this alternative treatment is promising for Ph+ ALL with positive reverse transcriptase-polymerase chain reaction (RT-PCR) following BMT.
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PMID:Successful prevention of hematological relapse for a patient with Philadelphia chromosome-positive acute lymphoblastic leukemia after allogeneic bone marrow transplantation by donor leukocyte infusion. 905 Dec 52

To assess the consequence of second BMT (BMT2) for leukemia relapse after allogeneic BMT, we analyzed the clinical course of 66 recipients who were treated by BMT2 in Japan. Diagnoses included 29 ANLL, 27 ALL, six CML and four MDS. Durations between the first BMT (BMT1) to relapse and BMT1 to BMT2 were 13.5 +/- 13.7 months and 17.4 +/- 13.9 months, respectively. Donors for BMT2 were replaced in 11 cases. Thirty-one patients were in CR (or CP) at BMT2. Earlier deaths were observed in those who received BMT2 within 12 months after BMT1, mostly caused by regimen-related toxicity and infections. Overall leukemia-free survival rate was 28% at 2 years and 16% at 4 years. Factors influencing the poor prognosis after BMT2 were early (<6 months) relapse, early (<12 months) BMT2, not in remission at BMT2, and ALL. Intensified conditioning did not affect either remission duration or LFS. Among the 39 cases observed for more than 100 days, 18 developed chronic GVHD (cGVHD) and showed longer remission duration than those without cGVHD. Our analysis indicates that BMT2 as treatment for leukemia relapse is effective in selected cases, and exploration of pre-BMT treatment and post-BMT immunotherapy is warranted.
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PMID:Second allogeneic bone marrow transplantation for post-transplant leukemia relapse: results of a survey of 66 cases in 24 Japanese institutes. 905 12

Extension of allogeneic transplants to older patients has been limited by a high risk of transplant-related death and graft-versus-host disease. To evaluate the feasibility in older patients, a retrospective analysis of the procedure was performed for first remission acute leukemia in 192 patients aged over 40 years and compared with a group of 1119 recipients aged from 16 to 40 years reported to the EBMT from 1986 to 1992. Patient-, disease-, and treatment-related variables were compared between the two age groups using the chi2 statistical method for categorical variables. Variables differing significantly or recognized as potential prognostic factors were included in a multivariate analysis. Leukemia-free survival and relapse were comparable among the age groups in the two types of leukemias. Incidence of graft-versus-host disease was higher in the older group of ALL patients. Older patients with AML in first remission had a higher treatment-related mortality incidence, with no influence on survival. A pair-matched analysis of AML patients did not show any statistical difference in the probability of LFS, RI, TRM, and survival for the two age cohorts of patients. These results suggest that BMT should be considered for patients over 40 years of age.
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PMID:Allogeneic bone marrow transplantation for acute leukemia in patients over the age of 40 years. Acute Leukemia Working Party of the European Group for Bone Marrow Transplantation (EBMT). 906 82

We report our findings in two cases of steroid-resistant severe acute GVHD after allogeneic BMT successfully treated with FK506 (tacrolimus). An 18-year-old female (patient 1) who underwent BMT from an HLA-identical sibling for ALL in first CR, developed generalized erythema and profuse watery diarrhea, which progressed to acute GVHD of grade III severity, resistant to steroid control. After continuous 24-h administration of FK506, the diarrhea improved within 10 days. Patient 2, a 9-year-old girl with AML who underwent unrelated BMT, had skin, gut and liver lesions of acute GVHD grade IV, which did not respond to high-dose steroid therapy. They were controlled, however, by continuous intravenous infusion of FK506. Both patients are still surviving after more than 1 year without any acute GVHD sequelae or signs of chronic illness. The adverse effects of FK506 were mild and tolerable in both cases. Comparison of our findings with those in the literature suggests that it is important to give FK506 at plasma concentrations as high as 25-35 ng/ml by continuous intravenous infusion for extended periods to control steroid-resistant severe acute GVHD.
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PMID:Successful treatment of steroid-resistant severe acute GVHD with 24-h continuous infusion of FK506. 908 43

We present a patient who underwent sibling allogeneic BMT because of refractory Ph+ve ALL and remained BCR-ABL-positive after marrow grafting. Haemopoietic precursor cells were predominantly BCR-ABL-negative and of donor origin. In T cells an exclusively donor genotype was demonstrated. Despite donor leucocyte infusion (DLI), 20 weeks after BMT BCR-ABL fusion mRNA increased in semiquantitative polymerase chain reaction and leukaemic infiltration of the patient's bone marrow was seen. After a second course of DLI the patient achieved sustained molecular remission but he developed severe graft-versus-host disease (GvHD) and died from bacterial sepsis 9 months after DLI.
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PMID:Relapse of Philadelphia chromosome positive acute lymphoblastic leukaemia after marrow transplantation: sustained molecular remission after early and dose-escalating infusion of donor leucocytes. 913 59

In a patient undergoing allogeneic BMT for ALL, chronic GVHD (cGVHD) with skin changes developed within 110 days after transplantation. One year post-BMT, anti-nuclear antibodies were detected. The patient's serum was used for immunoscreening of a HeLa cDNA library. Ten different overlapping positive clones were found to be partial clones of mitosin, a 350-kDa nuclear phosphoprotein which shows a speckled nuclear distribution in S phase and which relocates to the centromere and mitotic apparatus in M phase. Although autoantibodies against centromere protein-F, which is very similar to mitosin, have been reported in patients with cancer, this is the first report of autoantibodies against mitosin in a patient with cGVHD.
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PMID:Anti-mitosin antibodies in a patient with chronic graft-versus-host disease after allogeneic bone marrow transplantation. 915 73


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